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Physiology Diagnostics & the Atlas of Variation Professor Sue Hill OBE

Physiology Diagnostics & the Atlas of Variation Professor Sue Hill OBE Chief Scientific Officer for England. Physiology Diagnostics . 8 Clinical services Audiology Cardiac Physiology Gastrointestinal Physiology Neurophysiology Ophthalmic & Vision Science

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Physiology Diagnostics & the Atlas of Variation Professor Sue Hill OBE

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  1. Physiology Diagnostics & the Atlas of Variation Professor Sue Hill OBE Chief Scientific Officer for England

  2. Physiology Diagnostics • 8 Clinical services • Audiology • Cardiac Physiology • Gastrointestinal Physiology • Neurophysiology • Ophthalmic & Vision Science • Respiratory Physiology & Sleep Physiology • Urodynamics • Vascular Technology • > 300 different tests • > 15 million tests undertaken pa, demand growing • Key component of most clinical pathways

  3. What does the Atlas tell us? * national data collected monthly since 2008 # from GP database (QoF) data O from National Screening Programme data

  4. Challenging variation - Audiology • Data shows a 11 fold difference between highest and lowest areas (still 5 fold after exclusions) • Why is Norfolk so different to Suffolk? Or Hillingdon and Hounslow?- Can we account for this variation? • Undiagnosed and untreated audiology issues can profoundly affect an individual’s ability to communicate – and so the rest of their health

  5. Interventions to reduce unwarranted variation • Providing a ‘feedback loop’ challenge to the commissioning system – empowering clinicians in services and informing contract management • For patients: ensuring a fresh focus on the identification of undiagnosed, and untreated conditions and the prevention of disease progression • Improving adoption of new technology & service redesign • Quality assurance and peer review systems (such as IQIPS – Improving Quality In Physiological Sciences) • Tackling workforce shortages

  6. Diagnostic services in NHS – getting it right

  7. Getting it right – Mike Richards’s Vision …we need to harness robust and timely information from other sources to provide a more rounded picture of a trust…. Accreditation and peer review already play an important role in quality improvement…. I strongly believe that such schemes have a key role to play in the future of hospital inspection. We need to use information from these schemes to feed directly into CQC monitoring processes and the development of trust-specific key lines of enquiry for use at inspections.‘ Professor Sir Mike Richards, Chief Inspector of Hospitals

  8. Taking the Atlas forward in future • The Atlas of Variation represents a subset of diagnostic procedures – those that are monitored and recorded nationally • Some important diagnostics do not have sufficient data to build a variation picture – eg rate of EEG testing for epilepsy • Need to focus on impact on patient experience and outcomes when selecting additional indicators

  9. Any questions?

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