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Health Sector, Recent Projects

Review of the provision of out-of-hours emergency care arrangements for Borders Health Board

Quantics was asked to review the Borders out-of-hours service (BECS). Using available data sets on usage of various aspects of the service we were asked to consider whether it was the right service, in the right place, at the right time. Quantics was specifically asked to consider the long-term viability of the service, and make recommendations with this in mind.

This project required considerable use of the medical as well as the statistical experience available in-house. Data were provided from three overlapping datasets, one of which was on paper only.

Quantics conducted a user telephone survey and combined this information with the data sets, information from key staff interviews and geographical mapping to derive a number of recommendations for the Health Board.

Quantics was specifically commended by the Board for the quality of the report and for meeting the tight time-line specified.

pie chart

scatter chart of attendances

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Hip fracture care – Analysis of the Scottish Hip Fracture Audit data for Scottish Executive

Quantics was asked to analyse this national data set of 17,000 hip fracture records. The aim was to develop new methodology to case mix match patients and allow identification of hospitals with good or poor performance with respect to various outcome measures. Classification trees (see statistical papers) were used and the analysis showed that the variables required for case mix matching depend on the outcome being measured. Where outlying hospitals were identified, analysis of process factors compared with the average process for a case mix matched group, allowed identification of particular problems, e.g. failure to use aspirin DVT prophylaxis, and excessive non-medical delay to surgery.

This methodology has been adopted as part of the surgical governance portfolio (designed by Quantics) for all health boards in Scotland.

hip fracture care chart

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New community pharmacy contract

Following the publication of the report considering the future of community pharmacy services in Scotland ("The Right Medicine"), Quantics was commissioned to explore the impact of proposed changes to the remuneration structure on individual pharmacist pay and overall budget. The aim was to move away from an item-based fee towards a salary system and involved modelling dispensing activity at an individual pharmacist level, taking into account population demographics and deprivation.

new community pharmacy chart showing repeats and differences

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Surgical governance

The SEHD (Scottish Executive Health Department) and NHSQIS (NHS Quality Improvement Scotland) wish to provide all hospitals and health boards with a comprehensive surgical governance portfolio annually. Because of the work that Quantics had undertaken with major national surgical audits (vide infra) we were commissioned to help design the new portfolio.

Particular emphasis was laid on the need for acceptance by clinicians.

This involves sophisticated clinical case mix matching and presentation in a readily understandable way.

Equally important was information that would help clinicians to identify the process factors likely to be the cause of a particular hospital's good or poor performance.

location diagram for a sample drug

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SASM (The Scottish Audit of Surgical Mortality )

The Scottish Audit of Surgical Mortality aims to investigate every death under the care of a surgeon in Scotland and identify adverse factors in management. Quantics analysed the data from ~12,000 deaths and developed a new classification of adverse events according to their relative risk of being associated with the death. Hospitals with higher than expected numbers of "risky" adverse events can be identified, even if the number of deaths is not abnormal.

sasm chart

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Investigator-led clinical trials

Quantics has been involved in numerous clinical trials. We have experience of the earliest stages of trial design, grant and ethical committee submissions, data monitoring committees, formal analysis of results and final report writing.

Some of the trials are large, international, and multi-centre (e.g.: The Institute of Cancer Research International Breast Group Exemestane Study, 4635 patients over 20 countries) and some are small, local studies (e.g. Edinburgh Oncology Centre Fatigue in Cancer Pain Study - 70 patients). Quantics has particular experience in oncology trials.

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