SHAPE Strategic asset management

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shape
Supporting and Informing Strategic Health Planning
Peter Sellars DH Project Director
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Why Strategic Asset Management
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Background
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Background- Context
DH Policies
SHAPE Outputs
DH
To integrate DH key policies to healthcare
services strategic planning
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• Background - What does shape do?
• Provides strategic and local analysis of current
  clinical activity
• Brings together whole health economies physical
  estate and capacity
• Incorporates and uses GIS mapping
• Informs potential for operational savings within
  a health economy
• Highlights potential for services to transfer
  from acute to primary setting
• Provides strategic analysis to support investment
  needs and disinvestment opportunities
• Supports scenario planning

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Background- how shape can help you

• Service re-design and health reform
• Strategic planning
• Delivery quality and value agenda

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Shape Overview
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Shape - Development Phases
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Aligned to recent reconfigurations
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Phase 1 Autumn 2006

• Five year analysis of HES data to provide
  extensive clinical activity for the NHS
• National level
• SHA
• PCT
• Trusts
• Local GP
• National estate data base
• Acute, primary care, GP practices, etc

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Whats included

• Strategic overview of clinical activity
• Benchmark comparisons via health economy of
  various aggregate measures which examine the
  potential for internal technical efficiency
  savings such as
• Mean length of stay (LOS) by HRG with existing
  and/or projected national values
• Mean trimmed LOS by elective and non elective
  patients by HRG, by year
• Proportion of trimmed cases by HRG (as compared
  with existing and/or projected national values)
  by year and over a five year period
• Proportion of elective day-case admissions
  (relative to elective in-patient admissions) by
  HRG by year and over a five year period

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Whats included

• Strategic overview of clinical activity
• Identification of high volume case types by HRG
• Identification of low volume case types by HRG
  and what this signifies for role delineation
  within a SHA or health economy
• Benchmark comparisons via health economy of
  various aggregate measures which examine the
  potential for allocative efficiency savings such
  as
• Comparison of rates of admission with that
  expected under a Poisson distribution
  development of criteria that could be used to
  differentiate conditions in terms of the role of
  primary care

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Whats included

• Strategic overview of clinical activity
• Elective day case/top 40 HRG admissions
• Elective day case/top 40 HRG bed days
• Elective inpatient/top 40 HRG admissions
• Elective inpatient/top 40 HRG bed days
• Non elective/emergency/top 40 HRG admissions
• Non elective/emergency/top 40 HRG bed days
• Non elective/maternity/top 40 HRG admissions
• Non elective/maternity/top 40 HRG bed days
• Non elective/birth/top 40 HRG admissions
• Non elective/birth/top 40 HRG bed days
• View by, Health economy, Trust, PCT, GP practices
  

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Whats Included

• Strategic Overview of Estate infrastructure
• Extensive Estates Database linked to mapping
• Key performance indicators developed to provide a
  strategic overview and position of current estate
  and clinical activity
• Developed to support and inform investment and
  disinvestment needs

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Estates collection data
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Estates Data - Key Performance Indicators
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User Support

• To assist with the training and understanding of
• the shape methodology, the following
• Supporting documentation will be available.
• Shape concept
• Technical Guidance
• User Guidance
• Strategic Reporting Framework
• On-line User Guide

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Next Steps

• Pilot User Feedback
• Consultation
• Peer Review
• Validation and Testing

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Next Steps (Oct 06-March 07)

• Provision of base interactive GIS mapping
• Provision of strategic spatial planning module
• Provision of local trust modelling module
• Provision of decision tree module
• Provision of enhanced mapping functions to
  support scenario planning
• Enhanced clinical analysis

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Screen shots from prototype
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Password entry for each health economy
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HES Data how do we use it ?

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HRGS top 40 non - elective bed days LOS (Trim)
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HRGS view bed days by specialities
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HRGS 5 year profile
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HRGS 5 year profile with trim value
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Strategic overview of HES data by health economy
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Strategic overview potential bed savings
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Strategic overview potential bed savings by
shifting services Acute- Primary
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NORTH WEST LONDON SHAClinical overview screen
display
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NORTH WEST LONDON SHApotential for
redistribution of services (repeat admissions)
by PCT
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Functions
Web based system viewing functions
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SHAPE
Health economy overview of deprivation levels
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Health economy GP premises locations
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GP Premises location national deprivation index
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Health economy population density
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Health economy population density (zoom 1)
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Health economy population density (zoom 2)
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Health economy population density GP practices
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GP Premises - patient walk-times 5 to 20 min
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Acute Trust drive-time 5- 40 mins
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Stage 2 Planning Mapping Future Service Provision
High Service Provision Low Demand
Low Service Provision High Demand
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Stage 2 Geo-demographic Profiling of Services
Dominated by Stylish Singles
High Levels of Low Rise Council Council
Flats Victorian Low Status
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HRGS postcode tracking for health planning
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Apply postcode boundaries
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Whats included

• Estate
• All NHS properties within SHA (source NACS data
  set)
• Local ownership required to populate detailed
  data to support analysis of estate data
• Linked to GIS mapping and google maps for site
  viewing etc
• All GP premises (source DVO Binleys)
• Detailed practice information included

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SHAPE health economy data collection entry screen
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Health economy overview property portfolio
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Individual property information
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Example of Estate data collected
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Functional profile data collection screens
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Summary / progress
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Age Profile of Healthcare Estate
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Age Profile of Primary Care Estate
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Health economy functional use of space
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Next development phases 2006-07

• Provide clinical activity analysis and develop
  national interface to support all of the NHS (Oct
  06)
• Develop an estate strategic disinvestment
  investment model (Oct 06)
• Develop strategic spatial planning and supporting
  cost model (Dec 06)
• Develop software interface that links capacity
  planning to facilities required
• Provide added interactive GIS modelling and
  simulation planning (March 07)

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Care pathway development
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Care pathway events locations
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Care pathways facilities required
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Final thoughts

Its crucial that the patient services and the
supporting facilities we are planning today are
the right size, delivering the right functions
and provided in the right location to support
delivery of the future health and social care
agenda
Shape is being developed to support and inform
strategic and local planning and provision of
services. By brining together key information
sets including clinical activity, demographics,
geography, and estate infrastructure for use
within SHAs and PCTs.
www.dh.gov.uk/PolicyAndGuidance/OrganisationPolicy
/EstatesAndFacilitiesManagement
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Strategic spatial planning

• Without it how can we plan an estate that is
  inherently long-term
• Often only a fragmented series of views from an
  uncoordinated group of stakeholders / enthusiasts
  and is generally short-term
• Frequently the concept of a longer term vision is
  often initiated by the needs of those responsible
  for the capital development programme rather than
  by service visionaries
• Is absolutely essential that all those with a
  part of the jigsaw contribute to the creation of
  the overall picture
• Service Planners, Doctors, Clinicians, Nurses,
  Allied Health Professionals, Technologists,
  Capital Development Planners, Designers, Public
  ,Patient Representatives, Policy-makers,
  Providers and Managers, and Researchers,

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Key drivers for service reconfiguration
1 - Local Health Centres 2 - Community Health
Centres 3 - Local Hospitals 4 - Acute Hospitals 5
- Regional Centres
Movement of out-patients diagnostics and
treatments from acute towards community Key
issue is the movement of chronic disease
management to the community preventing
unnecessary hospitalisation
Movement of complex specialties or specialties
benefiting from higher critical mass to Centres
of Excellence
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Spatial planning modelPopulation driven
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GP Consulting
Treatmt. Rooms
Limited AHP Specialties
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Diagnostic Testing (1)
GP Consulting
Treatmt Rooms
Other Public Sector
Full Range of AHP Specialties
Diagnostic Imaging(2)
OOH Service
Social Services/ Community Care Professions
Comm Resource and Vol. Sector
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Proced. Rooms
Satellite Out-Patients Consulting
Diagnostic Testing (2)
Minor Injuries
Appropriate Private Sector
OPD
Treatmt Rooms
Full Range of AHP Specialties
Assess. Beds
Diagnostic Imaging(3)
OOH Service
Social Services/ Community Care Professions
Proced. Rooms
GP Beds
Diagnostic Testing (3)
Minor Injuries
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Step-down Beds
Endos. Suite
Mental Health Unit
CDU
Rehab. Beds
Day Surgery Theatres
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Main Theatres
Acute Beds
Diagnostic Imaging(4)
Full AE
Maternity Unit
Paediatric Unit
Specialist OPD
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CAA
Fracture Unit
Psychiatric Unit
Critical Care Unit
Diagnostic Testing(4)
Protect. Elective Centre
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strategic health asset planning and evaluation
shape

A web enabled system, which provides a unique and
comprehensive strategic asset planning tool
supporting health and social care delivery in
England. Presentation Monday 4 Sept 2006 Peter
Sellars
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Agenda

• Background
• Progress to date
• Whats included
• Clinical activity and analysis
• Estate information
• GIS mapping
• Next steps
• Moving prototype support national rollout
• Strategic Investment disinvestment model
• Strategic spatial planning
• Enhanced mapping functionalities
• Scenario planning Service Planning

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shape What? For Whom? Why?

• What?
• A web-enabled strategic asset planning resource

• Why ?
• To Support
• System Reform
• Improved whole system and community planning
• Innovation in service delivery and commissioning
• Integration of health and social care

• For Whom?
• SHAs
• Commissioners
• Whole Health Economies
• Department of Health

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Stage 1 Clinical Aims To provide a strategic
overview of current clinical activity and
performance within each health economy by
undertaking the following -
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Stage 1 Strategic overview The present
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Stage 3 Solution The road map
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Stage 2 Planning The future
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Next StepsBase GIS

• Base Geographical Information System (GIS)
• Mapping (December 2006)
• Geocoding
• Display of clinical and estate data
• Coverage of all Ordnance Survey (OS) data England
  wide.

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Next StepsBase GIS

• Spatial Data Warehouse
• census data
• geodemographic data
• lifestyles information (England wide)
• Satellite view of individual site layouts for
  example, as available via Google earth.

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Next StepsBase GIS

• Map layers around healthcare sites detailing
• Drive time distances
• Walk time distances
• Ability to deliver dynamic reports to the users
  based on up-front or underlying geospatial
  analysis.

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Next StepsEnhanced GIS

• Enhanced Geographical Information System
• (GIS) (March 2007)
• GIS mapping and interface for all Health Related
  Groups (HRG) contained within shape.
• Fully interactive capability for assessing access
  times for all level of services.
• Walk times to local health service facilities
  (GP, Community Hospitals).
• Drive times to specialist services and acute
  hospitals.

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Next StepsEnhanced GIS

• Link mapping facilities to
• Detailed health demographics data sets
• Deprivation
• Lifestyle
• future health care provision driven by
  epidemiological data
• 10 Performance Indicators to support strategic
  and local planning for sectors such as
• Specialist
• Acute
• Intermediate
• Primary

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Next StepsEnhanced GIS

• Removing or providing healthcare facilities
  within a given geographic area.
• Visual presentation of estates data by individual
  sites by type/function linked to relevant table
  information.
• Users able to update the information held in the
  tables.

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Next StepsEnhanced GIS

• Scenario modelling.
• Demographics GIS presentation
• Electoral Ward (Local Council) level including
  age, population, deprivation and potentially
  housing.
• Presentation of patient flows e.g. through an
  acute setting (local vs non-local).

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Stage 1 Aims Estate To provide a strategic
overview of the existing healthcare estate
condition, performance, capacity. To support and
inform health economies strategic solutions for
disinvestment and investment, by-
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Stage 1 Aims To provide concise strategic
overview of a health economy existing facilities
and profiles by the use of geographical
technology by -
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Structuring of Estate Data

• 2 Levels, Visually presented and structured to
  support
• Level 1
• SHA - mandatory (strategic overview spatial
  planning)
• Level 2
• PCT- desirable (support service planning)
• Trust- optional (local level decisions)