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Programme links



Professor Donal O'Donoghue

National Clinical Director for Kidney Care


"The resources available on this website have really helped to focus attention on the critical links between expenditure, outcomes and the drivers of spend for the kidney care programme.

In partnership with NHS Kidney Care, Health Investment Education Packs have been produced for every PCT. These are available by clicking on the Renal link below. The aim of the packs is to highlight the scale of variation in kidney disease care at PCT and GP Practice level.

The packs combine both programme budgeting and NHS Kidney Care tools to help search for unwarranted variation and support the health investment process.

It is imperative that PCT Clusters, and the emerging clinical commissioning groups, establish a clear framework and evidence base for making and evaluating health investment decisions in kidney care and all other areas.

When combined with the other resources on this site, the links below will help commissioners evaluate whether they are getting good value for money from their limited budgets across the major programmes of health care"


This section provides health investment toolkits for specific programmes:


Mental Health (£11bn national spend)

Circulation (£7bn)

Cancer (£6bn)

Musculo Skeletal (£5bn)

Genitourinary (£5bn)

Gastrointestinal (£5bn)

Respiratory (£4.5bn)

Social Care Needs (£3bn)

Endocrine, Nutritional & Metabolic (£3bn)


Mental Health (£11bn national spend)


Rightcare have released an atlas which identifies unwarranted variation across mental health and wellbeing indicators in England. Click here to access.



The Mental Health Observatory provides data about mental health care in England, collected routinely or through special surveys, by health and social services. The site includes mental health prevalence estimates and estimates of future numbers of patients with dementia.


Mental Health


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The Community Mental Health Profiles is an open access tool showing a profile of key mental health indicators for each Local Authority in England. It is used to help commissioners, providers, also service users at a local, regional, and national level to compare patterns of mental health needs in their area. Data can be explored using a web tool or downloaded as a PDF for each area.





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Circulation (£7bn)

Public Health England (PHE) have released CVD Commissioning for Value packs for each CCG in June 2014. 


SEPHO has produced really detailed cardiovascular health profiles for each PCT and Cardiac Network in England. Click on the following link to access them:


CVD health profiles


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Action on stroke services: an evaluation toolkit ('ASSET') has been created to help health care organisations improve and transform stroke services for patients. The following link provides access to a provider based spreadsheet showing comparative performance. You can use the toolkit to see the impact of several key improvements to TIA clinics and acute stroke care in terms of better patient outcomes and reduced lengths of stay. The link also contains case studies illustrating leading edge practice for key interventions




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The Department of Health has produced a commissioning pack for cardiac rehabilitation to help commissioners improve the quality of services for patients through clearly defined outcomes that help drive efficiency by reducing unwarranted variation in services. Click on the following icon to access the pack:


cardiac rehab 3


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Cancer (£6bn)

The Cancer Commissioning Toolkit is aimed at supporting the commissioning of cancer services across the NHS. It includes a range of high-level indicators, as well as a number of links to more detailed information, right across the patient’s journey: from prevention and screening through referral and treatment to living with and beyond cancer, as well as end of life care. It includes programme budgeting data. A new addition is a set of GP practice profiles, available to NHS users.


Cancer Commissioning Toolkit 3


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Musclo Skeletal (£5bn)

Click on the following icons to access a new tool and analysis providing information and interpretation of Patient Reported Outcome Measures (PROMs) data. The tool, called PROMT, is the first of its kind designed specifically for commissioners to assist with health investment decisions.

PROMs are currently collected for 4 procedures: hip and knee replacements, groin hernia and varicose veins. The tool, and analysis, enable commissioners to examine the relationship between a range of factors at local level: pre-operative and post-operative health status, health gain, activity volumes, expenditure, and demographic factors.

A step-by-step guide accompanies PROMT. It features a helpful case study using NHS Oldham as an example.


PROMs Analysis


PROMs analysis




PROMS tool image

Step-by-Step Guide


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Falls prevention resources

The Falls Prevention Resources pack comprises a collection of quality improvement best practice measures for assessing the impact of the number of falls in clinical hospital wards as well as preventing and managing falls.




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Genitourinary (£5bn)


Right Care has published the Atlas of Variation in Healthcare for People with Kidney Disease.

The kidney care atlas is a landmark in the study of variation in kidney care in England. Data from the UKRR and QOF, as well as other datasets, have been used to illustrate how aspects of healthcare specific to kidney disease vary.

The atlas highlights 18 of the many potential indicators relating to kidney care. They represent a sample of the variation in value and quality in renal services across England. Click on the following icon to access the atlas - it is available as a pdf and as an interactive system:



Kidney Atlas


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The Kidney Disease QOF toolkit provides a number of indicators to support the commissioning of kidney care: reported and expected prevalence, performance against the 3 QOF indicators for Chronic Kidney Disease. GPs can benchmark themselves against other similar groups and against their PCT and SHAs.


Kidney Care toolkit


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Health Investment Education Packs (HIEPs) have been designed to highlight the scale of variation in kidney disease care between PCTs and GP consortia. Each pack demonstrate how Programme Budgeting tools and NHS Kidney Care tools can help to identify unwarranted variation and support the health investment process.

The analyses presented provide examples of the indicators of expenditure, expenditure drivers, and the outcomes for kidney disease in a PCT/Consortium. A HIEP has been produced for each of the 151 PCTs in England. Click on the link below to access the packs:


Kidney Disease Health Investment Education Packs


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Gastrointestinal (£5bn)

The NHS Atlas of Variation in Healthcare for People with Liver Disease


Premature death from chronic liver disease is rising, largely as a result of lifestyle issues such as alcohol, drug taking and obesity. There is significant local variation in these mortality rates, with deprivation a key factor. The NHS Atlas of Variation in Healthcare for People with Liver Disease uses data sets in the form of maps to reveal the extent of variations in services and outcomes.


Liver Disease Atlas


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Respiratory (£4.5bn)

COPD pathway

The British Lung Foundation have released a COPD Pathway. Click here to access it.


INHALE Asthma Data Tool reveals marked variation in primary care practice across England

The INHALE Asthma Data Tool is a web-based portal that pulls together a range of thirteen asthma-related indicators from primary and secondary care, allowing comparisons between CCGs.

The Data Tool includes an Asthma Data Atlas -  an interactive map showing data for each CCG in England; and Asthma Spine Charts – where CCG data are benchmarked against the England value.





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The NHS Atlas of Variation in Healthcare for People with Respiratory Disease includes 20 indicators covering asthma, COPD, pneumonia, sleep disorders, prescribing and smoking cessation.

For each indicator achievement is mapped for all PCTs in England.Each map is accompanied by a narrative which describes:

• How big the variation is from area to area,

• why the variation matters for outcomes and value, and

• The steps can be taken to reduce variation in that area (including links to guidance and other resources)

Click on the following icon to access the Atlas.


Atlas of variation respiratory


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The chronic obstructive pulmonary disease (COPD) commissioning toolkit aims to make it easier to commission better outcomes by bringing together the clinical, financial and commercial aspects of commissioning in one place. The toolkit is part of a suite of tools and resources.




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The link below provides access to resources to support the Lung Improvement Programme. It provides national support for the local improvement of respiratory services. This covers Chronic Obstructive Pulmonary Disease (COPD), asthma and home oxygen services. It is an initiative to support the implementation of the National Strategy for COPD Services in England.

As part of NHS Improvement, Lung Improvement aims to support clinical teams, commissioners, service managers and other key stakeholders deliver effective clinical practice through process improvement and redesign.



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The London Health Observatory has produced respiratory Health Investment Packs for all PCTs in the capital. Click on the following link to access them:


London respiratory packs 2


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Social Care Needs (£3bn)

The National Audlt Social Care Intelligence Service (NASCIS) provides a suite of analytical tools and information resources allowing effective and timely access of social care data to support health investment decisions. The tools are provided by the Information Centre for Health and Social Care. Click on the attached icon to access the service:




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Endocrine, Nutritional and Metabolic (£3bn)


Diabetes Prevalence Model for CCGs

The Model shows the total diabetes prevalence by Local Authority and CCG, and estimates the projected prevalence of diabetes for 2012 – 2015, 2020, 2025, and 2030. Click the link below to access the model:



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Right Care has published the Atlas of Variation in Healthcare for People with Diabetes.

The aim of the diabetes atlas is to identify and quantify the extent of unwarranted variation that may be due to unjustified geographical differences in medical practice and/or patients not gaining access to the appropriate level of intervention for their need.

It includes 22 maps of indicators relating to the key care processes and outcomes, use of secondary care, diabetic complications and prescribing. Click on the following icon to access the pdf and interactive versions of the atlas:



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The National Diabetes Information Service provides a wealth of diabetes data and tools. A version of the SPOT tool is available specifically for diabetes. Click on the following icon to access these resources:


Diabetes 3


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The National Obesity Observatory provides information on data, evaluation and evidence relating to weight status and its determinents:




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