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Mapping a path to better healthcare

Geographic information is playing a vital role in helping the NHS plan and deliver services more effectively. Iain Goodwin from Ordnance Survey explains how a licensing agreement for the public sector enables health organisations to get the most out of digital maps.

The Health and Social Care Act is paving the way for a major shake-up of the NHS in England. Care is shifting from hospitals to local community based settings, GP-led commissioning groups are replacing PCTs and SHAs and responsibility for public health is moving to local authorities in April 2013. With such a challenging agenda, the need for evidence based, well informed and up-to-date information to support the planning of health and social care services has never been greater.

It is easy to see why geographic information has an important role to play in the design and delivery of public services. Everything has to happen somewhere so it’s not surprising that 90% of all data contains some sort of location element and can be linked to a map. Consequently, many NHS organisations throughout England are already using digital maps to help plan and tailor their services more effectively. However, using maps is only one half of the story. Central to the process is a licensing agreement between Government and Great Britain’s national mapping agency Ordnance Survey, which allows more effective joint working between public sector organisations.

The Public Sector Mapping Agreement

The Public Sector Mapping Agreement (PSMA) came into effect in April 2011, replacing all previous collective agreements between various parts of the public sector. Open to all public sector bodies, regardless of size, in England and Wales, the PSMA widens access to a broad range of Ordnance Survey digital mapping products and allows geographic data to be used within and shared between all agencies. Already, the PSMA has more than 2,300 member organisations, 263 of which are health related, and is having a significant impact in health and social care planning.

Planning future health services in Birmingham

The Heart of England NHS Foundation Trust in Birmingham is one of the country’s largest health care organisations with a patient population of over one million.

The trust serves a diverse area across the Midlands, stretching from Birmingham to South Staffordshire and includes three hospitals, a specialist chest clinic and a comprehensive range of community health services. With such a large area to cover, defining the trust’s catchment area is a complex process, particularly when the NHS landscape is changing so rapidly. Having access to up-todate and accurate geographic information is essential both to plan future health services and to monitor their quality and efficiency.

An expansion of the trust’s medical laboratory facilities, based at Heartlands Hospital in Bordesley Green, created an opportunity for the organisation to offer a better service to patients, and encourage more GPs to use the new testing services. The18 month building programme has created world-class clinical support facilities including a state of the art fully automated laboratory with specialist testing facilities including a molecular Diagnostics Suite. As a result, the Heart of England trust wanted to promote the new centre to local GPs who were unaware of the increased capacity and the expertise available.

Using geographic information, the trust’s planning and development policy team pinpointed the organisation’s catchment area to a 20 minute drive time around each of its three acute centres. The team then identified the current GPs who were referring tests to LabMed and went on to map surgeries which were in the hospital’s catchment area but not using the medical testing facilities. By analysing the results, the trust was able to promote LabMed services more widely and, more importantly, more accurately.

Joanna Hodgkiss, Head Of Planning and Development, said: “Online mapping has made a significant difference to the effectiveness of all our new projects. Before we kick off a major piece of work, the project is defined with all the necessary accurate information we need right from the start and any intervention is developed from this, not from anecdotal evidence.”

Better use of resources in Bristol

In Bristol, Ordnance Survey geographic information is helping to improve the planning and delivery of drug and alcohol treatment services as well as enabling joint working between the city council and local PCT. Here, Avon IM&T Consortium, which provides information and management technology solutions to four PCTs in South West England, was asked to map where people who use drug and alcohol services live to assess who goes where to access services. The aim was to identify geographic gaps in service provision and to help with future planning of treatment centres across the city.

The first step was to track down the data to support the project. There are currently more than 5,000 people using drug and alcohol services in Bristol, and responsibility for those services is shared between the PCT and local authority. Taking full advantage of the PSMA, Avon IM&T Consortium was able to pinpoint the locations of treatment centres and determine where people using drug and alcohol services live. Thanks to the PSMA, the team was able to use data provided by both the PCT and local authority to calculate the accessibility of local treatment centres, include hospital statistics on alcohol-related admissions and analyse the current provision of services.

The information was presented using the Consortium’s HealthGIS Maps tool, a unique interactive online application to help NHS decision-makers analyse information and plan services more accurately.

The benefits included more accurate planning and delivery of drug and alcohol services, better value for money and use of resources, as well as being a useful way to inform the Joint Strategic Needs Assessment, the means by which PCTs and local authorities work together to plan health and social care services for their community.

Reducing teenage pregnancies in Hull

Geographic information has been key to a successful campaign to reduce teenage pregnancies in Hull where conception rates have reduced by 35% since the city council started using digital maps to plan its sexual health advice services.

Just over a decade ago, national statistics singled out the city as having one of the highest teenage pregnancy rates in the country with conception rates among under 18s reaching almost twice the national average.

Working jointly with Hull PCT, the local authority started using Ordnance Survey digital maps to plan contraception and sexual health advice services. Presenting the information visually on digital maps immediately revealed the hot spots to target with high teenage pregnancy rates emerging in a number of different postcodes and at six of the 14 local schools. It was clear that services had to be targeted in these areas. However, the data also revealed that while 14,000 young people were already getting information and advice, only 2,000 were making it to contraception services. To understand the reasons behind this the council showed the maps to young people to get their views on the proposed location of services and got some interesting results.

Gail Teasdale, integrated services manager for children and young people’s services at Hull City Council, who manages the programme, explained: “Hull is like a collection of small villages and we found that some young people would not move off their estate to access services while others preferred the anonymity of a city centre location which was just a bus ride away. By using maps they were able to tell us more about the unofficial boundaries that exist in the city and where they would go to access contraception advice. Sexual health is often the last subject that young people want to talk about and therefore it is essential that we locate our services in an area and venue where they feel comfortable.”

While there is no magic solution to tackling teenage pregnancy, the strategy has had a major impact on reducing rates locally. Latest figures show that Hull recorded a 35% drop in conception rates among under 18s, compared to 24% achieved nationally. The policy has also proved to be a value for money investment. Hull spends £800,000 a year on the programme but saves more than £8m by reducing teen pregnancy rates and preventing children from going into care, both of which have huge cost implications.

Improving local services in Bromley

In the London Borough of Bromley, mapping is helping to raise awareness of the health needs of local people and informing recommendations to improve health services in the area.

The desire to improve local services and make the best use of NHS resources, including a local hospital building, led to a project being established which would look at the future of health services in the Orpington area of the borough. A project team comprising decision makers from health and social care organisations and representatives from patient groups was set up to review the provision of existing services and assess the health needs of the local population. To assist in the process, the group turned to the public health analyst team at NHS Bromley, which uses Ordnance Survey digital maps to help visualise the complex data required to inform service decision making.

Using hospital admissions data as the focus for analysis, each medical specialty was mapped. Using information on patient postcodes and borough boundaries, analysts were able to find out exactly who was using the hospital, where they lived and what conditions they were being treated for. Taking this a step further, the team divided the borough into three zones and overlaid the maps of each zone with demographic information on age, ethnicity and indicators to determine levels of deprivation. Putting all the data together it was possible to see at a glance which zone had the highest health needs, whether there was an older population or a projected growth in population, where the highest emergency admission rates were coming from as well as many other trends.

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