Presentation by Tony Marson, Professor of Neurology, University of Liverpool and The Walton Centre at ECO 15, Haydock Park Racecourse

1. Using routine data to plan and assess
service performance: Outputs from the
NWC Connected Health Cities Programme
Tony Marson
Professor of Neurology

2. Project Partners

3. Flow of pseudonymised commissioning datasets
Healthcare Data Laboratory NWC CHC Data Ark – (Trusted Research Environment) Pan-NWC DSCRO Data
(inc all APC, A& E and OPD admissions for NWC all providers)

4. Data ark and trusted researcher environment

5. Identifying cohorts and demand
Professor Tony Marson; Clinical Lead NWC CHC 21.06.2017

6. Standard approach: ARLD-Primary
Clinical approach: ARLD-Algorithm
1,667
3,060
= ARLD-Primary x 183%
Cheshire, Lancs. and Merseyside
Emergency Admissions 2016/17

7. Acute Beds

11. Patient pathways
Professor Tony Marson; Clinical Lead NWC CHC 21.06.2017

12. • 9000 attendances
• Wide variability across sites
• <50% first seizures referred to a
seizure clinic
• < 50% of ‘known epilepsy’ under
active follow up
• Inadequate assessments in
emergency departments
National Audit of Seizure Management in Hospitals 2011 & 2013

13. Implement a simple pathway….....

15. 0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
30 60 90 120 150 180 210 240 270 300 330 361
%receivingoutpatientappointment
Days to clinic
Days to Outpatient Appointment
Aintree Known
Aintree not Known
Chester Known
Chester not Known
East Cheshire Known
East Cheshire not Known
Mid Cheshire Known
Mid Cheshire not Known
RLBUHT Known
RLBUHT not Known
Southport Known
Southport not Known
Warrington Known
Warrington not Known
Whiston Known
Whiston not Known
Wirral Known
Wirral not Known
Known
Not known

16. Time to neurology appointment

19. Proportion with appointment within 3 months
With nurse support Without nurse support

21. Conclusions
• NWC CHC Data ark up an running with administrative data
• Algorithms developed to reliably identify cohorts
• Must have clinical credibility
• Service performance can be assessed with 3 month data lag
• Geographical mapping can help focus services
• This work scalable nationally
• Analysis of linked datasets planned and will add considerable
depth