1. NHS Outcomes Framework changes for 2016/17
April 2016

2. NHS Outcomes Indicators 2015/16
During the financial year 2015/16 Powys THB was given a set of 84 indicators and related measures to report against providing assurance to Welsh Government.
The indicators fall under the categories
Staying healthy
Safe care
Effective care
Dignified care
Timely care
Individual care
Our staff and resources
02/12/2018

3. NHS Outcomes Indicators 2016/17
For 2016/17 Welsh Government has updated the NHS Outcome Framework, Powys will now be measured against 96 indicators under the same 7 categories
Brief Summary of changes
14 outcome indicators from 2015/16 will not be used in 2016/17
31 indicators are new of which 12 are still under development
18 indicators will be revised including merging of some indicators/measures
02/12/2018

4. NHS Outcomes New Indicators 2016/17
Over the next 3 slides you will see a list of the new indicators, their related measure, target and data availability. A simple colour rating will give a brief overview on the reporting availability on the upcoming indicators. Please be aware that 12 are under development and may change before release.
Data availability key
Colour Key
Data currently available
Data reporting requires scoping but source is available
Data not currently available
Indicator not applicable to Powys THB
Welsh Government response to reporting schedule
The majority of the new measures (that are not deemed to be under development) will be collated from existing data streams and an agreed timetable will already be in place.
There are a number of measures that don’t have an existing data source and therefore a reporting template has been prepared (as detailed in the reporting guidance).  The submission date for this data/information is outlined on each individual template.
For new measures that are still under development, we will inform NHS organisations of the reporting timetable once it has been agreed.
02/12/2018

5. New Indicator Breakdown
Indicator No.
Performance Measure
Target
Policy Area
Data availability
RAG & Comment 6
Of those who had a condition or illness that reduced their ability to carry out day to day activities, the percentage who said that they had a personal care plan
Annual improvement
Primary Care 7
Percentage of pregnancies where the initial assessment was carried out by 10 completed weeks of pregnancy
Public Health
Data available 8
The percentage of pregnant women who are smokers at weeks 10
Percentage of eligible children being provided with access to universal service component of Healthy Child Wales Programme assessed by socio-economic quintiles.
Major Health Conditions
Data availability not currently scoped 11
Percentage of patients with hypertension in whom the last blood pressure reading (measures in the preceding 12 months) is 150/90 mmHg or less
Data available via QOF 12
Protection of vulnerable adults
TBC
Nursing 13
Percentage compliance with RRAILS Sepsis Six Bundle applied within 1 hour
12 month improvement trend
Healthcare Quality
Non Applicable in Powys 20
Percentage of GP practices that report at or above the national prescribing indicator target for the submission of yellow cards that monitor the safety of medicines
Submit one yellow card per 2,000 practice population
Pharmacy & Prescribing 21
Non steroid anti-inflammatory drug (NSAID) average daily quantity per 1,000 STAR-PUs (specific therapeutic group age related prescribing unit)
Maintain performance levels with the lower quartile or show a reduction towards the quartile below 26
Nutrition and hydration
Under Development 16/17
02/12/2018

6. New Indicator Breakdown
Indicator No.
Performance Measure
Target
Policy Area
Data availability
RAG & Comment 26
Nutrition and hydration
TBC
Nursing
Under Development 16/17 27
Pressure ulcers 28
Medicines management 29
Falls 30
Continence care 35
Indication of progress against the 21 criteria for the operational use of the NHS number
Annual improvement
Information Standards & Governance 36
Percentage of staff who have undergone information governance training as outlined in C-PIP Guidance 37
Percentage of episodes clinically coded within one month post episode end date
95% 38
Percentage of clinical coding accuracy attained in the NWIS national clinical coding accuracy audit programme 47
Evidence of public engagement events/opportunities offered locally by health boards and trusts
Digital Change and Innovation 49
Percentage of NHS employed staff who come into contact with the public who are trained in an appropriate level of dementia care
75%
Workforce & Organisation Development
Available via Workforce 74
Qualitative report providing evidence of implementation of the Welsh language guidance as defined in More Than Just Words
N/A
Operations & Welsh Language Policy
Available 75
Evidence that an individual’s independence is supported and maintained
Under Development 17/18
02/12/2018

7. New Indicator Breakdown
Indicator No.
Performance Measure
Target
Policy Area
Data availability
RAG & Comment 85
Percentage of inhaled corticosteroids prescribed in primary care that are low strength inhaled corticosteroids
Maintain performance level within upper quartile or show an increase towards the quartile above
Pharmacy & Prescribing
Under Development 16/17 86
Number of ENT procedures that do not comply with NICE ‘Do Not Do’ guidance for procedure of limited effectiveness (as agreed by the Planned Care Board)
Delivery & Performance 87
Number of ophthalmology procedures that do not comply with NICE ‘Do Not Do’ guidance for procedure of limited effectiveness (as agreed by the Planned Care Board) 88
Number of orthopaedics procedures that do not comply with NICE ‘Do Not Do’ guidance for procedure of limited effectiveness (as agreed by the Planned Care Board) 89
Number of urology procedures that do not comply with NICE ‘Do Not Do’ guidance for procedure of limited effectiveness (as agreed by the Planned Care Board) 92
Percentage of those who are undertaking performance appraisal who agree it helps them feel valued and improves how they do the job
Bi annual improvement
Workforce & Organisation Development 93
Percentage of staff who are engaged 94
Percentage of staff completing statutory and mandatory training
85% 96
Percentage of staff who would be happy with the standards of care provided by their organisation if a friend or relative needed treatment
02/12/2018

8. Existing Indicators
For 2016/17 Outcomes Framework 65 indicators are carried over or have been revised/merged. Please look to the table on the next slide for ongoing data issues around some measures.
To summarise the reporting gaps these involve primary care e.g. information from GP practices, data from Commissioned only services such as stroke although work is continuing to provide the data needed for assurance.
02/12/2018

9. Existing Indicators Indicator No. Performance Measure Target
Policy Area
Data availability
RAG & Comment 17
Fluoroquinolone items as a percentage of total antibacterial items prescribed
Maintain performance levels within the lower quartile or show a reduction towards the quartile below
Pharmacy & Prescribing
Requires Scoping 18
Cephalosporin items as a percentage of total antibacterial items prescribed 19
Co-amoxiclav items as a percentage of total antibacterial items prescribed 33
Implementation of the universal case note mortality review process
TBC
Healthcare Quality 48
Percentage of GP practice teams that have completed mental health Direct Enhanced Services (DES) in dementia care or other directed training
Annual improvement
Mental Health, Vulnerable Groups & Offenders 54
Number of people who have accessed ‘Add to Your Life’ site and have interacted with the self assessment tool
12 month improvement trend
Public Health
Currently not available 60
Percentage of patients who have a direct admission to an acute stroke unit within 4 hours
The most recent SSNAP UK National
Delivery & Performance 61
Percentage of patients who receive a CT scan within 12 hours 62
Percentage of patients who have been assessed by a stroke nurse within 24 hours 63
Percentage of patients who have received a formal swallow assessment in 72 hours 66
Number of ambulance handovers over one hour
Is not available for Powys THB 72
Qualitative report detailing progress against the 5 standards that enable the health and wellbeing of homeless and vulnerable groups to be identified and targeted
N/A
Qualitative report not reported by Information 73
Qualitative report detailing the achievements made towards implementation of the all Wales standard for accessible communication and information for people with sensory loss
Operations & Welsh Language Policy 82
Rate of patients who did not attend a GP appointment
12 month reduction trend
Primary Care
02/12/2018