Sharing information to understand the shared issues National Cardiac Services Review Day (CLICK)

Hello! Richard Thomas National Cardaic Informatics Manager Wales Cardiac Network NHS Wales Health Collaborative Public Health Wales Bore Da! Good Morning my name is Richard Thomas and I am the National Cardiac Informatics Manager with the Wales Cardiac Network. I joined the cardiac network in April this year and prior to this I worked for 15 years for UK Ambulance Services, 4 here in Wales and 11 within NHS England. My role is to take a senior strategic all Wales view in developing the use of existing and new cardiac related information and data to support the improvement of cardiac services across the whole cardiac pathway from primary to tertiary care and also to improve national clinical and/or local audits.  Although based in North Wales my role is an all-Wales remit with overall responsibility for providing leadership and support to cardiac informatics and information functions within the Cardiac Networks and the constituent health boards, Public Health Wales, Welsh Ambulance Services NHS Trust as well as the Heart Disease Implementation Group.  I am also responsible for ensuring that cardiac information meets the needs of health boards/trusts and their clinical teams in supporting the delivery of cardiac services, as well as the information needs for the work programme of the Heart Disease Implementation Group supporting national cardiac policy (CLICK).

informatics is about getting information to the right person at the right time. What is informatics? Its about getting information to the right person at the right time while always remembering that information delivery is crucial to health professionals and patients for the delivery of care. NHS Wales organisations are increasingly working together, to work together effectively we need to be able to share data about the services we provide and the people we provide these services to. For this review day obtaining information has been a struggle, there appears to be reluctance in information being shared not only across but within health board areas (CLICK).

Sharing information to understand shared issues I'm sure some of a lot of you have seen the knowledge pyramid before, it really does explain it all, CLICK without data there is no information CLICK, CLICK with no information there is no knowledge CLICK, CLICK and without knowledge there is no wisdom to do anything. If I could ask you to take one thing back to your organisations its to engage with your informatics teams, both them and me are here to assist you, and in turn free up more of your time for the people of Wales. CLICK

1. National RTT Times Open & Closed Combined National RTT Times: The following looks at the overall RTT Times for Cardiology. All data shown has been supplied and verified by the NHS Wales Informatics Service and is shows as up to 8, 16, 26 and 26 weeks plus. What we wanted to do was to show the staged 1-4 RTT times, however, this has proved problematic for most health bards so this presentation is not what we wanted to present but its what we have, please bear in mind we are presenting a piece of a picture, not a whole portrait. (CLICK).

NHS Wales Cardiology RTT A total of 117,655 patients waiting for Cardiology 51.6% (n=60,654) patients were seen within 8, 77.6% (n=91,318) were seen with 16 weeks and 93.6% (110,091) were seen within 26 weeks (CLICK). Data supplied by NHS Wales Informatics Services and is combined Open & Closed Pathways

2. Speciality RTT Times Cardiology Open & Closed Combined What were going to look at now is the cardiology RTT Times, the data is open and closed combined (CLICK).

Example Wait Times The graph shown is an example from a Health Board which shows that an 8, 16 or 26 week pathway is made up of a mixture of stage 1-4, Stage one Referral to Treatment Stage two Diagnostic Stage Stage three Back to Clinical to make the treatment Stage 4 Decision Stage The vast majority are stages 1-3, however if you look at 0 weeks you will see that some stage 4 start at zero weeks, this is currently being looked at as to why this happens. (Click)

8 Week Cardiology RTT by Health Board Here is an overview of the 8 week Cardiology RTT by Health Board, as you the national average was 51.6% with ABM and Cardiff & Vale failing to meet the national average. BCU were the best achieving Health Board at 57.3% and ABM the lower end with 42.3% (Click) Data supplied by NHS Wales Informatics Services and is combined Open & Closed Pathways

16 Week Cardiology RTT by Health Board Here is the 16 week overview again as you can see the national average was 77.6% again with Aneurin Bevan, BCU and Powys achieving this, with BCU the best achieving Health Board at 86.6% and ABM the lower end with 70.4% (Click) Data supplied by NHS Wales Informatics Services and is combined Open & Closed Pathways

26 Week Cardiology RTT Health Board For 26 weeks the national average was 93.6% again Aneurin Bevan, BCU and Powys achieving this. BCU were the best achieving Health Board overall at 98.3% however Cardiff & Vale were at the lower level with 90.3% (Click) Data supplied by NHS Wales Informatics Services and is combined Open & Closed Pathways

3. RTT Split By Health Board Open Pathway Additional information was supplied by the Welsh Health Specialised Services Committee better known as WHSSC, this allows us to look at RTT split by Health Board however this is for Open Pathways Only. What it does allow us to do is to not only split by Health Board but to look at how many patients within that Health Board were a) treated by the health board, b) treated by another health board within NHS Wales and c) Treated by NHS England, again this shows 8, 16 & 26 week RTT, the following slides look at each health baord (CLICK).

NHS Wales Patients Waiting Total Patients NHS Wales NHS England 14,520 90.8% 9.2% 13,190 1,330 Waiting Time Total NHS Wales NHS England 8 Weeks 4,729 31.6% 41.9% 16 Weeks 8,299 55.6% 72.5% 26 Weeks 11,815 80.3% 92.5% So within NHS Wales (CLICK) there were 14,520 patients, of these patients in total 90.8% were within NHS Wales and 9.2% by NHS England organisations. (CLICK) As you can see within 8 weeks 4,729 patients were treated, with 31.6% within NHS Wales and 41.9% within NHS England. Within 16 weeks 8,299 patients were treated, with 55.6% within NHS Wales and 72.5% within NHS England. Within 26 weeks 11,815 patients were treated, with 80.3% within NHS Wales and 92.5% within NHS England All remaining patients were seen within 26 weeks+ (CLICK) Data supplied by WHSSC and is for Open Pathways Open

Aneurin Bevan University Health Board Patients Waiting Total Patients In House NHS Wales NHS England 3,058 38.7% 58.5% 2.8% 1.184 1.788 86 Waiting Time Total In House NHS Wales NHS England 8 Weeks 1.047 29.3% 35.9% 67.4% 16 Weeks 1.811 55.1% 60.4% 91.9% 26 Weeks 2.526 81.7% 82.6% 96.5% Within Aneurin Bevan (CLICK) there were 3,058 patients of these patients in total 38.7% were seen in-house, 58.5% within NHS Wales and 2.8% within NHS England. (CLICK) As you can see within 8 weeks 1,047 patients 29.3% were treated in-house, 35.9% within NHS Wales and 67.4% within NHS England. Within 16 weeks 1,811 patients 55.1% were treated in-house, 60.4% within NHS Wales and 91.9% within NHS England. Within 26 weeks 2,562 patients 81.7% were treated in-house, 82.6% within NHS Wales and 96.5% within NHS England. All remaining patients were seen within 26 weeks+ (CLICK) Data supplied by WHSSC and is for Open Pathways Open

Abertawe Bro Morgannwg University Health Board Patients Waiting Total Patients In House NHS Wales NHS England 1,638 66.3% 29.3% 4.4% 1.086 480 72 Waiting Time Total In House NHS Wales NHS England 8 Weeks 521 24.7% 46.3% 43.1% 16 Weeks 889 46.8% 67.9% 76.4% 26 Weeks 1.291 73.1% 90.0% 90.3% Within ABM (CLICK) there were 1,638 patients of these patients in total 66.3% were seen in-house, 29.3% within NHS Wales and 4.4% within NHS England. (CLICK) As you can see within 8 weeks 521 patients 24.7% were treated in-house, 46.3% within NHS Wales and 43.1% within NHS England. Within 16 weeks 889 patients 46.8% were treated in-house, 67.9% within NHS Wales and 76.4% within NHS England. Within 26 weeks 1,291 patients 73.1% were treated in-house, 90% within NHS Wales and 90.3% within NHS England. All remaining patients were seen within 26 weeks+ (CLICK) Data supplied by WHSSC and is for Open Pathways Open

Betsi Cadwaladr University Health Board Patients Waiting Total Patients In House NHS Wales NHS England 1,671 54.3% 12.1% 33.6% 907 202 562 Waiting Time Total In House NHS Wales NHS England 8 Weeks 591 29.8% 53.5% 37.9% 16 Weeks 1.052 56.1% 80.2% 67.8% 26 Weeks 1.490 86.2% 94.6% 92.0% Within Betsi Cadwaladr (CLICK) there were 1,671 patients of these patients in total 54.3% were seen in-house, 12.1% within NHS Wales and 33.6% within NHS England. (CLICK) As you can see within 8 weeks 591 patients 29.8% were treated in-house, 53.5% within NHS Wales and 37.9% within NHS England. Within 16 weeks 1,052 patients 56.1% were treated in-house, 80.2% within NHS Wales and 67.8% within NHS England. Within 26 weeks 1,490 patients 86.2% were treated in-house, 94.6% within NHS Wales and 92.0% within NHS England. All remaining patients were seen within 26 weeks+ (CLICK) Data supplied by WHSSC and is for Open Pathways Open

Cardiff & Vale University Health Board Patients Waiting Total Patients In House NHS Wales NHS England 2,341 70% 25.1% 4.9% 1.639 588 114 Waiting Time Total In House NHS Wales NHS England 8 Weeks 695 26.2% 35.4% 50.0% 16 Weeks 1.226 47.8% 60.0% 78.9% 26 Weeks 1.838 74.0% 88.1% 93.9% Within Cardiff & Vale (CLICK) there were 2,341 patients of these patients in total 70% were seen in-house, 25.1% within NHS Wales and 4.9% within NHS England. (CLICK) As you can see within 8 weeks 695 patients 26.2% were treated in-house, 35.4% within NHS Wales and 50% within NHS England. Within 16 weeks 1,226 patients 47.8% were treated in-house, 60% within NHS Wales and 78.9% within NHS England. Within 26 weeks 1,838 patients 74% were treated in-house, 88.1% within NHS Wales and 93.9% within NHS England. All remaining patients were seen within 26 weeks+ (CLICK) Data supplied by WHSSC and is for Open Pathways Open

Cwm Taf University Health Board Patients Waiting Total Patients In House NHS Wales NHS England 2,094 49.8% 48.8% 1.4% 1.043 1.022 29 Waiting Time Total In House NHS Wales NHS England 8 Weeks 635 23.4% 36.4% 65.5% 16 Weeks 1.134 46.1% 61.3% 93.1% 26 Weeks 1.644 72.5% 84.2% Within Cwm Taf (CLICK) there were 2,094 patients of these patients in total 49.8% were seen in-house, 48.8% within NHS Wales and 1.4% within NHS England. (CLICK) As you can see within 8 weeks 635patients 23.4% were treated in-house, 36.4% within NHS Wales and 65.5% within NHS England. Within 16 weeks 1,134 patients 46.1% were treated in-house, 61.3% within NHS Wales and 93.1% within NHS England. Within 26 weeks 1,644 patients 72.5% were treated in-house, 84.2% within NHS Wales and 93.1% within NHS England. All remaining patients were seen within 26 weeks+ (CLICK) Data supplied by WHSSC and is for Open Pathways Open

Hywel Dda University Health Board Patients Waiting Total Patients In House NHS Wales NHS England 2,051 52.5% 44.4% 3.1% 1.076 911 64 Waiting Time Total In House NHS Wales NHS England 8 Weeks 545 21.9% 31.2% 39.1% 16 Weeks 1.010 42.1% 55.9% 75.0% 26 Weeks 1.513 66.6% 80.8% 93.8% Within Hywel Dda (CLICK) there were 2,051 patients of these patients in total 52.5% were seen in-house, 44.4% within NHS Wales and 3.1% within NHS England. (CLICK) As you can see within 8 weeks 545 patients 21.9% were treated in-house, 31.2% within NHS Wales and 39.1% within NHS England. Within 16 weeks 1,010 patients 42.1% were treated in-house, 55.9% within NHS Wales and 75% within NHS England. Within 26 weeks 1,513 patients 66.6% were treated in-house, 80.8% within NHS Wales and 93.8% within NHS England. All remaining patients were seen within 26 weeks+ (CLICK) Data supplied by WHSSC and is for Open Pathways Open

Powys Teaching Health Board Patients Waiting Total Patients In House NHS Wales NHS England 1,667 15.8% 60% 24.2% 263 1.001 403 Waiting Time Total In House NHS Wales NHS England 8 Weeks 695 41.1% 43.3% 38.2% 16 Weeks 1.177 79.8% 68.2% 70.5% 26 Weeks 1.513 96.6% 88.7% 92.1% And finally within Powys (CLICK) there were 1,667 patients of these patients in total 15.8% were seen in-house, 60% within NHS Wales and 24.2% within NHS England. (CLICK) As you can see within 8 weeks 695 patients 41.1% were treated in-house, 43.3% within NHS Wales and 38.2% within NHS England. Within 16 weeks 1,177 patients 79.8% were treated in-house, 68.2% within NHS Wales and 70.5% within NHS England. Within 26 weeks 1,513 patients 96.6% were treated in-house, 88.7% within NHS Wales and 92.1% within NHS England. All remaining patients were seen within 26 weeks+ (CLICK) Data supplied by WHSSC and is for Open Pathways Open

Thank you! Diolch yn fawr! Email: ricky.thomas@wales.nhs.uk Mobile: 07825 244717 Phone: 01745 448586 Ext 2297 WHTN: 1815 2297 Twitter: @cardiacnetwork Thank you for you time and attention, if you would like any further information please use the contact details shown 