Parkinson's Disease in the West Midlands. West Midlands SCN PD network May 2015

Transcription

1 Parkinson's Disease in the West Midlands Stoke-on-Trent West Midlands SCN PD network May 2015 Stafford Shrewsbury Wolverhampton Birmingham Solihull Coventry Warwick Hereford Worcester Meeting sponsored by educational grants from UCB Pharma, Abbvie, Britannia Pharmaceuticals, GE Healthcare, Medtronic, Teva Pharmaceuticals. West Midlands Strategic Clinical Network Parkinson's Disease Network meeting May 14th

2 West Midlands data on hospital admissions for patients with Parkinson's Disease Data Data are from Hospital Episodes Statistics (HES) data that each provider is required to submit to NHS England All West Midlands in-patient NHS providers and CCGs that admitted patients in are included Year All data shown are for the financial year (April 1st 2013 to March 31st 2014) Codes Age Admission Length of stay Readmission Tariff Costs Bed days The data given are for all admissions where G20 (Parkinson's Disease) and F023 (Dementia in PD) were recorded in the diagnostic coding Data are for patients of all ages An admission is defined as the entire period for which a patient was admitted (ie equates to an in-patient spell not episode) An admission is counted where the discharge date falls within the financial year A primary PD admission is when G20 or F023 were given as the primary diagnostic code for the admission A secondary PD admission is when G20 or F023 appeared anywhere in the diagnostic coding other than as the primary code Admission types are divided into elective and non-elective. Admissions previously categorised as 'other' are now incorporated into nonelective admissions ('other' refers to unknown, maternity or hospital transfers) The trim point of an admission is the target (or expected) length of stay for a specific HRG code. Defined nationally. LOS is defined as the continuous period between the date of admission and date of discharge of a patient in a provider hospital Defined as an admission with the same main specialty code that occurs within 14, 28 or 90 days of the discharge date of the original admission. This can be both an elective or a non-elective admission. The total cost attributed to a completed spell of care, based on the Healthcare Resource Group (HRG) tariff system. Every admission is allocated an HRG code once discharged. This reflects the combined diagnoses, procedures etc that occurred during the admission. A zero bed day (ZBD) is when a patient is discharged before midnight of the same day that they were admitted on If a patient stays in hospital less than 24 hours but overnight (ie crosses midnight), this counts as a one day admission Health Warning: This data is only as good as the coding inputted by the admitting hospital These are NOT league tables there will be many local reasons why data varies between Trusts / CCGs Many thanks to Suzanne Fletcher, Healthcare Partnership Manager, UCB Pharma for providing this HES data West Midlands Strategic Clinical Network Parkinson's Disease Network meeting May 14th

3 Provider Trusts in each Local Area Team Shropshire & Staffordshire Area Team University Hospital of North Staffordshire NHS Trust Burton Hospitals NHS Foundation Trust Shrewsbury & Telford Hospital NHS Trust Mid Staffordshire NHS Foundation Trust Staffordshire & Stoke on Trent Partnership NHS Trust Shropshire Community Health NHS Trust Robert Jones & Agnes Hunt Orthopaedic Hospital NHS Foundation Trust North Staffordshire Combined Healthcare NHS Trust South Staffordshire & Shropshire Healthcare NHS Foundation Trust Birmingham, Solihull & Black Country Area Team Heart of England NHS Foundation Trust Royal Wolverhampton NHS Trust Dudley Group NHS Foundation Trust Sandwell & West Birmingham Hospitals NHS Trust University Hospitals Birmingham NHS Foundation Trust Royal Orthopaedic Hospital NHS Foundation Trust Birmingham Community Healthcare NHS Trust Walsall Healthcare NHS Trust Birmingham & Solihull Mental Health NHS Foundation Trust Birmingham Women's NHS Foundation Trust Dudley & Walsall Mental Health Partnership NHS Trust Black Country Partnership NHS Foundation Trust Clinical Commissioning Groups (CCGs) per Local Area Team Shropshire & Staffordshire Area Team NHS Cannock Chase CCG NHS East Staffordshire CCG NHS North Staffordshire CCG NHS Shropshire CCG NHS South East Staffs And Seisdon Peninsular CCG NHS Stafford And Surrounds CCG NHS Stoke On Trent CCG NHS Telford And Wrekin CCG Birmingham, Solihull & Black Country Area Team NHS Birmingham Crosscity CCG NHS Birmingham South And Central CCG NHS Dudley CCG NHS Sandwell And West Birmingham CCG NHS Solihull CCG NHS Walsall CCG NHS Wolverhampton CCG West Midlands Strategic Clinical Network Parkinson's Disease Network meeting May 14th

4 Arden, Herefordshire & Worcestershire Area Team Worcestershire Acute Hospitals NHS Trust University Hospitals Coventry & Warwickshire NHS Trust South Warwickshire NHS Foundation Trust Wye Valley NHS Trust George Eliot Hospital NHS Trust Worcestershire Health and Care NHS Trust Coventry & Warwickshire Partnership NHS Trust Arden, Herefordshire & Worcestershire Area Team NHS Coventry And Rugby CCG NHS Herefordshire CCG NHS Redditch And Bromsgrove CCG NHS South Warwickshire CCG NHS South Worcestershire CCG NHS Warwickshire North CCG NHS Wyre Forest CCG Independent providers Spire Healthcare (NT3) Nuffield Health (NT2) Ramsay Healthcare UK Operations Ltd (NVC) BMI Healthcare (NT4) This list of provider Trusts includes all providers that admitted NHS PD patients during the financial year. West Midlands Strategic Clinical Network Parkinson's Disease Network meeting May 14th

5 CCG population size and estimates of PD population size 2013/14 population Estimate of PD prevalence (1 in 500) Estimate of PD prevalence (1 in 625) Arden, Herefordshire and Worcestershire AT 1,702,260 3,405 2,724 NHS Coventry And Rugby CCG 479, NHS Herefordshire CCG 182, NHS Redditch And Bromsgrove CCG 172, NHS South Warwickshire CCG 274, NHS South Worcestershire CCG 295, NHS Warwickshire North CCG 184, NHS Wyre Forest CCG 112, Birmingham and the Black Country AT 2,620,702 5,241 4,193 NHS Birmingham Crosscity CCG 740,338 1,481 1,185 NHS Birmingham South And Central CCG 249, NHS Dudley CCG 311, NHS Sandwell And West Birmingham CCG 545,234 1, NHS Solihull CCG 239, NHS Walsall CCG 273, NHS Wolverhampton CCG 262, Shropshire and Staffordshire AT 1,580,109 3,160 2,528 NHS Cannock Chase CCG 133, NHS East Staffordshire CCG 136, NHS North Staffordshire CCG 203, NHS Shropshire CCG 300, NHS South East Staffs And Seisdon Peninsular CCG 212, NHS Stafford And Surrounds CCG 145, NHS Stoke On Trent CCG 274, NHS Telford And Wrekin CCG 175, Grand Total 5,903,071 11,806 9,445 Population sizes include all ages and are derived from GP patient registers. West Midlands Strategic Clinical Network Parkinson's Disease Network meeting May 14th

6 Number of Hospital Admissions for Patients with PD Provider Trust Name Total number of Admissions Admissions for PD Admission type Primary Secondary Elective Non elective HEART OF ENGLAND NHS FOUNDATION TRUST UNIVERSITY HOSPITALS COVENTRY AND WARWICKSHIRE NHS TRUST THE ROYAL WOLVERHAMPTON NHS TRUST WORCESTERSHIRE ACUTE HOSPITALS NHS TRUST THE DUDLEY GROUP NHS FOUNDATION TRUST UNIVERSITY HOSPITAL OF NORTH STAFFORDSHIRE NHS TRUST SHREWSBURY AND TELFORD HOSPITAL NHS TRUST BURTON HOSPITALS NHS FOUNDATION TRUST UNIVERSITY HOSPITALS BIRMINGHAM NHS FOUNDATION TRUST SANDWELL AND WEST BIRMINGHAM HOSPITALS NHS TRUST WALSALL HEALTHCARE NHS TRUST SOUTH WARWICKSHIRE NHS FOUNDATION TRUST MID STAFFORDSHIRE NHS FOUNDATION TRUST WYE VALLEY NHS TRUST GEORGE ELIOT HOSPITAL NHS TRUST RAMSAY HEALTHCARE UK OPERATIONS LIMITED BMI HEALTHCARE STAFFORDSHIRE AND STOKE ON TRENT PARTNERSHIP NHS TRUST WORCESTERSHIRE HEALTH AND CARE NHS TRUST SPIRE HEALTHCARE BIRMINGHAM COMMUNITY HEALTHCARE NHS TRUST SHROPSHIRE COMMUNITY HEALTH NHS TRUST NUFFIELD HEALTH ROBERT JONES AND AGNES HUNT ORTHOPAEDIC HOSPITAL NHS FOUNDATION TRUST THE ROYAL ORTHOPAEDIC HOSPITAL NHS FOUNDATION TRUST BIRMINGHAM AND SOLIHULL MENTAL HEALTH NHS FOUNDATION TRUST NORTH STAFFORDSHIRE COMBINED HEALTHCARE NHS TRUST DUDLEY AND WALSALL MENTAL HEALTH PARTNERSHIP NHS TRUST West Midlands Strategic Clinical Network Parkinson's Disease Network meeting May 14th

7 COVENTRY AND WARWICKSHIRE PARTNERSHIP NHS TRUST BLACK COUNTRY PARTNERSHIP NHS FOUNDATION TRUST SOUTH STAFFORDSHIRE AND SHROPSHIRE HEALTHCARE NHS FOUNDATION TRUST BIRMINGHAM WOMEN'S NHS FOUNDATION TRUST Totals The above table shows all admissions to West Midlands hospitals for patients with Parkinson's Disease (ie where a code of G20 or F023 appeared in the admission diagnostic coding) in the year. For the rest of this data pack, only the data for the major acute hospitals (ie those in bold in the above table) is shown as these account for the majority of admissions. The other providers are cumulatively referred to as 'Other providers'. Key for 15 Acute Trusts: HEFT HEART OF ENGLAND NHS FOUNDATION TRUST UHNS UNIVERSITY HOSPITAL OF NORTH STAFFORDSHIRE NHS TRUST WAHT WORCESTERSHIRE ACUTE HOSPITALS NHS TRUST UHCW UNIVERSITY HOSPITALS COVENTRY AND WARWICKSHIRE NHS TRUST RWT THE ROYAL WOLVERHAMPTON NHS TRUST DGFT THE DUDLEY GROUP NHS FOUNDATION TRUST BHFT BURTON HOSPITALS NHS FOUNDATION TRUST SWBT SANDWELL AND WEST BIRMINGHAM HOSPITALS NHS TRUST STT SHREWSBURY AND TELFORD HOSPITAL NHS TRUST UHB UNIVERSITY HOSPITALS BIRMINGHAM NHS FOUNDATION TRUST SWFT SOUTH WARWICKSHIRE NHS FOUNDATION TRUST WHT WALSALL HEALTHCARE NHS TRUST MSFT MID STAFFORDSHIRE NHS FOUNDATION TRUST WVT WYE VALLEY NHS TRUST GEH GEORGE ELIOT HOSPITAL NHS TRUST West Midlands Strategic Clinical Network Parkinson's Disease Network meeting May 14th

8 Costs of Admissions in for Patients with PD Provider Trust Name Total number of admissions Total cost Trimpoint Cost only Excess Cost only HEART OF ENGLAND NHS FOUNDATION TRUST ,706,479 2,495, ,749 UNIVERSITY HOSPITALS COVENTRY AND WARWICKSHIRE NHS TRUST 935 2,511,804 2,131, ,049 THE ROYAL WOLVERHAMPTON NHS TRUST 918 1,546,222 1,449,210 97,012 WORCESTERSHIRE ACUTE HOSPITALS NHS TRUST 917 1,936,903 1,734, ,560 THE DUDLEY GROUP NHS FOUNDATION TRUST 845 1,858,636 1,651, ,235 UNIVERSITY HOSPITAL OF NORTH STAFFORDSHIRE NHS TRUST 842 2,140,479 2,008, ,959 SHREWSBURY AND TELFORD HOSPITAL NHS TRUST 655 1,652,150 1,511, ,627 BURTON HOSPITALS NHS FOUNDATION TRUST 602 1,459,125 1,273, ,957 UNIVERSITY HOSPITALS BIRMINGHAM NHS FOUNDATION TRUST 594 1,955,661 1,674, ,097 SANDWELL AND WEST BIRMINGHAM HOSPITALS NHS TRUST 567 1,271,215 1,128, ,492 WALSALL HEALTHCARE NHS TRUST , ,577 84,220 SOUTH WARWICKSHIRE NHS FOUNDATION TRUST , ,389 61,012 MID STAFFORDSHIRE NHS FOUNDATION TRUST , ,006 62,130 WYE VALLEY NHS TRUST , , ,163 GEORGE ELIOT HOSPITAL NHS TRUST , ,184 65,346 Other Providers ,219,794 2,517, ,586 TOTAL 11,076 26,216,393 23,093,198 3,123,195 Trim Point Cost: The basic (fixed) cost element of the total tariff cost. For each HRG code there are two different possible basic costs, dependent on whether the admission was elective or non-elective. Eg HRG Code - Description: KB01A - Diabetes with Hypoglycaemic Disorders 70 years and over. Elective Cost ( Tariff) - 1,159, Non-Elective Cost ( Tariff) - 2,280 Excess Cost: The variable cost element of the total tariff cost. Only applicable when the patient s length of stay exceeds the trim point (target length of stay) of the spell HRG code. Eg HRG Code - Description: KB01A - Diabetes with Hypoglycaemic Disorders 70 years and over Elective trim point ( Tariff) 19 days, Non-Elective trim point ( Tariff) 21 days, Per day long stay payment West Midlands Strategic Clinical Network Parkinson's Disease Network meeting May 14th

9 Costs of PD Admissions Elective admission costs Non-elective admission costs Provider Trust Name Total number of Admissions Total admission costs Total cost Trimpoint Cost Excess Cost Total cost Trimpoint Cost Excess Cost HEFT ,706, , ,986 10,532 2,459,961 2,259, ,217 UHCW 935 2,511, , ,465 11,881 2,215,459 1,847, ,168 UHNS 842 2,140, , ,367 7,432 1,925,680 1,801, ,527 UHB 594 1,955, , ,181 11,235 1,259, , ,862 WAHT 917 1,936, , ,708 1,804 1,725,390 1,524, ,756 DGFT 845 1,858, , , ,691,368 1,484, ,536 STT 655 1,652, , ,896 1,297 1,539,957 1,400, ,329 RWT 918 1,546, , ,243 9,097 1,309,881 1,221,966 87,915 BHFT 602 1,459, , , ,314,683 1,128, ,730 SWBT 567 1,271, , ,402 1,683 1,120, , ,810 WHT ,796 84,797 83,314 1, , ,263 82,736 WVT , , ,544 14, , , ,333 MSFT , , , , ,328 62,130 GEH ,530 59,095 59, , ,089 65,346 SWFT , , ,370 1, , ,019 59,169 Other Providers ,219,794 2,253,594 1,969, , , , ,996 TOTAL 11,076 26,216,393 5,261,669 4,903, ,632 20,954,724 18,190,161 2,764,563 West Midlands Strategic Clinical Network Parkinson's Disease Network meeting May 14th

10 Average Length of Stay for PD Admissions (ranked by non-elective LOS) Provider Trust Name Total number of admissions Total bed days Avg LOS All Admissions (Days) Avg LOS for Non Elective Admissions (Days) SOUTH WARWICKSHIRE NHS FOUNDATION TRUST WYE VALLEY NHS TRUST THE ROYAL WOLVERHAMPTON NHS TRUST UNIVERSITY HOSPITALS BIRMINGHAM NHS FOUNDATION TRUST WALSALL HEALTHCARE NHS TRUST HEART OF ENGLAND NHS FOUNDATION TRUST UNIVERSITY HOSPITALS COVENTRY AND WARWICKSHIRE NHS TRUST MID STAFFORDSHIRE NHS FOUNDATION TRUST BURTON HOSPITALS NHS FOUNDATION TRUST GEORGE ELIOT HOSPITAL NHS TRUST THE DUDLEY GROUP NHS FOUNDATION TRUST SHREWSBURY AND TELFORD HOSPITAL NHS TRUST WORCESTERSHIRE ACUTE HOSPITALS NHS TRUST SANDWELL AND WEST BIRMINGHAM HOSPITALS NHS TRUST UNIVERSITY HOSPITAL OF NORTH STAFFORDSHIRE NHS TRUST Other providers SOUTH STAFFORDSHIRE AND SHROPSHIRE HEALTHCARE NHS FOUNDATION TRUST BIRMINGHAM AND SOLIHULL MENTAL HEALTH NHS FOUNDATION TRUST BLACK COUNTRY PARTNERSHIP NHS FOUNDATION TRUST DUDLEY AND WALSALL MENTAL HEALTH PARTNERSHIP NHS TRUST COVENTRY AND WARWICKSHIRE PARTNERSHIP NHS TRUST NORTH STAFFORDSHIRE COMBINED HEALTHCARE NHS TRUST THE ROYAL ORTHOPAEDIC HOSPITAL NHS FOUNDATION TRUST BIRMINGHAM COMMUNITY HEALTHCARE NHS TRUST WORCESTERSHIRE HEALTH AND CARE NHS TRUST STAFFORDSHIRE AND STOKE ON TRENT PARTNERSHIP NHS TRUST SHROPSHIRE COMMUNITY HEALTH NHS TRUST West Midlands Strategic Clinical Network Parkinson's Disease Network meeting May 14th

11 ROBERT JONES AND AGNES HUNT ORTHOPAEDIC HOSPITAL NHS FOUNDATION TRUST BIRMINGHAM WOMEN'S NHS FOUNDATION TRUST SPIRE HEALTHCARE NUFFIELD HEALTH RAMSAY HEALTHCARE UK OPERATIONS LIMITED BMI HEALTHCARE Bed days per Provider Trust for All Admissions Provider Trust Name Total number of admissions All Admissions Zero Bed days One Day Stay Two Day Stay 3+ (Long Stay) HEART OF ENGLAND NHS FOUNDATION TRUST 1, UNIVERSITY HOSPITALS COVENTRY AND WARWICKSHIRE NHS TRUST THE ROYAL WOLVERHAMPTON NHS TRUST WORCESTERSHIRE ACUTE HOSPITALS NHS TRUST THE DUDLEY GROUP NHS FOUNDATION TRUST UNIVERSITY HOSPITAL OF NORTH STAFFORDSHIRE NHS TRUST SHREWSBURY AND TELFORD HOSPITAL NHS TRUST BURTON HOSPITALS NHS FOUNDATION TRUST UNIVERSITY HOSPITALS BIRMINGHAM NHS FOUNDATION TRUST SANDWELL AND WEST BIRMINGHAM HOSPITALS NHS TRUST WALSALL HEALTHCARE NHS TRUST SOUTH WARWICKSHIRE NHS FOUNDATION TRUST MID STAFFORDSHIRE NHS FOUNDATION TRUST WYE VALLEY NHS TRUST GEORGE ELIOT HOSPITAL NHS TRUST Other providers 1, TOTAL 11,076 3,659 1, ,569 West Midlands Strategic Clinical Network Parkinson's Disease Network meeting May 14th

12 Bed days per Provider Trust for Non Elective Admissions Provider Trust Name Number of Non- Elective Admissions Non-Elective Admissions Zero Bed days One Day Stay Two Day Stay 3+ (Long Stay) HEART OF ENGLAND NHS FOUNDATION TRUST UNIVERSITY HOSPITALS COVENTRY AND WARWICKSHIRE NHS TRUST UNIVERSITY HOSPITAL OF NORTH STAFFORDSHIRE NHS TRUST WORCESTERSHIRE ACUTE HOSPITALS NHS TRUST THE DUDLEY GROUP NHS FOUNDATION TRUST SHREWSBURY AND TELFORD HOSPITAL NHS TRUST THE ROYAL WOLVERHAMPTON NHS TRUST BURTON HOSPITALS NHS FOUNDATION TRUST SANDWELL AND WEST BIRMINGHAM HOSPITALS NHS TRUST WALSALL HEALTHCARE NHS TRUST UNIVERSITY HOSPITALS BIRMINGHAM NHS FOUNDATION TRUST SOUTH WARWICKSHIRE NHS FOUNDATION TRUST MID STAFFORDSHIRE NHS FOUNDATION TRUST GEORGE ELIOT HOSPITAL NHS TRUST WYE VALLEY NHS TRUST Other providers TOTAL West Midlands Strategic Clinical Network Parkinson's Disease Network meeting May 14th

13 Total Number of PD admissions per CCG in (ranked by non-elective admission) CCG Name All admissions Elective Non Elective BIRMINGHAM CROSSCITY COVENTRY AND RUGBY DUDLEY SOUTH WORCESTERSHIRE SANDWELL AND WEST BIRMINGHAM SHROPSHIRE WOLVERHAMPTON WALSALL STOKE ON TRENT SOUTH WARWICKSHIRE REDDITCH AND BROMSGROVE SOLIHULL NORTH STAFFORDSHIRE SOUTH EAST STAFFS AND SEISDON PENINSULAR EAST STAFFORDSHIRE WARWICKSHIRE NORTH STAFFORD AND SURROUNDS BIRMINGHAM SOUTH AND CENTRAL CANNOCK CHASE HEREFORDSHIRE TELFORD AND WREKIN WYRE FOREST West Midlands Strategic Clinical Network Parkinson's Disease Network meeting May 14th

14 Total Number of PD admissions per 100,000 GP population per CCG, (ranked by non-elective admission) CCG Name All admissions Elective Non Elective REDDITCH AND BROMSGROVE EAST STAFFORDSHIRE DUDLEY SOUTH WORCESTERSHIRE WOLVERHAMPTON SHROPSHIRE NORTH STAFFORDSHIRE CANNOCK CHASE WALSALL STOKE ON TRENT COVENTRY AND RUGBY STAFFORD AND SURROUNDS SOUTH EAST STAFFS AND SEISDON PENINSULAR SOLIHULL WARWICKSHIRE NORTH SOUTH WARWICKSHIRE BIRMINGHAM CROSSCITY HEREFORDSHIRE SANDWELL AND WEST BIRMINGHAM BIRMINGHAM SOUTH AND CENTRAL TELFORD AND WREKIN WYRE FOREST West Midlands Strategic Clinical Network Parkinson's Disease Network meeting May 14th

15 Average Length of Stay for PD admissions per CCG in (ranked by non-elective LOS) CCG Name All admissions Elective only Non-Elective only HEREFORDSHIRE SOUTH WARWICKSHIRE WYRE FOREST SOUTH WORCESTERSHIRE SHROPSHIRE WOLVERHAMPTON SOUTH EAST STAFFS AND SEISDON PENINSULAR BIRMINGHAM SOUTH AND CENTRAL SOLIHULL REDDITCH AND BROMSGROVE BIRMINGHAM CROSSCITY CANNOCK CHASE WALSALL STAFFORD AND SURROUNDS COVENTRY AND RUGBY WARWICKSHIRE NORTH TELFORD AND WREKIN DUDLEY SANDWELL AND WEST BIRMINGHAM EAST STAFFORDSHIRE STOKE ON TRENT NORTH STAFFORDSHIRE West Midlands Strategic Clinical Network Parkinson's Disease Network meeting May 14th

16 Total Tariff Cost of PD admissions per CCG in (ranked by non-elective admissions) CCG Name All Admissions Elective only Non Elective only BIRMINGHAM CROSSCITY 2,703, ,080 2,304,315 COVENTRY AND RUGBY 2,222, ,366 1,995,891 DUDLEY 1,726, ,100 1,523,859 SANDWELL AND WEST BIRMINGHAM 1,452, ,054 1,179,364 SHROPSHIRE 1,295, ,572 1,162,023 SOUTH WORCESTERSHIRE 1,334, ,458 1,098,442 WOLVERHAMPTON 1,196, ,681 1,038,526 STOKE ON TRENT 1,318, , ,143 WALSALL 1,000, , ,824 SOUTH EAST STAFFS AND SEISDON PENINSULAR 1,064, , ,008 REDDITCH AND BROMSGROVE 896, , ,305 SOLIHULL 905, , ,067 NORTH STAFFORDSHIRE 1,010, , ,882 WARWICKSHIRE NORTH 807, , ,556 SOUTH WARWICKSHIRE 862, , ,039 EAST STAFFORDSHIRE 805, , ,802 HEREFORDSHIRE 837, , ,968 BIRMINGHAM SOUTH AND CENTRAL 766, , ,402 STAFFORD AND SURROUNDS 727, , ,775 CANNOCK CHASE 675, , ,967 TELFORD AND WREKIN 468,677 68, ,700 WYRE FOREST 270,461 56, ,329 West Midlands Strategic Clinical Network Parkinson's Disease Network meeting May 14th

17 Total Tariff Cost of PD admissions per 100,000 GP population per CCG (ranked by non-elective admissions) CCG Name All Admissions Elective only Non Elective only DUDLEY 554,522 65, ,307 EAST STAFFORDSHIRE 590, , ,100 REDDITCH AND BROMSGROVE 520,320 60, ,321 CANNOCK CHASE 507,071 75, ,861 STAFFORD AND SURROUNDS 500,579 75, ,677 COVENTRY AND RUGBY 463,194 47, ,012 SOUTH EAST STAFFS AND SEISDON PENINSULAR 500, , ,847 WOLVERHAMPTON 456,104 60, ,982 SHROPSHIRE 431,583 44, ,088 SOUTH WORCESTERSHIRE 451,093 79, ,188 WARWICKSHIRE NORTH 437,523 68, ,741 NORTH STAFFORDSHIRE 497, , ,651 HEREFORDSHIRE 459,347 97, ,079 STOKE ON TRENT 481, , ,557 SOLIHULL 378,257 56, ,800 WALSALL 366,204 48, ,385 BIRMINGHAM CROSSCITY 365,157 53, ,252 BIRMINGHAM SOUTH AND CENTRAL 307,711 55, ,951 SOUTH WARWICKSHIRE 313,594 68, ,578 TELFORD AND WREKIN 267,346 39, ,000 SANDWELL AND WEST BIRMINGHAM 266,384 50, ,304 WYRE FOREST 240,246 49, ,384 West Midlands Strategic Clinical Network Parkinson's Disease Network meeting May 14th

18 Readmissions for PD patients in per Provider Trust Total readmissions (elective + non-elective) Number of individual patients (elective + non-elective) Provider Trust Total 90 day 28 day 14 day Total patient 90 day 28 day 14 day Name Admissions readmissions readmissions readmissions count readmissions readmissions readmissions HEFT 1, UHCW RWT WHAT DGFT UHNS STT BHFT UHB SWBT WHT SWFT MSFT WVT GEH Other providers 1, TOTAL 11,076 2,409 1, ,454 1, % total % total A readmission is defined here as an admission with the same main specialty code that occurs within 14, 28 or 90 days of the discharge date of the original admission. This can be both an elective or a non-elective admission. Note that the counts are cumulative (ie the 28 day readmission count includes the admissions that made up the 14 day count; the 90 day count includes both the 28 day and 14 day counts). Data are given for both total number of readmissions and for the number of individual patients who made up these counts. West Midlands Strategic Clinical Network Parkinson's Disease Network meeting May 14th

19 All West Midlands Non-Elective admissions (n = 7454), Primary Diagnosis Code for all West Midlands Non-Elective PD Admissions, top 50, ranked in order of frequency Primary diagnosis Diagnosis Name Rank No of Admissions % Admissions N390 Urinary tract infection, site not specified G20X Parkinson's disease R296 Tendency to fall, not elsewhere classified J181 Lobar pneumonia, unspecified J22X Unspecified acute lower respiratory infection J189 Pneumonia, unspecified S720 Fracture of neck of femur J690 Pneumonitis due to food and vomit R55X Syncope and collapse K590 Constipation R074 Chest pain, unspecified I951 Orthostatic hypotension L031 Cellulitis of other parts of limb J440 Chronic obstructive pulmonary disease with acute lower respiratory infection A099 Gastroenteritis and colitis of unspecified origin N179 Acute renal failure, unspecified I48X Atrial fibrillation and flutter I219 Acute myocardial infarction, unspecified I500 Congestive heart failure I639 Cerebral infarction, unspecified R268 Other and unspecified abnormalities of gait and mobility G459 Transient cerebral ischaemic attack, unspecified R073 Other chest pain E86X Volume depletion S721 Pertrochanteric fracture R410 Disorientation, unspecified R33X Retention of urine A419 Sepsis, unspecified West Midlands Strategic Clinical Network Parkinson's Disease Network meeting May 14th

20 J180 Bronchopneumonia, unspecified I269 Pulmonary embolism without mention of acute cor pulmonale S018 Open wound of other parts of head I209 Angina pectoris, unspecified R104 Other and unspecified abdominal pain G409 Epilepsy, unspecified R31X Unspecified haematuria R072 Precordial pain K920 Haematemesis F059 Delirium, unspecified T830 Mechanical complication of urinary (indwelling) catheter K922 Gastrointestinal haemorrhage, unspecified I802 Phlebitis and thrombophlebitis of other deep vessels of lower extremities J441 Chronic obstructive pulmonary disease with acute exacerbation, unspecified R568 Other and unspecified convulsions K562 Volvulus M255 Pain in joint S099 Unspecified injury of head S010 Open wound of scalp I200 Unstable angina R060 Dyspnoea R298 Other and unspecified symptoms and signs involving the nervous and musculoskeletal systems Note that this table shows primary diagnostic codes only. An individual patient may also have multiple secondary diagnostic codes for any given admission. West Midlands Strategic Clinical Network Parkinson's Disease Network meeting May 14th

21 Useful Websites and References West Midlands Strategic Clinical Network and Senate: UK Parkinson's Excellence Network: HSCIC (Health & Social Care Information Centre): WMQRS (West Midlands Quality Review Service): NHS England: All Party Parliamentary Group for Parkinson's Disease. Please Mind the Gap: Parkinson's Disease Services today. National Institute for Health and Clinical Excellence. Parkinson s Disease. National Clinical guidelines for diagnosis and management in primary and secondary care. London: NICE 2006 Bloem BR, Munneke M. Revolutionising management of chronic disease: the ParkinsonNet approach. BMJ Mar 19;348:g1838. doi: /bmj.g1838. Meeting sponsored by educational grants from UCB Pharma, Abbvie, Britannia Pharmaceuticals, GE Healthcare, Medtronic, Teva Pharmaceuticals. West Midlands Strategic Clinical Network Parkinson's Disease Network meeting May 14th