TISSUE VIABILITY SERVICES Service : Tissue viability service Purpose (Outcome) Statement: To ensure that all patients that have a wound or are deemed to be at risk of developing a wound will: 1) receive a holistic assessment 2) receive a prevention strategy, 3) receive evidence based care 4) receive health promotion of wound healing potential 5) have an enhanced quality of life. Ref. Indicator description TV01 Professionally trained staff The percentage of patients with leg ulcers assessed by a health care professional trained in leg ulcer management 100% Safety TV02 Referrals assessed The percentage of referrals accepted by the service that are assessed by a suitability qualified health care professional within seven days of receipt of the referral 95% Responsiveness TV03 Venous Leg Ulcer Management The percentage of non-complex venous leg ulcers in all settings where the first line of treatment is graduated multilayer high compressions system 95% Safety TV04 Venous Leg Ulcer healing rates The percentage of venous leg ulcers fully healed within 24 weeks of assessment tbc Social value TV05 Recurrent leg ulcer prevention Percentage of patients having a recurrence of a preventable VLU within a period of 12 months from the date of healing of a previous VLU. tbc Social value TV06 Inpatient pressure ulcer risk assessment All patients admitted to a community bed must receive a pressure ulcer risk assessment, using a recognised risk assessment tool, within six hours of admission tbc Responsiveness TV07 Domiciliary pressure ulcer risk assessment All patients referred onto community nursing services for a domiciliary visit must have a pressure ulcer risk assessment prior to discharge from the service, using a recognised assessment tool. TV08 NICE guidance compliant care plan and evaluation Percentage of patients who have developed, or who are at risk of developing a pressure ulcer, must have evidence of a NICE guidance-compliant Care Plan and evaluation. TV09 Community acquired avoidable pressure ulcers Number of reported pressure ulcers per 100,000 catchment population (2013/14) against specific criteria: TV10 The percentage of patients deemed to be at risk, who are Pressure ulcer prevention at four prevented from developing a new community acquired weeks avoidable pressure ulcers at four weeks following assessment TV11 Patients presenting a with foot care emergency to the service (defined as new ulceration, swelling or discolouration) should be referred for a specialist assessment within 24 hours of identification TV12 TV13 Specialist assessment Threshold Indicator type (max. 2) Title 100% Responsiveness Safety Patient experience Social value Patient experience Social value Social value Safety 95% Responsiveness Safety TV12 a: Percentage of patients reporting an increased quality of life (EQ-5D) upon discharge 95% Social value Patient experience TV12 b: Percentage of patients reporting an increased quality of life (EQ-5D) after three months following their initial assessment (for patients still on the caseload) 95% Social value Patient experience Friends and Family test score 95% Social value Patient experience tbc Increased quality of life Friends and Family test score Tissue viability services outcome indicators framework - July 2014 v2 - Front sheet - refined Page 1 of 18 TISSUE VIABILITY – 2014 draft 1 reviewed by Steering group on 15.5.14 Next steps – share for comment with all aCFTN + other participating trusts = draft 2 Purpose (Outcome) Statement: "To ensure that all patients that have a wound or are deemed to be at risk of developing a wound will; 1) receive a holistic assessment Indicator type (to be reviewed/refined) 2) receive a prevention strategy, 3) receive evidence based care 4) promotion of wound healing potential 5) enhance quality of life." The assessment and clinical investigation of all patients with lug ulcers should be undertaken by health care professionals TV01 trained in leg ulcer management. This should take place within 7 days of referral from any TV02 source. 100% Outcome 100% Safety TV04 70% Outcome TV05 100% TV06 100% The percentage of uncomplicated venous leg ulcers in all settings where the first line of treatment is graduated multi- TV03 layer high compressions system should be 1st line treatment. The percentage of venous leg ulcers healed within 24 weeks of assessment. Percentage of patients with preventable venous leg ulcers having a recurrence within a period of 12 months from the date of healing. All patients being admitted to a community bed must receive a pressure ulcer risk assessment, using a recognised assessment tool within 6 hours. All patients referred into community nursing services for a domiciliary visit must have a pressure ulcer risk assessment, using a recognised assessment tool. Patients who have developed or who are at risk of developing a pressure ulcer must have evidence of a NICE guidance-compliant Care Plan and evaluation. Number of new, community acquired (*avoidable) pressure ulcers Grades 2, 3, 4 and unstageable per 100,000 population whilst under the care of the trust in the previous financial year Safety Responsiven ess Social value Responsiven Safety ess TV07 TV08 TV09 Outcome Safety Social value The percentage of patients deemed to be at risk, who are prevented from developing a new community acquired TV10 avoidable* pressure ulcers at 4 weeks following assessment Outcome Safety Social value Patients with foot care emergency (defined as : new ulceration, swelling, discolouration) should be referred for TV11 specialist assessment within 24 hours Percentage of patients reporting an increased quality of life (EQ5D) on discharge or 3 months following initial assessment TV12 if still on the caseload. 100% Responsiven Safety ess Outcome Patient experience PROMs Social value Tissue viability services outcome indicators framework - July 2014 v2 - Front sheet draft Page 2 of 18 INDICATOR ASSURANCE SERVICE APPROACH AND CRITERIA Overarching approach Initial evaluation Peer review Methodology Review Group Indicator Governance Board To assess the indicator HSCIC will need details about: why the indicator is needed; the persons who will use, or benefit from the use of, the indicator; the methodology to be used in constructing the indicator; the data sources in relation to the methodology applied, and how the quality indicator is to be published. The quality of a national health and social care indicator is then appraised based on a transparent set of criteria and associated criteria: Is it clear what the indicator will measure? Clarity What are the reasons and evidence for measuring this? Rationale Are the data in the measure fit (enough) to support the purpose? Data Will the methods used support the stated purpose? Is it clear what Construction methods are used and how they have been tested and/or justified? Is the presentation of the indicator suitable and are all potential users able Interpretation to interpret the values? Risks and usefulness Are any limitation, risks or perverse incentives associated with the indicator explicitly stated? Can the indicator be used for quality improvements? Details of this page and further guidance can be found here: www.hscic.gov.uk/article/1674/Indicator-Assurance-Service Tissue viability services outcome indicators framework - July 2014 v2 - IAS framework (for reference) Page 3 of 18 Data quality rating High degree of confidence; underpinning data subject to audit or scrutiny Subject to retrospective reporting which will improve in accuracy and/or completeness over time Subject to likely under-reporting, which may or may not be addressed retrospectively Less degree of confidence in accuracy and/or completeness; unlikely to be addressed retrospectively Tissue viability services outcome indicators framework - July 2014 v2 - Data Quality rating key Page 4 of 18 References Whilst these references may have been produced a number of years ago, many of the recommendations remain relevant to today's services www.nice.org.uk/guidance/CG29 2005 www.sign.ac.uk/pdf/sign120.pdf 2010 www.rcn.org.uk/development/practice/clinicalguidelines/venous_leg_ulcers www.aafp.org/afp/2010/0415/p989.html Various 2010 Tissue viability services outcome indicators framework - July 2014 v2 - External references Page 5 of 18 TV01 Draft wording Professionally trained staff The assessment and clinical investigation of all patients with leg ulcers should be undertaken by health care professionals trained in leg ulcer management Revised wording (what is being measured) The percentage of patients with leg ulcers assessed by a health care professional trained in leg ulcer management Rationale Leg ulcers are complex wounds and patients should be managed by skilled practitioners who have the appropriate level of training and qualification. There is a significant evidence base to support this requirement. Stakeholders Commissioners Providers CQC Service users Construction Number of patients referred to the service presenting with a leg ulcer assessed by a suitably qualified healthcare professional divided by all patients referred to the service presenting with a leg ulcer, expressed as a percentage, in the period of measurement Key data items Count of patients with a leg ulcer assessed by a suitably qualified Numeric professional Count of patients assessed with a leg ulcer Numeric Draft threshold Revised threshold 100% 100% Indicator type (max. 2) Safety Responsiveness NHS Data Dictionary element Likely data collection methodIT solution Data Quality rating Comments This indicator can be combined with TV02 Tissue viability services outcome indicators framework - July 2014 v2 - TV01 Page 6 of 18 Comments Aggregate data Aggregate data TV02 Referrals assessed Draft wording This should take place within 7 days of referral from any source. Revised wording (what is being measured) The percentage of referrals accepted by the service that are assessed by a suitability qualified health care professional within seven days of receipt of the referral Rationale This indicator is proposed to establish how quickly a referral is assessed by a suitability qualified health care professional. The speed at which this occurs will determine how soon the patient can be seen by the service in order to establish their exact clinical need and subsequent care planning. Stakeholders Commissioners Providers Construction Number of referrals assessed within seven days of receipt of the referral divided by total referrals assessed, expressed as a percentage, in the period of measurement Key data items Community care contact type Count of assessments undertaken (aggregate) Count of referrals received that are accepted (aggregate) Date of screening (yyyy/mm/dd) Referral received date (yyyy/mm/dd) Draft threshold Revised threshold 100% 95% Indicator type (max. 2) Responsiveness Numeric Numeric Numeric Date Date NHS Data Dictionary element COMMUNITY CARE ACTIVITY TYPE CODE ASSESSMENT TOOL COMPLETION DATE REFERRAL REQUEST RECEIVED DATE Likely data collection methodIT solution Data Quality rating Comments Change to threshold on the basis that 100% implies not variation in processes, which is inherent in the way systems operate This indicator can be combined with TV01 Tissue viability services outcome indicators framework - July 2014 v2 - TV02 Page 7 of 18 Comments Use code 02 - Assessment Aggregate data Aggregate data No exact match in NHSDD TV03 Venous Leg Ulcer Management Draft wording The percentage of uncomplicated venous leg ulcers in all settings where the first line of treatment is graduated multi-layer high compressions system should be 1st line treatment. Revised wording (what is being measured) The percentage of non-complex venous leg ulcers in all settings where the first line of treatment is graduated multi-layer high compressions system Rationale This indicator is proposed to establish the proportion of patients whose routine treatment is the use of high compression multicomponent bandaging. Such management is considered good practice in the treatment of venous leg ulcers (VLU). Stakeholders Commissioners Providers Construction Number of patients on the caseload with a VLU who are treated with high compression multi-component bandaging divided by the total number of patients with a VLU on the caseload, expressed as a percentage in the period of measurement Key data items Number of patients on the caseload with a VLU Number of patients managed with high compression multicomponent bandaging Count of the number of patients on caseload Draft threshold Revised threshold 100% 100% Indicator type (max. 2) Safety Numeric Numeric NHS Data Dictionary element Comments Aggregate data, based on presence of identifying data Aggregate data, based on presence of identifying data Numeric Open referrals (aggregate data) as proxy for open on caseload Likely data collection methodIT solution Data Quality rating Comments Definition of a leg ulcer is a wound on the lower leg or foot that has not healed within six weeks Need to consider capturing exclusions e.g. non concordant patients Definition’ of ‘in all settings’ needed, since nursing home patients may receive 4-‐layer bandaging depending on commissioning arrangements. Therefore may need to consider clinic and patient's own home settings. Tissue viability services outcome indicators framework - July 2014 v2 - TV03 Page 8 of 18 TV04 Venous Leg Ulcer healing rates Draft wording The percentage of venous leg ulcers healed within 24 weeks of assessment. Revised wording (what is being measured) The percentage of venous leg ulcers fully healed within 24 weeks of assessment Rationale This indicator is proposed to establish the proportion of patients who experience a fully healed VLU at 24 weeks from assessment. Clinical studies often focus on healing rates at 12 and 24 weeks, although the rate and success of healing is also dependent on other factors such as mobility, complexity and the presence of co-morbidities. Stakeholders Commissioners Providers Construction The number of patients assessed as having a fully healed VLU at 24 weeks divided by the number of patients assessed 24 weeks ago, expressed as a percentage. The sample of patients used to construct this indicator will be those whose 24 week pathway falls within the reporting month. Key data items Count of patients assessed as having a VLU healed at 24 weeks Count of patients assessed for healing status at 24 weeks Community care contact type Draft threshold Revised threshold tba 70% Indicator type (max. 2) Social Value Numeric Numeric Numeric NHS Data Dictionary element Comments COMMUNITY CARE ACTIVITY TYPE CODE No exact match in NHSDD, aggregate data No exact match in NHSDD, aggregate data Use code 02 - Assessment Likely data collection methodClinical audit (sample-based) Data Quality rating Comments Tissue viability services outcome indicators framework - July 2014 v2 - TV04 Page 9 of 18 TV05 Recurrent leg ulcer prevention Draft wording Percentage of patients with preventable venous leg ulcers having a recurrence within a period of 12 months from the date of healing. Revised wording (what is being measured) Percentage of patients having a recurrence of a preventable VLU within a period of 12 months from the date of healing of a previous VLU. Rationale Stakeholders Commissioners Providers Service users Construction The number of patients identified as having a preventable VLU twelve months after healing confirmed, divided by the total number of patients healed twelve months previously Key data items Date VLU healed (yyyy/mm/dd) Patients with a previous (now healed) VLU Patient assessed as having a new preventable VLU Community care contact type Draft threshold Revised threshold tba tba Indicator type (max. 2) Social value Date Numeric Numeric Numeric NHS Data Dictionary element DISCHARGE DATE COMMUNITY CARE ACTIVITY TYPE CODE Likely data collection methodClinical audit (sample-based) Data Quality rating Comments If definition of 'preventable' is know, providers may consider using an electronic system to identify patients readmitted to community caseload within 12 month with diagnosis of recurrence of leg ulcer Tissue viability services outcome indicators framework - July 2014 v2 - TV05 Page 10 of 18 Comments No exact match in NHSDD; proxy for discharge from caseload No exact match in NHSDD, aggregate data No exact match in NHSDD, aggregate data Use code 02 - Assessment TV06 Inpatient pressure ulcer risk assessment Draft wording All patients being admitted to a community bed must receive a pressure ulcer risk assessment, using a recognised assessment tool within 6 hours. Revised wording (what is being measured) All patients admitted to a community bed must receive a pressure ulcer risk assessment, using a recognised risk assessment tool, within six hours of admission Rationale This indicator is proposed to establish how many patients receive a pressure ulcer risk assessment (using a recognised tool) within six hours of admission to a community hospital. Patients admitted from acute trusts or their usual place of residence ma be at risk of developing a pressure ulcer or may have already have a pressure ulcer upon admission. Prompt assessment of the patient will ensure that any risk factors are quickly identified and any treatment regimes can be incorporated into the patient's care plan. Stakeholders Commissioners Providers Construction The number of patients admitted to a community hospital bed who had a pressure ulcer risk assessment within six hours of admission, divided by all admissions within the period of measurement Key data items Admission date (yyyy/mm/dd) Admission time (hh:mm) Admissions Community care contact type PU Risk assessment time (hh:mm) Risk assessments within six hours of admission Draft threshold Revised threshold tbc 95% Indicator type (max. 2) Responsiveness Date Time Numeric Numeric Time Numeric NHS Data Dictionary element DATE OF ADMISSION TIME OF ADMISSION COMMUNITY CARE ACTIVITY TYPE CODE No exact match in NHSDD Comments Calculated. Aggregate data Use code 02 - Assessment Calculated. Aggregate data Likely data collection methodClinical audit (sample-based) Data Quality rating Comments 95% threshold in line with VTE assessment target; reflects that the assessment may be inappropriate for some patients, e.g. short stay or EoL. Tissue viability services outcome indicators framework - July 2014 v2 - TV06 Page 11 of 18 TV07 Domiciliary pressure ulcer risk assessment Draft wording All patients referred into community nursing services for a domiciliary visit must have a pressure ulcer risk assessment, using a recognised assessment tool. Revised wording (what is being measured) All patients referred onto community nursing services for a domiciliary visit must have a pressure ulcer risk assessment prior to discharge from the service, using a recognised assessment tool. Rationale This indicator is proposed because good practice, including NICE guidance (CG179), says that all patients should have a robust risk assessment encompassing the following factors: Significantly limited mobility Previous or current pressure ulcer Nutritional deficiency Inability to reposition themselves Significant cognitive impairment Stakeholders Commissioners Providers Service users Construction Key data items The number of patients discharged from the service, referred onto community nursing services for a domiciliary visit who had a pressure ulcer risk assessment divided by all referrals to community nursing services in the period, expressed as a percentage Community care contact type Numeric Discharge date Date Pressure Ulcer risk assessment undertaken Service referred to Draft threshold Revised threshold 100% 95% Indicator type (max. 2) Safety NHS Data Dictionary element COMMUNITY CARE ACTIVITY TYPE CODE DISCHARGE DATE Numeric Numeric Comments Use code 02 - Assessment Aggregate data Aggregate data Likely data collection methodClinical audit (sample-based) Data Quality rating Comments Change to threshold on the basis that 100% implies not variation in processes, which is inherent in the way systems operate Definition of 'community nursing service' will be specific to the provider Tissue viability services outcome indicators framework - July 2014 v2 - TV07 Page 12 of 18 TV08 Draft wording Revised wording (what is being measured) NICE guidance compliant care plan and evaluation Patients who have developed or who are at risk of developing a pressure ulcer must have evidence of a NICE guidance-compliant Care Plan and evaluation. Percentage of patients who have developed, or who are at risk of developing a pressure ulcer, must have evidence of a NICE guidance-compliant Care Plan and evaluation. Rationale This indicator is proposed because it represents good clinical practice in the management of patients with, or who are at risk of developing, a pressure ulcer. NICE guideline CG179 offers evidence-based advice on the prevention and management of pressure ulcers. Stakeholders Commissioners Providers Service users Construction Key data items Count of the number of patients on caseload Number of patients who have developed a pressure ulcer Number of patients who are at risk of developing a pressure ulcer Number of patients who have evidence of NICE guidance compliant care planning Draft threshold Revised threshold tba 100% Indicator type (max. 2) Patient Experience Social value Percentage Numeric Numeric Numeric Numeric NHS Data Dictionary element Not applicable Not applicable Not applicable Likely data collection methodClinical audit (sample-based) Data Quality rating Comments Tissue viability services outcome indicators framework - July 2014 v2 - TV08 Page 13 of 18 Comments Open referrals (aggregate data) as proxy for open on caseload Aggregate data Aggregate data Aggregate data TV09 Draft wording Revised wording (what is being measured) Community acquired avoidable pressure ulcers Number of new, community acquired (*avoidable) pressure ulcers Grades 2, 3, 4 and unstageable per 100,000 population whilst under the care of the trust in the previous financial year Number of reported pressure ulcers per 100,000 catchment population (2013/14) against specific criteria: New Avoidable Community acquired (under the care of the provider) Grades 2-4 inclusive Rationale To provide a reference point for providers in relation to the number of reported pressure ulcers (according to the above criteria). This will enable providers to compare and benchmark their reported performance. Providers should adopt a reduction trajectory underpinned by a zero tolerance approach. Stakeholders Commissioners Providers CQC Construction Total number of pressure ulcers meeting the criteria above in revised wording section divided by the provider's catchment population, divided by 100,000, expressed as a number to two decimal places. Key data items Community acquired, new, avoidable, Grade 2-4 pressure ulcers Numeric reported between April 2013 and March 2014 Catchment population Numeric NHS Data Dictionary element n/a Comments n/a ONS data for county(ies) covered by provider (URL link: http://www.ons.gov.uk/ons/taxonomy/index.html?nscl=Subnational+Population+Projections#tab-data-tables) Draft threshold tba Revised threshold To be benchmark based (although providers should adopt a reduction trajectory underpinned by a zero tolerance approach. Indicator type (max. 2) Patient Experience Social value Likely data collection methodIT solution Data Quality rating Comments This is an activity rather than an outcome measure. This data is also available through other sources, e.g. NHS Benchmarking Network and aspirant CFT provider network Trusts should use NPSA definitions in order to ensure consistency of reporting Tissue viability services outcome indicators framework - July 2014 v2 - TV09 Page 14 of 18 TV10 Draft wording Revised wording (what is being measured) Pressure ulcer prevention at four weeks The percentage of patients deemed to be at risk, who are prevented from developing a new community acquired avoidable* pressure ulcers at 4 weeks following assessment The percentage of patients deemed to be at risk, who are prevented from developing a new community acquired avoidable pressure ulcers at four weeks following assessment Rationale This indicator proposes to report the success of preventative measures in the management of the patient's tissue viability, with the view that at four weeks with no development of an avoidable pressure ulcers, the care plan and management have achieved the desired clinical outcome. Stakeholders Commissioners Providers CQC Construction Key data items Community care contact type Community acquired, new, avoidable, Grade 2-4 pressure ulcers reported between April 2013 and March 2014 Four week assessment date (yyyy/mm/dd) Initial assessment date (yyyy/mm/dd) Risk flag Draft threshold Revised threshold tba tba Indicator type (max. 2) Safety Social value Numeric Numeric NHS Data Dictionary element COMMUNITY CARE ACTIVITY TYPE CODE Date Date Alpha numeric Likely data collection methodIT solution Data Quality rating Comments Tissue viability services outcome indicators framework - July 2014 v2 - TV10 Page 15 of 18 Comments Use code 02 - Assessment Aggregate data =(Initial date + 28) TV11 Specialist assessment Draft wording Patients with foot care emergency (defined as: new ulceration, swelling, discolouration) should be referred for specialist assessment within 24 hours Revised wording (what is being measured) Patients presenting a with foot care emergency to the service (defined as new ulceration, swelling or discolouration) should be referred for a specialist assessment within 24 hours of identification Rationale This indicator is proposed to ensure that patients presenting with a foot care emergency receive a prompt referral for a specialist assessment, so that their condition does not deteriorate further and that the risk of further foot care complications are minimised. Stakeholders Commissioners Providers Service users Construction The number of patients presenting a with foot care emergency referred for a specialist assessment within 24 hours of identification, divided by all patients presenting a with foot care emergency referred for a specialist assessment, expressed as a percentage in the reporting period. Key data items Count of patients presenting with a foot care emergency Read Code for new ulceration, swelling or discolouration Reason for referral Referral made to specialist date (yyyy/mm/dd) Referral received to specialist date (yyyy/mm/dd) Draft threshold Revised threshold 100% 95% Indicator type (max. 2) Safety Responsiveness NHS Data Dictionary element Numeric Alpha NumericN/A REASON FOR REFERRAL TO COMMUNITY CARE Date REFERRAL REQUEST MADE DATE Date REFERRAL REQUEST RECEIVED DATE Likely data collection methodIT solution Data Quality rating Comments Limitations of Read codes made compromise ability to record foot care emergency types Tissue viability services outcome indicators framework - July 2014 v2 - TV11 Page 16 of 18 Comments Aggregate data Aggregate data if READ code available/recorded Use code 033 (Foot care/problems) TV12 Increased quality of life Draft wording Percentage of patients reporting an increased quality of life (EQ5D) on discharge or 3 months following initial assessment if still on the caseload. Revised wording (what is being measured) TV12 a: Percentage of patients reporting an increased quality of life (EQ-5D) upon discharge TV12 b: Percentage of patients reporting an increased quality of life (EQ-5D) after three months following their initial assessment (for patients still on the caseload) Rationale This indicator is proposed to establish from a patient's perspective, if they have seen the quality of life improve, either upon discharge from the service, or if they are still on the service's caseload, three months from their initial assessment. The review uses EQ-5D which is a standardised instrument for use as a measure of health outcomes, and which looks at the following five dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression Stakeholders Commissioners Providers Construction TV12 a: The number of patients reporting an increased quality of life upon discharge (using EQ-5D), divided by all patients discharged from the service in the reporting period, expressed as a percentage. TV12 b: The number of patients reporting an increased quality who have been on the caseload for three months or more (using EQ-5D), divided by all patients on the caseload in the reporting period, expressed as a percentage. Key data items Community care contact type Count of the number of patients reporting an increased quality of life (discharged) Count of the number of patients reporting an increased quality of life (on caseload) Date of initial assessment (yyyy/mm/dd) Assessment tool score at start of treatment Assessment tool score at end of treatment Draft threshold Revised threshold 100% 95% Indicator type (max. 2) Social value Patient experience Numeric Numeric NHS Data Dictionary element COMMUNITY CARE ACTIVITY TYPE CODE Comments Use code 02 - Assessment Aggregate data ASSESSMENT TOOL COMPLETION DATE PERSON SCORE PERSON SCORE No exact match in NHSDD No national codes exist for TV tools No national codes exist for TV tools Date Date Alpha Numeric Alpha Numeric Likely data collection methodManual recording Data Quality rating Comments Requires providers to adopt the EQ-5D tool Tissue viability services outcome indicators framework - July 2014 v2 - TV12 Page 17 of 18 TV13 Friends and Family test score Draft wording Friends and Family test score Revised wording (what is being measured) Friends and Family test score Rationale The F&FT provides a robust, nationally recognised approach to providing feedback of the patient's experience. The implementation of the FFT across all NHS services is an integral part of 'Putting Patients First', NHS England’s Business Plan for 2013/14 – 2015/16. It is designed to help service users, commissioners, clinicians and other stakeholders to better understand the patient's experience of the service they receive. The design of the F&FT means it can be benchmarked and easily compared between peer organisations. Stakeholders Commissioners Providers Service users Construction Key data items Aggregate figure taken from F&FT software Friends and Family test score Draft threshold Revised threshold tba tba Indicator type (max. 2) Patient Experience Social value Percentage Numeric NHS Data Dictionary element Not applicable Data Quality rating Comments F&FT score is an average based on all patients/service users sampled in the period Tissue viability services outcome indicators framework - July 2014 v2 - TV13 Page 18 of 18 Comments Aggregate figure taken from F&FT software
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