1. Measuring Clinical Performance in Secondary Care Bill Shields Director of Finance & Performance Portsmouth Hospitals NHS Trust

2. Measuring Clinical Performance in Secondary Care Where are we now? Why is measurement important? Future developments Current issues

3. Where are we now? The Impact of Payment by Results means: Activity volumes = Income Star Ratings: Primary Targets about Waiting Times Secondary Targets include some indicators of clinical quality Measurement of outputs NOT outcomes

4. Elective Inpatient Activity (FFCEs)

5. Day Case Activity

6. Emergency Inpatient Activity (FFCEs)

7. All New Outpatient Attendances (inc non-GP referrals)

8. NEW GP OUTPATIENT WL Shape

9. INPATIENT & DAY CASE WL Shape

10. Primary Star Targets

11. Secondary Star Targets

13. Benchmarking E.g. Day Case Rates; LoS; Beddays; mortality Sources include: –CHKS –Dr Foster –Performance Investigator

14. Standards for Better Health NHS Performance Rating developing beyond Stars Less Quantitative measures of waiting etc More holistic view of all aspects of NHS Organisations More on Quality of care and Patient Experience

15. Standards for Better Health New Framework for monitoring NHS performance Core and Developmental Standards organised into the following domains: Safety Clinical & Cost Effectiveness Governance Patient Focus Accessible & Responsive Care Care Environment & Amenities Public Health

16. Current Issues Data Quality –Especially clinical coding – completeness, accuracy and depth Credibility and relevance to Clinicians –Poor data quality prevents proper Clinician Engagement Statistical significance –Improving methods for indicating whether “outliers” are significant –Especially important for “alerts”