Planning Round 2014/15
Ambitions and Trajectories
Sutton CCG Board – Wednesday 5th March
Planning timetable
Draft submission on 14th February 2014:
•
•
•
•
•
Quality and Performance Assurance
Ambitions for Improving Outcomes
Quality Premium Measures
Other Measures
Activity Trajectories
Final submission required by 4th April 2014
Sutton CCG Board decision
• The Governing Body is asked to approve the
outcome ambitions and activity assumptions
required for the final submission on 4th April
2014.
Quality and Performance Assurance
i)
Do your plans ensure that the performance standards in
the NHS Constitution will be delivered throughout
2014/15 and 2015/16? Yes
ii) Have you assured provider CIPs are deliverable without
impacting on the quality and safety of patient care from
2014-15 till 2018-19? No
iii) Do you plan to manage HCAIs so that your local
population have no cases of MRSA in 2014-15 and
2015-16? Yes
Ambitions for Improving Outcomes
What is your ambition for securing additional years of life
from conditions considered amenable to healthcare?
Sutton CCG in top
30% nationally
Better
Worse
Ambitions for Improving Outcomes
What is your ambition for securing additional years of life
from conditions considered amenable to healthcare?
Assumptions:
3.2% reduction to 2013/14 and again for 14/15 as per
Quality Premium target
Reductions for subsequent years taken from NHSE
"Anytown" suburban model
Ambitions for Improving Outcomes
What is your ambition for securing additional years of life
from conditions considered amenable to healthcare?
NHSE’s “Anytown” planning model suggests a 10.9% reduction from
2013 to 2018 on a “do nothing more” model:
“Outcome ambition 1 (preventing premature mortality) are greatly
affected by health behaviours throughout life (e.g. smoking). As there
is a strong positive trend reduction in mortality and potential years of
life lost, because the cohorts of people entering the highest-risk agerange are progressively healthier, it seems sensible to make an
adjustment for that trend before setting levels of ambition.” [Setting 5year ambitions for improving outcomes: the commissioners how-to
guide]
Ambitions for Improving Outcomes
What is your ambition for securing additional years of life
from conditions considered amenable to healthcare?
Potential years of life lost per 100,000:
Baseline 12/13
1898
13/14
1837
14/15
1778
15/16
1723
16/17
1673
17/18
1628
18/19
1586
-3.2%
-3.2%
-3.1%
-2.9%
-2.7%
-2.6%
Ambitions for Improving Outcomes
What is your ambition for improving the health-related
quality of life for people with long-term conditions?
Sutton CCG in top
10% nationally
Worse
Better
Ambitions for Improving Outcomes
What is your ambition for improving the health-related
quality of life for people with long-term conditions?
Assumption:
0.5% improvement per year
Average EQ-5D score for people reporting having one or more longterm condition:
Baseline 12/13
77.1
13/14
77.6
+0.5
14/15
78.1
+0.5
15/16
78.6
+0.5
16/17
79.1
+0.5
17/18
79.6
+0.5
18/19
80.1
+0.5
Ambitions for Improving Outcomes
What is your ambition for reducing emergency admissions?
Sutton CCG in top
25% nationally
Better
Worse
Ambitions for Improving Outcomes
What is your ambition for reducing emergency admissions?
Reducing the amount of time people spend avoidably in hospital
through better and more integrated care in the community, outside
hospital – a composite measure per 100,000 population of:
• Unplanned hospitalisation for chronic ambulatory care sensitive
conditions
• •Unplanned hospitalisation for asthma, diabetes and epilepsy in
under 19s
• •Emergency admissions for acute conditions that should not
usually require hospital admission
• •Emergency admissions for children with lower respiratory tract
infections (LRTI)
Ambitions for Improving Outcomes
What is your ambition for reducing emergency admissions?
Assumption: Maintain current good performance - no increase as per
Quality Premium target 2014/15
Note rising trend since 2009:
Ambitions for Improving Outcomes
What is your ambition for reducing emergency admissions?
Assumption: Maintain current good performance - no increase as per
Quality Premium target 2014/15
Composite admissions per 100,000 population:
Baseline 12/13
1682
13/14
1682
14/15
1682
15/16
1682
16/17
1682
17/18
1682
18/19
1682
Ambitions for Improving Outcomes
What is your ambition for increasing the proportion of people
having a positive experience of hospital care?
Sutton CCG in top
20% nationally
Better
Worse
Ambitions for Improving Outcomes
What is your ambition for increasing the proportion of people
having a positive experience of hospital care?
Assumption: Maintain current good performance
The proportion of people reporting poor patient experience of
inpatient care:
Baseline 12/13
134.4
13/14
134.4
14/15
134.4
15/16
134.4
16/17
134.4
17/18
134.4
18/19
134.4
Ambitions for Improving Outcomes
What is your ambition for increasing the proportion of people
having a positive experience of care outside hospital, in
general practice and the community?
Sutton CCG at approx
mid-point nationally
Better
Worse
Ambitions for Improving Outcomes
What is your ambition for increasing the proportion of people having a
positive experience of care outside hospital, in general practice and the
community?
Assumption: Improve by 3% per year to achieve top quartile
performance
The proportion of people reporting poor experience of General
Practice and Out-of-Hours Services:
Baseline 12/13
5.8
13/14
5.6
-3%
14/15
5.5
-3%
15/16
5.3
-3%
16/17
5.1
-3%
17/18
5.0
-3%
18/19
4.8
-3%
Quality Premium Measures
Trajectories for 2014/15 for these measures included in
“Ambitions for Improving Outcomes”
• Reducing potential years of lives lost through causes
considered amenable to healthcare and addressing
locally agreed priorities for reducing premature mortality
(15 per cent of quality premium - £140k)
• Reducing avoidable emergency admissions (25 per cent
of quality premium - £230k)
Quality Premium Measures
• Improving access to psychological therapies (15 per cent of
quality premium - £140k)
• Target is 15% by March 2015
• Propose maintaining at 15% for 2015/16





2014/15 Q1
2014/15 Q2
2014/15 Q3
2014/15 Q4
2015/16
13%
13%
14%
15%
15%
Quality Premium Measures
• Addressing issues identified in the 2013/14 Friends and
Family Test (FFT), supporting roll out of FFT in 2014/15 and
showing improvement in a locally selected patient experience
indicator (15 per cent of quality premium - £140k)
• Addressed through FFT CQUIN
• Local indicator: Improving patient experience of hospital
care – measured by CQC Adult Inpatient Survey
Quality Premium Measures
• Improving the reporting of medication-related safety
incidents based on a locally selected measure (15 per
cent of quality premium - £140k)
• Have agreement with Chief Pharmacist at Epsom & St
Helier NHS Trust to increase reporting of medication
errors by 10% from 2013/14 Q4 to 2014/15 Q4.
Quality Premium Measures
• A further local measure (15 per cent of quality premium £140k)
• Proposed measure is improvement in patient
experience of GP Out of Hours (OOH) services.
• Sutton performs at a midpoint level nationally on the indicator of GP
OOH satisfaction (based on the GP survey).
• Sutton CCG has recently changed provider for GP out of hours
services so this is a good opportunity to drive improvements in
patient experience for this service.
• Links with the CCG’s “Out of hospital care” priority to improve the
quality of out of hours services.
• Proposal is to increase “good” experience to a minimum of 72%
(last reported rate was 70%)
Other Measures
• What is the trajectory for maximum number of Clostridium
Difficile infections in 2014/15?
• Public Health England are to provide CCG thresholds,
however in the absence of these we have been
advised by NHS England to set at 35 (threshold for
2013/14 was 37)
Other Measures
• What dementia diagnosis rate are you aiming for in
2014/15 and 2015/16?
• For the 2013/14 Planning Round Sutton CCG agreed a
trajectory to move from 37% in 2011/12 to 58% by
2015/16
• Everyone Counts (Dec 2013) gives target of 67% by
March 2015
• Proposal is for Sutton to continue to move towards
58% by March 2016
Other Measures
What dementia diagnosis rate are you aiming for in 2014/15
and 2015/16?
Proportion of estimated prevalence of dementia diagnosed:
Baseline 12/13
40.2%
13/14
43%
14/15
50%
15/16
58%
Other Measures
What level of Psychological Therapies recovery are you
aiming for in 2014/15 and 2015/16?
• 50% recovery rate by March 2015 (Everyone Counts)
• Maintain 50% recovery rate for 2015/16
Activity Trajectories
5 year trajectories are required for the following types of activity,
by provider:
• Elective inpatient admissions
• Elective daycase admissions
• Non-elective admissions
• GP referrals
• Other referrals
• GP-referred first outpatient attendances
• Other-referred first outpatient attendances
• Subsequent outpatient attendances
5 year trajectories are also required at aggregate level for:
• A&E attendances
Activity Trajectories
Assumptions:
• Baseline of April – November 2013, extrapolated for full
year
• Activity growth of 2.8% per year due to demographic
growth
• 2014/15 - Activity shifts planned through QIPP
workstreams applied
Activity Trajectories
Assumptions:
• 2015/16 – 2018/19 - Activity shifts applied as agreed
through South West London Out of Hospital Strategy
group, accelerated due to Better Care Fund workstreams
to achieve in 3 years from 2013/14, rather than the
previously planned 5 years:
o A & E 10% avoid
o Non-Elective Admissions 17.5% avoid
o Outpatients Attendances 5% avoid