Dr Foster Intelligence | Case studies

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We have had quite a big trend increase in emergency admissions this year and that was something that we identified through the Practice and Provider Monitor tool

Jo Turl Head of Performance and Information

Redesigning services

"We have to update the JSNA every year," said Jo Turl, head of performance and information at Torbay Care Trust. "It identifies inequalities in the population and areas that need improvement.

"Using more detailed data has really helped us to identify and focus on specific areas. For example, emergency admissions and teenage pregnancy is something that we have concerns over locally, and so the information we now receive through PPM [Practice and Provider Monitor tool] enables us to look at and compare our standard admissions with other PCTs across the country."

The trust, a community health and adult social care organisation in the south-west, is using the increased detail to encourage staff to own and manage their specific areas of information. The knowledge they have uncovered is now being used to address an issue that many trusts face – reducing unnecessary emergency admissions.

"We have had quite a big trend increase in emergency admissions this year and that was something that we identified through the Practice and Provider Monitor tool," Turl explained.

Unnecessary emergency admissions are an area of care that, once improved, should have great ramifications for the health of the local community. In many parts of the country, emergency admissions have been rising. Analysis shows that much of this demand could be better met in the community, rather than in hospitals. New models of care may provide the answer, as public service organisations better understand their communities and groups receive better support in looking after themselves.

Solution:

At Torbay, a range of staff are involved in the care trust's new methods of using information, including commissioners, performance and information leads, and service improvement managers. In order to encourage teamwork between GPs and the trust, and to reduce unnecessary emergency admissions more quickly, Turl's team created an incentive scheme.

"Practices get points for reducing emergency admissions, which enables us to help the local population use services more appropriately," she said.

"By understanding who is going to A&E and why, we can say to practices, 'look, this is what the PCT average was last year' and set them a target to beat. If they can beat it by one per cent, they earn points, and a point means a hundred pounds. It works on a scale, so if they get up to 12 points they can get the full amount."

Initially, providing such incentives may be a quick method for ingraining new processes into the local healthcare system, making change more rapid.

Turl continued: "By using PPM, the practices are able to see exactly how they are doing and monitor themselves against others. In terms of practice-based commissioning, this is exactly where we want to use it. These comparisons help us focus on relevant local issues and monitor the effectiveness of our changes."

Outcome:

The success of projects such as this should not only improve patient satisfaction, but also save lives. Patients will be receiving the care they need in the most appropriate environment, which should be as close to home as possible and provided by the most experienced staff. This will promote the sustainability of the changes made, in turn creating what could be substantive improvements in addressing inequality.

"Now that we can all access this data, we don’t have to ask the information team to set up specific queries, which was time consuming and labour intensive," Turl explained. "We had real trouble doing things like linking the patient journey and readmissions, which is something that we can do instantaneously now.

"Even more importantly, it also means that because we are all looking at the same data we can say to each other, 'Ok, let's not waste time talking about the data – we can see what the issues are so let's sit down and talk about what we can do about them'. So I think that has been a great improvement within the service."

Tool or service

Practice and Provider Monitor.