Lancashire Teaching Hospitals NHS Foundation Trust Advancing Quality Results October 2008 to June 2017

Lancashire Teaching Hospitals NHS Foundation Trust Participation Summary

Acute Kidney Injury Alcohol Related Liver Disease Chronic Obstructive Pulmonary Disease Diabetes Hip Fracture

Y1

Y2

Y3

Y4

Y5

Y6

Y7

-

-

-

-

-

-

-

-

-

-

-

-

-

Y8

Y9

Y10

Hip or Knee Replacement Surgery Pneumonia Sepsis

26,444 patients treated on the Advancing Quality clinical pathways at Lancashire Teaching Hospitals NHS Foundation Trust

Key Provider participated and was reported Did not Participate Provider participated but was not eligible for reporting Focus Area Not Available

503,964 patients treated within the Advancing Quality programme

-

Glossary of Terms Measures

For each focus area there are specified interventions that a patient should receive. These are defined and agreed by a clinical expert group and are based on national guidelines. Data is collected for each patient about each measure and this is collated and analysed.

Measure set

Each focus area consists of between 6 and 16 measures - the measure set. The measure set is reviewed regularly alongside new evidence and updated if required.

AQ periods

The programme is split into defined periods in line with achievement targets and CQUINs.

ACS Score

Appropriate Care Score - the percentage of patients who received all the measures that they were eligible for.

CPS Score

Composite Process Score - the percentage of measures achieved.

Eligible for reporting

Retired focus area

Transitioned Focus Area

In order to be eligible for public reporting, providers must meet the following conditions: 95% ICD10 coding completeness. 95% measure completeness for the clinical focus area. Pass independent assurance audit for the clinical focus area (ended during Year 8). The AQ programme has retired some focus areas due to high achievement from all participants.

The AQ programme has utilised national audits where data is available to provide benchmarking for participating organsiations.

Lancashire Teaching Hospitals NHS Foundation Trust Latest Results Overview (January to June 2017) Current Year CPS Score 0%

10%

20%

30%

40%

50%

60%

Acute Kidney Injury

69%

Chronic Obstructive Pulmonary Disease

48%

Diabetes

Hip or Knee Replacement Surgery

80%

67%

Alcohol Related Liver Disease

Hip Fracture

70%

58% #N/A 78%

Pneumonia Sepsis

85% 75%

90%

100%

Acute Kidney Injury Lancashire Teaching Hospitals NHS Foundation Trust - Participating The AKI measure set was launched in July 2015. There are 6 clinical process measures and 1 data collection measure in the AKI measure set.

Appropriate Care Score

Composite Process Score Trust CPS Scores

Trust ACS Scores

Overall CPS scores

100%

100%

75%

75%

50%

50%

25%

25%

0%

Overall ACS Score

16%

29%

29%

Jan 17Jun 17

Apr 15Mar 16

Jan 16Dec 16

Jan 17Jun 17

Y10

Y8

Y9

Y10

52%

67%

67%

Apr 15Mar 16

Jan 16Dec 16

Y8

Y9

0%

AQ Period Year 10 data is for the year to date (Jun 2017) and is therefore provisional and subject to change.

AQ Period

Alcohol Related Liver Disease Lancashire Teaching Hospitals NHS Foundation Trust - Participating The ARLD measure set was launched in April 2015. There are 8 clinical process measures and 3 data collection measures in the ARLD measure set.

Appropriate Care Score

Composite Process Score Trust CPS Scores

Trust ACS Scores

Overall CPS scores

100%

100%

75%

75%

50%

50%

25%

25%

0%

Overall ACS Score

17%

20%

20%

Jan 17Jun 17

Apr 15Mar 16

Jan 16Dec 16

Jan 17Jun 17

Y10

Y8

Y9

Y10

68%

72%

69%

Apr 15Mar 16

Jan 16Dec 16

Y8

Y9

0%

AQ Period Year 10 data is for the year to date (Jun 2017) and is therefore provisional and subject to change.

AQ Period

Chronic Obstructive Pulmonary Disease Lancashire Teaching Hospitals NHS Foundation Trust - Participating The COPD measure set was launched in December 2014 and following the annual review, amendments were made from April 2016. There are currently 5 clinical process measures and 1 data collection measure in the COPD measure set.

Appropriate Care Score

Composite Process Score Trust CPS Scores

Trust ACS Scores

Overall CPS scores

Overall ACS Score Measure Changes

Measure Changes

100%

100%

75%

75%

50%

50%

25%

25%

0%

0%

0%

24%

16%

Jan 17Jun 17

Apr 14Mar 15

Apr 15Mar 16

Jan 16Dec 16

Jan 17Jun 17

Y10

Y7

Y8

Y9

Y10

26%

30%

47%

48%

Apr 14Mar 15

Apr 15Mar 16

Jan 16Dec 16

Y7

Y8

Y9

0%

AQ Period Year 10 data is for the year to date (Jun 2017) and is therefore provisional and subject to change.

AQ Period

Diabetes Lancashire Teaching Hospitals NHS Foundation Trust - Particpating The Diabetes measure set was launched in February 2015 and following the annual review, amendments were implemented from April 2016. There are currently 10 clinical process measures in the Diabetes measure set.

Appropriate Care Score

Composite Process Score Trust CPS Scores

Trust ACS Scores

Overall CPS scores

Overall ACS Score Measure Changes

Measure Changes

100%

100%

75%

75%

50%

50%

25%

25%

0%

37%

46%

53%

Apr 15Mar 16

Jan 16Dec 16

Jan 17Jun 17

Y8

Y9

Y10

58% 0%

AQ Period Year 10 data is for the year to date (Jun 2017) and is therefore provisional and subject to change.

6%

16%

16%

22%

Apr 14Mar 15

Apr 15Mar 16

Jan 16Dec 16

Jan 17Jun 17

Y7

Y8

Y9

Y10

AQ Period

Hip Fracture Lancashire Teaching Hospitals NHS Foundation Trust - Participating The Hip Fracture measure set was launched in January 2015. There are currently 8 clinical process measures and 2 data collection measures in the Hip Fracture measure set.

Appropriate Care Score

Composite Process Score Trust CPS Scores

Trust ACS Scores

Overall CPS scores

100%

100%

75%

75%

50%

50%

25%

25%

0%

Overall ACS Score

0%

0%

#N/A

#N/A

Jan 17Jun 17

Apr 14Mar 15

Apr 15Mar 16

Jan 16Dec 16

Jan 17Jun 17

Y10

Y7

Y8

Y9

Y10

44%

51%

#N/A

#N/A

Apr 14Mar 15

Apr 15Mar 16

Jan 16Dec 16

Y7

Y8

Y9

0%

AQ Period Year 10 data is for the year to date (Jun 2017) and is therefore provisional and subject to change.

AQ Period

Hip and Knee Replacement Lancashire Teaching Hospitals NHS Foundation Trust - Participating The Hip or Knee Replacement measure set was launched in October 2008 and following the annual review, amendments were implemented from April 2016. There are currently 6 clinical process measures and 1 data completeness measure in this measure set.

Appropriate Care Score

Composite Process Score Trust CPS Scores

Trust ACS Scores

Overall CPS scores

Overall ACS Score Measure Changes

Measure Changes

100%

100%

75%

75%

50%

50%

25%

25%

0%

98%

98%

98%

98%

97%

96%

95%

94%

81%

78%

Oct 08- Oct 09- Apr 10- Apr 11- Apr 12- Apr 13- Apr 14- Apr 15- Jan 16- Jan 17Sep 09 Mar 10 Mar 11 Mar 12 Mar 13 Mar 14 Mar 15 Mar 16 Dec 16 Jun 17 Y1

Y2

Y3

Y4

Y5

Y6

Y7

Y8

Y9

0%

90%

91%

91%

91%

93%

88%

86%

83%

34%

19%

Oct 08- Oct 09- Apr 10- Apr 11- Apr 12- Apr 13- Apr 14- Apr 15- Jan 16- Jan 17Sep 09 Mar 10 Mar 11 Mar 12 Mar 13 Mar 14 Mar 15 Mar 16 Dec 16 Jun 17

Y10

AQ Period Year 10 data is for the year to date (Jun 2017) and is therefore provisional and subject to change.

Y1

Y2

Y3

Y4

Y5

Y6

AQ Period

Y7

Y8

Y9

Y10

Pneumonia Lancashire Teaching Hospitals NHS Foundation Trust - Participating The Pneumonia measure set was launched in October 2008 and following the annual review, amendments were implemented from October 2015. There are currently 5 clinical process measures in the Pneumonia measure set.

Appropriate Care Score

Composite Process Score Trust CPS Scores

Trust ACS Scores

Overall CPS scores

Overall ACS Score Measure Changes

Measure Changes

100%

100%

75%

75%

50%

50%

25%

25%

0%

80%

84%

86%

85%

86%

87%

86%

81%

82%

85%

Oct 08- Oct 09- Apr 10- Apr 11- Apr 12- Apr 13- Apr 14- Apr 15- Jan 16- Jan 17Sep 09 Mar 10 Mar 11 Mar 12 Mar 13 Mar 14 Mar 15 Mar 16 Dec 16 Jun 17

Y1

Y2

Y3

Y4

Y5

Y6

Y7

Y8

Y9

Y10

0%

54%

59%

65%

59%

62%

66%

63%

51%

50%

54%

Oct 08- Oct 09- Apr 10- Apr 11- Apr 12- Apr 13- Apr 14- Apr 15- Jan 16- Jan 17Sep 09 Mar 10 Mar 11 Mar 12 Mar 13 Mar 14 Mar 15 Mar 16 Dec 16 Jun 17 Y1

AQ Period Year 10 data is for the year to date (Jun 2017) and is therefore provisional and subject to change.

Y2

Y3

Y4

Y5

Y6

AQ Period

Y7

Y8

Y9

Y10

Sepsis Lancashire Teaching Hospitals NHS Foundation Trust - Participating The Sepsis measure set was launched in December 2014 and following the annual review, amendments were implemented from July 2016. There are currently 8 clinical process measures and 2 data collection measures in the Sepsis measure set.

Appropriate Care Score

Composite Process Score Trust CPS Scores

Trust ACS Scores

Overall CPS scores 100%

75%

75%

Score

100%

50%

50%

25%

25%

0%

Overall ACS Score

27%

38%

40%

40%

Jan 17Jun 17

Apr 14Mar 15

Apr 15Mar 16

Jan 16Dec 16

Jan 17Jun 17

Y10

Y7

Y8

Y9

Y10

52%

67%

71%

75%

Apr 14Mar 15

Apr 15Mar 16

Jan 16Dec 16

Y7

Y8

Y9

0%

AQ Period Year 10 data is for the year to date (Jun 2017) and is therefore provisional and subject to change.

AQ Period