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How we got to grips with our data

NHS North Lincolnshire turned to its PBC consortium to validate the data it was getting from providers – PCT chief executive Allison Cooke and Mark Janvier, PCT associate director of performance, explain

NHS North Lincolnshire turned to its PBC consortium to validate the data it was getting from providers – PCT chief executive Allison Cooke and Mark Janvier, PCT associate director of performance, explain

In North Lincolnshire, some concern about data quality prompted the PCT and PBC group to put our heads together. The PCT did not have the resources in terms of people, and much of the information required to back up acute trust data is locked up in the practice computer systems and not directly available to the PCT.

We knew the PBC teams wanted better information to inform their work and what transpired was an agreement, through PBC, for GPs to get involved in the data validation process. GP practices have the information and clinical knowledge to test the data we have received as commissioners.

The PCT provided all practices with samples of last year's records on outpatients, accident and emergency and inpatients – namely the data given to the PCT as part of the commissioning process.

In all, around 6,000 records were sent out for review.

The practices looked at the data and checked the facts – did the GP make that referral and was the treatment as expected?

The PCT agreed to pay practices 92p per patient on their registered list for completing the data validation exercise. The payment made was also linked to the PBC performance framework that has been in place for the last two financial years which looks at PBC engagement in moving forward on commissioning issues.

The total amount paid to practices was £113,000.

Initial findings

The data validation began in October. We have already been able to identify themes and it's given us a wealth of information to give back to our acute trust to try to improve the process.

Discharge information

It transpired that more than 60% of queries involved a discharge summary apparently not received by the GP. Having now got evidence of this problem, we intend to get it addressed.

Frequent attenders

The exercise has enabled us to identify the people who are using services frequently but inappropriately.

For 80% of the top 10 frequent users of services there was a rationale for their attendance. The challenge now is to look at the other 20%.

The process also flagged up that frequent attenders in hospital are also frequent attenders in primary care.

We are now thinking about what we can do for these patients who keep turning up in primary and secondary care but whose needs are not necessarily healthcare ones.

Reassurance

The project has also provided much reassurance in primary care that hospitals are doing legitimate things for the patients – demystifying perceptions that hospitals are running away with the money.

Finally, the data check has highlighted the variable performance between different providers in terms of the quality of data we receive.

The PCT paid practices 92p per registered patient to do a data validation exercise

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