nhs rightcare intelligence focus pack

NHS Blackpool CCG

NHS RightCareIntelligence Focus PackNeurological Problems

February 2019

Purpose and audience for this RightCare data packThis is a data pack produced by your RightCare regional analytical team to support your local operational work on the RightCare programme. This is not an official NHS England publication and has not been through national NHS England publication processes. It includes updated data from national sources, and any guidance or narrative is taken from previously produced RightCare packs from the national RightCare programme team.

The slides have been produced to support RightCare Delivery Partners in their work on priority areas, comparing activity, spend and outcomes vs similar CCGs. It is for sharing at local RightCare meetings via appropriate stakeholders within your CCG, in conjunction with support from your RightCare delivery partner and other colleagues, and is not for public use.

For further information please contact your regional analytical team -

South: [email protected]

M&E: [email protected]

London: [email protected]

North: [email protected]

Introduction: Welcome to your focus packWelcome to your focus pack on Neurology. This pack uses the most up to date data available. Information contained in this pack is personalised for your CCG and should be used to support local discussions and inform a more in-depth analysis around Neurological services.

Each of these focus packs provides detailed information on the opportunities to improve in the highest spending programmes previously covered by the NHS RightCare packs. They include a wider range of outcomes measures and information on the most common procedures and diagnoses for the condition in question.

By using this information, together with local intelligence and reports such as your Joint Strategic Needs Assessment, your CCG will be able to ensure its plans focus on those opportunities which have the potential to provide the biggest improvements in health outcomes, resource allocation and reducing inequalities.

One of the main focuses for NHS RightCare has always been reducing unwarranted variation in outcomes. NHS England, Public Health England and CCGs have legal duties under the Health and Social Care Act 2012 with regard to reducing health inequalities. Commissioners should continue to use these packs and supporting tools to drive local action to reduce inequalities in access to services and in the health outcomes achieved.

The primary objective for NHS RightCare is to maximise value:

• the value that the patient derives from their own care and treatment

• the value the whole population derives from the investment in their healthcare

The approach has been tested and proven successful in recent years in a number of different

health economies. The programme focusses on improving population value including improving

outcomes, quality, and releasing capacity and resources for future investment.

To build on the success and value of the NHS RightCare programme, NHS England and Public

Health England are taking forward the RightCare approach to ensure it becomes embedded in

the new commissioning and public health agendas for the NHS. It is now referenced in the

Mandate to NHS England, the NHS Planning Guidance, the CCG Improvement and Assessment

Framework and the Quality Premium for 2017-19.

The NHS RightCare programme includes the Intelligence (formerly Commissioning for Value)

packs and tools, the NHS Atlas series, NHS RightCare pathways, scenarios and casebooks. All

CCGs in England are now receiving support to implement NHS RightCare improvement

programmes through a team of Delivery Partners working with local health economies.

NHS RightCare

The NHS RightCare approach

NHS RightCare teams work locally with

systems to present a diagnosis of data

and evidence across that population.

NHS RightCare Delivery Partners and

their teams work collaboratively with

systems to look at the evidence to

identify opportunities.

Using nationally collected robust data, this collaborative working arrangement helps systems make improvements in both spend and patient outcomes. Throughout the process patient care is kept at the top of agenda by promoting the strong clinical interventions developed with senior clinical advisors and relevant stakeholders.

Further information

NHS RightCare tools, methodology and full details of all the data used in this pack are available on the

Intelligence pages of the NHS RightCare website at https://www.england.nhs.uk/rightcare/products/

If you have any questions about this pack or require any further information and support you can email the

National RightCare Analytical team directly at [email protected]

For more general information about how to use the NHS RightCare approach to get best value for your

population, visit www.england.nhs.uk/rightcare, email [email protected] or tweet @nhsrightcare. You can also

sign up to the NHS RightCare bulletin for regular updates on new products and tools.

NHS RightCare Intelligence

https://www.england.nhs.uk/rightcare/products/

mailto:[email protected]

http://www.england.nhs.uk/rightcare

mailto:[email protected]

https://twitter.com/nhsrightcare?lang=en

https://www.england.nhs.uk/email-bulletins/nhs-rightcare-bulletin/

This focus pack presents analysis of a wide range of indicators focussing predominantly on spend and activity. The indicators have been chosen with advice from national clinical leads and other key stakeholders.

The data in this pack are the latest available at the time of production. Data quality has been assessed and only indicators which are sufficiently robust have been included in the pack.

The data are presented as an exploration, starting with prevalence, then moving through primary care prescribing, admissions, outpatients and procedures.

Should you have any queries about the indicators or the data, please contact your local delivery partner or regional analytical team.

Your data

National average

Your CCG amongst national distribution

Confidence interval

Your CCG's value for the chosen indicator

Axis for indicator value

Your similar 10 CCGs

Average of best/lowest 5 similar CCGs

Your CCG's opportunity to the average of their best/lowest 5 performing peers

Indicator name

Interpreting the CCG charts

ContentsPart I: Neurological Conditions

➢ Section 1: Risk

➢ Section 2: Prevalence

➢ Section 3: Primary Care

➢ 3a: Primary Care Prescribing Spend

➢ 3b: Primary Care Prescribing Items

➢ Section 4: Secondary Care

➢ 4a: Inpatient spend and admissions

➢ 4b: Bed days

➢ 4c: Outpatients

➢ Section 5: Procedures

Part II: Chronic Pain

➢ Section 1: Prevalence

➢ Section 2: Primary Care

➢ 2a: Primary Care Prescribing Spend

➢ 2b: Primary Care Prescribing Items

➢ Section 3: Secondary Care

➢ 3a: Inpatient spend and admissions

➢ 3b: Bed days

➢ 3c: Outpatients

➢ Section 4: Procedures

Part III: Programme Budgeting Data

Part I - Neurological Conditions

Section 1 - Risk

Num. Source: English Indices of Deprivation (Ministry of Housing, Communities & Local Government)

Den. Source: English Indices of Deprivation (Ministry of Housing, Communities & Local Government)

NHS Blackpool CCG

Caveats: The Indices of Multiple Deprivation (IMD) 2015 provide a set of relative measures of deprivation for Lower Super Output Areas (LSOA) in England, based on seven domains of deprivation. LSOA level data was converted to 195 CCG level using the population

weighted average of the LSOA IMD values.For more information www.gov.uk/government/statistics/english-indices-of-deprivation-2015

Overall Index of Multiple Deprivation Score - 2015

England Best or Lowest 5 30.7

0.00

5.00

10.0

15.0

20.0

25.0

30.0

35.0

40.0

45.0

50.0 CCGs Similar 10 CCGs NHS Blackpool CCG England

40.3

29.6 30.2 30.4 31.2 32.3 32.4 32.6 33.5 35.3

43.1

0.00

5.00

10.0

15.0

20.0

25.0

30.0

35.0

40.0

45.0

50.0

St Helens Sunderland North EastLincolnshire

South Tyneside South Sefton Thanet Halton Stoke on Trent South Tees Blackpool Knowsley

Num. Source: NHS Digital Patients Registered at a GP Practice

Den. Source: NHS Digital Patients Registered at a GP Practice

NHS Blackpool CCG

Percentage GP registered population aged 75+ years - Oct-17

England 7.83 Best or Lowest 5 7.63

0.00

2.00

4.00

6.00

8.00

10.0

12.0

14.0


9.33

6.81 7.22 7.59 8.14 8.39 8.74 8.82 8.89 8.9310.2

0.00

2.00

4.00

6.00

8.00

10.0

12.0

Halton Knowsley Stoke on Trent South Tees Sunderland South Tyneside St Helens South Sefton North EastLincolnshire

Blackpool Thanet

Num. Source: English Indices of Deprivation (Ministry of Housing, Communities & Local Government)

Den. Source: English Indices of Deprivation (Ministry of Housing, Communities & Local Government)

NHS Blackpool CCG

Proportion of older people aged 60+ living in income deprived households (IDAOPI) - 2015

England Best or Lowest 5 0.22

0.00

0.10

0.20

0.30

0.40

0.50


0.260.21 0.21 0.22 0.22 0.23

0.26 0.26 0.26 0.27

0.35

0.00

0.05

0.10

0.15

0.20

0.25

0.30

0.35

0.40

North EastLincolnshire

St Helens Halton Stoke on Trent Thanet Blackpool South Tees South Tyneside South Sefton Sunderland Knowsley

Section 2 - Prevalence

Num. Source: Quality and Outcomes Framework (QOF), NHS Digital

Den. Source: Quality and Outcomes Framework (QOF), NHS Digital

NHS Blackpool CCG

Reported prevalence of patients with learning disabilities - 2017/18


0.00

0.20

0.40

0.60

0.80

1.00


0.500.47 0.510.59 0.61 0.62 0.62 0.64 0.64

0.690.75

0.00

0.10

0.20

0.30

0.40

0.50

0.60

0.70

0.80

0.90

South Sefton Blackpool St Helens North EastLincolnshire

South Tyneside Thanet Halton Knowsley Stoke on Trent South Tees Sunderland



NHS Blackpool CCG

Reported prevalence of patients aged 18 or over receiving drug treatment for epilepsy - 2017/18


0.00

0.20

0.40

0.60

0.80

1.00

1.20


1.20

0.92 0.93 0.97 0.98 1.04 1.06 1.10 1.10 1.12 1.15

0.00

0.20

0.40

0.60

0.80

1.00

1.20

1.40

Thanet South Tyneside Halton St Helens Sunderland South Sefton North EastLincolnshire

Knowsley South Tees Stoke on Trent Blackpool

Num. Source: GP Patient survey, NHS England

Den. Source: GP Patient survey, NHS England

NHS Blackpool CCG

Caveats: This indicator uses information from the GP patient survey. It is provided for context but should not be considered indicative of the prevalence of long term physical or mental health conditions in the population as a whole.

Percentage of people who responded to the GP Patient Survey who said that they have a long term physical or

mental health condition - 2018


0.00

10.0

20.0

30.0

40.0

50.0

60.0


61.854.9 56.9 56.9 57.4 57.4 57.8 57.8 58.6 58.8 58.8

0.00

10.0

20.0

30.0

40.0

50.0

60.0

70.0

South Tees Halton North EastLincolnshire

South Sefton Stoke on Trent Knowsley St Helens Sunderland Thanet South Tyneside Blackpool

Num. Source: GP Patient survey, NHS England

Den. Source: GP Patient survey, NHS England

NHS Blackpool CCG

Caveats: This indicator uses information from the GP patient survey. It is provided for context but should not be considered indicative of the prevalence of long term neurological conditions in the population as a whole.

Percentage of people who responded to the GP Patient Survey who said that they have a long term neurological

condition. - 2018


0.00

0.50

1.00

1.50

2.00

2.50

3.00

3.50

4.00

4.50


2.62

1.82 1.82 1.912.19

2.48 2.52 2.53 2.54 2.62 2.74

0.00

0.50

1.00

1.50

2.00

2.50

3.00

3.50

4.00

St Helens Sunderland Halton North EastLincolnshire

South Sefton South Tyneside Stoke on Trent Knowsley South Tees Blackpool Thanet

Section 3a - Primary Care

• Primary Care Prescribing Spend

Num. Source: NHS Business Services Authority

Den. Source: ASTRO-PU weighted populations for spend 2017/18

NHS Blackpool CCG

Primary Care Prescribing : Spend on Neurological Conditions (07) per 1,000 ASTRO-PU weighted population -

2017/18£205k

England 12,197 Best or Lowest 5 13,648

0.00

2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000

18,000

20,000 CCGs Similar 10 CCGs NHS Blackpool CCG England

14,738

11,82013,527 13,686 14,311 14,897 15,607 16,462 16,591 16,765 17,281

0.00

2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000

18,000

20,000


Thanet South Tyneside Sunderland Blackpool St Helens South Sefton South Tees Halton Stoke on Trent Knowsley



NHS Blackpool CCG

Primary Care Prescribing : Spend on Anti-epileptic drugs per 1,000 ASTRO-PU weighted population - 2017/18 £392k


0.00

1,000

2,000

3,000

4,000

5,000

6,000

7,000

8,000


8,138

5,715 5,893 5,950 6,294 6,419 6,823 6,902 7,230 7,5518,499

0.00

1,000

2,000

3,000

4,000

5,000

6,000

7,000

8,000

9,000


South Tyneside St Helens Sunderland Halton Thanet South Sefton South Tees Knowsley Blackpool Stoke on Trent



NHS Blackpool CCG

Primary Care Prescribing : Spend on Drugs used in neuromuscular disorders per 1,000 ASTRO-PU weighted

population - 2017/18£21k

England 170 Best or Lowest 5 151

0.00

100

200

300

400

500

600 CCGs Similar 10 CCGs NHS Blackpool CCG England

260

146 149 151 154 156 167 170 179 186

361

0.00

50.0

100

150

200

250

300

350

400

South Sefton Halton Thanet South Tyneside Knowsley Stoke on Trent St Helens Sunderland South Tees Blackpool North EastLincolnshire



NHS Blackpool CCG

Primary Care Prescribing : Spend on Drugs used in parkinsonism and related disorders per 1,000 ASTRO-PU

weighted population - 2017/18£61k


0.00

500

1,000

1,500

2,000

2,500

3,000


2,056

1,344

1,684 1,7581,921 1,959 1,983 2,099 2,177 2,213 2,302

0.00

500

1,000

1,500

2,000

2,500

Thanet South Tyneside Sunderland South Tees Knowsley St Helens Blackpool Stoke on Trent South Sefton North EastLincolnshire

Halton



NHS Blackpool CCG

Primary Care Prescribing : Spend on Neurological Conditions - (Other) (07X) prescribing per 1,000 ASTRO-PU

weighted population - 2017/18£186k


0.00

2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000


13,44711,234

12,343 12,376 12,838 13,492 14,216 15,025 15,190 15,334 16,022

0.00

2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000

18,000


South Tyneside Thanet Sunderland Blackpool St Helens South Sefton Stoke on Trent South Tees Halton Knowsley

Section 3b - Primary Care

• Primary Care Prescribing Items


Den. Source: ASTRO-PU weighted populations for items 2017/18

NHS Blackpool CCG

Primary Care Prescribing : Items for Neurological Conditions (07) per 1,000 ASTRO-PU weighted population -

2017/1846k Items

England 793 Best or Lowest 5 1,004

0.00

200

400

600

800

1,000

1,200

1,400

1,600


1,246

934 975 1,005 1,050 1,052 1,0761,184

1,281 1,300

1,570

0.00

200

400

600

800

1,000

1,200

1,400

1,600

1,800

Thanet South Sefton North EastLincolnshire

Stoke on Trent St Helens Halton Knowsley Blackpool South Tees South Tyneside Sunderland



NHS Blackpool CCG

Primary Care Prescribing : Items for Anti-epileptic drugs per 1,000 ASTRO-PU weighted population - 2017/18 41k Items


0.00

100

200

300

400

500

600

700


704

460 480 481 493 520564 581 591 616

757

0.00

100

200

300

400

500

600

700

800

St Helens South Sefton Thanet Halton North EastLincolnshire

Stoke on Trent Knowsley South Tees South Tyneside Blackpool Sunderland



NHS Blackpool CCG

Primary Care Prescribing : Items for Drugs used in neuromuscular disorders per 1,000 ASTRO-PU weighted

population - 2017/183k Items


0.00

10.0

20.0

30.0

40.0

50.0

60.0

70.0


37.7

20.6 21.7 22.8 23.027.2

29.7 31.1

37.239.6 40.6

0.00

5.00

10.0

15.0

20.0

25.0

30.0

35.0

40.0

45.0

Thanet Halton St Helens South Sefton Knowsley South Tyneside Stoke on Trent South Tees Blackpool Sunderland North EastLincolnshire



NHS Blackpool CCG

Primary Care Prescribing : Items for Drugs used in parkinsonism and related disorders per 1,000 ASTRO-PU

weighted population - 2017/189k Items


0.00

20.0

40.0

60.0

80.0

100

120

140


130

68.081.7 81.9 83.4 86.9 92.1 92.3

117

137 140

0.00

20.0

40.0

60.0

80.0

100

120

140

160

Thanet Stoke on Trent Halton South Sefton Knowsley St Helens South Tees South Tyneside Blackpool Sunderland North EastLincolnshire



NHS Blackpool CCG

Primary Care Prescribing : Items for Neurological Conditions - (Other) (07X) prescribing per 1,000 ASTRO-PU

weighted population - 2017/1841k Items


0.00

200

400

600

800

1,000

1,200


1,017

745 780 824 824 831 838954 961 992

1,176

0.00

200

400

600

800

1,000

1,200

1,400

Thanet South Sefton St Helens North EastLincolnshire

Stoke on Trent Halton South Tyneside Knowsley South Tees Blackpool Sunderland

Section 4a - Secondary Care

• Inpatient spend

• Percentage of all admissions which are day case

• Average annual rate of admissions

• Percentage of admissions where the main consultant is a

Neurologist/Neurosurgeon

Num. Source: National Commissioning Data Repository (NCDR) – Hospital Admissions Databases, SUS+ SEM (Secondary Uses Services Plus, Standard Extract Mart)

Den. Source: Mid-year GP registered population, NHAIS (National Health Application and Infrastructure Services), NHS Digital

NHS Blackpool CCG

Neurological Problems (07) - Elective spend per 1,000 age-sex weighted population - 2017/18 £249k


0.00

2,000

4,000

6,000

8,000

10,000

12,000

14,000


9,5078,044 8,073 8,142 8,161 8,281 8,657 9,165

10,086 10,60912,264

0.00

2,000

4,000

6,000

8,000

10,000

12,000

14,000

St Helens South Sefton South Tyneside Sunderland Halton Knowsley South Tees Blackpool Stoke on Trent North EastLincolnshire

Thanet



NHS Blackpool CCG

Neurological Problems (07) – Non-elective spend per 1,000 age-sex weighted population - 2017/18 £1,369k


0.00

5,000

10,000

15,000

20,000

25,000


21,867

11,933 12,99715,776 15,903 16,043

18,147

22,241 22,586 23,45626,136

0.00

5,000

10,000

15,000

20,000

25,000

30,000


Sunderland Stoke on Trent South Tees Thanet South Tyneside Blackpool St Helens Halton South Sefton Knowsley



NHS Blackpool CCG

Neurological Conditions (07X) - Total spend per 1,000 age-sex weighted population - 2017/18 £1,027k


0.00

5,000

10,000

15,000

20,000

25,000


18,442

10,16512,473 13,466 14,073 14,715 15,561 16,397 16,427 16,856 17,122

0.00

5,000

10,000

15,000

20,000

25,000


South Tees Sunderland Stoke on Trent Thanet South Tyneside Halton St Helens South Sefton Knowsley Blackpool



NHS Blackpool CCG

Neurological Conditions (07X) - Elective spend per 1,000 age-sex weighted population - 2017/18 £124k


0.00

1,000

2,000

3,000

4,000

5,000

6,000

7,000

8,000


4,881

3,438

4,316 4,393 4,424 4,426 4,429 4,742 4,8035,276 5,431

0.00

1,000

2,000

3,000

4,000

5,000

6,000

7,000


St Helens South Sefton South Tyneside South Tees Knowsley Sunderland Halton Blackpool Thanet Stoke on Trent



NHS Blackpool CCG

Neurological Conditions (07X) - Non-elective spend per 1,000 age-sex weighted population - 2017/18 £992k


0.00

5,000

10,000

15,000

20,000


13,536

6,7418,045 8,618 8,727

9,52411,134 11,595 12,107 12,452 12,725

0.00

2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000


South Tees Stoke on Trent Sunderland Thanet South Tyneside Halton St Helens South Sefton Knowsley Blackpool


Den. Source: National Commissioning Data Repository (NCDR) – Hospital Admissions Databases, SUS+ SEM (Secondary Uses Services Plus, Standard Extract Mart)

NHS Blackpool CCG

Caveats: Benchmarked to the highest 5

Neurological Conditions (07X) - % of all admissions which are day case admissions - 2017/18


0.00

10.0

20.0

30.0

40.0

50.0


28.7

20.9 21.0 23.726.9

32.5 32.5 34.439.4 40.2

47.0

0.00

10.0

20.0

30.0

40.0

50.0

60.0

South Sefton Knowsley St Helens Halton Blackpool South Tees Thanet South Tyneside North EastLincolnshire

Stoke on Trent Sunderland



NHS Blackpool CCG

Caveats: Neurological condition group classifications in this pack are based on the Public Health England Neurology Intelligence Network classification of Neurological Conditions: https://www.gov.uk/guidance/neurology-data-and-analysis-a-guide-for-health-

professionals

Rare and other neurological diseases - Elective spend per 1,000 age-sex weighted population - 2017/18 £48k


0.00

500

1,000

1,500

2,000


920

422560 595

772 851947 948

1,110 1,162 1,206

0.00

200

400

600

800

1,000

1,200

1,400

1,600

1,800


South Tees Sunderland South Tyneside Stoke on Trent Blackpool Thanet St Helens Knowsley South Sefton Halton



NHS Blackpool CCG


professionals

Rare and other neurological diseases - Non-elective spend per 1,000 age-sex weighted population - 2017/18 £37k


0.00

500

1,000

1,500

2,000

2,500

3,000

3,500

4,000

4,500


1,147

744860

1,003 1,055 1,078 1,137 1,157 1,188 1,281 1,333

0.00

200

400

600

800

1,000

1,200

1,400

1,600

1,800

2,000

Stoke on Trent South Tees St Helens Halton South Tyneside South Sefton Blackpool North EastLincolnshire

Sunderland Knowsley Thanet


Den. Source: Mid-year GP registered populations, NHAIS (National Health Application and Infrastructure Services), NHS Digital

NHS Blackpool CCG


professionals

Rare and other neurological diseases - Average annual rate of admissions per 100,000 age-sex weighted population

- 2015/16-2017/18


0.00

20.0

40.0

60.0

80.0

100


62.0

48.7

66.1 66.8 69.3 70.8 71.579.1 81.0 85.2 87.1

0.00

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0

100

South Tees Blackpool North EastLincolnshire

South Tyneside Halton St Helens South Sefton Thanet Sunderland Knowsley Stoke on Trent



NHS Blackpool CCG

Caveats: The numerator for this indicator only counts hospital spells where a neurologist or neurosurgeon was the main consultant listed against the whole spell. Both the neurologist and neurosurgeon main specialty codes have been included but for most

neurological conditions the spells will predominantly be with one speciality. Neurological condition group classifications in this pack are based on the Public Health England Neurology Intelligence Network classification of Neurological Conditions:

https://www.gov.uk/guidance/neurology-data-and-analysis-a-guide-for-health-professionals

Rare and other neurological diseases - Percentage of elective admissions where the main consultant for the spell is

a Neurologist or Neurosurgeon - 2017/183 Adms


0.00

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0


60.0

21.326.3

45.2 48.1 48.655.8

61.066.0

70.876.7

0.00

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0

Sunderland Stoke on Trent Knowsley South Tees St Helens Halton Blackpool North EastLincolnshire

South Tyneside Thanet South Sefton



NHS Blackpool CCG


neurological conditions the spells will predominantly be with one speciality. Neurological condition group classifications in this pack are based on the Public Health England Neurology Intelligence Network classification of Neurological Conditions:


Rare and other neurological diseases - Percentage of emergency admissions where the main consultant for the

spell is a Neurologist or Neurosurgeon - 2017/18


0.00

10.0

20.0

30.0

40.0

50.0

60.0


0.00 0.00 0.00 0.00 0.00 0.00

10.7 10.9 13.8

31.2

55.6

0.00

10.0

20.0

30.0

40.0

50.0

60.0

70.0

Blackpool South Sefton South Tyneside North EastLincolnshire

St Helens Halton Sunderland Thanet Knowsley South Tees Stoke on Trent



NHS Blackpool CCG

Caveats: This indicator definition does not include ICD10 codes for Tourette's syndrome or Huntington's Disease. Neurological condition classifications in this pack are based on the Public Health England Neurology Intelligence Network classification of Neurological

Conditions: https://www.gov.uk/guidance/neurology-data-and-analysis-a-guide-for-health-professionalsNeurological condition group classifications in this pack are based on the Public Health England Neurology Intelligence Network classification of Neurological

Conditions: https://www.gov.uk/guidance/neurology-data-and-analysis-a-guide-for-health-professionals

Parkinsonism and other Extrapyramidal Disorders - Elective spend per 1,000 age-sex weighted population -

2017/18£34k

England 158 Best or Lowest 5 93.5

0.00

100

200

300

400

500

600

700


273

28.676.3

97.1131 134 136 153

192 193215

0.00

50.0

100

150

200

250

300

350

400

South Sefton South Tyneside Stoke on Trent South Tees North EastLincolnshire

Thanet St Helens Knowsley Halton Sunderland Blackpool



NHS Blackpool CCG



Parkinsonism and other Extrapyramidal Disorders - Non-elective spend per 1,000 age-sex weighted population -

2017/18£83k


0.00

500

1,000

1,500

2,000


689

144216

289 331 382 415 456 472 501 538

0.00

200

400

600

800

1,000

1,200

Thanet North EastLincolnshire

Stoke on Trent South Tees Halton Sunderland South Sefton Knowsley South Tyneside St Helens Blackpool



NHS Blackpool CCG


Conditions: https://www.gov.uk/guidance/neurology-data-and-analysis-a-guide-for-health-professionalsNeurological condition group classifications in this pack are based on the Public Health England Neurology Intelligence Network classification of Neurological


Parkinsonism and other Extrapyramidal Disorders - Average annual rate of admissions per 100,000 age-sex

weighted population - 2015/16-2017/1848 Adms


0.00

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0


43.7

15.3 17.6 19.3 20.4 20.9 21.627.0 28.3

46.7 46.8

0.00

10.0

20.0

30.0

40.0

50.0

60.0


St Helens South Tees Stoke on Trent Thanet South Sefton South Tyneside Knowsley Blackpool Halton Sunderland



NHS Blackpool CCG


neurological conditions the spells will predominantly be with one speciality. This indicator definition does not include ICD10 codes for Tourette's syndrome or Huntington's Disease. Neurological condition group classifications in this pack are based on the Public

Health England Neurology Intelligence Network classification of Neurological Conditions: https://www.gov.uk/guidance/neurology-data-and-analysis-a-guide-for-health-professionals

Parkinsonism and other Extrapyramidal Disorders - Percentage of elective admissions where the main consultant

for the spell is a Neurologist or Neurosurgeon - 2017/1813 Adms


0.00

20.0

40.0

60.0

80.0

100


18.0

0.00 0.00 0.00 0.00

15.9 18.8

30.8

44.453.3

70.8

0.00

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0

South Sefton South Tyneside North EastLincolnshire

St Helens Halton Blackpool Sunderland Stoke on Trent Knowsley Thanet South Tees



NHS Blackpool CCG

Caveats: Some of the ICD10 codes in this indicator come under the Musculoskeletal Programme Budget Category (15X). The remainder come under Neurological Conditions (07X). Neurological condition group classifications in this pack are based on the Public


Neuromuscular Diseases - Elective spend per 1,000 age-sex weighted population - 2017/18


0.00

200

400

600

800

1,000

1,200

1,400


150

88.3 105 115

196 214 220 232 241 260 275

0.00

50.0

100

150

200

250

300

350

400

450


Sunderland South Tees Blackpool Halton Stoke on Trent Knowsley South Sefton St Helens South Tyneside Thanet



NHS Blackpool CCG



Neuromuscular Diseases - Non-elective spend per 1,000 age-sex weighted population - 2017/18 £23k


0.00

1,000

2,000

3,000

4,000

5,000


326

0.00

125 163 185255 282 308 335

401

517

0.00

100

200

300

400

500

600

700

800

South Tyneside Thanet Sunderland South Tees Halton North EastLincolnshire

Knowsley Blackpool St Helens South Sefton Stoke on Trent



NHS Blackpool CCG



Neuromuscular Diseases - Average annual rate of admissions per 100,000 age-sex weighted population - 2015/16-

2017/1812 Adms


0.00

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0


26.4

16.418.8 20.2 21.2 22.8 23.2 24.9 25.4 25.5

30.4

0.00

5.00

10.0

15.0

20.0

25.0

30.0

35.0

40.0

Sunderland South Tyneside Halton North EastLincolnshire

South Tees Knowsley South Sefton Thanet St Helens Blackpool Stoke on Trent



NHS Blackpool CCG


neurological conditions the spells will predominantly be with one speciality. Some of the ICD10 codes in this indicator come under the Musculoskeletal Programme Budget Category (15X). The remainder come under Neurological Conditions (07X). Neurological

condition group classifications in this pack are based on the Public Health England Neurology Intelligence Network classification of Neurological Conditions: https://www.gov.uk/guidance/neurology-data-and-analysis-a-guide-for-health-professionals

Neuromuscular Diseases - Percentage of elective admissions where the main consultant for the spell is a

Neurologist or Neurosurgeon - 2017/18


0.00

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0


66.7

0.00 0.00 0.00 0.00

32.0 33.3

45.051.5

56.5 58.3

0.00

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0

Knowsley North EastLincolnshire

Halton Sunderland South Tees St Helens South Sefton Thanet Stoke on Trent South Tyneside Blackpool



NHS Blackpool CCG

Caveats: The majority of tariff admissions for Epilepsy are non-elective. Neurological condition group classifications in this pack are based on the Public Health England Neurology Intelligence Network classification of Neurological Conditions:


Epilepsy - Elective spend per 1,000 age-sex weighted population - 2017/18 £41k


0.00

200

400

600

800

1,000


472

149215 227 229

296 341407 432

496

718

0.00

200

400

600

800

1,000

1,200

Halton South Tyneside Stoke on Trent North EastLincolnshire

Knowsley South Tees St Helens Sunderland Blackpool Thanet South Sefton



NHS Blackpool CCG

Caveats: The majority of tariff admissions for Epilepsy are non-elective.Neurological condition group classifications in this pack are based on the Public Health England Neurology Intelligence Network classification of Neurological Conditions:


Epilepsy - Non-elective spend per 1,000 age-sex weighted population - 2017/18 £142k


0.00

500

1,000

1,500

2,000

2,500


2,292

1,392 1,426 1,503 1,578 1,678 1,776 1,793 1,910 1,9202,100

0.00

500

1,000

1,500

2,000

2,500

3,000


Sunderland Thanet South Tees South Sefton Knowsley Stoke on Trent St Helens South Tyneside Halton Blackpool



NHS Blackpool CCG



Epilepsy - Non-elective admissions by children (0-17) per 100,000 age-sex weighted population - 2017/18 48 Adms


0.00

50.0

100

150

200

250

300

350

400

450


253

88.6 89.6 97.8126 133 135

152 154185 196

0.00

50.0

100

150

200

250

300

350


Sunderland South Sefton Knowsley Halton Thanet South Tyneside Stoke on Trent St Helens South Tees Blackpool



NHS Blackpool CCG



Epilepsy - Non-elective admissions by adults (18+) per 100,000 age-sex weighted population - 2017/18 29 Adms

England 100.0 Best or Lowest 5 110

0.00

50.0

100

150

200


130

90.4107 109 112

131 135 139 145 152163

0.00

20.0

40.0

60.0

80.0

100

120

140

160

180

200

Sunderland North EastLincolnshire

South Tees Thanet Blackpool Stoke on Trent Knowsley South Tyneside St Helens Halton South Sefton



NHS Blackpool CCG



Epilepsy - Average annual rate of admissions per 100,000 age-sex weighted population - 2015/16-2017/18 74 Adms


0.00

50.0

100

150

200


178

95.1

127145 152 157 160 163 164 164 173

0.00

20.0

40.0

60.0

80.0

100

120

140

160

180

200


Thanet Knowsley Halton Stoke on Trent South Tees South Sefton South Tyneside St Helens Blackpool



NHS Blackpool CCG


neurological conditions the spells will predominantly be with one speciality. The majority of tariff admissions for Epilepsy are non-elective. Neurological condition group classifications in this pack are based on the Public Health England Neurology Intelligence

Network classification of Neurological Conditions: https://www.gov.uk/guidance/neurology-data-and-analysis-a-guide-for-health-professionals

Epilepsy - Percentage of elective admissions where the main consultant for the spell is a Neurologist or

Neurosurgeon - 2017/182 Adms


0.00

20.0

40.0

60.0

80.0

100


53.2

0.00 0.00 0.00

21.4

37.946.9

52.6 53.3

68.3 70.7

0.00

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0

South Sefton North EastLincolnshire

Halton South Tyneside St Helens South Tees Sunderland Blackpool Knowsley Stoke on Trent Thanet



NHS Blackpool CCG


neurological conditions the spells will predominantly be with one speciality. The majority of tariff admissions for Epilepsy are non-elective. Neurological condition group classifications in this pack are based on the Public Health England Neurology Intelligence

Network classification of Neurological Conditions: https://www.gov.uk/guidance/neurology-data-and-analysis-a-guide-for-health-professionals

Epilepsy - Percentage of non-elective admissions where the main consultant for the spell is a Neurologist or

Neurosurgeon - 2017/18

England 3.82 Best or Lowest 5

0.00

10.0

20.0

30.0

40.0

50.0


0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.002.71 3.68

39.2

0.00

5.00

10.0

15.0

20.0

25.0

30.0

35.0

40.0

45.0

50.0

Blackpool South Sefton Knowsley South Tyneside North EastLincolnshire

Thanet St Helens Halton Sunderland South Tees Stoke on Trent



NHS Blackpool CCG

Caveats: The majority of tariff admissions for Epilepsy are non-elective. Neurological condition group classifications in this pack are based on the Public Health England Neurology Intelligence Network classification of Neurological Conditions:


Epilepsy - Non-elective admissions that are short stays (0 or 1 day) per 100,000 age-sex weighted population -

2017/1823 Adms


0.00

20.0

40.0

60.0

80.0

100

120

140


80.7

39.248.2

77.684.5 88.1 91.6 92.7 94.2 98.9

109

0.00

20.0

40.0

60.0

80.0

100

120

140


Thanet Blackpool South Tyneside Knowsley Stoke on Trent South Tees South Sefton Halton St Helens



NHS Blackpool CCG

Caveats: The ICD10 codes for this indicator come under the Cancers and Tumours Programme Budget Category (02). Neurological condition group classifications in this pack are based on the Public Health England Neurology Intelligence Network classification of

Neurological Conditions: https://www.gov.uk/guidance/neurology-data-and-analysis-a-guide-for-health-professionals

Tumours of the Nervous System - Elective spend per 1,000 age-sex weighted population - 2017/18 £69k

England 1,017 Best or Lowest 5 871

0.00

500

1,000

1,500

2,000

2,500


1,245

597777

9211,025 1,033 1,063 1,072 1,090

1,258 1,339

0.00

200

400

600

800

1,000

1,200

1,400

1,600

1,800

2,000


South Tees Knowsley Thanet Sunderland South Sefton Stoke on Trent St Helens Blackpool Halton South Tyneside



NHS Blackpool CCG



Tumours of the Nervous System - Non-elective spend per 1,000 age-sex weighted population - 2017/18 £67k


0.00

500

1,000

1,500

2,000

2,500


1,185

518

839 853 8921,061 1,139

1,343 1,439 1,477 1,501

0.00

500

1,000

1,500

2,000

2,500

Stoke on Trent South Tees Thanet Sunderland St Helens Halton Blackpool Knowsley South Tyneside North EastLincolnshire

South Sefton



NHS Blackpool CCG



Tumours of the Nervous System - Average annual rate of admissions per 100,000 age-sex weighted population -

2015/16-2017/18


0.00

20.0

40.0

60.0

80.0

100


49.239.3 43.5

52.162.4

68.0 70.2 70.876.1

85.3 86.1

0.00

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0

100

Thanet Halton Blackpool St Helens South Tees Stoke on Trent South Tyneside Sunderland Knowsley South Sefton North EastLincolnshire



NHS Blackpool CCG


neurological conditions the spells will predominantly be with one speciality. The ICD10 codes for this indicator come under the Cancers and Tumours Programme Budget Category (02). Neurological condition group classifications in this pack are based on the Public


Tumours of the Nervous System - Percentage of elective admissions where the main consultant for the spell is a

Neurologist or Neurosurgeon - 2017/186 Adms


0.00

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0


35.0

0.00

18.8 22.5 26.3 29.634.6 35.5 39.6 41.7

61.5

0.00

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0

Halton South Sefton Stoke on Trent Sunderland South Tees South Tyneside Blackpool St Helens Knowsley North EastLincolnshire

Thanet



NHS Blackpool CCG


neurological conditions the spells will predominantly be with one speciality. The ICD10 codes for this indicator come under the Cancers and Tumours Programme Budget Category (02). Neurological condition group classifications in this pack are based on the Public


Tumours of the Nervous System - Percentage of non-elective admissions where the main consultant for the spell is

a Neurologist or Neurosurgeon - 2017/182 Adms


0.00

10.0

20.0

30.0

40.0

50.0


17.9

0.00

10.3 10.4 10.515.0

18.4 19.0 20.022.6

30.2

0.00

5.00

10.0

15.0

20.0

25.0

30.0

35.0

40.0

45.0

50.0

Halton Knowsley South Tees St Helens Thanet Blackpool Stoke on Trent Sunderland South Sefton North EastLincolnshire

South Tyneside



NHS Blackpool CCG

Caveats: Nationally approximately two thirds of tariff admissions for Motor Neurone Disease and Spinal Muscular Atrophy are elective. Total figures are presented due to the small number of non-elective admissions. Neurological condition group classifications in

this pack are based on the Public Health England Neurology Intelligence Network classification of Neurological Conditions: https://www.gov.uk/guidance/neurology-data-and-analysis-a-guide-for-health-professionals

Motor Neurone Disease and Spinal Muscular Atrophy - Total spend per 1,000 age-sex weighted population -

2017/18


0.00

100

200

300

400

500

600

700


167

0.00 0.0055.3 58.2 72.3

131187 212

261

398

0.00

100

200

300

400

500

600

700

South Tyneside St Helens Stoke on Trent South Tees Sunderland North EastLincolnshire

Blackpool Halton Thanet Knowsley South Sefton



NHS Blackpool CCG



Motor Neurone Disease and Spinal Muscular Atrophy - Average annual rate of admissions per 100,000 age-sex

weighted population - 2015/16-2017/18


0.00

5.00

10.0

15.0

20.0


4.16

1.783.07

4.34 4.76 5.06 5.085.82 5.93 6.10

7.78

0.00

2.00

4.00

6.00

8.00

10.0

12.0

South Tyneside St Helens Blackpool North EastLincolnshire

Stoke on Trent Halton Sunderland Knowsley Thanet South Tees South Sefton



NHS Blackpool CCG

Caveats: The majority of tariff admissions for traumatic brain and spine injuries are non-elective. Total figures are presented due to the small number of elective admissions. The ICD10 codes for this indicator come under the Trauma and Injuries Programme Budget

Category (16X)Neurological condition group classifications in this pack are based on the Public Health England Neurology Intelligence Network classification of Neurological Conditions: https://www.gov.uk/guidance/neurology-data-and-analysis-a-guide-for-health-

professionals

Traumatic Brain and Spine injuries - Total spend per 1,000 age-sex weighted population - 2017/18


0.00

500

1,000

1,500

2,000

2,500

3,000

3,500

4,000

4,500


1,9211,799 1,842 2,023 2,208 2,246 2,3022,532 2,550 2,703 2,897

0.00

500

1,000

1,500

2,000

2,500

3,000

3,500

4,000

South Sefton South Tees Blackpool Halton Stoke on Trent St Helens North EastLincolnshire

Thanet South Tyneside Sunderland Knowsley



NHS Blackpool CCG


Category (16X)Neurological condition group classifications in this pack are based on the Public Health England Neurology Intelligence Network classification of Neurological Conditions: https://www.gov.uk/guidance/neurology-data-and-analysis-a-guide-for-health-

professionals

Traumatic Brain and Spine injuries - Average annual rate of admissions per 100,000 age-sex weighted population -

2015/16-2017/18


0.00

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0


33.829.9 32.0

41.8 43.1 44.1 46.7 46.7 47.955.2 57.4

0.00

10.0

20.0

30.0

40.0

50.0

60.0

70.0

South Tees Sunderland Blackpool South Tyneside South Sefton North EastLincolnshire

Stoke on Trent Thanet St Helens Halton Knowsley



NHS Blackpool CCG


neurological conditions the spells will predominantly be with one speciality. The majority of tariff admissions for traumatic brain and spine injuries are non-elective. Total figures are presented due to the small number of elective admissions. The ICD10 codes for

this indicator come under the Trauma and Injuries Programme Budget Category (16X) Neurological condition group classifications in this pack are based on the Public Health England Neurology Intelligence Network classification of Neurological Conditions:


Traumatic Brain and Spine injuries - Percentage of admissions where the main consultant for the spell is a



0.00

10.0

20.0

30.0

40.0

50.0

60.0

70.0


22.5

10.8 10.9 12.016.2 16.5 17.4 19.8 21.1

26.7

35.1

0.00

5.00

10.0

15.0

20.0

25.0

30.0

35.0

40.0

45.0

50.0

South Tees Halton South Tyneside North EastLincolnshire

St Helens Thanet Knowsley South Sefton Blackpool Sunderland Stoke on Trent



NHS Blackpool CCG

Caveats: The majority of tariff admissions for Central Nervous System infections are non-elective. Total figures are presented due to the small number of elective admissions. Neurological condition group classifications in this pack are based on the Public Health

England Neurology Intelligence Network classification of Neurological Conditions: https://www.gov.uk/guidance/neurology-data-and-analysis-a-guide-for-health-professionals

Central nervous system infections - Total spend per 1,000 age-sex weighted population - 2017/18 £192k


0.00

500

1,000

1,500

2,000

2,500


1,873

639 768 811 834986 1,002 1,030

1,446 1,492 1,618

0.00

500

1,000

1,500

2,000

2,500

3,000

Sunderland South Tees North EastLincolnshire

Stoke on Trent Knowsley Thanet South Sefton South Tyneside Halton St Helens Blackpool



NHS Blackpool CCG



Central nervous system infections - Average annual rate of admissions per 100,000 age-sex weighted population -

2015/16-2017/1812 Adms


0.00

10.0

20.0

30.0

40.0

50.0


29.3

19.2 19.8 20.4

26.0 26.9 27.5 29.1 29.2 29.2 30.9

0.00

5.00

10.0

15.0

20.0

25.0

30.0

35.0

40.0

Thanet South Tees Sunderland Stoke on Trent South Sefton Knowsley St Helens North EastLincolnshire

Halton Blackpool South Tyneside



NHS Blackpool CCG


neurological conditions the spells will predominantly be with one speciality. The majority of tariff admissions for Central Nervous System infections are non-elective. Total figures are presented due to the small number of elective admissions. Neurological

condition group classifications in this pack are based on the Public Health England Neurology Intelligence Network classification of Neurological Conditions: https://www.gov.uk/guidance/neurology-data-and-analysis-a-guide-for-health-professionals

Central nervous system infections - Percentage of admissions where the main consultant for the spell is a



0.00

10.0

20.0

30.0

40.0

50.0

60.0


0.00 0.00 0.00 0.00 0.00 0.00 0.00

11.5

21.4

32.1

48.6

0.00

10.0

20.0

30.0

40.0

50.0

60.0

70.0

Blackpool South Sefton Knowsley South Tees North EastLincolnshire

St Helens Halton Sunderland South Tyneside Thanet Stoke on Trent



NHS Blackpool CCG

Caveats: The majority of tariff admissions for Multiple Sclerosis and inflammatory disorders are elective. Total figures are presented due to the small number of non-elective admissions. Neurological condition group classifications in this pack are based on the

Public Health England Neurology Intelligence Network classification of Neurological Conditions: https://www.gov.uk/guidance/neurology-data-and-analysis-a-guide-for-health-professionals

Multiple Sclerosis and Inflammatory Disorders - Total spend per 1,000 age-sex weighted population - 2017/18 £56k


0.00

200

400

600

800

1,000

1,200


585

186 226 248293

357 365 406 417 430 447

0.00

100

200

300

400

500

600

700

800

900

South Sefton St Helens Knowsley North EastLincolnshire

Halton South Tees South Tyneside Stoke on Trent Thanet Sunderland Blackpool



NHS Blackpool CCG



Multiple Sclerosis and Inflammatory Disorders - Average annual rate of admissions per 100,000 age-sex weighted

population - 2015/16-2017/18


0.00

50.0

100

150

200

250

300


20.934.3 36.7 38.8

55.5 61.0

122 123 130 132

203

0.00

50.0

100

150

200

250

Blackpool Knowsley St Helens Halton South Sefton South Tees North EastLincolnshire

Thanet Sunderland South Tyneside Stoke on Trent



NHS Blackpool CCG


neurological conditions the spells will predominantly be with one speciality. The majority of tariff admissions for Multiple Sclerosis and inflammatory disorders are elective. Total figures are presented due to the small number of non-elective admissions.

Neurological condition group classifications in this pack are based on the Public Health England Neurology Intelligence Network classification of Neurological Conditions: https://www.gov.uk/guidance/neurology-data-and-analysis-a-guide-for-health-professionals

Multiple Sclerosis and Inflammatory Disorders - Percentage of admissions where the main consultant for the spell

is a Neurologist or Neurosurgeon - 2017/188 Adms


0.00

20.0

40.0

60.0

80.0

100


76.0

0.00

72.580.8 81.5

88.8 89.9 90.4 91.0 92.0 96.0

0.00

20.0

40.0

60.0

80.0

100

120

South Sefton Halton Blackpool Knowsley St Helens North EastLincolnshire

Thanet South Tees Stoke on Trent South Tyneside Sunderland



NHS Blackpool CCG

Caveats: The majority of tariff admissions for peripheral nerve disorders are elective. Total figures are presented due to the small number of non-elective admissions. Neurological condition group classifications in this pack are based on the Public Health England

Neurology Intelligence Network classification of Neurological Conditions: https://www.gov.uk/guidance/neurology-data-and-analysis-a-guide-for-health-professionals

Peripheral Nerve Disorders - Total spend per 1,000 age-sex weighted population - 2017/18


0.00

1,000

2,000

3,000

4,000

5,000


1,178883

1,130 1,2031,448 1,482 1,509

1,682

2,020 2,056 2,090

0.00

500

1,000

1,500

2,000

2,500

Thanet South Tyneside Blackpool South Sefton Sunderland Knowsley North EastLincolnshire

Stoke on Trent Halton St Helens South Tees



NHS Blackpool CCG



Peripheral nerve disorders - Average annual rate of admissions per 100,000 age-sex weighted population - 2015/16-

2017/1849 Adms


0.00

50.0

100

150

200


119

70.4 79.999.5 101 110 118 124

135 144

175

0.00

20.0

40.0

60.0

80.0

100

120

140

160

180

200

Thanet South Sefton South Tyneside North EastLincolnshire

Stoke on Trent Knowsley Blackpool Sunderland Halton St Helens South Tees



NHS Blackpool CCG


neurological conditions the spells will predominantly be with one speciality. The majority of tariff admissions for peripheral nerve disorders are elective. Total figures are presented due to the small number of non-elective admissions. Neurological condition group

classifications in this pack are based on the Public Health England Neurology Intelligence Network classification of Neurological Conditions: https://www.gov.uk/guidance/neurology-data-and-analysis-a-guide-for-health-professionals

Peripheral nerve disorders - Percentage of admissions where the main consultant for the spell is a Neurologist or

Neurosurgeon - 2017/183 Adms


0.00

5.00

10.0

15.0

20.0

25.0

30.0

35.0

40.0

45.0


3.30

0.00 0.00 0.00 0.00 0.00

3.474.31

5.04 5.156.17

0.00

2.00

4.00

6.00

8.00

10.0

12.0

Knowsley South Tyneside South Tees Thanet Sunderland Blackpool Halton North EastLincolnshire

Stoke on Trent South Sefton St Helens

Section 4b - Secondary Care

• Total bed days

• Elective bed days

• Non-elective bed days



NHS Blackpool CCG

Neurological Problems (07) – Total bed days per 100,000 age-sex weighted population - 2017/185,595 Bed

Days


0.00

2,000

4,000

6,000

8,000

10,000


7,336

4,163 4,226 4,250 4,560 4,670

5,923 5,9296,628 6,741

7,540

0.00

1,000

2,000

3,000

4,000

5,000

6,000

7,000

8,000

9,000


Sunderland South Tees Stoke on Trent Thanet Halton St Helens South Tyneside Knowsley Blackpool South Sefton



NHS Blackpool CCG

Neurological Conditions (07X) - Total bed days per 100,000 age-sex weighted population - 2017/183,712 Bed

Days


0.00

1,000

2,000

3,000

4,000

5,000

6,000

7,000

8,000


4,512

1,9912,299

2,675 2,887 3,0323,516 3,553 3,742

4,1534,864

0.00

1,000

2,000

3,000

4,000

5,000

6,000


South Tees Stoke on Trent Sunderland Thanet Halton St Helens Knowsley South Tyneside Blackpool South Sefton



NHS Blackpool CCG


professionals

Rare and other neurological diseases - Elective bed days per 100,000 age-sex weighted population - 2017/18


0.00

50.0

100

150

200

250

300

350

400


72.9

30.257.6 64.9 68.5

89.7 103 117

172 184 190

0.00

50.0

100

150

200

250

300


Sunderland St Helens South Tees Blackpool Knowsley Thanet South Tyneside Halton Stoke on Trent South Sefton



NHS Blackpool CCG


professionals

Rare and other neurological diseases - Non-elective bed days per 100,000 age-sex weighted population - 2017/18 160 Bed Days


0.00

200

400

600

800

1,000

1,200

1,400

1,600


331

182 183 207

324 336 366 382 391

478 486

0.00

100

200

300

400

500

600

700

Stoke on Trent North EastLincolnshire

South Tees St Helens Blackpool Sunderland Halton Knowsley Thanet South Tyneside South Sefton



NHS Blackpool CCG



Neuromuscular Diseases - Elective bed days per 100,000 age-sex weighted population - 2017/18


0.00

50.0

100

150

200

250

300


19.3

4.03

13.8 15.1 17.0 19.8 20.924.5

28.334.1 35.5

0.00

10.0

20.0

30.0

40.0

50.0

60.0


St Helens Knowsley Halton Blackpool South Tees Sunderland Thanet South Tyneside South Sefton Stoke on Trent



NHS Blackpool CCG



Neuromuscular Diseases - Non-elective bed days per 100,000 age-sex weighted population - 2017/18 115 Bed Days


0.00

200

400

600

800

1,000

1,200

1,400


136

0.00

55.4 58.775.7 82.9

106 116131

147180

0.00

50.0

100

150

200

250

300

South Tyneside Sunderland Thanet South Tees Halton North EastLincolnshire

St Helens South Sefton Blackpool Knowsley Stoke on Trent



NHS Blackpool CCG



Epilepsy - Elective bed days per 100,000 age-sex weighted population - 2017/18 36 Bed Days


0.00

50.0

100

150

200

250


53.5

25.0 25.433.5 37.1 37.9 41.5

75.2 81.4 83.8100

0.00

20.0

40.0

60.0

80.0

100

120

140

160

Halton Knowsley South Tyneside North EastLincolnshire

Stoke on Trent South Tees Blackpool Sunderland South Sefton Thanet St Helens



NHS Blackpool CCG



Epilepsy - Non-elective bed days per 100,000 age-sex weighted population - 2017/18 463 Bed Days


0.00

100

200

300

400

500

600

700

800

900


631

330372 383 409 413 426 434 462 483 516

0.00

100

200

300

400

500

600

700

800

South Tees Thanet Knowsley North EastLincolnshire

Sunderland St Helens Stoke on Trent Halton South Sefton South Tyneside Blackpool



NHS Blackpool CCG



Tumours of the Nervous System - Elective bed days per 100,000 age-sex weighted population - 2017/18 54 Bed days


0.00

100

200

300

400

500


110

49.578.6 85.2 85.7

103 110134 143

161

219

0.00

50.0

100

150

200

250

300


Thanet Halton Knowsley Stoke on Trent Blackpool St Helens South Tees Sunderland South Sefton South Tyneside



NHS Blackpool CCG



Tumours of the Nervous System - Non-elective bed days per 100,000 age-sex weighted population - 2017/18


0.00

100

200

300

400

500

600

700


261

82.2

149186

233281 295 297 312

361 367

0.00

50.0

100

150

200

250

300

350

400

450

500

Stoke on Trent Thanet South Tees Sunderland Blackpool Halton St Helens North EastLincolnshire

South Tyneside South Sefton Knowsley



NHS Blackpool CCG



Motor Neurone Disease and Spinal Muscular Atrophy - Total bed days per 100,000 age-sex weighted population -

2017/18


0.00

50.0

100

150

200

250

300

350

400


23.70.00 0.00 9.36 14.9

28.2 32.454.9 57.6 59.5

133

0.00

50.0

100

150

200

250

South Tyneside St Helens North EastLincolnshire

South Tees Blackpool Stoke on Trent Sunderland Halton Thanet Knowsley South Sefton



NHS Blackpool CCG


Category (16X). Neurological condition group classifications in this pack are based on the Public Health England Neurology Intelligence Network classification of Neurological Conditions: https://www.gov.uk/guidance/neurology-data-and-analysis-a-guide-for-health-

professionals

Traumatic Brain and Spine injuries - Total bed days per 100,000 age-sex weighted population - 2017/18


0.00

200

400

600

800

1,000

1,200

1,400


416 473 528 546 571 600713 730 740 753

867

0.00

200

400

600

800

1,000

1,200

Blackpool North EastLincolnshire

South Tees St Helens Halton Stoke on Trent Sunderland Thanet Knowsley South Sefton South Tyneside



NHS Blackpool CCG



Central nervous system infections - Total bed days per 100,000 age-sex weighted population - 2017/18 570 Bed Days


0.00

100

200

300

400

500

600

700

800

900


529

164 201 215 245 273 293335

421 425 457

0.00

100

200

300

400

500

600

700

800


Stoke on Trent South Tees Thanet Knowsley Halton South Sefton South Tyneside St Helens Blackpool



NHS Blackpool CCG



Multiple Sclerosis and Inflammatory Disorders - Total bed days per 100,000 age-sex weighted population - 2017/18 243 Bed Days


0.00

100

200

300

400

500

600

700


199

43.4 43.964.9 73.5 77.6 81.8

106 117150

168

0.00

50.0

100

150

200

250

300

St Helens South Sefton Halton North EastLincolnshire

Stoke on Trent South Tyneside South Tees Sunderland Thanet Knowsley Blackpool



NHS Blackpool CCG



Peripheral nerve disorders - Total bed days per 100,000 age-sex weighted population - 2017/18


0.00

50.0

100

150

200

250

300

350


78.570.3 72.9 83.0 84.5 96.7 106

149 158 167

202

0.00

50.0

100

150

200

250

South Sefton Thanet Blackpool South Tyneside Sunderland North EastLincolnshire

Stoke on Trent South Tees Knowsley St Helens Halton

Section 4c - Secondary Care

• Outpatients

SUS+ Outpatient Treatment Function Codes (TFC) CCG Activity

The following slides show SUS+ CCG outpatient activity for the Outpatient Treatment Function Codes (TFC) of most relevance to this Programme Budgeting Category. Only those TFCs classed as ‘specific acute’ have been included, and only where there is sufficient activity nationally.

Indirectly age-sex standardised rates of attended outpatient appointments for that TFC are shown – this includes both attended new (first) and follow-up appointments. Potential opportunities are provided by comparing each CCG’s rate to the average activity rates of its lowest 5 similar CCGs. It should be noted that local interpretation is required to determine whether higher or lower rates of Outpatient appointments TFC for primary care prescribing and elective inpatient admissions are appropriate.

There is likely to be significant variation nationally in how attended appointments are allocated to TFCs, particularly to the General Surgery and General Medicine TFCs. These TFCs are included in the RightCare Where to Look pack as they do not align with a specific programme.

Also included are the percentage of new outpatient attendances out of all outpatient attendances. These indicators are given to provide further context to the overall rate of appointments indicator, and for CCGs to see on average how many follow-up appointments a patient has. Variation in this measure is likely due to the mix of patients, the treatment method chosen and provider processes. However, given the amount of variation nationally, it is likely that provider processes are the key driver.

SUS+ Outpatient Treatment Function Codes (TFC) CCG Activity

For CCGs with higher percentages of new attended appointments (and therefore on average their patients having had relatively fewer follow-up appointments) they may find that their patients have had a poorer experience of care and may be more likely to be re-referred. It may also be an indication of over-referral from primary care, or prioritisation of new patient appointments in the outpatient setting. For CCGs with lower percentages of new appointments (and therefore on average their patients having had relatively more follow-up appointments) they may find that their capacity for seeing new patients is limited and may want to analyse their referral to treatment and waiting times data. It may also indicate under-referral from primary care.1

NHS RightCare encourages systems to use outpatient data to identify potential opportunities to reduce burden of referrals to secondary care services where appropriate. Working with Trusts and primary care, systems should work collectively to understand the drivers for their outpatient appointment rates in specific clinical specialties, and to ensure that local referral processes are appropriate and being adhered to. The NHS Operational Planning and Contracting guidance for 2019/202 states that systems should increase the focus on the development of primary care service to further reduce referrals to secondary care and secondary care follow-ups.

Spend indicators using SUS+ data for outpatients have not been presented; please refer to the Programme Budgeting indicator section for outpatient spend indicators for this programme.

These indicators are a new addition to the RightCare packs and any feedback to [email protected] would be welcome.

1 GIRFT Programme Urology National Specialty Report, July 2018 https://gettingitrightfirsttime.co.uk/wp-content/uploads/2018/07/GIRFT-Urology.pdf

2 https://www.england.nhs.uk/publication/preparing-for-2019-20-operational-planning-and-contracting/



NHS Blackpool CCG

Caveats: Only attended appointments are included in this indicator. This indicator includes both new (first) and follow-up appointments. This indicator includes all ages - age split indicators are available separately.

Neurology - Rate of outpatient appointments per 100,000 age-sex weighted population - 2017/181,470

Appointments


0.00

1,000

2,000

3,000

4,000

5,000


3,038

1,904 1,928 2,0502,517 2,713 2,744 2,773

3,1993,620

4,277

0.00

500

1,000

1,500

2,000

2,500

3,000

3,500

4,000

4,500

5,000

Thanet South Tees North EastLincolnshire

South Tyneside St Helens Halton Sunderland Blackpool Knowsley South Sefton Stoke on Trent



NHS Blackpool CCG

Caveats: Only attended appointments are included in this indicator. This indicator includes both new (first) and follow-up appointments. This indicator includes both the relevant general and paediatric Neurology Treatment Function Codes but is limited by age.

This is to ensure those patients aged 18 and over listed against the paediatric TFC are not excluded. Potential opportunities are provided by comparing each CCG’s rate to the average activity rates of its lowest 5 similar CCGs; as for primary care prescribing and

elective inpatient admissions, local interpretation is required to determine whether high or low rates of Outpatient appointments for the TFC are appropriate.

Neurology - Aged 18 and over - Rate of outpatient appointments per 100,000 age-sex weighted population -

2017/181,558

Appointments


0.00

1,000

2,000

3,000

4,000

5,000

6,000


3,667

2,191 2,327 2,3992,946 3,074 3,146 3,338

3,6354,200

5,290

0.00

1,000

2,000

3,000

4,000

5,000

6,000

Thanet South Tees North EastLincolnshire

South Tyneside St Helens Halton Sunderland Knowsley Blackpool South Sefton Stoke on Trent



NHS Blackpool CCG

Caveats: Only attended appointments are included in this indicator. CCGs with a higher percentage of new appointments may find that patients are having a poorer experience of care and are more likely to be re-referred. It may also indicate over-referral from

primary care, or prioritisation of new outpatient appointments over follow-ups. CCGs with a lower percentage may find that their capacity for seeing new patients is limited and should check their RTT data. It may also indicate under-referral from primary care. As it

cannot be said what represents an optimum performance for this indicator, a similar 10 benchmark is used and no opportunities are calculated.

Neurology - Percentage of outpatient appointments which are new - 2017/18


0.00

10.0

20.0

30.0

40.0

50.0

60.0


25.728.0

30.3 32.5 32.9 34.1 34.3 35.4 35.6 36.2 37.1

0.00

5.00

10.0

15.0

20.0

25.0

30.0

35.0

40.0

45.0


South Tees Stoke on Trent South Tyneside Halton Sunderland St Helens South Sefton Thanet Knowsley



NHS Blackpool CCG

Caveats: This indicator includes both the relevant general and paediatric Neurology Treatment Function Codes but is limited by age. This is to ensure those patients aged 18 and over listed against the paediatric TFC are not excluded. This measure aims to give CCGs

a more detailed understanding of their overall activity, and help illustrate potential drivers. Therefore, a similar 10 benchmark has been used, and no opportunities have been calculated. Local interpretation is required to determine whether high or low rates of

Outpatient appointments for the TFC are appropriate.

Neurology - Aged 18 and over - Percentage of new outpatient appointments where the referral was made by a GP -

2017/18


0.00

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0


60.1

40.149.4 51.2 51.4 54.3

62.9 64.3 65.0 66.5 66.5

0.00

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

Stoke on Trent Halton South Sefton St Helens Knowsley Blackpool North EastLincolnshire

Thanet Sunderland South Tees South Tyneside



NHS Blackpool CCG

Caveats: This indicator includes both the relevant general and paediatric Neurology Treatment Function Codes but is limited by age. This is to ensure those patients aged 18 and over listed against the paediatric TFC are not excluded. This measure aims to give CCGs

a more detailed understanding of their overall activity, and help illustrate potential drivers. Therefore, a similar 10 benchmark has been used, and no opportunities have been calculated. Local interpretation is required to determine whether high or low rates of

Outpatient appointments for the TFC are appropriate.

Neurology - Aged 18 and over - Percentage of new outpatient appointments where the referral was made by a

(non A&E) consultant - 2017/18


0.00

10.0

20.0

30.0

40.0

50.0


11.915.9

18.9 19.923.6

27.131.9

37.6 39.3 40.1 41.9

0.00

5.00

10.0

15.0

20.0

25.0

30.0

35.0

40.0

45.0

50.0

Blackpool Stoke on Trent Sunderland South Tyneside Thanet South Tees North EastLincolnshire

Knowsley South Sefton St Helens Halton



NHS Blackpool CCG

Caveats: Only attended appointments are included in this indicator. This indicator includes both new (first) and follow-up appointments. This indicator includes both the relevant general and paediatric Neurology ]Treatment Function Codes but is limited by age.

This is to ensure those patients aged 17 and under listed against the relevant general TFC are not excluded. Potential opportunities are provided by comparing each CCG’s rate to the average activity rates of its lowest 5 similar CCGs; as for primary care prescribing

and elective inpatient admissions, local interpretation is required to determine whether high or low rates of Outpatient appointments for the TFC are appropriate.

Paediatric neurology - Aged 0-17 - Rate of outpatient appointments per 100,000 age-sex weighted population -

2017/18


0.00

1,000

2,000

3,000

4,000

5,000

6,000

7,000

8,000


553387 417

546699

803 863

1,1791,355 1,395

1,498

0.00

200

400

600

800

1,000

1,200

1,400

1,600

1,800

South Tees Stoke on Trent Sunderland Blackpool North EastLincolnshire

Thanet South Tyneside Halton St Helens South Sefton Knowsley



NHS Blackpool CCG

Caveats: This indicator includes both the relevant general and paediatric Treatment Function Codes but is limited by age. This is to ensure those patients aged 17 and under listed against the relevant general TFC are not excluded. Only attended appointments are

included in this indicator. CCGs with a higher percentage of new appointments may find that patients are having a poorer experience of care and are more likely to be re-referred. It may also indicate over-referral from primary care, or prioritisation of new

outpatient appointments over follow-ups. CCGs with a lower percentage may find that their capacity for seeing new patients is limited and should check their RTT data. It may also indicate under-referral from primary care. As it cannot be said what represents an

optimum performance for this indicator, a similar 10 benchmark is used and no opportunities are calculated.

Paediatric neurology - Aged 0-17 - Percentage of outpatient appointments that are new - 2017/18


0.00

10.0

20.0

30.0

40.0

50.0

60.0

70.0


37.9

26.1 26.729.7 30.2 30.6 30.7

34.6 35.540.2 40.9

0.00

5.00

10.0

15.0

20.0

25.0

30.0

35.0

40.0

45.0

50.0

Halton St Helens Knowsley South Sefton Thanet North EastLincolnshire

Stoke on Trent South Tyneside Blackpool Sunderland South Tees



NHS Blackpool CCG

Caveats: This indicator includes both the relevant general and paediatric Neurology Treatment Function Codes but is limited by age. This is to ensure those patients aged 17 and under listed against the relevant general TFC are not excluded. This measure aims to

give CCGs a more detailed understanding of their overall activity, and help illustrate potential drivers. Therefore, a similar 10 benchmark has been used, and no opportunities have been calculated. Local interpretation is required to determine whether high or low

rates of Outpatient appointments for the TFC are appropriate.

Paediatric neurology - Aged 0-17 - Percentage of new outpatient appointments where the referral was made by a

GP - 2017/18


0.00

10.0

20.0

30.0

40.0

50.0

60.0

70.0


17.4

0.00 0.00

19.3 20.0

29.734.1 35.9

41.6 41.9

53.3

0.00

10.0

20.0

30.0

40.0

50.0

60.0

70.0

South Tees Thanet Blackpool Sunderland North EastLincolnshire

South Tyneside South Sefton St Helens Knowsley Halton Stoke on Trent



NHS Blackpool CCG

Caveats: This indicator includes both the relevant general and paediatric Neurology Treatment Function Codes but is limited by age. This is to ensure those patients aged 17 and under listed against the relevant general TFC are not excluded. This measure aims to

give CCGs a more detailed understanding of their overall activity, and help illustrate potential drivers. Therefore, a similar 10 benchmark has been used, and no opportunities have been calculated. Local interpretation is required to determine whether high or low

rates of Outpatient appointments for the TFC are appropriate.

Paediatric neurology - Aged 0-17 - Percentage of new outpatient appointments where the referral was made by a

(non A&E) consultant - 2017/18


0.00

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0


46.436.7

46.8 48.8 49.355.6 58.2

71.4 72.077.0 77.8

0.00

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0

Stoke on Trent Blackpool Knowsley Halton St Helens South Sefton South Tyneside Sunderland North EastLincolnshire

Thanet South Tees



NHS Blackpool CCG

Caveats: Only attended appointments are included in this indicator. This indicator includes both new (first) and follow-up appointments. This indicator includes all ages.

Neurosurgery - Rate of outpatient appointments per 100,000 age-sex weighted population - 2017/18167

Appointments


0.00

200

400

600

800

1,000

1,200

1,400

1,600


787

369567

693 773

1,0761,208 1,248 1,300

1,4341,536

0.00

200

400

600

800

1,000

1,200

1,400

1,600

1,800

Stoke on Trent Sunderland Thanet South Tees Blackpool North EastLincolnshire

South Tyneside Halton South Sefton Knowsley St Helens



NHS Blackpool CCG

Caveats: Only attended appointments are included in this indicator. This indicator includes both new (first) and follow-up appointments. This indicator includes both the relevant general and paediatric Neurosurgery Treatment Function Codes but is limited by age.

This is to ensure those patients aged 18 and over listed against the paediatric TFC are not excluded. Potential opportunities are provided by comparing each CCG’s rate to the average activity rates of its lowest 5 similar CCGs; as for primary care prescribing and

elective inpatient admissions, local interpretation is required to determine whether high or low rates of Outpatient appointments for the TFC are appropriate.

Neurosurgery - Aged 18 and over - Rate of outpatient appointments per 100,000 age-sex weighted population -

2017/18162

Appointments


0.00

200

400

600

800

1,000

1,200

1,400

1,600

1,800


929

392

658837 931

1,2711,468 1,476 1,485

1,6881,810

0.00

200

400

600

800

1,000

1,200

1,400

1,600

1,800

2,000

Stoke on Trent Sunderland Thanet Blackpool South Tees North EastLincolnshire

South Tyneside Halton South Sefton Knowsley St Helens



NHS Blackpool CCG




Neurosurgery - Percentage of outpatient appointments which are new - 2017/18


0.00

10.0

20.0

30.0

40.0

50.0


37.7

27.3 28.932.1 33.1

36.3 38.0 39.6 39.843.4

51.3

0.00

10.0

20.0

30.0

40.0

50.0

60.0

Sunderland South Tyneside Knowsley South Sefton Stoke on Trent Blackpool St Helens South Tees Thanet Halton North EastLincolnshire



NHS Blackpool CCG

Caveats: This indicator includes both the relevant general and paediatric Treatment Function Codes but is limited by age. This is to ensure those patients aged 18 and over listed against the paediatric TFC are not excluded. Only attended appointments are included

in this indicator. CCGs with a higher percentage of new appointments may find that patients are having a poorer experience of care and are more likely to be re-referred. It may also indicate over-referral from primary care, or prioritisation of new outpatient

appointments over follow-ups. CCGs with a lower percentage may find that their capacity for seeing new patients is limited and should check their RTT data. It may also indicate under-referral from primary care. As it cannot be said what represents an optimum

performance for this indicator, a similar 10 benchmark is used and no opportunities are calculated.

Neurosurgery - Aged 18 and over - Percentage of outpatient appointments that are new - 2017/18


0.00

10.0

20.0

30.0

40.0

50.0

60.0


37.9

26.1 28.832.2 33.0

37.5 38.6 39.7 40.444.7

53.1

0.00

10.0

20.0

30.0

40.0

50.0

60.0

Sunderland South Tyneside Knowsley South Sefton Stoke on Trent Blackpool St Helens South Tees Thanet Halton North EastLincolnshire



NHS Blackpool CCG

Caveats: Only attended appointments are included in this indicator. This indicator includes both new (first) and follow-up appointments. This indicator includes all ages. Due to low numbers, attended appointments recorded against the clinical neurophysiology

Treatment Function Code are not split out into 18+ and 17 and under.

Clinical Neurophysiology - Rate of outpatient appointments per 100,000 age-sex weighted population - 2017/18


0.00

200

400

600

800

1,000


27.2

237

376 398 423

552597

650 656713

797

0.00

100

200

300

400

500

600

700

800

900


Halton South Tyneside South Sefton South Tees Knowsley Stoke on Trent Sunderland St Helens Thanet



NHS Blackpool CCG




Clinical Neurophysiology - Percentage of outpatient appointments which are new - 2017/18


0.00

20.0

40.0

60.0

80.0

100


61.2

0.00 0.00 0.00 0.00

79.586.6 90.0 91.9 96.2 97.9

0.00

20.0

40.0

60.0

80.0

100

120

South Tyneside North EastLincolnshire

Thanet Sunderland Blackpool South Tees South Sefton Halton Knowsley St Helens Stoke on Trent



NHS Blackpool CCG

Caveats: Due to low numbers, attended appointments recorded against the clinical neurophysiology Treatment Function Code are not split out into 18+ and 17 and under. This measure aims to give CCGs a more detailed understanding of their overall activity, and

help illustrate potential drivers. Therefore, a similar 10 benchmark has been used, and no opportunities have been calculated. Local interpretation is required to determine whether high or low rates of Outpatient appointments for the TFC are appropriate.

Clinical Neurophysiology - Percentage of new outpatient appointments where the referral was made by a GP -

2017/18


0.00

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0


0.00 0.00 0.00 0.00 0.00 0.00 0.005.04

13.7

21.4

47.1

0.00

10.0

20.0

30.0

40.0

50.0

60.0

Blackpool South Sefton South Tyneside North EastLincolnshire

Thanet Sunderland Stoke on Trent South Tees Knowsley Halton St Helens



NHS Blackpool CCG

Caveats: Due to low numbers, attended appointments recorded against the clinical neurophysiology Treatment Function Code are not split out into 18+ and 17 and under. This measure aims to give CCGs a more detailed understanding of their overall activity, and

help illustrate potential drivers. Therefore, a similar 10 benchmark has been used, and no opportunities have been calculated. Local interpretation is required to determine whether high or low rates of Outpatient appointments for the TFC are appropriate.

Clinical Neurophysiology - Percentage of new outpatient appointments where the referral was made by a (non

A&E) consultant - 2017/18


0.00

20.0

40.0

60.0

80.0

100


0.00 0.00 0.00 0.00 0.00

46.8

66.9 71.986.0 87.6

97.6

0.00

20.0

40.0

60.0

80.0

100

120

Blackpool South Tyneside North EastLincolnshire

Thanet Sunderland St Helens Knowsley Halton South Tees South Sefton Stoke on Trent



NHS Blackpool CCG

Caveats: Only attended appointments are included in this indicator. This indicator includes both new (first) and follow-up appointments. This Treatment Function Code is not marked as "Specific Acute" in the SUS+ data - therefore, services may also be provided

outside an acute care setting. Potential opportunities are provided by comparing each CCG’s rate to the average activity rates of its lowest 5 similar CCGs; as for primary care prescribing and elective inpatient admissions, local interpretation is required to determine

whether high or low rates of Outpatient appointments for the TFC are appropriate.

Paediatric neurodisabiltiy - Aged 0-17 - Rate of outpatient appointments per 100,000 age-sex weighted population -

2017/18


0.00

1,000

2,000

3,000

4,000

5,000

6,000

7,000


0.00 0.00 0.00 0.00 0.00 0.00 9.55 28.5 3071,130

5,456

0.00

1,000

2,000

3,000

4,000

5,000

6,000

7,000

Blackpool South Sefton Knowsley South Tyneside Sunderland Stoke on Trent South Tees North EastLincolnshire

St Helens Halton Thanet



NHS Blackpool CCG

Caveats: This Treatment Function Code is not marked as "Specific Acute" in the SUS+ data - therefore, services may also be provided outside an acute care setting. Potential opportunities are provided by comparing each CCG’s rate to the average activity rates of its

lowest 5 similar CCGs; as for primary care prescribing and elective inpatient admissions, local interpretation is required to determine whether high or low rates of Outpatient appointments for the TFC are appropriate.Only attended appointments are included in

this indicator. CCGs with a higher percentage of new appointments may find that patients are having a poorer experience of care and are more likely to be re-referred. It may also indicate over-referral from primary care, or prioritisation of new outpatient

appointments over follow-ups. CCGs with a lower percentage may find that their capacity for seeing new patients is limited and should check their RTT data. It may also indicate under-referral from primary care. As it cannot be said what represents an optimum

performance for this indicator, a similar 10 benchmark is used and no opportunities are calculated.

Paediatric neurodisabiltiy - Aged 0-17- Percentage of outpatient appointments that are new - 2017/18


0.00

10.0

20.0

30.0

40.0

50.0

60.0

70.0


0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

27.5

0.00

5.00

10.0

15.0

20.0

25.0

30.0

35.0

Blackpool South Sefton Knowsley South Tyneside South Tees North EastLincolnshire

St Helens Halton Sunderland Stoke on Trent Thanet



NHS Blackpool CCG

Caveats: Only attended appointments are included in this indicator. This indicator includes both new (first) and follow-up appointments. Potential opportunities are provided by comparing each CCG’s rate to the average activity rates of its lowest 5 similar CCGs; as

for primary care prescribing and elective inpatient admissions, local interpretation is required to determine whether high or low rates of Outpatient appointments for the TFC are appropriate.

Paediatric epilepsy - Aged 0-17 - Rate of outpatient appointments per 100,000 age-sex weighted population -

2017/18


0.00

200

400

600

800

1,000

1,200

1,400


0.00 30.1 60.8 105194 205 225

474

685765

1,109

0.00

200

400

600

800

1,000

1,200

1,400

Blackpool Thanet South Tyneside St Helens Knowsley Halton South Sefton Sunderland North EastLincolnshire

Stoke on Trent South Tees



NHS Blackpool CCG




Paediatric epilepsy - Aged 0-17 - Percentage of outpatient appointments that are new - 2017/18


0.00

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0


0.00 0.00

17.5 20.1 20.924.4 26.7 28.4

31.9 32.0 33.3

0.00

10.0

20.0

30.0

40.0

50.0

60.0

Blackpool Thanet Halton South Tees Knowsley St Helens North EastLincolnshire

South Sefton Stoke on Trent Sunderland South Tyneside



NHS Blackpool CCG

Caveats: Only attended appointments are included in this indicator. This indicator includes both new (first) and follow-up appointments. This indicator includes both the relevant general and paediatric Neurosurgery Treatment Function Codes but is limited by age.

This is to ensure those patients aged 17 and under listed against the relevant general TFC are not excluded. Potential opportunities are provided by comparing each CCG’s rate to the average activity rates of its lowest 5 similar CCGs; as for primary care prescribing


Paediatric neurosurgery - Aged 0-17 - Rate of outpatient appointments per 100,000 age-sex weighted population -

2017/18


0.00

100

200

300

400

500

600

700


231

124 163 169217

267321

363451 469

600

0.00

100

200

300

400

500

600

700

800

Thanet South Tees South Tyneside Sunderland Blackpool Stoke on Trent North EastLincolnshire

Halton Knowsley St Helens South Sefton



NHS Blackpool CCG

Caveats: This indicator includes both the relevant general and paediatric Treatment Function Codes but is limited by age. This is to ensure those patients aged 17 and under listed against the relevant general TFC are not excluded. Only attended appointments are

included in this indicator. CCGs with a higher percentage of new appointments may find that patients are having a poorer experience of care and are more likely to be re-referred. It may also indicate over-referral from primary care, or prioritisation of new

outpatient appointments over follow-ups. CCGs with a lower percentage may find that their capacity for seeing new patients is limited and should check their RTT data. It may also indicate under-referral from primary care. As it cannot be said what represents an

optimum performance for this indicator, a similar 10 benchmark is used and no opportunities are calculated.

Paediatric neurosurgery - Aged 0-17 - Percentage of outpatient appointments that are new - 2017/18


0.00

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0


32.9

21.6 22.3 22.828.3 30.2 31.0 33.7 34.0

38.243.6

0.00

10.0

20.0

30.0

40.0

50.0

60.0


Halton St Helens Stoke on Trent Knowsley Blackpool South Sefton South Tyneside South Tees Sunderland



NHS Blackpool CCG

Caveats: Only attended appointments are included in this indicator. This indicator includes both new (first) and follow-up appointments. This indicator includes all attended appointments where nerve conduction studies (OPCS code A843) were the dominant

procedure of the OP attendance within a neurology, paediatric neurology or clinical neurophysiology outpatient clinic. Potential opportunities are provided by comparing each CCG’s rate to the average activity rates of its lowest 5 similar CCGs; as for primary care

prescribing and elective inpatient admissions, local interpretation is required to determine whether high or low rates of Outpatient appointments for the TFC are appropriate.

Nerve conduction studies - Rate of outpatient appointments per 100,000 age-sex weighted population (Neurology

or Clinical Neurophysiology clinics) - 2017/18


0.00

100

200

300

400

500


0.00 0.00 4.28 13.6 20.5 37.7

93.2133 150

316353

0.00

50.0

100

150

200

250

300

350

400

Blackpool Thanet South Sefton North EastLincolnshire

South Tyneside Sunderland Halton Stoke on Trent Knowsley St Helens South Tees



NHS Blackpool CCG

Caveats: Only attended appointments are included in this indicator. This indicator includes both new (first) and follow-up appointments. This indicator includes all attended appointments where electroencephalographies (OPCS code A841) were the dominant

procedure of the OP attendance within a neurology, paediatric neurology or clinical neurophysiology outpatient clinic. Potential opportunities are provided by comparing each CCG’s rate to the average activity rates of its lowest 5 similar CCGs; as for primary care

prescribing and elective inpatient admissions, local interpretation is required to determine whether high or low rates of Outpatient appointments for the TFC are appropriate.

Electroencephalographies (EEGs) - Rate of outpatient appointments per 100,000 age-sex weighted population

(Neurology or Clinical Neurophysiology clinics) - 2017/18


0.00

100

200

300

400

500


3.500.0025.3

54.3 63.896.6

159 170 170211

289

0.00

50.0

100

150

200

250

300

350

South Sefton Blackpool North EastLincolnshire

Knowsley Halton St Helens Thanet South Tyneside South Tees Stoke on Trent Sunderland



NHS Blackpool CCG

Caveats: Only attended appointments are included in this indicator. This indicator includes both new (first) and follow-up appointments. This indicator includes all attended appointments where electromyographies (OPCS code A842) were the dominant procedure

of the OP attendance within a neurology, paediatric neurology or clinical neurophysiology outpatient clinic. Potential opportunities are provided by comparing each CCG’s rate to the average activity rates of its lowest 5 similar CCGs; as for primary care prescribing


Electromyographies (EMGs) - Rate of outpatient appointments per 100,000 age-sex weighted population

(Neurology or Clinical Neurophysiology clinics) - 2017/18


0.00

100

200

300

400

500

600


4.340.00 7.03 23.8 48.891.6

139 148 168

310

567

0.00

100

200

300

400

500

600

700

South Sefton Blackpool South Tees North EastLincolnshire

Halton Knowsley St Helens Stoke on Trent South Tyneside Sunderland Thanet

Section 5 - Procedures



NHS Blackpool CCG

Caveats: This indicator has been expanded to include OPCS code A659. This is to align with the definition NHS England uses for its Evidence-Based Interventions Programme. Rate of spend where this was the dominant procedure for the admission and the primary

diagnosis for the admission was within the Neurological Conditions sub Programme Budget Category (07X). This OPCS code is one of the highest spend dominant procedures where the primary diagnosis was within sub PBC 07X.

Carpal tunnel release (A651, A659) - Total spend per 1,000 age-sex weighted population - 2017/18


0.00

200

400

600

800

1,000

1,200

1,400

1,600

1,800


460 525617 631

776885

977 986 1,0281,127

1,318

0.00

200

400

600

800

1,000

1,200

1,400

1,600

Blackpool Thanet South Tyneside South Sefton Stoke on Trent Knowsley Halton Sunderland North EastLincolnshire

St Helens South Tees



NHS Blackpool CCG

Caveats: Rate of spend where this was the dominant procedure for the admission and the primary diagnosis for the admission was within the Neurological Conditions sub Programme Budget Category (07X). This OPCS code is one of the highest spend dominant

procedures where the primary diagnosis was within sub PBC 07X.

U191: Implantation of electrocardiography loop recorder - Total spend per 1,000 age-sex weighted population -

2017/18


0.00

500

1,000

1,500

2,000

2,500


660

308 376

638 660 732 786 801929

1,245 1,267

0.00

200

400

600

800

1,000

1,200

1,400

1,600

1,800


St Helens South Sefton Blackpool Sunderland Knowsley Halton South Tees South Tyneside Thanet Stoke on Trent



NHS Blackpool CCG



U221: Electroencephalograph telemetry - Total spend per 1,000 age-sex weighted population - 2017/18


0.00

200

400

600

800

1,000


210

0.00

102161 176 207 227 229 258

346

464

0.00

100

200

300

400

500

600

700

800

Halton South Tyneside North EastLincolnshire

Stoke on Trent Knowsley Blackpool Sunderland St Helens South Tees South Sefton Thanet



NHS Blackpool CCG



A841: Electroencephalography Not elsewhere classified - Total spend per 1,000 age-sex weighted population -

2017/18£29k


0.00

200

400

600

800

1,000

1,200


249

0.00 0.00 0.00 0.0049.3 53.4

79.1 101148

333

0.00

50.0

100

150

200

250

300

350

400

450

500

South Sefton Knowsley St Helens Halton South Tees Thanet South Tyneside Sunderland North EastLincolnshire

Blackpool Stoke on Trent



NHS Blackpool CCG



A671: Cubital tunnel release - Total spend per 1,000 age-sex weighted population - 2017/18


0.00

50.0

100

150

200

250

300

350

400

450


47.046.967.4 73.3

100 108 114131

146 156 167

0.00

50.0

100

150

200

250

300

Knowsley Blackpool North EastLincolnshire

South Sefton Stoke on Trent South Tyneside Halton St Helens Sunderland Thanet South Tees

Part II - Chronic Pain

Section 1 - Prevalence



NHS Blackpool CCG

Reported prevalence of patients with Depression aged 18+ (%) - 2017/18


0.00

2.00

4.00

6.00

8.00

10.0

12.0

14.0

16.0


15.4

9.1310.5 10.9 11.7 11.8 12.7 13.0 13.4 14.0 14.3

0.00

2.00

4.00

6.00

8.00

10.0

12.0

14.0

16.0

18.0


South Tees Sunderland South Sefton South Tyneside Thanet Halton St Helens Stoke on Trent Knowsley Blackpool

Section 2a - Primary Care

• Primary Care Prescribing Spend



NHS Blackpool CCG

Primary Care Prescribing : Spend on Chronic Pain (07A) prescribing per 1,000 ASTRO-PU weighted population -

2017/18£55k


0.00

500

1,000

1,500

2,000


1,645

837

1,403 1,443 1,523 1,549 1,616 1,661 1,677 1,7341,915

0.00

500

1,000

1,500

2,000

2,500


South Tyneside Thanet South Tees Halton Knowsley Blackpool Sunderland St Helens South Sefton Stoke on Trent



NHS Blackpool CCG

Primary Care Prescribing : Spend on Antimigraine drugs per 1,000 ASTRO-PU weighted population - 2017/18 £39k


0.00

500

1,000

1,500

2,000


1,6771,405 1,405 1,418 1,536 1,579 1,593 1,653

1,852 1,895 1,933

0.00

500

1,000

1,500

2,000

2,500

Knowsley South Sefton North EastLincolnshire

St Helens Sunderland South Tyneside South Tees Blackpool Halton Stoke on Trent Thanet



NHS Blackpool CCG

Caveats: This is a pain/chronic pain prescribing indicator.

Primary Care Prescribing : Spend on Amitriptyline Hydrochloride per 1,000 ASTRO-PU weighted population -

2017/18£33k


0.00

100

200

300

400

500

600

700

800


671

442 455501 519 554 558 582 593 604 607

0.00

100

200

300

400

500

600

700

800

South Sefton North EastLincolnshire

St Helens Thanet Halton Stoke on Trent South Tyneside Knowsley Sunderland South Tees Blackpool



NHS Blackpool CCG


Primary Care Prescribing : Spend on Duloxetine Hydrochloride per 1,000 ASTRO-PU weighted population - 2017/18


0.00

100

200

300

400

500

600

700


295206

352 381 397 419469 478 507 542

723

0.00

100

200

300

400

500

600

700

800


Blackpool Sunderland Halton South Tyneside South Sefton Thanet South Tees Knowsley Stoke on Trent St Helens



NHS Blackpool CCG

Caveats: This indicator includes both presentations of the drug (0408010G0 - Gabapentin and 0407030AD Gabapentin (Neuropathic Pain). The majority of this prescribing is likely to be for neuropathic pain. The separate BNF indicator level on anti-epileptics only

includes 0408010G0 - Gabapentin, which is prescribed for seizures (BNF section 4.8.1).

Primary Care Prescribing : Spend on Gabapentin per 1,000 ASTRO-PU weighted population - 2017/18 £88k


0.00

200

400

600

800

1,000

1,200

1,400

1,600

1,800


1,588

838987

1,247 1,256 1,283 1,338 1,356 1,358

1,660 1,730

0.00

200

400

600

800

1,000

1,200

1,400

1,600

1,800

2,000


Thanet Stoke on Trent St Helens South Tyneside South Tees South Sefton Sunderland Blackpool Knowsley Halton



NHS Blackpool CCG

Caveats: Pregabalin is classified in the BNF as an anti-epileptic (BNF 4.8.1) but is presented separately here. It is not included in the BNF level Anti-epileptic drugs indicator as it is very rarely prescribed for this purpose and would heavily skew the indicator. The

majority of prescribing of the drug is for neuropathic pain.

Primary Care Prescribing : Spend on Pregabalin per 1,000 ASTRO-PU weighted population - 2017/18


0.00

1,000

2,000

3,000

4,000

5,000


1,792 2,064

2,880 2,9243,448 3,478

3,923 4,1724,574

5,0225,331

0.00

1,000

2,000

3,000

4,000

5,000

6,000


Thanet Stoke on Trent South Tyneside Sunderland South Sefton St Helens South Tees Halton Knowsley



NHS Blackpool CCG


Primary Care Prescribing : Spend on Buprenorphine per 1,000 ASTRO-PU weighted population - 2017/18 £72k


0.00

200

400

600

800

1,000

1,200


627

128 155240

285

421496 519

587691

809

0.00

100

200

300

400

500

600

700

800

900


Sunderland South Tees Halton Thanet Knowsley St Helens Blackpool South Sefton Stoke on Trent



NHS Blackpool CCG


Primary Care Prescribing : Spend on Fentanyl per 1,000 ASTRO-PU weighted population - 2017/18 £100k


0.00

500

1,000

1,500

2,000


1,201

635 648 668 674 711 726 783868 883

1,396

0.00

200

400

600

800

1,000

1,200

1,400

1,600

Knowsley South Sefton Halton Stoke on Trent St Helens Thanet South Tyneside Sunderland North EastLincolnshire

Blackpool South Tees



NHS Blackpool CCG


Primary Care Prescribing : Spend on Morphine per 1,000 ASTRO-PU weighted population - 2017/18 £144k


0.00

200

400

600

800

1,000

1,200

1,400

1,600

1,800


1,464

538 571748 771

8651,027 1,046 1,134 1,175

1,673

0.00

200

400

600

800

1,000

1,200

1,400

1,600

1,800


St Helens South Sefton Knowsley Halton Thanet Sunderland South Tyneside Blackpool South Tees



NHS Blackpool CCG


Primary Care Prescribing : Spend on Dihydrocodeine Tartrate per 1,000 ASTRO-PU weighted population - 2017/18 £16k


0.00

100

200

300

400

500


256

51.1

140

204229 239 250

286 291310 312

0.00

50.0

100

150

200

250

300

350


South Tees South Tyneside St Helens Stoke on Trent Blackpool Sunderland Halton South Sefton Knowsley

Section 2b - Primary Care

• Primary Care Prescribing Items



NHS Blackpool CCG

Primary Care Prescribing : Items for Chronic Pain (07A) prescribing per 1,000 ASTRO-PU weighted population -

2017/187k Items


0.00

50.0

100

150

200

250

300

350

400


260

202 205 219 231 246 247 257311

355

417

0.00

50.0

100

150

200

250

300

350

400

450


Thanet South Sefton Stoke on Trent Knowsley St Helens Halton Blackpool South Tees South Tyneside Sunderland



NHS Blackpool CCG

Primary Care Prescribing : Items for Antimigraine drugs per 1,000 ASTRO-PU weighted population - 2017/18 4k Items


0.00

20.0

40.0

60.0

80.0

100


88.6

57.4

70.6 71.3 74.5 76.2 77.0 78.8 78.985.7 86.9

0.00

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0

100

South Sefton Thanet South Tyneside Halton North EastLincolnshire

St Helens Stoke on Trent Knowsley Sunderland South Tees Blackpool



NHS Blackpool CCG


Primary Care Prescribing : Items for Amitriptyline Hydrochloride per 1,000 ASTRO-PU weighted population -

2017/1819k Items


0.00

50.0

100

150

200

250

300

350

400

450


349

200244 259 261 270

294 299 300331

371

0.00

50.0

100

150

200

250

300

350

400

South Sefton St Helens Thanet Halton North EastLincolnshire

Stoke on Trent South Tyneside Knowsley South Tees Blackpool Sunderland



NHS Blackpool CCG


Primary Care Prescribing : Items for Duloxetine Hydrochloride per 1,000 ASTRO-PU weighted population - 2017/18


0.00

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0


41.131.7

47.6 51.8 52.7

65.3 66.8 68.4 69.6 70.6

93.8

0.00

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0

100


Blackpool Halton South Sefton Thanet South Tees South Tyneside Stoke on Trent Sunderland Knowsley St Helens



NHS Blackpool CCG

Caveats: This indicator includes both presentations of the drug (0408010G0 - Gabapentin and 0407030AD Gabapentin (Neuropathic Pain). The majority of this prescribing is likely to be for neuropathic pain. The separate BNF indicator level on anti-epileptics only

includes 0408010G0 - Gabapentin, which is prescribed for seizures (BNF section 4.8.1).

Primary Care Prescribing : Items for Gabapentin per 1,000 ASTRO-PU weighted population - 2017/18 19k Items


0.00

50.0

100

150

200

250

300


274

147 160178 192 195 205 218 223 232

266

0.00

50.0

100

150

200

250

300


Thanet South Sefton St Helens Stoke on Trent Halton South Tyneside South Tees Knowsley Sunderland Blackpool



NHS Blackpool CCG

Caveats: Pregabalin is classified in the BNF as an anti-epileptic (BNF 4.8.1) but is presented separately here. It is not included in the BNF level Anti-epileptic drugs indicator as it is very rarely prescribed for this purpose and would heavily skew the indicator. The

majority of prescribing of the drug is for neuropathic pain.

Primary Care Prescribing : Items for Pregabalin per 1,000 ASTRO-PU weighted population - 2017/18


0.00

50.0

100

150

200


95.493.0114

155 165 166195 196

208 212 219

0.00

50.0

100

150

200

250


Blackpool Stoke on Trent Thanet South Sefton South Tyneside Halton St Helens Sunderland South Tees Knowsley



NHS Blackpool CCG


Primary Care Prescribing : Items for Buprenorphine per 1,000 ASTRO-PU weighted population - 2017/18 4k Items


0.00

5.00

10.0

15.0

20.0

25.0

30.0

35.0

40.0

45.0


29.4

4.80 6.028.32

11.7

22.225.9 28.0 28.9

32.637.8

0.00

5.00

10.0

15.0

20.0

25.0

30.0

35.0

40.0

45.0


Sunderland South Tees Halton Thanet Knowsley South Sefton Blackpool St Helens Stoke on Trent



NHS Blackpool CCG


Primary Care Prescribing : Items for Fentanyl per 1,000 ASTRO-PU weighted population - 2017/18 3k Items


0.00

10.0

20.0

30.0

40.0

50.0


33.3

13.3 14.216.2 16.2 16.9 17.6

20.0 20.325.0

31.3

0.00

5.00

10.0

15.0

20.0

25.0

30.0

35.0

40.0

Halton South Sefton South Tyneside Knowsley Stoke on Trent Sunderland St Helens Thanet South Tees North EastLincolnshire

Blackpool



NHS Blackpool CCG


Primary Care Prescribing : Items for Morphine per 1,000 ASTRO-PU weighted population - 2017/18 16k Items

England 84.3 Best or Lowest 5 108

0.00

50.0

100

150

200


191

79.3 82.9105

132 142 151 151178

196

230

0.00

50.0

100

150

200

250


South Sefton St Helens Knowsley Halton Thanet South Tyneside Blackpool Sunderland South Tees



NHS Blackpool CCG


Primary Care Prescribing : Items for Dihydrocodeine Tartrate per 1,000 ASTRO-PU weighted population - 2017/18 4k Items


0.00

20.0

40.0

60.0

80.0

100

120


59.4

10.9

35.7

48.6 48.754.3 55.6

63.7 66.1 67.8 70.5

0.00

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0


South Tees Stoke on Trent St Helens South Tyneside Blackpool South Sefton Halton Knowsley Sunderland

Section 3a - Secondary Care• Inpatient spend

• Percentage of all admissions which are day case

• Average annual rate of admissions

• Percentage of admissions where the main consultant is a

Neurologist/Neurosurgeon

• Admissions which are short stays



NHS Blackpool CCG

Caveats: This is a pain indicator - Chronic Pain (07A) sub PBC.

Admissions for Pain (07A) - Total spend per 1,000 age-sex weighted population - 2017/18 £341k


0.00

2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000

18,000


12,942

7,705

10,72811,812 12,437 12,629 13,549 13,863 14,327 14,700

17,485

0.00

2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000

18,000

20,000

Sunderland South Tyneside Stoke on Trent North EastLincolnshire

South Tees Blackpool Thanet St Helens Halton South Sefton Knowsley



NHS Blackpool CCG


Admissions for Pain (07A) - Elective spend per 1,000 age-sex weighted population - 2017/18 £187k


0.00

1,000

2,000

3,000

4,000

5,000

6,000

7,000

8,000


4,621

3,424 3,481 3,680 3,717 3,7264,226

4,656 4,741

6,987 7,168

0.00

1,000

2,000

3,000

4,000

5,000

6,000

7,000

8,000

Sunderland Halton South Sefton South Tyneside St Helens Knowsley Blackpool Stoke on Trent South Tees Thanet North EastLincolnshire



NHS Blackpool CCG


Admissions for Pain (07A) - Non-elective spend per 1,000 age-sex weighted population - 2017/18 £411k


0.00

2,000

4,000

6,000

8,000

10,000

12,000

14,000


8,318

4,2605,218

6,544 7,010 7,155 7,882

10,175 10,913 11,058

13,300

0.00

2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000


Thanet South Tyneside Stoke on Trent South Tees Blackpool St Helens Halton South Sefton Knowsley



NHS Blackpool CCG

Caveats: Benchmarked to the highest 5. This is a pain indicator - Chronic Pain (07A) sub PBC.

Admissions for Pain (07A) - % of all admissions which are day case admissions - 2017/18


0.00

10.0

20.0

30.0

40.0

50.0

60.0


38.0

23.9 23.9 25.3 27.7 29.033.3 35.1

41.946.4

57.8

0.00

10.0

20.0

30.0

40.0

50.0

60.0

70.0

Halton Knowsley South Sefton St Helens South Tees South Tyneside Stoke on Trent Blackpool Thanet Sunderland North EastLincolnshire



NHS Blackpool CCG

Caveats: The majority of tariff admissions for headaches and migraines are non-elective. The ICD10 codes for headaches come under the Chronic Pain sub programme budget category (07A). The ICD10 codes for migraines come under the Neurological Conditions

sub programme budget category (07X). Neurological condition group classifications in this pack are based on the Public Health England Neurology Intelligence Network classification of Neurological Conditions: https://www.gov.uk/guidance/neurology-data-and-

analysis-a-guide-for-health-professionals

Migraines and Headaches - Elective spend per 1,000 age-sex weighted population - 2017/18 £51k


0.00

100

200

300

400

500

600


427

78.4109 116

171 192 192 208 232 245305

0.00

100

200

300

400

500

600


St Helens South Tyneside South Tees South Sefton Sunderland Stoke on Trent Knowsley Halton Thanet Blackpool



NHS Blackpool CCG

Caveats: The majority of tariff admissions for headaches and migraines are non-elective. The ICD10 codes for headaches come under the Chronic Pain sub programme budget category (07A). The ICD10 codes for migraines come under the Neurological Conditions

sub programme budget category (07X).

Migraines and Headaches - Non-elective spend per 1,000 age-sex weighted population - 2017/18 £128k


0.00

500

1,000

1,500

2,000


1,478

554 627 747 7491,041 1,046

1,3631,645

1,849 1,938

0.00

500

1,000

1,500

2,000

2,500


Sunderland Stoke on Trent Thanet South Tees South Tyneside St Helens Blackpool Halton Knowsley South Sefton



NHS Blackpool CCG

Caveats: The majority of tariff admissions for headaches and migraines are non-elective.Neurological condition group classifications in this pack are based on the Public Health England Neurology Intelligence Network classification of Neurological Conditions:


Migraines and Headaches - Average annual rate of admissions per 100,000 age-sex weighted population - 2015/16-

2017/18133 Adms


0.00

50.0

100

150

200

250

300


224

110 121155 171 176 191

210

269 275 281

0.00

50.0

100

150

200

250

300

350


Sunderland Stoke on Trent South Tyneside Thanet South Tees St Helens Blackpool South Sefton Knowsley Halton



NHS Blackpool CCG


neurological conditions the spells will predominantly be with one speciality. The majority of tariff admissions for headaches and migraines are non-elective. Neurological condition group classifications in this pack are based on the Public Health England Neurology

Intelligence Network classification of Neurological Conditions: https://www.gov.uk/guidance/neurology-data-and-analysis-a-guide-for-health-professionals

Migraines and Headaches - Percentage of elective admissions where the main consultant for the spell is a



0.00

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0


91.1

0.00

16.4 16.9

59.3 60.9 62.5

79.1 79.6 82.4 83.6

0.00

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0

100


South Tees Thanet Sunderland South Tyneside Stoke on Trent St Helens Knowsley Halton South Sefton Blackpool



NHS Blackpool CCG


neurological conditions the spells will predominantly be with one speciality. The majority of tariff admissions for headaches and migraines are non-elective. Neurological condition group classifications in this pack are based on the Public Health England Neurology

Intelligence Network classification of Neurological Conditions: https://www.gov.uk/guidance/neurology-data-and-analysis-a-guide-for-health-professionals

Migraines and Headaches - Percentage of non-elective admissions where the main consultant for the spell is a



0.00

10.0

20.0

30.0

40.0

50.0


3.530.00 0.00 0.00 0.00 1.59 1.85 2.48 3.13

8.29

45.4

0.00

10.0

20.0

30.0

40.0

50.0

60.0

Knowsley North EastLincolnshire

Thanet Halton St Helens South Sefton South Tees South Tyneside Blackpool Sunderland Stoke on Trent



NHS Blackpool CCG

Caveats: The majority of tariff admissions for headaches and migraines are non-elective. Neurological condition group classifications in this pack are based on the Public Health England Neurology Intelligence Network classification of Neurological Conditions:


Migraines and Headaches - Non-elective admissions that are short stays (0 or 1 day) per 100,000 age-sex weighted

population - 2017/1851 Adms


0.00

50.0

100

150

200

250


107

41.960.5

81.8 94.9 109138

162184

208229

0.00

50.0

100

150

200

250

300


Stoke on Trent South Tyneside Blackpool Thanet South Tees St Helens Halton Knowsley South Sefton



NHS Blackpool CCG

Caveats: This is a pain indicator - Chronic Pain (07A) sub PBC. This diagnosis code is one of the highest spend individual ICD10 codes in the Chronic Pain sub programme budget category. Further work is needed to group ICD10 codes related to pain into clinically

meaningful categories - this indicator is provided for context to give CCGs an indication of which individual pain diagnoses codes are driving admissions spend within the Chronic Pain sub PBC.

R074: Chest pain, unspecified - Total spend per 1,000 age-sex weighted population - 2017/18


0.00

500

1,000

1,500

2,000


989842 902 917

1,123 1,213 1,261 1,2611,442

1,6171,821

0.00

500

1,000

1,500

2,000

2,500


South Tees Blackpool Sunderland South Tyneside St Helens Halton Thanet South Sefton Knowsley



NHS Blackpool CCG



R104: Other and unspecified abdominal pain - Total spend per 1,000 age-sex weighted population - 2017/18 £70k


0.00

500

1,000

1,500

2,000


1,236

519688

846945

1,148 1,235

1,489 1,5211,691 1,721

0.00

200

400

600

800

1,000

1,200

1,400

1,600

1,800

2,000

Sunderland South Tyneside South Tees Thanet Halton St Helens Blackpool Knowsley North EastLincolnshire

Stoke on Trent South Sefton



NHS Blackpool CCG



R101: Pain localized to upper abdomen - Total spend per 1,000 age-sex weighted population - 2017/18 £30k


0.00

200

400

600

800

1,000

1,200

1,400

1,600

1,800


944

561 574695

980 1,0591,165

1,462 1,501 1,5431,651

0.00

200

400

600

800

1,000

1,200

1,400

1,600

1,800

2,000

Thanet Sunderland South Tyneside Blackpool South Tees South Sefton St Helens Stoke on Trent Halton Knowsley North EastLincolnshire



NHS Blackpool CCG



R103: Pain localized to other parts of lower abdomen - Total spend per 1,000 age-sex weighted population -

2017/18


0.00

500

1,000

1,500

2,000

2,500


996683 812

998 1,130 1,182 1,284 1,4131,581

1,7972,158

0.00

500

1,000

1,500

2,000

2,500

3,000


Blackpool Thanet South Tees South Tyneside South Sefton Stoke on Trent St Helens Knowsley Halton



NHS Blackpool CCG



R073: Other chest pain - Total spend per 1,000 age-sex weighted population - 2017/18 £18k


0.00

200

400

600

800

1,000

1,200

1,400


601

331 362481

641 696 749 808 822936

1,299

0.00

200

400

600

800

1,000

1,200

1,400

1,600

Sunderland South Tyneside Stoke on Trent Blackpool St Helens North EastLincolnshire

Halton Thanet South Sefton Knowsley South Tees



NHS Blackpool CCG



R51X: Headache - Total spend per 1,000 age-sex weighted population - 2017/18 £87k


0.00

200

400

600

800

1,000

1,200

1,400

1,600

1,800


1,090

250

610 666 673782 826

1,0171,201

1,496 1,582

0.00

200

400

600

800

1,000

1,200

1,400

1,600

1,800

2,000


Thanet Sunderland Stoke on Trent South Tees South Tyneside St Helens Blackpool Halton Knowsley South Sefton



NHS Blackpool CCG



R072: Precordial pain - Total spend per 1,000 age-sex weighted population - 2017/18 £23k


0.00

200

400

600

800

1,000


391

114195 253

372 401

735801

931 962 967

0.00

200

400

600

800

1,000

1,200


Thanet Stoke on Trent South Sefton Blackpool Sunderland South Tyneside South Tees St Helens Halton Knowsley



NHS Blackpool CCG



M545: Low back pain - Total spend per 1,000 age-sex weighted population - 2017/18 £33k


0.00

500

1,000

1,500

2,000

2,500

3,000


1,073

703 721866

1,078 1,102 1,1151,272 1,287

1,8962,036

0.00

500

1,000

1,500

2,000

2,500

Halton Sunderland South Tyneside Blackpool St Helens Stoke on Trent South Tees South Sefton Knowsley North EastLincolnshire

Thanet



NHS Blackpool CCG



M2555: Pain in joint: Pelvic region and thigh - Total spend per 1,000 age-sex weighted population - 2017/18 £66k


0.00

200

400

600

800

1,000

1,200

1,400


650

199246 289

381429 456 459

572 607 637

0.00

100

200

300

400

500

600

700

800

900

Stoke on Trent Sunderland South Tees Thanet North EastLincolnshire

St Helens South Tyneside South Sefton Halton Knowsley Blackpool



NHS Blackpool CCG



M5456: Low back pain: Lumbar region - Total spend per 1,000 age-sex weighted population - 2017/18


0.00

200

400

600

800

1,000

1,200

1,400

1,600

1,800


266

116 156252 281 325 338

412

707 730

1,010

0.00

200

400

600

800

1,000

1,200

Halton Sunderland South Tyneside Blackpool St Helens Thanet South Sefton Knowsley South Tees Stoke on Trent North EastLincolnshire



NHS Blackpool CCG



M7966: Pain in limb: Lower leg - Total spend per 1,000 age-sex weighted population - 2017/18


0.00

200

400

600

800

1,000

1,200


80.962.9 72.8 105152 177

305

406 441486

662

0.00

100

200

300

400

500

600

700

800


South Tyneside Blackpool Sunderland Stoke on Trent Halton St Helens Knowsley South Tees South Sefton Thanet



NHS Blackpool CCG



M549: Dorsalgia, unspecified - Total spend per 1,000 age-sex weighted population - 2017/18 £159k


0.00

200

400

600

800

1,000

1,200

1,400


1,069

136 149 166312 341 392

462 523 566

932

0.00

200

400

600

800

1,000

1,200

1,400


Stoke on Trent Halton South Tees South Sefton St Helens Sunderland Knowsley South Tyneside Thanet Blackpool



NHS Blackpool CCG



G618: Other inflammatory polyneuropathies - Total spend per 1,000 age-sex weighted population - 2017/18


0.00

500

1,000

1,500

2,000


94.8

22.4

65.6 81.1

166 174194 201 207 210

255

0.00

50.0

100

150

200

250

300

350

St Helens South Sefton Thanet Blackpool Halton South Tees Knowsley South Tyneside Stoke on Trent Sunderland North EastLincolnshire



NHS Blackpool CCG



M2556: Pain in joint: Lower leg - Total spend per 1,000 age-sex weighted population - 2017/18 £31k


0.00

200

400

600

800

1,000


406

166 221 264 283 285 322 351471 486

849

0.00

200

400

600

800

1,000

1,200

Sunderland St Helens Halton South Tees Stoke on Trent South Sefton Thanet Blackpool South Tyneside Knowsley North EastLincolnshire



NHS Blackpool CCG



M2551: Pain in joint: Shoulder region - Total spend per 1,000 age-sex weighted population - 2017/18


0.00

100

200

300

400

500

600

700


173129 148 170 183 204 231

343 353 358399

0.00

100

200

300

400

500

600

Sunderland Halton South Tees Blackpool South Tyneside St Helens Stoke on Trent Knowsley Thanet South Sefton North EastLincolnshire



NHS Blackpool CCG



R102: Pelvic and perineal pain - Total spend per 1,000 age-sex weighted population - 2017/18


0.00

100

200

300

400

500

600


126114 129 137162 174 194 209 224

257

336

0.00

50.0

100

150

200

250

300

350

400

450

500

Knowsley Blackpool South Tyneside Sunderland South Sefton South Tees St Helens Halton North EastLincolnshire

Stoke on Trent Thanet

Section 3b - Secondary Care

• Total bed days

• Elective bed days

• Non-elective bed days



NHS Blackpool CCG


Admissions for Pain (07A) - Total bed days per 100,000 age-sex weighted population - 2017/183,712 Bed

Days


0.00

1,000

2,000

3,000

4,000

5,000

6,000

7,000

8,000


4,512

1,9912,299

2,675 2,887 3,0313,518 3,553 3,743

4,1524,864

0.00

1,000

2,000

3,000

4,000

5,000

6,000


South Tees Stoke on Trent Sunderland Thanet Halton St Helens Knowsley South Tyneside Blackpool South Sefton



NHS Blackpool CCG


Admissions for Pain (07A) - Elective bed days per 100,000 age-sex weighted population - 2017/18 224 Bed Days


0.00

100

200

300

400

500

600

700

800


458

273308 339 356

407 409 419 443

559 582

0.00

100

200

300

400

500

600

700

Sunderland Halton St Helens South Sefton South Tees Knowsley South Tyneside Stoke on Trent Blackpool Thanet North EastLincolnshire



NHS Blackpool CCG


Admissions for Pain (07A) - Non-elective bed days per 100,000 age-sex weighted population - 2017/181,881 Bed

Days


0.00

500

1,000

1,500

2,000

2,500


2,375

1,065 1,0841,439 1,548 1,616

2,044 2,060 2,0932,321

2,571

0.00

500

1,000

1,500

2,000

2,500

3,000

Sunderland Thanet Stoke on Trent South Tees North EastLincolnshire

St Helens South Tyneside Halton South Sefton Blackpool Knowsley



NHS Blackpool CCG



Migraines and Headaches - Elective bed days per 100,000 age-sex weighted population - 2017/18 75 Bed Days


0.00

20.0

40.0

60.0

80.0

100

120


55.0

6.81 7.90 10.815.9 16.9 18.2 18.7 19.8 22.4

27.9

0.00

10.0

20.0

30.0

40.0

50.0

60.0

70.0


South Tyneside St Helens Sunderland South Tees South Sefton Knowsley Halton Stoke on Trent Thanet Blackpool



NHS Blackpool CCG



Migraines and Headaches - Non-elective bed days per 100,000 age-sex weighted population - 2017/18 536 Bed Days


0.00

100

200

300

400

500


459

118148 156 165 167

219

296 300347 371

0.00

100

200

300

400

500

600

Thanet South Tees Sunderland Stoke on Trent North EastLincolnshire

St Helens South Tyneside Halton Knowsley South Sefton Blackpool

Section 3c - Secondary Care

• Outpatients



NHS Blackpool CCG

Caveats: Only attended appointments are included in this indicator. This indicator includes both new (first) and follow-up appointments. This indicator includes all ages.

Pain management - Rate of outpatient appointments per 100,000 age-sex weighted population - 2017/181,428

Appointments


0.00

1,000

2,000

3,000

4,000

5,000

6,000

7,000


1,814

590988 1,014

1,265 1,3191,681 1,724

1,958 2,129

2,941

0.00

500

1,000

1,500

2,000

2,500

3,000

3,500

Stoke on Trent South Tyneside Sunderland Halton South Tees St Helens South Sefton Blackpool Knowsley Thanet North EastLincolnshire



NHS Blackpool CCG




Pain management - Percentage of outpatient appointments which are new - 2017/18


0.00

10.0

20.0

30.0

40.0

50.0

60.0


29.5

19.824.0 27.1

33.9 36.241.4 42.9 44.2

48.856.5

0.00

10.0

20.0

30.0

40.0

50.0

60.0

70.0


Thanet South Tees Blackpool Sunderland St Helens Knowsley South Sefton Halton South Tyneside Stoke on Trent

Section 4 - Procedures



NHS Blackpool CCG

Caveats: Rate of inpatient tariff spend where this was the dominant procedure for the admission and the primary diagnosis for the admission was within the Chronic Pain sub Programme Budget Category (07A). This OPCS code is one of the highest spend dominant

procedures where the primary diagnosis was within sub PBC 07A.

V544: Injection around spinal facet of spine - Total spend per 1,000 age-sex weighted population - 2017/18 £95k


0.00

200

400

600

800

1,000

1,200

1,400


716

105165 178

291 339407

485 534640

954

0.00

200

400

600

800

1,000

1,200

Halton South Tees St Helens Knowsley Sunderland South Tyneside South Sefton North EastLincolnshire

Stoke on Trent Blackpool Thanet



NHS Blackpool CCG



G451: Fibreoptic endoscopic examination of upper gastrointestinal tract and biopsy of lesion of upper

gastrointestinal tract - Total spend per 1,000 age-sex weighted population - 2017/18£42k


0.00

200

400

600

800

1,000


446

169 176210 211

275309 332 347 362

419

0.00

100

200

300

400

500

600

South Sefton Thanet North EastLincolnshire

South Tyneside Sunderland St Helens Stoke on Trent South Tees Knowsley Halton Blackpool



NHS Blackpool CCG



K634: Coronary arteriography using two catheters - Total spend per 1,000 age-sex weighted population - 2017/18


0.00

200

400

600

800

1,000


112

0.0083.5 106

159227 258 261

415 423

649

0.00

100

200

300

400

500

600

700

800

900

South Tees Sunderland South Sefton Blackpool Stoke on Trent St Helens Knowsley Halton Thanet North EastLincolnshire

South Tyneside



NHS Blackpool CCG



A559: Unspecified diagnostic spinal puncture - Total spend per 1,000 age-sex weighted population - 2017/18 £72k


0.00

100

200

300

400

500

600

700


597

102 128 148217

335 336 345 358 364 381

0.00

100

200

300

400

500

600

700

800


South Tees Sunderland St Helens South Tyneside Knowsley Stoke on Trent South Sefton Halton Blackpool



NHS Blackpool CCG

Caveats: This indicator has been expanded to include OPCS code A558.

Other and Unspecified diagnostic spinal puncture (A558,A559) - Total spend per 1,000 age-sex weighted population

- 2017/18£175k


0.00

500

1,000

1,500

2,000


1,661

613 621 652 755 807 914 938 962

1,437 1,550

0.00

500

1,000

1,500

2,000

2,500

Thanet Sunderland South Tees South Tyneside Stoke on Trent North EastLincolnshire

Knowsley South Sefton Halton St Helens Blackpool



NHS Blackpool CCG



G459: Unspecified diagnostic fibreoptic endoscopic examination of upper gastrointestinal tract - Total spend per

1,000 age-sex weighted population - 2017/18£21k


0.00

100

200

300

400

500

600


221

71.6 75.4 89.4 118163 173

213 223

398

564

0.00

100

200

300

400

500

600

700

Sunderland South Tyneside St Helens South Tees Thanet South Sefton Knowsley Blackpool Halton Stoke on Trent North EastLincolnshire



NHS Blackpool CCG



A577: Injection of therapeutic substance around spinal nerve root - Total spend per 1,000 age-sex weighted

population - 2017/18


0.00

100

200

300

400

500

600

700

800

900


32.5 41.4 90.7 102 106 117 123196

382

777845

0.00

100

200

300

400

500

600

700

800

900

1,000

Blackpool Halton South Sefton Sunderland Stoke on Trent St Helens Knowsley South Tyneside South Tees Thanet North EastLincolnshire



NHS Blackpool CCG



A735: Injection of therapeutic substance around peripheral nerve - Total spend per 1,000 age-sex weighted

population - 2017/18£27k


0.00

100

200

300

400

500

600

700

800


309

126 143 172 176 190 198 227

387 400

488

0.00

100

200

300

400

500

600

South Tyneside South Tees Stoke on Trent Thanet Halton St Helens Sunderland Blackpool North EastLincolnshire

Knowsley South Sefton

Part III - Programme Budgeting

Programme Budgeting Expenditure Dataset: Charts for Neurological Problems

This pack includes the following indicators derived from the CCG Programme Budgeting Dataset:

• Aggregate expenditure on care settings recommended for benchmarking• Outpatient expenditure (for attendances and procedures in scope of national tariff) • Inpatient expenditure (for all elective and non-elective admissions in scope of national tariff)• Inpatient expenditure on elective admissions (in scope of national tariff)• Inpatient expenditure on non-elective admissions (in scope of national tariff)

The programme budgeting dataset provides an analysis of CCG’s total expenditure by 23 programmes of care, which are based on disease classifications known as Programme Budgeting Categories (PBCs). Neurological problems is PBC 07.

The dataset contains programme level expenditure data as reported by CCGs, rather than taken from central datasets. This means that it includes adjustments for local variations to national prices, contract penalties and best practice tariffs not processed through the Secondary Uses Service (SUS).

The data therefore provide a useful opportunity for triangulation against SUS indicators derived from the National Commissioning Data Repository (NCDR), which are calculated using activity combined with national prices.

Programme Budgeting Expenditure Dataset: OverviewThe CCG programme budgeting dataset provides information on CCG spend by ‘care setting’ as well as by condition. Examples of care settings include primary care prescribing, elective admissions, outpatient attendances etc. The programme budgeting dataset included 13 care settings in 2017/18.

Within the programme budgeting benchmarking tool the care settings are classified as either ‘care settings recommended for benchmarking’ or ‘other care settings’. ‘Care settings recommended for benchmarking’ are those in which expenditure can be reliably compared, as the underlying data sources and calculation methodologies are consistent across organisations. The ‘other care settings’ are not recommended for benchmarking as any variation may be due to differences in data source or calculation methodology.

The aim of the dataset is to eventually provide health condition group level expenditure which can be used for benchmarking across the whole care pathway.

Programme Budgeting Expenditure Dataset: OverviewThe ‘Aggregate expenditure on care settings recommended for benchmarking’ chart includes spend in the following care settings:

– Primary Care Prescribing

– Non-elective admissions (in National Tariff Scope)

– Elective admissions (in National Tariff Scope)

– Critical Care

– Drugs & devices

– Outpatient Attendances (in National Tariff Scope)

– Outpatient Procedures (in National Tariff Scope)

The following care settings are not currently recommended for benchmarking and have been excluded from this pack:

– A&E

– Emergency Transport

– Other Inpatient (outside of National Tariff Scope)

– Outpatient Activity (outside of National Tariff Scope)

– Other Inpatient (outside of National Tariff Scope)

– Other Health Care Services

– Running Costs

Programme Budgeting Expenditure Dataset: Spend on Problems of the Neurological System (PBC07) by Care Setting

78% of national CCG spend on problems of the neurological system is included within the care settings recommended for benchmarking. For chronic pain this figure is 93% and for other problems of the neurological system this figure is 73%.

Programme Budgeting Data: MappingsSpend in each care setting is allocated to a programme budgeting category using a specific mapping. A mapping is the assignment of a programme budgeting category to other classifications or definitions used within existing datasets.

For inpatient activity (including critical care), the mapping is based on the World Health Organisation International Classification of Diseases (ICD10), which has over 16,000 classifications. This is the same basis as programme level expenditure included in NCDR for inpatient activity.

ICD10 level classifications are currently only available for inpatient based care settings. Mappings for other care settings included within this pack are based on less granular classifications:

• Outpatient attendances are mapped using TFC (Treatment Function Code);

• Outpatient procedures are mapped using HRG (Healthcare Resource Group);

• High cost drugs and devices are mapped using a specific drug or device based mapping;

• Primary care prescribing expenditure is mapped at the BNF (British National Formulary) chemical level.

In some cases it is not possible to directly allocate an existing classification to a programme budgeting category. In these circumstances the expenditure is either included within the ‘other’ programme budgeting category, or is apportioned using a proxy. An example of an apportionment basis is outpatient attendance activity under the ‘General Medicine’ TFC, in which the activity is apportioned using percentages derived from linkages with the inpatient dataset.

Programme Budgeting Dataset: Inpatient Expenditure

The table below provides information on the differences between inpatient spend indicators derived directly from NCDR and those derived from the CCG programme budgeting dataset.

Programme Budgeting Expenditure Dataset: Information on the calculation of Indicators

Data are available for all 207 CCGS which existed in 2017/18. Figures have been aggregated for some organisations to create estimates which reflect the 2018/19 CCG structures.

The populations have been taken from or calculated using the 2017/18 overall weighted populations published in the CCG Allocations Workbook for 2016/17 to 2020/21.

Spend estimates and population adjustments have been used for the following CCGs:

• NHS Manchester;

• NHS Bristol, North Somerset and South Gloucestershire;

• NHS Leeds;

• NHS Berkshire West;

• NHS East Berkshire;

• NHS Buckinghamshire;

• NHS Birmingham and Solihull;

• NHS North Cumbria [North Cumbria (01H) values represent 61.9% of the programme budgeting figures and populations for Cumbria CCG (01H) in 2017/18];

• NHS Morecambe Bay [Morecambe Bay (01K) values represent 100% of Lancashire North CCG (01K) figures plus 38.1% of the 2017/18 Cumbria CCG (01H) figures in 2017/18].

Num. Source: 2017/18 Programme Budgeting dataset

Den. Source: Published 16/17 CCG allocations workbook, currently available at the following link:https://www.england.nhs.uk/wp-content/uploads/2016/04/j-overall-weighted-populations.xlsx

NHS Blackpool CCG

Caveats: Figures are taken from the 2017/18 CCG Programme Budgeting Expenditure Dataset. This is calculated using CCG self-reported spend and includes adjustments for local pricing and contracting arrangements. Services commissioned directly by NHS England

are not included. Data are available for all 207 CCGS which existed in 2017/18. Figures have been amended for some organisations to create estimates which reflect the 2018/19 CCG structures.

Chronic pain (PBC 07A) - Care Settings recommended for benchmarking spend per 1,000 overall weighted

population (PB dataset) - 2017/18


0.00

5,000

10,000

15,000

20,000

25,000


13,448

9,89011,730 11,917 12,538

14,333 14,731 15,14616,464

18,014 18,295

0.00

2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000

18,000

20,000

Sunderland South Tyneside Stoke on Trent South Tees Blackpool North EastLincolnshire

Halton South Sefton St Helens Thanet Knowsley



NHS Blackpool CCG



Chronic pain (PBC 07A) - Total inpatient spend per 1,000 overall weighted population (PB dataset) - 2017/18


0.00

2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000

18,000


9,398

6,621

8,991 9,13710,036

11,620 11,699 12,103 12,66213,691

14,802

0.00

2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000

Sunderland South Tyneside Stoke on Trent Blackpool South Tees Halton North EastLincolnshire

South Sefton St Helens Thanet Knowsley



NHS Blackpool CCG



Chronic pain (PBC 07A) - Elective spend per 1,000 overall weighted population (PB dataset) - 2017/18


0.00

2,000

4,000

6,000

8,000

10,000


3,170

1,952 2,336 2,586 2,762 2,896 2,930 3,211 3,288

6,6437,072

0.00

1,000

2,000

3,000

4,000

5,000

6,000

7,000

8,000

South Sefton Halton Knowsley St Helens South Tyneside Sunderland Blackpool South Tees Stoke on Trent Thanet North EastLincolnshire



NHS Blackpool CCG



Chronic pain (PBC 07A) - Non-elective spend per 1,000 overall weighted population (PB dataset) - 2017/18


0.00

2,000

4,000

6,000

8,000

10,000

12,000


6,229

3,6914,627

5,849 6,0966,825 7,048

9,284 9,900 10,151

12,216

0.00

2,000

4,000

6,000

8,000

10,000

12,000

14,000


Stoke on Trent South Tyneside Blackpool South Tees Thanet Halton St Helens South Sefton Knowsley



NHS Blackpool CCG



Chronic pain (PBC 07A) - Outpatient attendances and procedures spend per 1,000 overall weighted population (PB

dataset) - 2017/18


0.00

1,000

2,000

3,000

4,000

5,000


2,330

1,063 1,1751,482 1,543 1,563 1,717 1,734

1,9662,215

2,971

0.00

500

1,000

1,500

2,000

2,500

3,000

3,500

Stoke on Trent South Tees South Tyneside South Sefton Sunderland North EastLincolnshire

Halton St Helens Knowsley Blackpool Thanet



NHS Blackpool CCG



Neurological (Other) (PBC 07X) - Care Settings recommended for benchmarking spend per 1,000 overall weighted



0.00

5,000

10,000

15,000

20,000

25,000

30,000

35,000

40,000


24,327

20,01122,564 23,648

25,558 26,070 26,177 26,298 26,38827,948 28,346

0.00

5,000

10,000

15,000

20,000

25,000

30,000


Stoke on Trent South Tees Blackpool South Tyneside South Sefton Sunderland Halton Knowsley St Helens Thanet



NHS Blackpool CCG



Neurological (Other) (PBC 07X) - Total inpatient spend per 1,000 overall weighted population (PB dataset) -

2017/18


0.00

5,000

10,000

15,000

20,000

25,000


11,722

7,875 7,956 8,739

11,046 11,711 11,728 12,372 12,60013,828

14,680

0.00

2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000


Stoke on Trent South Tees Sunderland South Tyneside Blackpool Halton Knowsley South Sefton St Helens Thanet



NHS Blackpool CCG



Neurological (Other) (PBC 07X) - Elective spend per 1,000 overall weighted population (PB dataset) - 2017/18


0.00

1,000

2,000

3,000

4,000

5,000


2,336

1,6301,974 2,050 2,132

2,660 2,784 2,824 2,902

3,545

4,140

0.00

500

1,000

1,500

2,000

2,500

3,000

3,500

4,000

4,500

South Sefton St Helens North EastLincolnshire

Knowsley Blackpool Halton South Tees South Tyneside Stoke on Trent Sunderland Thanet



NHS Blackpool CCG



Neurological (Other) (PBC 07X) - Non-elective spend per 1,000 overall weighted population (PB dataset) - 2017/18


0.00

5,000

10,000

15,000

20,000


9,385

5,0545,825 5,956

7,5008,887 9,068

10,240 10,540 10,97011,854

0.00

2,000

4,000

6,000

8,000

10,000

12,000

14,000


South Tees Sunderland South Tyneside Halton Blackpool Knowsley Thanet South Sefton St Helens



NHS Blackpool CCG



Neurological (Other) (PBC 07X) - Outpatient attendances and procedures spend per 1,000 overall weighted



0.00

500

1,000

1,500

2,000

2,500

3,000


511 535643 653 654 751 829

1,166 1,246

1,767 1,859

0.00

200

400

600

800

1,000

1,200

1,400

1,600

1,800

2,000

Blackpool South Sefton Halton North EastLincolnshire

Stoke on Trent South Tees Knowsley St Helens South Tyneside Thanet Sunderland

Additional Information

Commissioners can take the following actions now:

• Identify the key opportunities for improvement within the pathways included in

the neurology focus pack for your population and compare with current reform

activity and improvement plans

• Engage with clinicians and other local stakeholders, including public health

teams in local authorities and commissioning support organisations and

explore the opportunities along the pathways further using local data

• Revisit the Intelligence section of the NHS RightCare website regularly as

new content is added

• Always consider risk factor reduction (e.g. older people living in income

deprived households) as an opportunity to improve population health and

reduce disease prevalence

• Discuss the opportunities highlighted in this pack as part of the STP planning

process and consider STP wide action where appropriate

• Speak to your NHS RightCare Delivery Partner about other practical steps for

Next steps and actions

nhs rightcare intelligence focus pack

Documents