LTC Year of Care Commissioning Community of Practice Webinar Series

1. www.england.nhs.uk
LTC Year of Care Commissioning
Community of practice
Creating and Reporting on a Whole
Population Dataset to Develop a Capitated
Budget
Thursday 12 November 2015
12pm – 1pm
Peter Gough
Kent YoC Commissioning EIS
Kent and Medway Health Information Service
Julie Renfrew
LTC Year of Care Commissioning Programme
NHSIQ

2. www.england.nhs.uk
LTC Year of Care Commissioning
Developing a Year of Care Capitated Budget approach for
those with Complex Care Needs
• 5 Early Implementer sites
• 35 Fast Followers
• Whole Population Datasets
• Implementation Guide
• Simulation Modelling
• Specialist Support Team

3. www.england.nhs.uk
LTC Person Centred Care:
Delivering Person Centred Care for People with LTCs
• Early Adopter sites
• 4 regional learning networks
• Snapshot Survey
• Simulation Modelling
• Specialist Support Team
#A4PCC #LTCImp

4. www.england.nhs.uk
LTC Tools & Resources:
Simulation model
Unbundling recovery simulation model

5. www.england.nhs.uk
Action for Person
Centred Care
o Taking action to make person-centred care
for people with long-term conditions a reality
o Looking at what needs to change and why
we need to change
o Co-produced with NHS England and
Coalition for Collaborative Care and
developed with health and care
professionals, policy makers and people
with long-term conditions
o What you can do:
o Make a commitment embedding
patient-centred care in your work at
www.engage.england.nhs.uk/survey/lt
c-declaration
o Tell your teams about our work
o Use the hashtag #A4PCC when you
see work that is relevant to person-
centred care for people with LTCs
o Let us know of any events, activities or
social media opportunities that we can
join forces with you
#A4PCC – Action for Person-Centred

6. www.england.nhs.uk
Date Webinar Hosted by Bev Matthews &
16 Nov 2015 Enabling self-management: more
than smart phones and digital
widgets
Ian Briggs
Associate Director Business Development
Jeannie Hardy
County Durham and Darlington NHS
Foundation Trust
17 Dec 2015 Long Term Conditions Year of
Care Commissioning Simulation
Model
Julie Renfrew, NHS Improving Quality
Claire Cordeaux , Simul8
Coming soon Continuing the discussion about
behavioural change and care
planning
Angela Coulter
Kings Fund
LTC Lunch & Learn E-Seminars
Establishing a Virtual Community for all to share and learn
#A4PCC #LTCImp

7. www.england.nhs.uk
LTC YoC Commissioning - EIS sharing learning...
Date Webinar Led by and details of session
12 November 2015
(note 12-1)
Kent EIS
Creating and Reporting on a
Whole Population Dataset [to
develop a capitated budget]
Peter Gough, Kent & Medway Health Informatics Service
- Buy in from organisations
- Defining outcomes and methodology. Devising the dataset
- Building and linking data. Designing and using reports
9 December 2015 Southend EIS
Developing robust capitated
budgets
Steve Downing,
Head of Finance, Southend CCG
Content TBC
19 January 2016 Leeds EIS
integrated data to support service
redesign decision making (TBC)
Tricia Cable, LTC YoC Commissioning Programme lead,
Leeds EIS
- The Leeds approach
- How and who...using the integrated data
- Challenges, lessons learned...what next
11 February 2016 Kent EIS
Commissioning Integrated models
of care
Alison Davis, Integration Programme Health and Social
Care, Working on behalf of Kent County Council and
South Kent Coast and Thanet CCG's
- The South Kent model of care (what it looks like)
- Roadmap to delivery
- Contracting models and evaluation.
X March 2016 West Hants EIS
Topic TBC
Kate Smith, West Hants CCG
All webinars 12.30pm to 1.30pm unless stated...

8. Creating and Reporting on a
Whole Population Dataset to
Develop a Capitated Budget
Kent LtC YoC Commissioning EIS
Peter Gough
Kent and Medway HIS

9. Overview
Initial research by Public Health
Started with blank sheet of paper
Initial aim to develop CB for YoC popn
Constantly developing
Always wanted to use whole population
linked data

10. Key Areas
Buy in from organisations
Defining Outcomes
Defining Methodology
Devising Dataset
Building & Linking Data
DQ on Dataset
Designing Reports
Using Reports

11. Buy In – Kind of Important
Make organisations supplying data feel
important in the development
Ensure both providers and
commissioners feel part of the process

12. Defining Outcomes
Important to have initial aims
Be flexible with them
Our initial aim:
Capitated budget for YoC Pats
Expanded aims
Whole population analysis of costing
Whole population analysis of health metrics

13. Defining Methodology
Identify Year of Care Patient Cohort
Risk Strat Band 1 or 2 (top 5% of popn)
Rising Risk score –
Rapid – 3 consecutive rises (15 points overall)
Gradual – 4 rises in 6 months
Age 18 or over
2 or more of QOF LTCs (from GP data)
Remain in for minimum 6 months
Flagged as B,C,D,E depending on number of
LTCs

14. Defining Methodology
How to create main dataset
Key is to link data at a patient level
Need common identifier – NHS Number
Also need to keep data pseudonymous
THIS WAS A PROBLEM!!!!
A REAL PROBLEM
Took 6 months to solve

15. Defining Methodology
Solution:
Need method for organisations to flow
data into dataset pseudonymised but flag
as YoC
SQL Hashing Tool – via SQL Server
directly or via excel add in
Two numbers never exist in same place –
pseudonymisation happens in transit

16. Defining Methodology
Now have a way of linking all datasets
by patient without knowing who they
were or being able to link to any other
dataset
There was much rejoicing

18. Devising Dataset
Need to create common dataset from various
data providers:
Primary Care – GP datasets
Secondary Care (SUS)
Community data
Out of Hours
Hospice data
Social Care data
Ambulance data
Mental Health data

19. Devising Dataset
Agree key fields
Look for common fields
End up with:
a dataset with certain fields populated for all
data
Individual provider datasets with all fields
populated
Has to be a best fit – can’t be perfect

20. Devising Dataset
Common Data Fields
Age
Activity Date
Commissioner Code
GP Practice Code
Cost
Provider Code
Provider Site
Pseudonymised NHS Number
Gender

21. Devising Dataset
Common Calculated Fields
Data Currency
Staff Type
YoC Currency (B,C,D,E)
YoC Patient (Yes/No)
YoC PoD
YoC Practice (Yes/No)

22. Building and Linking Data
Probably the easiest part
Run Monthly Risk Stratification data
Flow in YoC flagged patients
Flow in related LTCs
Create automation for flowing in already
accessible data
Create access for external providers to load
data in via excel
Run in external data

23. Data Quality
Different organisations have different
levels of DQ and completeness
NHS Number key DQ item
Cost is second – needs to add up to
current budgets if data to be used for
CB

24. Designing Reports
Initial aim to prove purpose of project
and get people interested
Give access to all
Keep them iterative
Ensure all organisations involved in
design process

33. Using Reports
Need to be useful or no-one will use them
Need to achieve outcomes
Aims of current reports:
Look at costs across sector
Design reports to get CB
Look at health factors influencing this
Allow users to carry out ad-hoc reporting

34. Thanks
peter.gough@nhs.net
Any Questions?

35. www.england.nhs.uk
LTC Year of Care Commissioning
Community of practice
Creating and Reporting on a Whole Population
Dataset to Develop a Capitated Budget
Questions and discussion
#A4PCC #LTCImp

36. www.england.nhs.uk
LTC YoC Commissioning - EIS sharing learning...
Date Webinar Led by and details of session
12 November 2015
(note 12-1)
Kent EIS
Creating and Reporting on a
Whole Population Dataset [to
develop a capitated budget]
Peter Gough, Kent & Medway Health Informatics Service
- Buy in from organisations
- Defining outcomes and methodology. Devising the dataset
- Building and linking data. Designing and using reports
9 December 2015 Southend EIS
Developing robust capitated
budgets
Steve Downing,
Head of Finance, Southend CCG
Content TBC
19 January 2016 Leeds EIS
integrated data to support service
redesign decision making (TBC)
Tricia Cable, LTC YoC Commissioning Programme lead,
Leeds EIS
- The Leeds approach
- How and who...using the integrated data
- Challenges, lessons learned...what next
11 February 2016 Kent EIS
Commissioning Integrated models
of care
Alison Davis, Integration Programme Health and Social
Care, Working on behalf of Kent County Council and
South Kent Coast and Thanet CCG's
- The South Kent model of care (what it looks like)
- Roadmap to delivery
- Contracting models and evaluation.
X March 2016 West Hants EIS
Topic TBC
Kate Smith, West Hants CCG
All webinars 12.30pm to 1.30pm unless stated...