How healthy is your local authority area?

Here’s a great article pointing to some interesting health data from the Guardian:  England’s health data: How does your local authority compare?

This was published back in June but I’ve only just read it properly… and it’s fab! The Guardian is very good at messing around with data and transforming it into graphical prettiness… as the walls of our office testify. And they’ve produced this very cute interactive health map from this particular dataset.

About the Health profile data:

The data used for this health comparison tool is from the health profiles published on the Public Health Observatories website:

Every year, the Department of Health and the Public Health Observatories publish a detailed guide to health across each of the regions of England – by a load of indicators. This year, for the first time, they are published by local authority – giving us a level of comparative data we have never had before.

There are loads of great tools on the Public Health Observatories site, including a really good “Build-a-report” tool called Instant Atlas which throws up some interesting statistics with a little bit of fiddling about. It’s easy to use and brings up key facts on a nice red, amber, green sliding scale which makes things really easy to read.  (In fact I have just said “Woah, I didn’t know that!” about five times while writing this and having a play with the Instant Atlas.)

What to do with this data:

  • Have a fiddle with the Instant Atlas and learn some facts about your local authority area. This is really useful for pinning down key public health problems in your local area – and it’s so useful having data for local authority area, because this is of course the LINk boundary area too. Find out the key ‘problem areas’ in your area and use this knowledge when putting your work plan together.



Indices of Deprivation: finding out about your neighbourhood

The Office for National Statistics is the place to go for useful information about the area where you live. It’s super-handy for report writing, if you want to throw in some charming maps and bar-charts to illustrate the demographics of your area, with lots of lovely footnotes showing that you have done your research properly, see?

Find out some basic info about your neighbourhood

How Taunton compares

I recommend starting by looking at the statistics that are available for your neighbourhood, which you can find at  For a nice easy-to-read summary, enter your postcode in the right-hand section (‘Neighbourhood Summary’) and press SEARCH.

This will give you lots of useful figures  – numbers of people living in your area, number of houses – and lots of other information from the Indices of Deprivation.  It shows in a very simple graphical format how your neighbourhood compares with the national picture.

You can browse for more data covering all sorts of areas by clicking on the tabs at the top of the website, which will tell you information about people, health, business, work, education, housing – and all in nice simple diagrams! What’s not to like about that?

What are the Indices fo Deprivation?

Since the 1970s the government has calculated local measures of deprivation in England. This information is used to target resources (it’s v. useful for supporting funding applications). The following comes from the introduction to the report The English Indices of Deprivation 2010:

Deprivation covers a broad range of issues and refers to unmet needs caused by a lack of resources of all kinds, not just financial. The English Indices of Deprivation attempt to measure a broader concept of multiple deprivation, made up of several distinct dimensions, or domains, of deprivation.

The seven ‘domains’ are:

  1. Income deprivation
  2. Employment deprivation
  3. Health deprivation and disability
  4. Education, skills and training deprivation
  5. Barriers to housing and services
  6. Crime
  7. The living environment deprivation

Find out more:

If you want to find out more about the Indices of Deprivation you can view the full reports and excel spreadsheets via:

What to do with this data:

  • Put it in your reports of course! This data is perfect for producing lots of lovely nuggets of information for providing background information for reports.  Very useful for the ‘local background’ section of your LINk Annual Report, too.
  • Print out boundary maps: There is a very useful tool for printing out boundary maps on the ONS site here. If you have a bit of a fiddle you can print off all sorts of useful maps – ward boundaries, PCT boundaries, Local Authority boundaries – all of which is useful for many reasons, not least so you can work out whether you are actually turning up at the right LINk…

NHS Frontline cuts

There’s been a fair bit of news coverage about cuts to staff in NHS organisations.  There is a lot of attention about this because the conservative party pledged not to cut frontline NHS staff during the election campaign. So the first thing to bear in mind is that these figures are hot potatoes that are being tossed about by all sides in the argument. There are hundreds of commentators discussing these figures, for example, this article from media agency ‘eGov monitor’.

NHS savings and cuts
The NHS has to save £20 billion by 2014.  This is to enable the NHS to balance the books, as there is an aging population which requires more health services, and a higher drugs bill because of scientific advances in medicines and treatments. This £20 billion was set out by the Labour government in 2009 and reaffirmed as the plan of action by the coalition government in their spending review.

The programme to drive this savings plan is called ‘QIPP’ – Quality, Innovation, Productivity and Prevention.  Each trust has its own QIPP plans, which detail how it will save money over the next few years.

What are frontline staff? Definitions of ‘clinical’ and ‘non-clinical
When looking at job loss figures, roles are usually divided into clinical and non-clinical staff. Clinical staff may be doctors, nurses, midwives, Health Care Assistants (HCAs), consultants, dentists, pharmacists, and other staff members who are involved in the direct care of patients. These may also be referred to as ‘frontline staff’.

Non-clinical staff includes staff who are receptionists, catering staff, cleaners and janitors, administrators and staff working in a non-clinical job such as Human Resources or various management and administrative roles.  (Not all managers are non-clinical though, of course – many managers, such as Matrons, are clinical staff.)

Frontline First website:
The Royal College of Nursing has been running a Frontline First campaign. The idea of the campaign is to speak out about frontline cuts and propose alternative ideas for saving money while protecting patient safety:

Frontline First will empower nursing staff to speak out against the NHS cuts that are harming patient care, expose where they see waste in the system and champion nurse-led innovations and ideas that are saving money whilst keeping patients safe.

To find out what information they have in your area, click on the interactive map over your area, and then click on ‘read more’.

False Economy website:
Another interesting resource is the ‘False Economy’ website at This ‘anti-cuts’ website is backed by the TUC.

You can click on your area and view the information that they have about your local services.

The False Economy campaign has recently undertaken a piece of research into cuts in health services. This research looked at responses to Freedom of Information requests put to health service trusts and shows over 50,000 job losses. Here’s an article that they’ve put together about their research.

The False Economy NHS data is also published by my favourite source of facts-n-figures, the Guardian Datablog:

This data has also been turned into an interactive map by thedatastudio (and you know how I love interactive maps):

  • Interactive Map of NHS job cuts
    You can click on your area of this map and see what data has been released under the FOI requests. (Bear in mind that if trusts show no job losses, this may be because they have not responded to the FOI requests, not necessarily because they are not losing any positions.)

What you can do with this data:
Have a good look through the websites above and make sure you know what information has been released by your local trusts about job losses.

Frontline, back-end or jiggling about in the middle – whatever the political arguments, a good healthcare organisation will be working with their LINk where changes are occuring that affect services to patients.  So keep your ear to the ground and make sure that where services are reduced or changed, you are confident that proper plans are in place to ensure that patient safety isn’t compromised.

Mapping 18-week Treatment Targets

You remember those nice chaps at Tactix4 who produced the interactive maps showing who was hitting their 4-hour A&E Targets? Well, as they promised, they have been fiddling with even MORE lovely maps, this time showing who is hitting their 18-week targets.

Check out this glorious 18-week Referral to Treatment Target Map.

Filter results by specialty!

Now you would have to have a heart of stone not to love this map. Not only can you see the general results for each Trust, but you can also drill down, using the handy drop-down menu, and see how each Trust is faring by specialty!  Go and have a fiddle RIGHT NOW!

What are these 18-week targets?

Along with the 4-hour target for A&E, the 18-week target is one of the main ways that local health service performance is measured.

The 18-week target meant that patients referred from a GP for further treatment (e.g. to a consultant) had to start that treatment within 18 weeks. This target was brought in because patients would sometimes have to wait a very long time (months or even years!) for treatment to start. An 18-week wait is still quite a long time – but this is the longest wait allowed. Many patients would be seen in a much shorter timeframe.

There is a good Q&A on the 18-week target on the NHS Choices website.

As I’ve mentioned before, these current targets are being replaced from April 2011 with eight new “clinical quality indicators”. These new indicators will include ‘patient experience’, ‘effectiveness of care’ and ‘patient safety’.

Have the 18-week Targets been scrapped then?
No, the 18-week targets have not been scrapped, but this target is no longer being ‘actively performanced managed’ and hospitals are no longer face penalties if these targets are missed.  But waiting times are not really supposed to be increasing. NHS chief Sir David Nicholson wrote in a recent letter to staff:

“Let me be clear that the government has stated its strong support for the rights in the NHS Constitution, which established patients’ right to access services within maximum waiting times or to be offered a range of alternative providers if this is not possible.”

So while this target may no longer be measured, referral for treatment within 18 weeks still remains a right for all patients.

Are waiting times in the NHS Constitution?
Yes! The NHS Constitution became law in January 2010. It brings together in one place details of what staff, patients and the public can expect from the NHS. It sets out the rights of patients and makes clear what patients can expect from the NHS. This includes maximum waiting times.

(You can read a good summary of the NHS Constitution on the NHS Choices website.)

Where is the data on these maps from?
The data comes from the statistics provided by each Acute Trust, which are sent to the Department of Health each month. (See the DH page for this data.) (For more info about the Acute Trusts, see my previous post on the 4-hour A&E Target maps.)

The data on these maps is the ‘admitted’ data – i.e. it shows the wait for patients who were admitted for treatment. Tactix4 explain:

The performance map shows how long people have waited for treatment. The figures used are those relating to patients treated in the last month for which data is available. The figures reflect the specialty selected, and look at patients whose RTT pathways ended in admission for treatment.

Of course, lots of patients won’t need to be admitted, and will just be treated as outpatients.  Tactix4 are hoping to make this data available soon as well!

What to do with this data:
Have a good play with the maps. Find your local trust and see how it is performing against the 18-week target.  Green means that 100% of patients are being seen within the target; amber means that over 95% are seen within the target (95% is the old official ‘target’, so this is okay).  Red means that less than 95% are being seen within the target waiting times.

If you are receiving issues from members of the public about waiting times at a particular hospital, you could check this map for some more definitive data. And if your local Trust is missing its targets, then we need to find out why.

For the future, as I said with the 4-hour target maps, this sort of interactive mapping has huge potential for patient choice – for which Local HealthWatch will be responsible.

A patient might want to know which access to this sort of information in order to decide which A&E department to attend. ‘Do you want to be seen quickly?’ – then chose the hospital which meets waiting time targets. ‘Do you want a hospital with a good reputation?’ – then chose the hospital which has good reports on Patient Opinion… This gives you an idea of how the data might be useful for patients wanting to exercise choice.

So have a good look around these maps – and if you can think of ways that they can be made more user-friendly, or more useful for LINks, let me know and I will pass your ideas back to Tactix4!

Thanks again to Tactix4 for some fantastic mapping. 🙂

Mapping 4-hour A&E Targets

Tactix4 Performance Map

Tactix4 Map

I was recently rummaging around the internet when I came across a very cool map put together by healthcare software developers Tactix4. The map showed how hospitals were faring on their 4-hour Accident & Emergency targets by placing red, amber or green pins on an interactive map. (Acute Trusts release this information once a week.)

I dropped them an email saying that interactive maps are really my absolutely most favourite thing, and asking whether they could make this map a little more useful for LINks by showing a little bit of historical data on the map as well, so that we could compare the last week’s performance against previous weeks.  A lovely man called Dave Green replied and said he would give it a go! Dave is obviously the sort of chap who can’t quite resist fiddling with a good idea until he has cracked it, and two days later he’d produced the maps. And if there’s anything I love more than an interactive map, it’s an interactive healthcare software developer.

Cool Map 1: A&E 4 Hour Waiting Target Performance >>

Click on your local acute trust and see how it performed in the last week against the A&E 4 Hour Waiting Target. You will also see a link to the relevant page on Patient Opinion.

Cool Map 2: A&E 4 Hour Waiting Target Improvement >>

This map shows how your local acute trust’s performance compares to the previous four weeks. Green means it’s improved since last week, amber means it’s stayed the same, and red means that it’s got worse (it still might be within the targets, but it’s declined from the previous week). Hover over your local acute trust with your mouse and you will see the last 4 weeks’ performance, listed with dates.

What are these 4-hour waiting targets?
One of the key performance indicators set by the Department of Health for NHS hospitals over the last ten years has been ‘the 4-hour Target’.  This meant that a target percent of patients (originally 100% but rapidly revised to 98%) attending an A&E department must be seen, treated, admitted or discharged in under four hours.

Last year, the Department of Health announced that the 4 hour A&E target was to be scrapped, along with other targets – and immediately reduced the target from 98% to 95%.

From April 2011 the 4-hour target will be replaced with eight new “clinical quality indicators”. These new indicators will include ‘patient experience’, ‘effectiveness of care’ and ‘patient safety’ (and I am desperately wondering how many doughnuts I would need to send Tactix4 to persuade them to map those for us too…).

What is an Acute Trust exactly?
The figures on these maps are figures from ‘Acute Trusts’. Hospitals are managed by acute trusts. Acute trusts are responsible for hospitals’ services, finances, strategy, development, etc. and employ the staff that work in the hospital.

Most acute trusts will be responsible for just one hospital, and sometimes ‘acute trust’ and ‘hospital’ are used more of less interchangeably. Acute Trusts are also sometimes called ‘Hospital Trusts’. You will probably know what happens in your local area. Bear in mind, though, that some acute trusts are regional or national centres for more specialised care – and others are attached to universities, training healthcare professionals. They can also provide services in the community, for example through health centres, clinics or in people’s homes.

There is an excellent article summarising all the different sorts of trusts in the NHS on the NHS Choices website.

What to do with this data:
Have a look at your local area and compare the performance of your local trust against the 4-hour target. If you are receiving issues from members of the public about a particular hospital, this might be another indicator that things need looking into a bit more.

For the future, this sort of interactive mapping has huge potential for patient choice. For example, if Local Healthwatches have responsibility for giving information that facilitates patient choice, then a patient might want access to this sort of information in order to decide which A&E department to attend. ‘Do you want to be seen quickly?’ – then chose the hospital which meets waiting time targets. ‘Do you want a hospital with a good reputation?’ – then chose the hospital which has good reports on Patient Opinion. Of course, these specific targets won’t exist for much longer, but this gives you an idea of how the data might be useful for patients wanting to exercise choice.

So, while the 4-hour target might be on the way out, these figures are still useful for giving us an idea of current performance, and they’re definitely a great way of showcasing how useful interactive maps can be. Big thanks to Tactix4!