Overview of SWCS GIS Service - July 2014

Trevor Foster

GIS ManagerNHS South West Commissioning Support

Overview of SWCS GIS Service

South West Commissioning Support (SWCS)GIS and Mapping Service

• What is GIS?• About us• How GIS is used in healthcare - Example analysis and maps• Demonstration - HealthGIS Maps (online mapping portal)

– BNSSSG CCGs project– GP Finder– MapCat (map catalogue)

• Case study examples

What is GIS?

• Geographic Information System(Wikipedia):– “GIS is the merging of cartography, statistical analysis,

and database technology”– “integrates, stores, analyses and

displays geographic information for informing decision making”

• Data management and preparation – maps and health data• Geocoding/georeferencing• Analysis – statistical, spatial• Thematic styling• Layers; Admin boundaries, road network, sites, people

Helps support business decision making

Around: Using:

• Contract management• Performance monitoring• Service review/development• Public Health• Commissioning• Estate planning & facilities mgt• Emergency planning• Travel & Access analysis

• Ordnance Survey digital data/maps• Population statistics• Patient distribution• GP and Hospital activity data------------------------------• MapInfo Professional• Cadcorp SIS• RouteFinder• Visography TRACC (public transport)

• What is GIS“Everything happens somewhere”“80% of data has a geographical component”

SWCS - GIS and Mapping Service

• Formerly Avon IM&T Consortium - moved to South West CSU in 2013

• Supporting Avon HA/PCTs/CCGs since 1995• Ordnance Survey licensing - OpenData & PSMA (2010/11)• Growth in demand from wider NHS• Developed team of specialised GIS analysts/developers• Traditional GIS analysis and mapping• HealthGIS Maps (on-line mapping portal)• Licensed partner with Ordnance Survey (May 2014)

• Bristol, North Somerset, South Glos, Somerset CCGs, Area Team• Other Area Teams – East Anglia (Serco), Shropshire & Staffs• Strategic Clinical Network (SW) – formerly Avon, Som, Wilts +

Peninsula, Dorset, 3 Counties (Glos) cancer networks• Public Health depts in Local Authorities – Avon, Wiltshire, Dorset• Community Health – Bristol, North Somerset, South

Gloucestershire, Sirona Care & Health• PCC (Primary Care Commissioning)• NHS Property Services (BNSSSG)• Mental Health Trust (NW London)• Ad-hocs; Acute Trusts, BBC Children in Need, NHS Scotland

Customers

Contract management

• GP contract map• Where GIS started in Avon – mid

90’s• Patient details from ‘Exeter

System’ registration database• Postcodes• Graduated symbols thematic• Options to include age/sex

• Surgery location• Contractual area• Registered patients• Drive-time areas

(peak-time) for (10, 15 minutes)

• No. & % patients in each area

GP Outer Areas

• Final map• Contractual area• Registered patients• Outer Area boundary• Proposal by practice• No. & % patients in

each area

GP Outer Areas Project

Service development

• Number of overlapping practice areas across PCT

• PCT aims to provide choice of at least 2 practices to each patient

Number ofGP practices

Populationcovered

Population %

0 0 0.0

1 6,504 2.4

2 18,178 6.8

3 57,755 21.6

4 67,946 25.4

5 or more 117,298 43.8

Total 267,681

Service development

• Planned housing development areas

• Supplemented with travel access analysis

• Quarterly/monthly performance monitoring reports

• Vacc & Imms, Cancer screening

• RAG (Red, Amber, Green) traffic lights for targets achievement

Performance monitoring

• CQUIN scheme – Equity of Access

• Ambulance response times “A8” performance by division

• Top 10 through to Bottom 10 performing divisions

• “identify 10 rural areas with significant variance against the performance in the urban centres”

Performance monitoring

Commissioning Services – community provider

• Community nurse teams• Individual visits• Shows overlapping areas• Used to define/review team

members/areas

Commissioning Services – community provider

• Community nurse teams for 1 selected day

• Individual visits for 7 teams• Visit locations and order• Categorised by staff

member and by Job Band• Also plot actual and

optimum routes taken

• Head & Neck cancer review• Service provider sites• Actual patient attendances

by site• Spidergrams show ‘as the

crow flies’ (Euclidean) distance travelled

Commissioning Services

• Somerset GP Out of Hours• Service provider sites• No. calls by type• Deprivation• Population density


• Service reconfiguration• Impact assessment after new

hospital opened• Change in Emergency Dept

attendance rates


• Wiltshire Vascular Surgery service review

• Commissioned by Wiltshire Public Health

• Service provider sites• Drive-time isochrones• Salisbury District

Hospital

Travel network analysis


• Composite drive-time zones to any hospital site

• Identify gaps in service availability

• Plus, analysis by ‘blue-light’ drive-time

• Public transport, walking options


• Population number and % within drive-time zone• ONS national mid-year population estimates

Wiltshire population with access to Vascular Surgery hospital - Average Car Travel

Hospital RUH Bath Salisbury Southampton Combined (all hospitals)

Number % Number % Number % Number %

0-15 minutes 0 0.0% 23,248 5.1% 0 0.0% 23,248 5.1%

15-30 minutes 7,899 1.7% 51,961 11.3% 1,832 0.4% 59,860 13.0%

30-45 minutes 128,739 28.0% 49,762 10.8% 11,621 2.5% 188,305 41.0%

45-60 minutes 119,539 26.0% 62,883 13.7% 50,497 11.0% 143,977 31.3%

60-75 minutes 79,844 17.4% 109,819 23.9% 56,079 12.2% 44,445 9.7%

75-90 minutes 95,977 20.9% 105,723 23.0% 29,649 6.4% 0 0.0%

>90 minutes 27,837 6.1% 56,439 12.3% 310,157 67.4% 0 0.0%

Total Wiltshire Population 459,835

? If target = 60 minutes • 40% access Salisbury• 90% access any hospital

Case StudyCommunity Service Review

Community Service Review

Main condition or treatment patients admitted for?• Inpatients split by

treatment specialty• Pie symbols at each

community hospitalInterpretation• Minehead inpatients

have more variety• Question

classification, as most appears as General Medicine

• South Somerset all similar size and doing the same thing


Patient’s distance from home to community hospital?• Spidergram show

distributionInterpretation• All sites have

significant number of patients travelling long distances

• Appear to be no outliers

Questions• What percentage of

people are treated near to home?


Population density• Persons per hectare

by LSOAInterpretation• Community

hospitals are generally located in areas of high population density except when there is an acute hospital


• Hospital catchment areas

• Calculated by travel times

• Stats:– Population– Inpatients– Bed occupancy

rate


• Number of patients in/outside catchment area

Interpretation• Williton and

Shepton Mallet have very low proportion of patients within catchment area


Delayed discharges• Pie symbols with

volume and reason for delay

Interpretation• Significant variation

between sites• Question over

consistent classification

• Interesting relationship between delayed discharges and location of care homes


Care Homes• Care homes, and

care homes with nursing

Interpretation• Large number of

care homes in Minehead for its population


Attendance at MIU and A&E by postcode• Ratio of attendance• Locations of MIU

and A&E servicesInterpretation• 75% of people use

MIU when they live near one

• Wincanton MIU is the exception to this

• Further information?

• Contact us at [email protected]

or [email protected]

Telephone: 0117 9002490

• Visit our website:

http://www.healthgis.nhs.uk

http://nww.healthgis.nhs.uk (NHS staff only)

mailto:[email protected]

mailto:[email protected]

http://www.healthgis.nhs.uk/

http://nww.healthgis.nhs.uk/

Health & Medicine

Overview of SWCS GIS Service - July 2014