SCOTTISH HEALTH & SOCIAL CARE Operational Measures and Definitions Version 1 12/10/15 Version Control Version Changes Author
CONTENTS Operational Data Measurements Page Introduction 2 User Referral 3 Individual User(s) Clinical Activity 4 Other Clinically Related Activity 5 Waiting Times 6 Workforce 7 Episode of Care 8 Glossary 9 1
INTRODUCTION The Allied Health s to date have no standardised national or local data to evidence the value they add to health and social care in Scotland. Action point 6.1 of the AHP National Delivery plan advocates capturing national data for display in dashboard format across health and social care. A working group comprising of clinicians & staff from Information s of NHS National s Scotland, the Scottish Government and AHP ehealth have met regularly to advance this work stream. To date they have: Sponsored a survey about AHP IT Readiness to capture a minimum data set Reviewed the minimum data set of 2011 Given regular updates to and sought advice from the AHP Directors and National Leads including Social Care. Determined the desirable outputs from this data collection. The purpose of this document is to describe the outputs from national and local AHP data collection around 6 headings and in line with the AHP Scotland Consensus on Quality Values (2013). It is NOT a data set but when such a data set is developed it would give data to evidence what AHPs were delivering around Referral Individual User(s) Clinical Activity Other Clinically Related Activity Waiting Times Workforce Episode of Care Further project plans have yet to be finalised. 2
KPI User Referral Data Source ISD Data Dictionary AHP Minimum Data Set 2011 NCDDP legacy standards ISD Waiting Times Manual Business Description/Definition: The number of new service users referred or self referring to a specific AHP or in a given time period. Adapted from AHP Waiting Times Census 2011 All referrals to all the 12 AHP services in NHS Scotland All sources of referral Board/ Partnership Area Life Stage Gender Postcode Referral Source Team Speciality DOB / CHI/Age Band Gender Postcode Referral Source Referral Reason Referral Urgency Monthly Real Time 3
KPI Individual User(s) Clinical Activity Business Description/Definition: Data Source: ISD Data Dictionary AHP Minimum Data Set 2011 NCDDP legacy standards ISD Waiting Times Manual Activity is the time spent on clinical work completed by AHPs that can be attributed to an individual or group of service users. NHS Scotland Quality Improvement Hub. All direct and indirect activity relating to service user including face to face, telephone, video conferencing, and group work. This includes any activities carried out about or on behalf of these individuals i.e. advising carers, teachers or home care staff on how to identify specific problems associated with the service user Non-patient related indirect activity i.e. public health advice. Board/ Partnership Area User Contact Type Location New/Return DNA/CNA User Contact Type Location New/Return DNA/CNA Monthly Real Time 4
KPI Other Clinically Related Activity Business Description/Definition: Data Source: Fife AHP Activity Document The time spent on other clinically related activity completed by AHPs not attributed to an individual or group of service users but is still part of the AHP role i.e. public health work, non-specific advisory work, educational sessions NHS Scotland Quality Improvement Hub. Clinical activity which is not attributable to an individual service user i.e. public health work at a population wide level or targeted for specific groups. Non-clinical activity which is part of an AHPs role i.e. staff supervision student supervision CPD research management activity These will be covered by the additional AHP workforce and workload planning toolkit Board/Social Care area Location Location Monthly Real Time 5
KPI Waiting Times Data Source: ISD Data Recording Manual for Waiting Times. Business Description: How long a service user has to wait from receipt of referral to first contact (this may be a direct or indirect contact and may not involve a clinician seeing the service user) 1 ISD Data Dictionary Waiting Times Standard ISD Waiting Times Web Page All 12 AHP professions & services. From the date the referral is received until the 1 st contact with the AHP wherever the care take place e.g. acute, outpatient or community setting. Adjusted Waits Transfers from different health board. e.g. from Golden Jubilee to NHS WI. When service users are transferred between professions or to the same profession but in another location within the same health board e.g. A person who has been a patient within a stoke unit may require further AHP management on discharge from hospital. Partnership Board Location Postcode New DNA (?) Location Postcode DOB / CHI New DNA Gender When Required Monthly 6
KPI Workforce Data Source: ISD Workforce Data Set with adaptation ISD Data Dictionary Business Description: The total number of AHPs employed in Health & Social Care. Workforce Define Workforce at Dictionary.com all AHP s & s Non AHP e.g. Clinical Psychologists, Clinical Scientists, Social Workers. # per profession* # per grade* # per service # per employer* # WTE* # 5/7 day working # Vacancies* # Gender* # Age Group* # Present at work # per profession # per grade # per service # per employer # WTE # 5/7 day working # Vacancies # Gender # Age Group # Present at work When Required *Currently available quarterly. Real Time 7
KPI Episode of Care Data Source UCPN Unique Care Pathway Number? IoRN Indicator of Relative Needs? ISD Data Dictionary EQ5D European Quality of Life 5 dimensions Business Description/Definition: An AHP episode can take place in any setting and is initiated by a referral or admission that involves a first contact and is ended by a discharge. # No of Days from 1 st contact until discharge. # No of contacts from 1 st contact until discharge ISD Data Dictionary Episode of Care All AHP episodes of care Any setting Referrals which did not result in a 1 st contact Transfers between same professions within a health board. (This is one episode of care). Complexity (Nurse/Workforce) Discharge Outcome/Reason Complexity (Nurse/Workforce) Discharge Outcome (service user level) Discharge Outcome (AHP level) When Required Real Time 8
GLOSSARY OF DEFINITIONS Term Adjusted wait Explanation The length of time from receipt of referral until 1 st appointment minus any unavailability (e.g. medically unwell, holiday, prison sentence) (Source 4 week rapid access to MSK paper) AHP Allied Health al (Arts Therapist, Dietician, Occupational Therapist, Orthoptist, Orthotist, Paramedic, Physiotherapist, Podiatrist, Prosthetist, Radiographer (diagnostic and therapeutic), Speech and Language Therapist). (Sources NHS Scotland Workforce Information, ISD Data Dictionary) Complexity A measure of the time taken and the level of knowledge, skill and experience to complete and activity. (Source ISD Nursing Workforce and Workload Planning Tool) Direct contact A contact between a healthcare professional and a patient. (Source ISD Data Dictionary- Patient Contact Category) Episode of care (concurrent) A service user can have more than one episode of care running at the same time. They can be under the care of a number of clinicians from different specialities within a profession or between different professions concurrently. (Source Health and Social Care Information Centre) Gender Male, female, not specified or not known. (Source ISD Data Dictionary) Indirect contact A contact between a healthcare professional and another person on behalf of a patient, e.g. parent, carer. (also known as a 'proxy' contact ) (Source ISD Data Dictionary- Patient Contact Category) Length of wait The length of time (in days) between receipt of a new referral and first contact with an AHP. (Source ISD Data Dictionary) Life stage Chronological concept of a service user s life stage. Defined as child, working age or older person. (No source) New contact The first time a service user is seen at the start of their episode of care. It can be a direct or an indirect contact. (Source AHP National Minimum Dataset for Scotland) New referral When a service user refers themselves or is referred to an AHP service. This doesn t include referrals or re-referrals for the same issue within an episode of care. 9
(Source ISD Data Dictionary) Present at Work The time (in working days as a WTE) of AHPs being present at work minus the number of working days lost to all forms of sickness/absence. (Sources NHS Scotland Workforce Information, ISD Data Dictionary) Return contact A second or subsequent contact regarding a service user in an existing episode of care. This can cover different locations/teams in the same profession in the same board/partnership area within the same episode of care. This may be a direct or indirect contact. (Source AHP National Minimum Dataset for Scotland) user An individual who is in receipt of AHP services. (Source - ISD Data Dictionary) Vacancy number The number of posts that have been cleared for recruitment but have no AHP in post. (Source Scottish Workforce Information Standard System) 10