Select Committee on Health Written Evidence


Evidence submitted by BMI Healthcare (ISTC 59)

BMI HEALTHCARE

Clinical Outcomes Data collection for GSup2 Contract

  The Second General Supplementary contract (GSup2) was awarded in Summer 2005.  BMI Healthcare was one of the successful bidders and was awarded a large volume of orthopaedic procedures to be carried out under the terms of the project agreement.

  The contractual reporting requirements related to both Key Performance Indicators (KPIs) and also to patient HRG specific tracking information.

Key Performance Indicators

  The KPIs required reporting on a monthly basis and were presented both electronically and in hard copy at the monthly Performance Management Review (PMR). The purpose of the PMR was to enable formal review of the progress made towards completing the contract and for discussion of all KPI's to identify any trends and to agree necessary actions.

  In tandem with this reporting process, a regular contact was established between the Central Contracts Management Unit (CCMU) clinical lead and the BMI clinical contract lead. This enabled each party to understand the workload being undertaken at each BMI hospital undertaking G Sup 2 work and to review and understand any adverse KPI data. It should be noted that there was no necessity for any "Joint Service Review" during the period of the contract.

  All KPI data was presented to the DH as required by the contract. The breadth and depth of the data was in line with what is regularly collected from all BMI hospital and as such provided comprehensive view of the clinical outcomes across the contract, consistent with that which we collect for all BMI patients.

  The data areas collected are as shown below:

    —  Did Not Attends (DNAs)-Daycases
    —  DNAs-Inpatients
    —  Cancellations for clinical reasons
    —  Cancellations for non-clinical reasons
    —  Unplanned Returns to theatre
    —  Rejections at referral
    —  Total referrals
    —  Unforeseen day case to inpatient stays
    —  Transfers to another facility
    —  Emergency admissions within 29 days
    —  Procedures under local anaesthetic
    —  Provider performance data
    —  Clinician performance data
    —  Patient satisfaction level (daycases)
    —  Patient satisfaction level (inpatients)
    —  Complaints received
    —  Complaints not handled within timescales
    —  Incidents reported to the NPSA
    —  NHS staff recruited
    —  Facility condition
    —  Security breaches
    —  Data protection breaches
    —  Patients treated after treat by date

HRG KPI Data

  In addition to the above, KPI data was also collected by HRG. The following areas were recorded by HRG:

    —  Total Outpatient sessions attributed to each HRG
    —  Emergency admissions by HRG
    —  Length of stay by HRG (day-case and inpatient)
    —  Average length of induction by HRG
    —  Average duration of surgery by HRG
    —  Average length of recovery by HRG
    —  Total procedures under local anaesthetic by HRG

  Again the data was submitted consistently to the CCPP and was discussed at the PMR meetings.

BMI PATIENT TRACKER

  On a weekly basis the contract required submission of a tracking form to identify each patient and what point they had reached in the patient pathway. The tracker included the following information:

    —  SHA
    —  NHS Number
    —  HRG Code
    —  Breach date
    —  Date referral received
    —  Date medical notes received
    —  Outpatient assessment date
    —  Outpatient appointment outcome
    —  Pre-operative assessment date
    —  Pre-operative assessment outcome
    —  Admission date
    —  Procedure date
    —  Procedure outcome
    —  Discharge date
    —  Follow up status
    —  Episode complete date
    —  Reason patient failed to start pathway
    —  Patient contacted date

  The completion of the tracker allowed both the DH and the local SHA to have an accurate view of the situation regarding each patient.

Additional Information

  As the contract drew to a close, BMI were asked to present data to the DH relating to reasons for rejected referrals. It is understood that this was required to enable The Department to fully understand the referral processes and ways of improving them across the NHS in the future. BMI provided this data in a timely way as requested.

Conclusions

  Data provision to the DH for the duration has been a straightforward process and has not presented a significant problem to BMI in terms of compliance or delivery.

Jane Rooney

Clinical Service Director, Amicus Heathcare

28 April 2006



 
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Prepared 25 July 2006