the diagnosis challenge

7/31/2019 The diagnosis challenge

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The diagnosis challenge

Kate Schneider

Programme Lead, Dementia, Mental Health, Autism

NHS South of England (West)

Kate Mitchell

Joint Dementia Programme Manager

NHS Cornwall & Isles of Scilly


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Knowing the scale of the challenge data for

GPs, CCGs, Local Area Teams, LAs

Dementia Prevalence Calculator:

1. true prevalence within GP registered patient

populations2. adjusted and validated for patients in care homes

3. more reliable diagnosis rates, and QOF figures

4. setting local trajectories for improvement

5. modelling pathways (demand v. supply; costs)

6. GP, CCG, Local Area Team, and Local Authority levels


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Data sourcesGP Practice Lists

PHO database

(unadjusted practice listsAge/Gender)

Care/Nursing Homes

CQC database

(Homes Specialty Beds)

Postcode / Wards

Ordinance Survey database(English Postcodes &Electoral wards)

Prevalence Rates

Dementia UK (2007)

National DementiaPrevalence Rates (NDPR)

Residential CarePrevalence Rates

Dementia Severity

CCG allocation

Prescribing database /PHOdatabase

Dementia Registers

QOF (2011) data

List Indicators

PHO Database / QOF 2011(IMD,IDAOP,CHD,Stroke,

Hypertension)

Dementia

Calculator

Care Home ResidentsAge Profile - BUPA

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General Practice profile: prevalence; diagnosis

A Practice List 6,175 6,175

B Per cent of list at 65+ years 20% 20%

Estimated dementia cases Using Using

NDPR Adj NDPR

& NDP{RC}R

Living in the community 61

Living in Residential Care 16

Total 88 77

C Estimated cases as proportion of list 1.4% 1.2%

Practice dementia register 38 38

D Dementia register as proportion of list 0.6% 0.6%

E Diagnosis Rate 43.2% 49.4%

Diagnosis Gap 50 39

Proportion undiagnosed 56.8% 50.6%

Estimated Severity of potential cases

Mild 42

Moderate 25

Severe 10

77

ASHBURTON SURGERY

Summary of Results

0

5

10

15

20

25

55-

59

60-

64

65-

69

70-

74

75-

79

80-

84

85-

89

90-

95

95+

Numberofcases

Est. cases by age group

Using NDPR

Using - Adj NDPR+ NDP{RC}R

88

77

38

-

20

40

60

80

100

1

Numberofcase

s

Comparison of total estimated cases with

dementia register

NDPR

Adj NDPR+ NDP{RC}R

Dementia Register

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Setting local trajectories for improvement

Proposed increase in Diagnosis Rate 2%

2011 2012 2013 2014 2015

Projected cases - (From the forecast page) 77 79 81 83 84

Proposed diagnosis rate 49.4% 51.4% 53.4% 55.4% 57.4%

Resulting dementia register 38 41 43 46 48

Target diagnosis rate for 2015 70%

Annual percentage point increase required to meet target 5.2%

Target rates 49.4% 54.5% 59.7% 64.8% 70.0%

Dementia Register (Target) 38 43 48 54 59

Please enter your proposed annual

percentage point increase in diagnosis rate

(See Note)

ASHBURTON SURGERY

Reviewing the impact of changes in your practices' diagnosis rate

38 39 40 41 42

2 35 62

58

1139

3633

2925

2011 2012 2013 2014 2015

Proposed scale of Dementia Register

vs Target & Current

At current rate Proposed Increase in diagnosis rate

Gap to target Undiagnosed

Changes in diagnosis rate

To see the impact of changes in your diagnosis rate enter your proposed annual percentage point change in your practice's diagnosis rate i.e. if your current rate is25% and you would like it to increase to 27% next year enter 2%. The model will calculate the impact this change will have on your practice's dementia register giventhe forecasted change in your practice list.

The model also shows the annual percentage point change required to reach a target diagnosis rate of X% by 2015 and the chart will display the gap to this targetshould there be one.

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Moving from

knowing the scaleof the

challenge, to

planningwhat to do about it, to

actingto achieve improvement


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10 Key Steps- CCGs

1. Understand

and plan forneeds

2. Improve access

3. Build capacity

and support

4. Driveimprovement

5. Ensure

transparency


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10 Key Steps- GPs

6. Educate;

promote

7. Recognise;screen; assess;refer

8. Find cases

9. Diagnose; code

10. Review


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Resource Packbrings together thedimensions of the challenge


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Calculator & Resource Pack expected publicationthis Autumn, following NHS Mandate & Outcomes Framework

GP Practice Lists

PHO database(unadjusted practice lists

Age/Gender)

Care/Nursing Homes

CQC database(Homes Specialty Beds)

Postcode / Wards

Ordinance Survey database(English Postcodes &Electoral wards)

Prevalence Rates

Dementia UK (2007)

National DementiaPrevalence Rates (NDPR)

Residential CarePrevalence Rates

Dementia Severity

CCG allocation

Prescribing database /PHOdatabase

Dementia Registers

QOF (2011) data

List Indicators

PHO Database / QOF 2011(IMD,IDAOP,CHD,Stroke,

Hypertension)

DementiaCalculator

Care Home ResidentsAge Profile - BUPA


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www.dementiapartnerships.org.ukknowledge portal

[email protected]
http://www.dementiapartnerships.org.uk/http://www.dementiapartnerships.org.uk/

the diagnosis challenge

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