The MLCSU Strategy Unit has developed a series of three reports designed to inform commissioner planning for acute services and support acute contract negotiations.
Each report is focused on a specific aspect of commissioner planning — demographics, opportunities, and finances. Together the reports provide a complete picture of a CCG’s activity and costs over a 5-year horizon, for a range of demographic and opportunities scenarios.
The reports are available to all CCGs (or to CSUs on behalf of groups of CCGs). All three reports are underpinned by the most recent activity and cost data sourced from hospital episode statistics (HES) and secondary uses service (SUS) PbR tables provided by the Health and Social Care Information Centre.
What effect will an older population have on demand for health and care services? We explain why typical approaches ‘overlook the fact that rising life expectancy makes… older people “younger”, healthier, and fitter than their peers in earlier cohorts, and how this omission causes the effect of population ageing to be overstated. We outline the three main theories of population ageing and use curve fitting techniques alongside trends in health expectancies to adjust for changes in population health status. Results are reported for three scenarios covering all types of inpatient, outpatient, and A&E activity (including breakdowns by diagnosis and specialty).
We identify and estimate savings for more than 50 potential opportunities to reduce commissioner spend on acute hospital services. The opportunities are based on subsets of activity commonly targeted by commissioner QIPP schemes, including; admissions for acute and chronic ambulatory care sensitive conditions; medicines related admissions; and frequent A&E attenders. Algorithms underpinning the opportunities have been developed over several years drawing on published research, grey literature, and findings from other projects completed by the Strategy Unit. Trends in local CCG performance against each ‘opportunity’ are profiled and compared with statistical neighbours (after controlling for age/sex differences); and savings are estimated for three levels of possible improvement. The report includes extensive guidance on methods, and how to interpret and use the findings.
The final report in the series draws on the methods and findings from the Demographics and Opportunities reports to estimate the scale of financial challenge facing CCGs. Projected CCG income and expenditure, for both acute and non-acute services, are profiled over a 5-year planning horizon. The combined effect of a range of plausible scenarios for demographic change and savings realisation are evaluated enabling financial managers to plan based on circumstances that reflect their local health economy.