Select Committee on Health Written Evidence


Supplementary evidence submitted by Netcare Healthcare Ltd (ISTC 27A)

GREATER MANCHESTER SURGICAL CENTRE INFORMATION RETURNS

187 Separate Data Items Captured Throughout the Patient Care Pathway

10 PATIENT RELATED OUTCOMES MEASURES (PROMS) QUESTIONNAIRES

  Clinical data collected to measure the success of the elective surgery:

    —  Anderson-McGall Hand Function Questionnaire.

    —  Foot Function Index.

    —  Generic follow-up questionnaire.

    —  Hip Harris Score.

    —  Knee Injury and Osteoarthritis Outcome Score.

    —  Knee Society Rating Score.

    —  Leeds Dyspepsia Score.

    —  Varicose Veins questionnaire.

    —  Hiatus Hernia questionnaire.

    —  Lower Extremity Range of Motion—Foot.

    —  Oxford Hip Score.

    —  Upper Extremity Range of Motion—Hand.

AUDITING

  Peapod Business Continuity Report September 2005—Business Continuity/Disaster Recovery Review.

  KPMG Audit November 2005—Information process review.

  BS7799-2—Continual information asset review.

  Indigo4—Monthly data quality checks on submitted Commissioning Data Sets (CDS).

  Daily, weekly and monthly auditing (see below).

DAILY DATA PROCESSING AND QUALITY REVIEWS

  Data Checks—performed as first process each morning. Automated reports detect and report on specific erroneous data items that will impact on the validity and accuracy of patient activity and reporting.

  Exception Reports—produced after the data checks for use by the relevant GMSC operational managers tensure data objectives are met before producing the activity reports:

    —  All data for the previous Pre Operative Assessment clinic has been captured timeously and accurately.

    —  All data for the previous Follow-Up Assessment clinic has been captured timeously and accurately.

    —  All data for the discharges for the previous day has been captured timeously and accurately.

  Activity Reports—after confirmation of completed data capturing, the activity reports are prepared and submitted tthe Primary Care Trusts:

    —  Preop Appointment Confirmation Report—all appointments booked on the previous day by the Patient Choice Centre.

    —  Preop Activity Report—outcomes for every Pre Operative Assessment attended at the previous days' clinic.

    —  Discharge Summary Report—data on all patients discharged for the previous day.

WEEKLY DATA PROCESSING AND QUALITY REVIEWS

  Weekly Data Checks—daily data checks are repeated for the period of the week tensure all data is valid.

  LP8 Report (weekly activity report)—constructed by repeating the daily activity reports and comparing these against the submitted daily activity reports. All anomalies are investigated and information confirmed with the Contract Management Unit prior tsubmission tthe Department of Health.

MONTHLY DATA PROCESSING AND QUALITY REVIEWS

  CDS—monthly activity report constructed for Inpatient and Outpatient data after combining and reproducing the daily data checks and reports. CDS shows all activity for the previous month, submitted to Indigo4 for data checks, and ClearNet for submission tthe NHS.

  26 Key Performance Indicators (KPI's)—produced for reporting on aspects of the Inpatient Admissions. Submitted tthe Department of Health. KPI information includes:

    —  Admissions.

    —  Discharges.

    —  Cancellations.

    —  Returns To Theatres.

    —  Readmission.

    —  Complications.

    —  Transfers out.

    —  Deaths.

  Patient Satisfaction Surveys—All discharged patients are requested to complete a patient satisfaction survey, which is captured for statistical and performance analysis and review.

RETURNS TO OTHER BODIES

  NJR—National Joint Registry—clinical data for total hip replacement operations and total knee replacement operations.

  NCEPOD—National Confidential Enquiries into Patient Outcomes and Deaths—reporting on elective surgery outcomes.

  SSI—Surgical Site Infection Surveillance—reporting on surgical infections.

Greater Manchester Surgical Centre Key Performance Indicators



KPI
Data Required
Description

KPI 01       Total # of In-patient DNA's, Total # of Day case DNA's, Total In-patient Activity, Total Day case Activity Incidence of In-patient and /or Day case activities not commenced because of DNA's will be calculated as a percentage of all activities.
KPI 02Total # of Cancellations after admission (non-clinical), Total # In-patient Day case admissions Procedures cancelled by the Provider for non-clinical reasons on or after the day of admission. For the purpose of performance measurement this is measured as a percentage of all patients admitted to the facility.
KPI 03Total # of Cancellations after admission (clinical), Total # In-patient Day case admissions Procedures cancelled by the Provider for clinical reasons on or after the day of admission. For the purpose of performance measurement this is measured as a percentage of all patients admitted to the facility.
KPI 04Total # Patients Returning to Theatre, Total Admissions (to the Facility) Patient returning to operating theatre for procedure that was unforeseen at the time the patient's previous procedure was completed as a percentage of all patients admitted to the facility.
KPI 05Total # Outpatient Assessments per HRG, Total # of Appointments by HRG Outpatient assessments and appointments for each HRG.
KPI 06Total # Patients Reject at Referral, Total # Referrals to the Facility In respect of the facility, the rate of rejection by the Provider in respect of patients referred within referral protocol (Schedule 3) as a percentage of all patients who are referred.
KPI 07Total # Unforeseen In-patient Admissions, Total # In-patient Day case admissions For Day cases, In-patient admission to the facility or to other Providers' facilities (including NHS Providers) which was unforeseen at the time of admission. For the purpose of the performance threshold as a percentage of all Day cases in the facility.
KPI 08Total # Orthopaedic Day case In-patient Transfers, Total # Other Day case In-patient Transfers, Total # Orthopaedic Day case In-patient Admissions, Total # Other Day case In-patient Admissions Transfers of patients to another Provider of inpatient treatment that was not in the management plan for that patient on admission to the facility. For the purpose of the performance threshold as a percentage of all inpatients in the facility for Minor Surgery, Orthopaedics and Other Procedures.
KPI 09Total # Emergency and Readmission within previous 29 Days, Total # Patients Discharged from the Facility, Total # Emergency and Readmission within previous 29 Days by HRG. Emergency admissions/readmission of patients who have received inpatient treatment and have been discharged within 29 days of such discharge where such admission or readmission is related to or arising from the relevant inpatient treatment. For the purposes of the performance threshold measured by HRG as a percentage of all patients discharged.
KPI 10Length of Day case Stays in hours by HRG Length of Day case Stays in hours by HRG.
KPI 11Average Length of In-patient Stay in Days by HRG Average Length of In-patient Stay in Days by HRG.
KPI 12Average Duration of Induction Period, Average Duration of Surgery Procedure, Average Duration of Recovery Period. All data to be in minutes and by HRG Average Duration of Induction Period, Average Duration of Surgery Procedure, Average Duration of Recovery Period. All data to be in minutes and by HRG.
KPI 13Number of Repeat Activity within 5 Years by HRG. Number of Repeat Activity within 5 Years by HRG.
KPI 14Total # Completed Day case In-patient Procedures carried out under Local Anaesthetic by HRG Percentages of procedures carried out under local anesthetic by HRG as a percentage of all procedures.
KPI 15TBA TBA
KPI 16Provider Performance Data Timeliness, completeness and accuracy of Provider Performance data provided to the Joint Service Review and/or to Sponsor.
KPI 17Clinician Performance Data Timeliness, completeness and accuracy of Provider clinician reporting to referring health body's clinician.
KPI 18Outpatient Satisfaction Level, Day case and In-patient Satisfaction level Patient/customer satisfaction (by survey) based on a survey of 10% of all patients at each facility in each contract month.
KPI 19Total # Outpatient Complaints, Total # Complaints received from Day cases and In-patients, Total # Patients Treated in this Facility Rate of patient complaints ie number of complaints received as a percentage of all patients referred for outpatient treatment or In-patient/Day case treatment.
KPI 20Total # Complaints Not Handled within Contract Timescales Patient Complaints Handling—Complaints not handled within relevant time scales set out in Agreement.
KPI 21Total # Incidents Reported to NPSA or Other Body Incidents, which are reportable to NPSA or other statutory body.
KPI 22Total # of NHS Staff Recruited in Breach of Clause 9 NHS Staff recruited in breach of Clause 9 of the agreement.
KPI 23Condition of the Facility Condition of facility, measured by inspection by a sponsor and/or the Provider and assessed against the requirements of the facility manual and operational procedures.
KPI 24Total # Security Breaches Related to Services Breach of security related to the services where there is an identifiable risk of loss, harm or damage to people or property.
KPI 25Total # Breaches by Provider of Confidentiality or data protection Breach by the Provider of confidentiality and/or data protection requirements in the agreement.
KPI 26Total # Treatments After Agreed Treat By date Failure to meet Treat By Date.



Greater Manchester Surgical Centre Data Items


Data Items Collected
Classification

Estimated Length Of Procedure
Activity / Efficiency
Induction Start Time
Activity / Efficiency
Non Attendance Reason
Activity / Efficiency
Non Attendance Reason For Admission
Activity / Efficiency
Postop Appointment Non Attendance Reason
Activity / Efficiency
Recovery End Time
Activity / Efficiency
Time Into Theatre
Activity / Efficiency
Time Out Of Theatre
Activity / Efficiency
Allergies
Clinical
ASA Status
Clinical
Deaths
Clinical
Diagnosis
Clinical
Discharge Comments
Clinical
Discipline
Clinical
District Nurse Comments
Clinical
Evidence Of Wasting
Clinical
Has The Patient Been Readmitted to GMSC—Details
Clinical
Has The Patient Been Readmitted to GMSC?
Clinical
Has The Patient Been Readmitted to Hospital—Details
Clinical
Has The Patient Been Readmitted to Hospital?
Clinical
Has The Patient Had An Uneventful Recovery—Details
Clinical
Has The Patient Had An Uneventful Recovery?
Clinical
Height
Clinical
Histology Results Available
Clinical
Histology Results Available Comments
Clinical
Histology Taken
Clinical
Indications For Surgery
Clinical
IntraOperative Blood Loss
Clinical
IntraOperative Complications
Clinical
IntraOperative Complications Details
Clinical
Is Chair or Stretcher Required For Admission
Clinical
Is Chair or Stretcher Required For Further Postop Appointment
Clinical
Is Chair or Stretcher Required For Postop Appointment
Clinical
Is Chair or Stretcher Required For Preop Assessment
Clinical
Is The Patient Taking Medication
Clinical
Is The Patient Taking Medication (Confirmation At Preop Assessment)
Clinical
Laterality Operated On
Clinical
Laterality To Be Operated On
Clinical
Medication Dose
Clinical
Medication Dose (Confirmation At Preop Assessment)
Clinical
Medication Frequency
Clinical
Medication Frequency (Confirmation At Preop Assessment)
Clinical
Medication Name
Clinical
Medication Name (Confirmation At Preop Assessment)
Clinical
Medication route
Clinical
Medication route (Confirmation At Preop Assessment)
Clinical
Medication To Take Home—Dose
Clinical
Medication To Take Home—Frequency
Clinical
Medication To Take Home—Further Supply From GP Required
Clinical
Medication To Take Home—Name
Clinical
Medication To Take Home—Route
Clinical
Occupational Therapist Comments
Clinical
Occupational Therapist Comments (Confirmation At Preop Assessment)
Clinical
Other Procedures Performed
Clinical
Patient Mobility—Bed Bound
Clinical
Patient Mobility—House Bound
Clinical
Patient Mobility—Stairs
Clinical
Patient Mobility—Transfer
Clinical
Patient Mobility—Walking
Clinical
Patient Mobility—Walking Aid Used
Clinical
Patient Mobility—Wheelchair Bound
Clinical
Patient Passed Away
Clinical
Patient Related Outcome Measures—Anderson-McGall Hand Function Questionnaire
Clinical
Patient Related Outcome Measures—Foot Function Index
Clinical
Patient Related Outcome Measures—Generic Patient Follow Up Questionnaire
Clinical
Patient Related Outcome Measures—Hip Harris Score
Clinical
Patient Related Outcome Measures—Knee Injury & Osteoarthritis Outcome Score
Clinical
Patient Related Outcome Measures—Knee Society Rating Score
Clinical
Patient Related Outcome Measures—Leeds Dyspepsia
Clinical
Patient Related Outcome Measures—Lower Extremity Range of Motion - Foot
Clinical
Patient Related Outcome Measures—Oxford Hip Score
Clinical
Patient Related Outcome Measures—Upper Extremity Range of Motion - Hand
Clinical
Physiotherapist Comments
Clinical
Physiotherapist Comments (Confirmation At Preop Assessment)
Clinical
Post Operative Complications
Clinical
Post Operative Complications Details
Clinical
Preop Assessment Fit For Surgery Classification
Clinical
Preop Assessment Fit For Surgery Classification Temporary or Permanent
Clinical
Preop Assessment Fit For Surgery Classification Unfit Reason
Clinical
Primary Procedure Performed
Clinical
Procedure As Per Consent
Clinical
Prosthesis Used
Clinical
Prosthesis Used Details
Clinical
Readmissions
Clinical
Reason For Admission
Clinical
Region Operated On
Clinical
Region To Be Operated On
Clinical
Returns To Theatre
Clinical
Significant Co-Pathology
Clinical
Social Circumstances
Clinical
Surgical Fit For Surgery Classification
Clinical
Surgical Fit For Surgery Classification Temporary or Permanent
Clinical
Surgical Fit For Surgery Classification Unfit Reason
Clinical
Surgical Technique Used
Clinical
Sutures / Stitches Removed When
Clinical
Theatre Nurse Name
Clinical
Transfers Out
Clinical
Weight
Clinical
Admitting Ward
Non-Clinical
Anaesthetist
Non-Clinical
Anaesthetist Nurse Name
Non-Clinical
Arrival Date
Non-Clinical
Arrival Time
Non-Clinical
Consent For Surgery Obtained
Non-Clinical
Consultant Surgeon
Non-Clinical
Date of Procedure
Non-Clinical
Did Patient Attend Preop
Non-Clinical
Discharge Date
Non-Clinical
Discharge Equipment
Non-Clinical
Discharge Equipment Instructions
Non-Clinical
Discharge Equipment Quantity
Non-Clinical
Discharge Time
Non-Clinical
District Nurse Comments (Confirmation At Preop Assessment)
Non-Clinical
District Nurse Contact Details
Non-Clinical
District Nurse Contact Details (Confirmation At Preop Assessment)
Non-Clinical
District Nurse Name
Non-Clinical
District Nurse Name (Confirmation At Preop Assessment)
Non-Clinical
Escort To Travel For Admission
Non-Clinical
Escort To Travel For Further Postop Appointment
Non-Clinical
Escort To Travel For Postop Appointment
Non-Clinical
Escort To Travel For Preop Assessment
Non-Clinical
Ethnicity
Non-Clinical
Follow Up Appointment Required In Units (Weeks or Months)
Non-Clinical
Follow Up Appointment Required In Value
Non-Clinical
Follow Up Appointment Required?
Non-Clinical
Further Follow Up Required
Non-Clinical
Gender
Non-Clinical
GP Code
Non-Clinical
GP Name
Non-Clinical
GP Practice Address
Non-Clinical
GP Practice Code
Non-Clinical
GP Practice Email Address
Non-Clinical
GP Practice Fax Number
Non-Clinical
GP Practice Name
Non-Clinical
GP Practice Postcode
Non-Clinical
GP Practice Telephone Number
Non-Clinical
Intended HRG Code
Non-Clinical
Intended HRG Description
Non-Clinical
Intended OPCS Code
Non-Clinical
Interpreter Required
Non-Clinical
Is Patient A Direct Referral
Non-Clinical
Is Patient Off Waiting List
Non-Clinical
Is Transport Required For Admission
Non-Clinical
Is Transport Required For Further Postop Appointment
Non-Clinical
Is Transport Required For Postop Appointment
Non-Clinical
Is Transport Required For Preop Assessment
Non-Clinical
Language
Non-Clinical
Next Of Kin—Additional Contact Telephone Number
Non-Clinical
Next Of Kin—Address
Non-Clinical
Next Of Kin—Name
Non-Clinical
Next Of Kin—Postcode
Non-Clinical
Next Of Kin—Telephone Number
Non-Clinical
NHS Breach Date
Non-Clinical
Notes
Non-Clinical
Occupational Therapist Contact Details
Non-Clinical
Occupational Therapist Contact Details (Confirmation At Preop Assessment)
Non-Clinical
Occupational Therapist Name
Non-Clinical
Occupational Therapist Name (Confirmation At Preop Assessment)
Non-Clinical
Occupational Therapist Requirements
Non-Clinical
Occupational Therapist Requirements (Confirmation At Preop Assessment)
Non-Clinical
Patient Address
Non-Clinical
Patient Attended Admission
Non-Clinical
Patient Attended Postop Appointment
Non-Clinical
Patient Date of Birth
Non-Clinical
Patient Forename
Non-Clinical
Patient NHS Number
Non-Clinical
Patient Postcode
Non-Clinical
Patient Satisfaction Surveys
Non-Clinical
Patient Surname
Non-Clinical
Patient Telephone Number
Non-Clinical
Patient Title
Non-Clinical
PCT Code
Non-Clinical
PCT Name
Non-Clinical
Physiotherapist Contact Details
Non-Clinical
Physiotherapist Contact Details (Confirmation At Preop Assessment)
Non-Clinical
Physiotherapist Name
Non-Clinical
Physiotherapist Name (Confirmation At Preop Assessment)
Non-Clinical
Postop Appointment Arrival Date
Non-Clinical
Postop Appointment Arrival Time
Non-Clinical
Pre-op Anaesthetist
Non-Clinical
Preop Arrival Date
Non-Clinical
Preop Arrival Time
Non-Clinical
Preop Assessment Appointment End Time
Non-Clinical
Preop Assessment Appointment Start Time
Non-Clinical
Pre-op Assessment Consultant
Non-Clinical
Referred HRG Code
Non-Clinical
Referred HRG Description
Non-Clinical
Referred OPCS Code
Non-Clinical
Referrer Address
Non-Clinical
Referrer Name
Non-Clinical
Referrer Postcode
Non-Clinical
Referrer Telephone Number
Non-Clinical
Surgical Assistant Name
Non-Clinical
Verbal Consent To Access Medical Records Obtained
Non-Clinical
Which Type Of Ambulance Crew Required For Admission
Non-Clinical
Which Type Of Ambulance Crew Required For Further Postop Appointment
Non-Clinical
Which Type Of Ambulance Crew Required For Postop Appointment
Non-Clinical
Which Type Of Ambulance Crew Required For Preop Assessment
Non-Clinical

Netcare Healthcare Ltd
March 2006








 
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Prepared 25 July 2006