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Magic numbers

22 November 2016

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A recent report published by the King’s Fund identifies that the workload for GP practices has increased

substantially in recent years and has not been matched by growth in either funding or workforce. A significant increase in demand for consultations is compounded by the growing complexity of health conditions as people are living longer, and by the challenges of recruiting new GPs,

practice managers and other practice staff.

Like all areas of the NHS, GP practices need to achieve better outcomes, in less time and at a lower cost. That’s where patient data can prove extremely useful –if it’s delivered in the right way.

Outside the analyst community, there aren’t too many people queuing up to look at pages and pages of data – particularly if it’s delivered on an Excel spreadsheet. And why would you? If it’s

“Robust data can fuel good decisions, saving both time and money and ultimately improving patient care”

a choice between reading a weighty report or tackling an urgent clinical priority, we all know what would come first. But the reality is, practices need a better understanding of their patients and a better understanding of the interventions that work. Robust data can fuel good decisions, saving both time and money and ultimately improving patient care.

So how do you go about getting the right information – and what do you do with it when it’s available?

Collaborative solutions

The Arden & GEM Business Intelligence team was recently asked to develop a prescribing data report for practices in Lincolnshire. Lincolnshire West clinical commissioning group (CCG) wanted to understand what practices were prescribing and whether they were within budget. A couple of years ago, that would have resulted in the development of a useful but one- dimensional report that would identify which practices were over budget, but not why, and there would be precious little insight to help tackle the problem.

But we interrogate each new piece of work to see where we can add value. In the case of the prescribing data report, having worked with practice managers and GPs, we knew that analysing and presenting prescribing data could give practices and CCGs meaningful information that could directly support better patient care.

In agreement with Lincolnshire West CCG, we approached Lincolnshire East CCG to broaden the reach of the tool to include real insight into the reasons behind variances between practices. Our team then obtained the budgets, phasing plan and other local intelligence. The data extracted was quality assured by Arden & GEM’s prescribing experts.

Using this data, we developed a suite of reports. These allow CCGs to look at spend and variances overall, by medication and by practice. GP practices can interrogate why particular prescribing decisions have been made.

The suite of reports available include:

  • Spend v actual
l Cost and items per 1,000 list size
  • Range of drugs prescribed

  • Benchmarked maps
  • High-cost drugs (per unit)
  • Growth between years

Making it meaningful for practices

However useful this data is, we know it will only be used if it’s easy to access and interrogate. With both practice managers and GPs under significant pressure, we wanted this report to be intuitive and responsive to different practice needs. That’s why we designed the tool as a flexible suite of reports

with simple user interaction using the Tableau platform.

This enables practice managers and GPs to change the data they see and the way it is presented, simply by including different parameters. For example, visually striking ‘heat maps’ can be used to identify spend against budget across a locality, while specific demographic or clinical data can be included to zone in on a particular patient cohort.

The report was launched in September 2016, and practices have already begun to identify opportunities to take action on budget issues. For example, by including the facility to benchmark not only across a local area but also against comparable practices (in term of list size and patient demographics), practices can easily identify opportunities to share best practice to tackle overspend.

Wider benefits

The prescribing dashboard is just one example of the type of reports being made available to practices.

Arden & GEM has recently launched a new emergency care dashboard. This enables practices to analyse their patients’ use of the 111 service. The data includes what happened as a result of the call such as A&E attendance, ambulance response or referral to a doctor. By being able to show usage by time and day of the week, practices can identify possible causes for reliance on 111 and tackle any inappropriate use that could be resulting in unnecessary A&E attendance.

We have also begun working with practices on a new outpatient report that will show what proportion of patients referred to a hospital specialist are discharged after the first appointment. This again is designed to support practices to reduce unnecessary hospital attendance and identify priority areas for internal training. The report also enables practices to identify the patients to aid direct patient care.

Why does data matter?

Our experience of working with GP practices suggests that tools that support efforts to improve patient care and find more efficient ways of working are in high demand. But the relevance and ease of use are crucial. If you can access a level of detail that shows you where other practices are performing better in comparable circumstances, you have a fast track to best practice.

Two-way relationship

Analysts don’t want to hide away behind computer screens – our team is encouraged to get out and meet practice managers and GPs, often at locality meetings. We have found that working directly with users means we can help them gain a real understanding of how to make the reports work for their individual circumstances.

The response has been very positive – recently, one of our analysts was asked to stay at a locality meeting for an extra hour because there was so much interest in what the data was able to show!

But visiting practices is about more than training. Is there something you’d like to do but would like to see information on? By sharing some of your top issues or ambitions with an experienced analyst, you might find they have a solution to help you achieve your goals more quickly. l

Helen Seth, associate director of business intelligence at Arden & GEM Commissioning Support Unit


Beccy Baird; Anna Charles; Matthew Honeyman; David Maguire; Preety Das: Understanding Pressures in General Practice, The Kings Fund. May 2016.