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Interpreting Metrics - improving performance

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									 Interpreting Metrics -
improving performance
         Emma Hanson
 Joint Commissioning Manager
       Dementia Services
         West Kent
  Recorded and Expected Prevalence of Dementia in all ages by Practice-Based Commissioning Group in NHS West Kent
  Source: Quality and Outcomes Framework via The Health and Social Care Information Centre, Dementia UK report - Alzheimer's society
  Analysis produced by Kent & Medway Public Health Observatory (MC) - 01 Oct 2009

                                    1.6%
                                           2006-07   2007-08   2008-09     Expected



                                    1.4%




                                    1.2%
Prevalence of Dementia (all ages)




                                    1.0%




                                    0.8%




                                    0.6%




                                    0.4%




                                    0.2%




                                    0.0%
                                              DGS                Invicta              M&M   S&W            T&TW                  Weald   WK PCT- NIC   NHS WK total

                                                                                                  Area
                        DEM - 01 Dementia Registers

            2006/07      2006/07                     2007/08     2007/08
            Practice     Disease         2006/07     Practice    Disease         2007/08
Surgery     List Size    Register       Prevelance   List Size   Register       Prevelance

Surgery A       4,567               2       0.04%        4,462              3       0.07%

Surgery B       4,209               3       0.07%        4,260              3       0.07%

Surgery C       2,562               3       0.12%        2,535              3       0.12%

Surgery D       2,485               3       0.12%        2,455              3       0.12%

Surgery E      11,960           22          0.18%       12,339          21          0.17%

Surgery F       1,871               5       0.27%        1,786              4       0.22%

Surgery G       2,671               6       0.22%        2,670              8       0.30%

Surgery H       3,801               9       0.24%        3,708          12          0.32%
Interpreting Metrics -
improving performance

• 6 days of memory assessment service
  per week
• Provider estimates 2 new diagnosis per
  day per service
• 2 diagnosis x 6 clinics x 48 weeks =
  576
Interpreting Metrics -
improving performance
• 2006/07 DEM 01 = 2433
• 2007/08 DEM 01 = 2525
• difference = 92 new cases of dementia
  across the whole of West Kent
• Provider estimates 576 new diagnosis
  but QOF DEM 01 only grew by 92
• hunch - even accounting for deaths and
  people moving out of area - does not
  seem right
Interpreting Metrics -
improving performance

• Performance issue?
• Data quality issue?
• Mixture ?
Interpreting Metrics -
improving performance
Performance issue - Capacity
Service specifications for memory
assessment services
  – What does a memory assessment service
    consist of ?
  – How many assessments should they be able
    to do ?
  – What mechanisms do we put in place to
    ensure performance monitoring?
Interpreting Metrics -
improving performance
Performance issue - Awareness
Admiral Nurse Project working in Primary
Care holding clinics
  – to support GPs
  – encourage people to go forward for formal
    diagnosis
  – ensure diagnosis or not
    • PwD and their carers have good quality advice
      information and guidance, and
    • are supported to access services as necessary
Interpreting Metrics -
improving performance
Data Quality Issues
• Provider audit all people they have
  provided with diagnosis
• Filter per GP
• Collate a Practice list of people know to
  have a diagnosis
• Write to Practices to ratify lists
• Practice enter missing data onto QoF
Interpreting Metrics -
improving performance

Mixture - most likely
• this two pronged approach to rectify
  issue
• 2008/09 QoF 2,841 < of 316
• can we sustain only time and,
• the 2009/10 QoF will tell !!

								
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