programme where are we now? current pct performance within sha no decision about me, without me:...
TRANSCRIPT
Programme
• Where are we now? Current PCT performance within SHA
• No decision about me, without me: Local patients views
• Are there alternative ways of delivering care and achieving QIPP targets?
• Round Table Discussion
COPD
• COPD causes >25,000 deaths a year in England and Wales (5% all deaths)
• 835,000 people in England have been diagnosed with COPD
• DoH estimate >3 million people have COPD
• Thus 2 million have undiagnosed COPD
Key Facts
• Approx 9% GP patient population
• GP consultation rates x2 angina
• Average list will contain 200 COPD patients
NHS Costs
NHS Costs
• COPD is an expensive disease for the NHS when it is not identified and treated early
• >75% costs is due to severe/very severe patients
• Direct cost of COPD to NHS is £810-930 million a year
• Without change this is set to grow
Patient Perspective
Patient Perspective
• COPD is a progressive illness, and the number of people dying as a result of COPD increases with age
• COPD is disabling. Although it affects people in different ways, those with COPD often have breathlessness, reduced exercise tolerance, a cough and repeated chest infections
COPD Exacerbations & Survival
• 13.9% of people admitted with an exacerbation of COPD die within 90 days
• 25% of people admitted with an exacerbation of COPD die within 1 year
Social Costs
• Quality of life is undermined. • Restricted mobility leads to social isolation and the
psychological conditions that go with it. • A British Lung Foundation survey found that 90% of
people with severe COPD were unable to participate in socially important activities such as gardening, 66% were unable to take a holiday because of their disease and 33% had disabling breathlessness.
Socio-Economic Bias• Smoking is more prevalent in lower socioeconomic groups• 26% of routine and manual workers smoke vs. 15% in managerial &
professional occupations• DoH estimates that the routine and manual occupational group
represents 50% people with (diagnosed or undiagnosed) COPD in England
• Men aged between 20 and 64 employed in unskilled manual occupations are 14 times more likely to die from COPD than men in professional roles, and are around seven times more likely than those in managerial and technical occupations
The Disadvantaged
• The picture is even worse for smokers from the most disadvantaged sectors of society, where in some cases (e.g. for people with schizophrenia) smoking prevalence can reach 74%
Societal Costs
• ~25% of people with COPD are prevented from working due to the disease
• Leading to 20.4 million lost working days among men and 3.5 million days among women every year
• The annual cost of COPD- related lost productivity to employers and the economy has been put at £3.8 billion
Current Performancein
West Midlands
PCT Expenditure on RespiratoryDH 2009-10 Programme Budgeting Benchmark Workbook v1.0
PCT Total Expenditure (£m per 100,000 own population)
Spend on Respiratory (£m per 100,000 own population)
Cluster Sub Group Average (£m per 100,000 own
population)
National Rank
Shropshire County PCT 160.3 7.1 8.4 139Dudley PCT 160.6 7.5 8.2 123
Herefordshire PCT 164.5 7.7 8.4 110Telford & Wrekin PCT 158.3 7.7 8.2 107
Warwickshire PCT 164.3 7.7 8.1 108Wolverhampton City PCT 162.8 7.7 8.6 112 Coventry Teaching PCT 162.8 7.8 8.5 104South Birmingham PCT 171.7 7.8 8.6 102
Heart of Birmingham Teaching PCT 181 7.9 7.8 100South Staffordshire PCT 158.7 7.9 8.1 99North Staffordshire PCT 160 8.3 8.2 77
Sandwell PCT 158.3 8.5 8.6 65Walsall Teaching PCT 163.2 8.7 8.5 61
Solihull Care Trust 197.6 8.9 8.4 53Birmingham East & North 162.8 9 8.6 48
Stoke on Trent Teaching PCT 161.7 9.3 9.2 44Worcester PCT 161.1 9.4 9.3 31
National Average of £8.4m, an SHA average of £8.2m
PCT Expenditure on RespiratoryDH 2009-10 Programme Budgeting Benchmark Workbook v1.0
PCT Total Expenditure (£m per 100,000 own population)
Spend on Respiratory (£m per 100,000 own population)
Cluster Sub Group Average (£m per 100,000 own
population)
National Rank
Shropshire County PCT 160.3 7.1 8.4 139Dudley PCT 160.6 7.5 8.2 123
Herefordshire PCT 164.5 7.7 8.4 110Telford & Wrekin PCT 158.3 7.7 8.2 107
Warwickshire PCT 164.3 7.7 8.1 108Wolverhampton City PCT 162.8 7.7 8.6 112 Coventry Teaching PCT 162.8 7.8 8.5 104South Birmingham PCT 171.7 7.8 8.6 102
Heart of Birmingham Teaching PCT 181 7.9 7.8 100South Staffordshire PCT 158.7 7.9 8.1 99North Staffordshire PCT 160 8.3 8.2 77
Sandwell PCT 158.3 8.5 8.6 65Walsall Teaching PCT 163.2 8.7 8.5 61
Solihull Care Trust 197.6 8.9 8.4 53Birmingham East & North 162.8 9 8.6 48
Stoke on Trent Teaching PCT 161.7 9.3 9.2 44Worcester PCT 161.1 9.4 9.3 31
Spend per 100,000 of own population on COPDDH 2009-10 Programme Budgeting Benchmark Workbook v1.0
PCT Total Expenditure (£m per 100,000 own population)
Spend on Respiratory (£m per 100,000 own population)
Spend on Airways Disease
Cluster average Spend on Airways
Disease
National Rank
Heart of Birmingham Teaching PCT 181 7.9 0.8 0.8 141Herefordshire PCT 164.5 7.7 1 1.3 127
Shropshire County PCT 160.3 7.1 1 1.3 133Warwickshire PCT 164.3 7.7 1 1.2 119
Wolverhampton City PCT 162.8 7.7 1 1.4 120Dudley PCT 160.6 7.5 1.1 1.4 115
South Staffordshire PCT 158.7 7.9 1.1 1.2 108Telford & Wrekin PCT 158.3 7.7 1.1 1.4 104
Worcester PCT 161.1 9.4 1.1 1.2 102Sandwell PCT 158.3 8.5 1.2 1.4 90
South Birmingham PCT 171.7 7.8 1.3 1.4 76 Coventry Teaching PCT 162.8 7.8 1.4 1.4 59North Staffordshire PCT 160 8.3 1.5 1.4 47
Solihull Care Trust 197.6 8.9 1.5 1.3 22Walsall Teaching PCT 163.2 8.7 1.5 1.4 42
Birmingham East & North 162.8 9 1.6 1.4 37Stoke on Trent Teaching PCT 161.7 9.3 1.8 1.7 22
Note Airways Disease does not include Asthma
Spend per 100,000 of own population on COPDDH 2009-10 Programme Budgeting Benchmark Workbook v1.0
PCT Total Expenditure (£m per 100,000 own population)
Spend on Respiratory (£m per 100,000 own population)
Spend on Airways Disease
Cluster average Spend on Airways
Disease
National Rank
Heart of Birmingham Teaching PCT 181 7.9 0.8 0.8 141Herefordshire PCT 164.5 7.7 1 1.3 127
Shropshire County PCT 160.3 7.1 1 1.3 133Warwickshire PCT 164.3 7.7 1 1.2 119
Wolverhampton City PCT 162.8 7.7 1 1.4 120Dudley PCT 160.6 7.5 1.1 1.4 115
South Staffordshire PCT 158.7 7.9 1.1 1.2 108Telford & Wrekin PCT 158.3 7.7 1.1 1.4 104
Worcester PCT 161.1 9.4 1.1 1.2 102Sandwell PCT 158.3 8.5 1.2 1.4 90
South Birmingham PCT 171.7 7.8 1.3 1.4 76 Coventry Teaching PCT 162.8 7.8 1.4 1.4 59North Staffordshire PCT 160 8.3 1.5 1.4 47
Solihull Care Trust 197.6 8.9 1.5 1.3 22Walsall Teaching PCT 163.2 8.7 1.5 1.4 42
Birmingham East & North 162.8 9 1.6 1.4 37Stoke on Trent Teaching PCT 161.7 9.3 1.8 1.7 22
Note Airways Disease does not include Asthma
West Midlands COPD Non-Elective Admissions
PCT 2007/08 2008/09 2009/10 2007/08 2008/09 2009/10 2007/08 2008/09 2009/10 2007/08 2008/09 2009/10National 2.1 2.3 2.2 146 155 140 - - - - - -
SHA 2.0 2.2 2.2 147 154 143 - - - - - -
Herefordshire PCT 1.5 1.5 1.4 117 109 98 1 1 1 23 16 22
Heart Of Birmingham Teaching PCT 1.6 1.6 1.5 229 237 215 4 2 2 31 23 27
Warwickshire PCT 1.6 1.6 1.6 133 126 119 5 3 3 35 30 36
Shropshire County PCT 1.7 1.8 1.7 110 118 108 6 5 4 45 44 42
Telford and Wrekin PCT 2.0 2.3 1.8 127 134 101 9 9 5 74 79 49
Worcestershire PCT 1.5 1.9 1.8 122 147 130 3 6 6 30 54 52
South Staffordshire PCT 1.5 1.7 1.8 109 121 127 2 4 7 24 36 55
North Staffordshire PCT 2.1 2.1 2.0 128 122 108 10 8 8 82 73 70
Solihull Care Trust 2.0 2.4 2.1 139 164 136 8 12 9 73 89 77
Dudley PCT 2.1 2.4 2.2 160 169 149 11 11 10 83 87 86
Wolverhampton City PCT 2.1 2.3 2.2 156 162 149 12 10 11 84 84 88
South Birmingham PCT 2.3 2.6 2.4 151 167 150 13 13 12 94 100 96
Coventry Teaching PCT 1.9 2.1 2.4 135 142 156 7 7 13 71 72 98
Sandwell PCT 2.8 3.0 2.7 170 176 157 14 14 14 119 117 115
Walsall Teaching PCT 3.0 3.0 2.7 194 181 153 17 16 15 129 119 116
Birmingham East and North PCT 2.9 3.1 3.0 212 226 210 15 17 16 122 123 124
Stoke On Trent PCT 3.0 3.0 3.3 163 162 166 16 15 17 125 118 133
National rankCOPD admissions per 1000 population Rank within SHACOPD admissions per 1000 registered pts
Deprivation & Admissions
Deprivation & Admissions
Deprivation & Admissions
West Midlands non-elective COPD hospitalisation costs
PCT 2007/08 2008/09 2009/10 2007/08 2008/09 2009/10 2007/08 2008/09 2009/10 2007/08 2008/09 2009/10National 4.2 4.6 5.1 297 314 329 - - - - - -
SHA 4.1 4.6 5.1 297 315 336 - - - - - -
Heart Of Birmingham Teaching PCT 3.4 3.3 3.5 495 500 491 6 2 1 43 23 25
Herefordshire PCT 3.1 3.1 3.5 241 227 238 3 1 2 27 15 26
Shropshire County PCT 3.3 3.4 3.8 212 220 239 5 3 3 36 27 31
Warwickshire PCT 3.3 3.6 4.1 272 271 297 4 6 4 35 39 41
Worcestershire PCT 2.8 3.5 4.2 219 268 301 1 5 5 13 38 45
Telford and Wrekin PCT 3.9 4.6 4.2 244 271 238 7 9 6 61 76 46
North Staffordshire PCT 4.4 4.0 4.4 263 231 239 11 7 7 87 58 55
South Staffordshire PCT 2.9 3.5 4.6 212 245 320 2 4 8 18 32 66
Solihull Care Trust 4.1 5.1 4.8 286 349 311 10 12 9 77 100 72
Dudley PCT 4.0 4.3 5.0 298 303 334 8 8 10 68 67 73
Wolverhampton City PCT 4.6 4.8 5.2 334 331 348 12 11 11 93 84 83
Coventry Teaching PCT 4.0 4.6 5.7 279 308 366 9 10 12 73 79 100
South Birmingham PCT 4.9 5.7 5.8 328 367 369 13 13 13 104 109 106
Sandwell PCT 5.5 5.7 6.2 332 332 358 15 14 14 116 111 110
Walsall Teaching PCT 6.5 6.8 6.8 426 407 381 17 16 15 133 131 119
Birmingham East and North PCT 6.2 6.9 7.0 452 501 493 16 17 16 129 132 124
Stoke On Trent PCT 5.5 6.0 7.2 304 320 362 14 15 17 115 116 127
COPD tariff per 1000 population COPD tariff per 1000 registered pts Rank within SHA National rank
West Midlands non-elective COPD hospitalisation length of stay
PCT 2007/08 2008/09 2009/10 2007/08 2008/09 2009/10 2007/08 2008/09 2009/10National 8.3 8.0 7.7 - - - - - -
SHA 8.4 8.2 7.9 - - - - - -
Solihull Care Trust 8.2 8.5 6.7 7 11 1 62 98 23
North Staffordshire PCT 8.7 7.2 6.8 10 4 2 101 34 27
Heart Of Birmingham Teaching PCT 8.7 7.8 7.2 11 9 3 102 62 46
Stoke On Trent PCT 7.4 7.1 7.3 5 3 4 30 29 51
Herefordshire PCT 8.4 7.7 7.4 8 7 5 73 58 55
Birmingham East and North PCT 9.5 9.1 7.6 14 13 6 130 130 65
Telford and Wrekin PCT 6.9 7.5 7.7 1 6 7 17 49 74
Dudley PCT 7.3 6.9 7.8 4 2 8 28 26 77
Sandwell PCT 7.2 6.6 7.9 3 1 9 23 21 91
Walsall Teaching PCT 8.6 9.7 8.1 9 17 10 87 142 97
Wolverhampton City PCT 9.3 8.3 8.1 13 10 11 123 93 100
Shropshire County PCT 9.7 9.4 8.2 17 16 12 139 138 102
South Staffordshire PCT 7.5 7.3 8.2 6 5 13 37 38 104
Worcestershire PCT 7.1 7.7 8.2 2 7 14 22 58 105
Coventry Teaching PCT 9.6 9.1 8.3 16 12 15 136 129 109
Warwickshire PCT 9.1 9.2 8.9 12 14 16 117 134 132
South Birmingham PCT 9.6 9.4 9.4 15 15 17 133 136 144
National rankCOPD Length of stay Rank within SHA
West Midlands non-elective COPD hospitalisation 28-day readmission rate
PCT 2007/08 2008/09 2009/10 2007/08 2008/09 2009/10 2007/08 2008/09 2009/10National 0.20 0.21 0.22 - - - - - -
SHA 0.19 0.21 0.22 - - - - - -
Herefordshire PCT 0.18 0.16 0.14 5 1 1 38 4 2
Solihull Care Trust 0.20 0.26 0.18 14 17 2 92 145 17
South Staffordshire PCT 0.18 0.18 0.19 6 5 3 39 18 21
North Staffordshire PCT 0.21 0.19 0.19 17 7 4 107 34 22
Heart Of Birmingham Teaching PCT 0.20 0.21 0.19 10 9 5 80 72 27
Telford and Wrekin PCT 0.20 0.22 0.20 9 11 6 76 80 42
Worcestershire PCT 0.15 0.22 0.20 3 12 7 17 87 47
Wolverhampton City PCT 0.14 0.18 0.21 1 6 8 5 27 54
Walsall Teaching PCT 0.20 0.22 0.21 11 14 9 81 100 55
Dudley PCT 0.15 0.16 0.22 4 2 10 18 7 66
Stoke On Trent PCT 0.20 0.21 0.22 12 10 11 84 78 83
Warwickshire PCT 0.19 0.20 0.23 8 8 12 73 54 86
Shropshire County PCT 0.15 0.16 0.23 2 3 13 12 8 88
Coventry Teaching PCT 0.20 0.17 0.24 13 4 14 91 14 104
Sandwell PCT 0.19 0.22 0.24 7 13 15 62 93 106
Birmingham East and North PCT 0.21 0.23 0.25 16 15 16 106 111 110
South Birmingham PCT 0.21 0.23 0.25 15 16 17 97 112 118
COPD readmissions per spell Rank within SHA National rank
PCT Cost Saving Potentials for COPD
PCT PopulationCOPD
RegisterCOPD
admissionsCOPD admissions
per 1000 populationCost per spell (£)
Admissions reduced if average
Savings if average admissions (£)
Savings if admissions -10% (£)
Savings if admissions -20% (£)
National 54,003,337 829,767 116,130 2.2 2,350 0 0 27,286,400 54,572,800SHA 5,707,214 86,020 12,299 2.2 2,350 26 61,292 2,890,700 5,781,400Herefordshire PCT 180,142 2,649 259 1.4 2,436 0 0 63,100 126,200Heart Of Birmingham Teaching PCT 313,934 2,218 476 1.5 2,288 0 0 108,900 217,800Warwickshire PCT 546,003 7,527 899 1.6 2,488 0 0 223,700 447,400Shropshire County PCT 295,342 4,688 504 1.7 2,222 0 0 112,000 224,000Telford and Wrekin PCT 169,429 2,996 304 1.8 2,342 0 0 71,200 142,400Worcestershire PCT 572,989 7,993 1,038 1.8 2,318 0 0 240,600 481,200South Staffordshire PCT 605,435 8,726 1,112 1.8 2,511 0 0 279,200 558,400North Staffordshire PCT 208,582 3,846 414 2.0 2,222 0 0 92,000 184,000Solihull Care Trust 220,953 3,400 463 2.1 2,281 0 0 105,600 211,200Dudley PCT 312,366 4,631 692 2.2 2,238 20 45,398 154,900 309,800Wolverhampton City PCT 256,543 3,848 575 2.2 2,329 23 54,315 133,900 267,800South Birmingham PCT 386,532 6,122 918 2.4 2,461 87 213,578 225,900 451,800Coventry Teaching PCT 349,333 5,420 846 2.4 2,346 95 222,401 198,500 397,000Sandwell PCT 322,378 5,612 883 2.7 2,277 190 432,151 201,100 402,200Walsall Teaching PCT 266,448 4,773 731 2.7 2,488 158 393,223 181,900 363,800Birmingham East and North PCT 424,787 6,059 1,270 3.0 2,350 357 837,982 298,500 597,000Stoke On Trent PCT 276,018 5,512 915 3.3 2,183 321 701,557 199,700 399,400
North Staffs: COPD Admissions Practice Level Data
Stoke: COPD Admissions Practice Level Data
South Staffs: COPD Admissions Practice Level Data
West Midlands non-elective Asthma hospitalisation data
PCT 2007/08 2008/09 2009/10 2007/08 2008/09 2009/10 2007/08 2008/09 2009/10 2007/08 2008/09 2009/10National 1.2 1.3 1.2 81 86 77 - - - - - -
SHA 1.3 1.5 1.4 93 103 96 - - - - - -
Shropshire County PCT 0.7 0.9 0.8 47 60 51 2 2 1 6 23 14
Herefordshire PCT 0.6 0.8 0.8 50 55 55 1 1 2 2 3 17
Warwickshire PCT 0.7 1.0 0.9 60 75 67 3 3 3 7 33 35
Worcestershire PCT 1.0 1.2 1.0 82 88 72 6 6 4 60 57 48
Dudley PCT 1.0 1.0 1.1 76 72 71 5 4 5 52 36 60
North Staffordshire PCT 1.2 1.2 1.1 74 68 59 10 8 6 91 65 67
South Staffordshire PCT 1.0 1.2 1.2 72 82 81 4 7 7 47 60 75
Walsall Teaching PCT 1.3 1.4 1.3 84 84 72 11 9 8 101 96 97
Telford and Wrekin PCT 1.1 1.2 1.3 68 68 76 7 5 9 67 56 101
Solihull Care Trust 1.2 1.5 1.5 86 104 94 9 10 10 88 114 108
Coventry Teaching PCT 1.2 1.6 1.5 81 105 99 8 11 11 78 119 121
South Birmingham PCT 1.6 1.7 1.6 104 110 102 12 13 12 126 127 131
Stoke On Trent PCT 1.9 1.8 1.6 104 99 82 16 14 13 146 137 132
Wolverhampton City PCT 1.6 1.7 1.7 119 117 113 13 12 14 130 126 136
Sandwell PCT 1.8 2.0 1.9 106 115 108 15 15 15 140 142 143
Birmingham East and North PCT 1.8 2.2 2.2 129 160 156 14 16 16 139 147 148
Heart Of Birmingham Teaching PCT 2.7 3.1 3.3 397 471 470 17 17 17 151 151 151
Asthma admissions per 1000 population Asthma admissions per 1000 registered pts Rank within SHA National rank
Deprivation & Asthma Admissions
Deprivation & Asthma Admissions
Deprivation & Asthma Admissions
West Midlands non-elective Asthma hospitalisation costs
PCT 2007/08 2008/09 2009/10 2007/08 2008/09 2009/10 2007/08 2008/09 2009/10 2007/08 2008/09 2009/10National 1.1 1.2 1.1 74 79 74 - - - - - -
SHA 1.2 1.4 1.4 86 94 92 - - - - - -
Herefordshire PCT 0.6 0.7 0.8 44 49 52 1 1 1 2 3 9
Shropshire County PCT 0.6 0.8 0.8 40 51 49 2 3 2 4 13 12
Worcestershire PCT 0.9 1.1 0.9 73 81 66 6 7 3 50 61 39
Warwickshire PCT 0.8 1.0 1.0 63 77 69 3 4 4 20 46 45
Dudley PCT 0.8 0.8 1.0 61 56 66 4 2 5 26 12 49
North Staffordshire PCT 1.2 1.1 1.0 71 63 57 10 8 6 100 65 63
South Staffordshire PCT 0.8 1.0 1.1 61 72 78 5 6 7 34 52 73
Telford and Wrekin PCT 1.0 1.0 1.2 61 60 70 7 5 8 63 49 93
Walsall Teaching PCT 1.4 1.4 1.3 93 84 74 11 10 9 125 114 104
Solihull Care Trust 1.1 1.3 1.4 75 86 90 9 9 10 79 91 114
South Birmingham PCT 1.7 1.7 1.5 111 112 96 15 14 11 144 137 122
Stoke On Trent PCT 1.6 1.7 1.5 89 90 77 13 13 12 141 134 127
Wolverhampton City PCT 1.5 1.5 1.6 109 101 107 12 11 13 133 116 132
Coventry Teaching PCT 1.0 1.6 1.6 72 103 105 8 12 14 73 127 137
Sandwell PCT 1.6 1.8 1.7 97 104 100 14 15 15 142 141 142
Birmingham East and North PCT 1.7 2.0 2.0 124 145 139 16 16 16 145 149 148
Heart Of Birmingham Teaching PCT 2.4 2.8 3.4 355 416 476 17 17 17 151 151 151
Asthma tariff per 1000 population Asthma tariff per 1000 registered pts Rank within SHA National rank
West Midlands non-elective Asthma hospitalisation length of stay
PCT 2007/08 2008/09 2009/10 2007/08 2008/09 2009/10 2007/08 2008/09 2009/10National 2.8 2.8 2.7 - - - - - -
SHA 2.8 2.7 2.6 - - - - - -
Solihull Care Trust 2.2 1.9 2.5 2 1 8 15 3 56
North Staffordshire PCT 2.9 2.8 2.6 12 12 10 88 80 58
Heart Of Birmingham Teaching PCT 2.5 2.2 2.6 7 3 11 39 12 62
Stoke On Trent PCT 2.2 2.8 2.3 3 13 5 18 86 30
Herefordshire PCT 2.0 2.7 2.5 1 9 7 9 69 50
Birmingham East and North PCT 3.2 2.6 2.1 14 6 1 115 52 15
Telford and Wrekin PCT 3.0 2.7 2.6 13 10 12 94 71 66
Dudley PCT 2.3 2.0 2.3 5 2 2 23 5 23
Sandwell PCT 2.6 2.7 2.3 8 8 2 56 67 23
Walsall Teaching PCT 4.1 3.7 2.9 17 17 15 147 143 105
Wolverhampton City PCT 2.8 2.5 2.5 11 5 6 77 47 44
Shropshire County PCT 2.4 2.7 2.8 6 7 14 35 65 94
South Staffordshire PCT 2.3 2.4 2.5 4 4 8 20 30 56
Worcestershire PCT 2.6 2.7 2.3 8 11 4 56 74 29
Coventry Teaching PCT 2.7 3.6 3.6 10 16 16 69 139 142
Warwickshire PCT 3.9 3.2 3.6 16 14 17 141 125 144
South Birmingham PCT 3.7 3.3 2.6 15 15 12 138 130 66
Asthma Length of stay Rank within SHA National rank
West Midlands non-elective Asthma hospitalisation 28-day readmission rate
PCT 2007/08 2008/09 2009/10 2007/08 2008/09 2009/10 2007/08 2008/09 2009/10National 0.10 0.11 0.11 - - - - - -
SHA 0.11 0.11 0.12 - - - - - -
Dudley PCT 0.10 0.07 0.09 9 2 1 81 12 33
South Birmingham PCT 0.09 0.13 0.10 5 14 2 55 123 46
Shropshire County PCT 0.11 0.09 0.10 13 4 3 105 35 58
North Staffordshire PCT 0.09 0.12 0.11 3 13 4 46 114 74
Coventry Teaching PCT 0.08 0.10 0.11 2 8 5 27 62 78
Heart Of Birmingham Teaching PCT 0.11 0.10 0.11 11 7 6 85 59 81
South Staffordshire PCT 0.11 0.10 0.11 15 9 7 113 71 93
Sandwell PCT 0.13 0.09 0.12 16 6 8 138 39 97
Walsall Teaching PCT 0.07 0.09 0.12 1 4 9 12 35 99
Birmingham East and North PCT 0.10 0.12 0.12 7 12 10 66 111 110
Warwickshire PCT 0.11 0.11 0.13 14 10 11 106 81 117
Stoke On Trent PCT 0.11 0.13 0.13 12 16 12 89 140 119
Telford and Wrekin PCT 0.09 0.08 0.13 4 3 13 54 20 122
Wolverhampton City PCT 0.10 0.11 0.14 8 11 14 75 82 130
Herefordshire PCT 0.10 0.07 0.14 10 1 15 82 8 131
Solihull Care Trust 0.10 0.13 0.14 6 15 16 63 127 133
Worcestershire PCT 0.17 0.17 0.18 17 17 17 149 149 149
Asthma readmissions per spell Rank within SHA National rank
PCT Cost saving Potential for AsthmaPCT Population
Asthma Register
Asthma admissions
Asthma admissions per 1000 population
Cost per spell (£)
Admissions reduced if average
Savings if average admissions (£)
Savings if admissions -10% (£)
Savings if admissions -20% (£)
National 54,003,337 3,180,080 63,590 1.2 967 0 0 6,149,600 12,299,200SHA 5,707,214 348,023 8,268 1.4 959 0 0 793,200 1,586,400Shropshire County PCT 295,342 19,203 239 0.8 958 0 0 22,900 45,800Herefordshire PCT 180,142 11,634 147 0.8 932 0 0 13,700 27,400Warwickshire PCT 546,003 34,752 506 0.9 1,030 0 0 52,100 104,200Worcestershire PCT 572,989 34,768 575 1.0 915 0 0 52,600 105,200Dudley PCT 312,366 18,417 330 1.1 924 0 0 30,500 61,000North Staffordshire PCT 208,582 13,647 227 1.1 960 0 0 21,800 43,600South Staffordshire PCT 605,435 34,509 708 1.2 958 0 0 67,800 135,600Walsall Teaching PCT 266,448 16,027 346 1.3 1,014 32 32,718 35,100 70,200Telford and Wrekin PCT 169,429 10,557 227 1.3 930 27 25,556 21,100 42,200Solihull Care Trust 220,953 13,206 321 1.5 956 61 58,171 30,700 61,400Coventry Teaching PCT 349,333 20,658 539 1.5 1,059 128 135,232 57,100 114,200South Birmingham PCT 386,532 24,110 627 1.6 933 172 160,339 58,500 117,000Stoke On Trent PCT 276,018 17,741 450 1.6 942 125 117,762 42,400 84,800Wolverhampton City PCT 256,543 14,973 436 1.7 940 134 125,930 41,000 82,000Sandwell PCT 322,378 20,397 604 1.9 929 224 208,418 56,100 112,200Birmingham East and North PCT 424,787 25,479 944 2.2 892 444 395,851 84,200 168,400Heart Of Birmingham Teaching PCT 313,934 17,945 1,042 3.3 1,013 672 681,370 105,600 211,200
North Staffs: Asthma Admissions Practice Level Data
Stoke: Asthma Admissions Practice Level Data
South Staffs: Practice Level Asthma Admissions
