Public Expenditure on Health and Personal Social Services 2008 - Health Committee Contents



3.1.3  What proportion of NHS activity by volume was performed by ISTCs from 2004 onwards? Could the Department supply a breakdown of ISTC activity by HRG, together with information on the waiting times profile for each HRG, to show how long patients being treated by ISTCs have been waiting? What are DH doing to ensure that all private suppliers of NHS care accurately complete and return activity statistics? (Q18)

Answer

  1.  The information requested is given in Table 18a to Table 18c.

  2.  Table 18a shows the volume of activity delivered by ISTCs by financial year. The Department of Health's Central Contracts Management Unit (CCMU) is unable to calculate the proportion of NHS activity delivered by ISTCs as it does not hold data relating to the total NHS activity delivered.

  3.  Table 18b shows ISTC phase 2 activity delivered by HRG. CCMU does not hold data at HRG level for activity delivered under the wave 1 contracts.

  4.  Table 18c shows the referral to treatment (RTT) data which is available for the ISTC contracts. Typically this information is available by specialty, by site. In some instances, the RTT data is available by specialty by provider only. RTT data is not available at the HRG level for the ISTC contracts.

  5.  The Department of Health has been actively engaged with independent sector providers involved with the ISTC programme to ensure compliance with all mandatory reporting requirements. The obligation to submit accurate and timely activity data to SUS (Secondary Uses Service) and UNIFY is a requirement of the contract held with each provider.

  6.  During the mobilisation phase the Department conducts extensive system checks to ensure providers develop the appropriate IM&T capability to be able to submit mandatory reports to the required format and frequency.

  7.  During service delivery, regular checks are made via the Connecting for Health landing and staging reports, for CDS (commissioning data set) reporting compliance. Under Phase 2 contracts, failure to submit mandatory reports may result in immediate revenue deduction sanctions being applied on a monthly basis. All other contracts have data submission and quality as a part of the performance management process which may also lead to sanctions under the contract. The Department ensures that sanctions are brought against providers when appropriate.

  8.  The Department works closely with the NHS Information Centre to assess the quality of data being submitted into SUS and joint workshops are held periodically with providers to discuss ways in which the quality of data can be improved.

Table 18a

ISTC WAVE 1 AND PHASE 2—TOTAL DELIVERED ACTIVITY
Activity type 2003-042004-05 2005-062006-07 2007-082008-09 Total


Procedures
3,663 12,73537,73667,210 98,23518,582238,161
Diagnostics- - 22,12247,13094,870 22,156186,278
Primary care-- 8,69241,06045,110 8,188103,050
Renal-- --7,972 8,85716,829


Source: Central Contract Management Unit, DH.

Footnote:

1.  The above data is inclusive of results to 31 May 2008.


Table 18b

ISTC PHASE 2—DELIVERED ACTIVITY BY HEALTHCARE RESOURCE GROUP (HRG)


HRG
HRG description 2005-062006-07 2007-082008-09 Total activity

to date


Diagnostics
0 029,1219,309 38,430
Renal Dialysis0 07,9728,857 16,829
A07Intermediate Pain Procedures 0014 216
B20Orbit / Lacrimal Intermediate Complexity 0010 313
C04Minor Mouth or Throat Procedures 0015 1934
C21Intermediate Ear Procedures 001 01
C22Intermediate Nose Procedures 0081 32113
C31Major Ear Procedures 00223 25
C32Major Nose Procedures 007053 123
C42Complex Major Nose Procedures 008 816
C55Minor Ear Procedures 005725 82
C56Minor Nose Procedures 0041 5
C57Major Mouth or Throat Procedures 006 17
C58Intermediate Mouth or Throat Procedures 00266 157423
F06Diagnostic Procedures, Oesophagus and Stomach 0044 3478
F15Stomach or Duodenum—Therapeutic Endoscopic or Intermediate Procedures 000 11
F35Large Intestine—Endoscopic or Intermediate Procedures 00323 164487
F44General Abdominal—Endoscopic or Intermediate Procedures <70 w/o cc 001 01
F71Abdominal Hernia Procedures >69 or w cc 004 59
F72Abdominal Hernia Procedures <70 w/o cc 0045 2065
F73Inguinal Umbilical or Femoral Hernia Repairs >69 or w cc 0071 32103
F74Inguinal Umbilical or Femoral Hernia Repairs <70 w/o cc 00439 161600
F92Anus—Intermediate Procedures >69 or w cc 003 03
F93Anus—Intermediate Procedures <70 w/o cc 0022 1436
F94Anus—Minor Procedures >69 or w cc 0014 317
F95Anus—Minor Procedures <70 w/o cc 0068 51119
G13Cholecystectomy >69 or w cc 007 29
G14Cholecystectomy <70 w/o cc 00107 52159
H04Primary Knee Replacement 00241 126367
H07Primary or Revisional Shoulder, Elbow, or Ankle Replacements 005 38
H08Joint Replacements or Revisions, Site Unspecified 003 03
H09Anterior Cruciate Ligament Reconstruction 0012 1325
H10Arthroscopies0 0661334 995
H11Foot Procedures—Category 1 0037 2057
H12Foot Procedures—Category 2 0080 48128
H13Hand Procedures—Category 1 00232 112344
H14Hand Procedures—Category 2 0094 32126
H16Soft Tissue or Other Bone Procedures—Category 1 >69 or w cc 0029 1039
H17Soft Tissue or Other Bone Procedures—Category 1 <70 w/o cc 00311 125436
H18Soft Tissue or Other Bone Procedures—Category 2 >69 or w cc 007 916
H19Soft Tissue or Other Bone Procedures—Category 2 <70 w/o cc 0082 35117
H20Muscle, Tendon or Ligament Procedures—Category 1 0059 3897
H21Muscle, Tendon or Ligament Procedures—Category 2 0095 31126
H22Minor Procedures to the Musculoskeletal System 00300 182482
H51Removal of Fixation Device >69 or w cc 000 11
H52Removal of Fixation Device <70 w/o cc 0021 1334
H70Resurfacing of Hip 004013 53
H71Revisional Procedures to Hips 003 14
H72Revisional Procedures to Knees 004 26
H80Primary Hip Replacement Cemented 00112 83195
H81Primary Hip Replacement Uncemented 0031 1849
J01Complex Breast Reconstruction using Flaps 008 311
J05Intermediate Breast Surgery w/o cc 005 16
J06Minor Breast Surgery w cc 000 11
J07Minor Breast Surgery w/o cc 0011 516
J30Major Skin Procedures >49 or w cc 002 02
J31Major Skin Procedures <50 w/o cc 001 12
J32Intermediate Skin Procedures 002 13
J34Minor Skin Procedures—Category 2 w cc 001 12
J35Minor Skin Procedures—Category 2 w/o cc 007 1219
J36Minor Skin Procedures—Category 1 w cc 0012 113
J37Minor Skin Procedures—Category 1 w/o cc 00282 134416
J47Total Mastectomy w/o cc 001 01
J50Other Major Breast Surgery 000 22
L11Ureter Open Procedure 0010 1
L12Ureter Major Endoscopic Procedure 002 02
L13Ureter Intermediate Endoscopic Procedure 003 58
L17Bladder Major Endoscopic Procedure 004 15
L19Bladder Intermediate Endoscopic Procedure w/o cc 00234 38272
L21Bladder Minor Endoscopic Procedure w/o cc 0013 013
L26Bladder Neck Open Procedures Female 001 01
L27Prostate Transurethral Resection Procedure >69 or w cc 0022 830
L28Prostate Transurethral Resection Procedure <70 w/o cc 0016 420
L29Prostate or Bladder Neck Intermediate Endoscopic Procedure (Male and Female) 005 27
L30Prostate or Bladder Neck Minor Endoscopic Procedure (Male and Female) 005 49
L33Urethra Major Open Procedures 001 01
L34Urethra Intermediate or Minor Procedures >69 or w cc 004 04
L35Urethra Intermediate or Minor Procedures <70 w/o cc 004 48
L38Penis Minor Open Procedure > 69 or w cc 003 14
L39Penis Minor Open Procedure <70 w/o cc 0045 3075
L41Vasectomy Procedures 0060 6
L42Scrotum Testis or Vas Deferens Open Procedures >69 or w cc 002 24
L43Scrotum Testis or Vas Deferens Open Procedures <70 w/o cc 0025 1742
L45Extracorporeal Lithotripsy 000 11
M01Lower Genital Tract Minor Procedures 0021 728
M02Lower Genital Tract Intermediate Procedures 003 36
M03Lower Genital Tract Major Procedures 008 210
M05Upper Genital Tract Minor Procedures 0068 36104
M06Upper Genital Tract Intermediate Procedures 0028 735
M07Upper Genital Tract Major Procedures 0016 1430
100General Surgery Outpatients 002,302 9073,209
101Urology Outpatients 00465169 634
106Upper Gastrointestinal Surgery 0025 732
110Trauma and Orthopaedics Outpatients 004,767 2,8387,605
120ENT Oupatients0 01,190627 1,817
150Neurosurgery0 0350 35
160Plastic Surgery0 012924 153
502Gynaecology Outpatients 00302 117419
Q11Varicose Vein Procedures 0076 24100
Q15Amputations0 001 1
R02Surgery for Prolapsed Intervertebral Disc 0017 1229
R03Decompression and Effusion for Degenerative Spinal Disorders 007 18
R09Revisional Spinal Procedures 002 02
PhysioPhysiotherapy0 0670 67
Total0 051,510 25,33376,843



Source:

Central Contract Management Unit, DH

Footnotes:

1.  The above data is inclusive of results to 31 May 2008.

2.  All information provided has been based on the most up to date information at the time of submission.

3.  Renal is represented as sessions rather than procedures or outpatients due to the nature of the service.

4.  The above table includes all activity types (procedures, outpatients, diagnostics, physiotherapy and renal).





Table 18c

RTT WAIT TIMES BY SPECIALTY AND BY ISTC PROVIDER


Provider Site
Scheme Specialty% of Patients Treated within 18 weeks 50% of Patients Treated within|

UKSH

Shepton Mallett NHS Treatment Centre
LP7General Surgery100% 7 weeks
Trauma & Orthopaedics 99%6 weeks
Ophthalmology 100%8 weeks
Total (LP7) 99%7 weeks
NETCARE

Greater Manchester Surgical Centre
LP8General Surgery94% 8 weeks
Trauma & Orthopaedics 76%12 weeks
Ear, Nose & Throat (ENT) 91%7 weeks
Total (LP8) 82%10 weeks
RAMSAY HEALTHCARE (3)

Ramsay Reading Hospital NHS Treatment Centre
GC4
Ramsay New Hall Hospital NHS Treatment Centre
Bodmin NHS Treatment Centre
Horton NHS Treatment Centre
Gainsborough NHS Treatment Centre
Boston NHS Treatment Centre
Clifton Park NHS Treatment Centre
Cobalt NHS Treatment Centre General Surgery100% 6 weeks
Blakelands NHS Treatment Centre Ophthalmology100%6 weeks
Ramsay Euxton Hall HospitalE05 Gynaecology100%3 weeks
Ramsay Fulwood Hospital
Ramsay Renacres Hospital
Gisburne NHS Treatment Centre
Ramsay Tees Valley Treatment Centre
Total (Ramsay) 100%5 weeks
CIRCLE (3)

Eccleshill NHS Treatment Centre
LP2 General Surgery83% 10 weeks
The Midlands NHS Treatment CentreLP3 Urology79%12 weeks
Trauma & Orthopaedics 70%11 weeks
Ear, Nose & Throat (ENT) 83%12 weeks
Ophthalmology 89%13 weeks
Oral Surgery 47%19 weeks
Rheumatology 74%10 weeks
Gynaecology 82%12 weeks
Total (LP2 & LP3 combined) 80%13 weeks
PHG

Peninsula NHS Treatment Centre
LP9 Trauma & Orthopaedics95% 13 weeks
Total (LP9) 95%13 weeks
Barlborough NHS Treatment CentreLP4 Trauma & Orthopaedics97% 11 weeks
Total (LP4) 97%11 weeks
Mid Kent NHS Treatment CentreGC6 General Surgery97% 6 weeks
Total (GC6) 97%6 weeks
North East London NHS Treatment Centre GC7General Surgery100% 7 weeks
Trauma & Orthopaedics 100%8 weeks
Ear, Nose & Throat (ENT) 100%6 weeks
Ophthalmology 100%6 weeks
Total (GC7) 100%7 weeks
CARE UK

Will Adams NHS Treatment Centre (Medway)
GC8General Surgery 100%3 weeks
Urology 100%5 weeks
Trauma & Orthopaedics 100%5 weeks
Ophthalmology 100%4 weeks
Gastroenterology 100%4 weeks
Total (GC8 Medway) 100%4 weeks
St Mary's NHS Treatment Centre (Portsmouth) GC8General Surgery 100%3 weeks
Urology 100%5 weeks
Trauma & Orthopaedics 100%5 weeks
Ophthalmology 100%4 weeks
Gastroenterology 100%4 weeks
Total (GC8 Portsmouth) 100%4 weeks
Sussex Orthopaedic NHS Treatment Centre (Brighton) GC8Trauma & Orthopaedics Data Not AvailableData Not Available
SPIRE HEALTHCARE (3)

Regency Hospital
E06 Trauma & Orthopaedics80% 13 weeks
Fylde Coast HospitalE06 Trauma & Orthopaedics80% 13 weeks
E06General Surgery 96%11 weeks
SPIRE North Cheshire Hospital Urology99%4 weeks
SPIRE Murrayfield Hospital Trauma & Orthopaedics98% 11 weeks
SPIRE Hospital Manchester Ear, Nose & Throat (ENT)97% 8 weeks
SPIRE Hospital Washington Gastroenterology100% 6 weeks
Gynaecology 96%13 weeks
Total 97%10 weeks
INTERHEALTH (3)

Kidderminster NHS Treatment Centre
GC5WTrauma & Orthopaedics 100%6 weeks
The Cheshire & Merseyside NHS Treatment Centre
Total 100%6 weeks




Source:

Central Contract Management Unit (DH)

Notes:

1.  The data above is an extract from UNIFY 2, which captures wait time information across the NHS and the indpendent sector.

2.  This data is for the period February, March and April 2008 and has been used for publishing the latest RTT wait time information on the NHS Choices website.

3.  The following providers have submitted their data at provider level only and are in the process of migrating to site-level reporting:

-  Circle

-  Ramsay Healthcare

-  Spire Healthcare

-  Interhealth

4.  The provider data for Ramsay may include wait times for NHS-funded patients at non-ISTC sites.

5.  CareUK commenced submitting RTT information to UNIFY 2 in May 2008.







 
previous page contents next page

House of Commons home page Parliament home page House of Lords home page search page enquiries index

© Parliamentary copyright 2009
Prepared 8 December 2008