better information --> better decisions --> better health 8 th October 2014 David Baird, Service Manager Andrew Lee, Principal Information Analyst, Health & Social Care Information ISD, Public Health & Intelligence

Joint Strategic Commissioning

Static reports Database queries Forecasting Predictive Modelling Evaluation Good Data Value Difficulty Information Knowledge Intelligence Information to Intelligence For Improved Outcomes What’s available Now What’s coming next and How we Can help The Future

The Challenge 2012 – Population aged % 61% 2035 – Population aged % 25% 40% £4.6bn Total spend aged 65+ Hospital Spend (£2.3bn) Emerg adm (£1.4bn) 48% 20% Had multiple admissions Stay < 2 days 491,000 £93m 51,145 31% Days lost to delays Cost of delays Aged 65+ rec HC Rec 10+ hours HC

The Future Strategic Plan established Co-Productive Approach Analyse Aware of Current and Future Demands Service User Pathways Risk Prediction Plan Identify areas for Service Change Quantify Cost Impact Investment and Dis-Investment Scenario Planning Review Evaluating Service Impact Do Developed Skill Sets Identified Areas for Building Capacity Personal Outcomes Approach (at the heart of your decisions) Evidence Based Decisions

Information: What’s Available Now CHP Profiles Hospital Admissions and A & E Delayed Discharges SPARRA and ACP Planning Prescribing & Polypharmacy Efficiency & Productivity Scorecard NASA linkage Workforce and Workload Care Homes Social Care Census Respite survey Mental Health and Learning Disabilities Care Inspectorate

Health & Social Care Data Integration & Intelligence project (HSCDIIP) Key Objective To develop a nationally linked Health and Social care file at an individual service user level (Activity & Costs) Four Key Work streams Inputs Information Governance IT solution Outputs Information: What’s Coming Next

Paint the current picture Population ProjectionsResource Consumption Admission PracticeDelayed Discharges Home Care Information: What’s Available Now

Paint the current picture Home CareCare Homes Local Data Sets Information: What’s Available Now

Population Projections Admission PracticeDelayed Discharges Home Care Information: What’s Coming Next

Population Projections Admission PracticeDelayed Discharges Home Care Information: What’s Coming Next “Analysis is one of the most important activities in the commissioning cycle. Poor analysis of past or future trends will result in flawed commissioning decisions and wasted resources” Social Work Inspection Agency (SWIA) Guide to Strategic Commissioning

All Partnerships (All Ages) per weighted capita Understand Variation in Spend Information – How we Can Help

Understand Resource Use for Cohorts of Clients Information – How we Can Help

JFMAMJJASOND JFMAMJJASOND JFMAMJJASOND Year 2009 Year 2010 Year 2011 Added to WL OP assessment (ophthalmology; £70) Treatment (DC; ophthalmology; procedure; £976) Added to WL Treatment (DC; ophthalmology; procedure; £976) A&E (£103) Em admission (gen med; 3 days; £1,323) Prescriptions (£1,159) Diagnosed CHD Added to QoF Dementia Register Em admission (resp med; procedure; 4 days; £1721) Em admission (gen med; 24 days; £8,042) Delayed Discharge (Home) A&E (£103) Em admission (gen med; 2 days; £882) Transfer Geriatrics (40 days; £15,640) Homecare (364hrs; £6,137) No record of Homecare Discharge to Care Home; Prescriptions £1,159 Prescriptions £1, Days in acute setting at cost of £27, Days in acute setting at cost of £16,522 HC + ACP IC Service User X: female, age 72, lives alone, diabetic since 68 Information – How we Can Help

Identify areas of high resource use to help first year of planning Information – How we Can Help

Forecast resource impact based on a ‘do nothing’ Scenario See Andrew - example Information – How we Can Help

Example: West Dunbartonshire ACPs Information – How we Can Help

Predictive Analysis / Scenario Planning Releasable costs / PBMA ‒Modelling Impact of Service Redesign ‒Model various scenario's ‒Establish potential options ‒Understand ‘Real’ financial implication of service change ‒PBMA ‒Evidence Based Decisions Information – How we Can Help

Performance Monitoring Evaluation Assessment OutcomesImpact AnalysisWhat WorksOutcomesIndicatorsBenchmarking Evaluation

Static reports Database queries Forecasting Predictive Modelling Evaluation Good Data Value Difficulty Information Knowledge Intelligence Information to Intelligence For Improved Outcomes Guidance Public Health Expertise Analytical Support