nhs confederation - independent sector providers …/media/confederation/file… · web viewthe nhs...

75
Independent sector providers caring for NHS patients Comparative performance indicators May 2015 Edition 16

Upload: others

Post on 08-Jul-2020

5 views

Category:

Documents


0 download

TRANSCRIPT

Page 1: NHS Confederation - Independent sector providers …/media/Confederation/File… · Web viewThe NHS Partners Network is the trade association representing the widest range of independent

Independent sector providers caring for NHS patientsComparative performance indicators

May 2015

Edition 16

Page 2: NHS Confederation - Independent sector providers …/media/Confederation/File… · Web viewThe NHS Partners Network is the trade association representing the widest range of independent

New in this edition

Updated data this month Friends and family test results VTE RTT waiting times Diagnostic times Monthly volume numbers and share by specialty: inpatient and outpatient elective

NB, all the graphs and charts in this document are derived directly from data provided by independent sources including NHS England, the Health and Social Care Information Centre and the Care Quality Commission. The relevant source, including links wherever possible, is given by each visualisation.

If organisations wish to refer to specific visualisations contained within this data, we would recommend that the relevant source data, together with the relevant explanatory notes as published in this document, are included in any citations.

For more information about the data underlying the visualisations in this presentation, please contact [email protected]

Page 2 of 53

Page 3: NHS Confederation - Independent sector providers …/media/Confederation/File… · Web viewThe NHS Partners Network is the trade association representing the widest range of independent

ContentsNew in this edition................................................................................................................................................................................................................................................. 2

Patient experience................................................................................................................................................................................................................................................. 6

Friends and family test performance..................................................................................................................................................................................................................... 7

Friends and family test – performance of all providers.........................................................................................................................................................................................8

Friends and family test – the top performers........................................................................................................................................................................................................ 9

Friends and family test response rates................................................................................................................................................................................................................ 10

Clinical quality..................................................................................................................................................................................................................................................... 11

CQC standards 2013–14...................................................................................................................................................................................................................................... 12

CQC compliance rates – hospital care standards................................................................................................................................................................................................. 13

CQC compliance rates – community healthcare standards.................................................................................................................................................................................14

CQC compliance rates – independent ambulances............................................................................................................................................................................................. 15

Patient outcomes and safety............................................................................................................................................................................................................................... 16

Patient Reported Outcome Measures (PROMs).................................................................................................................................................................................................. 18

PROMs – primary hip replacement.................................................................................................................................................................................................................. 19

PROMs – primary knee replacement.............................................................................................................................................................................................................. 24

PROMs – groin hernia...................................................................................................................................................................................................................................... 29

Rate of assessment for VTE (blood clots)............................................................................................................................................................................................................ 32

Infection control data.......................................................................................................................................................................................................................................... 33

Page 3 of 53

Page 4: NHS Confederation - Independent sector providers …/media/Confederation/File… · Web viewThe NHS Partners Network is the trade association representing the widest range of independent

Efficiency indicators............................................................................................................................................................................................................................................. 34

Referral to treatment times................................................................................................................................................................................................................................. 35

Percentage of patients treated within 18 weeks................................................................................................................................................................................................. 36

Typical waiting times........................................................................................................................................................................................................................................... 37

Average waiting times by specialty...................................................................................................................................................................................................................... 38

Waiting times for 95% of patients....................................................................................................................................................................................................................... 39

Diagnostic waiting times...................................................................................................................................................................................................................................... 40

Numbers of patients treated............................................................................................................................................................................................................................... 42

Elective admissions and GP referrals (1).............................................................................................................................................................................................................. 44

Elective admissions and GP referrals (2).............................................................................................................................................................................................................. 45

Elective admissions and GP referrals (3).............................................................................................................................................................................................................. 46

Acute elective patients treated by independent sector and NHS organisations..................................................................................................................................................47

Monthly number of acute elective patients treated by the independent sector................................................................................................................................................48

Number of inpatients treated by the independent sector by specialty...............................................................................................................................................................49

Number of outpatients treated by the independent sector by specialty............................................................................................................................................................50

Share of inpatients treated by the independent sector by specialty...................................................................................................................................................................51

Proportion of NHS outpatients treated by the independent sector by specialty.................................................................................................................................................52

Diagnostic tests carried out by independent sector by modality........................................................................................................................................................................53

Page 4 of 53

Page 5: NHS Confederation - Independent sector providers …/media/Confederation/File… · Web viewThe NHS Partners Network is the trade association representing the widest range of independent

Independent sector performance

The NHS Partners Network is the trade association representing the widest range of independent sector providers of NHS clinical services ranging through acute, diagnostic, primary and community care, as well as dental services. Our members are drawn from both the “for profit” and “not for profit” sectors and include large international hospital groups and small specialist providers. All are committed to working in partnership with the NHS and to the values set out in the NHS Constitution.

This document gives an overview of the performance of independent sector providers of care to NHS patients. It focuses on care sectors represented by NHSPN members and the indicators available cover five broad domains of quality:

Patient experience Clinical quality Patient outcomes and safety Efficiency indicators The contribution of the sector shown by numbers of patients treated

All the visualisations shown in this document are based on publicly available data published by organisations such as NHS England, Public Health England, the Health and Social Care Information Centre and the Care Quality Commission.

Not all data collected for traditional NHS organisations and independent sector providers can be compared easily. Historic differences in the way NHS and independent sector providers have been regulated have often required independent providers to collect different information from their NHS counterparts. As the range of information is increasingly harmonised, we hope to be able to produce more comparative information published by third parties such as the organisations listed above.

Page 5 of 53

Page 6: NHS Confederation - Independent sector providers …/media/Confederation/File… · Web viewThe NHS Partners Network is the trade association representing the widest range of independent

Patient experience

Page 6 of 53

Page 7: NHS Confederation - Independent sector providers …/media/Confederation/File… · Web viewThe NHS Partners Network is the trade association representing the widest range of independent

Friends and family test performanceThe Government’s preferred measure of patient satisfaction, the Friends and Family Test (FFT), applies equally to traditional NHS and the independent sector. Collected monthly since April 2013, around 99% of patients would be ‘extremely likely’ or ‘likely’ to recommend independent providers compared with a national average of around 94%. At present, acute inpatient care is the only area where the FFT is collected by both independent and NHS providers however NHS England is in the process of rolling out the FFT across all NHS care.

Apr-14 May-14 Jun-14 Jul-14 Aug-14 Sep-14 Oct-14 Nov-14 Dec-14 Jan-15 Feb-15 Mar-15 Average0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%

Friends and Family Test scores (inpatients)

Percentage of inpatients who would recommend their provider during the past 12 months. Source: NHS England. Green bars: independent providers and blue bars: Av of all providers to NHS patients

Page 7 of 53

Page 8: NHS Confederation - Independent sector providers …/media/Confederation/File… · Web viewThe NHS Partners Network is the trade association representing the widest range of independent

Friends and family test – performance of all providersIndependent providers cluster at the ‘high end’ of performance. The graph below shows the performance of all providers that collect the FFT for inpatient acute care and which produce a minimum response rate of 20% amounting to at least 20 patients per month. Green bars represent independent organisations and blue bars show NHS hospitals.

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%Friends and Family score by site (inpatients) – March 2015

Blue columns are NHS organisations, green columns are independent providers. Only sites with a response rate of 20% or above, that produced 20 or more responses and with actual response data are shown. Source: NHS Eng

Page 8 of 53

Page 9: NHS Confederation - Independent sector providers …/media/Confederation/File… · Web viewThe NHS Partners Network is the trade association representing the widest range of independent

Friends and family test – the top performersThe graph below shows all those hospitals that scored a 100% recommendation rate (extremely likely and likely to recommend) as measured by patients in their response to the FFT for acute inpatient care. Within this group, organisations are ordered on the basis of those with the highest proportion of patients ‘extremely likely’ to recommend their providers (highest on left, lowest on right). NB some providers with an overall percentage recommendation rate below 100% may have achieved higher rates of patients ‘extremely likely’ to recommend them than those shown on this graph.

BMI -

The

Som

erfiel

d Hosp

ital -

NT4

38

Fulw

ood Hal

l Hosp

ital -

NVC07

Orth

opaedic

s an

d Spin

e Sp

ecia

list H

ospita

l

BMI -

The

Highfiel

d Hosp

ital -

NT4

20

Sunder

land E

ye In

firmar

y - R

LNGM

The

Berks

hire In

depen

dent H

ospita

l - N

VC02

The

Spen

cer W

ing

(Ram

sgat

e Road

) - N

N801

Spire

Suss

ex H

ospita

l - N

T309

Nuffi

eld H

ealth

, Brig

hton H

ospita

l - N

T205

BMI -

Gorin

g Hal

l Hosp

ital -

NT4

17

The

Horder

Cen

tre -

St Jo

hns Road

Notti

ngham

Woodth

orpe

Hospita

l - N

VC40

Fairfi

eld H

ospita

l - N

VG01

Kidder

min

ster

Hosp

ital -

RW

P31Circ

le R

eadin

g

Benen

den H

ospita

l - N

WF0

1

Moorfi

elds

Eye

Hospita

l (City

Road

) - R

P601

BMI -

The

Droitw

ich S

pa Hosp

ital -

NT4

12

Spire

Met

hley

Park

Hospita

l - N

T350

BMI -

Thre

e Sh

ires

Hospita

l - N

T441

Spire

Lee

ds Hosp

ital -

NT3

32

South

Wes

t London E

lecti

ve O

rthopae

dic C

entre

- RVRTC

Sprin

gfiel

d Hosp

ital -

NVC18

Spire

Ches

hire H

ospita

l - N

T324

Spire

Har

penden

Hosp

ital -

NT3

16

BMI T

he Cav

ell H

ospita

l - N

T451

Nuffi

eld H

ealth

, Der

by Hosp

ital -

NT2

13

Spire

Norw

ich H

ospita

l - N

T318

Birmin

gham

Wom

en's

Hosp

ital -

RLU

01

Spire

Cla

re P

ark

Hospita

l - N

T345

Birmin

gham

Mid

land E

ye C

entre

(Bm

ec) -

RXK03

Spire

Bush

ey H

ospita

l - N

T315

Berw

ick

Infirm

ary

- RTF

DH0%20%40%60%80%

100%

Friends and Family score by site (inpatients) – March 2015_x000d_Organisations with overall 100% recommendation rate,

ranked by % extremely likely to recommend

Blue columns represent NHS orgs and green columns show independent providers. Shows only sites with response rate of 20% or above, with 20 or more responses and a 100% recommendation rate. Ranking by

percentage of patients 'extremely likely' to recommend.

Page 9 of 53

Page 10: NHS Confederation - Independent sector providers …/media/Confederation/File… · Web viewThe NHS Partners Network is the trade association representing the widest range of independent

Friends and family test response ratesResponse rates to the FFT are used by the CQC to measure NHS Trusts’ reporting culture. On average independent providers manage response rates of over 45% compared with an England average of 37%.

Apr-14

May-14

Jun-14Jul-1

4

Aug-14

Sep-14

Oct-14

Nov-14

Dec-14

Jan-15

Feb-15

Mar-15

Averag

e0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

Friends and Family Test response rates (inpatients)

Friends and Family Test inpatient response rates for the past 12 months. Green bars show independent providers and blue bars represents average for all organisations treating NHS patients. Source: NHS England

The data that underpins all the FFT graphs above is available at: http://www.england.nhs.uk/statistics/statistical-work-areas/friends-and-family-test/friends-and-family-test-data/

Page 10 of 53

Page 11: NHS Confederation - Independent sector providers …/media/Confederation/File… · Web viewThe NHS Partners Network is the trade association representing the widest range of independent

Clinical quality

Page 11 of 53

Page 12: NHS Confederation - Independent sector providers …/media/Confederation/File… · Web viewThe NHS Partners Network is the trade association representing the widest range of independent

CQC standards 2013–14The CQC is currently introducing a new approach to regulating independent and NHS organisations. This will go live across all areas of care from April 2015. We hope that this will allow a fair and appropriate comparison between all providers of health and social care.

The existing regime is based on compliance with a set of standards defined by the CQC. The CQC has assessed all providers against these outcome measures for the past three years. In general the IS complies with more outcome measures than its NHS peers. The graphs that follow show the rate at which independent and NHS organisations comply with CQC standards. We have shown all relevant standards for the care areas covered by NHS Partners Network members, i.e.:

hospital care standards community healthcare standards independent ambulances (the CQC does not hold comparable State of Care category data for NHS ambulance services)

The graphs that follow are compiled from information provided by the CQC in response to a Freedom of Information request. It provides more detail compliance rates for comparable categories of independent and NHS organisations than was provided in figure 1.2 in the CQC’s latest annual State of Care report.

Source: http://www.cqc.org.uk/content/state-care-2013-14 and the CQC via a Freedom of Information request.

NB when interpreting the graphs below, higher compliance is better. Also, breaches are classed either as minor, moderate or major. It is therefore better if the proportion of breaches classed as minor is higher, as this means a lower proportion of all breaches were moderate and major breaches.

Page 12 of 53

Page 13: NHS Confederation - Independent sector providers …/media/Confederation/File… · Web viewThe NHS Partners Network is the trade association representing the widest range of independent

CQC compliance rates – hospital care standards

Respect & involvem

ent

Care & welfare

Nutritional needs

Safeguarding

Cleanliness and infection contro

l

Medicines managem

ent

Safety a

nd suitability of prem

isesSta

ffing

Supporting worke

rs

Monitoring service quality Complain

ts

0.0%10.0%20.0%30.0%40.0%50.0%60.0%70.0%80.0%90.0%

100.0%

Hospital compliance rates

Percentage of inspections that were compliant with CQC essential standards in 2013-14. Source: CQC. Blue bars show NHS organisations and green bars indicate independent providers.

Respect & involvem

ent

Care & welfar

e

Nutritional needs

Safeguarding

Cleanliness and infecti

on control

Medicines m

anagement

Safety a

nd suitability of prem

isesSta

ffing

Supporting worke

rs

Monitoring service quality Complain

ts

0.0%10.0%20.0%30.0%40.0%50.0%60.0%70.0%80.0%90.0%

100.0%

Hospital care – proportion of breaches classed as minor

Percentage of inspections that were compliant with CQC essential standards in 2013-14. Source: CQC. Blue bars show NHS organisations and green bars indicate independent providers.

NB the total number of moderate and major breaches for independent providers relating to medicines management and safety and suitability of premises is significantly lower than that for NHS organisations. The reason the graphs show a higher apparent proportion for NHS organisations is related to the fact that there are a considerably greater proportion of overall breaches by NHS organisations for these standards compared with their independent sector counterparts.

Page 13 of 53

Page 14: NHS Confederation - Independent sector providers …/media/Confederation/File… · Web viewThe NHS Partners Network is the trade association representing the widest range of independent

CQC compliance rates – community healthcare standards

Respect & involvement

Care & welfa

re

Nutritional n

eeds

Safeguarding

Cleanliness and infection control

Medicines management

Safety a

nd suitability

of premises

Staffing

Supporting workers

Monitoring service q

uality Complaints

0.0%10.0%20.0%30.0%40.0%50.0%60.0%70.0%80.0%90.0%

100.0%

Community healthcare compliance rates

Percentage of inspections that were compliant with CQC essential standards in 2013-14. Source: CQC. Blue bars show NHS organisations and green bars indicate independent providers.

Respect & involvem

entCare & welfare

Nutritional n

eeds

Safeguarding

Cleanliness a

nd infection control

Medicines m

anagement

Safety a

nd suitability

of premises

Staffing

Supporting workers

Monitoring service quality Complaints

0.0%10.0%20.0%30.0%40.0%50.0%60.0%70.0%80.0%90.0%

100.0%

Community healthcare – proportion of breaches classed as minor

Percentage of inspections that were compliant with CQC essential standards in 2013-14. Source: CQC. Blue bars show NHS organisations and green bars indicate independent providers.

Page 14 of 53

Page 15: NHS Confederation - Independent sector providers …/media/Confederation/File… · Web viewThe NHS Partners Network is the trade association representing the widest range of independent

CQC compliance rates – independent ambulancesNB, information for independent ambulances is shown below. The CQC does not hold comparable State of Care category data for NHS ambulance services. Because the actual number of breaches is very low, we have not produced a graph of the proportion of minor breaches as this would not be statistically meaningful.

Respect

& involvement

Care & welfa

re

Nutritional n

eeds

Safegu

arding

Cleanliness

and infec

tion contro

l

Medicines m

anagement

Safety

and suitab

ility o

f premises

Staffing

Supporting worke

rs

Monitorin

g servic

e qualit

yComplain

ts

0.0%10.0%20.0%30.0%40.0%50.0%60.0%70.0%80.0%90.0%

100.0%

Independent ambulance compliance rates

Percentage of inspections that were compliant with CQC essential standards in 2013-14. Source: CQC. Green bars indicate independent providers. No data is available for NHS Ambulance Trusts.

Page 15 of 53

Page 16: NHS Confederation - Independent sector providers …/media/Confederation/File… · Web viewThe NHS Partners Network is the trade association representing the widest range of independent

Patient outcomes and safety

Page 16 of 53

Page 17: NHS Confederation - Independent sector providers …/media/Confederation/File… · Web viewThe NHS Partners Network is the trade association representing the widest range of independent

Patient outcomes and safety

Indicators that relate to outcomes and safety for which it is reasonable to make comparisons between independent sector organisations and their NHS counterparts include:

Patient Reported Outcome Measures (PROMs); and Rate of assessment for VTE (blood clots)

Infection control information is also an important indicator. Because Public Health England analyses information collected for the independent sector and the NHS organisations on a different basis, its view is that like-for-like comparison should not be made. For completeness, we have published rates for independent sector providers in the pages that follow. These show that independent providers have very low rates of healthcare-acquired infections.

Page 17 of 53

Page 18: NHS Confederation - Independent sector providers …/media/Confederation/File… · Web viewThe NHS Partners Network is the trade association representing the widest range of independent

Patient Reported Outcome Measures (PROMs)Patient Reported Outcome Measures (PROMs) are collected by the Health and Social Care Information Centre for a range of elective procedures: hip and knee replacements, groin hernias and varicose vein treatment.

The Health and Social Care Information Centre (HSCIC) publishes casemix-adjusted health gain by provider each quarter. The graphs that follow are based on the most recently available 12-month period (April 2013 to March 2014, provisional data – released Feb 2015).

PROMs data is not published for all organisations that submit completed PROMs questionnaires. The HSCIC collects data from every organisation that offers these types of surgery as it is a national requirement that all organisations should offer PROMs questionnaires to patients eligible to participate. However, it is voluntary for patients to complete these forms and the HSCIC only publishes adjusted data for organisations that have a representative number of completed records.

The pages that follow use funnel plot data from http://www.hscic.gov.uk/catalogue/PUB16477 for two different types of PROMs scores for primary knee and hip replacements. These graphs show adjusted health gain. The original source files provided by the HSCIC should be used to identify positive and negative statistical outliers.

The Oxford Scores focus on joint function and pain and include questions about patients’ mobility and factors such as ability to navigate stairs and use transport specifically affected by the hip or knee. More information about these measures is available at http://www.isis-innovation.com/outcomes/orthopaedic/. The EQ-5DTM score, developed by the EuroQol Group, is a standardised instrument for use as a measure of health outcome and has a broader base than the Oxford scores. Its questions relate to mobility, self-care, usual life activities, pain/discomfort and anxiety/depression. More information about the EQ-5D is available at http://www.euroqol.org. The Health and Social Care Information Centre also provides an informative guide to PROMs methodology used by the Centre, available at http://www.hscic.gov.uk/article/3843/Background-information-about-PROMs.

Page 18 of 53

Page 19: NHS Confederation - Independent sector providers …/media/Confederation/File… · Web viewThe NHS Partners Network is the trade association representing the widest range of independent

PROMs – primary hip replacement

The tables below show average adjusted health gain on PROMs reported by the Health and Social Care Information for independent providers compared to the national average.

Independent providers England average20.800

21.000

21.200

21.400

21.600

21.800

22.000

22.200

22.400

Oxford hip score – average health gain

Average adjusted health gain on PROMs reported by the Health and Social Care Information Cen-tre. Green line shows patient-weighted average for independent providers for which HSCIC pub-

lishes a value. Blue line shows England average.

Independent providers England average0.420

0.425

0.430

0.435

0.440

0.445

0.450

0.455

0.460

0.465

Hip replacement EQ 5D – average health gain

Average adjusted health gain on PROMs reported by the Health and Social Care Information Cen-tre. Green line shows patient-weighted average for independent providers for which HSCIC pub-

lishes a value. Blue line shows England average.

Page 19 of 53

Page 20: NHS Confederation - Independent sector providers …/media/Confederation/File… · Web viewThe NHS Partners Network is the trade association representing the widest range of independent

0

5

10

15

20

25

PROMs adjusted average health gain primary hip replace-ment_x000d_Oxford Hip Score Apr 2013 to Mar 2014

Graph shows average adjusted health gain on Patient Reported Outcome Measures (PROMs) reported by the Health and Social Care Information Centre.

Green lines relate to independent providers and blue bars treated by NHS organisationsPage 20 of 53

Page 21: NHS Confederation - Independent sector providers …/media/Confederation/File… · Web viewThe NHS Partners Network is the trade association representing the widest range of independent

BMI - TH

REE SH

IRES HOSP

ITAL

BMI - TH

E PARK HOSP

ITAL

SPRIN

GFIELD

HOSPITA

L

NUFFIELD

HEA

LTH, C

AMBRIDGE HOSP

ITAL

SPIRE C

LARE P

ARK HOSP

ITAL

NUFFIELD

HEALTH

, PLYM

OUTH HOSP

ITAL

SHEP

TON M

ALLET N

HS TREA

TMEN

T CEN

TRE

ST HUGH'S

HOSPITA

L

SPIRE W

ELLES

LEY HOSP

ITAL

SPIRE C

AMBRIDGE LEA

HOSPITA

L

NUFFIELD

HEA

LTH, N

ORTH ST

AFFORDSH

IRE HOSP

ITAL

NORTHAMPTO

N GENER

AL HOSP

ITAL N

HS TRUST

EMER

SONS G

REEN N

HS TREA

TMEN

T CEN

TRE

SPIRE L

ITTLE

ASTON HOSP

ITAL

CIRCLE BATH

HOSPITA

L

SPIRE L

EICEST

ER HOSP

ITAL

CHELSEA

AND W

ESTMIN

STER HOSP

ITAL N

HS FOUNDATIO

N TRUST

YEOVIL

DISTRICT H

OSPITA

L NHS F

OUNDATION TR

UST

THE R

OYAL O

RTHOPAED

IC HOSPITA

L NHS F

OUNDATION TR

UST

SPIRE P

ORTSMOUTH

HOSPITA

L

NUFFIELD

HEA

LTH, T

HE GROSV

ENOR HOSP

ITAL,

CHESTER

THE H

ORDER CEN

TRE -

ST JO

HNS ROAD

RIVERS H

OSPITA

L

BMI - TH

E CHILT

ERN HOSP

ITAL

NUFFIELD

HEALTH

, YORK HOSP

ITAL

WOODLAND HOSP

ITAL

BMI - TH

E SANDRIN

GHAM HOSPITA

L

WEST M

IDLANDS H

OSPITA

L

SPIRE S

USSEX HOSP

ITAL

NEW HALL

HOSPITA

L

BMI - TH

E RIDGEW

AY HOSP

ITAL

BMI THE L

ANCASTER HOSP

ITAL

PENIN

SULA

NHS T

REATM

ENT C

ENTR

E

IPSWICH HOSP

ITAL N

HS TRUST

GUY'S AND ST

THOMAS'

NHS FOUNDATIO

N TRUST

BMI THE H

UDDERSFI

ELD HOSP

ITAL

BMI - TH

E BEA

UMONT HOSP

ITAL

BARLBOROUGH N

HS TREA

TMEN

T CEN

TRE

DUCHY HOSP

ITAL

EUXTO

N HALL HOSP

ITAL

DARTFORD AND GRAVESH

AM NHS T

RUST

OXFORD UN IVER

SITY H

OSPITA

LS NHS T

RUST

OAKS HOSP

ITAL

KING'S

COLLEGE H

OSPITA

L NHS F

OUNDATION TR

UST

NUFFIELD

HEA

LTH, W

OLVER

HAMPTO

N HOSPITA

L

IMPER

IAL COLLE

GE HEA

LTHCARE N

HS TRUST

ROYAL D

EVON AND EX

ETER N

HS FOUNDATIO

N TRUST

ROYAL S

URREY COUNTY

HOSPITA

L NHS F

OUNDATION TR

UST

NUFFIELD

HEA

LTH, T

AUNTON HOSP

ITAL

SPIRE H

ARPENDEN

HOSPITA

L

05

10152025

PROMs adjusted average health gain primary hip replacement_x000d_Oxford Hip Score Apr 2013 to Mar 2014 (top 50

providers)

Graph shows average adjusted health gain on Patient Reported Outcome Measures (PROMs) reported by the Health and Social Care Information Centre.

Green lines relate to independent providers and blue bars treated by NHS organisationsPage 21 of 53

Page 22: NHS Confederation - Independent sector providers …/media/Confederation/File… · Web viewThe NHS Partners Network is the trade association representing the widest range of independent

00.05

0.10.15

0.20.25

0.30.35

0.40.45

0.50.55

0.6

PROMs adjusted average health gain – primary hip re-placement_x000d_EQ-5D Score Apr 2013 to Mar 2014

Graph shows average adjusted health gain on Patient Reported Outcome Measures (PROMs) reported by the Health and Social Care Information Centre.

Green lines relate to independent providers and blue bars treated by NHS organisations

Page 22 of 53

Page 23: NHS Confederation - Independent sector providers …/media/Confederation/File… · Web viewThe NHS Partners Network is the trade association representing the widest range of independent

BMI - TH

E PARK HOSP

ITAL

NUFFIELD

HEALTH

, CAMBRIDGE H

OSPITA

L

BMI - TH

REE SH

IRES HOSP

ITAL

SPIRE C

LARE P

ARK HOSP

ITAL

SPRIN

GFIELD

HOSPITA

L

RIVERS H

OSPITA

L

NUFFIELD

HEALTH

, EXETE

R HOSPITA

L

BMI - TH

E CHILT

ERN HOSP

ITAL

SPIRE C

AMBRIDGE LEA

HOSPITA

L

BMI - TH

E SANDRIN

GHAM HOSPITA

L

KING'S

COLLEGE H

OSPITA

L NHS F

OUNDATION TR

UST

THE R

OYAL O

RTHOPAED

IC HOSPITA

L NHS F

OUNDATION TR

UST

ROWLEY H

ALL HOSP

ITAL

IMPER

IAL COLLE

GE HEA

LTHCARE N

HS TRUST

NORTHAMPTO

N GENER

AL HOSP

ITAL N

HS TRUST

SPIRE H

ULL AND EA

ST RIDIN

G HOSPITA

L

YEOVIL

DISTRIC

T HOSP

ITAL N

HS FOUNDATIO

N TRUST

THE H

ORDER CEN

TRE -

ST JO

HNS ROAD

OXFORD UN IVER

SITY H

OSPITA

LS NHS T

RUST

ROYAL S

URREY COUNTY

HOSPITA

L NHS F

OUNDATION TR

UST

GUY'S AND ST

THOMAS'

NHS FOUNDATIO

N TRUST

ST HUGH'S

HOSPITA

L

BMI THE L

ANCASTER HOSP

ITAL

NUFFIELD

HEALTH

, TAUNTO

N HOSPITA

L

NORTH W

EST LO

NDON HOSPITA

LS NHS T

RUST

00.15

0.30.45

0.6

PROMs adjusted average health gain – primary hip replace-ment_x000d_EQ-5D Score Apr 2013 to Mar 2014 top 50

providers

Graph shows average adjusted health gain on Patient Reported Outcome Measures (PROMs) reported by the Health and Social Care Information Centre.

Green lines relate to independent providers and blue bars treated by NHS organisations

Page 23 of 53

Page 24: NHS Confederation - Independent sector providers …/media/Confederation/File… · Web viewThe NHS Partners Network is the trade association representing the widest range of independent

PROMs – primary knee replacement

The tables below show average adjusted health gain on PROMs reported by the Health and Social Care Information for independent providers compared to the national average.

Independent providers England average15.90016.00016.10016.20016.30016.40016.50016.60016.70016.80016.900

Oxford knee score – average health gain

Average adjusted health gain on PROMs reported by the Health and Social Care Information Cen-tre. Green line shows patient-weighted average for independent providers for which HSCIC pub-

lishes a value. Blue line shows England average.

Independent providers England average0.318

0.320

0.322

0.324

0.326

0.328

0.330

0.332

Knee replacement EQ5D – average health gain

Average adjusted health gain on PROMs reported by the Health and Social Care Information Cen-tre. Green line shows patient-weighted average for independent providers for which HSCIC pub-

lishes a value. Blue line shows England average.

Page 24 of 53

Page 25: NHS Confederation - Independent sector providers …/media/Confederation/File… · Web viewThe NHS Partners Network is the trade association representing the widest range of independent

02468

101214161820

PROMs adjusted average health gain – primary knee re-placement_x000d_Oxford Knee Score Apr 2013 to Mar 2014

Graph shows average adjusted health gain on Patient Reported Outcome Measures (PROMs) reported by the Health and Social Care Information Centre.

Green lines relate to independent providers and blue bars treated by NHS organisationsPage 25 of 53

Page 26: NHS Confederation - Independent sector providers …/media/Confederation/File… · Web viewThe NHS Partners Network is the trade association representing the widest range of independent

BMI - TH

E BEA

UMONT HOSP

ITAL

WINFIE

LD HOSP

ITAL

NUFFIELD

HEALTH

, CAMBRIDGE H

OSPITA

L

NUFFIELD

HEALTH

, DER

BY HOSP

ITAL

FULW

OOD HALL HOSP

ITAL

SPIRE C

HESHIRE H

OSPITA

L

BENEN

DEN HOSP

ITAL

PARK HILL HOSP

ITAL

NUFFIELD

HEA

LTH, W

OLVER

HAMPTON HOSP

ITAL

NUFFIELD

HEALTH

, PLYM

OUTH HOSP

ITAL

NUFFIELD

HEALTH

, TAUNTO

N HOSPITA

L

IPSWICH HOSP

ITAL N

HS TRUST

BMI WOODLA

NDS HOSP

ITAL

SPRIN

GFIELD

HOSPITA

L

DARTFORD AND GRAVESH

AM NHS T

RUST

EUXTO

N HALL

HOSPITA

L

NORTHER

N DEVON HEA

LTHCARE N

HS TRUST

SPIRE E

LLAND HOSP

ITAL

FITZW

ILLIAM HOSP

ITAL

NUFFIELD

HEALTH

, TEES

HOSPITA

L

SPIRE P

ORTSMOUTH

HOSPITA

L

BMI - TH

E PARK HOSP

ITAL

THE R

OTHER

HAM NHS F

OUNDATION TR

UST

ISLE O

F WIGHT N

HS TRUST

EMER

SONS G

REEN N

HS TREA

TMEN

T CEN

TRE

0

6

12

18

PROMs adjusted average – health gain primary knee replacement_x000d_Oxford Knee Score Apr 2013 to Mar 2014 (top 50

providers)

Graph shows average adjusted health gain on Patient Reported Outcome Measures (PROMs) reported by the Health and Social Care Information Centre.

Green lines relate to independent providers and blue bars treated by NHS organisationsPage 26 of 53

Page 27: NHS Confederation - Independent sector providers …/media/Confederation/File… · Web viewThe NHS Partners Network is the trade association representing the widest range of independent

0

0.05

0.1

0.15

0.2

0.25

0.3

0.35

0.4

0.45

PROMs adjusted average health gain – primary knee replacement_x000d_EQ-5D Score Apr 2013 to Mar 2014

Graph shows average adjusted health gain on Patient Reported Outcome Measures (PROMs) reported by the Health and Social Care Information Centre.

Green lines relate to independent providers and blue bars treated by NHS organisationsPage 27 of 53

Page 28: NHS Confederation - Independent sector providers …/media/Confederation/File… · Web viewThe NHS Partners Network is the trade association representing the widest range of independent

BMI THE L

ANCASTER HOSP

ITAL

NUFFIELD

HEALTH

, CAMBRIDGE H

OSPITA

L

NORTHAMPTO

N GENER

AL HOSP

ITAL N

HS TRUST

SPIRE S

USSEX HOSP

ITAL

BENEN

DEN HOSP

ITAL

WINFIE

LD HOSP

ITAL

WIRRAL UNIVER

SITY T

EACHIN

G HOSPITA

L NHS F

OUNDATION TR

UST

FULW

OOD HALL HOSP

ITAL

SPIRE C

AMBRIDGE LEA

HOSPITA

L

DUCHY HOSP

ITAL

NORTHER

N DEVON HEA

LTHCARE N

HS TRUST

NUFFIELD

HEALTH

, DER

BY HOSP

ITAL

SPIRE C

HESHIRE H

OSPITA

L

WOODLAND HOSP

ITAL

NEW HALL

HOSPITA

L

COUNTESS O

F CHEST

ER HOSP

ITAL N

HS FOUNDATIO

N TRUST

FITZW

ILLIAM HOSP

ITAL

BMI - TH

E RIDGEW

AY HOSP

ITAL

EUXTO

N HALL HOSP

ITAL

SHEP

TON M

ALLET N

HS TREA

TMEN

T CEN

TRE

NUFFIELD

HEALTH

, WOLV

ERHAMPTO

N HOSPITA

L

BMI - TH

REE SH

IRES HOSP

ITAL

SPIRE L

EICEST

ER HOSP

ITAL

NORTH TE

ES AND HARTLE

POOL NHS F

OUNDATION TR

UST

NOTTINGHAM W

OODTHORPE H

OSPITA

L

NUFFIELD

HEALTH

, PLYM

OUTH HOSP

ITAL

BMI ST E

DMUNDS HOSP

ITAL

ISLE O

F WIGHT N

HS TRUST

ROYAL S

URREY COUNTY

HOSPITA

L NHS F

OUNDATION TR

UST

SPIRE P

ORTSMOUTH

HOSPITAL

NUFFIELD

HEALTH

, LEIC

ESTER

HOSPITA

L

BMI WOODLA

NDS HOSP

ITAL

SPIRE A

LEXANDRA HOSP

ITAL

SPRIN

GFIELD

HOSPITA

L

STOCKPORT N

HS FOUNDATIO

N TRUST

BMI - TH

E PARK HOSP

ITAL

AIREDALE

NHS FOUNDATIO

N TRUST

EMER

SONS G

REEN N

HS TREA

TMEN

T CEN

TRE

OAKLANDS H

OSPITA

L

SPIRE H

ULL AND EA

ST RIDIN

G HOSPITA

L

EAST

CHESHIRE N

HS TRUST

EAST

LANCASH

IRE HOSP

ITALS

NHS TRUST

ST HUGH'S

HOSPITA

L

THE R

OTHER

HAM NHS F

OUNDATION TR

UST

IPSWICH HOSP

ITAL NHS T

RUST

SPIRE H

ARPENDEN HOSP

ITAL

BMI - TH

E ALEX

ANDRA HOSPITA

L

BMI GISB

URNE PARK HOSP

ITAL

THE H

ORDER CEN

TRE -

ST JO

HNS ROAD

PINEH

ILL HOSP

ITAL

00.10.20.30.4

PROMs adjusted average – health gain primary knee replace-ment_x000d_EQ-5D Score Apr 2013 to Mar 2014 (top 50

providers)

Graph shows average adjusted health gain on Patient Reported Outcome Measures (PROMs) reported by the Health and Social Care Information Centre.

Green lines relate to independent providers and blue bars treated by NHS organisationsPage 28 of 53

Page 29: NHS Confederation - Independent sector providers …/media/Confederation/File… · Web viewThe NHS Partners Network is the trade association representing the widest range of independent

PROMs – groin hernia

The tables below show average adjusted health gain on PROMs reported by the Health and Social Care Information for independent providers compared to the national average.

Independent providers England average0.083

0.084

0.085

0.086

0.087

0.088

0.089

Groin hernia EQ5D – average health gain

Average adjusted health gain on PROMs reported by the Health and Social Care Information Cen-tre. Green line shows patient-weighted average for independent providers for which HSCIC pub-

lishes a value. Blue line shows England average.

Page 29 of 53

Page 30: NHS Confederation - Independent sector providers …/media/Confederation/File… · Web viewThe NHS Partners Network is the trade association representing the widest range of independent

0

0.02

0.04

0.06

0.08

0.1

0.12

0.14

0.16

PROMs adjusted average health gain – groin hernia_x000d_EQ-5D Score Apr 2013 to Mar 2014

Graph shows average adjusted health gain on Patient Reported Outcome Measures (PROMs) reported by the Health and Social Care Information Centre.

Green lines relate to independent providers and blue bars treated by NHS organisationsPage 30 of 53

Page 31: NHS Confederation - Independent sector providers …/media/Confederation/File… · Web viewThe NHS Partners Network is the trade association representing the widest range of independent

BMI - TH

E FOSC

OTE HOSP

ITAL

WYE VALLE

Y NHS T

RUST

ROYAL L

IVERPOOL A

ND BROADGREEN UNIVER

SITY H

OSPITA

LS NHS T

RUST

SPIRE S

OUTH BANK HOSP

ITAL

OAKS HOSP

ITAL

SPIRE D

UNEDIN

HOSPITA

L

ROYAL D

EVON AND EX

ETER N

HS FOUNDATIO

N TRUST

ROYAL B

ERKSH

IRE NHS F

OUNDATION TR

UST

SALIS

BURY NHS F

OUNDATION TR

UST

SPIRE H

ULL AND EA

ST RIDIN

G HOSPITA

L

CAMBRIDGE UNIVER

SITY H

OSPITA

LS NHS F

OUNDATION TR

UST

BMI GISB

URNE PARK HOSP

ITAL

RIVERS H

OSPITA

L

THE B

ERKSH

IRE INDEP

ENDEN

T HOSP

ITAL

CIRCLE BATH

HOSPITA

L

BARNSLEY H

OSPITA

L NHS F

OUNDATION TR

UST

BMI - TH

E HARBOUR HOSP

ITAL

NORTH CUMBRIA UNIVER

SITY H

OSPITA

LS NHS T

RUST

SPIRE M

ETHLEY

PARK HOSPITA

L

ROYAL U

NITED HOSP

ITALS

BATH N

HS FOUNDATIO

N TRUST

PENNIN

E ACUTE

HOSPITA

LS NHS T

RUST

COBALT HOSPITA

L

WALSALL

HEALTH

CARE NHS T

RUST

NORTHER

N DEVON HEA

LTHCARE N

HS TRUST

TAUNTO

N AND SOMER

SET N

HS FOUNDATIO

N TRUST

00.040.080.120.16

PROMs adjusted average – groin hernia_x000d_EQ-5D Score Apr 2013 to Mar 2014 (top 50 providers)

Graph shows average adjusted health gain on Patient Reported Outcome Measures (PROMs) reported by the Health and Social Care Information Centre.

Green lines relate to independent providers and blue bars treated by NHS organisationsPage 31 of 53

Page 32: NHS Confederation - Independent sector providers …/media/Confederation/File… · Web viewThe NHS Partners Network is the trade association representing the widest range of independent

Rate of assessment for VTE (blood clots)All providers of acute adult inpatient care are required to provide information on the percentage of admitted patients who are risk-assessed for venous thromboembolism (blood clots). The graph below shows data for the past year. The average rate for independent providers is 98.7% compared with a national average of 96.1%.

Mar-2014

Apr-2014

May-2014

Jun-2014

Jul-2014

Aug-2014

Sep-2014

Oct-2014

Nov-2014

Dec-2014

Jan-2015

Feb-2015

Average

90.0%91.0%92.0%93.0%94.0%95.0%96.0%97.0%98.0%99.0%

100.0%

Percentage of admitted patients risk-assessed for VTE_x000d_ Mar 14 to Feb 15

Percentage of admitted patients risk-assessed for Venous Thromboembolism (VTE) by NHS (blue bars) and independent sector providers (green bars). Source: NHS England

Source: http://www.england.nhs.uk/statistics/statistical-work-areas/vte

Page 32 of 53

Page 33: NHS Confederation - Independent sector providers …/media/Confederation/File… · Web viewThe NHS Partners Network is the trade association representing the widest range of independent

Infection control dataInfection control information that allows direct comparisons between the NHS and independent sector is not available. In 2009, the Health Protection Agency, now part of Public Health England, which has responsibility for collecting infection-control data, published its rationale for this approach here. This is summarised on page 1 of the commentary linked below.

Despite this lack of comparative information, Public Health England data makes it clear that there are very low healthcare acquired infection rates in the independent sector.

During the twelve months between Apr 2013 and March 2014, the total number of reported infections across the entire independent estate (NHS-funded and privately funded care) was just:

No of cases

Rate per 100,000

MRSA bacteraemia 11 0.48C difficile infection 71 3.12MSSA bacteraemia 32 1.40E. coli bacteraemia 147 6.45

The number of modified bed-days published by Public Health England for this twelve-month period was 2,277,796.

Source: Public Health England (https://www.gov.uk/government/statistics/mrsa-mssa-and-e-coli-bacteraemia-and-clostridium-difficile-infection-annual-data-for-independent-sector-healthcare-organisations)

Page 33 of 53

Page 34: NHS Confederation - Independent sector providers …/media/Confederation/File… · Web viewThe NHS Partners Network is the trade association representing the widest range of independent

Efficiency indicators

Page 34 of 53

Page 35: NHS Confederation - Independent sector providers …/media/Confederation/File… · Web viewThe NHS Partners Network is the trade association representing the widest range of independent

Referral to treatment times

Referral to treatment times show that patients are treated earlier by independent sector providers compared with those treated by NHS organisations. Waiting times are an important indicator of organisational efficiency and for patients deciding where to choose treatment.

Mean* and median waiting times are generally shorter across most specialties for both inpatients and outpatients treated by independent providers compared with their NHS peers.

Charts have been updated this month to cover waiting times during February 2015. During that month: Outpatients treated by independent providers had on average (mean) waited for 5.2 weeks, i.e. 12 fewer days than the English average outpatient waiting time Inpatients treated by independent providers waited an average (mean) of 9.9 weeks: 5.7 fewer days than the English average inpatient waiting time 95% of outpatients treated by independent sector organisations were treated within 12 weeks, compared with an English average of 17 weeks to treat the same

proportion of outpatients 95% of inpatients treated by independent sector organisations were treated within 16.4 weeks, with NHS organisations taking 24.4 weeks to treat the same

proportion of outpatients – over six weeks above the 18-week commitment.

http://www.england.nhs.uk/statistics/statistical-work-areas/rtt-waiting-times/

* NB Means have been inferred from data published by NHS England. This data shows numbers of patients waiting between 1 and 2 weeks, 2 and 3 weeks, etc. up to 52+ weeks for RTT times and 13+ weeks for diagnostic waiting times. Mean values have been calculated on the assumption that patients who have been waiting between 1 and 2 weeks have waited an average of 1.5 weeks etc. Also, for those patients waiting longer than 52 weeks (RTT) or 13 weeks (diagnostics), we have used values of 52.5 (RTT) and 13.5 weeks (diagnostics) which is likely to be an underestimate. As we are looking at national trends rather than specific provider-level performance we have counted all patients when calculating means rather than excluding organisations with low volumes.

Page 35 of 53

Page 36: NHS Confederation - Independent sector providers …/media/Confederation/File… · Web viewThe NHS Partners Network is the trade association representing the widest range of independent

Percentage of patients treated within 18 weeks

The graphs below show the proportion of patients seen within the 18-week referral to treatment commitment enshrined within the NHS constitution.

Apr 14 May 14 Jun 14 Jul 14 Aug 14 Sep 14 Oct 14 Nov 14 Dec 14 Jan 15 Feb 15 Mar 15 Average0.0%

10.0%20.0%30.0%40.0%50.0%60.0%70.0%80.0%90.0%

100.0%

Inpatients seen within 18 weeksRTT for completed admitted patient pathways: percentage of patients

treated within 18 weeks

Source: NHS England, Monthly Referral to Treatment (RTT) waiting times for completed admitted pathways (on an ad-justed basis). Blue bars represent national average performance and green bars show figures for independent providers.

Apr 14 May 14 Jun 14 Jul 14 Aug 14 Sep 14 Oct 14 Nov 14 Dec 14 Jan 15 Feb 15 Mar 15 Average0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%

Outpatients seen within 18 weeksRTT for completed non-admitted patient pathways: percentage of

patients treated within 18 weeks

Source: NHS England, Monthly RTT waiting times for completed non-admitted pathways. Includes outpatientsand patients whose waiting times were stopped without treatment. Blue bars show national average and green bars show independent providers.

Page 36 of 53

Page 37: NHS Confederation - Independent sector providers …/media/Confederation/File… · Web viewThe NHS Partners Network is the trade association representing the widest range of independent

Typical waiting times

Median waiting times illustrate the typical experience of most patients when waiting for care.

Apr 14 May 14 Jun 14 Jul 14 Aug 14 Sep 14 Oct 14 Nov 14 Dec 14 Jan 15 Feb 15 Mar 15 Average0.001.002.003.004.005.006.007.008.009.00

10.00

Typical inpatient waiting timesMonthly RTT for completed admitted patient pathways – average

median waiting time in weeks

Source: NHS England, Monthly Referral to Treatment (RTT) waiting times for completed admitted pathways (on an ad-justed basis). Blue bars represent national average performance and green bars show figures for independent providers.

Apr 14 May 14 Jun 14 Jul 14 Aug 14 Sep 14 Oct 14 Nov 14 Dec 14 Jan 15 Feb 15 Mar 15 Average0.00

1.00

2.00

3.00

4.00

5.00

6.00

Typical outpatient waiting timesMonthly outpatient RTT waiting times – average median waiting time

in weeks

Source: NHS England, Monthly RTT waiting times for completed non-admitted pathways. Includes outpatientsand patients whose waiting times were stopped without treatment. Blue bars show national average and green bars show independent providers.

Page 37 of 53

Page 38: NHS Confederation - Independent sector providers …/media/Confederation/File… · Web viewThe NHS Partners Network is the trade association representing the widest range of independent

Average waiting times by specialty

The graphs below show a weighted average of inpatient and outpatient waiting times by specialty.

General Surgery Urology

Trauma & OrthopaedicsENT

OphthalmologyOral Surgery

Neurosurgery

Plastic Surgery

Gastroenterology

Dermatology

Rheumatology

Gynaecology Other

0.00

2.00

4.00

6.00

8.00

10.00

12.00

14.00Inpatient waiting times March 2015

Weighted average of admitted patient waiting times (weeks). Green bars show patients treated by independent sector organisations. Blue bars England average. All specialities shown where volumes >= 100 patients. Data source: NHS Eng

General Surgery Urology

Trauma & OrthopaedicsENT

OphthalmologyOral Surgery

Neurosurgery

Plastic Surgery

Gastroenterology

Dermatology

Thoracic MedicineNeurology

Rheumatology

Gynaecology Other

0.001.002.003.004.005.006.007.008.009.00

10.00

Outpatient waiting times March 2015

Weighted average of non-admitted patient waiting times (weeks). Green bars show patients treated by independent sector organisations. Blue bars England average. All specialities shown where volumes >= 100 patients. Data source: NHS

Eng

Page 38 of 53

Page 39: NHS Confederation - Independent sector providers …/media/Confederation/File… · Web viewThe NHS Partners Network is the trade association representing the widest range of independent

Waiting times for 95% of patients

It is likely that there will be a small number of patients for whom treatment takes a significantly longer than expected amount of time. The graphs below show the maximum waiting time for 95% of patients, i.e. the longest period that most patients can reasonably expect to have to wait.

Apr 14 May 14 Jun 14 Jul 14 Aug 14 Sep 14 Oct 14 Nov 14 Dec 14 Jan 15 Feb 15 Mar 15 Average0.0

5.0

10.0

15.0

20.0

25.0

Waiting times for 95% of inpatientsMonthly RTT for completed admitted patient pathways – 95th

percentile waiting time (in weeks)

Source: NHS England, Monthly Referral to Treatment (RTT) waiting times for completed admitted pathways (on an ad-justed basis). Blue bars represent national average performance and green bars show figures for independent providers..

Apr 14 May 14 Jun 14 Jul 14 Aug 14 Sep 14 Oct 14 Nov 14 Dec 14 Jan 15 Feb 15 Mar 15 Average0.0

2.0

4.0

6.0

8.0

10.0

12.0

14.0

16.0

18.0

Waiting times for 95% of outpatientsMonthly outpatient RTT waiting times – 95th percentile waiting time

(in weeks)

Source: NHS England, Monthly RTT waiting times for completed non-admitted pathways. Includes outpatientsand patients whose waiting times were stopped without treatment. Blue bars show national average and green bars show independent providers.

Page 39 of 53

Page 40: NHS Confederation - Independent sector providers …/media/Confederation/File… · Web viewThe NHS Partners Network is the trade association representing the widest range of independent

Diagnostic waiting times

The graph below shows mean waiting times for diagnostic tests by modality. MRI scans and non-obstetric-ultrasound are the most frequently provided diagnostic tests by independent organisations.

AUDIOLOGY_ASSESSMENTS

COLONOSCOPY CT

CYSTOSCOPY

DEXA_SCAN

ECHOCARDIOGRAPHY

ELECTROPHYSIOLOGY

FLEXI_SIGMOIDOSCOPY

GASTROSCOPY MRI

NON_OBSTETRIC_ULTRASOUND

PERIPHERAL_NEUROPHYS

0.00

0.50

1.00

1.50

2.00

2.50

3.00

Average waiting time for diagnostic tests by type and sector in March 2015

Chart shows mean time (weeks) spent waiting by patients for diagnostic tests for each type where vol of proceduces >= 100. Blue bars show national average waiting times. Green bars show mean waiting times

for independent providers. Source: NHS England

Source: http://www.england.nhs.uk/statistics/statistical-work-areas/diagnostics-waiting-times-and-activity NB see note in section on referral to treatment times about the calculation of mean waiting time values

Page 40 of 53

Page 41: NHS Confederation - Independent sector providers …/media/Confederation/File… · Web viewThe NHS Partners Network is the trade association representing the widest range of independent

Cancelled elective operationsOperations that are cancelled on the day of surgery for non-clinical reasons are disruptive and distressing for patients. Cancellations are also a good indicator of an organisation’s system-wide efficiency.

NHS England does not publish the total number of elective operations alongside its cancellations data so it is not possible to make a precise calculation of comparative cancellation rates, however, the data published at www.england.nhs.uk/statistics/statistical-work-areas/cancelled-elective-operations reveals that NHS patients treated by independent sector providers experience far fewer cancellations on the day than those treated by traditional NHS organisations.

The data shows that less than 0.5% of non-clinical cancellations occur at independent providers. Also, of that small number of patients who do experience a cancellation at an independent provider, hardly any wait longer than a further 28 days for their treatment (just four patients in total in the whole of the last 12 months). Cancelled Operations (elective only)

Period NHS provider non-clinical cancellations (percentage of all cancellations)

Independent provider non-clinical cancellations (percentage of all cancellations)

Percentage of all patients still waiting for treatment after 28 days following last minute elective cancellation (NHS organisations)

Percentage of all patients still waiting for treatment after 28 days following last minute elective cancellation (Independent providers)

Quarter 1, 2014-15 (April to June 2014) 99.20% 0.80% 99.88% 0.12%Quarter 2, 2014-15 (July to September 2014) 99.66% 0.34% 99.85% 0.15%Quarter 3, 2014-15 (October to December 2014) 99.76% 0.24% 100.00% 0.00%Quarter 4, 2014-15 (January to March 2015) 99.57% 0.43% 99.94% 0.06%Average 99.55% 0.45% 99.92% 0.08%

Page 41 of 53

Page 42: NHS Confederation - Independent sector providers …/media/Confederation/File… · Web viewThe NHS Partners Network is the trade association representing the widest range of independent

Numbers of patients treated

Page 42 of 53

Page 43: NHS Confederation - Independent sector providers …/media/Confederation/File… · Web viewThe NHS Partners Network is the trade association representing the widest range of independent

Numbers of patients treated by independent providersElective care is critically dependent on independent sector provision.

Around 20% of all elective gastroenterology procedures and hip and knee replacements are now carried out by the independent sector. In some areas of the country this figure is far higher.

As well as NHS patients, many independent sector providers also treat large numbers of privately-funded patients as well.

The graphs in the section that follows show a steady increase in the number and proportion of procedures carried out by independent providers since 2011 when easily comparable statistics were first published. However, the overall number of NHS patients treated by independent organisations remains a small fraction of total NHS volumes.

Page 43 of 53

Page 44: NHS Confederation - Independent sector providers …/media/Confederation/File… · Web viewThe NHS Partners Network is the trade association representing the widest range of independent

Elective admissions and GP referrals (1)

Analysis of quarterly hospital activity data (http://www.england.nhs.uk/statistics/statistical-work-areas/hospital-activity/quarterly-hospital-activity/) shows that the number of patients treated by the independent sector is steadily growing.

Apr to Jun 11

Jul to Sep

11

Oct to Dec 1

1

Jan to Mar 1

2

Apr to Jun 12

Jul to Sep

12

Oct to Dec 1

2

Jan to Mar 1

3

Apr to Jun 13

Jul to Sep

13

Oct to Dec 1

3

Jan to Mar 1

4

Apr to Jun 14

Jul to Sep

14

Oct to Dec 1

4

0,000

20,000

40,000

60,000

80,000

100,000

120,000

Independent sector quarterly elective admissions

Quarterly admissions to independent sector providers: NHS elective activity. Source: NHS England Apr to Jun 11

Jul to Sep

11

Oct to Dec 11

Jan to Mar 1

2

Apr to Jun 12

Jul to Sep

12

Oct to Dec 12

Jan to Mar 1

3

Apr to Jun 13

Jul to Sep

13

Oct to Dec 13

Jan to Mar 1

4

Apr to Jun 14

Jul to Sep

14

Oct to Dec 14

0,000

20,000

40,000

60,000

80,000

100,000

120,000

140,000

160,000

180,000

200,000

GP referrals for independent sector outpatients appointments

Quarterly GP referrals for independent sector outpatients appointments. Source: NHS England

Page 44 of 53

Page 45: NHS Confederation - Independent sector providers …/media/Confederation/File… · Web viewThe NHS Partners Network is the trade association representing the widest range of independent

Elective admissions and GP referrals (2)

Despite the growth in independent sector provision, it is clear that traditional NHS providers still dominate overall provision for NHS patients.

Apr to Jun 11

Jul to Sep

11

Oct to Dec 1

1

Jan to Mar 1

2

Apr to Jun 12

Jul to Sep

12

Oct to Dec 1

2

Jan to Mar 1

3

Apr to Jun 13

Jul to Sep

13

Oct to Dec 1

3

Jan to Mar 1

4

Apr to Jun 14

Jul to Sep

14

Oct to Dec 1

4

0,000

200,000

400,000

600,000

800,000

1,000,000

1,200,000

1,400,000

Quarterly independent sector and NHS admissions

Quarterly elective admissions to independent sector providers (green bars) and NHS organisations (blue bars). Source: NHS England

Apr to Jun 11

Jul to Sep

11

Oct to Dec 1

1

Jan to Mar 1

2

Apr to Jun 12

Jul to Sep

12

Oct to Dec 1

2

Jan to Mar 1

3

Apr to Jun 13

Jul to Sep

13

Oct to Dec 1

3

Jan to Mar 1

4

Apr to Jun 14

Jul to Sep 14

Oct to Dec 1

4

0,000

500,000

1,000,000

1,500,000

2,000,000

2,500,000

3,000,000

3,500,000

Total GP referrals for outpatients appointments

Quarterly GP referrals for outpatients appointments. Independent sector providers (green bars) and NHS organisations (blue bars). Source: NHS England

Page 45 of 53

Page 46: NHS Confederation - Independent sector providers …/media/Confederation/File… · Web viewThe NHS Partners Network is the trade association representing the widest range of independent

Elective admissions and GP referrals (3)

The overall percentage of patients treated by the independent sector has grown in accordance with the increasing number of patients choosing independent providers.

Apr to Jun 11

Jul to Sep

11

Oct to Dec 1

1

Jan to Mar 12

Apr to Jun 12

Jul to Sep

12

Oct to Dec 1

2

Jan to Mar 1

3

Apr to Jun 13

Jul to Sep

13

Oct to Dec 1

3

Jan to Mar 1

4

Apr to Jun 14

Jul to Sep

14

Oct to Dec 1

4

0.00%

1.00%

2.00%

3.00%

4.00%

5.00%

6.00%

7.00%

8.00%

9.00%

Elective admissions to independent sector providers as a proportion of all NHS patients

Quarterly admissions to independent sector providers as a proportion of all NHS elective activity. Source: NHS England

Apr to Jun 11

Jul to Sep

11

Oct to Dec 1

1

Jan to Mar 1

2

Apr to Jun 12

Jul to Sep

12

Oct to Dec 12

Jan to Mar 1

3

Apr to Jun 13

Jul to Sep

13

Oct to Dec 1

3

Jan to Mar 14

Apr to Jun 14

Jul to Sep

14

Oct to Dec 1

4

0.00%

1.00%

2.00%

3.00%

4.00%

5.00%

6.00%

Percentage GP referrals for independent sector outpatients ap-pointments

Quarterly GP referrals independent sector outpatients appointments as a proportion of all NHS elective activity. Source: NHS England

Page 46 of 53

Page 47: NHS Confederation - Independent sector providers …/media/Confederation/File… · Web viewThe NHS Partners Network is the trade association representing the widest range of independent

Acute elective patients treated by independent sector and NHS organisations

For most specialties, independent sector provision represents a small proportion of overall care. However, in some specialties, notably trauma & orthopaedics and ophthalmology, the proportion of care provided by independent organisations has reach significant levels.

General Surgery Urology

Trauma & OrthopaedicsENT

OphthalmologyOral Surgery

Neurosurgery

Plastic Surgery

GastroenterologyDermatology

RheumatologyGynaecology

0

10,000

20,000

30,000

40,000

50,000

60,000

Inpatients treated by independent providers and NHS organisations during March 2015

Total number of admitted pathways. Blue columns represent patients treated by NHS organisations and green columns show those treated by independent providers. Source: NHS England

General Surgery Urology

Trauma & OrthopaedicsENT

OphthalmologyOral Surgery

Neurosurgery

Plastic Surgery

GastroenterologyDermatology

Thoracic MedicineNeurology

RheumatologyGynaecology

0

10,000

20,000

30,000

40,000

50,000

60,000

70,000

80,000

90,000

Outpatients treated by independent providers and NHS organisations during March 2015

Total number of non-admitted pathways. Blue columns represent patients treated by NHS organisations and green columns show those treated by independent providers. Source: NHS England

Page 47 of 53

Page 48: NHS Confederation - Independent sector providers …/media/Confederation/File… · Web viewThe NHS Partners Network is the trade association representing the widest range of independent

Monthly number of acute elective patients treated by the independent sector

Apr-11Jun-11

Aug-11Oct-1

1Dec-1

1Feb

-12Apr-12

Jun-12Aug-12

Oct-12Dec-1

2Feb

-13Apr-13

Jun-13Aug-13

Oct-13Dec-1

3Feb

-14Apr-14

Jun-14Aug-14

Oct-14Dec-1

4Feb

-15

0

5,000

10,000

15,000

20,000

25,000

30,000

35,000

Total inpatient acute elective patients (all specialties) treated by independent providers since April 2011

Number of admitted adjusted patients pathways completed each month. Source: NHS England (www.england.nhs.uk/statistics/statistical-work-areas/rtt-waiting-times

Apr-11Jun-11

Aug-11Oct-1

1Dec-1

1Feb

-12Apr-12

Jun-12Aug-12

Oct-12Dec-1

2Feb

-13Apr-13

Jun-13Aug-13

Oct-13Dec-1

3Feb

-14Apr-14

Jun-14Aug-14

Oct-14Dec-1

4Feb

-15

05,000

10,00015,00020,00025,00030,00035,00040,00045,000

Total outpatient acute elective patients (all specialties) treated by independent providers since April 2011

Non-admitted patients pathways completed each month. Source: NHS England (www.england.nhs.uk/statistics/statistical-work-areas/rtt-waiting-times

Page 48 of 53

Page 49: NHS Confederation - Independent sector providers …/media/Confederation/File… · Web viewThe NHS Partners Network is the trade association representing the widest range of independent

Number of inpatients treated by the independent sector by specialty

Apr-11

Jul-1

1

Oct-11

Jan-1

2

Apr-12

Jul-1

2

Oct-12

Jan-1

3

Apr-13

Jul-1

3

Oct-13

Jan-1

4

Apr-14

Jul-1

4

Oct-14

Jan-1

50

5,000

10,000

15,000

20,000

25,000

30,000

35,000

Number of NHS inpatients treated by independent providers by specialty Apr 11 to Mar 15

OtherGynaecologyGeriatric MedicineRheumatologyNeurologyThoracic MedicineDermatologyCardiologyGastroenterologyGeneral MedicineCardiothoracic SurgeryPlastic SurgeryNeurosurgeryOral SurgeryOphthalmologyENTTrauma & Or-thopaedicsUrologyGeneral Surgery

Admitted adjusted patients pathways completed each month. Source: NHS England (www.eng-land.nhs.uk/statistics/statistical-work-areas/rtt-waiting-times

Page 49 of 53

Page 50: NHS Confederation - Independent sector providers …/media/Confederation/File… · Web viewThe NHS Partners Network is the trade association representing the widest range of independent

Number of outpatients treated by the independent sector by specialty

Apr-11

Jul-1

1

Oct-11

Jan-1

2

Apr-12

Jul-1

2

Oct-12

Jan-1

3

Apr-13

Jul-1

3

Oct-13

Jan-1

4

Apr-14

Jul-1

4

Oct-14

Jan-1

50

5,00010,00015,00020,00025,00030,00035,00040,00045,000

Number of NHS outpatients treated by independent providers by specialty Apr 11 to Mar 15

OtherGynaecologyGeriatric MedicineRheumatologyNeurologyThoracic MedicineDermatologyCardiologyGastroenterologyGeneral MedicineCardiothoracic SurgeryPlastic SurgeryNeurosurgeryOral SurgeryOphthalmologyENTTrauma & Or-thopaedicsUrologyGeneral Surgery

Non-admitted patients pathways completed each month. Source: NHS England (www.england.nhs.uk/statistics/statistical-work-areas/rtt-waiting-times

Page 50 of 53

Page 51: NHS Confederation - Independent sector providers …/media/Confederation/File… · Web viewThe NHS Partners Network is the trade association representing the widest range of independent

Share of NHS inpatients treated by the independent sector by specialty

Apr-11

Jul-1

1

Oct-11

Jan-1

2

Apr-12

Jul-1

2

Oct-12

Jan-1

3

Apr-13

Jul-1

3

Oct-13

Jan-1

4

Apr-14

Jul-1

4

Oct-14

Jan-1

50.00%

5.00%

10.00%

15.00%

20.00%

25.00%Share of all NHS inpatients treated by independent providers by

specialty Apr 11 to Mar 15TotalGeneral SurgeryUrologyTrauma & Or-thopaedicsENTOphthalmologyOral SurgeryNeurosurgeryPlastic SurgeryCardiothoracic SurgeryGeneral MedicineGastroen-terologyCardiologyDermatologyThoracic MedicineNeurologyRheumatologyGeriatric MedicineGynaecologyOther

Share of all NHS admitted adjusted patients pathways completed each month treated by independent providers.

Source: NHS England (www.england.nhs.uk/statistics/statistical-work-areas/rtt-waiting-times)

Page 51 of 53

Page 52: NHS Confederation - Independent sector providers …/media/Confederation/File… · Web viewThe NHS Partners Network is the trade association representing the widest range of independent

Proportion of NHS outpatients treated by the independent sector by specialty

Apr-11

Jul-1

1

Oct-11

Jan-1

2

Apr-12

Jul-1

2

Oct-12

Jan-1

3

Apr-13

Jul-1

3

Oct-13

Jan-1

4

Apr-14

Jul-1

4

Oct-14

Jan-1

50.00%

2.00%

4.00%

6.00%

8.00%

10.00%

12.00%

14.00%

16.00%Share of all NHS outpatients treated by independent providers by

specialty Apr 11 to Mar 15TotalGeneral SurgeryUrologyTrauma & Or-thopaedicsENTOphthalmologyOral SurgeryNeurosurgeryPlastic SurgeryCardiothoracic SurgeryGeneral MedicineGastroen-terologyCardiologyDermatologyThoracic MedicineNeurologyRheumatologyGeriatric MedicineGynaecologyOther

Share of all NHS non-admitted patients pathways completed each month treated by independent providers.

Source: NHS England (www.england.nhs.uk/statistics/statistical-work-areas/rtt-waiting-times)

Page 52 of 53

Page 53: NHS Confederation - Independent sector providers …/media/Confederation/File… · Web viewThe NHS Partners Network is the trade association representing the widest range of independent

Diagnostic tests carried out by independent sector by modality

The pie chart below shows the range of diagnostic tests provided by independent sector organisations.

Independent sector workload (all tests carried out by independent providers for which waiting times are collected) during March 2015

AUDIOLOGY_ASSESSMENTSCOLONOSCOPYCTCYSTOSCOPYDEXA_SCANECHOCARDIOGRAPHYELECTROPHYSIOLOGYFLEXI_SIGMOIDOSCOPYGASTROSCOPYMRINON_OBSTETRIC_ULTRASOUNDPERIPHERAL_NEUROPHYS

Page 53 of 53