outcomes benchmarking support packs: ccg level · comparable intelligence to support clinical...

Public

Health

England

NHS South

Tyneside CCG

Outcomes benchmarking support packs: CCG level

Produced with input from:

Forward and Introduction

Local decision making is at the heart of the NHS, and the NHS Commissioning Board, Public Health England and the Local Government Association are committed to providing high quality comparable intelligence to support clinical commissioning groups (CCGs) and health and wellbeing boards (HWBs) identify local priorities and agree local plans.

Alongside the publication of the NHS Commissioning Board’s 2013-14 Planning Guidance, we have produced initial information packs at Local Authority and CCG level that set out key data to inform the local position on outcomes. The Local Authority level packs present high level comparative information on the NHS, the Adult Social Care and the Public Health Frameworks. The CCG level packs provide a more detailed analysis of NHS outcomes and other relevant indicators.

The purpose of these is to provide CCGs and HWB partners with a quick and easy-to-use summary of their current position on outcomes as they take up their role, building on the data sets in the CCG outcomes indicators and other existing data sets. The information should be used alongside the local intelligence that is being collected to inform local Joint Strategic Needs Assessments and it will support commissioners working together to set the priorities for the Joint Health and Wellbeing Strategy. Where possible we have signposted other relevant information sources that might help build an understanding of the specific issues locally.

These information packs represent a starting point for the way the NHS CB will provide support in this area going forward and we hope you find them useful. We would like to offer you an open invitation to work co-productively with us on an on-going basis to help shape these tools in a way that would be most helpful for you locally. If you have any comments or suggestions for improvement please email [email protected].

Forward and Introduction 2

Section 1: Background information

Population profile . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5

Deprivation map . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6

Disease prevalence (QOF) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7

Section 2: CCG Outcomes Indicators

Summary spine chart 9

1 Preventing people from dying prematurely

1a Potential years of life lost (PYLL) from causes considered amenable to healthcare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10

1.1 Under 75 mortality rate from cardiovascular disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11

1.2 Under 75 mortality rate from respiratory disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12

1.3 (proxy indicator) Emergency admissions for alcohol related liver disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13

1.4 Under 75 mortality rate from cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14

2 Improving quality of life for people with long term conditions

2.1 Health related quality of life for people with long term conditions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15

2.2 Proportion of people feeling supported to manage their condition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16

2.3i Unplanned hospitalisation for chronic ambulatory sensitive conditions (adults) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17

2.3ii Unplanned hospitalisation for asthma, diabetes and epilepsy in under 19s . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18

3 Helping people to recover from episodes of ill health or following injury

3a Emergency admissions for acute conditions that should not usually require

hospital admission . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19

3b Emergency readmissions within 30 days of discharge from hospital . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20

3.1i Patient reported outcome measures for elective procedures – hip replacement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .21

3.1ii Patient reported outcome measures for elective procedures – knee replacement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .22

3.1iii Patient reported outcome measures for elective procedures – groin hernia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23

3.2 Emergency admissions for children with lower respiratory tract infections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .24

4 Ensuring that people have a positive experience of care

4ai Patient experience of GP services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .25

4aii Patient experience of GP out of hours services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .26

4aiii Patient experience of NHS dental services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .27

4a, 4.1, 4.2, 4.3 Patient experience of hospital care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .28

5.2i Incidence of Healthcare associated infection (HCAI): MRSA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .29

5.2iI Incidence of Healthcare associated infection (HCAI): C Difficile . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .30

Section 3: Activity rates and trends

1 Non-elective activity rates and growth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .32

2 GP Referrals rates and growth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .33

3 Elective activity rates and growth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .34

4 Prescribing rates and growth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .35

Sources and references . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .36

ContentsPage

SECTION 1

Background Information

Age

Population profile (registered patients, April 2011)

The chart below shows the number of people registered with this CCG's practices by sex and 5-year

age band.

The darker outlines show the profile of the England population.

0-4

5-9

10-14

15-19

20-24

25-29

30-34

35-39

40-44

45-49

50-54

55-59

60-64

65-69

70-74

75-79

80-84

85+

0 2,000 4,000 6,000 8,000 0 2,000 4,000 6,000 8,000

Females Males

Deprivation map

The map below shows the levels of deprivation in and around this CCG, based on the Index of

Multiple Deprivation 2010 (IMD2010).

The IMD2010 is calculated at LSOA level. However, in this map we have given each postcode within

the same LSOA the same colour, rather than shade the entire LSOA area. This presentation

emphasizes where people live rather than open countryside.

CCG boundary

LA boundary

Shared LA/CCG boundary

QOF Disease Register

Coronary Heart Disease 7,477 (4.9%)

Stroke or Transient Ischaemic Attacks (TIA) 3,527 (2.3%)

Hypertension 24,622 (16.1%)

Chronic Obstructive Pulmonary Disease 5,032 (3.3%)

Hypothyroidism 7,245 (4.7%)

Cancer 2,912 (1.9%)

Mental Health 1,203 (0.8%)

Asthma 8,833 (5.8%)

Heart Failure 1,697 (1.1%)

Heart Failure Due to LVD 1,332 (0.9%)

Palliative Care 284 (0.2%)

Dementia 1,122 (0.7%)

Atrial Fibrillation 2,598 (1.7%)

Cardiovascular Disease Primary Prevention 2,219 (1.4%)

Diabetes Mellitus (17+) 8,055 (6.4%)

Epilepsy (18+) 1,110 (0.9%)

Depression (18+) 21,480 (17.4%)

Chronic Kidney Disease (18+) 2,732 (2.2%)

Obesity (16+) 18,723 (14.7%)

Leaning Disability (18+) 641 (0.5%)

Disease prevalence (QOF)

Number (%) and practice ranks chart

The table below shows the prevalence (number and percentage) of diseases covered by the QOF

for the practices in this CCG in 2010/11. The chart shows the distribution of the CCG's practices'

prevalence in terms of ranks. Individual practices are shown as vertical bars with the height of the

bar proportional each practice's population. The blue box shows the range of the middle 50% of

practices in the CCG.The large diamond shows the average rank for the CCG and the dashed

blue line shows the England average.

Higher Prevalence

SECTION 2

CCG Outcomes Indicators

Outcome Indicator

1a Potential years of life lost (PYLL) from causes

considered amenable to healthcare

1.1 Under 75 mortality rate from cardiovascular disease

1.2 Under 75 mortality rate from respiratory disease

1.3 (proxy indicator) Emergency admissions for alcohol

related liver disease

1.4 Under 75 mortality rate from cancer

2 Health related quality of life for people with long term

conditions

2.1 Proportion of people feeling supported to manage

their condition

2.3i Unplanned hospitalisation for chronic ambulatory

sensitive conditions (adults)

2.3ii Unplanned hospitalisation for asthma, diabetes

and epilepsy in under 19s

3a Emergency admissions for acute conditions that

should not usually require hospital admission

3b Emergency readmissions within 30 days of

discharge from hospital

3.1i Patient reported outcome measures for elective

procedures – hip replacement

3.1ii Patient reported outcome measures for elective

procedures – knee replacement

3.1iii Patient reported outcome measures for elective

procedures – groin hernia

3.2 Emergency admissions for children with lower

respiratory tract infections

4ai Patient experience of GP services

4aii Patient experience of GP out of hours services

4aiii Patient experience of NHS dental services

5.2i Incidence of Healthcare associated infection

(HCAI): MRSA

5.2iI Incidence of Healthcare associated infection

(HCAI): C Difficile

NHS South Tyneside CCG

Summary spine chart

The chart below shows the distribution of the CCGs on each indicator in terms of ranks. This CCG is

shown as a red diamond. The yellow box shows the interquartile range and median of CCGs in the same

ONS cluster as this CCG. The dotted blue line is the England median. Each indicator has been

orientated so that better outcomes are towards the right (light blue).

CCG and cluster distribution

This CCG is in the Mining & Manufacturing cluster

Better Worse

London

07H09F05V03Q02N01C05N05P08F03D10L03E06K

08C

06W

1a Potential years of life lost (PYLL) from causes considered amenable to

healthcareAge/sex standardised rate per 100,000 population

Source: Health and Social Care Information Centre

This CCG is shown in red. Yellow bars are other CCGs in the same ONS

Cluster as this CCG. Horizontal lines are the England and cluster averages.

Darker shades = more

years of life lost

2,485

0

500

1,000

1,500

2,000

2,500

3,000

3,500

4,000

London

07X06K09E08K08J04L07H03Q11C05G09P02A99G

11T

99Q

1.1 Under 75 mortality rate from cardiovascular disease

Age/sex standardised rate per 100,000 population




Darker shades = higher

mortality rate

79.6

0

20

40

60

80

100

120

140

London

08X08Y06N09Y09E99H10C11N11C02V07H09J08N

04M

10Q

1.2 Under 75 mortality rate from respiratory disease






mortality rate

34.7

0

10

20

30

40

50

60

70

80

London

06Y09E03F08N10N06T05H10L06H01R08F08G08T

03W

04H

1.3 (proxy indicator) Emergency admissions for alcohol related liver disease



admission rate




This is a proxy indicator and is

used in place of mortality from

liver disease due to small

numbers

67.1

0

10

20

30

40

50

60

70

80

90

London

11X05H04Q04L99N08D99F07V03D08W06F99E09Y

08K

09C

1.4 Under 75 mortality rate from cancer






mortality rate

167.4

0

20

40

60

80

100

120

140

160

180

200

London

07T02R04X08Y01E06M03J13P04C04J08D03T08M

06T

06P

2 Health related quality of life for people with long term conditions

Source: GP Patient Survey; provisional analysis



Average EQ-5D index for people who report having a LTCs

Darker shades = Lower

Quality of Life

0.66

0.0

0.1

0.2

0.3

0.4

0.5

0.6

0.7

0.8

0.9

London

04H09Y01R05V05P00Q06N09D10Y01D02M05W12D

10X

13P

2.1 Proportion of people feeling supported to manage their condition

Source: GP Patient Survey; provisional analysis



% who report "Yes, definitely" or "Yes, to some extent" (latter given half weight)

Darker shades = less

supported

56.5%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

London

07K09G06F04H04F00H08R09F07Q06V04G09J06W

99M

05G

2.3i Unplanned hospitalisation for chronic ambulatory sensitive conditions

(adults)Age/sex standardised rate per 100,000 population





admission rate

1,416

0

500

1,000

1,500

2,000

2,500

London

07Y04K10Y99K10W05Q09E09C04C03C07N00L03G

05N

10A

2.3ii Unplanned hospitalisation for asthma, diabetes and epilepsy

in under 19s Age/sex standardised rate per 100,000 population





admission rate

409

0

100

200

300

400

500

600

700

800

London

05T04F01H07M03M08J03K10J08T04M99J05V00R

07N

01K

3a Emergency admissions for acute conditions that should not usually require

hospital admission (adults)Age/sex standardised rate per 100,000 population





admission rate

1,674

0

500

1,000

1,500

2,000

2,500

London

07T00X11J08V04L03E07J06K09J02A02N05J04Y

08J

99H

3b Emergency readmissions within 30 days of discharge from hospital

% rate standardised by age, sex, method of admission and diagnosis/procedure





readmission rate

12.8%

0%

2%

4%

6%

8%

10%

12%

14%

16%

London

08K10Y02H99D99M05C00J05X03W05H11D01W13P

02E

01F

3.1i Patient reported outcome measures for elective procedures – hip replacement

EQ-5D Index casemix adjusted health gain





health gain

0.42

0.00

0.10

0.20

0.30

0.40

0.50

0.60

London

03L07Q03F03H13P00J05W04Q01Y04N09H07M10W

02R

02A

3.1ii Patient reported outcome measures for elective procedures – knee

replacementEQ-5D Index casemix adjusted health gain





health gain

0.30

0.00

0.05

0.10

0.15

0.20

0.25

0.30

0.35

0.40

0.45

0.50

London

99G02F09C09N00T11H04D03Q03K04M02Q07M11M

04H

07V

3.1iii Patient reported outcome measures for elective procedures – groin hernia

EQ-5D Index casemix adjusted health gain





health gain

0.09

-0.05

0.00

0.05

0.10

0.15

0.20

London

07V11H10W09X08F12D11T06D04R99N02E06F02V

05Q

02D

3.2 Emergency admissions for children with lower respiratory tract infections

Age/sex standardised rate per 100,000 population under age 19





admission rate

318

0

100

200

300

400

500

600

700

800

London

05A05Y03K12A05P02R01A10X10E04K06Y00Y03N

02E

04X

4ai Patient experience of GP services

% who report their experience as "very good" or "fairly good"

Source: GP Patient Survey; provisional analysis. This indicator is not age/sex

standardised but survey responses are weighted for non-response.



Darker shades = worse

experience

92%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

London

06Y05J10H06V06D00K09N02Y02V00Q10Y07X07J

06W

99D

4aii Patient experience of GP out of hours services

Source: Health and Social Care Information Centre. This indicator is not

age/sex standardised but survey responses are weighted for non-response.





experience

74%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

London

10H09N03W08P08X06T11N11M08R07N10N09G08G

08N

02A

4aiii Patient experience of NHS dental services


Source: GP Patient Survey; provisional analysis. This indicator is not age/sex

standardised but survey responses are weighted for non-response.




experience

92%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Providers (ordered by number of

admissions) for this CCG

Number of

Admissions / spells

(Acute 2010/11)

4b Inpatient

Overall

Experience

4.1 Outpatient

Overall

Experience

4.2 Inpatient

Respons-

iveness to

needs

4.3 A&E Overall

Experience

1South Tyneside NHS FT 28,553

R

E

9

75 80 68 81

2City Hospitals Sunderland NHS FT 10,042

R

L

N

78 82 71 86

3

The Newcastle Upon Tyne Hospitals

NHS FT4,430

R

T

D

79 83 72 83

4County Durham & Darlington NHS FT 1,079

R

X

P

76 80 68 83

5Gateshead Health NHS FT 876

R

R

7

79 82 71 83

CCG weighted average 76 81 69 82

England average 76 80 67 80

Composite experience scores (out of 100) at this CCG's main 5 providers

4b, 4.1, 4.2, 4.3 Patient experience of hospital care

The table below shows the composite score based on people who reported that their experience was "very good" or "fairly

good" in various patient surveys.

Note that these scores refer to all patients surveyed at the providers and do not refer specifically to this CCG's patients.

Source: Inpatient, outpatient and A&E surveys

0

10

20

30

40

50

60

70

80

90

100

4b Inpatient OverallExperience

4.1 Outpatient OverallExperience

4.2 Inpatient Respons-iveness to needs

4.3 A&E OverallExperience

CCG weighted average

England average

This CCG's providers

London

00R10Q05J12A03N03T99D02A11D08K07N99P00G

12D

04V

5.2i Incidence of Healthcare associated infection (HCAI): MRSA

Rate per 100,000 registered population, not age/sex standardised


rate

Source: Health Protection Agency

Note: 12 CCGs had zero cases of MRSA.



2.59

0.0

1.0

2.0

3.0

4.0

5.0

6.0

7.0

London

08R06L03K04R02D02W10T03V09H08H03H00N09J

07Q

01R

5.2iI Incidence of Healthcare associated infection (HCAI): C. Difficile

Rate per 100,000 registered population. Not age/sex standardised


rate

Source: Health Protection Agency



23.3

0

10

20

30

40

50

60

70

SECTION 3

Activity Rates and Trends

Rates in 2011 calendar year and annualised growth between 2007/8 and 2011

1ii Non-elective admissions growth

Source: NHS Comparators (excludes activity not covered by mandatory PbR tariffs)

The chart below shows the range of annualised growth in non-elective admissions rates between 2007/08 and 2011 for

CCGs across England (in blue). This CCG is in red and other CCGs in its ONS cluster are shown in yellow. The chart

shows that non-elective admissions rate grew by an annualised 3.9% in this CCG compared to a median of 0.7% in its

ONS cluster and the national average of 1.2%.

1i Non-elective admission rates

The chart below shows the range of non-elective admission rates (emergency and other non-elective admissions) per

1,000 population for CCGs across England (in blue). The rate for this CCG is in red and other CCGs in its ONS cluster

are shown in yellow. The rates are standardised for age and sex.

Interpretation: If the rate for this CCG is high it could mean a higher level of morbidity in the population, ineffective

management in primary care, poor NHS community provision, a low admission threshold and/or be influenced by

proximity of patients to A&E.


The chart shows that in 2011 this CCG had 134 non-elective admissions per 1,000 population compared to a median of

125 in its ONS cluster and the national average of 111.

0

20

40

60

80

100

120

140

160

180

No

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2ii GP referral growth

2i GP referral rates

Source: NHS Comparators (includes all mandatory and non-mandatory PbR activity)

The chart below shows the range of first outpatient attendances following a GP referral per 1,000 population for CCGs

across England (in blue). The rate for this CCG is in red and other CCGs in its ONS cluster are shown in yellow. The

rates are standardised for age and sex.

The chart shows that in 2011 this CCG had 223 first outpatient attendances following a GP referral per 1,000

population compared to a median of 182 in its ONS cluster and the national average of 188.

Interpretation: If the rate for this CCG is high it could mean a higher level of morbidity in the population, ineffective

management in primary care or a high level of inappropriate referrals.

Source: NHS Comparators (includes all mandatory and non-mandatory PbR activity)

The chart below shows the range of annualised growth of first outpatient attendances following a GP referral per 1,000

population for CCGs between 2007/08 and 2011 for CCGs across England (in blue). This CCG is in red and other

CCGs in its ONS cluster are shown in yellow. The chart shows that the referral rate grew by an annualised 2.2% in this

CCG compared to a median of 2.7% in its ONS cluster and the national average of 4.6%.

0

50

100

150

200

250

300

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3i Elective admission rates

The chart below shows the range of total elective (ordinary and daycase) admission rates per 1,000 population for

CCGs across England (in blue). The rate for this CCG is in red and other CCGs in its ONS cluster are shown in yellow.

The rates are standardised for age and sex.

The chart shows that in 2011 this CCG had 174 elective admissions per 1,000 population compared to a median of 133

in its ONS cluster and the national average of 123.

3ii Elective admission growthThe chart below shows the range of annualised growth of elective (ordinary and daycase) admissions between 2007/08

and 2011 for CCGs across England (in blue). This CCG is in red and other CCGs in its ONS cluster are shown in

yellow. The chart shows that the referral rate grew by an annualised 5.6% in this CCG compared to a median of 4.0%

in its ONS cluster and the national average of 4.4%.

Interpretation: If the rate for this CCG is high, it could mean that there is a higher level of morbidity in the population,

ineffective management in primary care, a high availability of specialist services or a low level of patients receiving

private treatment.



0

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4i Prescribing spend rates (biggest programmes) in primary care

The chart below shows the range of spend rates per 1,000 for the 4 biggest prescribing programmes in primary care:

Circulation, Respiratory, Endocrinology and Mental Health. The rates are not standardised for age and sex.

The chart shows that in 2011 this CCG spent an average £97 per person compared to a median of £90 in its ONS

cluster and the national average of £79.

Source: NHS Comparators

Interpretation: If the rate for this CCG is high it could mean a higher level of morbidity in the population. The data are

not age standardised so there could be a higher proportion of elderly in the population.

Source: NHS Comparators

The chart below shows the range of annualised growth of prescribing spend in primary care for the 4 biggest

programmes between 2007/08 and 2011 for CCGs across England (in blue) This CCG is in red and other CCGs in its

ONS cluster are shown in yellow. The chart shows that the referral rate grew by an annualised 3.5% in this CCG

compared to a median of 0.6% in its ONS cluster and the national average of 0.5%.

4ii Prescribing spend growth (biggest programmes) in primary care

0

20

40

60

80

100

120

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Information Centre Indicator Portal http://indicators.ic.nhs.uk

PH Outcomes Framework Tool http://www.phoutcomes.info

National General Practice Profiles http://www.apho.org.uk/PRACPROF

Spend and Outcomes Tool (SPOT) http://www.yhpho.org.uk/spot

Quality and Outcomes Framework database http://www.qof.ic.nhs.uk

LA Health Profiles http://www.apho.org.uk/default.aspx?QN=p_health_profiles

Health Investment Network http://www.networks.nhs.uk/nhs-networks/health-investment-network

NHS Comparators http://www.nhscomparators.nhs.uk

1.3 Source: Health and Social Care Information Centre. Data are 2010/11-2011/12. Directly age/sex standardised rates per

100,000 population.

Email: [email protected].

Contains National Statistics data © Crown copyright and database right 2012

5.2i, 5.2ii Source: Health Protection Agency. Data are October 2011 to September 2012. Population denominator is

registered population at April 2012.

Activity data Source: NHS Comparators. Data are calendar year 2011 and annualised growth rates between 2007/8 and

2011.

Additional Resources

Sources and references

1a Source: Health and Social Care Information Centre. Data are 2009 and 2010 combined. Directly age/sex standardised

rate per 100,000 population.

1.1, 1.2, 1.4 Source: Health and Social Care Information Centre. Data are 2011. Directly age/sex standardised rates per

100,000 population.

2, 2.1 Source: GP Patient Survey. Data are July 2011 - March 2012. This indicator is not standardised for age/sex, but

survey responses are weighted for non-response.

© Crown copyright 2012

2.3i, 2.3ii Source: Health and Social Care Information Centre. Data are 2011/12. Directly age/sex standardised rates per

100,000 population.

3a Source: Health and Social Care Information Centre. Data are 2011/12. Directly age/sex standardised rates per 100,000

population

3b Source: Health and Social Care Information Centre. Data are 2010/11. Percentage indirectly standardised for age, sex,

method of admission and diagnosis/procedure; admissions for cancer/obstetrics are excluded.

3.1i, 3.1ii, 3.1iii Source: Health and Social Care Information Centre. Data are 2010/11 and 2011/12 combined. Age, sex

and casemix adjusted. Some CCG values are suppressed due to small numbers.

4ai Source: GP Patient Survey. Data are July 2011 - March 2012. This indicator is not standardised for age/sex but survey

responses are weighted for non-response.

3.2 Source: Health and Social Care Information Centre. Data are 2011/12. Directly age/sex standardised rate per 100,000

population.

4.3 Source: A&E Survey / Health and Social Care Information Centre. Data are 2008. Composite of 5 questions in the

survey.

ONS Clusters for CCGs are derived from LA data by Yorkshire and Humber PHO. Source: Spend and Outcomes Tool

(SPOT).

4aii Source: GP Patient Survey / Health and Social Care Information Centre. Data are July 2011 - March 2012. This

indicator is not standardised for age/sex but survey responses are weighted for non-response.

4aiii Source: GP Patient Survey. Data are July-Sept 2011. This indicator is not standardised for age/sex but survey

responses are weighted for non-response.

4b, 4.1, 4.2 Source: Inpatient Survey / Health and Social Care Information Centre. Data are 2011. Composite indicators of 5

domains in the survey.

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