The NHS Reforms on One Side of A4 … including Public Health England

And then I made a version with Public Health England on it…

“Where is Public Health England?” pointed out a keen Twitterer, who was perusing my very pretty “NHS Reforms on one side of A4“, so I had to go back and glue in some more pieces.

Hmmm… I do worry that the trouble with sharing this version with members of the public is that it might be tipping the diagram into Thanks-But-Now-I-Really-Am-Glazing-Over territory (the ‘PCT Clustering’ effect), but I will include it for accuracy:

NHS Reforms with Public Health England

 What to do with this data:


The NHS Reforms on one side of A4

What you can download here:

>> The NHS Reforms on one side of A4
>> The NHS Reforms in Somerset on one side of A4
>> The NHS Reforms document in PowerPoint, so you can make your own local version!

After explaining the NHS Reforms for the millionth time to a member of the public (in biro on the back of an NHS Catering serviette) I set myself the challenge of trying to produce a one-page diagram showing the very basics of the reforms.

Here is my final effort:

The NHS Reforms - on one side of A4

The NHS Reforms - on one side of A4

I decided to make it very simple and stick to the BIG MESSAGES, rather than attempting to capture the detail e.g. of clustering, which seems to make the most enthusiastic member of the public glaze over and start looking for their PPI sandwich rations, but so far this diagram seems to do the job. I think it gets the balance between boring people senseless and over-simplifying, but I’m very open to any suggested amendments.

And then I made a local version…

Well I liked this so much that I made a local version for Somerset, showing exactly what budgets were going where, and what the GP localities looked like in the county. So here is the local picture for Somerset:

The NHS Reforms in Somerset

The NHS Reforms: Somerset version

What to do with this data:


Local HealthWatch Briefing Paper v.1

It’s probably fair to say that I’ve become a bit of a HealthWatch Geek over the last few months. This is largely because I am naturally a bit swotty but also because I like a treasure hunt, and finding out any solid facts about Local HealthWatch feels rather like finding a needle in a big haystack of very boring documents from the Department of Health.

Anyway, to save our lovely local LINk people the trouble of staying up half the night reading through the footnotes in Department of Health Impact Assessments, I’ve put together a Local HealthWatch Briefing paper.

Now it has to be said that this is all my personal interpretation of the available documents, and others may disagree!  If you disagree, please let me know and we can plan a lovely HealthWatch dinner party and spend all night discussing involvement and scrutiny over port and cheese.  (Or I could just amend this document.)  It is also written in a way that hopefully makes it accessible to as many people as possible, so I’ve tried to avoid long words that might add clarification or accuracy, but would also put people off or confuse people. So as such, it may not be as nuanced as it could be!

View the HealthWatch Briefing Paper:

Click to view the HealthWatch Briefing paper

Click to view the HealthWatch Briefing paper

What to do with this document:

Please do have a read and let me know your thoughts. Feel free to distribute it or upload it to your website if you want to. You are very welcome to use any part of this for any purpose that you like – if you want a copy in Word so that you can fiddle about with it, please email me and I’ll be happy to send you a copy.  Enjoy!

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.


NHS Organograms – the old vs. the new

The poor Datagoat has been rather neglected of late, but I have a nice juicy organogram to cheer us all up.  I am working on some other bits and pieces too, but this was too delicious not to share.

The Westminster Blog has published these fabbie organograms showing how the structure of the NHS is changing.  Click on the smaller images in the blog and they will take you to larger, clearer images.

The Westminster Blog

A yummy organogram

What to do with this data

The diagrams speak for themselves which is why I love them so much.  They are very useful for conveying to people some of the enormous complexity of how things are changing.

I have printed them out and stuck them on the wall of the datagoat’s pen so I can admire them during the day, and I recommend that you do the same.*

*They have actually missed out Local HealthWatches, so you will need to draw those on with a crayon.

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. 🙂

Healthwatch: What will it look like?

Healthwatch (or even HealthWatch) – what will it look like?  Unfortunately, we don’t have a very clear answer to that question yet, but we do have some source material from which we can extract some Best Guesses.

Health & Social Care Bill (draft): Here is our primary source: the draft Health & Social Care Bill – all 281 clauses of it. This draft legislation is the coalition government’s vision for health and social care in England and was presented to parliament on 19 January 2011. Various parts mention Healthwatch England and Local Healthwatch, in particular Part 5: Public Involvement & Local Government and Schedule 13: Local Healthwatch Organisations.

Along with the Bill, we have the Explanatory Notes. Explanatory notes have to be published alongside Acts of Parliament, in order to make them more accessible to the average person who is not legally qualified and perhaps is a tad baffled by what the squillions of pages of legalese might actually mean.

More interesting, perhaps, is some of the information that’s tucked away in the Combined Impact Assessments.  (Impact Assessments summarise the thinking that has gone on around a government Bill, for example, and looks at what the consequences will be.) These Impact Assessments contain more information on exactly how the government is defining things such as ‘information and advice’ (which it is aligning to the PCT PALS function).

What to do with this data:
Well you can have a trawl through all of the above if you are brave enough, or you can just have a look through our best guesses, which we’ve put into the following document: What we (sort of) know about Local Healthwatch. It’s a bit of a stab in the dark – so any clarifications (or alternate interpretations) would be very welcome!

Department of Health Live Consultations

Want to find out what the Department of Health is currently consulting on? Go to to Live Consultations webpage.

This webpage links to all the live consultations, which you can then download in their full glory.

What to do with this data:
Signpost people to this web page; make sure they know where they can find live consultations.

Many of the consultations run to 50-60 pages which can be quite daunting if you want to try and share these with members of the public for their views, for example in a group. Don’t feel obliged to answer all the questions – it’s not an exam!  You can select key questions and use these for discussions, if that is more appropriate.  Then just send your response to these selected questions back to the Department of Health.

The webpage for each consultation may have the questions in an alternative format – for example, Easy-Read. If an Easy-Read version isn’t available, drop an email to the Department of Health and ask for one. This can also be useful for getting a quick grasp of what the consultation is about, or for sharing the consultation with groups who are best served by an Easy-Read version.

And don’t forget to keep an eye on the Department of Health Responses to Consultations Page – to see what they did with all your feedback!