Our consultant knowledge and extensive networks enable them to share best practice and innovative ideas within the healthcare sector.
CHKS staff understand the NHS and the intricacies of NHS trust work. Consultants are always willing to help and provide assistance and reports whenever asked and I know I will get an answer to a question quickly.
Mark Williams, Principal Information Analyst, East Cheshire NHS Trust
A comparison of first and second waves across England, Wales and Northern Ireland.
The purpose of this study was to use data metrics and qualitative standards to identify strengths and weaknesses in how patients with a dementia are being cared for in an acute hospital setting.
The accuracy of data has major financial implications for trusts and is therefore a crucial factor in determining a hospital’s overall performance. Data can also be the basis for driving improvement within acute services, which means…
Value for money is arguably more important than ever for a strained NHS, making streamlining services and boosting efficiency of paramount importance.
Waiting times in accident and emergency departments are a key indication of how hospitals are performing…
Patient experience is strongly linked to patient outcomes – evidence shows that patients that have a better experience of care generally have better health outcomes – so its effect on overall hospital quality, as well as the health of the nation, cannot be underestimated…
Trusts continue to face the challenge of managing growing demand with a limited budget – essentially treating more people with less money – and, under these conditions, improving patient safety may seem like a difficult task…
Despite competing priorities coupled with a challenging financial environment, improving care quality and patient outcomes should be at the top of every trust’s agenda…
Since 2001, CHKS has celebrated achievement in healthcare quality and improvement through its Top Hospitals awards. These include national awards for patient safety, quality of care, patient experience and data quality, which are decided on the basis of an analysis of publicly available datasets.
This year, for the first time, the Top Hospital Awards considered all UK hospitals, meaning the winners are representative of the best hospital performance throughout England, Wales and Northern Ireland.
A strong theme that emerged among the 2018 winners was a focus on hospital culture. Engaging and motivating frontline hospital staff has had positive effects far beyond improving staff wellbeing and patient experience, helping to fulfil wider objectives, too. By encouraging creativity and innovation among staff, trusts have achieved financial savings, made services more efficient and enhanced patient safety.
The award winners featured in this report demonstrate commitment to continual improvement through innovation. Here, we share these trusts’ experiences and ideas and highlight examples of best practice, all of which embody high-quality, patient-centered care.
Since 2001, CHKS has celebrated achievement in healthcare quality and improvement through its Top Hospitals awards. These include national awards for patient safety, quality of care, patient experience and data quality, which are decided on the basis of an analysis of publicly available datasets. There is also an international award for quality improvement. We run the event annually to recognise healthcare organisations that have excelled in these areas.
A common theme that emerged among this year’s winners was a focus on putting the patient at the centre of care. The winners also value their staff and use their experiences of daily work on the frontline to shape the future of the patient experience.
This report shares the award winners’ experiences and ideas, and highlights associated examples of best practice, which can go a long way towards promoting excellent, patient-centred care across the UK.
Our latest CHKS Health Insight report on non-elective care focuses on weekend mortality in the NHS. We add another dimension to the debate, which has seen some heated exchanges between the different sides. Through our analysis we have found a clear link between the weekly admissions cycle and average severity of patients presenting on the weekend, something which can explain all of the increase in hospital mortality associated with weekend admissions. In our view it is important to reflect on this aspect of the debate (severity of presentation) as it has been under-representedand under-analysed so far, with the focus mainly being on staffing levels and availability of support services within and outside the hospital at the weekend.
In our latest health insight report on non-elective care, we highlight the possibility that a number of patients with major illnesses are at risk of worsening health outcomes due to not seeking active care over the weekend. Through our analysis we have identified a weekend dip in emergency admissions that does not correspond to the trend in daily A&E attendances. This weekend drop is seen for all major diagnosis groups, including myocardial infarction, stroke, COPD, and asthma, conditions for which timely clinical input is vital in diagnosing and quickly treating patients to improve their chances and speed of recovery, and which require emergency hospital admission and treatment. We believe this decrease is unexpected as the incidence of a medical or surgical condition is not likely to follow a cyclical weekly pattern.
CHKS has been working with the Royal College of Emergency Medicine (RCEM) to analyse treatment times within Emergency Departments in English hospitals. Our analysis focused on variation in treatment times within the four hour target and beyond. We found significant variation between trusts both within four hours and post four hours. This suggests two further indicators might also be considered as useful additional measures of performance.
Our latest report aims to help trusts meet the 24/7 challenge by sharing examples of best practice. As well as contributions from Clifford Mann, president, Royal College of Emergency Medicine and Chris Hopson, chief executive, NHS Providers we have included case studies on three NHS trusts shortlisted by an expert panel for the CHKS Excellence in Delivering 24/7 Emergency Care Award 2016.
The market for analytics has matured significantly in the past five years and, although the health sector in the UK has many years of experience in this area, it would be fair to say it has not been at 'the cutting edge'. A combination of the NHS Five Year Forward View, the Dalton Report and the government's austerity strategy requires the NHS make savings - and to reinvent themselves as broader-based service providers, with a new care model and range of delivery options.
But the real challenge, as yet undefined, is how all of this will be achieved. We predict that with clear, effective implementation of analytics across the whole range of its functions, the NHS could achieve billions of savings over coming decades. And the effective application of analytical tools to visualise new service models, and the change management to deliver it, will be key. By following and adopting appropriate models and approaches from other industries, which have invested heavily in this area, the NHS could achieve billions of savings over the coming decades.
CHKS recently carried out research into the timeliness of CT scans for patients admitted as emergencies. Our intention was to establish whether there were differences in scanning rates or speed of scanning between weekdays and weekends. Although we did not find significant differences during the week, we were surprised by the level of variation of scanning rates between trusts. We found that those with faster scans discharged patients over 1.5 day sooner. Even if the slower trusts were to achieve a modest 1 day reduction in stay, by increasing the speed of scanning, we estimate the gross savings across all trusts would be £145m per year.
Our latest report focuses on selected winners from Top Hospital Awards 2015 in order to explain how they have become the leaders in their field. Our aim is to share best practice and we believe there are lessons to be learned from all our award winners.
This report highlights best practice, not only at the winning trust from the award winner of the CHKS top hospitals accident and emergency care award 2015, but at other trusts throughout the country. It looks at what makes a top A&E department and focuses on the areas of good practice and innovation that enable them to provide a good patient experience while avoiding gridlock and crowding, which can be detrimental to patients’ health and recovery times.
This year’s CHKS Data Quality and Clinical Coding Conference was well attended with over 130 delegates from across the UK. Our aim was to discuss and share knowledge on improving data quality and promoting quality, value and transparency in healthcare. Delegates had the opportunity to hear from national organisations, clinicians and sector leads on the importance of clinical coding to future developments. They were able to share experiences and best practice. You can find slide presentations from the day here.
In a recent HSJ article Dr Steve Kell, co-chair of NHS Clinical Commissioners, described five ways CCGs could progress their role in leading health service transformation. He included a call for better tools to further support intelligent commissioning
Monitor has published the findings from the 2014/15 payment and tariff assurance framework, delivered by CHKS, part of Capita Health Partners. The findings show that nearly half of trusts (49%) had inaccurate reference costs submissions. Reference costs are an annual return completed by every NHS provider which are used by Monitor to determine the national tariff paid hospital care. We found that many trusts who fell into the medium risk category were not undertaking the detailed work necessary to produce accurate cost information. Where trusts used cost information to inform decision making, the reference costs submission were more liable to be correct. Please click here to download the report.
CHKS can help trusts improve the accuracy of their cost information, as well as assure the data that underpins payment and costs. We can also support trusts in joining up cost, income and quality through our industry leading value triangle.
Following publication of the latest SHMI figures for hospital trusts in England, we have published a short report looking at six factors that are likely to have an impact on the measure. Our report is a timely reminder that the SHMI can be used as a starting point for identifying higher than expected mortality, but also that it should also be used as part of a wider quality assurance process.
Our latest analysis, as featured in the HSJ shows CCGs need better access to data around the scale and value of specialised services activity being commissioned monthly on their behalf by NHS England. Researchers from CHKS found a significant variation in the volume of specialised services activity across England. They also looked in more detail at how much of the activity above has been charged back to the CCGs (despite the fact it qualified as specialised services activity) and this varies by up to 4.0 per cent across the country. The total cost of the misattribution to individual CCGs ranges from £50,000 to £373,000 per month so a significant financial burden for individual CCGs to bear.
Please click here to read the full story in the HSJ. (Note: behind subscriber paywall).Or email us at info@chks.co.uk for the full report and to find out more about how we can support you to drive improvements.
Our briefing on behalf of the Department of Health on the quality of clinical coding in the NHS sets out the findings from the 2013/14 PbR data assurance audit programme. For the past seven years we have reviewed the accuracy of clinical coding across the NHS, and in 2013/14 we audited 50 acute trusts. We found that the accuracy of clinical coding across the NHS remains variable – the coding of comorbidities remains an area of concern for both providers and commissioners. The briefing describes the causes of poor coded data, such as source documentation and the increasing pressures on coding departments, and considers the impact poor data quality will have on the planned developments for the national payment system. We have developed a checklist to enable Board members and senior managers to support improvement in the quality of coded data at their organisation.
Our 2013/14 mental health briefing on behalf of the Department of Health sets out the findings from our costing and data quality reviews supporting the currency development in mental health. We reviewed a further 25 NHS mental health providers in 2013/14. Since 2012/13 we have reviewed costing and activity data at 34 (60 per cent) mental health trusts. The work supports improvement and identifies areas where mental health trusts can take action prior to the implementation of any national payment system. We reviewed processes at trusts to support accurate costing of care clusters, from board level down to the appropriateness of cost allocations used to determine care cluster costs. Service user records were reviewed to check that they supported the activity data used by the trust that is important for costing and payment purposes. This included reviewing the accuracy of the:
We have developed a checklist to help support mental health trust Board members’ and senior managers’ to improve the accuracy of care cluster costing and the activity data that underpins it. Please click here to download the briefing.
A case study looking at how the CHKS Coding and Financial Assurance team worked with Spire Healthcare has been included in a report from the Health and Social Care Information Centre (HSCIC) on data quality. The Quality of Nationally Submitted Health and Social Care Data, England, Annual Report 2014, Experimental Statistics focuses on the importance of good quality data and the data quality assessment and reporting processes used by the HSCIC on the data it receives. The report also includes a summary of the teams work under the PbR data assurance framework. The inclusion highlights the team’s credentials and expertise in data quality.
This year we have added a new category to our Top Hospitals awards programme for excellence in maternity care. The award identifies outstanding maternity care and is based on an evaluation of a range of key clinical and CQC indicators. In recognition of this award we have also published What makes a top hospital? - maternity care. Like others in the series, this report shares learning from top hospitals and establishes common themes that any acute sector organisation hoping to improve maternity care should take into consideration.
An audit of NHS costing has found some significant accuracies in a sample of 50 trusts. The biggest problem is lack of organisational support and a failure to actively use the data. It's time to take costing seriously says associate director of coding and financial assurance Howard Davis in his latest article for HFMA magazine.
A recent audit, carried out by CHKS, has found improvements are needed in the quality of cost information at the majority of trusts reviewed. Just one-in-ten NHS acute trusts (12 per cent) have good quality costing information across all services, according to the audit of the costing arrangements and the 2012/13 reference costs submissions of 50 acute trusts. The audit results show trusts need to take costing more seriously, not just to improve its quality and the accuracy of payment within the NHS, but also to help them understand their business properly so they can make sustainable savings in the long-run.
To coincide with Dementia Awareness week, we have just published our What makes a top hospital? report – dementia care. The report examines best practice in dementia care in acute hospitals and what every hospital should do to ensure it provides high standards of diagnosis and care, and fully supports an integrated care pathway. This is a pathway that offers people with dementia a seamless transition between home and place of care, high-quality treatment and appropriate lengths of stay where required. Read the report here.
This guide, published in partnership with the NHS Confederation simplifies the jargon and helps non-executive directors (NEDs) better understand NHS data, and helps give them the confidence to ask the right questions about it. It explains how data can be used to determine what is going on in a hospital, looks at data and trends in elective hospital admissions, waiting times and patient experience and then moves on to A&E, non-elective admissions, readmissions and diagnostics. The final part of the guide considers how we can make good use of data across: quality, safety, contracting and finance.
Our Payment by Results Data Assurance Framework report (July 2013) summarises the findings of reviews undertaken at nine mental health trusts and their commissioners between October 2012 and January 2013.
'Patient and Staff Experience' is the latest report in our 'What Makes a Top Hospital?' series. In discussing themes such as how successful trusts use feedback, measuring staff and patient experience and what good feedback looks like, the report is an invaluable resource for any trust that wants to use feedback to inform service improvement. It also features a number of helpful case studies including York Teaching Hospital NHS Foundation Trust and Macmillan.
This briefing, produced in association with the NHS Confederation, will help non-executive directors (NEDs) better understand NHS data and how it can be used to determine what is going on in their hospital. This fourth briefing looks at how to make good use of data across: quality and safety, including mortality; activity; contracting; and finance. It also includes a short technical guide on ICD-10, OPCS-4 and healthcare resource groups.
This briefing, produced in association with the NHS Confederation, will help non-executive directors (NEDs) better understand NHS data and how it can be used to determine what is going on in their hospital. This third briefing looks at A&E, non-elective admissions, readmissions and diagnostics.
This briefing, produced in association with the NHS Confederation, will help non-executive directors (NEDs) better understand NHS data and how it can be used to determine what is going on in their hospital. This second briefing looks at elective hospital admissions, waiting times and patient experience.
This first in a series of four non-executive directors’ guides to hospital data has just been published in partnership with the NHS Confederation. The guides have been developed to increase the non-executive director’s understanding of NHS data and give them the confidence to ask the right questions about it. All the guides will be available from the NHS Confederation and CHKS websites.
Analysis of the data set which Hospital Standardised Mortality Ratios (HSMRs) are based on
raises questions about its suitability for this purpose. HSMRs rely on an assumption that the
data set is uniform and consistent over time. This analysis shows that it has been both
changing over time and varies between organisations – creating problems for the
interpretation of HSMRs and is therefore a call for improved and consistent coding of hospital
activity.
Our experience has shown that external influence is undoubtedly one of the factors that distinguishes top hospitals in the UK from others in the sector. While its benefits may not be immediate, there are significant paybacks in the longer term for those trusts that invest time and energy in this activity.
The latest reports in the What makes a top hospital? series has found that organisational culture is key to delivering sustainable, high quality and safe care. Acute sector organisations that have invested in developing a vision and ensuring that every employee ‘lives’ this vision every day reap the rewards through improved performance. They are more likely to be amongst the top performing organisations and have historically been either shortlisted or runners up in national awards. The report was launched at the NHS Confederation’s Northern Ireland annual conference.
Mortality measurement is a complex issue and much has been written about the usefulness of mortality ratios.
CHKS has launched the third report in its What makes a top hospital? series - focussing on leadership. Over the last 20 years CHKS has seen many examples of excellence in the delivery of healthcare. The idea behind this series of five reports is simply to share these examples of success in the hope that other organisations can take something from each of them. This latest report looks at the features of leadership that are found in top performing acute organisations.
A mortality ratio is described as the number of observed deaths divided by the number of predicted deaths. The technical definitions for observed deaths and predicted deaths vary from model to model.
We wanted to update you on the latest developments of the new Summary Hospital-level Mortality Indicator (SHMI)1 following an update from the NHS Information Centre (IC) today (23rd September 2011).
The Summary Hospital-level Mortality Index (SHMI) is the new indicator to be used as the national standard for reporting mortality across the NHS in England.R
CHKS has launched the second report in its What makes a top hospital? series. The new report is on safety and highlights examples of acute sector trusts that have made significant improvements in patient safety. The report examines common themes with the aim of sharing the energy and enthusiasm for providing high-quality care that we have found in the NHS. By sharing these case studies we hope that other organisations can take something from each of them.
What is a standardised mortality ratio? A simple count of deaths alone does not take account of the difference in size of hospitals. Un-adjusted mortality is a calculation created by dividing the number of deaths by the number of patients treated in a given hospital, for a given period. It produces a percentage rate of patients who die in that hospital. This is perhaps the simplest way to judge hospital mortality performance.
CHKS, together with its editorial advisory group, has produced the first in a series of What makes a top hospital? reports. Our first report examines quality improvement and change - asking how hospitals can improve quality and ensure change is embedded within an organisation.
