Shaping district diabetes services: a novel performance index scoring system to successfully negotiate with Clinical Commissioning Groups

Authors

  • Emma Russell-Jones Royal Sussex County Hospital, Brighton, UK
  • Roselle Herring Royal Surrey County Hospital, Guildford, Surrey, UK
  • Klaus Green The Mill Surgery, Godalming, Surrey, UK
  • Victoria Hordern Royal Surrey County Hospital, Guildford, Surrey, UK

DOI:

https://doi.org/10.15277/bjdvd.2015.010

Abstract

Aims: To establish whether a recently reported performance index scoring system developed in two diverse populations (Medway and Guildford, UK) could be used to successfully negotiate with a Clinical Commissioning Group (CCG) to shape diabetes services and set priorities.

Methods: We collated demographic details for the area’s population with diabetes with diabetes scores from local primary care Quality and Outcomes Framework (QOF) records, together with exception reporting. Data from Hospital Episode Statistics and Dr Foster were used to record the Standardised Admission Rate (SAR) for a first/new referral to a secondary-care diabetes outpatient appointment or for emergency admission to hospital for diabetes. Hospital notes for patients from one GP practice were reviewed to clarify why patients were seen in secondary rather than primary care.

Results: The prevalence of diabetes was low (4%) compared with figures from the Strategic Health Authority (SHA) (4.5%) and nationally (5.6%). Total diabetes QOF points achieved (99.3) were higher than for the SHA (97.8) and nationally (95.3); 61.1% achieved HbA1c <7%, which was much higher than the SHA (57.2%) or national average (54.3%). The exception-reporting rate (9.8%) was lower than the SHA (10.5%) or national average (14%). The SAR was lower than the Surrey average for a first outpatient visit (87.8 vs. 128.9) or emergency admissions (85 vs. 106.7).

Conclusions: The performance index scoring system enabled an assessment of diabetes care that transcended primary and secondary care. A successful negotiation took place between the local diabetes stakeholders and the CCG with a plan for improving and developing the current model of care. The scoring system is applicable to any district in the UK and may be of interest to clinicians and commissioners.

References

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Guildford and Waverley Clinical Commissioning Group. Available at http://www.guildfordandwaverleyccg.nhs.uk (August 2014).

NHS England. Action for diabetes. Available at http://www.england. nhs.uk/ourwork/qual-clin-lead/action-for-diabetes/(August 2014)

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Russell-Jones EC, Gough A, Scobie IN. The Novel use of commonly captured data to assess a district’s diabetes service that encompasses both primary and secondary care. QJM 2013;106:737-45. http://dx.doi.org/10.1093/qjmed/hct097

Quality Outcomes Framework indicators. Available at: http://www.dhsspsni.gov.uk/qof-indicators.pdf (August 2014).

Hospital Episode Statistics. Available at http://http://webarchive.nationalarchives.gov.uk/20130107105354/http://www.dh.gov.uk/en/Publicationsandstatistics/Statistics/HospitalEpisodeStatistics/index.htm (August 2014).

Dr Foster. Available at: http://www.drfosterhealth.co.uk/(August 2014)

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Published

2015-06-06

Issue

Section

Learning from practice

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