IN ACTION DATA


when they arrive at out-of-hours that care plan is available to be seen by those users who are then talking to the patient who is in need of urgent help,” he adds. “What’s perhaps very clever, is we can then track outcomes using the same system because it’s providing a clinical source, but it also has all the other data sources in it, so you can track the impact across all different areas.” This includes GP interventions, acute interventions, community interventions and now social care interventions as well.


This puts the power in the hands of not only the commissioners, but clinicians, managers and healthcare workers throughout the NHS to make empirical decisions – and this inevitably helps with the financial savings agenda associated with QIPP. “The system allows [commissioners] to challenge any invoice that the CCG receives which they think is inappropriate,” says Meaker. “That’s quite a difficult process, because you have to create a closed loop with your acute provider. When we first piloted a challenge system, clinicians became frustrated because they were unable to see the actual result of the challenge. It took us another year and a half to get the closed loop with the acute hospital agreed; now we can link GP challenges to the consultants in the acute hospital to accept or reject, or add comments, to the GP commissioner’s challenge.” The beauty of the web-based system is


its flexibility and the ability to search for pretty much any variable a commissioner might need. Interpreting it is the next step. The CCGs have provided training for GP practices to help them interpret the information at population level (since most of them are accustomed to looking at a single patient or, at its widest, practice data). This has been beneficial for QP QOF, where practices determine improvement plans and report on wider trends, e.g. unplanned or planned care. The next step will be incorporating the system further with community and social care so local authorities also have access to the data. “What really needs to happen with informatics is clinicians need to engage


using data to drive decision-making and support and validate decision-making within CCGs,” says Meaker. The team demonstrated this is possible by focusing on COPD specifically in the area as a pilot project, which has already won the 2013 Innovation Challenge Prize Fund award. “It’s really important to demonstrate that the money you’re investing is delivering and if it’s not you have to decommission the service because it’s not delivering and invest in something that does.” He adds: “I think everybody needs to evaluate the direction their programmes are going and that commissioning decisions are based on the value-added or not.” Furthermore, it’s important to understand the complexities of data sets – just pulling up info on diabetics is one thing, but there are many variables within that condition alone. “The learning from the COPD project was that you have to sit down with the clinicians and they have to tell you what it is clinically they are looking for – to the data person – so the two are sat working as one,” says Meaker. “Part of the reasons we built this flexibility into the system was to try and get it so the clinician could start to drive the data analysis themselves rather than having to explain to a third-party what it is they’re trying to look for.” This is another example of the administrative and clinical sides of healthcare merging. All of this work is about improving the


quality of data available to commissioners and it seems the strength here is in numbers. “If you went back five years, the quality of data was really very poor, whereas today, because we’ve put the data in front of a range of different people, it forces the quality of the data to improve,” says Meaker. That, he says, actually helps commissioners make – and track – better commissioning decisions, so they have the proof they need to improve patient outcomes.


For information on how to go about collecting data from GPs, see page 34 for an overview of NHS Oldham, which is undergoing a similar project


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