CCG Outcomes Indicators - March 2013 release
Clinical Commissioning Group (CCG) indicators form part of the CCG Outcomes Indicator Set. The indicators aim to provide clear, comparative information for CCGs and Health and Wellbeing boards about the quality of health services commissioned by CCGs and, as far as possible, the associated health outcomes. They therefore help CCGs and Health and Wellbeing boards to understand where they may need to focus their efforts to improve services and outcomes.
The indicator set comprises 16 indicators and draws on a variety of data sources to provide users with the ability to compare at CCG level, including:
· Mortality (Primary Care Mortality Database)
· Hospital Episodes Statistics
· GP Patient Survey
· GP registered population, extracted directly from GP systems
This release sees one indicator published as part of the CCG indicator set for the first time:
· 1.7 - Under 75 mortality rate from liver disease
It also includes two indicators that are being published with a revised calculation methodology:
· 2.6 - Unplanned hospitalisation for chronic ambulatory care sensitive conditions
· 3.1 - Emergency admissions for acute conditions that should not usually require hospital admission
Each of the remaining indicators has been updated to reflect the latest available CCG structures. For this release values for each indicator are presented across 211 CCGs.
The indicators here relate to four of the five quality domains as presented in the NHS Outcomes Framework, which are, preventing people from dying prematurely; enhancing the quality of life for people with long-term conditions; helping people to recover from episodes of ill health or following injury and ensuring that people have a positive experience of care.
A description of the indicators relevant to the domains, with an indication of key findings where these are of particular note, are the following:
· Potential Years of Life Lost due to amenable causes are given for each CCG. Conditions considered amenable to healthcare should not result in premature deaths where timely and effective healthcare is available. The concept of ‘amenable’ mortality generally relates to deaths under the age of 75 and figures are reported for males and females separately.
· Mortality rates in the under 75s from cancer, respiratory disease, cardiovascular disease and liver disease form part of the set of indicators aimed at reducing premature mortality from the major causes of death. Some variation can be observed, for example in 2011 the lowest rate of mortality due to cardiovascular disease was 31 per 100,000 while the highest rate was 127.
· Five indicators are intended to measure the effective management of a range of conditions within primary care settings.
Two indicators focus upon emergency admissions for people of all ages due to:
o Chronic ambulatory care sensitive conditions
o Acute conditions that should not usually require hospitalisation
Two similar indicators are included for children and young people under the age of 19:
o Emergency admissions for asthma, diabetes and epilepsy
o Lower respiratory tract infections (LRTIs)
The remaining indicator looks at emergency admissions for adults aged 19 and over due to:
o Alcoholic liver disease
These emergency admission rates also show variation across the CCGs. For example, in 2011/12 the ambulatory care admission rates per 100,000 registered patients varied from 215 for one CCG to 1,742 for another CCG while the comparable indicator for children has minimum and maximum values of 74 and 753 respectively.
· In recognition of the importance of seeking patient feedback on the quality and effectiveness of their experience, treatment and care, this release includes Patient Reported Outcome Measures (PROMs) for four elective procedures:
o Hip replacement
o Knee replacement
o Groin hernia treatment
o Varicose veins surgery
· Patient feedback of Primary Care is collected in the GP Patient Survey; patient experience of GP Out-of-Hours services is reported in this release with more indicators expected in subsequent publications.