The Angus HSCP set out its vision for change and improvement in its Strategic Commissioning Plan 2019-22. The purpose of performance reporting is to show progress against priorities set out in that plan and to provide assurance over our arrangements for clinical, care and professional governance, how we manage our finances, and how we develop our workforce.
Relationship to National Outcomes
The Scottish Government set out nine National Outcomes to be progressed through the integration of Health and Social Care. They also set out a set of National Core Indicators aimed at showing progress on integration and by which Health and Social Care Partnerships could benchmark their performance across Scotland.
There is a clear relationship between the Angus Strategic Priorities, the National Outcomes and the National Core Indicators.
| Angus Strategic Priorities and Performance Areas | National Wellbeing outcomes | National Core perfomance measures |
|---|---|---|
| Priority 1 | 1. Healthier Living. People are able to look after and improve their own health and wellbeing and live in good health for longer. | NI-11 Premature mortality rate. |
| Improving health, wellbeing and independence | 5. Reduce Health Inequality. Health and social care services contribute to reducing health inequalities. | NI-16 Falls rate per 1,000 population in over 65s. |
| 6. Carers are Supported. People who provide unpaid care are supported to look after their own health and wellbeing. This includes reducing any negative impact of their caring role on their own health and wellbeing. | NI-1 Percentage of adults able to look after their health very well or quite well. | |
| NI-8 Percentage of carers who feel supported to continue in their caring role. | ||
| Priority 2 | 2. Independent Living. People, including those with disabilities, long term conditions, or who are frail, are able to live as far as reasonably practicable, independently at home or in a homely setting in their community. | NI-18 Percentage of adults with intensive needs receiving care at home. |
| Supporting Care needs at Home | 3. Positive Experiences and Outcomes. People who use health and social care services have positive experiences of those services and have their dignity respected. | NI-15 Proportion of last 6 months of life spent at home or in community setting. |
| Priority 3 | 4. Quality of Life. Health and social care services are centred on helping to maintain or improve the quality of life of service users. Everyone should receive the same quality of service no matter where they live. | NI-6 Percentage of people with positive experience of care at their G.P. practice. |
| Developing integrated and enhanced primary care and community responses | NI-12 Rate of emergency admissions for adults. | |
| NI-13 Rate of emergency bed days for adults. | ||
| NI-14 Readmissions to hospital within 28 days of discharge. | ||
| NI-21 Percentage of people admitted from home to hospital during the year, who are discharged to a care home (data not available) | ||
| NI-22 Percentage of people who are discharged from hospital within 72 hours of being ready. (data not available) | ||
| Priority 4 | NI-19 Number of days people spend in hospital when they are ready to be discharged. | |
| Improving Integrated care pathways for priorities in care | ||
| Performance Area 1 | 8. Engaged Workforce. People who work in health and social care services are supported to continuously improve the information, support, care and treatment they provide and feel engaged with the work they do. | NI-10 Percentage of staff who say they would recommend their workplace as a good place to work. (data not available) |
| Managing our workforce | ||
| Performance Area 2 | 7. People are Safe. People who use health and social care services are safe from harm. | NI-17 Proportion of care services graded ‘good’ (4) or better in Care Inspectorate Inspections. |
| Clinical and Care Governance | NI-2 Percentage of adults supported at home who agree that they are supported to live as independently as possible. | |
| NI-3 Percentage of adults supported at home who agree that they had a say in how their help, care or support was provided. | ||
| NI-4 Percentage of adults supported at home who agree that their health and care services seemed to be well co-ordinated. | ||
| NI-5 Percentage of adults receiving any care or support who rate it as excellent or good. | ||
| NI-7 Percentage of adults supported at home who agree that their services and support had an impact in improving or maintaining their quality of life. | ||
| NI-9 Percentage of adults supported at home who agree they felt safe. | ||
| Performance Area 3 | 9. Resources are used Efficiently and Effectively. To deliver Best Value and ensure scarce resources are used effectively and efficiently in the provision of health and social care services. | NI-20 Percentage of total health and care spend on hospital stays where the patient was admitted in an emergency. |
| Managing our resources | NI- 23 Expenditure on end of life care. (data not available) |
Angus performance summary and comparison against Scotland.
Quantitative Indicators 2020
National Indicators:
| Indicator | Title | Angus 2016/17 | Angus 2017/18 | Angus 2018/19 | Angus 2019/20 | Angus 2020/21 | Scotland 2020/21 |
|---|---|---|---|---|---|---|---|
| NI-11 | Premature mortality rate per 100,000 persons | 408 | 383 | 346 | 374 | 375 | 457 |
| Premature rates in Angus have improved from our baseline year and continue to be lower than the Scottish average. There is a slight increase inpremature mortality in Angus between 2018 and 2019 which may be related to an increase in drug deaths. | |||||||
| NI-12 | Emergency admission rate for adults (per 100,000 population) | 10353 | 10896 | 10927 | 10872 | 9414 | 11111 |
| Angus emergency admission rates continues to increase. This is the opposite of the Scottish picture where admission rates are decreasing. Angus continues to perform better than the Scottish average but the variation between Scotland rates and Angus rates continues to reduce. | |||||||
| NI-13 | Emergency bed day rate for adults (per 100,000 population) | 105039 | 105392 | 99515 | 95732 | 83901 | 102961 |
| Bed day rates in Angus continue to decline at a faster rate than Scotland as a whole. The average length of stay in hospital following an emergency admission continues to decline. | |||||||
| NI-14 | Readmission to hospital within 28 days for adults (per 1,000 population) | 96 | 93 | 97 | 106 | 113 | 115 |
| Readmissions to hospital within 28 days of discharge continue to increase in Angus. The rate of increase is similar to that for Scotland as a whole. | |||||||
| NI-15 | Proportion of last 6 months of life spent at home or in a community setting. | 0.89 | 0.9 | 0.91 | 0.92 | 0.93 | 90 |
| Angus is amongst the best performing partnerships in Scotland in relation to this indicator. | |||||||
| NI-16 | Falls admission rate per 1,000 population aged 65+ | 20.3 | 20.6 | 24.9 | 25.1 | 22.5 | 21.7 |
| Falls admission rates for people over 65 in Angus are increasing at a faster rate than Scotland as a whole and exceeded the Scottish average in 2018/19. In 2019/20 there has been a reduction in falls admissions in Angus when compared to 2018/19 due to a range of improvement activity. | |||||||
| NI-17 | Proportion of care services graded ‘good’ (4) or better in Care Inspectorate inspections ( *2015/16) | 0.779 | 0.845 | 0.832 | 0.793 | 0.835 | 0.325 |
| There have been changes to inspection processes following the introduction of the National Care Standards There is therefore a difficulty in making comparisons between current and previous performance. Angus gradings however have fallen more than Scotland as a whole | |||||||
| NI-18 | Percentage of adults with intensive care needs receiving care at home. | 0.522 | 0.503 | 0.561 | 0.556 | 0.58 | 0.629 |
| This indicator is focused on the proportion of people known to the Partnership who receive personal care. The proportion of people in Angus who have a community alarm is higher than the Scottish average. This indictor does not include other types of service for example day care which also supports people to live independently at home. These services do not exist in all partnership areas but contribute significantly in Angus to the ay people are supported in our community. | |||||||
| NI-19 | Number of days people spend in hospital when they are ready to be discharged (per 1,000 population) | 355 | 419 | 214 | 260 | 246 | 488 |
| Angus continues to perform well in relation to addressing delays in timely discharge against the Scottish average. | |||||||
| NI-20 | Percentage of health and care resource spent on hospital stays where the patient was admitted in an emergency | 0.253 | 0.255 | 0.24 | 0.23 | 0.199 | 0.212 |
| Dundee and Perth & Kinross Partnerships perform at a similar level to Angus for this indicator. This indicator is influenced by the cost of hospital care in Tayside as well as bed day use. |
Local Indicators:
| Indicator | Title | Angus 2016/17 | Angus 2017/18 | Angus 2018/19 | Angus 2019/20 | Angus 2020/21 | Scotland 2020/21 |
|---|---|---|---|---|---|---|---|
| LI | Personal care hours rate per 1,000 18+ | 3489 | 3790.9 | 415.9 | 2382.5 | 6245.6 | N/A |
| Personal care provision has increased across all localities of Angus. | |||||||
| LI | Care home nights rate per 1,000 65+ | 10924.3 | 10123 | 10108.8 | 9663.1 | 9254.7 | N/A |
| People are entering care homes later in life and for a shorter periods. The number of people in long term at any one time has reduced. |
