ISD reconfiguration why

1
ISD reconfiguration - why?

• challenge outwith ISD
• initiative rich NHSiS!
• clinical governance, public health, managed
  clinical networks, joined up government,
  redesigned health care....
• increased/changing demands (quicker, more access)
• new customers (Public Health Institute, Local
  Authorities)
• new technology
• Scottish parliament
• changes in the population and their expectations
• key role of information now recognised in all
  policy papers

2
ISD reconfiguration
Head of Primary Care Information
Head of Data Intelligence
Head of Acute Care Information
Head of Cancer

• Heads of Programmes

Clinical Governance Support Drugs/Subs
misuse Performance Assessment Framework etc
line management
line management
line management
line management
team
3
ISD reconfiguration

• Heads of Groups
• manage and allocate ISD resources
• staff development
• organisational development
• promote ISD
• develop and deliver generic information services
• there will still be core work not covered by
  programmes (SHS, definitions, adhoc service etc)
• deliver ISDs strategy

4
ISD reconfiguration

• Heads of Programmes
• NHSiS expert in field/keeper of ISDs world class
  reputation
• Design, lead and deliver the programmes of work
• each member of staff will have one line manager
• Mentor/coach in specialist areas
• Specific/specialist customer focus
• Influence ISDs strategy

5
ISD reconfiguration

• Programmes
• Clinical Governance Support
• Drugs/Substance misuse
• CHD/Stroke
• Mental Health
• Maternal/Child Health
• Joint Community Care Planning
• Public Health
• Information for General Practice Teams
• Performance Management
• Data deficit
• Waiting lists/times

6
A typical day in Acute...
7
Acute Care Information Group Business As Usual
Lorna Jackson, Head of Group
Patient (record linkage)
Patient (non-record linkage)
Workforce
Costs, Resources, HRGs
Katharine Sharpe (c. 12 staff)
Scott Heald (c. 20 staff)
James Boyd (c. 20 staff)
Brian Reid (c. 6 staff)
8

• Main Customers
• Scottish Executive
• PQs, briefing for National Statistics releases,
  policy formulating...
• Health Boards Trusts
• planning, monitoring performance/effectiveness,
  supporting clinical governance...
• Universities
• Chief Scientists Office
• Media/public

9
Patient (Non-Linkage)- 3 teams of 6 covering

• Sexual Health (Team Leader Neil Graham)
• Genitourinary Medicine
• Maternity (SMR02)
• Births (SMR02/SMR11)
• Stillbirths Infant Deaths
• Abortions
• Family Planning
• Blue data collection and analysis
• Red analysis

10
Trends in Syphillis Gonorrhoea - New Cases,
1922, 1980 and 2000
Syphillis Ghoea Others 1922 5242 4194 3106
1980 204 4856 13460 2000 35 586 21492
11
Patient (Non-Linkage)- continued

• Activity (Team Leader Judith Tait)
• Acute Activity (SMR01)
• Outpatient Activity (SMR00)
• Psychiatric Activity (SMR04)
• Cervical Cytology
• Private Nursing Homes
• NHS Complaints
• Population Mortality (GRO data)
• Blue data collection and analysis
• Red analysis

12
Patient (Non-Linkage)- continued

• Activity (Team Leader David Murphy)
• Acute Activity (SMR01)
• Outpatient Activity (SMR00)
• Accident Emergency Waiting Times Survey
• Infectious Diseases
• Firework Injuries
• Population Mortality (GRO data)
• Routine Extracts to Health Boards Trusts
• Blue data collection and analysis
• Red analysis

13
Record Linkage - James Boyd
Linked data
Linkable data
Hospital Discharges SMR1 Psychiatric Inpatients
SMR4 Scottish Cancer Register SMR6 RG Death
Records
1st January 1981 to 31st March 2001
External Data
RG Births Records Maternity (SMR2) Neo-Natal
(SMR11) RG Still Births/Infant Deaths
Other ISD Data
1st January 1980 to 31st December 1999
14
Why are linked records important?
15
How does record linkage work ?

• Bring together the pairs of records to be
  compared (Blocking)
• Quantify the relative probability that the two
  records belong to the same person (calculating
  weights)
• Make the linkage decision

16
An example of a patient history
17
Costs, Resource HRGs - Brian Reid

• Covering
• Cost Book (the Blue Book)
• High-level activity (ISD(S)1)
• HRGs (Healthcare Resource Groups)

18
Workforce - Katharine Sharpe

• Two teams
• 1 covering data collection - Chantal Spense
• 1 covering data analysis - Peter Martin
• Workforce planning - data from varous sources
• MEDMAN - medical and dental manpower (ie doctors)
• NAMs - non-medical staff (nurses, clerical etc)
• ErBOD - earnings database

19
Other Key Areas
Waiting Lists Times - Stephen Young SKIPPER,
PAF - Katrina Bird E-Scrips, Clinical Governance
- Fiona Campbell
20
SKIPPER
21
e-SCRIPs

• Developing a web application to give consultants
  access to their SMR01 data
• Rolling application (eSCRIPS) out to gt1800
  consultants in Scotland
• First system of its type in the UK

22
(No Transcript)
23
Other Groups

• Primary Care Information - Susan Burney
• similar to above - focus on Primary Care
• GP morbidity/workload, pharmacy, dental,
  ophthamics
• Data Intelligence - Kate Harley
• SMR quality, definitions and standards, clinical
  coding, new areas (elderly, primary care)
• Cancer - Roger Black
• registration, audit, analytical services/studies
• Gpass, ISSG, IT