Planned care is a material element of secondary care expenditure, accounting for over 30% of providers’ total annual expenditure when outpatient spend is included. Elective care represents 34% of activity in acute specialist trusts, 23% in acute teaching trusts and 21% in district general hospitals.
Media commentary has tended to focus an increasing demand for emergency care putting pressure on A&E departments and the four hour wait target. However, planned care has also seen a significant increase in demand in recent years. Between 2008/09 and 2015/16, GP referrals increased by 25%, other referrals by 36%, and first outpatient attendance, by 32%. Total elective admissions have risen by 24%.
Planned Care for Commissioners was a new project in 2016/17 work programme, aiming to provide a strategic overview of the investment in the healthcare system on planned care, and develop benchmarking analytics to fill the gap in the data already available to commissioners.
The project takes a holistic view of elective care commissioning and covers; access, outpatient activity, DNA rates, elective admissions, waiting times and attendance rates. The project also links with the provider project on Theatres completed by acute trusts.
The 2016 project covered 51 commissioning organisations across NHS England and Wales. A desktop toolkit and national report is available to members via the Network website members’ area: http://members.nhsbenchmarking.nhs.uk/home and bespoke reports have been made available to project participants.
Findings from the Planned Care 2016 project include:
- There has been a 9% increase in first outpatient attendances in the last 12 months
- There has been a 7% increase in general and acute admissions in the last 12 months
- 86% of commissioners have referral protocols or clinical guidelines in place that aim to improve the quality of referrals
- 68% of commissioners have a policy to manage Consultant to Consultant referrals
- Activity data shows variation across CCGs
The Network Steering Group has agreed to include the Planned Care benchmarking project in the Network’s 2017 work programme (collecting 2016/17 data).
For more information on this work please contact:
Jessica Grantham, Project Manager