HC Deb 09 July 1984 vol 63 cc410-3W
Mr. Galley

asked the Secretary of State for Social Services if he will list the main performance indicators applicable to the National Health Service; and what are his plans for improving management information systems and performance data.

Mr. Kenneth Clarke

In September 1983 we published the performance indicators which cover a range of functions most health districts might be expected to provide. Copies of the booklets containing values for the indicators are in the Library.

We have appointed a joint NHS/DHSS group to advise on the future development, publication and use of performance indicators. The joint group has set up eight working groups to develop indicators for services to children; the elderly; the mentally handicapped; the mentally ill; support services; acute services; estate management; and manpower. We have asked the joint group to report this autumn with recommendations for performance indicators to be published early in 1985.

On the improvement of management information, I refer my hon. Friend to my hon. Friend's reply to my hon. Friend the Member for Birmingham, Northfield (Mr. King) on 12 April at columns 381–382.

Acute Services

Activity Indicators

  1. 1. Percentage of total admissions classified as immediate.
  2. 2. Gross admission rate per 1,000 population served.
  3. 3. Average length of stay.
  4. 4. Annual throughput per bed.
  5. 5. Turnover interval.
  6. 6. Day cases as a percentage of deaths and discharges and day cases.
  7. 7. New outpatient referral rate per 1,000 population served.
  8. 8. Ratio of return to new outpatients.
  9. 9. Waiting list per 1,000 population served.
  10. 10. Estimated days taken to clear waiting lists at present level of activity. [Indicators 1 to 10 are tabulated for the following specialties by health district: General Medicine; General Surgery; Orthopaedics; Gynaecology.]

Financial Indicators

  1. 11. Actual cost per day and per case by hospital and district (and "expected" costs per case for category A hospitals based on national and local lengths of stay).
  2. 12. Percentage component costs by hospital.
  3. 13. Inpatient catering costs per IP day by hospital.
  4. 14. Domestic and cleaning cost per2 by hospital.

[Indicators 11 to 14 are tabulated by the following categories:

  • Category A—Type 1 hospitals over 100 beds, Type 2 and 3 hospitals over 200 beds.
  • Category B—Type 1, 2 and 3 hospitals under 50 beds.
  • Category C—Other type 1, 2 and 3 hospitals.]

Manpower Indicators

  1. 15. Percentage breakdown of nursing staff by registered: enrolled: learners: auxiliary nursing staff for hospital types 1, 2 and 3.
  2. 16. Acute sector nursing staff: (i) number of day cases and inpatients, (ii) number of day cases and inpatient days for hospital types 1, 2 and 3 MI/MH units to be excluded.
  3. 17. Nursing auxiliaries/assistants: domestic staff in hospital types 1, 2 and 3.

[Indicators 15 to 17 are tabulated by district].

A and E Services

Activity indicators

  1. 18. New A and E patient referral rate per 1,000 population served.
  2. 19. Ratio of return to new A and E patients.

[Indicators 18 and 19 are tabulated by district].

Financial Indicators

  1. 20. Cost per new A and E case by hospital and by district.

[Indicator 20 is tabulated for all hospitals with A and E departments].

Maternity Services

Activity Indicators

  1. 1. Percentage admissions resulting in a birth—still or live.
  2. 2. Gross admission rate per 1,000 population served.
  3. 3. Average length of stay.
  4. 4. Annual throughput per bed.
  5. 5. Turnover interval.
  6. 6. Day cases as percentage of deaths and discharges and day cases.
  7. 7. New outpatient referral rate per 1,000 population served.
  8. 8. Ratio of return to new outpatients.

[Indicators 1 to 8 are tabulated by district].

Financial Indicators

  1. 8. Cost per day and per case by hospital and district.
  2. 9. Percentage component costs by hospital.
  3. 10. Inpatient catering costs per IP day by hospital.
  4. 11. Domestic and cleaning costs per M2 by hospital.

[Indicators to 8 to 11 are tabulated for all single specialty maternity hospitals].

Manpower Indicator

  1. 12. All nursing and midwifery staff in hospital maternity departments plus district midwives: all births in district.

[Indicator 12 is tabulated by district].

Services for the elderly

Financial Indicators

  1. 1. Cost per IP day by district and by hospital.
  2. 2. Percentage component costs by hospital.
  3. 3. Inpatient catering costs per IP day by hospital.
  4. 4. Domestic and cleaning costs per M2 by hospital.

[Indicators 1 to 4 are tabulated for type 4, 5 and 6 hospitals].

Manpower Indicators

  1. 5. Percentage breakdown of nursing staff by registered: enrolled: learners: auxiliary nursing staff for hospital types 4, 5 an 6 by district.
  2. 6. Number of WTE geriatric nursing staff: occupied bed days in hospital types, 4, 5, 6 by district.
    3. 412
  3. 7. Nursing auxiliaries/assistants: domestic staff in types 4, 5 and 6 hospitals by district.

[Indicators 5 to 7 relate only to single specialty hospitals].

Services for the Mentally Ill

Financial Indicators

  1. 1. Cost per IP day by district and by hospital.
  2. 2. Percentage component costs by hospital.
  3. 3. Inpatient catering costs per IP day by hospital.
  4. 4. Domestic and cleaning cost per M2 by hospital.

[Indicators 1 to 4 are tabulated for mental illness (type 12), hospitals].

Manpower Indicators

  1. 5. Percentage breakdown of nursing staff by registered: enrolled: learners: auxiliary nursing staff for type 12 hospitals by district.
  2. 6. Nursing of WTE MI nursing staff: occupied bed days in type 12 hospitals by district.
  3. 7. Nursing auxiliaries/assistants: domestic staff in type 12 hospitals by district.

[Indicators 5 to 7 relate only to single specialty hospitals].

Services for the Mentally Handicapped

Financial Indicators

  1. 1. Cost per IP day by district and by hospital.
  2. 2. Percentage component costs by hospital.
  3. 3. Inpatient catering costs per IP day by hospital.
  4. 4. Domestic and cleaning cost per M2 by hospital.

[Indicators 1 to 4 are tabulated for mental handicap (type 13), hospitals].

Manpower Indicators

  1. 5. Percentage breakdown of nursing staff by registered: enrolled: learners: auxiliary nursing staff for type 13 hospitals.
  2. 6. Number of WTE MH nursing staff: occupied bed days in type 13 hospitals by district.
  3. 7. Nursing auxiliaries/assistants: domestic staff in type 13 hospitals by district.

[Indicators 5 to 7 relate only to single specialty hospitals].

Cross Sectoral Indicators

Ambulance Services

Financial

  1. 1. Cost per 1000 population served.
  2. 2. Average cost per 1000 patients carried.
  3. 3. Cost of management and supervision as percentage of total cost.
  4. 4. Comprehensive staff cost (including overtime) per WTE.

Manpower

  1. 5. Overtime costs as percentage total staff wages and salary costs for ambulance staff.

[Indicators 1 to 5 are tabulated by ambulance service].

Laundry Services

  1. 1. Laundry cost per 100 articles by laundry.

[Indicator 1 is tabulated by laundry service and by district].

Estate Management Indicators

  1. 1. Land owned or occupied (hectares): managed population (1,000).
  2. 2. Building area M2: bed.
  3. 3. Maintenance and operation expenditure 100 M3 per annum and as a five-year moving average 100 M3 per annum.
  4. 4. Energy use GJ/100m3and cost £/GJ.
  5. 5. Disposable land as percentage of all land.
  6. 6. Cost per 100 m3 to bring condition up to condition B.

[Indicators 1 to 6 are tabulated by district].

Whole Discipline Manpower Indicators

  1. 1. Comprehensive staff cost (including overtime) per WTE by major staff groups (A and C, nursing midwifery, professional and technical, works and maintenance, medical and dental, ancillary).
  2. 2. Percentage breakdown of staff (including agency staff) by major staff group (as at 1. above) by WTE.
  3. 3. Overtime costs as percentage total staff wages and salary costs for each of the following staff groups:
    4. 413
    1. i. nurses.
    2. ii. ancillary staff.
  4. 4. Contribution of part-time staff to total WTE for ancillary staff.

Other Manpower Indicators

  1. 5. Medical laboratory scientific officers: number of un-weighted requests.
  2. 6. Diagnostic Radiographers: radiological units.

[Indicators 1 to 6 are tabulated by district].