Omitted Data Could Derail Ccg Efficiency Plans Survey Reveals
Monday, 31 October 2011
One of the key benefits of allowing family doctors to commission health services was that, being closer to the patients themselves, they would be in a better position to drive up quality and push down costs, improving the care pathway for the patient.
But in order for groups of doctors to do this, they must be able to access and understand good quality information from all the CCGs clinical systems.
But even when all GP practices within a CCG are working with the same clinical systems, the variation in the data they input into their clinical systems is huge and makes it incredibly difficult for that information to be used beyond the four walls of each individual practice, according to health informatics specialist, iQ Medical.
It has now carried out a survey of CCGs across the country and found that when entering data into their clinical systems, practices are routinely missing out details in in-patient activity, particularly procedures, and failing to summarise out-patient activity.
When it comes to in-patient Activity, the study revealed that some practices within a CCG routinely scan and attach discharge letters to patients' records with a note of partial read codes, while others failed to record referrals at all.
Graham Poulter, managing director of iQ Medical, said: "When GP practices worked in isolation, this level of data quality may have been acceptable as third parties would never need or be able to access such information.
"Now the rules have changed. CCGs need to be able to access that information in order to coordinate and monitor group performance.
"At best, such poor standards of data quality threaten to undermine any successes the CCG has planned; at worst, badly distorted results could damage not only their financial but their clinical performance as well."
The problem of poor quality data isn't restricted to GP practices, Mr Poulter added.
He said: "Historically, PCTs have not validated SUS data against the original GP's instructions. CCGs now have a unique opportunity to do this, through negotiating new contracts, to enable them to challenge inaccurate invoices and drive up the quality of patient care.
"Before any of that can happen, CCGs must first tackle the problem of poor data - whether it's information they are responsible for or information that has come from someone else."
iQ Medical has developed a standardised data template which works with all clinical systems within a CCG and is a big step forward as it allows CCGs to create common formatted information which can then be automatically transferred to a secondary system for monitoring performance and analysis, in line with planned commissioning objectives.
Mr Poulter added: "Doing this, then linking referral to discharge to SUS data, would create one of most valuable sources of information in the NHS, allowing both operational and strategic decisions to be made on the basis of strong evidence.
"Failure to do so, or attempting to do it without standardising data entry first, would be to miss one of the greatest opportunities created by the current NHS reforms."
In order to successfully manage a CCG, managers need to record and access accurate information which then allows them to analyse the data by:
- Referrals by GP, date and read code
- Admission and discharge dates
- Episode types
- Referral sources
- Contract monitoring
- Excess bed days
- QIPP targets
- National and local tariffs
These can only be monitored effectively if all the practices within a CCG agree on a common methodology that supports their internal processes, but also allows for this data to be inputted in a structured way which can then be accessed and analysed automatically, via a range of reports, in minutes.
iQ Budget and Data Manager does this and is currently being installed into a number of CCG pathfinders which have identified the importance of this information, and of good data quality, to their future success.
· Since 2003, iQ Medical has developed a range of products specifically for general practice. It currently works with more than 3,500 practices and numerous PCTs to deliver support through innovative and unique management tools.
· The efficiencies which iQ Medical helps create ease the increasing workload in primary care and ensure a greater in-depth understanding of patients and their care needs.
· iQ Medical’s tools deliver more quality performance and productivity through innovation – the criteria by which all Commissioning Care Groups – will be judged in the future.
· The company’s focus is to deliver greater value and accountability for the NHS budget, which can be effectively monitored by iQ Budget & Data Manager.
· iQ Budget & Data Manager enables accurate and automatic validation of secondary care information compared with primary care information from the practice clinical systems. This includes extensive customisable reporting to support contract monitoring, commissioning targets and service re-design and also offers integral financial monitoring.
· iQ HealthMaps provides each practice with a comprehensive understanding of the diverse health needs of their local populations in order to support the development of a comprehensive JSNA which will target improvements, optimise service delivery and reduce costs in the face of increasing financial pressures.
· iQ Medical also provides a range of “back office compliance” tools for practices to manage employment law, health and safety, practice finances, QOF, equipment inventory, drug stocks and service continuity planning.
· These will improve CCG performance by standardising all these GP practices’ compliance activities.