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 2015 1
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 2013-14 are included Year All data shown are for the financial year 2013-2014 (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 2013-14 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 2015 2
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 2015 3
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 2013-14 financial year. West Midlands Strategic Clinical Network Parkinson's Disease Network meeting May 14th 2015 4
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 479,768 960 768 NHS Herefordshire CCG 182,272 365 292 NHS Redditch And Bromsgrove CCG 172,277 345 276 NHS South Warwickshire CCG 274,878 550 440 NHS South Worcestershire CCG 295,926 592 473 NHS Warwickshire North CCG 184,562 369 295 NHS Wyre Forest CCG 112,577 225 180 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 249,018 498 398 NHS Dudley CCG 311,432 623 498 NHS Sandwell And West Birmingham CCG 545,234 1,090 872 NHS Solihull CCG 239,300 479 383 NHS Walsall CCG 273,114 546 437 NHS Wolverhampton CCG 262,266 525 420 Shropshire and Staffordshire AT 1,580,109 3,160 2,528 NHS Cannock Chase CCG 133,137 266 213 NHS East Staffordshire CCG 136,351 273 218 NHS North Staffordshire CCG 203,167 406 325 NHS Shropshire CCG 300,196 600 480 NHS South East Staffs And Seisdon Peninsular CCG 212,615 425 340 NHS Stafford And Surrounds CCG 145,234 290 232 NHS Stoke On Trent CCG 274,102 548 439 NHS Telford And Wrekin CCG 175,307 351 280 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 2015 5
Number of Hospital Admissions 2013-2014 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 1122 56 1076 189 933 UNIVERSITY HOSPITALS COVENTRY AND WARWICKSHIRE NHS TRUST 935 41 899 235 700 THE ROYAL WOLVERHAMPTON NHS TRUST 918 39 881 426 492 WORCESTERSHIRE ACUTE HOSPITALS NHS TRUST 917 35 887 256 661 THE DUDLEY GROUP NHS FOUNDATION TRUST 845 27 820 269 576 UNIVERSITY HOSPITAL OF NORTH STAFFORDSHIRE NHS TRUST 842 42 800 153 689 SHREWSBURY AND TELFORD HOSPITAL NHS TRUST 655 34 626 150 505 BURTON HOSPITALS NHS FOUNDATION TRUST 602 24 579 149 453 UNIVERSITY HOSPITALS BIRMINGHAM NHS FOUNDATION TRUST 594 94 500 245 349 SANDWELL AND WEST BIRMINGHAM HOSPITALS NHS TRUST 567 44 529 150 417 WALSALL HEALTHCARE NHS TRUST 451 16 436 82 369 SOUTH WARWICKSHIRE NHS FOUNDATION TRUST 392 30 362 118 274 MID STAFFORDSHIRE NHS FOUNDATION TRUST 348 19 329 121 227 WYE VALLEY NHS TRUST 297 20 278 96 201 GEORGE ELIOT HOSPITAL NHS TRUST 278 16 262 66 212 RAMSAY HEALTHCARE UK OPERATIONS LIMITED 233 0 233 233 0 BMI HEALTHCARE 179 0 179 179 0 STAFFORDSHIRE AND STOKE ON TRENT PARTNERSHIP NHS TRUST 166 32 134 123 43 WORCESTERSHIRE HEALTH AND CARE NHS TRUST 151 21 134 0 151 SPIRE HEALTHCARE 146 0 146 146 0 BIRMINGHAM COMMUNITY HEALTHCARE NHS TRUST 127 12 116 44 83 SHROPSHIRE COMMUNITY HEALTH NHS TRUST 78 13 65 0 78 NUFFIELD HEALTH 75 0 75 75 0 ROBERT JONES AND AGNES HUNT ORTHOPAEDIC HOSPITAL NHS FOUNDATION TRUST 66 0 66 53 13 THE ROYAL ORTHOPAEDIC HOSPITAL NHS FOUNDATION TRUST 62 0 62 56 6 BIRMINGHAM AND SOLIHULL MENTAL HEALTH NHS FOUNDATION TRUST 9 4 5 6 3 NORTH STAFFORDSHIRE COMBINED HEALTHCARE NHS TRUST 6 0 6 1 5 DUDLEY AND WALSALL MENTAL HEALTH PARTNERSHIP NHS TRUST 5 1 4 0 5 West Midlands Strategic Clinical Network Parkinson's Disease Network meeting May 14th 2015 6
COVENTRY AND WARWICKSHIRE PARTNERSHIP NHS TRUST 5 0 5 0 5 BLACK COUNTRY PARTNERSHIP NHS FOUNDATION TRUST 2 2 1 0 2 SOUTH STAFFORDSHIRE AND SHROPSHIRE HEALTHCARE NHS FOUNDATION TRUST 2 2 1 0 2 BIRMINGHAM WOMEN'S NHS FOUNDATION TRUST 1 0 1 1 0 Totals 11076 624 10497 3622 7454 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 2013-14 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 2015 7
Costs of Admissions in 2013-2014 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 1122 2,706,479 2,495,730 210,749 UNIVERSITY HOSPITALS COVENTRY AND WARWICKSHIRE NHS TRUST 935 2,511,804 2,131,755 380,049 THE ROYAL WOLVERHAMPTON NHS TRUST 918 1,546,222 1,449,210 97,012 WORCESTERSHIRE ACUTE HOSPITALS NHS TRUST 917 1,936,903 1,734,343 202,560 THE DUDLEY GROUP NHS FOUNDATION TRUST 845 1,858,636 1,651,401 207,235 UNIVERSITY HOSPITAL OF NORTH STAFFORDSHIRE NHS TRUST 842 2,140,479 2,008,520 131,959 SHREWSBURY AND TELFORD HOSPITAL NHS TRUST 655 1,652,150 1,511,524 140,627 BURTON HOSPITALS NHS FOUNDATION TRUST 602 1,459,125 1,273,169 185,957 UNIVERSITY HOSPITALS BIRMINGHAM NHS FOUNDATION TRUST 594 1,955,661 1,674,564 281,097 SANDWELL AND WEST BIRMINGHAM HOSPITALS NHS TRUST 567 1,271,215 1,128,723 142,492 WALSALL HEALTHCARE NHS TRUST 451 992,796 908,577 84,220 SOUTH WARWICKSHIRE NHS FOUNDATION TRUST 392 597,400 536,389 61,012 MID STAFFORDSHIRE NHS FOUNDATION TRUST 348 796,136 734,006 62,130 WYE VALLEY NHS TRUST 297 873,060 704,897 168,163 GEORGE ELIOT HOSPITAL NHS TRUST 278 698,530 633,184 65,346 Other Providers 1313 3,219,794 2,517,208 702,586 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 (2012-13 Tariff) - 1,159, Non-Elective Cost (2012-13 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 (2012-13 Tariff) 19 days, Non-Elective trim point (2012-13 Tariff) 21 days, Per day long stay payment - 203. West Midlands Strategic Clinical Network Parkinson's Disease Network meeting May 14th 2015 8
Costs of PD Admissions 2013-2014 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 1122 2,706,479 246,518 235,986 10,532 2,459,961 2,259,744 200,217 UHCW 935 2,511,804 296,346 284,465 11,881 2,215,459 1,847,290 368,168 UHNS 842 2,140,479 214,798 207,367 7,432 1,925,680 1,801,153 124,527 UHB 594 1,955,661 696,415 685,181 11,235 1,259,246 989,384 269,862 WAHT 917 1,936,903 211,513 209,708 1,804 1,725,390 1,524,634 200,756 DGFT 845 1,858,636 167,268 166,569 699 1,691,368 1,484,832 206,536 STT 655 1,652,150 112,193 110,896 1,297 1,539,957 1,400,628 139,329 RWT 918 1,546,222 236,340 227,243 9,097 1,309,881 1,221,966 87,915 BHFT 602 1,459,125 144,442 144,216 227 1,314,683 1,128,953 185,730 SWBT 567 1,271,215 151,085 149,402 1,683 1,120,130 979,321 140,810 WHT 451 992,796 84,797 83,314 1,483 907,999 825,263 82,736 WVT 297 873,060 147,374 132,544 14,831 725,686 572,353 153,333 MSFT 348 796,136 136,677 136,677 0 659,459 597,328 62,130 GEH 278 698,530 59,095 59,095 0 639,436 574,089 65,346 SWFT 392 597,400 103,213 101,370 1,843 494,188 435,019 59,169 Other Providers 1313 3,219,794 2,253,594 1,969,005 284,590 966,200 548,204 417,996 TOTAL 11,076 26,216,393 5,261,669 4,903,037 358,632 20,954,724 18,190,161 2,764,563 West Midlands Strategic Clinical Network Parkinson's Disease Network meeting May 14th 2015 9
Average Length of Stay for PD Admissions 2013-2014 (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 392 4720 12.0 16.9 WYE VALLEY NHS TRUST 297 3129 10.5 14.7 THE ROYAL WOLVERHAMPTON NHS TRUST 918 7004 7.6 13.9 UNIVERSITY HOSPITALS BIRMINGHAM NHS FOUNDATION TRUST 594 5331 9.0 13.8 WALSALL HEALTHCARE NHS TRUST 451 5047 11.2 13.5 HEART OF ENGLAND NHS FOUNDATION TRUST 1122 11393 10.2 11.9 UNIVERSITY HOSPITALS COVENTRY AND WARWICKSHIRE NHS TRUST 935 8402 9.0 11.6 MID STAFFORDSHIRE NHS FOUNDATION TRUST 348 2705 7.8 11.6 BURTON HOSPITALS NHS FOUNDATION TRUST 602 5257 8.7 11.5 GEORGE ELIOT HOSPITAL NHS TRUST 278 2328 8.4 10.9 THE DUDLEY GROUP NHS FOUNDATION TRUST 845 6239 7.4 10.7 SHREWSBURY AND TELFORD HOSPITAL NHS TRUST 655 5356 8.2 10.5 WORCESTERSHIRE ACUTE HOSPITALS NHS TRUST 917 7063 7.7 10.3 SANDWELL AND WEST BIRMINGHAM HOSPITALS NHS TRUST 567 4317 7.6 10.1 UNIVERSITY HOSPITAL OF NORTH STAFFORDSHIRE NHS TRUST 842 5904 7.0 8.3 Other providers SOUTH STAFFORDSHIRE AND SHROPSHIRE HEALTHCARE NHS FOUNDATION TRUST 2 288 144.0 144.0 BIRMINGHAM AND SOLIHULL MENTAL HEALTH NHS FOUNDATION TRUST 9 1083 120.3 119.3 BLACK COUNTRY PARTNERSHIP NHS FOUNDATION TRUST 2 139 69.5 69.5 DUDLEY AND WALSALL MENTAL HEALTH PARTNERSHIP NHS TRUST 5 291 58.2 58.2 COVENTRY AND WARWICKSHIRE PARTNERSHIP NHS TRUST 5 284 56.8 56.8 NORTH STAFFORDSHIRE COMBINED HEALTHCARE NHS TRUST 6 1160 193.3 42.8 THE ROYAL ORTHOPAEDIC HOSPITAL NHS FOUNDATION TRUST 62 395 6.4 36.2 BIRMINGHAM COMMUNITY HEALTHCARE NHS TRUST 127 3450 27.2 32.9 WORCESTERSHIRE HEALTH AND CARE NHS TRUST 151 4912 32.5 32.5 STAFFORDSHIRE AND STOKE ON TRENT PARTNERSHIP NHS TRUST 166 4473 26.9 31.4 SHROPSHIRE COMMUNITY HEALTH NHS TRUST 78 2178 27.9 27.9 West Midlands Strategic Clinical Network Parkinson's Disease Network meeting May 14th 2015 10
ROBERT JONES AND AGNES HUNT ORTHOPAEDIC HOSPITAL NHS FOUNDATION TRUST 66 594 9.0 21.9 BIRMINGHAM WOMEN'S NHS FOUNDATION TRUST 1 6 6.0 0.0 SPIRE HEALTHCARE 146 176 1.2 0.0 NUFFIELD HEALTH 75 73 1.0 0.0 RAMSAY HEALTHCARE UK OPERATIONS LIMITED 233 235 1.0 0.0 BMI HEALTHCARE 179 128 0.7 0.0 Bed days per Provider Trust for All Admissions 2013-2014 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 1,122 303 147 74 598 UNIVERSITY HOSPITALS COVENTRY AND WARWICKSHIRE NHS TRUST 935 294 120 67 454 THE ROYAL WOLVERHAMPTON NHS TRUST 918 433 71 23 391 WORCESTERSHIRE ACUTE HOSPITALS NHS TRUST 917 309 111 42 455 THE DUDLEY GROUP NHS FOUNDATION TRUST 845 356 99 35 355 UNIVERSITY HOSPITAL OF NORTH STAFFORDSHIRE NHS TRUST 842 223 110 70 439 SHREWSBURY AND TELFORD HOSPITAL NHS TRUST 655 180 71 44 360 BURTON HOSPITALS NHS FOUNDATION TRUST 602 180 76 42 304 UNIVERSITY HOSPITALS BIRMINGHAM NHS FOUNDATION TRUST 594 193 86 29 286 SANDWELL AND WEST BIRMINGHAM HOSPITALS NHS TRUST 567 176 95 38 258 WALSALL HEALTHCARE NHS TRUST 451 91 61 29 270 SOUTH WARWICKSHIRE NHS FOUNDATION TRUST 392 114 29 17 232 MID STAFFORDSHIRE NHS FOUNDATION TRUST 348 108 40 16 184 WYE VALLEY NHS TRUST 297 86 32 23 156 GEORGE ELIOT HOSPITAL NHS TRUST 278 92 28 12 146 Other providers 1,313 521 70 41 681 TOTAL 11,076 3,659 1,246 602 5,569 West Midlands Strategic Clinical Network Parkinson's Disease Network meeting May 14th 2015 11
Bed days per Provider Trust for Non Elective Admissions 2013-2014 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 933 152 133 71 577 UNIVERSITY HOSPITALS COVENTRY AND WARWICKSHIRE NHS TRUST 700 106 108 57 429 UNIVERSITY HOSPITAL OF NORTH STAFFORDSHIRE NHS TRUST 689 107 100 63 419 WORCESTERSHIRE ACUTE HOSPITALS NHS TRUST 661 93 100 34 434 THE DUDLEY GROUP NHS FOUNDATION TRUST 576 112 86 33 345 SHREWSBURY AND TELFORD HOSPITAL NHS TRUST 505 46 64 40 355 THE ROYAL WOLVERHAMPTON NHS TRUST 492 48 56 17 371 BURTON HOSPITALS NHS FOUNDATION TRUST 453 55 65 39 294 SANDWELL AND WEST BIRMINGHAM HOSPITALS NHS TRUST 417 55 81 34 247 WALSALL HEALTHCARE NHS TRUST 369 22 56 26 265 UNIVERSITY HOSPITALS BIRMINGHAM NHS FOUNDATION TRUST 349 41 61 21 226 SOUTH WARWICKSHIRE NHS FOUNDATION TRUST 274 12 24 13 225 MID STAFFORDSHIRE NHS FOUNDATION TRUST 227 4 31 16 176 GEORGE ELIOT HOSPITAL NHS TRUST 212 32 26 12 142 WYE VALLEY NHS TRUST 201 15 28 17 141 Other providers 396 3 6 10 377 TOTAL 7454 903 1025 503 5023 West Midlands Strategic Clinical Network Parkinson's Disease Network meeting May 14th 2015 12
Total Number of PD admissions per CCG in 2013-2014 (ranked by non-elective admission) CCG Name All admissions Elective Non Elective BIRMINGHAM CROSSCITY 988 225 763 COVENTRY AND RUGBY 843 200 643 DUDLEY 652 143 509 SOUTH WORCESTERSHIRE 607 164 443 SANDWELL AND WEST BIRMINGHAM 595 165 430 SHROPSHIRE 546 116 430 WOLVERHAMPTON 577 188 389 WALSALL 649 267 382 STOKE ON TRENT 501 131 370 SOUTH WARWICKSHIRE 470 150 320 REDDITCH AND BROMSGROVE 396 90 306 SOLIHULL 379 75 304 NORTH STAFFORDSHIRE 428 139 289 SOUTH EAST STAFFS AND SEISDON PENINSULAR 423 144 279 EAST STAFFORDSHIRE 336 104 232 WARWICKSHIRE NORTH 300 79 221 STAFFORD AND SURROUNDS 273 81 192 BIRMINGHAM SOUTH AND CENTRAL 263 74 189 CANNOCK CHASE 278 91 187 HEREFORDSHIRE 281 103 178 TELFORD AND WREKIN 204 73 131 WYRE FOREST 265 191 74 West Midlands Strategic Clinical Network Parkinson's Disease Network meeting May 14th 2015 13
Total Number of PD admissions per 100,000 GP population per CCG, 2013-2014 (ranked by non-elective admission) CCG Name All admissions Elective Non Elective REDDITCH AND BROMSGROVE 230 52 178 EAST STAFFORDSHIRE 246 76 170 DUDLEY 209 46 163 SOUTH WORCESTERSHIRE 205 55 150 WOLVERHAMPTON 220 72 148 SHROPSHIRE 182 39 143 NORTH STAFFORDSHIRE 211 68 142 CANNOCK CHASE 209 68 140 WALSALL 238 98 140 STOKE ON TRENT 183 48 135 COVENTRY AND RUGBY 176 42 134 STAFFORD AND SURROUNDS 188 56 132 SOUTH EAST STAFFS AND SEISDON PENINSULAR 199 68 131 SOLIHULL 158 31 127 WARWICKSHIRE NORTH 163 43 120 SOUTH WARWICKSHIRE 171 55 116 BIRMINGHAM CROSSCITY 133 30 103 HEREFORDSHIRE 154 57 98 SANDWELL AND WEST BIRMINGHAM 109 30 79 BIRMINGHAM SOUTH AND CENTRAL 106 30 76 TELFORD AND WREKIN 116 42 75 WYRE FOREST 235 170 66 West Midlands Strategic Clinical Network Parkinson's Disease Network meeting May 14th 2015 14
Average Length of Stay for PD admissions per CCG in 2013-2014 (ranked by non-elective LOS) CCG Name All admissions Elective only Non-Elective only HEREFORDSHIRE 12.8 5.8 16.9 SOUTH WARWICKSHIRE 11.5 1.1 16.3 WYRE FOREST 4.6 0.3 15.7 SOUTH WORCESTERSHIRE 10.8 0.8 14.5 SHROPSHIRE 11.2 0.8 14.0 WOLVERHAMPTON 9.6 0.6 13.9 SOUTH EAST STAFFS AND SEISDON PENINSULAR 9.5 1.0 13.9 BIRMINGHAM SOUTH AND CENTRAL 10.7 2.9 13.8 SOLIHULL 11.6 3.1 13.7 REDDITCH AND BROMSGROVE 11.1 2.2 13.6 BIRMINGHAM CROSSCITY 11.9 6.0 13.6 CANNOCK CHASE 9.1 0.7 13.2 WALSALL 7.7 0.4 12.8 STAFFORD AND SURROUNDS 9.1 1.3 12.4 COVENTRY AND RUGBY 9.3 0.9 11.8 WARWICKSHIRE NORTH 8.7 1.0 11.4 TELFORD AND WREKIN 7.5 0.5 11.3 DUDLEY 9.0 1.1 11.2 SANDWELL AND WEST BIRMINGHAM 8.4 1.5 11.0 EAST STAFFORDSHIRE 7.4 0.6 10.5 STOKE ON TRENT 11.5 14.2 10.5 NORTH STAFFORDSHIRE 11.2 16.7 8.5 West Midlands Strategic Clinical Network Parkinson's Disease Network meeting May 14th 2015 15
Total Tariff Cost of PD admissions per CCG in 2013-2014 (ranked by non-elective admissions) CCG Name All Admissions Elective only Non Elective only BIRMINGHAM CROSSCITY 2,703,395 399,080 2,304,315 COVENTRY AND RUGBY 2,222,256 226,366 1,995,891 DUDLEY 1,726,959 203,100 1,523,859 SANDWELL AND WEST BIRMINGHAM 1,452,417 273,054 1,179,364 SHROPSHIRE 1,295,595 133,572 1,162,023 SOUTH WORCESTERSHIRE 1,334,900 236,458 1,098,442 WOLVERHAMPTON 1,196,207 157,681 1,038,526 STOKE ON TRENT 1,318,587 360,444 958,143 WALSALL 1,000,154 133,330 866,824 SOUTH EAST STAFFS AND SEISDON PENINSULAR 1,064,642 216,634 848,008 REDDITCH AND BROMSGROVE 896,392 105,087 791,305 SOLIHULL 905,169 135,102 770,067 NORTH STAFFORDSHIRE 1,010,581 267,699 742,882 WARWICKSHIRE NORTH 807,500 126,945 680,556 SOUTH WARWICKSHIRE 862,002 186,962 675,039 EAST STAFFORDSHIRE 805,180 142,378 662,802 HEREFORDSHIRE 837,260 177,292 659,968 BIRMINGHAM SOUTH AND CENTRAL 766,255 138,853 627,402 STAFFORD AND SURROUNDS 727,011 110,236 616,775 CANNOCK CHASE 675,099 100,132 574,967 TELFORD AND WREKIN 468,677 68,977 399,700 WYRE FOREST 270,461 56,133 214,329 West Midlands Strategic Clinical Network Parkinson's Disease Network meeting May 14th 2015 16
Total Tariff Cost of PD admissions per 100,000 GP population per CCG 2013-2014 (ranked by non-elective admissions) CCG Name All Admissions Elective only Non Elective only DUDLEY 554,522 65,215 489,307 EAST STAFFORDSHIRE 590,520 104,420 486,100 REDDITCH AND BROMSGROVE 520,320 60,999 459,321 CANNOCK CHASE 507,071 75,210 431,861 STAFFORD AND SURROUNDS 500,579 75,902 424,677 COVENTRY AND RUGBY 463,194 47,182 416,012 SOUTH EAST STAFFS AND SEISDON PENINSULAR 500,737 101,890 398,847 WOLVERHAMPTON 456,104 60,123 395,982 SHROPSHIRE 431,583 44,495 387,088 SOUTH WORCESTERSHIRE 451,093 79,905 371,188 WARWICKSHIRE NORTH 437,523 68,782 368,741 NORTH STAFFORDSHIRE 497,414 131,763 365,651 HEREFORDSHIRE 459,347 97,268 362,079 STOKE ON TRENT 481,057 131,500 349,557 SOLIHULL 378,257 56,457 321,800 WALSALL 366,204 48,818 317,385 BIRMINGHAM CROSSCITY 365,157 53,905 311,252 BIRMINGHAM SOUTH AND CENTRAL 307,711 55,760 251,951 SOUTH WARWICKSHIRE 313,594 68,016 245,578 TELFORD AND WREKIN 267,346 39,346 228,000 SANDWELL AND WEST BIRMINGHAM 266,384 50,080 216,304 WYRE FOREST 240,246 49,862 190,384 West Midlands Strategic Clinical Network Parkinson's Disease Network meeting May 14th 2015 17
Readmissions for PD patients in 2013-2014 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 1,122 253 129 63 933 160 79 41 UHCW 935 155 85 44 700 82 38 25 RWT 918 390 285 247 492 105 50 29 WHAT 917 180 98 49 661 97 51 29 DGFT 845 241 184 151 576 70 38 17 UHNS 842 149 72 40 689 95 51 31 STT 655 94 52 32 505 56 24 12 BHFT 602 140 68 38 453 86 40 22 UHB 594 115 51 28 349 93 45 24 SWBT 567 127 59 23 417 75 36 17 WHT 451 82 38 23 369 53 24 13 SWFT 392 74 41 18 274 51 23 11 MSFT 348 56 32 9 227 32 20 9 WVT 297 43 20 7 201 30 15 6 GEH 278 67 37 15 212 39 23 12 Other providers 1,313 243 87 33 396 198 71 32 TOTAL 11,076 2,409 1,338 820 7,454 1,322 628 330 % total 21.7 12.1 7.4 % total 17.7 8.4 4.4 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 2015 18
All West Midlands Non-Elective admissions (n = 7454), 2013-2014 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 1 716 9.6 G20X Parkinson's disease 2 445 6.0 R296 Tendency to fall, not elsewhere classified 3 296 4.0 J181 Lobar pneumonia, unspecified 4 275 3.7 J22X Unspecified acute lower respiratory infection 5 249 3.3 J189 Pneumonia, unspecified 6 216 2.9 S720 Fracture of neck of femur 7 205 2.8 J690 Pneumonitis due to food and vomit 8 199 2.7 R55X Syncope and collapse 9 126 1.7 K590 Constipation 10 120 1.6 R074 Chest pain, unspecified 11 118 1.6 I951 Orthostatic hypotension 12 104 1.4 L031 Cellulitis of other parts of limb 13 86 1.2 J440 Chronic obstructive pulmonary disease with acute lower respiratory infection 14 85 1.1 A099 Gastroenteritis and colitis of unspecified origin 15 78 1.0 N179 Acute renal failure, unspecified 16 75 1.0 I48X Atrial fibrillation and flutter 17 61 0.8 I219 Acute myocardial infarction, unspecified 18 60 0.8 I500 Congestive heart failure 19 60 0.8 I639 Cerebral infarction, unspecified 20 59 0.8 R268 Other and unspecified abnormalities of gait and mobility 21 58 0.8 G459 Transient cerebral ischaemic attack, unspecified 22 56 0.8 R073 Other chest pain 23 56 0.8 E86X Volume depletion 24 54 0.7 S721 Pertrochanteric fracture 25 53 0.7 R410 Disorientation, unspecified 26 52 0.7 R33X Retention of urine 27 48 0.6 A419 Sepsis, unspecified 28 47 0.6 West Midlands Strategic Clinical Network Parkinson's Disease Network meeting May 14th 2015 19
J180 Bronchopneumonia, unspecified 29 45 0.6 I269 Pulmonary embolism without mention of acute cor pulmonale 30 42 0.6 S018 Open wound of other parts of head 31 40 0.5 I209 Angina pectoris, unspecified 32 40 0.5 R104 Other and unspecified abdominal pain 33 39 0.5 G409 Epilepsy, unspecified 34 36 0.5 R31X Unspecified haematuria 35 36 0.5 R072 Precordial pain 36 36 0.5 K920 Haematemesis 37 35 0.5 F059 Delirium, unspecified 38 34 0.5 T830 Mechanical complication of urinary (indwelling) catheter 39 33 0.4 K922 Gastrointestinal haemorrhage, unspecified 40 33 0.4 I802 Phlebitis and thrombophlebitis of other deep vessels of lower extremities 41 32 0.4 J441 Chronic obstructive pulmonary disease with acute exacerbation, unspecified 42 31 0.4 R568 Other and unspecified convulsions 43 30 0.4 K562 Volvulus 44 29 0.4 M255 Pain in joint 45 29 0.4 S099 Unspecified injury of head 46 27 0.4 S010 Open wound of scalp 47 25 0.3 I200 Unstable angina 48 25 0.3 R060 Dyspnoea 49 25 0.3 R298 Other and unspecified symptoms and signs involving the nervous and musculoskeletal systems 50 24 0.3 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 2015 20
Useful Websites and References West Midlands Strategic Clinical Network and Senate: www.wmscnsenate.nhs.uk UK Parkinson's Excellence Network: www.parkinsons.org.uk/professionals HSCIC (Health & Social Care Information Centre): www.hscic.gov.uk WMQRS (West Midlands Quality Review Service): www.wmqrs.nhs.uk NHS England: www.england.nhs.uk All Party Parliamentary Group for Parkinson's Disease. Please Mind the Gap: Parkinson's Disease Services today. www.parkinsons.org.uk/content/inquiry-access-health-and-social-care 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. 2014 Mar 19;348:g1838. doi: 10.1136/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 2015 21