Key Service Outcomes. Commissioning Data and minimum data sets The Commissioners require data on the services in order to benchmark the service against this specification and provide assurance on service delivery and clinical outcomes, together with information required to monitor and manage the contractual agreement. This data will be provided through national and local information collection. Providers shall comply with guidance relating to clinical coding as published by the NHS Classification Services and with the definitions of activity maintained under the NHS Data Model and Dictionary. Providers shall collect and provide national datasets within the timescales set out in the relevant Information Centre guidance and all applicable Information Standards Notice(s) and submit coded data to SUS. Providers shall ensure that all patients seen within the service are entered onto the National Bariatric Surgery Registry, and comply with the data requirements of the registry. Procedure mix undertaken, primary surgical procedures, revision procedures. Total and by CCG. Providers shall comply with all local information collection requirements as listed in this service specification and in the contractual agreement with the commissioner. The outcome measures listed below will be derived from information collected at individual patient level. The outcome measures are to be collected for all patients.
Key Service Outcomes. Quality Performance Indicator Threshold Method of measurement Consequence of breach Report Due Length of Wait In line with Waiting list Review & NHS Blood heart analysis action plan and availability / Transplant urgency report every 6 months Mortality As agreed CUSUM Review & NHS Blood with action plan and NHSBT Transplant report every 6 months, plus exception reporting Outcomes VAD database Review & NHS Blood action plan and Transplant report every 6 months Bridge to heart transplant in adults (ventricular assist devices) For (a) longer-term VADs and (b) short- term VADs): • Transplanted alive • Transplanted died • Explanted alive • Explanted died • VAD alive • VAD died Actuarial survival after long-term VADs implantation at: • 30 days • 90 days • One year • Two years • Three years Significant variation from the national average or, in services with one or two national centres, significant variation from the outcomes achieved in the previous three years Annual report (September of contract year) with data from previous financial year April to March Performance notice as set out in Clause 32.4 Review & action plan NHS ENGLAND Annual report (September of contract year)
Key Service Outcomes. 2.1 Delivery of these Services will contribute towards improving the health of patients (especially those with existing or as yet undiagnosed long term conditions). Including these services with primary care will: Increase access to and uptake of the services Ensure provision is accessible, acceptable and a responsive service throughout Thurrock area, recognising the diverse needs of the local population. Prioritise prevention and continuing to tackle stigma and discrimination Promote service integration, quality, value for money and innovation
Key Service Outcomes. Section 2.1 4 gives a list of the services expected from Genetic Services and a number of ‘proxy’ outcomes. The information section of the contract provides the basic individual patient data and activity reporting required as part of the basic billing and contract monitoring arrangements (e.g. new/follow up outpatients and types of test/source of referral). Proxy outcome measures that will be monitored and for which providers will be required to submit information are (in addition to those listed in the Genetics Dashboard): • New to follow up ratios • Numbers of new and follow up patients seen • Proportion of appointments held at RGC compared with proportion in outreach clinics • Reason for referral broken down into main disease categories (this will aid future service planning) • Percentage of ethnic origin data recorded • Number of genetic tests carried out by MOLU and CYTU (GENU) (methods of counting genetic tests) • Numbers and type of tests sent to other laboratories NHS England/E01/S/a Genetic Dashboard measures (subject to some review for 2013/14) The summary measures are listed below. Details of numerators and denominators and other guidance can be found on the Genetics Dashboard) • Pick up rate for genetic testing - Proportion of tests that return a positive result for affected patients that have the test to determine a diagnosis and are seen in clinical genetics • Multi Disciplinary Clinics (MDC) - Proportion of clinical genetic clinics that are part of a MDC/multi-disciplinary team (MDT) • Clinical audits- Proportion of nationally approved clinical audits completed and action plans put in place (the number and type of audits need to be agreed) • Laboratory reporting times - Proportion of Cytogenetics reports meeting turn round times as agreed by the professional organisations (CMGS/ACC) • Laboratory reporting times - Proportion of Molecular reports meeting turn round times as agreed by the professional organisations (CMGS/ACC) • Educational sessions provided by clinical genetics to other specialties to support genetics in mainstream medicine - number of educational sessions provided by clinical genetics to other specialties • Poor patient experience - number of written complaints about the genetics department • Good patient experience - number of letters/emails from patients, carers or non- genetics consultants registering thanks to the genetics department • Patients waiting excessively for pre-natal (PN) genetic test results where the patient i...
Key Service Outcomes. All providers are expected to collect and share required information from the services that contributes to the national mental health minimum dataset. Some of the outcomes outlined in this section refer to the same data but are mentioned here with a focus on Bristol Mental Health outcomes. Where the same data is required for more than one purpose it will only need to be collected once. 4.1 All agencies who encounter people in serious emotional distress encourage them to attend the Bristol Sanctuary a. Baseline number of people using the Bristol Sanctuary by GP area. b. Satisfaction of services sign posting people to the Bristol Sanctuary , e.g. Police, Ambulance, A&E, Local helplines, crisis service, Organisations working with people who are deaf, blind, on the autism spectrum, having learning difficulties etc. c. Reduced numbers of people in emotional distress being held in a police cell as a place of safety d. Reduced numbers of people in emotional distress with no physical health needs being seen in A&E 4.2 The service will ensure equity of access to services for the diverse Bristol population a. Consistent recording of demographic & nature of incident information b. Equality and diversity data collection and analysis that leads to service changes to improve access to services c. Evidence of reasonable adjustments to service delivery to meet the needs of people with learning disabilities and autism by using experience based methodologies d. Evidence of service delivery and collaborative working with specialist agencies and service providers to meet the needs of marginalised groups, such as men, people who self harm, black and minority ethnic communities, people with physical impairment etc. e. Evidence of engagement with other services to promote appropriate sign posting and referrals. f. Evidence of marketting, communication campaigns and search engine optimisation to raise awareness and attendance 4.3 People using the Bristol Sanctuary and their families or carers are satisfied with the service and feel that they are treated with empathy, dignity and respect a. Feedback from service users and carers on how satisfied people are with the service they have received (disaggregated to highlight any adverse impacts on particular social groups) b. Service user outcomes feedback (disaggregated to highlight any adverse impacts on particular social groups) 4.4 In line with Transitions Strategy Improve Access for 16-25, particularly
Key Service Outcomes. Results from treatment of lower urinary tract fistula vary widely in published literature. A recent analysis of outcomes from the Hospital Episode Data (HES) database indicates re- operation rates varying between 0% and 50%.[3] Those units undertaking more than 30 procedures over 10 years achieved a significantly lower re-operation rates than those undertaking lower numbers (7.4% vs. 13.2%).[3] Although primary fistula repair is appropriate in most cases, a small number may require urinary diversion; this is more likely in women with gynaecological malignancy. The rate of urinary diversion in women with a diagnosis of lower urinary tract fistula also varies considerably, and may be seen as another measure of outcome. The overall rate of diversion in England is 25.5%,[3] whereas in the unit undertaking the largest number of fistula repairs nationally, the rate of diversion was only 2.7%.[1] References: 1.
Key Service Outcomes. The purposes and goals of the service are to offer comprehensive diagnostic investigations, monitoring and expert clinical opinion for t he specialised dermatology conditions/ diseases listed in Table 1. The desired high level outcomes of the service are: accurate, definitive diagnosis access to and therapy with the most effective treatments; avoidance of inappropriate therapies and reduction in treatment related morbidity and mortality; improved quality of life; improved survival. All services will use the DLQI – Dermatology Quality of Life Index or the CDLQI – Children’s Dermatology Quality of Life Index tool to capture outcome data at agreed points in the patient’s pathway. Additionally condition/disease specific outcomes will also be captured and reported. 5. Location of Provider Premises The CRG has undertaken work to identify where in the country current specialised dermatology activity is being undertaken. However this is currently in draft form and has not been validated or tested against any commissioning criteria.
Key Service Outcomes. Therapeutic response and toxicity from MRT treatments are sometimes unpredictable. It is likely that one major cause of this is that patients receive a very wide range of absorbed doses that are not subsequently calculated. This is in xxxxx contrast to external beam radiotherapy with its standardised dosimetry; the need to avoid undue toxicity leads to all patients being treated according to the dose limiting criteria of normal tissues, identified in clinical trials. Individualised treatment using MRT, based on accurate dosimetry obtained using standardised protocols, would in many cases enable higher activities and absorbed doses to be delivered where this may achieve improved tumour control. It would also prevent unnecessarily high
Key Service Outcomes. Patient related outcomes (where relevant to the repertoire of the Service Provided): • The provider shall demonstrate the efficacy of the service in excluding drug allergy e.g. to penicillin allowing use of beta-lactam antibiotics for severe chronic conditions such as bronchiectasis and the outcome of desensitisation to drugs such as penicillin when other antibiotics are not effective. • The provider shall demonstrate the efficacy of desensitisation/immunotherapy by monitoring for(for example): • Significant improvement in Quality of Life (using validated tools like HRQOL and EQ5D measures). • Improvement in symptom scores. • Reduction in time away from school and work. • Reduction in medication use in patients (e.g. in severe hay fever undergoing pollen Subcutaneous and sublingual immunotherapy and severe insect venom allergy). • Successful tolerance to future allergen exposure. • The provider shall demonstrate the efficacy of exclusion of food allergy in children or adults on previously restricted diets resulting in fewer allergic reactions, health care service visits and by discharging patients with appropriate self-management plans where indicated. • The provider shall monitor the % patients on omalizumab for asthma reviewed by allergist before commencing therapy and proportion continuing on therapy after 16 week assessment as per NICE guidance (where relevant). • The provider shall demonstrate an improvement in symptom score, medication use and emergency attendances of patients on omalizumab for asthma by assessing these parameters before commencing therapy and after 16 week as per NICE guidance and at regular intervals if the therapy continues (where relevant). • The provider shall demonstrate an improvement in symptom score, medication use and emergency attendances of patients with severe allergic eczema where allergen avoidance and eradication is instigated (e.g. food avoidance diets, reduction in bacterial load on skin using antiseptics). • The provider shall ensure an improvement in patient confidence and effectiveness in the management of their allergies through public engagement strategy for the service to ensure that patient views of the service are measured (where necessary in collaboration with patient organizations). The provider shall undertake PREM (Patient Related Experience Measures) surveys for patients and carers on an annual basis and achieve >75% satisfaction and act on any deficiencies identified. • The provider shall ensure that t...
Key Service Outcomes. 12 NHS England/C06/S/a The following are key service outcomes which will be delivered through the commissioning of Specialised Perinatal Mental Health Services: • All women in late pregnancy or following delivery requiring an emergency psychiatric admission will be admitted directly to an In-Patient Mother and Baby Unit or transferred within 24 hours of admission from an Adult Mental Health Admission Unit. • All women requiring psychiatric admission are admitted with their infant to an In-Patient Mother and Baby Unit unless there are exceptional reasons not to do so. • All mothers on an In-Patient Mother and Baby Unit will receive a daily assessment of their need for supervision, support and assistance to ensure that the emotional and physical needs of both mothers and their infants are safely met. • There will be an improvement in the patient’s quality of life as the result of admission to a Specialised In-Patient Mother and Baby Unit and/or referral to a Specialised Perinatal Community Psychiatric Team. • There should be a reduction in the numbers of admissions to a Specialised In- Patient Mother and Baby Unit of women with relapse or a recurrence of a pre- existing condition. • A reduction in the number of in-patient readmissions within 1 month of discharge from the In-Patient Mother and Baby Unit. • A reduction in delayed discharges from an In-Patient Mother and Baby Unit. • A reduction in the mean length of stay on an In-Patient Mother and Baby Unit. • A reduction in the use of The Mental Health Act. 13 NHS England/C06/S/a 5. Location of Provider Premises There are 17 In-Patient Mother and Baby Units, 11 of which have integrated Perinatal Community Psychiatric Teams (see Appendix 1) Appendix 1 In-Patient Mother and Baby Units • Northumberland, Tyne and Wear NHS FT • Beadnell Mother and Baby Unit, Morpeth, Northumberland* • Leeds Partnership NHS FT • Mother and Baby Unit, The Mount, Leeds* • Manchester Mental Health and Social Care Trust • The Xxxxxxxx Xxxx, Wythenshawe Hospital, Manchester* • Nottinghamshire Healthcare NHS Trust • Xxxxxxxx Xxxxx Mother and Baby Unit, Queen's Medical Centre, Nottingham* • Derbyshire Mental Health Services NHS FT • The Beeches, Derby City General Hospital, Derby* • Leicestershire Partnership NHS Trust • Mother and Baby Unit, Glenfield Hospital, Leicester* • South Staffordshire and Shropshire Healthcare NHS FT • Xxxxxxxxxxx Mother and Baby Unit, St George's Hospital, Stafford* • Birmingham and Solihull Mental Health NHS ...
