Transcript Slide 1

Board Exception Report - Performance
February 2010
(December 2009 data presented)
Produced by Business Intelligence
1
Index
•Health Care Associated Infections (HCAI)
•Emergency Care
•Access
•Cancer
•Primary Care
•Cardiac
•Sexual Health
•Health Improvement
•Stroke & Transient Ischaemic Attacks (TIA)
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
April
May
June
July
August
September
October
November
December
January
Community 2008/09
Community 2009/10
YTD DH Community trajectory
YTD Actual Community 2008/09
February
March
Jun-09
Jul-09
Aug-09
Sep-09
Oct-09
Nov-09
Dec-09
Jan-10
Feb-10
Mar-10
Community Cumulative
stretch target
Community Cumulative
DH target
May-09
Community cumulative
actual
Apr-09
YTD Actual Community 2009/10
15
33
57
70
96
115
133
144
161
12
25
39
54
71
89
106
125
143
161
183
206
23
41
58
77
96
117
140
170
199
232
262
292
Headline: NHS West Sussex [Nursing Homes and General Practice] had 17 cases of Clostridium difficile (C.Diff) in December ’09 which brings
the total YTD to 161. Whilst this is below the community cumulative Department of Health target, it exceeds the Strategic Health Authority
(SHA) stretch target by 18 cases.
Current Actions: Several pieces of work have commenced to continue with efforts to reduce incidents of C.Diff, including:•sign up of a third of GP practices to the HCAI Local Enhanced Scheme (LES)
•an information crib sheet to all the GPs re-issuing the antibiotic guidance
•an HCAI newsletter.
Future Actions: The Quality Directorate are in the process of arranging 3 sessions for the prescribing leads for each practice across the patch.
They will not be infection control sessions but will be learning sets with a microbiologist, a pharmacist and one of the Quality team advising
lessons learnt from the Root Cause Analyses. The bid to the SHA for an antibiotic pharmacist did not receive approval but we are exploring
whether there are alternative routes of funding.
Other: On a positive note, MRSA cases are at 17 against a target of 19 and C.Diff for Acutes is also within DH tolerances. Overall NHS West
Sussex is green against all the DH HCAI targets.
Lead: Julia Dutchman-Bailey, Director of Quality
health and wellbeing, for life
3
Emergency Care - A&E 4 hour wait
West Sussex PCT
Emergency care - A&E attendances
120%
30,000
110%
No. Attendances >/< 4hrs
90%
98% target
80%
20,000
70%
60%
15,000
50%
40%
10,000
30%
% Attendances < 4hr
100%
25,000
20%
5,000
10%
23,837
18,551
18,509
23,133
19,090
18,309
251
329
395
307
133
330
521
370
545
98.7%
98.5%
97.9%
98.7%
99.3%
98.2%
97.7%
98.1%
97.0%
99.3%
99.4%
99.7%
99.7%
99.6%
99.5%
99.5%
99.8%
100.0%
13
Mar-10
19,128
Mar-10
Feb-10
22,663
12
Feb-10
Jan-10
Dec-09
18,957
Jan-10
Nov-09
Dec-09
Oct-09
Nov-09
Sep-09
Oct-09
Aug-09
Sep-09
Jul-09
Aug-09
Jun-09
Jul-09
11
Jun-09
May-09
A&E 7
Attendances
8 > 4 hours
9 - Commissioner
10
May-09
A&E Attendance <= 4
hours - Commissioner
A&E Attendances > 4
hours - Commissioner
% A&E attendances <=
4 hours - PCT
Commissioner
% A&E attendances <=
4 hours - PCT Provider
Services
6
Apr-09
A&E Attendance
<= 4 hours
- Commissioner
2
3
4
5
% A&E attendances <= 4 hours - PCT Commisioner
Apr-09
Mar-09
Feb-09
Jan-09
Dec-08
Nov-08
Oct-08
Sep-08
Aug-08
Jul-08
Jun-08
May-08
0%
Apr-08
0
Headline: Overall the NHS West Sussex position is red for the A&E 4 hour wait for December mainly due to adverse weather conditions affecting
all Sussex Trusts. The position split by Trust is as follows:
•BSUH = 75 breaches
•SASH = 260 breaches
•WSHT = 203 breaches
Current Actions: Contract managers are aware of the reasons for the breaches and are working with the Acute Trusts to plan more effectively for
winter pressures. Surrey PCT have issued a performance notice against SASH for an unacceptable level of performance for A&E 4 hour waits.
Future Actions: Performance will be monitored closely on a monthly basis and any deviation from plan will be picked up by the contract
managers and remedial action plans put in place
Other: The position against the target has remained steady throughout the year. The current cumulative position at December 2010 is 98.39% for
the Commissioner target so the indication is that this will be rectified by year end.
health and wellbeing, for life
4
Lead: Tina Wilmer, Programme Director Unscheduled care
Emergency Care - Ambulance Response Times
West Sussex PCT
Ambulance Response times to Cat A - % within 8 minutes
100%
95%
90%
85%
80%
75%
70%
65%
60%
Sep-09
Oct-09
Nov-09
Dec-09
74.2%
78.2%
80.1%
76.2%
75.3%
70.4%
NHS West Sussex
(Cumulative)
78.1%
76.0%
75.4%
74.8%
75.3%
76.1%
76.1%
76.0%
75.7%
79.6%
77.0%
76.2%
74.5%
77.6%
78.3%
76.1%
78.1%
69.7%
79.6%
78.3%
77.6%
76.8%
77.0%
77.2%
77.0%
77.2%
76.3%
Feb-10
Jan-10
Dec-09
Nov-09
Mar-10
Mar-10
Aug-09
74.8%
Feb-10
Jul-09
75.3%
Jan-10
Jun-09
78.1%
SECAmb (Monthly)
SECAmb
(Cumulative)
Oct-09
Sep-09
Aug-09
Jul-09
Jun-09
% Cat A 8 minutes
NHS West Sussex
(Monthly)
May-09
Monthly Actual Performance SECAMB
Apr-09
Monthly Actual performance West Sussex
May-09
Apr-09
Mar-09
Feb-09
Jan-09
Dec-08
Nov-08
Oct-08
Sep-08
Aug-08
Jul-08
Jun-08
May-08
Apr-08
75% target
Headline: Performance for Cat A <8 minutes has dropped below target for the first time since July 2009, due to adverse weather conditions,
combined with exceptionally high activity in emergency care, particularly during the first weekend of snow. Whilst Cat A <8 minutes was not
achieved during the month, it remained above 75% for the year to date. The Cat A <19 minute target was maintained above 95% during the
month, which was a significant achievement bearing in mind the weather conditions.
Current Actions: No remedial action at this stage. Continued monitoring of performance by SECSCG.
Future Actions: Possible application of contractual framework to be determined by SEC SCG.
Other: Continued monitoring of performance to ensure compliance
Lead: Dominic Ellett, Assistant Director Acute Contracting
health and wellbeing, for life
5
Emergency Care - Ambulance Response Times
West Sussex PCT
Ambulance Response times to Cat B - % within 19 minutes
100%
95%
95% target
90%
85%
80%
75%
70%
65%
Sep-09
Oct-09
Nov-09
Dec-09
90.7%
92.8%
92.7%
93.3%
91.4%
87.2%
NHS West Sussex
(Cumulative)
92.9%
91.5%
91.5%
91.1%
91.3%
91.6%
91.8%
91.8%
91.2%
95.5%
93.9%
93.2%
92.7%
94.0%
94.1%
93.2%
94.0%
88.4%
95.5%
94.7%
94.2%
93.8%
93.8%
93.9%
93.8%
93.8%
93.1%
Feb-10
Jan-10
Dec-09
Nov-09
Mar-10
Mar-10
Aug-09
91.9%
Feb-10
Jul-09
90.9%
Jan-10
Jun-09
93.8%
SECAmb (Monthly)
SECAmb
(Cumulative)
Oct-09
Sep-09
Aug-09
Jul-09
Jun-09
% Cat B 19 minutes
NHS West Sussex
(Monthly)
May-09
Monthly Actual Performance SECAMB
Apr-09
Monthly Actual Performance West Sussex
May-09
Apr-09
Mar-09
Feb-09
Jan-09
Dec-08
Nov-08
Oct-08
Sep-08
Aug-08
Jul-08
Jun-08
May-08
Apr-08
60%
Headline: SECAmb continue to perform at levels below the contracted requirement for West Sussex and for South East Coast as a whole. Poor
weather conditions in December have contributed to further deterioration. Overall activity is 2.5% above baseline for YTD.
Current Actions: Contractual framework and penalty applied for non-performance.
Future Actions: No further action at this stage. Subject to review by SECSCG.
Other: The performance notice issued to SECAmb in relation to consistent underachievement against this target was removed in December as
a penalty was imposed as per contracting performance criteria.
Lead: Dominic Ellett, Assistant Director Acute Contracting
health and wellbeing, for life
6
Access – Diagnostic Test Waiting Times
West Sussex PCT
Diagnostic Tests (within 6 weeks)
No patient >6 weeks
250
200
150
100
50
0
5
0.0
15
0.0
57
206
0
0
0
0
0
22
0.0
18
0.0
7
0.0
57
0.0
206
0.0
Dec-09
Nov-09
Oct-09
Sep-09
Aug-09
Jul-09
Jun-09
May-09
Apr-09
Mar-09
Feb-09
Jan-09
7
Mar-10
0
18
Feb-10
0
14
0.0
22
Jan-10
0
12
0.0
Dec-09
15
Nov-09
5
Oct-09
14
Sep-09
12
Aug-09
Jul-09
Dec-08
Nov-08
Oct-08
Sep-08
Aug-08
Jul-08
Jun-09
Total
Target
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
Apr-09
Jun-08
May-08
Apr-08
0
0.0
0.0
0.0
Headline: There were 206 breaches of the 6 week target in December. BSUH were responsible for 116 of these; Flexi-Sigmoidoscopy (38) and
Gastroscopy (66) due to job planning and capacity issues. There has been a complete review of the entire booking process at the hospital and
additional clinics have been added. Further breaches are expected at the end of January 2010 due to the size of the issue and the Board have
been briefed on this. Other contributors include West Sussex Health with 55 audiology assessment breaches and Western Sussex Hospitals with
34 breaches (mostly non-obstetric ultrasound and Gastroscopy).
Current Actions: Action plans have been received and contract managers are managing the situation. We are in contact with Brighton & Hove
City PCT and the provider to implement the trust remedial action plan as a matter of urgency.
Future Actions: West Sussex Health have assured the Trust that appointments are always offered when cancellations occur and
communication will be improved to ensure management are able to address issues as soon as they arise and flag them up through the risk
management process.
Other: Continued work with Providers has kept the breaches to a minimum throughout the year and the current issue at BSUH should be rectified
by next month.
Lead: Debra Wheeler, Head of Market & Capacity Management
health and wellbeing, for life
7
Access – Stage of Treatment Waiting Times
Inpatient waiting >26 weeks
Outpatient waiting >13 weeks for first appointment
2
Mar-10
Jan-10
Feb-10
Nov-09
Dec-09
Oct-09
Sep-09
Jul-09
Aug-09
Jun-09
Apr-09
May-09
Mar-09
Jan-09
Feb-09
Nov-08
Apr-08
Dec-08
0
Dec-09
Nov-09
Oct-09
Sep-09
Jul-09
Aug-09
Jun-09
Apr-09
May-09
Mar-09
Jan-09
Feb-09
Nov-08
Dec-08
Oct-08
Sep-08
Jul-08
Aug-08
Jun-08
Apr-08
May-08
0
4
Oct-08
20
6
Sep-08
40
8
Jul-08
60
10
Aug-08
80
12
Jun-08
100
14
May-08
No of patients >26 weeks
No of patient >13 weeks
120
Maximum wait of 13 weeks for an outpatient appointment.
Patients
waiting >13
weeks
Apr-08
May-08
Jun-08
Jul-08
Aug-08
Sep-08
Oct-08
Nov-08
Dec-08
Jan-09
Feb-09
Mar-09
Apr-09
May-09
Jun-09
Jul-09
Aug-09
Sep-09
Oct-09
Nov-09
Dec-09
1
1
0
0
3
16
45
59
84
96
109
104
43
23
2
0
0
1
1
10
2
Jan-10
Feb-10
Mar-10
Jan-10
Feb-10
Mar-10
Maximum wait of 26 weeks for an inpatient appointment.
Patients
waiting >26
weeks
Apr-08
May-08
Jun-08
Jul-08
Aug-08
Sep-08
Oct-08
Nov-08
Dec-08
Jan-09
Feb-09
Mar-09
Apr-09
May-09
Jun-09
Jul-09
Aug-09
Sep-09
Oct-09
Nov-09
Dec-09
4
5
4
3
9
8
12
9
6
3
6
5
0
1
1
1
1
1
2
1
2
Headline: SASH were responsible for the two 13 week waiters (one in Ophthalmology, one in Paediatric medicine). Both patients have now been
seen. The 26 week breach was at Western Sussex Hospitals in Ophthalmology due to a TCI (to come in) card being filed within a patient’s notes.
Current Actions: Root Cause Analyses (RCA) and breach reports have been received and action plans are in place at both providers
Future Actions: Execution of the action plans will be monitored to ensure learning from RCAs is implemented.
Other: Indicative tolerances are set at: Achieving <=0.03%, Underachieving <=0.15% and Failing >0.15%. Overall NHS West Sussex are YTD at:
•13 week at December is 0.08% underachieving in relation to numbers of patients seen overall.
•26 week at December is 0.017% and therefore achieving the target in relation to numbers of patients seen overall.
Lead: Debra Wheeler, Head of Market & Capacity Management
health and wellbeing, for life
8
Access – GP Referrals
West Sussex PCT
GP Referrals - General & Acute Specialties
16,000
14,000
GP Referrals
12,000
10,000
8,000
6,000
4,000
2,000
2007/08 Actuals
GP Referrals
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
YTD Total
Average p/m
2007/08 Actuals
9,454
11,087
10,872
11,757
11,155
10,310
11,141
10,649
8,276
11,548
10,914
9,893
94,701
7,892
2008/09 Actuals
12,485
12,072
12,658
12,911
11,156
12,692
12,986
11,376
10,635
11,982
11,630
13,188
108,971
9,081
2008/09 Actuals
2009/10 Actuals
12,606
12,189
13,557
13,896
11,367
13,106
13,323
12,573
11,049
113,666
12,630
2009/10 Actuals
Mar
Feb
Jan
Dec
Nov
Oct
Sep
Aug
Jul
Jun
May
Apr
0
2009/10 Plan
2009/10 Plan
10,052
9,138
9,595
10,509
9,138
10,052
10,509
9,138
9,595
9,595
9,138
10,052
116,510
Headline: GP referrals continue to run above planned levels but decreased in month as per the seasonal trend
Current Actions: Contract managers are working with each Acute Trust and Practice Based Commissioning (PBC) Group in order that trends are
identified and understood. Peer review within PBC localities using benchmarked data is being used to inform the debate. Other referrals have
decreased against previous years although still running ahead of plan. Data from Western Sussex Hospitals Trust new PAS system is being
validated as activity is being double counted but not double charged
Future Actions: The new head of planned care Debra Wheeler (Head of Market and Capacity Management) will work with PBC and Programme
Manager to continually review the position.
Other: 2010/11 contracts are being set at outturn.
Lead: Debra Wheeler, Head of Market & Capacity Management
health and wellbeing, for life
9
Primary Care - Dental
West Sussex PCT
Primary Care - Dental services
600,000
100%
550,000
80%
500,000
60%
450,000
40%
400,000
20%
350,000
300,000
0%
Jun-08
Sep-08
Dec-08
Mar-09
No. of Patients (Actual)
Patients seen in previous 24
months
Jun-08
Sep-08
Dec-08
Mar-09
Jun-09
Sep-09
Dec-09
Mar-10
% achieved
92%
92%
93%
95%
101%
102%
99%
Jun-09
No. of Patients (Target)
No. Patients
(Actual)
403,369
403,603
409,181
415,525
418,588
422,734
426,218
Sep-09
Dec-09
Mar-10
% actual achieved
No. Patients
(Target)
439,702
439,702
439,702
439,702
415,525
415,525
429,198
440236
Headline: Department of Health Access target for end March 2011 – 58% (465,000) of West Sussex Residents to access NHS Dental Services
Current Actions: A tender exercise to consolidate and further increase general dental access throughout the county for 2010/11 is in
process. Following issue of Invitation To Tender (ITT) documentation, bids have been received from twenty-five Dental Providers, covering various
locations across West Sussex and are currently being evaluated. There is a timeline in place but there is currently a delay and the implications in
relation to its exact effect on evaluation are not yet clarified.
Future Actions: Dental contracts have been extended within 2009/10 to manage capacity.
Other: Specialist Dental services; orthodontics, sedation, minor oral surgery, community dental and emergency dental being reviewed alongside
general dental access.
Lead: David Grant, Contract Manager Dental Services
health and wellbeing, for life
10
Cancer - 2 week wait
West Sussex PCT
Cancer - Two week GP referral to first OP appointment
120%
1,800
target 93 %
1,600
100%
1,400
% wait < 2 weeks
No. Patients waiting >/< 2 weeks
2,000
80%
1,200
1,000
60%
800
40%
600
400
20%
200
Mar-10
Feb-10
Jan-10
Dec-09
Nov-09
Oct-09
Sep-09
Aug-09
Jul-09
Jun-09
May-09
0%
Apr-09
0
Patients waiting < 2 weeks
from urgent GP referral to first
OP appointment
Patients waiting > 2 weeks
from urgent GP referral to first
OP appointment
% of patients waiting < 2
weeks
Dec-09
Nov-09
Oct-09
Sep-09
Aug-09
Jul-09
Jun-09
Apr-09
May-09
% patients w aiting < 2 w eeks
1,144
1,041
1,212
1,278
1,109
1,235
1,223
1,186
1,126
98
89
113
99
113
94
89
57
85
92.1%
92.1%
91.5%
92.8%
90.8%
92.9%
93.2%
95.4%
92.98%
Headline: The number of breaches has increased again this month and analysis of the reasons given by trusts shows that the vast majority are due
to patient choice i.e. a patient has declined an offer of an appointment which was within a 2 week window as specified within policy. This was made
worse by patients not wanting to attend before the Christmas period and due to the adverse weather conditions.
Current Actions: Working with Cancer networks and acute trusts to ensure issues are not related to capacity. All GP practices provided with patient
leaflets and information.
Future Actions: Continue to monitor and work with GPs to ensure patients informed of the reasons why a 2 week appointment is being offered.
Other: National thresholds may change over time.
Lead: Alison Hempstead, Cancer Programme Director
health and wellbeing, for life
11
Cardiac - Thrombolysis
West Sussex PCT
Cardiac - Thrombolysis, 60 minute call to needle time
90%
80%
70%
150
target 68 %
60%
50%
100
40%
30%
50
% waiting < 60 mins
Waiting >/< 60 mins call to needle
100%
200
20%
10%
Mar-10
Dec-09
Sep-09
Jun-09
Mar-09
Dec-08
Sep-08
Jun-08
Mar-08
Dec-07
Sep-07
0%
Jun-07
0
Actual YTD
Period
Jun
Sep
Dec
Mar
Jun
Sep
Dec
Mar
Jun
Sep
Dec
Mar
Total Call to
Needle
07
07
07
08
08
08
08
09
09
09
09
10
57
48
41
62
39
32
24
35
26
18
29
Call to Needle < =
60 mins
Target (AHC)
37
32
27
49
33
29
22
29
23
11
14
68%
68%
68%
68%
68%
68%
68%
68%
68%
68%
68%
68%
Actual Quarterly
Actual YTD
65%
67%
66%
79%
85%
91%
92%
83%
88%
61%
48%
65%
66%
66%
70%
85%
87%
88%
87%
88%
77%
66%
Call to Needle > 60
mins
20
16
14
13
6
3
2
6
3
7
15
Headline: Last quarter thrombolysis figures dropped dramatically. It would appear that this can largely be attributed to a decrease in data collection
around the St Richard's site. The % dropped from 75% in Q2 to 20% in Q3. Overall our performance is 66% YTD.
Current Actions: The trust have plans in place to ensure data quality and data collection is improved through additional resource and will be
actioned imminently.
Future Actions: NHS West Sussex will continue to review the data on a monthly basis. Overall the target has been achieved and this appears to be
a data issue which should now be resolved.
Other: NHS West Sussex has now recruited to a Cardiac Programme Manager and their role will be to review and performance monitor Providers to
ensure compliance
health and wellbeing, for life
Lead: Tina Wilmer, Programme Director Unscheduled 12
care
Sexual Health - Chlamydia
West Sussex PCT
Sexual Health - Screening for Chlamydia - % patients screened
45%
40%
% Patients screened
35%
30%
25%
target
25%
20%
15%
10%
Annualised Screening or
testing
The population aged 15 - 24
years
572
433
1,701
501
363
2,108
458
793
1,889
1,467
1,467
1,467
1,750
1,750
1,750
2,033
2,033
2,033
6,864
6,030 10,824
9,621
8,568 11,356 10,519 10,394 11,757
87,400 87,400 87,400 87,400 87,400 87,400 87,400 87,400 87,400
Mar-10
Feb-10
Jan-10
Dec-09
Nov-09
Oct-09
Sep-09
Aug-09
Jul-09
Jun-09
May-09
Apr-09
Dec-09
Nov-09
Oct-09
Sep-09
Aug-09
Jul-09
Jun-09
May-09
Dec-09
Nov-09
Oct-09
Sep-09
Aug-09
Jul-09
Jun-09
Target % population aged 15 - 24 s creened or tes ted for chlam ydia
Apr-09
No. 15 - 24 year old persons
screened or tested for
Chlamydia
target
May-09
Apr-09
Actual % population aged 15 - 24 s creened or tes ted for chlam ydia
Mar-09
Feb-09
Jan-09
Dec-08
Nov-08
Oct-08
Sep-08
Aug-08
Jul-08
Jun-08
Apr-08
0%
May-08
5%
Annualised Actual % population aged 15 - 24
screened or tested for chlamydia
7.9% 6.9% 12.4% 11.0% 9.8% 13.0% 12.0% 11.9% 13.5%
Target % population aged 15 - 24 screened
or tested for chlamydia
25.0% 25.0% 25.0% 25.0% 25.0% 25.0% 25.0% 25.0% 25.0%
Headline: There has been a significant increase in numbers screened for Chlamydia in December 2009, almost reaching the YTD highest position
which was in September.
Current Actions: NHS West Sussex have issued a performance notice against West Sussex Hospitals for poor performance against chlamydia
screening within the contract.
Future Actions: The Local Enhanced Scheme has been through Executive Team at NHS West Sussex and approved, however funding is not yet
released. Next steps are to implement plans to mail out to all 21-24 year olds about screening as there is good evidence that this will increase up-take
of screening in other counties.
Other: Significant improvements in numbers screened demonstrate that the work carried out by the Programme have been successful.
Lead: Paul Woodcock, Programme Manager Sexual Health
health and wellbeing, for life
13
Health Improvement - Immunisations
West Sussex PCT
West Sussex PCT
Health Improvement - Immunisation rates 2008-10
Aged 1 immunized for Diphtheria/Tentus/Pertussis (DTaP) / Polio (IPV) / Haemophilos influenzae Type B (Hib)
Health Improvement - Immunisation rates 2008-10
Aged 2 immunised for Haemophilos influenzae Type B (Hib) / Meningococcal group C meningitis (MenC)
98%
98%
96%
96%
96% target
95% target
94%
94%
92%
92%
90%
90%
88%
88%
86%
86%
84%
84%
82%
82%
80%
80%
Jun-08
Sep-08
Dec-08
Mar-09
Aged 1 immunized for DTaP/IPV/Hib
Jun-08
Sep-08
Dec-08
Mar-09
Jun-09
Sep-09
Dec-09
Mar-10
Jun-09
Sep-09
Dec-09
Jun-08
Mar-10
target
Aged 1 immunized for
DTaP/IPV/Hib
Mar-09 YTD Target
94.4%
95.0%
94.8%
95.0%
94.8%
95.0%
94.9%
95.0%
94.8%
95.0%
94.8%
95.0%
94.5%
95.0%
0.0%
0.0%
Sep-08
Dec-08
Mar-09
Aged 2 immunised for Hib/MenC
Jun-08
Sep-08
Dec-08
Mar-09
Jun-09
Sep-09
Dec-09
Mar-10
Jun-09
Sep-09
Dec-09
Mar-10
target
Aged 2 immunised for
Hib/MenC
Mar-09 YTD Target
92.6%
96.0%
92.8%
96.0%
92.9%
96.0%
93.0%
96.0%
94.0%
96.0%
94.2%
96.0%
92.6%
96.0%
0.0%
0.0%
Headline: The data for the recent quarter is preliminary. We have seen the expected decline in performance in Q3 owing to the additional burden of the
swine flu vaccination programme in GP practices.
Current Actions: DTP/IPV aged 1 - There has been a small decline in Q3 however this is very close to target and to achieve this would require 16 more
children to complete their primary course. Hib/MenC at age 2 - There has been a decline in Q3, however NHS West Sussex may not achieve the target
set by the end of 2009/10 as further 165 children would need to be immunised.
Future Actions: Work is ongoing with the HIS to address inaccuracies in the records held by Child Health Bureau. The Director of Public Health is being
approached to approve the funding (from within the PH directorate) to continue the data reconciliation exercise. This should result in improved statistics
describing immunisation coverage for the cohorts in question.
Others: Work by the Immunisation Co-ordinator is on-going with the Practices to encourage take-up
Lead: Nick Kendall, Consultant in Public Health
health and wellbeing, for life
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Health Improvement - Immunisations
West Sussex PCT
West Sussex PCT
Health Improvement - Immunisation rates 2008-10
Aged 2 immunised for Measules / Mumps / Rubella (MMR)
Health Improvement - Immunisation rates 2008-10
Aged 5 immunised for Diphtheria/Tetanus/Pertussis (DTaP) / Polio (IPV)
98%
98%
96%
96%
94%
94%
92%
96% target
92%
92% target
90%
90%
88%
88%
86%
86%
84%
84%
82%
82%
80%
Jun-08
Sep-08
Dec-08
Aged 2 immunised for MMR
Jun-08
Sep-08
Dec-08
Mar-09
Jun-09
Sep-09
Dec-09
Mar-10
Mar-09
Jun-09
Sep-09
Dec-09
Mar-10
80%
Jun-08
target
Aged 2 immunised for MMR Mar-09 YTD Target
88.7%
91.0%
88.8%
91.0%
88.8%
91.0%
89.0%
91.0%
90.8%
92.0%
90.4%
92.0%
89.8%
92.0%
0.0%
0.0%
Sep-08
Dec-08
Mar-09
Aged 5 immunised for DTaP/IPV
Jun-08
Sep-08
Dec-08
Mar-09
Jun-09
Sep-09
Dec-09
Mar-10
Jun-09
Sep-09
Dec-09
Mar-10
target
Aged 5 immunised for
DTaP/IPV
Mar-09 YTD Target
87.7%
96.0%
86.8%
96.0%
86.7%
96.0%
87.2%
96.0%
89.8%
96.0%
90.7%
96.0%
88.5%
96.0%
0.0%
0.0%
Headline: MMR vaccine dose 1 at age 2 - The MMR coverage has shown a very small decline this month. It is unlikely that the PCT will achieve the
92% coverage target for the year 2009/10. Another 91 children would have to be immunised by the end of March. MMR dose 2 aged 5 - This year’s
target is green, although the achievement of the 95% target for 2010/11 is doubtful (representing a step change from 84% to 95% in one year).
Current Actions: Children under 5 are now being called into the surgeries for their swine flu vaccines until the end of February 2010. There will be the
opportunity to persuade parents who have not decided, about the safety and efficacy of other childhood vaccines (parents may prefer to come back to
have their child immunised at a separate appointment). The Immunisation co-ordinator will draw this to the attention of the practice managers.
Future Actions: The latest Immform data show 85% coverage of dose 1 of the school based immunisations. The current programme is set to recover
and the PCT should meet this year’s target. There is a detailed project plan held by NHS West Sussex.
Other: For the month of January 2010, the school based immunisations have been set back owing to the closure of schools during the bad weather.
health and wellbeing, for life
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Lead: Nick Kendall, Consultant in Public Health
Health Improvement – Breastfeeding
West Sussex PCT
West Sussex PCT
Breastfeeding Initiation rates at 6-8 weeks
Coverage of breast feeding status
100%
100%
90%
90%
80%
80%
70%
70%
60%
90% Target
60%
48% Target
50%
50%
40%
40%
30%
30%
20%
20%
10%
10%
0%
Jun-08
Sep-08
Dec-08
Mar-09
Jun-09
Sep-09
Dec-09
0%
Mar-10
Jun-08
Actual No. of infants at 6-8 weeks who are breastfed
Jun-08
Sep-08
Dec-08
Mar-09
Jun-09
Sep-09
Dec-09
Mar-10
The number of children
recorded as being
partially breastfed
(receiving both breast
milk and infant formula)
at 6-8 weeks during
quarter 4.
251
233
235
199
221
251
232
Target No. of infants at 6-8 weeks who are breastfed
No.r of infants
recorded as being
totally breastfed at 6-8 No. of infants due for a 6–8
weeks during quarter week checks during quarter
4.
4
717
2,184
720
2211
700
2205
617
2019
646
2,092
714
2,284
582
2,212
Prevalence - No. of
infants at 6-8 weeks
who are breastfed
against the no. that are
due for checks during
q4
44.32%
43.10%
42.40%
40.42%
41.44%
42.25%
36.80%
The number of children
being recorded as not at
all breastfed at 6–8
weeks during quarter 4.
813
813
726
660
717
770
650
Sep-08
Dec-08
Mar-09
Jun-09
Actual No.children with a breastfeeding status recorded
Jun-08
Sep-08
Dec-08
Mar-09
Jun-09
Sep-09
Dec-09
Mar-10
Coverage: No.children with
a breastfeeding status as a
percentage of all infants due
for a 6–8 week check
81.55%
79.87%
75.33%
73.11%
75.72%
75.96%
66.18%
Sep-09
Dec-09
Mar-10
Target No.children with a breastfeeding status recorded
Target
85.00%
85.00%
85.00%
85.00%
90.00%
90.00%
90.00%
90.00%
Headline: The targets for prevalence and coverage have not been met
Current Actions: The backlog of data entry has now been completed and NHS West Sussex has recently submitted revised figures. An action plan is
being implemented by West Sussex Health to address data cleansing issues. This will improve the achievement, however we are unlikely to meet the
2009/10 target.
Future Actions: The new manager for the Child Health Bureau is now in place and has been tasked with prioritising this indicator to improve the current
systems
Other: For clarification, prevalence is the number of babies actually recorded as being breastfed against the number of babies due their 6/8 week check
and coverage is the number asked.
Lead: Catherine Scott, Programme Director, Health and Wellbeing
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health and wellbeing, for life
Health Improvement - Diabetic Retinopathy
West Sussex PCT
Health Improvement - Diabetic Retinopathy, % patients offerred screening for Diabetic Retinopathy
100% target
100%
80%
60%
40%
20%
0%
Jun-08
Sep-08
Dec-08
Mar-09
% achievement
Jun-08
Sep-08
Dec-08
Mar-09
Jun-09
Sep-09
Dec-09
Offered screening for
diabetic retinopathy
25912
23924
22854
22613
26337
26788
27616
Total no. with diabetes
(including those exclusions
from screening)
27,866
28,888
27,391
30,317
31,276
30,346
30,051
% achievement
93%
83%
83%
75%
84%
88%
92%
Jun-09
Sep-09
Dec-09
% Target
% Target
100%
100%
100%
100%
100%
100%
100%
Headlines: Brighton & Sussex University Hospitals NHS Trust Diabetic Retinopathy Screening (DRS) service has indicated it expects to
experience some capacity issues in the last quarter of 09/10, however the Programme envisages meeting the Annual Health Check (AHC)
target for 2009/10. Western Sussex NHS Trust DRS service continues to perform ahead of the planned trajectory submitted in the in-year
recovery plan and is confident it will meet the AHC target by the end of 2009/10.
Current Actions: Western Sussex Hospitals Trust has seen dramatic increases in the uptake of screening and the trajectory is indicating
that they will achieve green status by year end.
Future Actions: Work is on-going with Western Sussex Hospitals Trust to ensure the continued improvements in uptake.
Other: The joint working carried out by NHS and West Sussex Hospitals Trust has been a very positive step in improving the target.
Lead: Viv Mussell, Programme Manager Screening
health and wellbeing, for life
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Stroke & TIA
West Sussex PCT
West Sussex PCT
Stroke - time on a stroke unit
Stroke - Patients at risk of TIA scanned and treated < 24 hours
Mar-09
Mar-11
Dec-10
313
272
288
301
123
132
157
148
39.3% 48.5% 54.5% 49.2% 0.0% 0.0% 0.0% 0.0% 0.0%
65.0% 66.0% 68.0% 69.0% 70.0% 72.0% 75.0% 78.0% 80.0%
No. with TIA who are high risk
No. with TIA who are scanned and treated < 24 hrs
% with TIA who are scanned and treated < 24 hrs
Target %
31
10
32%
29%
39
17
44%
35%
75
26
34.7%
41%
0
45%
0
48%
0
52%
0
57%
% treated < 24 hrs
Mar-11
Dec-10
Sep-10
Jun-10
Mar-10
Dec-09
Sep-09
Jun-09
Mar-09
Mar-11
Dec-10
Target %
Sep-10
Target %
Jun-10
No. with TIA who are scanned and treated < 24 hours
% with TIA who are scanned and treated<24 hours
Mar-10
No. with TIA who are high risk
Dec-09
Jun-09
Mar-09
% who spend > 90% of their time on a stroke unit
-200%
No. who spend > 90% of time on a stroke unit
Sep-09
No. admitted to hospital with stroke
No. with stroke who are admitted to hospital
No. who spend > 90% of time on a stroke unit
% who spend > 90% of their time on a stroke unit
Target %
Sep-10
Jun-10
Mar-10
Dec-09
Sep-09
-200%
Jun-09
0
-150%
Mar-11
-150%
100
Dec-10
200
-100%
Sep-10
-100%
300
-50%
Jun-10
-50%
400
0%
Mar-10
500
50%
45% 09/10 Target
60% 10/11 target
Dec-09
0%
600
100%
Sep-09
700
50%
200
190
180
170
160
150
140
130
120
110
100
90
80
70
60
50
40
30
20
10
0
Jun-09
70% 09/10 Target
80% 10/11 target
% time on stroke unit
800
No. at high risk of TIA treated </> 24 hrs
100%
900
Mar-09
No. stroke admissions >/< 90% time on stroke
unit
1000
0
60%
Headline: There remains an issue with the recruitment of stroke nurses within NHS West Sussex and this has impacted on the targets.
Current Actions: Patients at Surrey and Sussex NHS Healthcare Trust (SASH) are currently diverted to Guildford or Brighton out of hours. The Sussexwide position is to implement tele-medicine which should improve the current situation. Surrey PCT have issued a performance notice against SASH in
relation to stroke performance consistently falling below target.
Future Actions: Western Sussex Hospitals have recently installed a new information system and are currently reviewing quarter 3 numbers as part of a
data quality exercise and looking to re-submit at year end based on improved data capture.
Other: The current position should improve by the next quarter due to the actions taken by the Programme stated above.
Lead: Tina Wilmer, Programme Director Unscheduled care
health and wellbeing, for life
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