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Methods StethoscopeTM is an easy to use online tool that transforms a wide range of healthcare information into transparent, benchmarked, comparative, actionable intelligence – so that decision makers can understand variation and see opportunities to improve patient outcomes. StethoscopeTM is an evolved version of the NHS East Midlands Quality Observatory’s Acute Trust Quality Dashboard (ATQD) and provides, free to the public, a quarterly summary of over 80 clinical quality and performance metrics for every non-specialist hospital and CCG in England. The information contained in Stethoscope has been used for Trust board packs to enable conversations among board members about the Trust’s differences to the national cohort but to also shed new light on data that leads to action being taken. It has also been used as input by the NHS National Trust Development Authority in its review of applicant Foundation Trusts, NHS London for its Clinical Commissioning Group Assurance Framework and content was used as part of the Keogh Mortality review process. More timely and granular information for hospital executives, non-executives directors, performance managers and clinical directors is subscription based, with alerts, bespoke user generated dashboards and drill down capability.
We use Stethoscope to help identify some of the key issues affecting the CCG but then to also drill into the detail so that we can focus our analysis at the areas where we are likely to have the most influence and impact. The comparative and statistical analysis then gives us the confidence to raise and constructively challenge what the variation means.
David Hodson Head of Information at East and North Hertfordshire CCG

Consultancy

We may need to undertake a consultancy project to answer your question, such as an investigation into raised hospital mortality or capacity failure. We also undertake consultancy for organisation and whole system capacity modelling using a number of modelling tools we have built for acute providers and health economies to inform bed base reconfiguration. Our consultancy projects typically focus on the following areas:
  • Mortality Investigations
  • Urgent Care Investigations
  • Capacity Modelling
  • Travel time analysis
  • Bespoke analysis

MORTALITY INVESTIGATIONS

We undertake reviews of NHS Trusts with high apparent mortality rates, where either Summary Hospital-level Mortality Indicator (SHMI) or Hospital Standardised Mortality Ratio (HSMR) is significantly higher than peer or National averages. This might mean more people are dying while admitted to these hospitals than most others in the country. We have been approached by organisations ranging from a small NHS hospital, a health oversight and scrutiny committee for a Local Authority to an NHS England Local Area Team investigating a Trust in their area. These organisations are often under significant media and political pressure to investigate the causes of their apparent high mortality rate and require independent investigation to provide expert guidance on what is really going on. In response we use a multi-faceted approach of in-depth data analysis, qualitative interviews and process review to develop a wide ranging response. This helps us diagnose the problem and then inform a range of changes, both within the hospital and more widely within the community, to improve the health of the population the hospital serves, as well as the in-patient mortality rate in the hospital. This approach, as well as the reviews themselves, informed the NHS Keogh Mortality reviews in 2013 at some NHS Trusts.

CASE STUDY: WALSALL COUNCIL – INDEPENDENT REVIEW OF MORTALITY RATES AT THE MANOR HOSPITAL

The council required an independent review of the Walsall Healthcare NHS Trust as they had been identified as having a higher HSMR than other Trusts in the area. The review built upon existing work and reviews within the Trust, and provided independent verification and assessment to the Council. This involved investigating underlying data used in the calculation of HSMR, looking at the health profile of the population as well as community end-of-life and primary care provision, and the quality of the delivery of care within the Trust itself. As a result of the review it was discovered that the factors relating to the provision of palliative care, including the number of locally available hospices and coding practices in the Trust, had contributed to heightened HSMR. Coupled with a comprehensive review of initiatives put in place by the Trust to address specific specialities with higher HSMR, this provided assurance to the Council and other stakeholders involved in the local health economy that the Trust was in fact providing safe care and that the apparent alarm caused by HSMR was, in this case, an artefact of how the metric is calculated.

URGENT CARE INVESTIGATIONS

Methods Analytics have undertaken a number of reviews of Hospitals and Local Health Economies, focused on the Urgent and Emergency Care pathway. Reviews are usually based on Non-elective health services, often under pressure and where reports of increases in emergency admissions and A&E attendances are common. The reviews involve looking at the entire Urgent Care pathway in the local health economy, from Primary Care referral to secondary care, to population demand and activity in Secondary Care, through to modelling future usage and proposing service changes. Reviews are commissioned by the organisation themselves or oversight bodies such as Local Authorities or NHS England Local Area Teams. In undertaking these reviews we work closely with all relevant organisations in the geography, understand the concerns and issues and then deploy a range of approaches to investigate. Our strength is that we combine a data led approach, using both local and national data sources, clinical pathway review and analysis together with a bringing a range of clinician and NHS management experience to understand the population and multi-organisation processes and behaviours that combine to create a problem.

CASE STUDY: NHS CAMBRIDGE AND ELY SYSTEM AND RESILIENCE – REVIEW OF SYSTEM DEMAND FOR EMERGENCY AND URGENT HEALTH SERVICES

Non-elective health services in Cambridge and Ely were under significant and accelerating pressure particularly since the start of 2014, with an apparent rise in the number of emergency admissions. An independent review as requested to analyse the factors underlying the current situation through a systematic evaluation of the drivers of demand, important service features, and system responses to these pressures. The overall goal of the review was to identify where changes to services and care pathways might allow demand to be more effectively met, thereby enabling the local health economy to offer appropriate, effective and rapid care whenever and wherever it is needed. The review involved looking at population demand and activity, modelling future usage, proposing service changes, interviewing clinicians, and on the ground process analysis. The review brought together an experienced team of clinicians, specialist health analysts and data modellers to conduct the review and deliver strategic recommendations.

CASE STUDY: SOUTHERN DERBYSHIRE CCG – EVALUATION OF WINTER FUNDING 2013/14 INITIATIVES

Southern Derbyshire CCG sought an evaluation of 12 initiatives on the Urgent Care Pathway in the region to understand how each initiative supported the 2013/14 winter plan, particularly in terms of reduced pressure compared to winter 2012/13. The review entailed conducting a desktop review of existing internal workstream evaluations, interviewing clinician and commissioning leads responsible for each initiative, attending monthly Urgent Care boards with executive representation across Southern Derbyshire health community, analysing HES and other data sources to evidence impact of each initiative in reducing pressure, and writing two reports delivered to the board with independent assessment and recommendations on which initiatives were the most beneficial. This was used to prioritise allocation of future spend over the winter period.

Travel Time Analysis

We work with clients to shape the requirement for travel time analysis which is used to compare the ability of the organisation to serve the surrounding area both in terms driving of their geographic area and the population they serve. The analysis is often performed using peak and off-peak driving conditions to understand the effect that the time of day has on the travel times

CASE STUDY: NHS SPECIALISED VASCULAR SERVICES RECONFIGURATION

As a joint project with Mercator GeoSystems we undertook the driving-time analysis element and the production of the mapping outputs to be used in the final report, based on data we had gained from NHS Hospital Episode Statistics and their technical definition of relevant activity. The first step of the analysis was to create a catchment area around the two sites based on the target population and competing service providers adjacent to the area. To compare the two sites we then calculated the driving time to each location from their respective catchments in 10 minute increments and aggregated up the target population in each of these 10 minute bands. Each band’s population could then be expressed as a percentage of the total catchment population allowing a comparison of the two sites to be undertaken. The next step was to perform a similar analysis but based on the surrounding geographical area. Instead of comparing population we were now looking at square miles around each of the sites in order to understand the relative drive time to cover increasing percentages of the surrounding area.

CASE STUDY – NHS ENGLAND: EAST OF ENGLAND SPECIALISED FERTILITY SERVICES PROCUREMENT

NHS England undertook a procurement for specialised fertility service for the East of England. As part of the scoring process to assess bidders fairly they commissioned Methods Analytics to undertake a travel time analysis of the bidders proposed locations for services. Methods Analytics created peak and off-peak travel time maps, demonstrating the proportion of the relevant population sub-groups that would be able to access the bidders proposed sites within time bands set by NHS England.

Capacity Modelling

We have worked with a number of acute provider Trusts and health economies undertaking formal capacity modelling to help them understand bed base requirements and the impact of proposed changes to patient flows and organisational behaviours.

CASE STUDY: PAHT – URGENT CARE CAPACITY MODELLING

The West Essex health economy, comprising the Princess Alexandra Hospital Trust, West Essex CCG, East and North Hertfordshire CCG as well as community, mental health and social service providers commissioned Methods Analytics to undertake a two phase capacity modelling exercise to provide an understanding of the capacity required across the economy to deliver the quality of care commitment to their patients and achieve the Emergency care four hour standard. We initially undertook a very rapid arithmetic modelling exercise for the acute site only to meet local urgent priorities and then developed an economy wide, very granular simulation that enabled them to understand and assess scenarios at a specialty, site and service level.

Bespoke Analysis

The Methods Analytics team comprises of a highly qualified and experienced group of information and analytics specialists who are able to provide analysis of the quality of services, make comparisons, assesses change over time and provide credible insight on the local context. Our analysts are skilled SQL developers who regularly build dashboards and bespoke business intelligence solutions using an array of tools depending on best fit for the customer requirements. We are vendor neutral and do not promote a specific toolset or solution from any one supplier. We have extensive knowledge of the datasets frequently used in the public sector. We use a wide range of information sources and tools to ensure that our information is robust and evidence based, and we work closely with stakeholders and the public to understand the type of intelligence they need from us.

CASE STUDY: GREATER EAST MIDLANDS CLINICAL SENATE AND NETWORKS – UPPER GASTRO INTESTINAL CANCER PATHWAY REDESIGN

We have worked with the NHS East Midlands Clinical Senate and Cancer Network utilising the STAR process to inform a region wide review and redesign of the Upper Gastro-intestinal Cancer Pathway. We have supported the local project manager and regional clinical leads across this large region to deploy this powerful but complex methodology to effectively inform a pathway redesign to improve the issues identified with variation in both processes and outcomes of care dependant on where the patient lives and where they are treated. We worked through a number of stages, educating a large stakeholder group of clinician, patients and carers and managers on the process and why it was being used. Developing internal value criteria for assessing pathway changes. Creating an information pack to inform pathway development including sourcing a wide range of possible changes based on our assessment of the pathways in place and the data informing activity and outcomes delivered across the region. We then facilitated workshops where potential changes were introduced, examined and scored by the stakeholder group using the rigorous social-technical methodology. The weighted benefits of interventions from these workshops was then combined with health-economic cost appraisals using local PLICS data to develop value triangles, that were easily assessable by non-technical stakeholders. This enabled us to hand ownership of changes to the wide stakeholder group, with a deep understanding of the impact pathway changes would have on value, as they defined it, enabling development of a new, consensual, high value care pathway for the region.

CASE STUDY: NORTH EAST QUALITY OBSERVATORY SYSTEM (NEQOS) – BESPOKE ANALYSIS

Members of the team have conducted several bespoke projects for the North East Quality Observatory System (NEQOS), including the development and definition of Commissioning for Quality & Innovation (CQUIN) indicators to be used in Acute and Community contracts within the North East, developing PROMs reports in the region and other specific pieces of analysis. The CQUIN project repeated over several years and involved researching existing and newly developed data sources, calculating baselines, liaising with lead commissioners and clinical innovation team leads through a series of workshops with the purpose of finalising the indicators for inclusion in their NHS standard operating contracts.

CASE STUDY: DEPARTMENT OF HEALTH – SUPPORTING NEW MODELS OF CARE

Methods assisted the Department of Health in supporting the implementation of new care models of primary care. Through select pilot sites, the evaluation assisted each pilot site setup the evaluation criteria including formulating desired objectives, benefits and outcomes and articulating these in the Full Business Case. The project also involved agreeing how success of each piloted new model of care would be measured, and how evidence would be collected to inform the evaluation, including establishing the baseline for the pilot patient population.

Proud of our products

We provide a number of products for the NHS and bespoke products for the healthcare marketwhich enable benchmarking and comparative, actionable intelligence. Some of these tools are free to the public which you can try out today and some are subscription based. In our bespoke work we start with finding out what question the client needs to answer. This initial engagement shapes the analysis, which may require a project to create a bespoke intelligence product which may be online or a produced as a report pack.

Royal College of Surgeons – Procedures Explorer Tool and Quality Dashboards

Methods Analytics worked with the Royal College of Surgeons and Surgical Specialist Associations to create two tools to support their work on elective surgery commissioning guides. Both are derived from Hospital Episode Statistic (HES). They were developed through a collaborative project between the Royal College of Surgeons, Surgical Specialty Associations, NHS England and Right Care. The aim of the data tools is to allow providers and CCGs to investigate and discuss, local interpretation of information on variation.
The dashboards and PET are a fantastic piece of collaborative work and I’m enormously grateful (and impressed) by the team you have created.
Mr Nigel Beasley, Clinical Lead Department of Health Rightcare Programme and Co-Chair East Midlands Clinical Networks and Senate

Quality Dashboards

The dashboards shows indicators for activity commissioned by CCGs across the relevant surgical pathways and provide an indication of the quality of care provided to patients.

Procedures Explorer Tool

The tool shows further detailed information on performance measures for individual procedures and was developed in Qlikview.

CASE STUDY: ALS/AUGIS – SURGICAL OUTCOME AND AUDIT TOOL

The Association of Laparoscopic Surgeons (ALS) and the Association of Upper Gastrointestinal Surgeons (AUGIS) wanted to create a procedures explorer tool covering indicators across the clinical pathways: Gallstones, Reflux, Hernia, Appendicectomy, Splenectomy and Bariatric for their 700+ members. The procedure explorer tool offers cuts of data at provider Trust and site level and users (members of ALS / AUGIS) are able to navigate through to pseudonymised consultant level via their websites with log in capability. There is also a consultant view which allows individual consultant data to accessed and used for re-validation and activity monitoring. The tool has been developed in Qlikview with several indicators such as Activity Volumes, Standardised admission rates, Readmission rates, Re-operation rates, Daycase Rates, Short Stay rates shared across all pathways with bespoke indicators that have been created for specific areas of interest.  

CASE STUDY: CARITAS CARE

Methods Analytics got involved in working with Caritas Care, a voluntary charity who are based in Preston, after being put forward by Advisory as being able to help creating a ‘Balanced Score Card’. We spent a day with the senior management team going through the types of data and indicators that they might want to collect to start to monitor the progress and success of their strategy. The organisation offered a wide variety of services including Adoption and Foster Care which required a complex set of metrics to monitor effectively. Caritas Care understood the importance of engaging with staff at all levels in the rollout of their strategy and to support the development of the balanced scorecard, and this lead to the creation of a set of nearly 300 indicators covering all services in the domains of the Customer Perspective, Internal Processes, Learning and Growth and Finance. Methods Analytics then developed a model to support the capture of the data, and to provide visualisations of the success of the strategy in several views using easy to understand Red, Amber, Green ratings. Once data is complete for each of the indicators, the model automatically evaluates the performance of each service and domain. This empowers staff at all levels to make decisions based on real data and to focus on the areas that need the most improvement. The project even led to the appointment of an analyst into the Caritas Care team to support the data collection and requirements to run the BSC model.
Working with Methods to help us to develop a Balanced Scorecard has been a great experience. They have been so helpful in listening to what we wanted to develop at our charity, and the Methods Analytics team has then skillfully taken our ideas and turned them into a reality. We are delighted with the results, and now have a bespoke database which will assist us in the performance management of our whole charity.
Amanda Forshaw, Chief Executive
Examples of the balanced scorecard are below*
* Data represented here is fully synthesised and does not represent Caritas Care’s current state of performance.
Methods Analytics built and maintains the online Navigator tool for GP Access, a service which helps GP practices track important metrics pertaining to patient appointments and bookings. This enables GPs to improve outcomes and access to their services. GP Access won the 34th John Perry award for implementation of novel computing systems in general practice. GP Access is transforming primary care across the UK. Invented by GPs, it now serves over 500 000 people. Their research and case studies show: • Improved continuity of care • Increased patient satisfaction • Saving time and money for GPs • A reduction in A&E attendances • Success across diverse practices – ranging in size, demographics and deprivation Methods Analytics have worked with the GP Access team to deliver a tool to explore the improved outcomes which are made possible by following the GP Access principles.
Methods Analytics quickly understood the brief and worked with it flexibly, this meant interaction, problem solving and generating new creative ideas through the early stages. Methods Analytics helped us to quickly deliver a service which works. The team have been great to work with being responsive to our customers issues, and our customers are starting to rely on Methods Analytics work as much as we are.
Harry Longman is Chief Executive for GP Access

Managed Services

Methods Analytics provides analysis and reporting capabilities for ongoing quality surveillance as a managed service for several clients. This includes providing reports refreshed at set intervals, through either an online interactive access controlled portal showing web based dashboards, or through refreshing static reports and dashboards in Microsoft Word or Excel. The service begins with defining the requirements of the reports, establishing the indicator definitions and data sources, working with all stakeholders to gain consensus on the measurement approach, and moves through to designing the visualisations, adding interpretative narrative and finally implementing, and in many cases hosting, the reporting platform. Managed services can also include the provision of skilled resources to work within your organisation to design, build and implement business intelligence tools and reporting platforms internally.

CASE STUDY: NHS ENGLAND SPECIALISED COMMISSIONING QUALITY DASHBOARD PROGRAMME

Methods Analytics have been working with NHS England since May 2013 managing the delivery of the Specialised Service Quality Dashboard Programme. We work with 40 of the National Specialised Service Clinical Reference Groups to develop clinically meaningful measures and then undertake the data collection and reporting services for specialised services in the NHS. We undertake quarterly data collection, providing over 1000 Specialised Service unit dashboards to the provider units, National Clinical Reference Groups and commissioners each quarter. This project has allowed the NHS to monitor the quality of specialised service provision where before no equivalent data existed.

CASE STUDY: SKILLS FUNDING AGENCY

Methods Analytics runs a managed service for the provision of Management Intelligence and Business Intelligence specialist resources for the Skills Funding Agency. This involves a team of between 4 and 10 on site SQL developers who produce MI/BI reports using Microsoft SSRS, SSAS and SQL. Scoping of work packages occurs using an agile approach with rapid turnaround of deliverables over several iterations.

Business Intelligence and Data Warehouse Development as a Service

Methods Analytics provides Business Intelligence and Data Warehouse development as a service for several clients in the UK public sector, including Healthcare, Education and Police. This includes conducting large scale data migrations, Data Warehouse and ETL development, reporting and visualisation solutions including data acquisition, managed refresh and alerting, and integration and consolidation of legacy data sources. A significant part of this service involves working alongside client resources in a collaborative mentorship role so that knowledge transfer occurs seamlessly and in an ongoing fashion. These engagements predominantly involve working on client site with the Microsoft BI stack (SQL Server SSIS, SSAS, SSRS), but also Tableau and Qlikview, and increasingly involve building this capability in the cloud (Azure, Power BI, or bespoke web development using Ruby on Rails, .NET, HTML5, Java and AngularJS) depending on client requirements. Scoping of work packages typically occurs using an agile development approach with rapid turnaround of deliverables over several iterations.

CASE STUDY: UK REGIONAL POLICE FORCE DATA MIGRATION

A UK Police force committed to implementing the Athena integrated information management system (a system designed to be used by multiple police forces within the UK). Before doing so they were dependent on migrating required data from their existing legacy local integrated information management system. This data migration, or Back Record Conversion (BRC), covered all of their required operational records (Including investigation, Intelligence, Custody and Case Preparation), consisting of 20 years of information which needed to be migrated into Athena as a prerequisite for go live. The accepted solution design involved us building a staging data warehouse, using Microsoft SQL Server 2014 and SSIS as the ETL tool to extract and transform data from the source system, and creating multiple XML output files for input into the vendor provided Athena Test Harness. The development of each XML output file followed an Agile development process using bi-weekly sprints and daily scrum meetings. JIRA was used for sprint planning, product backlog, progress tracking and issue management.

MS gold tableau-desktop-certified_0 We are accredited Microsoft Gold Partners for Data Analytics and Data Platform, which are competencies relating to the Microsoft Business Intelligence stack. Our permanent team also consists of certified Tableau developers who can be deployed on client site or work remotely as required. We employ a unique mixed delivery model which is based on using our permanent staff and carefully selected Associates. This model provides a number of benefits including flexible access to a large pool of resources to enable us to easily scale our service up or down; a broad range of skills and experience to meet all project requirements; and ready access to locally based resources, which expands our access to specific technical accredited resources considerably.