Activity Flows West Sussex Fit for the Future Updated activity projections

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Activity Flows West Sussex Fit for the Future
Updated activity projections

• 29th April 2008

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Introduction

• This document details
• The six options currently being considered as
  part of Fit For the Future
• The activity that West Sussex PCT expects to
  commission from each Acute Trust in and around
  West Sussex in 2012-13 for
• Baseline scenario (i.e., no Fit for the Future
  reconfiguration)
• Option A (Model 1)
• Option C (Model 1)
• Option B (Model 2)
• Option 3 (Model 2)
• Option B-variant 1 (Model 3)
• Option 3-variant 1 (Model 3)
• It also updates AE attendances figures
• Please see paper of the 14th February PCT Board
  meeting for further details
• Please see slide at end for notes about the
  activity

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Options being considered as part of FFF
Model 1
Model 2
Model 3
Options

• Option A (MGH at Worthing)
• Option C (MGH at Chichester)

• Option B (MGH at Chichester)
• Option 3 (MGH at Worthing)

• Option B-variant 1 (MGH at Chichester)
• Option 3-variant 1 (MGH at Worthing)

• CCH _at_ RSCH
• 1 MGH
• LGH (definition variant 1) at either Worthing/
  Chichester
• LGH (definition variant 1) _at_ PRH

Service model

• CCH _at_ RSCH
• 1 MGH
• LGH (original definition) at either Worthing/
  Chichester
• CH _at_ PRH

• CCH _at_ RSCH
• 1 MGH
• LGH (original definition) at either Worthing/
  Chichester
• LGH (original definition) _at_ PRH

• LGH performs
• Outpatients, routine electives, diagnostics
• AE, acute medicine, ITU
• LGH does not do
• Emergency surgery, obstetrics, paediatrics
• Complex elective surgery
• IP treatment on children

Service definition at LGH site

• LGH performs
• Outpatients, routine electives, diagnostics
• UCC
• LGH does not do
• Acute medicine, emergency surgery, obstetrics,
  paediatrics
• ITU or AE
• Complex electives
• IP treatment on children

• LGH performs
• Outpatients, routine electives, diagnostics
• UCC
• LGH does not do
• Acute medicine, emergency surgery, obstetrics,
  paediatrics
• ITU or AE
• Complex electives
• IP treatment on children

Note that Option 3 was not included in
consultation because it failed the financial
sustainability hurdle financial information
about Option 3 was published in the supporting
information to consultation
Variants developed since consultation
Options included in consultation
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Projected activity commissioned by West Sussex
PCT in 2012-13Baseline i.e., assuming no FFF
reconfiguration
Births data is projected from 2007 numbers of
births data applies to West Sussex PCT patients
only patient flows are based on travel-times
data from each electoral ward to each hospital,
weighted by the population of each electoral
ward. Source West Sussex PCT (April 2008)
Steer Davies Gleave off-peak travel times model
5
Projected activity commissioned by West Sussex
PCT in 2012-13Option A (Model 1)
Note that West Sussex PCT is commissioner for
about 90 of RWSs activity, so total inpatient
activity transferred from RWS under this option
would be about 27,000 spells
Note that West Sussex PCT is commissioner for
about 60 of PRHs activity (about 75 of its
non-elective activity, about 35 of its inpatient
elective activity), so total inpatient activity
transferred from PRH under this option would be
17,000 spells
i.e., 34,000 spells, or 23 of the inpatient
activity commissioned by West Sussex PCT,
changes site
Births data is projected from 2007 numbers of
births data applies to West Sussex PCT patients
only patient flows are based on travel-times
data from each electoral ward to each hospital,
weighted by the population of each electoral
ward. Source West Sussex PCT (April 2008)
Steer Davies Gleave off-peak travel times model
6
Projected activity commissioned by West Sussex
PCT in 2012-13Option C (Model 1)
Note that West Sussex PCT is commissioner for
about 60 of PRHs activity (about 75 of its
non-elective activity, about 35 of its inpatient
elective activity), so total inpatient activity
transferred from PRH under this option would be
17,000 spells
i.e., 41,000 spells, or 28 of the inpatient
activity commissioned by West Sussex PCT,
changes site
Note that West Sussex PCT is commissioner for
about 95 of WaSHs activity, so total inpatient
activity transferred from WaSH under this option
would be about 33,000 spells
Births data is projected from 2007 numbers of
births data applies to West Sussex PCT patients
only patient flows are based on travel-times
data from each electoral ward to each hospital,
weighted by the population of each electoral
ward. Source West Sussex PCT (April 2008)
Steer Davies Gleave off-peak travel times model
7
Projected activity commissioned by West Sussex
PCT in 2012-13Option B (Model 2)
i.e., 38,000 spells, or 26 of the inpatient
activity commissioned by West Sussex PCT,
changes site
Note that West Sussex PCT is commissioner for
about 60 of PRHs activity (about 75 of its
non-elective activity, about 35 of its inpatient
elective activity), so total inpatient activity
transferred from PRH under this option would be
11,000 spells
Note that West Sussex PCT is commissioner for
about 95 of WaSHs activity, so total inpatient
activity transferred from WaSH under this option
would be about 33,000 spells
Births data is projected from 2007 numbers of
births data applies to West Sussex PCT patients
only patient flows are based on travel-times
data from each electoral ward to each hospital,
weighted by the population of each electoral
ward. Source West Sussex PCT (April 2008)
Steer Davies Gleave off-peak travel times model
8
Projected activity commissioned by West Sussex
PCT in 2012-13Option 3 (Model 2)
Note that West Sussex PCT is commissioner for
about 90 of RWSs activity, so total inpatient
activity transferred from RWS under this option
would be about 27,000 spells
i.e., 31,000 spells, or 21 of the inpatient
activity commissioned by West Sussex PCT,
changes site
Note that West Sussex PCT is commissioner for
about 60 of PRHs activity (about 75 of its
non-elective activity, about 35 of its inpatient
elective activity), so total inpatient activity
transferred from PRH under this option would be
11,000 spells
Births data is projected from 2007 numbers of
births data applies to West Sussex PCT patients
only patient flows are based on travel-times
data from each electoral ward to each hospital,
weighted by the population of each electoral
ward. Source West Sussex PCT (April 2008)
Steer Davies Gleave off-peak travel times model
9
Projected activity commissioned by West Sussex
PCT in 2012-13Option B-variant 1 (Model 3)
i.e., 17,000 spells, or 12 of the inpatient
activity commissioned by West Sussex PCT,
changes site
Note that West Sussex PCT is commissioner for
about 75 of PRHs non-elective activity, so
total inpatient activity transferred from PRH
under this option would be 3,000 spells
Note that West Sussex PCT is commissioner for
about 95 of WaSHs activity, so total inpatient
activity transferred from WaSH under this option
would be about 16,000 spells
Births data is projected from 2007 numbers of
births data applies to West Sussex PCT patients
only patient flows are based on travel-times
data from each electoral ward to each hospital,
weighted by the population of each electoral
ward. Source West Sussex PCT (April 2008)
Steer Davies Gleave off-peak travel times model
10
Projected activity commissioned by West Sussex
PCT in 2012-13Option 3-variant 1 (Model 3)
Note that West Sussex PCT is commissioner for
about 90 of RWSs activity (but only 75 of its
births), so total inpatient activity transferred
from RWS under this option would be about 12,000
spells
i.e., 13,000 spells, or 9 of the inpatient
activity commissioned by West Sussex PCT,
changes site
Note that West Sussex PCT is commissioner for
about 75 of PRHs non-elective activity, so
total inpatient activity transferred from PRH
under this option would be 3,000 spells
Births data is projected from 2007 numbers of
births data applies to West Sussex PCT patients
only patient flows are based on travel-times
data from each electoral ward to each hospital,
weighted by the population of each electoral
ward. Source West Sussex PCT (April 2008)
Steer Davies Gleave off-peak travel times model
11
Baseline AE attendances activity by site for
West Sussex responsible (GP Registered) patients
(2007 - 2008 full year)
The figures have not been projected to 2012-13
although there will be underlying growth. At
BSUH, the figures are not easily split between
commissioners at Royal Sussex County and PRH.
For illustration overall, (for all commissioners)
Royal Sussex County receives around 100,000
attendances per annum and PRH around 30,000.
Page 4 of the document entitled 'Activity flows -
01 October 07' (http//www.southeastcoastfff.nhs.u
k/Home/West-Sussex/Documents.aspx) was prepared
as part of the AE CRAG sub-group and this
provides the best illustrative proportional split
of case mix. Therefore the numbers for West
Sussex PCT only are shown here for
illustration. All sites would be expected to
keep all standard and minor activity in all
options. In Models 1 and 2 all high cost
attendances would move from the LGH site but
under Model 3 the majority of high cost activity
would be retained at the LGH.
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PATIENT FLOWS / ACTIVITY NotesPrincess
Royal Hospital and Royal Sussex County Hospital
(are both part of Brighton and Sussex University
Hospitals NHS Trust) is also shown for
2012/13.Elective inpatients or daycases are not
split between medicine and surgery however all
specialty specific information is available on
request. 1 For inpatient activity, the
activity is shown in spells and is the activity
that West Sussex PCT expects to commission in
2012 -13 (by method of admission and by site) ie
it excludes activity from other PCTs. The
proportion of each sites activity that is
commissioned by West Sussex PCT (for Worthing
and Chichester, more than 90 of activity is
commissioned by West Sussex PCT for Princess
Royal, the proportion commissioned by West Sussex
PCT is much smaller so activity from other PCTs
also needs to be considered).2 For
information WASH has a relatively high other
elective day cases category in the raw data -
WaSHs other elective day cases are all
daycases for medical specialties. Numbers of
spells in 2007-08 General Medicine 3382 
Medical Oncology (i.e., chemotherapy) 2690 
Clinical haematology 1997  Cardiology 979 .
Note that RWS has significant but slightly
smaller numbers in each of General Medicine
(coded to Gastroenterology) Clinical
haematology cardiology but no elective
daycases in Medical Oncology. 3 For
information, RWST codes patients to Other IP
non-electives which is a code that WaSH does not
use in 2007-08 RWS have admitted about 3,000
patients as inpatient non-electives to specialty
AE, without the coding then showing the
patient being passed onto either a medical,
surgical or paediatric specialty in the way that
you might normally expect. In these figures there
have been counted as Other.