PCT Cluster finds £600,000 with CCG+

NHS South of Tyne and Wear has been credited with £400,000 from its local acute trusts as a result of overcharging that it identified using business intelligence tool CCG+

The primary care trust cluster has also identified more than £200,000 in rolling savings from doing more care, such as deep vein thrombosis treatment, in the community.

The cluster has deployed Actuate’s CCG+, which, under the name GPC+, won the ‘most promising IT for GP-led commissioning’ category of the EHI Awards 2011 in association with BT.

The system is built on the ActuateOne platform, and uses BIRT Performance Analytics to create dashboards, performance maps, and key performance indicators.

GPs using the system get an urgent care clinical dashboard using daily feeds from acute providers, revealing which of their patients have been to A&E and admitted to hospital or discharged.

This high level summary is followed by more detailed reports – drawing on additional data from sources such as the NHS Secondary Uses Service – which arrive about four weeks later.

The tool also provides risk stratification reports showing the likelihood of patients being admitted to hospital in the next year and allows practices to see how they compare with others on performance measures such as referrals to secondary care.

Scott Watson, head of business delivery at NHS South of Tyne and Wear, said that in working through reports highlighting patient lengths of stay, practices identified a number of instances in which they had been charged for longer hospital stays than their patients had been admitted for.

Discrepancies were also identified in which patients who were not registered with a local practice had been charged to the local PCT. This resulted in three acute hospitals having to credit the PCTs £400,000.

“That’s a significant number of operations that we are able to fund now,” Watson noted.

Another £200,000 in savings had been identified in rolling savings, such as providing more care in the community, and this was expected to increase over time.

“By putting information in the hands of GPs, they are starting to get an understanding of what they are spending in secondary care and whether that’s appropriate,” he added.

Watson said the organisation started developing the system in its current form early last year.

“We identified clusters of GP practices to sit down with us and tell us what they want to see in a business information system that would support their commissioning agenda,” he said.

The system was piloted over a couple of months, and then rolled out across the three PCT areas. The deployment was completed in August 2011, but there is still an on-going training programme with about 117 practices – 90% – done so far.

The cluster area has three Clinical Commissioning Groups aligned to the three PCT areas which are Gateshead, South Tyneside and Sunderland Teaching PCTs. Watson said the tool would help the CCGs with the authorisation process.

“The software is very flexible, from a development standpoint it’s ideal really.”

The trusts provide Actuate with an NHS base and intelligence for developing the system and, in return, get the expertise of the company’s staff to develop the tool for local use.

“We try things out, give them ideas, and they give us staff time, skills and expertise,” said Watson.

He said the feedback from GPs had been generally good, “primarily because the system has been developed in conjunction with the practices and the CCGs”.

The cluster was working on using Emis Web to integrate primary care data with community and secondary data to produce reports showing the entire patient pathway through the health system. The primary data would also enhance the risk stratification reports.

Watson said the £600,000 savings meant the system had already paid for itself in terms of investment.

CCG+ uses BIRT (Business Intelligence and Reporting Tools) Performance Analytics and BIRT Report Designer.