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Age Appropriate Vaccinations for 2 Year Olds
Weightings and Prioritisation Model
Reporting
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Membership list, meeting minutes and key messages (including an update from the most recent meeting that was held on 29 October) can be found by clicking here.
The next Governance Group meeting will be held in February 2011.
The last Advisory Group meeting for 2010 was held on 30 November in Wellington. Key topics for discussion included:
Key messages resulting from the discussions are being prepared for Group sign off and will be reported in the next bulletin.
Information about the Advisory Group (including a full membership list) can be found by clicking here.
For the performance period 1 July 2010 onwards, performance against the ‘Age Appropriate Vaccinations for 2 Year Olds’ indicator will be measured using data sourced from the National Immunisation Register (NIR) for all PHOs. The benefits of the transition are:
The change also means that the Programme will be aligning its definition of a fully vaccinated 2 year old cohort with that used by the Ministry of Health:
The Ministry of Health and DHBs will continue to receive data at National, DHB regional and PHO levels. PHOs will receive data at National, DHB regional, PHO and practice levels.
All enquiries may be directed to PHOPerformance@dhbnz.org.nz
For the performance period commencing 1 January 2011 onwards the Programme will be reporting two performance measures for the Breast Cancer Screening indicators.
It is important to note that although Breastscreen Aoteroa (BSA) recommends that mammograms should be performed regularly for women from the age of 45 years, targets are only agreed with BSA providers for the 50 to 69 year age band. Therefore the Programme has aligned with this approach to ensure providers, practices and PHOs are not disadvantaged.
All enquiries may be directed to PHOPerformance@dhbnz.org.nz
Work continues regarding the development of indicators which focus on the treatment and management of patients with Diabetes or patients who have had a CVD event (or are at risk of having a CVD event). The indicators which are being considered for Phase 2 implementation are:
Prevalence estimates for 2011 have been calculated by the Ministry and released to the Programme. The Programme has generated the relevant information for DHBs and PHOs and will make this available via Nexus by Monday 6th December to assist with the 2011 target setting negotiations. It is important to note that the baseline information for the Ischaemic Heart Disease and Diabetes indicators have been adjusted to take into account the new 2011 estimates.
All enquiries may be directed to Natasha.Maraku@dhbnz.org.nz
Measurement of the RSM indicators has been contentious due their contradictions with other Programme indicators, completeness of data sourced to measure the indicators and their particular focus on laboratory tests conducted and pharmaceuticals dispensed rather than tests ordered and pharmaceuticals prescribed.
Although the RSM indicators will continue to be reported by the Programme, the indicators will be reported as ‘information only’ from the performance period commencing 1 January 2011. Funding currently allocated to the GP Referred Laboratory and Pharmaceutical Expenditure indicators will be redirected to the CVD | Diabetes and Smoking indicators (refer to Weighting and Indicator Model section).
The Programme will be working with the Advisory Group to identify alternative methods to deliver the best use of medicines | tests. Progress updates will be provided in future bulletins.
All enquiries may be directed to Stewart.Pye@dhbnz.org.nz
A model to prioritise and weight Programme indicators has been developed by the Advisory Group in consultation with health economists from the Ministry of Health. The methodology sees each indicator group (i.e. breast cancer, cervical cancer, influenza, immunisation, cardiovascular disease, diabetes and smoking) assessed according to the following criteria:
The Governance Group accepted the table below as an interim solution that will be applied to the indicators from 1 January 2011 while an independent review of the methodology is undertaken (between January and June):
| Indicator | Indicator Group |
Weighting |
|---|---|
| Breast Cancer |
7 |
| Breast cancer screening coverage (High Needs) |
7 |
| Cervical Cancer |
5 |
| Cervical cancer screening coverage (Other/Total Population) |
2 |
| Cervical cancer screening coverage (High Needs) |
3 |
| Immunisations |
11 |
| 2 year old age appropriate vaccinations (Other/Total Population) |
4 |
| 2 year old age appropriate vaccinations (High Needs) |
7 |
| Influenza |
5 |
| 65 year + influenza vaccinations (Other/Total Population) |
2 |
| 65 year + influenza vaccinations (High Needs) |
3 |
| CVD |
24 |
| Ischaemic CVD Detection (Other/Total Population) |
4 |
| Ischaemic CVD Detection (High Need) |
8 |
| CVD Risk Assessment (Other/Total Population) |
4 |
| CVD Risk Assessment (High Need) |
8 |
| Diabetes |
24 |
| Diabetes Detection (Other/Total Population) |
4 |
| Diabetes Detection (High Need) |
8 |
| Diabetes Follow Up After Detection (Other/Total Population) |
4 |
| Diabetes Follow Up After Detection (High Need) |
8 |
| Smoking |
24 |
The smoking indicators have been allocated a combined weighting of 24%. A proposal in terms of how the weighting will be applied across each of the funded smoking indicators is being considered by Governance Group and will be communicated to the sector later this month.
Any changes to the model will be communicated in future bulletins.
All enquiries may be directed to Natasha.Maraku@dhbnz.org.nz
Three of the four smoking indicators will be funded next year. These indicators are:
i. % of eligible population that have ever had a smoking status recorded;
iii. % of current smokers who have been given brief advice in the last 12 months; and
iv. % of current smokers who have been given or referred to cessation support services in the last 12 months.
Note: Indicator ii (% of current smokers) will remain as information only.
¼ of the funding will be apportioned to the activity of recording smoking status with the remaining ¾ of funding allocated to the provision of brief advice and cessation support ONCE a threshold of 70% of an eligible population has their smoking status recorded.
The target setting methodology that will be applied to indicator i, is as follows:
| PHO baseline coverage rate (x) | x < 40% | 40 ≤ x < 70% | 70 ≤ x < 90% |
|---|---|---|---|
| Expected annual improvement | 20% point gain to maximum of 48% | 10% point gain to maximum of 77% | 5% point gain to maximum of 94.5% |
The proposed target setting methodology for indicators iii and iv is being forwarded to the Governance Group for endorsement in December and the agreed methodology will be communicated in due course.
All enquiries may be directed to Natasha.Maraku@dhbnz.org.nz
The process for publicly releasing DHB and PHO performance information for the period ending 30 June 2010 has been completed. All reports are now available on the public pages of the DHBNZ website.
A new Quintile Overview Report has been included in the suite of reports released. This report replaces the Overview Report with Local Targets report as the inclusion of local targets in the original report format resulted in some unexpected comparisons with lower performing PHOs appearing to be rated more highly than PHOs with better absolute performance. Actual performance values are still available by referencing individual organisational reports.
It is also worth noting that performance relating to the Ischaemic Heart Disease indicator is now included as part of the publicly reported indicator set, now that a complete set of data is available to the Programme.
All enquiries may be directed to Stewart.Pye@dhbnz.org.nz
Since the last bulletin, changes to improve the timeliness of collecting data and reporting information by the Programme have been agreed by the Governance Group. The following changes will be implemented by 1 April 2011:
The Governance Group has also endorsed the Programme to carry out analysis (to be completed by 1 April 2011) to:
All enquiries may be directed to Shane.Kerr@dhbnz.org.nz
The 2011 target setting process has been initiated and it is expected that negotiations between DHBs and PHOs are well underway. Organisations are required to agree six monthly targets for all indicators (excluding influenza which requires a single annual target) for the performance periods 1 January to 30 June 2011 and 1 July to 31 December 2011.
It is important to note that the recent availability of the 2011 CVD and Diabetes prevalence estimates has meant that the target setting templates originally posted to Nexus in November have been updated to reflect the new estimates. Additionally, the templates have also been updated to:
All DHB templates must be updated with the PHO agreed targets in Nexus by Friday 10th December 2010.
Where PHOs or practices within PHOs have merged (or are due to merge throughout 2011), in most cases the Programme has proposed targets for the newly formed organisations by combining the indicator data (numerators and denominators) for each of the merging organisations using performance values pertaining to the most recently completed six month performance period. The Programme has then calculated the combined performance value (to determine a baseline for the new organisation) upon which targets are proposed using the Programme’s standard target setting methodology. Slight variations to this process may occur where it is requested by DHBs and PHOs.
All enquiries may be directed to Serena@dhbnz.org.nz
Medtech has confirmed that there is an issue with the Medtech32 Clinical Event Export which is related to the calculation of screening outcomes where multiple smoking screening terms have been used, together with users historically changing values in the setup of screening terms.
Note: For those practices who have only ever used read codes to record smoking information, your data is correct.
Medtech has advised the following:
It is essential that practices are given the necessary timeto load the Medtech32 update and then resend files to their PHOs | MSOs for reloading and reprocessing (before forwarding replacement extracts on to the Programme). Therefore we will be granting an extension for you to resubmit your 1 Jul to 30 Sep 10 SU andCPI report data - to 20 January 2011. The original date for resubmitting data was 26 November 2010.
This means that come 20 January 2011 – the Programme will accept two SU and CPI reports from PHOs (one report covering the period 1 Jul to 30 Sep 10, and a second report covering the period 1 Oct to 31 Dec 10). Please make sure you load any resubmitted reports into Nexus and overwrite the original report you submitted for this period. The Programme has already taken a copy of your original version as part of the recently completed Reasonableness Report process.
Note: We have included the SU report in this resubmission process because it uses the same data source as the CPI report. If you do not need to resubmit the SU report, the one currently held in Nexus will be used as the final report.
Please be aware that to ensure these reports are put through the standard reasonableness reporting process, it is likely that the Programme may defer releasing the quarterly Progress Reports (covering the period Jul to Sep 10) until February 2011. We will communicate any changes to timeframes when required.
If you have any questions – please feel free to contact PHOPerformance@dhbnz.org.nz
June 2011 will see a number of existing Advisory Group 2 – year term memberships come to an end. The process for appointing new or existing members to the Advisory Group will be (noting that existing members are eligible for reappointment):
October 2010 - Appointment process confirmed by Governance Group at 29th October meeting
November 2010 - Appointment process communicated to existing Advisory Group members
December 2010 - Appointment process communicated to sector
February 2011 - Release Advisory Group application forms to sector with completed applications due back to Programme mid-April
April 2011 - Applications sent to Governance Group members for individual member consideration
May 2011 - Group review of applications and confirmation of successful applicants at face to face quarterly meeting
June 2011 - Letters confirming appointment results sent to applicants
Letters of thanks sent to out-going members
July 2011 - Publish new appointments on public pages of DHBNZ website and notify all Programme DHB, PHO and MOH points of contact and media contacts
The Programme’s next series of DHB, PHO and Ministry of Health quarterly reports are due to be posted to Nexus in the New Year. These reports cover PHO performance progress for the quarterly period ending 30 September 2010.
Any enquiries may be directed to PHOPerformance@dhbnz.org.nz.
Please remember to notify the Programme of any changes to staff which you have appointed as key Programme contacts. Remember that nominated Programme contacts are able to access all Programme information pertaining to your organisation - including performance indicator information, data sets and payment details.
If you would like to review or update your list of key contacts for the Programme, please email PHOPerformance@dhbnz.org.nz for further information.