NHS Redbridge is aiming to reduce costs while reorganising services with the help of a risk stratification tool.

Population Health Management, a software application developed by data modelling specialist Health Analytics, contains both primary and secondary care data.

It is giving health professionals a previously unattainable level of data on referral rates, secondary and community care contacts, patients at high risk of emergency admission, and costs.

Conor Burke, interim chief executive of NHS Redbridge, said most risk stratification in the UK has been limited to the analysis of hospital data and to creating algorithms to reduce hospital re-admission among high risk patients.

“We’ve taken that into a new dimension with the help of Health Analytics and it is generating a lot of interest from GPs and other primary care trusts," he said.

Information from the PCT’s 49 GP practices is uploaded to an online data warehouse every week. In the past year, it has analysed and cross-referenced 20m records.

One of the tool’s first applications has been to first time referrals. Over the last three years, NHS Redbridge has logged a 36% increase in referrals, and it wants to cut these by 30% this year. Variations in referral rates between practices is as high as 400% in some specialties.

PHM is able to provide up-to-date information about the number of first time referrals being made by each practice, along with details of the patient’s condition. Previously, staff had to wait up to two months before they could analyse this data.

Burke added: “There is no doubt that PHM has uncovered areas of performance that need improvement; but you can’t fix something until you know what’s broken.

“We must have GPs and practice managers on board to make this work and have spent the past two years nurturing that relationship.”

Dr Hector Spiteri, clinical director for one of the five polysystems, said he believed the tool would not replace GP judgement but enable more informed decisions to be made about commissioning the most effective services.

He added: “I’m hopeful this will be a very useful tool for practitioners both in terms of the freshness and amount of information available to its ability to produce health driven algorithms that can help us prevent ill health instead of simply treating it.”

Link: Health Analytics Limited