Consultant treatment outcomes now published online – NHS England

Posted on July 25, 2013. Filed under: Clin Governance / Risk Mgmt / Quality, Surgery | Tags: , |

Consultant treatment outcomes now published online – NHS England

“NHS England is committed to making more information available about how services and professionals are performing. The aim is to drive up the quality of care in the NHS and help people choose the treatment that suits them best.

This initiative is a central part of NHS England’s ambition to ensure every patient gets high quality care, and to build improved services for the future.

On NHS Choices you’ll find links to information about individual consultants in a number of clinical areas. You can look at their results for a range of operations and treatments to help you make decisions about your care.

Prof Sir Bruce Keogh, National Medical Director of NHS England, said: ‘This is a major breakthrough in NHS transparency.

‘We know from our experience with heart surgery that putting this information into the public domain can help drive up standards. That means more patients surviving operations and there is no greater prize than that.’

The reporting of the data was led by Prof Ben Bridgewater from the Healthcare Quality Improvement Partnership (HQIP). Prof Bridgewater is a practising heart surgeon who leads the successful cardiac consultant-level reporting which paved the way for this work.”

… continues on the site

Everyone counts: Publication of Consultant clinical outcomes: Frequently Asked Questions

Your choices: consultant choice – the data

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SPend and Outcome Factsheets and Tool (SPOT) – Public Health England

Posted on May 21, 2013. Filed under: Health Economics, Public Hlth & Hlth Promotion | Tags: , , |

SPend and Outcome Factsheets and Tool (SPOT) – Public Health England

“About SPOT

NHS England has commissioned Public Health England to develop a tool which helps commissioners to link health outcomes and expenditure. The development of this tool and a Spend and Outcome Factsheet for every PCT and CCG in England has been led by PHE Knowledge and intelligence team (Northern and Yorkshire)’s Health Economics work programme.

Programme budgeting is a well-established technique for assessing investment in programmes of care rather than services. All PCTs in England have submitted an annual programme budgeting return since 2003/4. The tool and factsheets use this Programme Budgeting data and overall indicators of health outcome by programme (where available) to present PCTs and CCGs with an analysis of the impact of their expenditure. This allows easy identification of those areas which require priority attention, where relative potential shifts in investment opportunities will optimise local health gains and increase quality.

Commissioners can use the tool and the factsheets to gain an overview of outcome and expenditure across all programmes.”

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Public Health Outcomes Framework 2013 to 2016 and technical updates – Department of Health [England] – 1 May 2013

Posted on May 7, 2013. Filed under: Public Hlth & Hlth Promotion | Tags: , , , , |

Public Health Outcomes Framework 2013 to 2016 and technical updates – Department of Health [England] – 1 May 2013

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Health Outcomes of Care: An Idea Whose Time Has Come – Canadian Institute for Health Information (CIHI) and Statistics Canada – 16 August 2012

Posted on August 17, 2012. Filed under: Health Status, Patient Participation | Tags: , , |

Health Outcomes of Care: An Idea Whose Time Has Come – Canadian Institute for Health Information (CIHI) and Statistics Canada – 16 August 2012

“Learning about gains in Canadians’ health status—especially from patients themselves—would provide a more comprehensive picture of population health and health care services, according to a report by the Canadian Institute for Health Information (CIHI) and Statistics Canada.

There is currently little clear connection between processes of care and outcomes—important information in determining the value obtained from health care investments. Although there are no standard, comprehensive, repeated measures of health status at the population level in Canada that could be used to assess outcomes of care, the country has seen progress:

In home and continuing care, the Resident Assessment Instrument (RAI) system allows care providers to gauge individuals’ progress.
In rehabilitation, the FIM® instrument helps care providers assess patients’ physical and cognitive status.

Both of these tools feed into CIHI databases, allowing our reports to inform decisions at multiple levels in the health care system.

By providing the patient’s perspective and adding information on quality of life, patient-reported outcome measures (PROMs) would provide further insight to help assess how the health care system is:

… continues on the site

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Preliminary Draft Methodology Report: Our Questions, Our Decisions: Standards for Patient-centered Outcomes Research – Patient-Centered Outcomes Research Institute – published for public comment 23 July 2012

Posted on July 24, 2012. Filed under: Patient Participation, Research | Tags: , , |

Preliminary Draft Methodology Report: Our Questions, Our Decisions: Standards for Patient-centered Outcomes Research – Patient-Centered Outcomes Research Institute – published for public comment 23 July 2012

Extract from the executive summary:

“In this first report, the Methodology Committee puts forward 60 standards to guide patient-centered outcomes research (Appendix A). The initial range of topics was chosen to reflect areas in which the Committee believed that there were either substantial deficiencies or inconsistencies in how the methods were applied in practice, or for which there was specialized knowledge in how best to conduct research that had not been effectively disseminated.(1-3)”

… continues on the site

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Setting levels of ambition for the NHS Outcomes Framework – 4 July 2012

Posted on July 5, 2012. Filed under: Health Mgmt Policy Planning | Tags: , |

Setting levels of ambition for the NHS Outcomes Framework – 4 July 2012

“NHS Outcomes Framework: a technical annex setting levels of ambition published

Developing our NHS care objectives: a consultation on the draft mandate to the NHS Commissioning Board’ explains that the Secretart of State will hold the NHS Commissioning Board to account for delivering improvements in health outcomes.

This technical annex provides more information on the NHS Outcomes Framework and the preparatory work underway for setting these outcome objectives (‘levels of ambition’). The levels of ambition themselves will be included in the final mandate.

The purpose of this technical annex is to support the consultation on the draft mandate. It explains the proposed methodology for deriving levels of ambition and use examples to illustrate the planned approach. The technical annex is aimed at those who are interested in the measurement of health outcomes.”

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Advanced outcomes – A discussion paper on how best to measure and capture outcomes for people with advanced cancer – Rare Cancers Foundation – 22 June 2012

Posted on July 3, 2012. Filed under: Oncology, Patient Participation | Tags: |

Advanced outcomes – A discussion paper on how best to measure and capture outcomes for people with advanced cancer – Rare Cancers Foundation – 22 June 2012

“The discussion paper has used an assessment of the NHS Outcomes Framework indicators and feedback from the RCF’s Patients’ Army to work out what matters to patients with advanced cancer and whether outcomes for this group of patients are represented within the health reforms. It also looks at the potential of current and future data sources to provide a mechanism for measuring outcomes in advanced cancer and proposes a series of measures that will improve the quality of information available on outcomes for advanced cancer.Importantly, it also suggests how improvements in these outcomes might be incentivised.”

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Better Care: An Analysis of Nursing and Healthcare System Outcomes – Canadian Health Services Research Foundation – 18 June 2012

Posted on June 27, 2012. Filed under: Chronic Disease Mgmt, Health Mgmt Policy Planning, Multidisciplinary Care | Tags: , , |

Better Care: An Analysis of Nursing and Healthcare System Outcomes – Canadian Health Services Research Foundation – 18 June 2012

Gina Browne, et al

“Key messages

Problems arise when circumstances in the world change and conventional wisdom does not.

The present federally funded Canadian healthcare system has been driven principally by insured physicians and hospitals providing acute and episodic care that is a poor match to the changing  demographics of persons with chronic disease living longer. The current health system consumes nearly one-half of provincial budgets.

There are solutions.

Recent analysis of 2005 expenditures by member countries of the Organisation for Economic Co-operation and Development on health and social services has empirically demonstrated that, after adjusting for overall gross domestic product per capita, it is the ratio of social service expenditures to health service expenditures that is better associated with improved outcomes in key health indicators and not the amount spent on health services.

Models of proactive, targeted nurse led care that focus on preventive patient self-management for people with chronic disease are either more effective and equally or less costly, or are equally effective and less costly than the usual model of care.

Additional key components of more effective and efficient healthcare models involve community based, nurse led models of care with an interdisciplinary team that includes the primary care physician. Such complex intervention requires specially trained or advanced practice nurses who supplement the care provided by physicians and other healthcare professionals. The proactive, comprehensive, coordinated model of community care is patient and family centered, targeted at community-dwelling individuals with complex chronic conditions and social circumstances.

Telemonitoring offers added effectiveness and efficiencies to healthcare, especially for remote populations.

The monitoring, evaluation and performance measurement system for the provision of healthcare should build on and link to pan-Canadian efforts already under way, such as the Longitudinal Health and Administrative Data Initiative.

Nurse-led models of care can be financed by costs averted from hospitals and emergency departments to home or community care. For example, after managing the current hospital caseload of patients awaiting alternative levels of care, the number of hospital beds could be reduced to free up funds for this reallocation of funding.

In Ontario alone, representing 37% of the Canadian population, independent reports estimate that millions of dollars could be saved in direct healthcare costs within one year by:

having nurses provide leading practices in home wound care
integrating nurse-led models of care to reduce high hospital readmissions by 10% for those with chronic conditions
providing 25% of palliative care in the home as opposed to in acute hospital settings
providing community care for patients in hospital designated as needing an alternative
providing proactive community care and patient self-management for those with congestive heart failure and other chronic conditions

Getting from problems to solutions is possible.”

… continues on the site

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Estimating the NIH Efficient Frontier – PLoS ONE 7(5): e34569 – 2 May 2012

Posted on May 15, 2012. Filed under: Health Economics, Public Hlth & Hlth Promotion, Research | Tags: , |

Estimating the NIH Efficient Frontier – PLoS ONE 7(5): e34569 – 2 May 2012

Bisias D, Lo AW, Watkins JF (2012) Estimating the NIH Efficient Frontier. PLoS ONE 7(5): e34569. doi:10.1371/journal.pone.0034569

“Abstract

Background
The National Institutes of Health (NIH) is among the world’s largest investors in biomedical research, with a mandate to: “…lengthen life, and reduce the burdens of illness and disability.” Its funding decisions have been criticized as insufficiently focused on disease burden. We hypothesize that modern portfolio theory can create a closer link between basic research and outcome, and offer insight into basic-science related improvements in public health. We propose portfolio theory as a systematic framework for making biomedical funding allocation decisions–one that is directly tied to the risk/reward trade-off of burden-of-disease outcomes.

Methods and Findings
Using data from 1965 to 2007, we provide estimates of the NIH “efficient frontier”, the set of funding allocations across 7 groups of disease-oriented NIH institutes that yield the greatest expected return on investment for a given level of risk, where return on investment is measured by subsequent impact on U.S. years of life lost (YLL). The results suggest that NIH may be actively managing its research risk, given that the volatility of its current allocation is 17% less than that of an equal-allocation portfolio with similar expected returns. The estimated efficient frontier suggests that further improvements in expected return (89% to 119% vs. current) or reduction in risk (22% to 35% vs. current) are available holding risk or expected return, respectively, constant, and that 28% to 89% greater decrease in average years-of-life-lost per unit risk may be achievable. However, these results also reflect the imprecision of YLL as a measure of disease burden, the noisy statistical link between basic research and YLL, and other known limitations of portfolio theory itself.

Conclusions
Our analysis is intended to serve as a proof-of-concept and starting point for applying quantitative methods to allocating biomedical research funding that are objective, systematic, transparent, repeatable, and expressly designed to reduce the burden of disease. By approaching funding decisions in a more analytical fashion, it may be possible to improve their ultimate outcomes while reducing unintended consequences.”

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An Outcomes Strategy for COPD and Asthma: NHS Companion Document – 11 May 2012

Posted on May 14, 2012. Filed under: Chronic Disease Mgmt, Respiratory Medicine | Tags: , , |

An Outcomes Strategy for COPD and Asthma: NHS Companion Document – 11 May 2012

Action plan for respiratory disease treatment published

“A new action plan for treatment of respiratory problems is set out in guidance published today for the NHS.

Some 45 best practice actions are outlined for the treatment of Chronic Obstructive Pulmonary Disease (COPD) and asthma. The two can be confused due to similar symptoms and understanding the similarities and differences will help doctors provide better treatment. A key part of the new strategy is reducing the variation in COPD diagnosis and care around the country.

COPD kills around 23,000 people per year, and if the new guidelines are followed across the NHS then an estimated 7,800 lives could be saved annually. The NHS currently spends £1bn a year on COPD. It costs nearly ten times more to treat severe COPD than the mild disease, so improved diagnosis rates could deliver significant cost savings too.”

… continues

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NHS Information Centre – Indicator Portal

Posted on March 28, 2012. Filed under: Clin Governance / Risk Mgmt / Quality | Tags: , , , |

NHS Information Centre – Indicator Portal

“This website gathers together a number of health and social care indicators. Currently these include:

Compendium of Population Health Indicators
A wide-ranging collection of over 1,000 indicators designed to provide a comprehensive overview of population health at a national, regional and local level. These indicators were previously available on the Clinical and Health Outcomes Knowledge Base website (also known as NCHOD).

GP Practice data
This is a collection of practice level data and is designed to improve healthcare and support patients in making better, informed choices about the practice they choose to register with.

Local Basket of Inequalities Indicators (LBOI)
This collection of 60 indicators helps organisations to measure health and other factors which influence health inequalities such as unemployment, poverty, crime and education. These indicators were previously available on the London Health Observatory website.

NHS Outcomes Framework
The NHS Outcomes Framework indicators will be used by the Secretary of State to hold the NHS Commissioning Board to account.

Summary Hospital-level Mortality Indicator (SHMI)
SHMI is the new hospital-level indicator which uses standard and transparent methodology for reporting mortality at hospital trust level across the NHS in England.”

Media release – New information to help improve patient outcomes 

“New information that will help put the NHS on the side of patients and improve results for patients has been published today.

As part of the Government’s drive to improve results for patients, new detailed information on 20 of the 30 NHS Outcomes Framework indicators, which measure the care patients receive, has been published by the NHS Information Centre.”

… continues

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NHS Outcomes Framework indicators – Autumn 2011 release, England – 16 December 2011

Posted on December 20, 2011. Filed under: Clin Governance / Risk Mgmt / Quality, Health Mgmt Policy Planning | Tags: , , |

NHS Outcomes Framework indicators – Autumn 2011 release, England – 16 December 2011

“Summary

The NHS Outcomes Framework indicators form part of the NHS Outcomes Framework, which will:

1.provide national level accountability for the outcomes the NHS delivers
2.drive transparency, quality improvement and outcome measurement throughout the NHS.”

 

 

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NHS Outcomes Framework 2012-13 – 9 December 2011

Posted on December 8, 2011. Filed under: Clin Governance / Risk Mgmt / Quality | Tags: , |

NHS Outcomes Framework 2012-13 – 9 December 2011

“The attached document sets out the changes that have been made to the indicators in the NHS Outcomes Framework and is designed to help NHS organisations to start to think through what to focus on outcomes means in practical terms.”

Media response
Lansley issues 60 non-targets for NHS
Andrew Lansley’s brilliantly backward steps
 
Andrew Lansley launches 60 NHS ‘patient outcome measures’

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Truly inefficient or providing better quality of care? Analysing the relationship between risk adjusted hospital costs and patients’ health outcomes – Centre for Health Economics, University of York – 14 October 2011

Posted on October 18, 2011. Filed under: Clin Governance / Risk Mgmt / Quality, Health Economics | Tags: , |

Truly inefficient or providing better quality of care? Analysing the relationship between risk adjusted hospital costs and patients’ health outcomes – Centre for Health Economics, University of York – 14 October 2011
CHE Research Paper 68

Extract from the introduction

“Any health system that aims to make the best use of its scarce resources will be concerned about variations in costs between different providers of the same health care. If providers can reduce costs to the level of best practice, resources might be released to provide benefits elsewhere. But in analysing variations in provision, it is important to ensure that an assessment of best practice includes not just costs but also patient outcomes. High costs are not always simply due to inefficiency and may be associated with better outcomes. Low costs may sometimes be a symptom of low quality care leading to poor outcomes.

Comparative cost analysis in a multiple regression framework can help to address the question of ‘which variation in cost is justifiable’ (Keeler, 1990). By benchmarking providers against each other on the basis of their observed costs, a regulator can gain insights into the cost structure and identify the resource implications of heterogeneity (Shleifer, 1985). Over the past three decades, several hundred studies have conducted comparative analyses of hospital costs (Hollingsworth, 2008). While these have contributed to a better understanding of provider heterogeneity with respect to patient case-mix and production constraints, they have not convincingly addressed the issue of variations in quality and, particularly, health outcome as a potential explanation for observed costs (Newhouse, 1994, Jacobs et al., 2006). As a consequence, high quality hospitals may be incorrectly deemed inefficient and vice versa.

Since April 2009, all providers of publicly-funded care in the English National Health Service (NHS) are required to collect patient-reported outcome measures (PROMs) for four elective procedures: unilateral hip and knee replacements, varicose vein surgery, and groin hernia repairs (Department of Health, 2008a). Standardised questionnaires, including both generic (the EQ-5D) and conditionspecific instruments, are collected from all eligible inpatients before and 3 or 6 months after surgery.

Building on this initiative, this paper has two aims. First, we wish to explore to what extent variation in health outcomes are associated with observed cost variation in the provision of care that remains after controlling for case-mix and production constraints. Second, we investigate whether the new information on health outcomes changes our judgement of provider cost performance. We perform sensitivity analysis to assess the degree to which our findings depend on the choice of PROM instrument.”

… continues

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Increasing the Utilization of Health Outcomes for Better Information and Care – Nursing Health Services Research Unit – 2011

Posted on June 28, 2011. Filed under: Clin Governance / Risk Mgmt / Quality, Knowledge Translation, Nursing | Tags: , |

Increasing the Utilization of Health Outcomes for Better Information and Care – Nursing Health Services Research Unit – 2011

Extract from the Executive Summary:

“This report presents evidence in published literature about successful outcomes/performance monitoring implementation strategies, as well as recommendations from healthcare managers to provide a process evaluation of the Ministry of Health and Long Term Care (MOHLTC) Health Outcomes for Better Information and Care (HOBIC) implemented between 2006 and 2010.The findings demonstrate implementation and sustainability strategies for healthcare initiatives that have been evaluated and published in academic literature, and interview feedback from healthcare managers in acute and long-term care settings in which HOBIC was implemented. The research design for this project included two key components: a literature review on successful outcomes/performance monitoring implementation strategies and interviews with HOBIC leadership in MOHLTC identified sites to discuss specific implementation and utilization strategies and recommendations for HOBIC going forward. Rogers’ Model of the Innovation-Decision Process (2003) was used as a theoretical model to link the implementation processes, specifically the five sequential stages of the process of innovation decision-making: knowledge, persuasion, decision, implementation, and confirmation. This theoretical model describes how, why, and at what rate new ideas and technology spread through culture, and therefore has particular relevance to HOBIC utilization and uptake. A review of published literature focused on the terms: practice change, practice implementation, practice improvement, implementation strategy, successful implementation, nursing practice change, nursing intervention implementation and nursing implementation adoption. This revealed an initial 2,338 abstracts which were scanned, and 29 studies that were selected (Appendix A) and analysed for key themes, strategies, and sustainability efforts that proved successful. Expert consultation was sought through semi-structured phone interviews with HOBIC leaders from 12 acute care sites and four long-term care sites. Qualitative analysis of interview content focused on motivators and strategies for implementation, utilization and sustainability practices, and recommendations for practice-change going forward.”

… continues on the site

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Manual for Cancer Services – UK – updates 7 April 2011

Posted on April 14, 2011. Filed under: Oncology | Tags: , , , |

Manual for Cancer Services: acute oncology – including metatastic spinal cord compression measures – UK – 7 April 2011

Author: Department of Health
Following a three month consultation period, this is the final version of the acute oncology measures for inclusion in the Manual of Cancer Services 2008.

AND

Manual for Cancer Services: Network Service User Partnership Group Measures – UK – 7 April 2011

Author: Department of Health
Following a three month consultation period, this is the final version of the Network Service User Partnership Group Measures for inclusion in the Manual of Cancer Services 2008.

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A novel performance monitoring framework for health research systems: experiences of the National Institute for Health Research in England – 24 March

Posted on April 5, 2011. Filed under: Research | Tags: , |

A novel performance monitoring framework for health research systems: experiences of the National Institute for Health Research in England
Anas El Turabi , Michael Hallsworth , Tom Ling  and Jonathan Grant
Health Research Policy and Systems 2011, 9:13doi:10.1186/1478-4505-9-13
Published: 24 March 2011

“Abstract (provisional)

Background
The National Institute for Health Research (NIHR) was established in 2006 with the aim of creating an applied health research system embedded within the English National Health Service (NHS). NIHR sought to implement an approach for monitoring its performance that effectively linked early indicators of performance with longer-term research impacts. We attempted to develop and apply a conceptual framework for defining appropriate key performance indicators for NIHR.

Method
Following a review of relevant literature, a conceptual framework for defining performance indicators for NIHR was developed, based on a hybridisation of the logic model and balanced scorecard approaches. This framework was validated through interviews with key NIHR stakeholders and a pilot in one division of NIHR, before being refined and applied more widely. Indicators were then selected and aggregated to create a basket of indicators aligned to NIHR’s strategic goals, which could be reported to NIHR’s leadership team on a quarterly basis via an oversight dashboard.

Results
Senior health research system managers and practitioners endorsed the conceptual framework developed and reported satisfaction with the breadth and balance of indicators selected for reporting.

Conclusions
The use of the hybrid conceptual framework provides a pragmatic approach to defining performance indicators that are aligned to the strategic aims of a health research system. The particular strength of this framework is its capacity to provide an empirical link, over time, between upstream activities of a health research system and its long-term strategic objectives.”

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Clinical and service integration: The route to improved outcomes – The King’s Fund – 22 November 2010

Posted on January 19, 2011. Filed under: Health Systems Improvement | Tags: , |

Clinical and service integration: The route to improved outcomes – The King’s Fund – 22 November 2010
56 pages ISBN: 978 1 85717 605 6

“Over the past decade a number of health policies have sought to put the patient first and to improve health outcomes. Choice and competition have been key elements of these policies, but the importance of integrated care was highlighted by Lord Darzi in the final report of the NHS Next Stage Review.

Does integration of care act as a barrier to choice and competition? This question has long been debated and highlights the complexities and nuances of the issue. The debate should be informed by evidence on the performance of integrated systems – and by greater clarity on the terminology used.”

…continues on the site

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Improving outcomes: a strategy for cancer – UK Department of Health – 12 January 2011

Posted on January 18, 2011. Filed under: Oncology | Tags: |

Improving outcomes: a strategy for cancer – UK Department of Health – 12 January 2011

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NHS outcomes framework – 20 December 2010

Posted on January 14, 2011. Filed under: Health Economics, Health Mgmt Policy Planning | Tags: , |

NHS outcomes framework – 20 December 2010

Pages: 56

“The first NHS outcomes framework sets out the outcomes and corresponding indicators that will be used to hold the NHS Commissioning Board to account for the outcomes it delivers through commissioning health services from 2012/13. The framework sets direction of travel in the journey towards improving outcomes, and offers an opportunity for the NHS to begin to understand what an NHS focussed on outcomes means for individuals, organisations and health economies.”

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Transparency in outcomes – a framework for the NHS – Consultation opens – 19 July 2010

Posted on July 21, 2010. Filed under: Clin Governance / Risk Mgmt / Quality | Tags: , |

Transparency in outcomes – a framework for the NHS – Consultation opens – 19 July 2010

 Closing date: 11 October 2010
 Creator/s: UK Department of Health
 
“The Government’s White Paper, Equality and excellence: liberating the NHS, set out how the Secretary of State for Health will hold the NHS Commissioning Board to account for delivering better health outcomes through a national NHS Outcomes Framework.  We are now launching a full consultation and engagement process on how we should develop the NHS Outcomes Framework.

The purpose of this consultation is to seek the help of those working in the NHS, patients and the public in developing this NHS Outcomes Framework

The consultation document explains and asks for views on:

the principles that should underpin the NHS Outcomes Framework; a proposed structure and approach that could be used to develop the framework; the potential outcome indicators  (existing and future) that could be presented in the framework, including the proposed rationales for selection; how the proposed NHS Outcomes Framework can support equality across all groups and can help reduce health inequalities; and how the framework can support the necessary partnership working between public health and social care services needed to deliver the best possible outcomes for patientsThe consultation closes on 11 October 2010.”

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Getting the most out of PROMs: Putting health outcomes at the heart of NHS decision-making – The King’s Fund – 11 March 2010

Posted on March 17, 2010. Filed under: Clin Governance / Risk Mgmt / Quality | Tags: , |

Getting the most out of PROMs: Putting health outcomes at the heart of NHS decision-making – The King’s Fund – 11 March 2010
Authors: Nancy J Devlin, John Appleby ISBN: 978 1 85717 591 2  No. of pages: 92

Getting the most out of PROMs (pdf 3720kb)

patient-reported outcome measures (PROMs)

“Summary

More than 100 years ago Florence Nightingale suggested a health-related outcome measure for her patients: relieved, unrelieved and dead. Despite the developments in medical technology since then, attempts to measure the positive outcomes of health care have been slow in coming. An important step forward was made in 2009 when the English NHS began collecting patient-reported outcome measures (PROMs) for four elective procedures. Using a series of structured questions that ask patients about their health from their point of view, PROMs are intended to enable the patient perspective to inform decision-making at all levels of the NHS.

Evaluating the outputs of health care services is not straightforward as services must be looked at in terms of their effects and not simply ‘added up’ to measure what is produced. Traditional clinical ways of measuring health and the effects of treatment are increasingly accompanied by PROMs. Although it is argued PROMs should supplement, rather than replace, existing measures of quality and performance, they are likely to become a key part of the way health care is funded, provided and managed.

The aim of this report is to provoke and encourage thinking about the wide range of ways in which PROMs data can be used to inform decisions. It draws on Bupa’s example to discuss how providers can use PROMs data to improve clinical performance. It also offers practical advice for commissioners in using PROMs data to assess value for money and decide how to purchase health care systems.”

…continues

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The link between healthcare spending and health outcomes for the new English primary care trusts, London, The Health Foundation, 2009

Posted on July 6, 2009. Filed under: Clin Governance / Risk Mgmt / Quality, Health Economics, Primary Hlth Care | Tags: , |

The link between healthcare spending and health outcomes for the new English primary care trusts by Stephen Martin, Nigel Rice and Peter C. Smith, University of York.  London, The Health Foundation, 2009   ISBN 978-1-906461-09-6 64 p.

“This study was produced as part of the Quest for Quality and Improved Performance (QQUIP), an initiative of The Health Foundation.”

“Abstract

English programme budgeting data have yielded major new insights into the link between healthcare spending and health outcomes. This paper updates two recent studies that used programme budgeting data for 295 primary care trusts (PCTs) in England to examine the link between spending and outcomes for several programmes of care (Martin, Rice and Smith 2008a; 2008b). We use the same  economic model employed in the two previous studies.

The paper focuses on the dilemmas facing decision-makers who must allocate a fixed budget across programmes of care so as to maximise social welfare, given a health production function for each programme. We estimate two equations – a health outcome equation and an expenditure equation – for each programme (data permitting). The two previous studies employed expenditure data for 2004/05 and 2005/06 for 295 PCTs and found that in several care programmes – cancer, circulation problems, respiratory problems, gastro-intestinal problems, trauma burns and injury, and diabetes – expenditure had the anticipated negative effect on the mortality rate.

Each health outcome equation was used to estimate the marginal cost of a life year saved. In 2006/07 the number of PCTs in England was reduced – largely through a series of mergers – to 152. In addition, several changes were made to the methods employed to construct the programme budgeting data. This paper employs updated budgeting and mortality data for the new 152 PCTs to re-estimate health production and expenditure functions, and also presents updated estimates of the marginal cost of a life year saved in each programme. Although there are some differences the results we obtained are broadly similar to those presented in our two previous studies.”

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