Cost Calculator Social Prescribing

Transcription

1 Cost Calculator Social Prescribing User Guide 5 th June, 2017 Version 1.1

2 Overview The Cost Calculator tool for Social Prescribing and Expert Patient Programme (SP/EPP) supports planning, commissioning and implementing of Social Prescribing initiatives at London, STP and CCG levels. Its key purposes are: 1) Identification of Social Prescribing Interventions 2) Demand and Capacity Planning 3) Modelling Financial Impact a. Population Growth (% increase) b. PbR Uplift (% increase) c. Alternative Service Cost (Per Patient Per Year PPPY) 4) Source Data for further Analysis To open the tool, double click the Excel file that was sent to you by HLP e.g. NHS London.xlsm. You may be prompted to Enable Macros and other security settings depending on the setup of Excel on your computer. The Excel tool has the following tabs: An Introduction page is shown that provides more information on the tool, external links to the interactive dashboard, detailed initiative reports and links to help and support pages, as shown below. External Links

3 Identification of Social Prescribing Interventions The recommended Social Prescribing interventions are evidence based and use Population Health Management (PHM) analytics to match patients to interventions based on their clinical history, current acuity and future risks. By identifying existing Social Prescribing interventions locally and comparing those with the recommendations listed in the tools, commissioners can perform a gap analysis to facilitate access to a range of support services that will enable individuals to significantly improve their health and wellbeing. The recommended services can be found in the Summary tab. The upper section of the tab shows a list of Social Prescribing initiatives with the current spend and the opportunity. The current spend includes patients that have conditions that are suitable for outof-hospital care but may not be suitable for Social Prescribing. The Commissioning Opportunities section includes patients that match the clinical service specifications of the reference interventions and are therefore considered to be likely to benefit from a specific intervention.??? The Patients column represents the number of patients matched to an initiative; Activity represents the number of acute services the patients received and Cost represents the PbR cost of the services consumed. Some patients may be automatically double counted when interventions are overlapping e.g. patients in the New Beginnings Course could be present in Dementia Café so that all patients are included if only one of the interventions is chosen. If both are chosen, a deduplication step can be

4 applied if required. Alternatively, patients might participate in more than one intervention or can choose which one they prefer. A Top 5 Initiatives Overview pie chart can be found at the bottom of the Summary page that visually shows the patients affected and activity reduction. Demand and Capacity Planning The information in the summary table can support commissioners to perform a demand and capacity analysis by using the number of patients that are listed for each intervention.

5 For example, in London there are 24,869 patients that received hospital care for diabetes-related complications that could have been avoided if those patients were receiving support from Social Prescribing interventions like the Living with Diabetes course. If all patients are targeted over a 2 year period, up to 12,434 patients per year would spend 6 weeks enrolled; with 8 courses per year, a total of 1,554 places for each course would be required across London. For an average CCG in London, that would mean 50 places for each course with 8 courses per year ie. 400 patients per year. If all these patients were to participate, with a 100% efficacy of the service, an equivalent of 4.87m in acute cost could be avoided each year. Although 100% may not be achievable, by targeting the most suitable patients that use acute services, the high rate of success using population health analytics and predictive modelling could, typically, deliver around an 80% success rate. Modelling Financial Impact The Cost Calculator enables commissioners to identify price points per patient per year for alternative service provision and facilitates comparison with acute spend. The Cost Calculator can be configured for variation in population growth which is set to 1.1% by default, for change in PbR tariff uplift which is set to 1.3% by default and for the cost of an alternative service provision which is set at per patient per year (pppy). Users are advised to check and adjust the population growth forecast and PbR uplift for their geographical area and alter the defaults where necessary. The alternative service cost can be changed to identify a price point where the cost of the alternative service does not exceed the cost of the acute service provision. In the example below, the

6 alternative service cost has been set at 100 pppy and the Social Prescribing initiative to Living with Diabetes. The drop down list of the Alternative Service Cost is shown below. By setting the pppy cost of an alternative service, either by using the drop down list or by typing in a free text value, the acute spend or alternative service cost by month can be seen in the time series chart below. ROI The chart shows the past acute cost (2013/ /17, 1 st April 31 st March) and the forecast till 31 st March 2021 as a green line at the top. The blue line at the bottom is the cost estimate for the alternative service by month, currently set to 100 pppy. The difference between the two lines across the forecasted timeframe is the potential Return on Investment (ROI) over four years. In this case the ROI for the selected SP intervention is 12.42m for all of London. By selecting different Social Prescribing interventions from the drop down list in the chart, different price points can be identified that can support the procurement of alternative services. Furthermore, the acute cost represents only a part of the total cost of patient care and is therefore understating the true ROI when costs of social services or mental health are included. The Cost Calculator provides additional information such as the past and predicted number of patients that would benefit from the selected SP intervention. The diagram below shows the number of patients that would benefit from Living with Diabetes as a time series chart with over 165k patients potentially benefitting from the service over four years.

7 The last bar chart on the Cost Calculator tab summarises the number of patients and total net savings by year, as shown below. Source Data for further Analysis The Cost Calculator tool includes the Source Data that is used to enable further analysis, such as breakdown of an initiative by Condition which is particularly useful for Self-Management for Chronic Conditions. The Data Dictionary tab contains information on the meaning of each column.