Explaining opportunities

  • Depending on the category, the opportunities are calculated based on comparison with a group of your peers, all provider trusts nationally, or a specific target for your trust.
  • You should not add opportunities together because some categories overlap and this may result in double-counting.
  • Each trust’s opportunities are unique and you will see a different sub-set of opportunities depending on your data and how you compare.
  • Each opportunity page explains how it has been calculated. We have used different approaches to give you the most appropriate and useful figures for each category. For example, for Estates opportunities we have used a peer group based on trusts that have the same type of estate according to the ERIC data collection.
  • For some opportunities we are using a new peer list, recommended peers, made up of 10 trusts similar to yours according to a number of variables. It is a refinement of the peer selector tool that we have been developing with NHS Digital.
  • Some opportunities have a single value, and some have an upper and lower value. Where there’s an upper and lower value, it shows how you might be able to improve if you compare yourself with other trusts in different ways (for example, comparing with the median of your peers or comparing with the top-performing peers). The values are explained for each type of opportunity.
  • For each opportunity we have expressed the estimated productivity gains in terms of units of clinical activity, numbers of additional staff or cash amounts. These examples are just a different way to illustrate the potential difference in productivity and it is up to trusts to uncover the reasons for variations, work out whether they are warranted or not, and realise any benefits in the way that provides the best outcomes for patients.
  • Some trusts may have been shown an early preview of opportunities but the figures you’ll see will be different, because we’ve updated our methodology including the recommended peers list.
  • Opportunities indicate a potential productivity gain, and we recommend validating the figures with your local data.

System-level Opportunities

  • System-level opportunities identify areas within a system where there is potential to improve productivity, increase capacity or provide better quality services. They are calculated at system/STP level with a breakdown by trust and by specialty or procedure depending on the opportunity.
  • You should not add opportunities together because some categories overlap, and this may result in double-counting. It is also the case that some opportunity breakdowns only represent a subset of the total opportunity figure.
  • A top quartile benchmark has been used for system-level opportunities – this means the opportunity can be achieved if a system was equal to the top quartile performance.
  • The system-level opportunities currently cover length of stay, readmissions, delayed transfers of care (DTOC), British Association of Day Surgery (BADS) procedures, and outpatients.
  • The system-level opportunities currently cover a range of specialities including cardiology, urology, orthopaedics, ophthalmology, cardiothoracic surgery, general surgery, vascular surgery, and neurosurgery.
  • Some of the opportunity pages will have a list of related metrics, which can be viewed alongside the opportunity for additional context.
  • Information on how to interpret the opportunity, how the opportunity has been calculated and data sources are included on the opportunity page.
  • Length of stay and readmission opportunities are the only opportunities with suppression applied. GIRFT metrics are only produced when the total Trust activity for the period of analysis for that metric is 8 or more. GIRFT metrics are usually reported quarterly but based on the preceding 12-month period, and the suppression is for the numerator of the metric.

Non-elective bed days – RightCare

  • Non-elective bed day opportunities are produced by RightCare and show the opportunity figure as a range instead of a single figure.
  • Opportunity breakdowns are by CCG.
  • For each CCG, a potential opportunity value is calculated if they are statistically significantly higher than:
    • the average (mean) of their similar ten CCGs
    • the average (mean) of the five similar CCGs with the lowest rates.
  • Where a CCG rate is statistically significantly higher, then the opportunity value is the reduction in bed days that would be delivered if the CCG reduced its rate to:
    • the average rate of their similar ten CCGs (the lower range opportunity value)
    • the average rate of the lowest five similar CCGs (the upper range opportunity value).
  • The CCG opportunities are summed to create the STP values.
  • You should not add opportunities together because some categories overlap, and this may result in double-counting. It is also the case that some opportunity breakdowns only represent a subset of the total opportunity figure.
  • Information on how to interpret the opportunity, how the opportunity has been calculated and data sources are included on the opportunity page.
  • For some opportunities, due to variation in coding of Same Day Emergency Care, unit activity with a length of stay of 0 days are excluded from the overall bed day opportunity. Please see ‘How this opportunity was identified and calculated’ section at the bottom of the opportunity page for further details.

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