Transcript www.westsussex.nhs.uk

Board Report – Performance
September 2009
Produced by Business Intelligence (Performance)
1
Cleanliness and HCAI
West Sussex PCT
Cleanliness and HCAI - MRSA infections
10
9
8
7
6
45
40
35
30
25
5
4
3
2
1
0
20
15
10
5
9
10
Cum ulative Trajectory
2
4
0
4
2
4
3
0
3
3
6
1
1
3
0
8
1
0
2
1
BSUH
SASH
March
February
January
December
November
Mar-10
7
Feb-10
4
Jan-10
1
YTD MRSA Infections
Dec-09
0
2
Nov-09
0
0
Oct-09
3
2
Sep-09
Jul-09
2
acquired pos t adm is s ion
Cumulative trajectory
Aug-09
Jun-09
YTD Actual MRSA Inf ections 2009/10
May-09
MRSA 2009/10
YTD Actual MRSA Inf ections 2008/9
Apr-09
MRSA 2008/9
acquired pre adm is s ion
Wes tern
QVH
October
September
August
July
June
May
April
0
10
13
15
17
19
21
22
22
The was only one case of MRSA recorded in July for Western Hospitals Trust. Cases have fallen month on month to a total of 10 for
July against a DH target of 8,compared to 18 cases this time last year.
Numbers for August show 2 cases of MRSA. Trust and Community attributable show a fifty percent split. Work continues with W est
Sussex Trusts through the HCAI Task Force.
Brighton Trust shows 12 cases against a target of 10. 7 Hospital acquired, however the PCT is only measured against the Host Trust
so BSUH and SASH are for information only.
Lead: Mona Walker – Interim Director of Quality
2
Cleanliness and HCAI
West Sussex PCT
Cleanliness and HCAI - Commissioner Clostridium difficile infections (Community)
100
350
90
300
80
70
250
60
200
50
40
150
30
100
20
50
10
0
0
October
November
January
March
Dec-09
Jan-10
Feb-10
Mar-10
YTD Community 2009/10
Nov-09
YTD Actual C.diff 2008/9
February
Oct-09
YTD DH Community trajectory
December
Sep-09
Community 2009/10
September
Aug-09
Community Cumulative
stretch target
Community Cumulative
DH target
August
Jul-09
Community cumulative
actual
July
Jun-09
Community 2008/9
June
May-09
May
Apr-09
April
15
33
57
70
12
25
39
54
71
89
106
125
143
161
183
206
23
41
58
77
96
117
140
170
199
232
262
292
There were 32 cases for July against a DH trajectory of 50 and a stretch target of 45. This demonstrates the lowest number of cases in a
month since the start of the year. From a year to date point of view we have 163 cases against a DH target of 210 and a stretch target of
179. This is an improvement on last year when we were 22 cases above DH target.
Community cases have also decreased and for the first time this year is showing green against stretch trajectory of 2 cases.
SASH is the only provider who are above stretch trajectory-by one case, however this does not affect the PCT target as we are only
measured against the Host trust.
Lead: Mona Walker – Interim Director of Quality
3
Emergency Care
Category A with 8 minutes response time by District for July – target 75%
District
July 2009
+ / - since last month
June 2009
Adur
75.80%
+1.06%
74.74%
Arun
77.64%
-1.48%
79.12%
Chichester
61.26%
+1.70%
59.56%
Crawley
84.81%
-0.31%
85.12%
Horsham
59.47%
+2.87%
56.60%
Mid Sussex
61.27%
-11.48%
72.75%
Worthing
86.05%
+3.05%
83.00%
West Sussex PCT
73.14%
-0.82%
73.96%
The cumulative position has dropped below the 75% target for the first time this. The 75% target has not been met for 3 consecutive months
and for the first time this month, SECAmb as a whole has dropped below the target.
In order to have achieved the 75% target:Chichester – require to achieve 50 additional responses <8mins for July and 142 cumulatively
Horsham – require to achieve 47 additional responses <8mins for July and 173 cumulatively
Mid Sussex – require to achieve 43 additional responses <8mins for July and 109 cumulatively
West Sussex – require to achieve 43 additional responses <8mins for July and 16 cumulatively
The number of Wards in the lower performing categories (<25% and 25-50%) has increased by 50% since last month (from 24 to 36) –
the decrease is replicated within the 50-75% category.
From the month 10 board update last year, an update was given that listed a number of schemes which would improve the ambulance
response times for Category A within 8 minutes. Having monitored the response times since then a significant improvement has not been
made at Ward level. A short report on the key action points will be agreed with SECAmb and an update will be provided next month. Ward
level analysis can be found in Appendix 1.
4
Emergency Care
Category B with 19 minutes response time by District for July – target 95%
District
July 2009
+ / - Target
Adur
97.56%
+2.56%
Arun
94.80%
-0.20%
Chichester
84.98%
-10.02%
Crawley
91.75%
-3.25%
Horsham
83.59%
-11.41%
Mid Sussex
82.19%
-12.81%
Worthing
95.18%
+0.18%
West Sussex PCT
90.24%
-4.79%
Both cumulatively and monthly, the 95% target has not been achieved. Underachievement has occurred for 4 consecutive months.
5
Waiting times
West Sussex PCT
18 weeks - diagnostic tests
No. patients >/< 6 weeks
70
60
50
40
30
20
10
15
0.0
Mar-10
Feb-10
Jan-10
Dec-09
Nov-09
Oct-09
Sep-09
Aug-09
Mar-10
0
5
0.0
Feb-10
0
Jan-10
0
16
0.0
Dec-09
0
12
0.0
Quarterly data
Nov-09
15
Other
Oct-09
5
Cystoscopy
Sep-09
16
Colonoscopy
Aug-09
Jul-09
12
Jul-09
Jun-09
May-09
Apr-09
Mar-09
Feb-09
Jan-09
Dec-08
Nov-08
Oct-08
Sep-08
Aug-08
Jun-09
Total
Target
Cardiology - echocardiography
May-09
Patients waiting > 6 weeks
for 15 key diagnostic tests
(monthly data)
Patients Waiting 6+ Weeks
for all other diagnostic tests
on Quarterly Census
Audiology - Audiology Assessments
Apr-09
Non-obstetric ultrasound
Jul-08
Jun-08
May-08
Apr-08
0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
There were 15 breaches of the 6 week diagnostic wait in July. These consisted of the following:
Portsmouth Hospital – 1 patient was an ECG delay and this was due to capacity, St Georges Hospital Colonoscopy – 1 patient
breached as Consultant was on annual leave and no locum was arranged for cover
Great Ormond Street (1 patient) and UCL (2 patients) MRI breaches due to capacity- to be rectified by end of the month
UCL – (1 patient) sleep studies awaiting confirmation from patient
Park Surgery – 8 patients waiting 6-7 weeks was a capacity issue and will be raised via contracting. 1 patient waiting 11-12 weeks is
patient choice. These issues are still being raised with the practice through a variation to the contract.
Lead: Bianca Kokkolas, Head of Performance and Programme Management
6
Waiting times
6.) Maximum wait of 26 weeks for an inpatient appointment.
Apr-08 May-08 Jun-08 Jul-08 Aug-08 Sep-08 Oct-08 Nov-08 Dec-08 Jan-09 Feb-09 Mar-09
Patients waiting >26 weeks
for IP appointment
4
5
4
3
9
8
12
9
6
3
6
5
Apr-09 May-09 Jun-09 Jul-09 Aug-09 Sep-09 Oct-09 Nov-09 Dec-09 Jan-10 Feb-10 Mar-10
Patients waiting >26 weeks
for IP appointment
0
1
1
1
SASH – T&O patient
Patient cancelled on original date. Ward did not pass on information and patient was booked and discharged
on IT system and therefore was removed from waiting list.
This is the third month in a row where SASH have breached due to administrative errors. This has been raised
with their host commissioner, Surrey PCT and awaiting response.
Lead: Bianca Kokkolas Head of Performance and Programme Management
7
Sexual Health – Chlamydia screening
West Sussex PCT
W est Sussex PC T
Sexual Health - Screening for Chlamydia - number of paitients screened
Sexual Health - Screening for C hlamydia - % patients screened
2500
45.0%
40.0%
N o . P atien ts screen ed
2000
1500
1000
500
35.0%
30.0%
25.0%
20.0%
15.0%
10.0%
Annualised Screening or testing
The population aged 15 - 24 years
1,467 1,467 1,467 1,750
6,864 6,030 10,824 9,621
87,400 87,400 87,400 87,400
M ar - 10
J an- 10
F eb- 10
D ec - 09
O c t- 09
N ov - 09
Sep- 09
J ul- 09
Aug- 09
J un- 09
M ay - 09
Apr - 09
M ar - 09
J an- 09
F eb- 09
D ec - 08
N ov - 08
O c t- 08
Sep- 08
J ul- 08
Aug- 08
J un- 08
A nnualised A ctual % population aged 15 24 screened or tested for chlam ydia
Target % population aged 15 - 24 screened
or tested for chlam ydia
7.9%
6.9% 12.4% 11.0%
25.0% 25.0% 25.0% 25.0%
Agreement has now been reached as to the funding of the programme, and the contract variation with Western Sussex
Hospitals Trust has been prepared.
A formal letter has been drafted and will be sent to the Trust for them to sign off.
The trajectory for achievement of this target has not yet been agreed but there will be a meeting at the end of Sept to agree this.
The IT system for the collection of data has been ordered and the Trust await delivery.
Lead: Paul Woodcock Public Health Programme Manager
8
M ar-10
F eb-10
J an-10
D ec -09
N ov -09
O c t -09
S ep-09
A ug-09
J ul-09
Mar-10
Feb-10
Jan-10
Dec-09
M ay - 08
Mar-10
Feb-10
Jan-10
Nov-09
Dec-09
Oct-09
Sep-09
Nov-09
Oct-09
Sep-09
Aug-09
Jul-09
501
J un-09
1,701
A ctual % population aged 15 - 24 screened or tested for chlam ydia
Target % population aged 15 - 24 screened or tested for chlam ydia
M ay -09
433
target
A pr-09
572
Jun-09
May-09
Apr-09
No. 15 - 24 year old persons
screened or tested for Chlamydia
target
Aug-09
Jul-09
Jun-09
May-09
Apr-09
Mar-09
Feb-09
Jan-09
Nov-08
Dec-08
Oct-08
Sep-08
Aug-08
Jul-08
Jun-08
May-08
Apr-08
Total number Screened
0.0%
Apr - 08
5.0%
0
Childhood Immunisation
West Sussex PCT
West Sussex PCT
Health Improvement - Immunisation rates 2008-10
Aged 1 immunized for DTaP/IPV/Hib
Health Improvement - Immunisation rates 2008-10
Aged 2 immunised for PCV
97%
97%
96%
96%
95%
94%
95%
93%
92%
94%
91%
93%
90%
89%
92%
88%
87%
91%
86%
85%
90%
Jun-08
Sep-08
Dec-08
Mar-09
Jun-09
Sep-09
Dec-09
Aged 1 immunized for DTaP/IPV/Hib
Jun-08
Mar-10
Sep-08
Dec-08
Mar-09
Jun-09
Sep-09
Aged 2 immunised for PCV
target
Dec-09
Mar-10
target
West Sussex PCT
West Sussex PCT
Health Improvement - Immunisation rates 2008-10
Aged 2 immunised for MMR
Health Improvement - Immunisation rates 2008-10
Aged 2 immunised for Hib/MenC
97%
97%
96%
96%
95%
94%
95%
93%
92%
94%
91%
90%
93%
89%
92%
88%
87%
91%
86%
85%
90%
Jun-08
Sep-08
Dec-08
Mar-09
Aged 2 immunised for Hib/MenC
Jun-09
Sep-09
Dec-09
target
Mar-10
Jun-08
Sep-08
Dec-08
Aged 2 immunised for MMR
Mar-09
Jun-09
Sep-09
Dec-09
Mar-10
target
9
Childhood Immunisation
West Sussex PCT
West Sussex PCT
Health Improvemet - Immunisation rates 2008-10
Aged 5 immunised for DTaP/IPV
Health Improvemet - Immunisation rates 2008-10
Aged 5 immunised for MMR
97%
97%
96%
96%
95%
95%
94%
94%
93%
93%
92%
92%
91%
91%
90%
90%
89%
89%
88%
88%
87%
87%
86%
86%
85%
85%
84%
84%
83%
83%
82%
82%
81%
81%
80%
80%
Jun-08
Sep-08
Dec-08
Mar-09
Aged 5 immunised for DTaP/IPV
Jun-09
Sep-09
Dec-09
target
Mar-10
Jun-08
Sep-08
Dec-08
Aged 5 immunised for MMR
Mar-09
Jun-09
Sep-09
Dec-09
Mar-10
target
DTaP/IPV/Hib age 1 is almost on target. Hib/MenC age 2 uptake is within 2.1% of the target and MMR age 2 is within 1.4% of the
target. Although there has been a marked increase in uptake during the last quarter, considerable improvement is required for
DTaP/IPV age 5 which is 6.4% below target.
An immunisation action plan has been developed using NICE guidance. The immunisation coordinator is consulting with practice
managers, GP locality groups and the head of children’s services. A data reconciliation project is also in progress to improve the
accuracy of records.
Lead: Nick Kendall
10
Cancer Waiting Times
West Sussex PCT
Cancer - Two week GP referral to first OP appointment
West Sussex PCT
31 days from ECAD/DTT to second/subsequent Drug treatment
100%
100%
120
1500
80%
100
80%
1000
60%
80
60%
40%
60
20%
40
0%
20
500
0
Apr-09
May-09
Jun-09
40%
20%
0
Jul-09
0%
Apr-09
Total referrals seen during the period
Number of Breaches
% meeting 2w w target
Target
Total Treated
May-09
Jun-09
Number of Breaches
Jul-09
% meeting target
Target
West Sussex PCT
West Sussex PCT
62 days from decision to treat to first treatment from Consultant Upgrade
62 days from decision to treat to first treatment through screening
100%
25
100%
80%
20
80%
20
60%
15
60%
15
40%
10
40%
20%
5
20%
0%
0
35
30
25
10
5
0
Apr-09
May-09
Jun-09
0%
Apr-09
Jul-09
Total Treated
Total Treated
Number of Breaches
% meeting target
May-09
Jun-09
Number of Breaches
Jul-09
% meeting target
Target
Target
Draf t Target - still to be f inalised
The change to the counting methodology we knew would have an impact and we are continuing to see this effect. Acute trusts
report a specific problem in patients refusing the offered appointment within the 2 weeks. This then has a knock on effect
throughout the pathway. The PCT has taken remedial action in writing to all GPs in West Sussex and explaining the constraints
on trusts surrounding 2ww referrals and the need to ensure that patients understand they are on an urgent pathway. Via local
cancer action groups we are also taking a local perspective and for Worthing have instigated some audits around referrals,
which our GP lead will be looking at with the trust to identify any trends or particular problem areas.
Lead: Alison Hempstead
11
Appendix 1
Focused Wards: Cat A (8 min) Calls
Wards with <60% Cat A (8 min) Response Rates in 08/09 - Arising 09/10
District
Arun District
Arun District
Arun District
Arun District
Chichester District
Chichester District
Chichester District
Chichester District
Horsham District
Horsham District
Horsham District
Horsham District
Horsham District
Horsham District
Horsham District
Mid Sussex District
Mid Sussex District
Mid Sussex District
Total Late
YTD Total
YTD Total Cat A
Total Calls Cat A Resps. Cat A Resps. Resps. >8 min
Ward
08/09
08/09
09/10
09/10
Arundel
171
83
79
29
Barnham
244
100
94
35
Pagham and Rose Green
271
145
102
53
Yapton
175
88
79
42
East Wittering
215
106
67
36
Petworth
186
143
73
63
Southbourne
185
156
77
54
West Wittering
142
68
53
26
Billingshurst and Shipley
271
175
80
61
Bramber, Upper Beeding
139
88
32
20
Chanctonbury
150
80
67
35
Chantry
297
166
124
67
Itchingfield, Slinfold
160
91
61
43
Southwater
176
101
73
46
Steyning
184
96
55
24
Ardingly and Balcombe
175
106
69
34
Crawley Down and Turner
147
111
32
26
Hurstpierpoint and Down
190
100
77
41
Number of Responses >8 min
Apr
4
10
10
11
8
15
8
2
10
4
8
10
7
7
2
6
7
9
May
4
6
13
12
7
16
13
4
22
8
8
22
11
13
11
4
10
12
Jun
11
8
12
7
13
17
15
9
14
3
13
15
19
10
7
9
5
10
Jul
10
11
18
12
8
15
18
11
15
5
6
20
6
16
4
15
4
10
12
Appendix 1 (continued)
13