Determining local service levels for a service for the diagnosis and initial management of transient ischaemic attack and non-disabling stroke
Benchmarks for a standard population
Available data suggest that the standard benchmark rate for carotid endarterectomy is 12 per 100,000 population per year. This is around a 50% increase in the current rate of carotid endarterectomy procedures currently performed in the NHS in England.
For an average primary care trust population of 300,000, the average number of people requiring carotid endarterectomy is 36 per year.
For an average general practice list size of 10,000, the average number of people requiring carotid endarterectomy is one per year.
Examine the assumptions used in estimating these figures.
A transient ischaemic attack (TIA) service is likely to fall under the programme budgeting category 210B (problems of circulation - cerebrovascular disease).
Use the service for the diagnosis and initial management of TIA and non‑disabling stroke commissioning and benchmarking tool to determine the level of service that might be needed locally and to calculate the cost of commissioning the service using the indicative benchmark and/or your own local data.
Further information
Sources of further information to help you in assessing local health needs and reducing health inequalities include:
- Annex A of the Commissioning framework for health and well-being outlines the process and data needed to undertake a joint strategic needs assessment.
- The Department of Health's Delivering quality and value - focus on benchmarking.
- NICE Health equity audit - learning from practice briefing.
- The No delays achiever provides access to service improvement tools aimed at reducing time between referral and treatment.
- The Disease management information toolkit (DMIT) is a good‑practice tool for decision-makers, commissioners and deliverers of care for people with long-term conditions, which presents data on conditions that contribute to high numbers of emergency bed days. It models the effects of possible interventions that may be commissioned at a local level and helps users to consider the likely impact of commissioning options.
- Disease prevalence models produced by the Association of Public Health Observatories (APHO) provide primary care trust-level prevalence estimates for hypertension and coronary heart disease.
- PRIMIS+ provides support to general practices on information management, recording for, and analysis of, data quality, plus a comparative analysis service focused on key clinical topics.
- Payment by Results (PbR) for stroke and transient ischaemic attack (TIA) services.
This page was last updated: 26 March 2010
- TIA service
- Commissioning a service for the diagnosis and initial management of transient ischaemic attack and non-disabling stroke
- Specifying a service for the diagnosis and initial management of transient ischaemic attack and non-disabling stroke
- Determining local service levels for a service for the diagnosis and initial management of transient ischaemic attack and non-disabling stroke
- Assumptions used in estimating a population benchmark
- The commissioning and benchmarking tool
- Ensuring corporate and quality assurance
