Transcript Performance Management Summary December 2010

REPORT STATUS: OPEN
BOARD OF DIRECTORS’ MEETING – 25th July 2012
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Report Title: Performance Management Report Summary
Report From: Robert Harrison, Director of Performance and Delivery
Report Purpose: For information
1.
Background
This report summarises HDFT’s latest performance position – based on key performance indicators used by the Department of
Health, Monitor and the Care Quality Commission. The report also looks at locally defined performance measures and presents a
summary of the latest activity position for June.
2.
Key messages for June 2012
The Trust will declare Amber-green status to Monitor as it has reported 4 cases of C-difficile in the quarter which places it above
the performance trajectory of 3 per quarter.
Provisional data indicates that the Trust achieved all of the RTT 18 weeks standards in June.
The 5 key Emergency Department clinical quality indicators continue to be achieved.
Provisional data demonstrates that the SINAP (Stroke Improvement National Audit Programme) performance indicators are at
77.5% in June, compared to 74.5% in May.
TIA performance for June is below the national standard of 60%.
All cancer waiting times standards were achieved for the quarter.
3.
Recommendations/ Next Steps
That the Board of Directors note the information provided in the report.
Performance Framework 2012/13
•
The key performance indicators are based on the Department of Health 2012/13 performance framework, the 2012/13
Monitor Compliance Framework and a number of supporting performance measures.
Performance Highlights
•
There was one case of Hospital acquired C. difficile in June which increases the year-to-date position to 4 cases, which is
above the performance trajectory of 3 per quarter.
•
Provisional data indicates that the Trust achieved all of the RTT 18 weeks standards in June.
•
The 5 key Emergency Department clinical quality indicators continue to be achieved.
•
Provisional data suggests the SINAP (Stroke Improvement National Audit Programme) performance indicators have shown
further improvement in June and the Trust’s overall score remains above the national average at 77.5%, compared to 74.5%
last month. However, TIA performance for June continues to be below the standard of 60%.
•
Cancer Waiting Times standards - 5 out of 7 standards were achieved in June. However, all standards were achieved for
the quarter.
•
The Trust reported no mixed sex accommodation breaches for June.
•
The average length of stay remains lower than the levels recorded in previous years, and this is indicative of a general
downward trend in recent years.
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Red rated measures in CQC Quality & Risk Profile
• The number of red rated measures ("worse than expected" or much worse that expected“) in the Quality & Risk Profile this month is 6, a
decrease from 7 last month.
• The following measures are red-rated but have had a local review with actions completed:
• PEAT score for Trust Policy Information - Do the Trusts cleaning arrangements ensure that cleaning services are available 24
hours a day?;
• Proportion of disabled car parking spaces available to total number of car parking spaces available for use.
• The following red-rated measures have a local review underway that has not yet been completed:
• The following previously red-rated measure which has had a local review with actions completed is no longer red-rated this month:
• Standardised in hospital mortality rates by health resources group chapters: R - spinal surgery and primary spinal conditions;
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2012/13 Performance Framework
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Community Services Standards Focus
HPV Immunisation Cohort 9 (Year 8 11/12)
Percentages for Dose 1 and Dose 2 remain at 92% and 90%. As in
2011 Dose 3 began in March and this month is at 81%, compared to
82% in June 2011.
Delivery of Community Equipment within 7 Working Days
The first graph shows the percentage of equipment delivered within 7
working days in the month for each store across both health and
social care (excluding non-standard equipment). The percentage
delivered in 7 working days decreased in June for York, Harrogate
and Scarborough stores, and Colburn store’s performance remained
consistent. The second graph compares the total volume of deliveries
by store.
Out of Hours Service (OOH) Data Quality
The Director of Performance & Delivery, together with the Out of Hours
(OOH) team, met with YAS (Yorkshire Ambulance Service) in June. It
was acknowledged that there are ongoing definitional issues with the
data from the Adastra system, particularly around the reporting of call
start and stop times which affect the performance calculations. However
it is not yet possible to quantify the impact of this on performance. YAS
will continue to work with Adastra to resolve these issues. In the
meantime, the data reported this month remains unvalidated and is
reported as per the figures received from YAS.
It was agreed that the Information Team at HDFT will be provided with a
full OOH data set each month from the Adastra system which will enable
in-house performance reporting against the OOH national quality
requirements going forward.
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Acute Services - Efficiency Indicators
Medical Bed Occupancy
Medical bed occupancy has shown a steady decrease
over the last two and a half years, with the percentage
dropping from 102% in December 2009 to 96% in June
2012.
General and acute (G&A) Bed Occupancy
G&A bed occupancy levels were at 84.3% in June, 3%
lower than in June last year. However the reduction is
due to the long Bank Holiday weekend at the
beginning of June when occupancy levels were
significantly lower than during a normal working week.
Looking at Q1 overall, G&A bed occupancy was 87.4%
this year, compared with 85.6% in the same period last
year.
Day case rates
Performance against the basket of 25 procedures
performed as a day case has improved in recent
months and the percentage is above the level reported
at the same time last year. Please note that data for
June is provisional only.
Average Length of Stay (ALOS)
The ALOS remains lower than the levels recorded in
2011/12, and this is indicative of a general downward
trend which shows that the ALOS for non-elective
cases in 2008/09 was 7.1 days, compared to 5.2 days
in 2012/13 to date. Likewise, ALOS for elective cases
has fallen from 3.9 days in 2008/09 to 2.7 days in
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2012/13.
Acute Activity
The activity profile for 2012/13 requires agreement in
line with completion of contract negotiation.
New Outpatients
New outpatient activity in June 2012 was 7.4% lower
than at the same time last year (5,426 vs. 5,860). The
number of Consultant led attendances in June 2012
was 7.6% lower than in 2011, and Nurse led activity
was down by 6.9% in June.
It is estimated that around 570 appointments were lost
as a result of the Jubilee Bank Holiday. Had these
appointments taken place, the total new outpatient
activity in June 2012 would have been approximately
2.3% higher than June last year.
Follow up Outpatients
There were 9.6% fewer follow-up outpatient
attendances in June 2012 than at the same time last
year (11,951 vs. 13,225). Consultant led attendances
were 13.7% below the total in June 2011, and Nurse led
activity was down by 1.9% in June 2012.
Elective Admissions
The total of elective admissions were 0.7% lower in
June 2012 than at the same time last year (2,282 vs.
2,299). There were 2.5% more day cases in June 2012
than in 2011 and inpatient elective admissions were
down by 17.9%.
Non Elective Admissions
Non-elective admissions activity was 6.6% higher in
June 2012 than at the same time in 2011 (1,450 vs.
1,360).
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Patient Reported Outcome Measures (PROMS)
• Last month’s report presented average health gain scores from the
provisional PROMs data for the period April to December 2011.
• The “average health gain” measures the difference between the pre
and post operative survey responses to assess improvements in the
patient’s health following the procedure.
• When compared to other acute trusts, HDFT’s average health gain
scores were just above the national average for knee replacement
but below average for hip replacements and groin hernia, where our
scores put us in the bottom 25% of acute trusts.
• However the health gains scores do not assess the overall outcome
for the patient and a low health gain score may be reflective of the
fact that patients’ scores before surgery were better than average
and so a large health gain is less likely.
• The charts on the left illustrate this by showing both the average
outcome score and the average health gain score for each acute
Trust.
• As can be seen, for knee replacements, HDFT have one of the best
outcome scores across all trusts but are only just above national
average score for the average health gain.
• Similarly for hip replacements and groin hernia, HDFT’s outcome
scores are good, but the average health gains for HDFT are below
national average.
• HDFT’s outcome scores are above national average for all three
procedures.
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Care and Quality – Hospital Mortality Information
• There is no update on the published mortality scores since last month. The NHS Information Centre last published an update of its
mortality measure, the Summary Hospital Mortality Index (SHMI), in April. A further update is expected later this month.
• HDFT’s latest SHMI score is 93.8, below the national average (100) and lower than the previously published score (98.0).
• Dr. Foster continue to use the Hospital Standardised Mortality Ratio (HSMR). HDFT’s current score is 101.1.
• For both measures, the national score is set at 100 – a score significantly above 100 indicates higher than expected death rates,
whereas a score significantly below 100 indicates lower than expected death rates.
• The chart below compares local trusts’ scores on the latest publically available data for both measures.
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Monitor – 2012/13 compliance framework
The Compliance Framework, published by Monitor in
March 2012, outlines the approach that will be taken to
regulating NHS Foundation Trusts in 2012/13.
Service performance will be assessed on a quarterly basis
according to a matrix, the results for Q1 are shown in the
adjacent table, where:
• Green = a score of less than 1.0
• Amber-green = a score from 1.0 to 1.9
• Amber-red = a score from 2.0 to 3.9
• Red = a score of 4.0 or more
The Trust’s Monitor rating for Q1 is Amber-Green.
Three quarters’ successive failure of a national
requirement and other targets weighted 1.0: Where an
NHS foundation trust fails to meet the same national
requirement or the same target weighted 1.0 for three or
more consecutive quarters, Monitor will consider red-rating
the Trust and escalation for consideration of significant
breach.
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