1. Presentation title: 32pt Arial Regular, black Recommended maximum length: 1 line Presented by Julian Denney, Assistant Chief Executive NHSI strategy : Driving innovation by example

2. Presentation Overview NHSI Overview Current Information based products - BCBV Strategy Going Forward

3. Our mission The NHS Institute for Innovation and Improvement supports the NHS to transform healthcare for patients and the public by rapidly developing and spreading new ways of working, new technology and world class leadership.

4. The Case for Improvement The NHS is improving; Improved mortality from CHD and Cancer Faster access to A&E, GP, Outpatients and Surgery Improved patient satisfaction It bears comparison with most other health care systems; But it needs to improve a lot more because There is wide variation in clinical practice Evidence that care is not as safe as it could be Costs of care are rising in a manner which is unsustainable Patient experience is still not satisfactory

5. Learning Leadership Development Leadership Development Product and technological Innovation (NIC) Product and technological Innovation (NIC) Service Improvement Priority programmes that help drive the NHS reform agenda Priority programmes that help drive the NHS reform agenda The NHS Institute: Scope

6. Our priorities Safer Care Delivering Quality and Value Care Outside Hospital No Delays Building Capability for a self improving NHS –Learning –Leadership –Service Transformation Exploiting Innovation - National Innovation Centre (NIC)

7. Presentation Overview NHSI Overview Current Information based products - BCBV Strategy Going Forward

8. The challenge facing the NHS is improving clinical and service quality while controlling costs…….. NHS providers and commissioners operate in an environment where : Frontline clinical services use 80% of NHS resources Productivity & efficiency varies widely A focus on access related targets has meant less concern about delivering VFM Achieving financial balance is a challenge A Payment by Results system that is beginning to highlight where costs exceed income There is relatively poor benchmark information to help inform decision making Clear benchmarks to guide performance analysis, comparison and best practice Sustainable solutions to improve performance of core clinical processes To help the NHS meet this challenge : NHS Better Care, Better Value Indicators High Volume Care

9. The NHS Better Care, Better Value Indicators help the NHS know where to look……. Clear high level performance comparison Opportunity scaling …and what to focus on by using the Indicator Explorer….. Breakdown by specialty

10. NHS Indicators – Clinical Reduced variation in length of stay ( bed days saved) Day case rate for Audit Commission basket for 25 procedures Reduction in wasted bed days as a result of admission prior to operation Admission rates for selected procedures where thresholds for surgery vary Reduction of avoidable emergency admissions against 19 recognised diagnoses Referral rate standardised - first Outpatient appointment Proportion of statin prescriptions that are low cost AHT PCT

11. Reduce wasted bed days

12. Procedure thresholds

13. Productivity Opportunity Indicator Changes between Q1 06/07 and Q1 07/08

14. Low cost statin Indicator Changes between Q1 06/07 and Q1 07/08

15. Low cost statin Indicator Changes by SHA between Q1 06/07 and Q1 07/08

16. Better Care, Better Value Indicators Feedback 87% PCT and Trust Board /clinical Directors awareness The “productivity opportunity” illustrated by the indicators, was seen as a key element in raising interest and incentivising organisations. PCTs had a lower level of knowledge about the BCBVIs. It was suggested that in PCTs, BCBVIs and other data could be promoted as a lever for change through commissioning.

17. Indicators AHTPCTQ1Q2Q3Q4 Existing indictors – modifications etc FCEs per consultant (publish) √ X pre op length of stay (add trust drill to specialty and emergency /elective split) √ X outpatient referral rates (add drill down to specialty) √ X day case rate (expand to larger basket) √ X surgical rates (add drill down to HRG) √ X emergency admissions (add drill down to HRG) √ X New indictors new to follow up outpatient ratio ( by speciality) √ X Outpatient DNA rates ( by speciality) √ X elective readmission rates (up to 14 days) √ X non elective readmission rates (up to 14 days) √ X generic prescribing savings √ X basket of specific prescribing savings (inc. statins, proton pump inhibitors, ACE inhibitors and antiplatelet prescribing) √ X Mental health admissions/bed days √ X Staff stability √√ X T I M E T A B L E

18. Presentation Overview NHSI Overview Current Information based products - BCBV Strategy Going Forward

19. Our Strategy: Information Tools and Services “Some is not a number, soon is not a time” (Institute for healthcare improvement: Don Berwick) We see good quality information as absolutely critical part of improvement – we have done so since the NHSI Institute was founded and will continue to do so in the future. Therefore, where appropriate our products will have an information component. However – we are an improvement and innovation organisation – not an information organisation. Our information strategy is derived from improvement and innovation imperatives rather than the other way round

20. Our Strategy: NHS Partners DH are our sponsors, so our approach to information strategy is developed with them We’re at the early stages of building a partnership with the NHS Information Centre. We see our role as complementary: we provide tools and techniques to interpret information produced by the NHSIC to support innovation and improvement in the NHS. We have a partnership with Connecting for Health, with a senior manager seconded to them

21. Our Strategy: Private Sector Role We are a commissioning organisation and will continue to be one We value the pace, responsiveness and good market understanding that the private sector can bring The private sector have given us expertise, innovation and customer impact We would like to see a more plural market so that we get a wider range of credible tenders for our work in future