NHS England Activity Analysis July 2016/17 Karen Byrne NHS Oldham CCG

Transcription

1 NHS England Activity Analysis July 2016/17 Karen Byrne NHS Oldham CCG Page 1

2 Table of Contents Précis... 3 Areas of under/over performance for investigation/explaination... 3 Introduction... 4 Analysis... 4 Latest Position... 4 Appendix I... 4 NHS Oldham View... 4 Appendix II... 5 Elective Daycase (Acute) (E.M.10b) -2.57% below plan... 5 Elective Ordinary (Acute) (E.M.10a) -3.34% below plan... 5 First Attendances (Acute) (E.M.8) +3.53% above plan... Error! Bookmark not defined. Follow Ups (Acute) (E.M.9) -4.02% under plan... 6 Appendix III... 7 SUS Vs. tnr Variances... 7 Page 2

3 Précis Areas of under/over performance for investigation/explanation Elective Daycases are underperforming against plan by -5.7% (-476 spells) Elective Ordinary activity is underperforming by -9.6% (-188 spells) Outpatient Follow Up Attendances are over performing by -6.0% (-3,467 attendances) Page 3

4 Introduction NHS England closely monitors current (and historic) CCG activity and its relationship with operational plans. If trigger points are breached with in year performance, an exception report is required. This report will provide a local reconciliation of planned activity vs actual activity for the period concerned. Analysis Latest Position Variance Analysis: Month 4 SUS Actuals Vs. Plan Variance Ref Description 16/17 Plan 16/17 Activty Result E.M.11 Non Elective Spells (Acute) 9,287 9, % E.M.10b Elective Daycase Spells (Acute) 8,344 7, % E.M.10a Elective Ordinary Spells (Acute) 1,958 1, % Total Elective Spells (Acute) 10,302 9, % Total Spells (Acute) 19,589 18, % E.M.8 OPFA (Acute) 32,459 32, % E.M.9 OPFUP (Acute) 57,791 54, % Total OP Attendances 90,250 87, % E.M.12 A&E Attendances - All types 32,059 32, % Pods with a variance of +/-2% Elective Daycase (Acute) (E.M.10b) Elective Ordinary (Acute) (E.M.10a) OPFUP (Acute) (E.M.9) Appendix I NHS Oldham View Specialist and Dental Activity incorrectly assigned to CCG s in SUS (Unadjusted) Lancaster House SUS Submission (Adjusted) a) Specialist Activity There is an issue with the PSS issued by HSCIC, in that the national tool does not recognise new ICD10 codes; this has resulted in some specialist activity being assigned to CCG s. Providers have implemented an override in some areas but not all, as it would be very time consuming and difficult to recreate the 16/17 grouper at each organisation. It has previously been estimated that it will take up to six months to fix the issue. It would be extremely Page 4

5 difficult for commissioners to identify all of the incorrectly identified Spec Comm data in SUS. b) Lancaster House Lancaster House have not submitted their Outpatient SUS data for the Urology service for May to July. As these values are significant a manual adjustment has been made to the SUS figures based on estimates; this equates to circa 340 First attendances and 920 Follow-up attendances per month. Appendix II Elective Daycase (Acute) (E.M.10b) -5.70% below plan The M4 position for Daycases is presenting an underperformance of -476 spells. This underperformance is predominately in Pain Management and Ophthalmology. Pennine Acute Pain Management: Plan: The plan was based on month 8 15/16 outturn with a reduction of circa 30 spells per month due to the service moving to PMSK; resulting in a plan of around 63 spells per month. Activity: Actual activity year to date is an average 21 spells per month, giving an underperformance of -168 Spells YTD. Salford Royal Pain Management: Plan: There was a planned increase of circa 7 spells per month as part of the movement of activity from NHSE back to CCG s. Activity: There has been no increase in activity from the levels seen in 15/16. This has resulted in an underperformance of -28 spells. Pennine Acute Ophthalmology: Plan: There was no adjustment to the FOT plan for Ophthalmology Daycases at Pennine Acute. Activity: There has been a reduction of -230 spells YTD at Pennine Acute when compared to the same period last in 15/16. Elective Ordinary (Acute) (E.M.10a) -9.60% below plan The M4 position for Elective is presenting an underperformance of -188 spells, which is predominately at University Hospital South Manchester and Pennine Acute South Manchester Cardiac and Thoracic Surgery: Plan: The plan was based on Month 9 15/16 outturn, which resulted in an annual plan of 120 spells. Page 5

6 Activity: There only been three admissions this year resulting in a YTD underperformance of -37 spells. Pennine Acute Paediatric ENT, Gastroenterology and Urology: Plan: There was no adjustment to the FOT plan for Elective activity for Paediatric ENT, Gastroenterology and Urology. Activity: There has been a reduction of -38, -43 and -36 spells respectively at Pennine Acute compared to the same period last year. Follow Ups (Acute) (E.M.9) -6.0% under plan The M4 position for OPFUP is presenting an under performance of -3,467 attendances, which is predominately Dermatology, ENT and Ophthalmology. Tameside and Virgin Care Dermatology: Plan: The entire month 8 15/16 FOT Tameside s Dermatology activity was transferred to Virgin Care, approx. annual value of 3,890 activities. Activity: Whilst Activity at Tameside is reducing there are still patients yet to transition to the new service; this has resulted in an over performance of 619 at TFT. Activity has begun to pick up at Virgin Care with a marked increase in month 4, however the slow start to the year has resulted in an underperformance YTD of around -1,000. This gives a total underperformance across the two providers of Pennine Acute and Care UK ENT: Plan: The plan was based on month 8 15/16 FOT. Activity: There has been a reduction of -500 activities across al providers YTD compared with the same period last year, in particular Pennine Acute (-265) and Care UK (-144). Pennine Acute Ophthalmology: Plan: All Pennine Acute acute ophthalmology outpatient activity was transferred to the Pennine Acute community contract. There were no other amendments to the 15/16 M8 FOT. Activity: There are -854 fewer follow-ups at Pennine Acute YTD than in the same period last year. There has been additional activity at other providers, most notably Central Manchester FT (183 additional attendances compared to the same period last year). Giving a total reduction of -647 attendances across all providers. Additional Plan: Page 6

7 Overall 800 additional follow ups were added to the 16/17 plan for demographic and nondemographic growth and other known commissioning intentions that we are currently seeing underperformance against plan in multiple areas. Appendix III SUS Vs. tnr Variances NHS England require a month variance analysis on SUS Vs. Temporary National Repository (tnr), the current variances are as follows: Variance Analysis: Month 4 SUS Actuals Vs. TNR Ref Description 16/17 Activity 16/17 TNR Result E.M.11 Non Elective Spells (Acute) 9,340 9, % E.M.10b Elective Daycase Spells (Acute) 7,868 7, % E.M.10a Elective Ordinary Spells (Acute) 1,770 1, % Total Elective Spells (Acute) 9,638 9, % Total Spells (Acute) 18,978 18, % E.M.8 OPFA (Acute) 32,862 31, % E.M.9 OPFUP (Acute) 54,324 49, % Total OP Attendances 87,186 81, % E.M.12 A&E Attendances - All types 32,184 32, % It is suspected that the commissioner assignment method (CAM) has resulted in NHS England assigning fewer activities to Oldham CCG than are assigned via SUS. This significantly impacts on the actual activity numbers being compared. Oldham CCG is unable to replicate the CAM as it requires restricted patient information. Page 7