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ICD
International classification of diseases. Version 10 is currently in use. Every patient admitted to hospital should have an associated ICD code – this contributes to defining the HRG. The reports generated from this data are only as good as the coding and analysis but are often used to analyse demand for services. Local coding and information departments can tell you know more about how they are applied and interpreted locally. See here. Chapter X is diseases of the respiratory system. Chronic lower respiratory diseases are J40-J47.
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Independent sector (IS)
An umbrella term for all non-NHS bodies delivering healthcare, including a wide range of private companies and voluntary organisations.
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Independent sector treatment centre (ISTC) and Treatment centres (TCs)
These are providers of elective surgery and tests for patients. Commercial providers have won a number of tenders from the NHS to expand capacity. The price is normally agreed outside the national tariff. A new book by Player and Leys, with foreward by Dr Wendy Savage, Confuse and Conceal on the story has just been published, see here.
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Indicative Allowance (social care)
The Indicative Allowance is also known as the Gross Individual Budget and is the maximum amount of funding made available to meet an individual’s social care support needs. It is worked out through the RAS
Related Words
RAS - resource allocation system (social care)
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Indicators for Quality Improvement (IQI) http://www.ic.nhs.uk/services/measuring-for-quality-improvement
High Quality Care for All, the final report of the NHS Next Stage Review, defined quality in the NHS as safe and effective care of which the patient's whole experience is positive. The NHS Information Centre and the Department of Health have identified an initial, but evolving, set of over 200 indicators to describe the quality of a broad range of services. The long-term vision is to produce an extensive menu of indicators. Some will be used at national level; others will be included as part of local contract negotiations. See also here
Related Words
National Quality Board; Quality; Quality observatory; Quality Standards
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Indicators for Quality Improvement IQI
In response to High Quality Care for All these indicators have been developed by the NHS Information Centre drawn from national datasets and are primarily intended for use by NHS staff to inform quality improvement activities, supported by appropriate statistical techniques to analyse and interpret the data. There are over 200 available from the Information Centre
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Indirect payments (social care)
Indirect Payments are similar to Direct Payments, but instead of being paid to the individual who needs the service, payments are made to a nominated individual or into a trust. The trustees or nominated people then pay for services on the individual’s behalf.
Related Words
Direct Payments (social care)
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Individual Budgets (social care)
Service users/patients receive an Individual Budget and use this to pay for a variety of services. The individual budget contains funding from several sources, including social services, the Independent Living Fund, Supporting People, Disabled Facilities Grant and Access to Work. It can also be used to purchase equipment if this is needed. Crucially, individual budgets encompass a number of different agencies but are accessed at a single point, making the system easier to navigate for service users compared to the old multi-agency approach.
Related Words
Direct Payments (social care); Individual Health Budget (IHB); Personalisation (health and social care)
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Individual Health Budget (IHB)
IHB's are being piloted at present (autumn 2009) for participating PCTs. They offer the following budget options to patients
- Notional budget held by commissioner
- Budget managed by a third party on pts behalf e.g care provider, independent user trust
- Direct Payment to service user for health care
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Individual Service Fund (social care)
An Individual Service Fund is an individual budget that a service provider manages on behalf of a service user. Payments are made with the understanding that the service provider can deliver what is needed and it meets the criteria set out in the service user’s support plan.
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Information Prescriptions (IP)
http://www.informationprescription.info/index.html
One of five core elements of self care identified in patient prospectus Your Health, your way 2008. April 2009. The NHS Constitution, published in January 2009, makes the provision of patient information a right and is backed up by legislation for the first time. The NHS Constitution also states that they “will help people to access relevant information about their long-term condition.’ Information prescriptions will contain a series of links or signposts to guide people to sources of information about their health and care – for example information about conditions and treatments, care services, benefits advice and support groups. Online resource to help set up a system http://www.informationprescription.info/resource/index.html. Final report of evaluation of pilots: http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_086889
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Integrated care organisations (ICOs)
These form part of the Next Stage Review and are seen as a means of achieving improved coordination of care, delivering better services between secondary, primary and social care, and providing improved overall care for patients more economically. A national pilot in England is due to start in 2009. Core features include primary care involvement. They may be disease-specific or generic services. Social care is not compulsory. Indeed, the term integrated care can be used, as it is for IMPRESS, to mean care crossing primary, community and secondary care boundaries, but it can also mean integration between health and social care. There is a very good literature review by Naomi Fulop, as well as a prospectus on the integrated care pilots (see here)
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Integrated Service Improvement Programme (ISIP)
An NHS in England approach and set of tools to help health and social care communities work together to plan and make changes that will address current national priorities to achieve financial balance, bring care closer to home and out of hospital and address the 18-week waits target. It looks daunting, but is a systematic and thorough approach to ensure the changes planned will make a positive difference. See here
There are nine useful principles to judge your service against, to help make the case for service change: (see here)
- Health Equality Across Populations
- Support Individual Wellbeing
- Care Provided in the Right Setting
- Appropriate Access and Choice for All
- Timely, Convenient and Responsive Services
- High Quality Clinical Outcomes
- Optimise Workforce Capacity and Capability
- Efficient and Effective Delivery of Services
- Financial Balance Across the Local Health Economy.
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Integration
IMPRESS, as a joint initiative between two clinical societies, started from the point of wanting to explore how to improve patient care through improvments in the care pathway across primary and secondary care. Therefore, in effect, it was advocating integration between primary and secondary care. As community providers have moved at arms length from primary care trusts, so IMPRESS has explicitly included community service providers too. It is also aware that for many, integration - and see entry on integrated care organisations and pilots - means integration with social care providers so that patients get the services they need without the need to understand or negotiate boundaries. There are many useful resources for the evidence base on integration. Few, as yet, can describe significant benefits, particularly from integration of organisations. See Rebecca Rosen's review In addition, Naomi Fulop and colleagues produced a review of the literature on integration to support the selection of the DH pilot sites. See IMPRESS good practice examples for updates. In terms of making a difference, integration of DATA seems to be an important step, but so is finding a common vocabulary. This Jargon Buster includes both health and social care vocabulary. The Practical Guide to Integrated Working from the Integrated Care Network (2008) offers some further insights itnto what integration means - between health and local authority services. It also offers a definition: "In its most complete form, integration refers a single system of needs assessment, service commissioning and /or service provision." The end point is improved outcomes.
Related Words
Integrated care organisations (ICOs)
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Intermediate care
Also known as step up, step down and transitional care – this is care out of hospital for people who are medically stable but still need temporary care in a community bed or home-care for recovery and rehabilitation. Commissioners are increasing their investment in such services in order to provide care closer to home, to reduce avoidable admissions and excess lengths of stay. The services are often nurse-led but there needs to be clear agreement about medical responsibility, See also Opportunity Locator. Further information can be found here. Care Service Improvement Partnership change agent team here.
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Invisible Lives
Recent report by the British Lung Foundation that used Mosaic data to identify hot spots for COPD. Download the pdf report here.
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Invitation to tender (ITT)
See here
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