Strategic Plans

Analysis in Joint Commissioning Cycle >Analysis key part of commissioning cycle. >Analysis sets out thinking, reasoning, decisions for rest of plan. >Without robust analysis rest of plan will be weak and lack credibility. >Good information allows partnerships to analyse effectively and sets basis for rest of plan.

Patient level data linking >Health and social care linked data at patient/client level has a number of benefits. >Total resource across total population, segment of population, by deprivation category, high resource cohorts. >Who uses joint services, does level of social care make a difference to hospital admissions? >Follow cohort through time to see if change to service/care pathway is having desired effect.

Alcohol and Drug >Define substance misuse cohort. −Use data from criminal justice and ADP services to augment data −Prevalence and population characteristics >Size and distribution of spend. >Comparative to non substance misuse population. >Follow as service is redesigned.

Breakdown of costs Non- substance misuse: Substance misuse:

Anticipatory Care Plans >Health resource of 120 patients given ACPs. >2009/10 – 2012/13 −583 A and E attendances (£60,000) −1345 outpatient appointments (£170,000) −6743 days in hospital (£2m) −31,455 Dispensed items (£311,000) >Follow this cohort and non ACP cohort to analysis impact of ACPs.

Health and Social Care by SIMD 65+ cost per capita

Dementia >Define dementia cohort - from GP LTC register. >Prevalence and population characteristics >What health and social resources do dementia patients use? −Comparative to non dementia population >Forecast future demand as a result of demographic pressure >Assist with planning and evaluating services redesign

Cost Attributable to Dementia

NHS Board X– individual level analysis >Inpatient services at maximum capacity >Requirement to understand current utilisation of services. Who? how old? how often? how long? Why? >Exploratory work – acute and community activity (SMR01 and SMR01E linkage), length of stay analysis, admissions, allocated bed day analysis, available beds, forecasting. >Granular analysis - study cohort of long stay patients −400 acute inpatients - linked to length of stay information (acute, community, outwith HB treatment, total bed days) −Categorised by partnership (CHP), age band, admission type −Linked to delayed discharge, SPARRA, other local information info not on SMRs >Benefits of linked individual level data - understanding full hospital pathway, delayed discharge prevention, informed decisions

Explorative analysis of acute bed days in 2011/12 by partnership indicates a potential saving of 40 acute beds if occupied bed days consistent for all residents. This is due to a marked divergence in acute length of stay between the two partnership groups. A study cohort of long stay patient showed that Partnership A used 35% more bed days than partnership B with the associated number of stays only 2% higher. Community Hospital stay linked to delayed discharge - 50% of study cohort with a stay in a community hospital were recorded as having a delayed discharge. Less than 1 % who only had an acute hospital stay resulted in a delay. 60% of partnership A residents with a community element to their stay also had a delayed discharge episode, this compares to 30% for partnership B residents. IRF mapping for 2010/11 shows partnership A 75+ per capita spend approximately 30% higher for emergency acute inpatients than partnership B. Service Utilisation Analysis Results

>For more information on Integrated Resource Framework (IRF) and patient/client level data linking contact: >Andrew Lee >Ishbel Robertson >Christine McGregor or