The NHS Outcomes Framework 2013/14 Technical Appendix - Gov.uk

Domain 1Preventing people from dyingprematurelyIndicator Structure1.1 Domain 1, Preventing people from dying prematurely, comprises two overarchingindicators and seven improvement areas, summarised below.Overarching indicators1a Potential Years of Life Lost (PYLL) from causes considered amenable to healthcare i Adults ii Children and Young people1b Life expectancy at 75 i males ii femalesImprovement areasReducing premature mortality from the major causes of death1.1 Under 75 mortality rate from cardiovascular disease1.2 Under 75 mortality rate from respiratory disease1.3 Under 75 mortality rate from liver disease1.4 Under 75 mortality from canceri One and ii Five -year survival from all cancers1.4.iii One and iv Five-year survival from breast, lung and colorectal cancerReducing premature death in people with serious mental illness1.5 Excess under 75 mortality rate in adults with serious mental illnessReducing deaths in babies and young children1.6.i Infant mortality ii Neonatal mortality and stillbirths iii Five-year survival from allcancers in childrenReducing premature death in people with learning disabilities1.7 Excess under 60 mortality in people with learning disabilitiesDomain 11.2 The overarching indicators cover Potential Years of Life Lost from causes consideredamenable to healthcare, and life expectancy at 75.1.3 Deaths from causes considered ‘amenable’ to health care (as defined for indicators1a.i and ii below) are premature deaths that should not occur in the presence of timelyand effective health care. These indicators have been chosen to capture howsuccessfully the NHS is meeting its objective to prevent people from dyingprematurely where it can make a difference. With the exception of a very smallnumber of deaths at age 75 and over, indicators 1a.i and ii cover the ages 0-74because it is generally considered that most premature deaths occur in this agegroup, and because it is more difficult to determine the cause of death in older peoplebecause they often have multiple co-morbidities. However, to ensure that the NHS isheld to account for doing all that it can to prevent avoidable deaths in older people,Life Expectancy at 75 is included as a second overarching indicator in this domain.This indicator captures all deaths at ages 75 and over.6