Transcript Slide 1

Board Report - Performance
December 2009
Produced by Business Intelligence
1
Cleanliness and HCAI – Nursing Homes/General Practice
West Sussex PCT
Cleanliness and HCAI - Commissioner Clostridium difficile infections (Community)
100
350
90
300
80
250
70
60
200
50
150
40
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
96
115
133
12
25
39
54
71
89
106
125
143
161
183
206
23
41
58
77
96
117
140
170
199
232
262
292
The PCT has reduced the overall number of cases of C.Difficile by 46% compared to the same time last year. This comparison is in line with
national statistics where the rate of decrease has been greatest among Acute Trust apportioned cases ( 61%) and 40% in all other episodes. The
rate of decrease on Acute hospital sites may reflect stricter regimes of prescribing and rapid isolation of presenting index cases.
The largest rates occur in the over 65 year olds, Data suggests this may be reflecting specific differences in the epidemiology of the disease within
this age group and requires a particular focus upon how these patients are managed in different settings.
Providers are ahead of target except Community Primary care/Nursing homes where they are 25 cases above their stretch target. Community
does not include West Sussex health who are within target.
Lead: Mona Walker – Interim Director of Quality
health and wellbeing, for life
2
Emergency Care – 4 hour A&E Wait
Year to date - com m is s ioner 99.5%
West Sussex PCT
Emergency care - A&E attendances
120%
30,000
110%
100%
90%
98% target
% Attendances < 4hr
No. Attendances >/< 4hrs
Perf ormance Traf f ic Light
25,000
80%
20,000
70%
60%
15,000
50%
40%
10,000
30%
5,000
20%
10%
BSUH
QVH
SASH
WESTERN
18,509
23,133
251
329
395
307
133
330
521
98.7%
98.5%
97.9%
98.7%
99.3%
98.2%
97.7%
99.0%
99.6%
98.8%
98.1%
99.5%
99.3%
93.6%
98.0%
99.2%
99.6%
95.3%
99.1%
99.3%
99.5%
98.8%
99.3%
99.1%
99.9%
94.5%
98.5%
Feb-10
Jan-10
Dec-09
Nov-09
Oct-09
Sep-09
Mar-10
Mar-10
Oct-09
18,551
Feb-10
Sep-09
23,837
Jan-10
Aug-09
19,128
Dec-09
Jul-09
22,663
Nov-09
Jun-09
18,957
99.3%
99.3%
98.4%
98.4%
Aug-09
Jul-09
Jun-09
May-09
May-09
A&E Attendance <= 4
hours - Commissioner
A&E Attendances > 4
hours - Commissioner
% A&E attendances <=
4 hours - PCT
Commissioner
A &E A ttendances > 4 hours - Commissioner
Apr-09
A &E A ttendance <= 4 hours - Commissioner
% 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
98.9%
99.1%
94.3%
97.8%
Although individual Trust A&E performance has taken a dip across the board, it is the Surrey & Sussex Healthcare (SASH) performance
failure in October that has pushed the PCT Commissioner position below the 98% target. SASH performance is not as low as July when they
were issued a performance notice by Surrey PCT, although the numbers of attendances have risen sharply for month 7 contributing to the
current position. SaSH have received assistance from the Emergency Care Intensive Support Team and they are now working through
implementation of agreed action plans to address their performance.
From the first six months of 2007/08 to the first six months of 2008/09, the total A&E attendances for NHS West Sussex increased by 2.4%
and from 2008/09 to 2009/10, this has increased by 7.3%. For BSUH the increase was 6.8% and 8.3%, SASH was 2.3% and 12.2% and
Western Sussex Hospitals was 1.3% and 6%.
Lead: Paul Goddard – Head of Acute Contracting
health and wellbeing, for life
3
Emergency Care – Ambulance Response Times
West Sussex PCT
Ambulance Response times to Cat B - % within 19 minutes
100%
95%
95% target
90%
85%
80%
Oct-09
92.2%
93.6%
92.8%
93.7%
93.3%
93.2%
Feb-10
Jan-10
Dec-09
Nov-09
Oct-09
Sep-09
Aug-09
Jul-09
Mar-10
Mar-10
Sep-09
90.2%
92.2%
Feb-10
Aug-09
91.3%
92.9%
Jan-10
Jul-09
90.3%
93.3%
Dec-09
Jun-09
92.9%
95.1%
Nov-09
May-09
% Cat B 19 minutes
W SX PCT
SECAMB
Monthly Performance SECAMB
Apr-09
Montly Actual Performance West Sussex
Jun-09
May-09
Apr-09
Mar-09
Feb-09
Jan-09
Dec-08
Nov-08
Oct-08
Sep-08
Aug-08
Jul-08
Jun-08
Apr-08
70%
May-08
75%
SECAmb continue to perform at levels below the contracted requirement for West Sussex and for SEC as a whole.
SECSCG have been seeking to manage this with the provider. Proposals from SECSCG have been made to all PCTs in this respect with a
choice provided to continue to manage performance through contractual process (including the application of penalties) or to vary the level of
expected performance to a level below national standard and seek a small reduction in contract value. The majority of commissioners
(accounting for over 73% of the investment) wanted to vary the contract and manage the financial risks for 2009/10. NHS West Sussex does
not support this position and has expressed a wish to apply contractual process. Confirmation as to the agreed course of action has yet to be
received.
Lead: Tina Wilmer / Dominic Ellett
health and wellbeing, for life
4
18 weeks
W est S ussex P C T
1 8 we e ks - d ia g no stic te sts
No. patients >/< 6 weeks
70
60
50
40
30
20
18
7
0
0
0
0
0
0
0
12
0.0
14
0.0
5
0.0
15
0.0
22
0.0
18
0.0
7
0.0
M ar-10
Feb-10
Jan-10
Dec-09
Nov-09
Oct-09
M ar-10
22
Feb-10
15
Quar ter ly data
Jan-10
Oct-09
5
Other
Dec-09
S ep-09
14
Cy s tos c opy
Nov-09
A ug-09
12
S ep-09
A ug-09
Jul-09
Jun-09
M ay-09
A pr-09
M ar-09
Feb-09
Jan-09
Dec-08
Nov-08
Oct-08
S ep-08
A ug-08
Jul-09
Colonos c opy
Jun-09
T o ta l
Target
Car diology - ec hoc ar diogr aphy
M ay-09
P atients waiting > 6 week s
for 15 k ey diagnos tic tes ts
(m onthly data)
P atients W aiting 6+ W eek s
for all other diagnos tic tes ts
on Q uarterly Cens us
A udiology - A udiology A s s es s ments
A pr-09
Non- obs tetr ic ultr as ound
Jul-08
Jun-08
M ay-08
0
A pr-08
10
0.0
0.0
0.0
0.0
0.0
In October there were 7 breaches of the 6-week diagnostic target:
1 at BSUH for audiology – an onward referral to a clinic open once a month that did not have capacity – now rectified
3 at Guys – 1 in each of sleep studies, urodynamics and cyctoscopy. The Trust are having problems with data submissions and have estimated
these figures.
1 at Portsmouth – patient choice
2 at Park Surgery – for 1, the GP had requested a time outside the 6 weeks
Lead: Bianca Kokkolas – Head of Performance and Programme Management
health and wellbeing, for life
5
18 weeks
5
.)M
a
x
im
u
m
w
a
ito
f1
3
w
e
e
k
s
fo
ra
n
o
u
tp
a
tie
n
ta
p
p
o
in
tm
e
n
t.
A
p
r
0
8M
a
y
0
8J
u
n
0
8 J
u
l0
8A
u
g
0
8S
e
p
0
8O
c
t0
8N
o
v
0
8D
e
c
0
8J
a
n
0
9F
e
b
0
9M
a
r
0
9
P
a
tie
n
ts
w
a
itin
g
>
1
3
w
e
e
k
s
f
o
rO
P
a
p
p
o
in
tm
e
n
t
1
1
0
0
3
1
6
4
5
5
9
8
4
9
6
1
0
9
1
0
4
A
p
r
0
9M
a
y
0
9J
u
n
0
9 J
u
l0
9A
u
g
0
9S
e
p
0
9O
c
t0
9N
o
v
0
9D
e
c
0
9J
a
n
1
0F
e
b
1
0M
a
r
1
0
P
a
tie
n
ts
w
a
itin
g
>
1
3
w
e
e
k
s
f
o
rO
P
a
p
p
o
in
tm
e
n
t
4
3
2
3
2
0
0
1
1
6
.
)M
a
x
im
u
m
w
a
ito
f2
6
w
e
e
k
s
f
o
ra
n
in
p
a
t
ie
n
ta
p
p
o
in
t
m
e
n
t
.
A
p
r
0
8M
a
y
0
8J
u
n
0
8J
u
l0
8A
u
g
0
8S
e
p
0
8O
c
t0
8N
o
v
0
8D
e
c
0
8J
a
n
0
9F
e
b
0
9M
a
r
0
9
P
a
tie
n
ts
w
a
itin
g
>
2
6
w
e
e
k
s
f
o
rI
P
a
p
p
o
in
tm
e
n
t
4
5
4
3
9
8
1
2
9
6
3
6
5
A
p
r
0
9M
a
y
0
9J
u
n
0
9J
u
l0
9A
u
g
0
9S
e
p
0
9O
c
t0
9N
o
v
0
9D
e
c
0
9J
a
n
1
0F
e
b
1
0M
a
r
1
0
P
a
tie
n
ts
w
a
itin
g
>
2
6
w
e
e
k
s
f
o
rI
P
a
p
p
o
in
tm
e
n
t
0
1
1
1
0
0
1
Both the Inpatient and Outpatient breaches in October occurred at Brighton & Sussex University Hospitals Trust.
The Outpatient breach was at 13 weeks and was in Elderly Medicine. There was a three week delay in consultant triage of the referral prior to
arranging the appointment. The Service Manager was not notified that an appointment was not available within 13 weeks. BSUH have reviewed
their process for triaging referrals in elderly medicine and escalation processes.
The Inpatient breach was in T&O and was at 29weeks. The patient declined the original operation date offered. Surgery was then cancelled twice:
the first time due to the patient needing to be treated by a particular consultant who was unavailable and the second time due to ward closure
because of an MRSA infection outbreak.
Year to date, NHS West Sussex is achieving the Inpatient waiting times target as the current percentage is at 0.01% against a target of less than
0.03%. Based on an estimated final year activity figure of 77,232, as long as there are less than 23 breaches in total, we should achieve the target.
NHS West Sussex is currently underachieving on the Outpatient waiting times target. Based on an estimated final year activity figure of 127,202 as
long as the number of breaches do not exceed 190, then we should still under achieve rather than fail this target.
Lead: Bianca Kokkolas – Head of Performance and Programme Management
health and wellbeing, for life
6
Sexual Health
West Sussex PCT
West Sussex PCT
Sexual Health - Screening for Chlamydia - number of paitients screened
Sexual Health - Screening for Chlamydia - % patients screened
2500
45.0%
40.0%
2000
No. Patients screened
35.0%
1500
1000
500
30.0%
25.0%
20.0%
15.0%
10.0%
5.0%
Annualised Screening or
testing
The population aged 15 - 24
years
Mar-10
Jan-10
Feb-10
Dec-09
Oct-09
Nov-09
Sep-09
Jul-09
Aug-09
Jun-09
Apr-09
May-09
Mar-09
Jan-09
Feb-09
Dec-08
Oct-08
Nov-08
Sep-08
Jul-08
Aug-08
Jun-08
Apr-08
572
433
1,701
501
363
2,108
458
1,467
1,467
1,467
1,750
1,750
1,750
2,033
6,864
6,030
10,824
9,621
8,568
11,356
10,519
87,400
87,400
87,400
87,400
87,400
87,400
87,400
Annualised Actual % population aged 15 - 24
screened or tested for chlamydia
Target % population aged 15 - 24 screened
or tested for chlamydia
7.9%
6.9% 12.4% 11.0%
Oct-09
Sep-09
Aug-09
Jul-09
Jun-09
May-09
Oct-09
Sep-09
Aug-09
Jul-09
May-08
Mar-10
Jan-10
Feb-10
Dec-09
Nov-09
Oct-09
Aug-09
Sep-09
Actual % population aged 15 - 24 screened or tested for chlamydia
Target % population aged 15 - 24 screened or tested for chlamydia
target
Jun-09
0.0%
Apr-09
No. 15 - 24 year old persons
screened or tested for
Chlamydia
target
May-09
Apr-09
Total number Screened
Jul-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
May-08
Apr-08
0
9.8% 13.0% 12.0%
25.0% 25.0% 25.0% 25.0% 25.0% 25.0% 25.0%
The chlamydia trajectory continues to form one of the areas of contention within the contract variation with WSHT, this continues to be
worked on by the PCT Programme Manager. The Performance notice is also a barrier to the contract variation being signed, the
contracting team and SACS are working on this
The IT system is now operational and existing data is being entered into the system, which will make interrogation of the system much
easier. The LES is completed but is yet to be signed off.
Lead: Paul Woodcock Public Health Programme Manager
health and wellbeing, for life
7
Cancer Targets
West Sussex PCT
Cancer - Two week GP referral to first OP appointment
West Sussex PCT
Cancer - Two week GP referral to first OP appointment
95.0%
2000
1800
94.0%
1600
1400
93.0%
1200
1000
92.0%
800
600
91.0%
400
200
90.0%
0
Apr-09
Apr-09
May-09
Jun-09
Jul-09
Total ref errals seen
Aug-09
Sep-09
May-09
Jun-09
Jul-09
Aug-09
Sep-09
Oct-09
Oct-09
% meeting 2w w target
Number of Breaches
West Sussex PCT
62 days from decision to treat to first treatment from Consultant Upgrade
25
Target
West Sussex PCT
62 days from decision to treat to first treatment from Consultant Upgrade
100.0%
20
95.0%
15
90.0%
85.0%
10
80.0%
5
75.0%
0
70.0%
Apr-09
May-09
Jun-09
Total Treated
Jul-09
Aug-09
Sep-09
Oct-09
Apr-09
May-09
Jun-09
Jul-09
% meeting target
Number of Breaches
Draft Target - still to be finalised
Aug-09
Sep-09
Oct-09
Target
Draft Target - still to be finalised
2 week wait – Patients choosing to cancel or change their appointment continues to be an issue. However this month we have met the 93% target for
the first time since the new methodology was introduced. Year to date we are still slightly under target at 92.2 %
Consultant Upgrades – There were 3 breaches; reasons given by the trusts were:
• Longer than usual diagnostic pathway requiring two MDT's discussion prior to treatment decision and delay to treatment planning following inter-trust
referral
• Delay to treatment planning (chemo)
• Delays in pathway due to patient choice
health and wellbeing, for life
Lead: Alison Hempstead Programme Director Cancer
8
Performance Notices
Trust
SECAmb
SASH
Western Sussex Hospitals Trust
Western Sussex Hospitals Trust
Western Sussex Hospitals Trust
WSPCT
Sussex Partnership Trust
Reason
Category B % within 19 minutes
A&E Performance
Breast Screening Action Plan not supplied
Diabetic Retinopathy Action Plan not effective
Chlamydia Screening - performance
Over Performance in Demand Plan
Failure to provide the methodology for the audit of care planning by 31 July
2009 as required
Failure to provide a plan for ending mixed sex accommodation by 30th
June 2009
Failure to provide a plan for widening the provision of women-only dayareas by 30th June 2009
The number of people receiving Early Intervention in Psychosis Service
has been below the target trajectory for three consecutive months in
Brighton and Hove and in West Sussex
Baseline figures for the proportion of adults in contact with secondary
mental health services in employment were not supplied by the end of
June
The number of completed IAPT treatments has been significantly below
the target trajectory for three consecutive months for both East Sussex
PCTs and Brighton and Hove PCTs
The percentage of face-to-face assessments carried out within 5 days of
assessment has been below the target for three consecutive months in
Brighton and Hove PCT
The percentage of interventions carried out within five days of assessment
has been significantly below the target for three consecutive months in
Brighton and Hove PCT
The trajectory for the increase in the numbers of people receiving direct
and indirect payments has not been reached in any month since the
beginning of the contract year, in breach of Schedule 3 Part 4.B Item 8 of
The trajectory for the reduction in the numbers of people accommodated in
registered care has not been reached in any month since the beginning of
the contract year, in breach of Schedule 3 Part 4.B Item 7 of the Contract
BSUH
SASH
SASH
The provider has materially failed to meet the requirements of clause 19 in
complying with reasonable request for the purpose of audit the provision of
the services and for information to the provision of services
BHCPCT
Cesarian Section Rates continue to be below target within contract
Surrey PCT
Stroke performance continue to be below target within contract
Surrey PCT
Sussex Partnership Trust
Sussex Partnership Trust
Sussex Partnership Trust
Sussex Partnership Trust
Sussex Partnership Trust
Sussex Partnership Trust
Sussex Partnership Trust
Sussex Partnership Trust
Sussex Partnership Trust
health and wellbeing, for life
By whom
Helen Medlock
Surrey PCT
Sue Braysher
Sue Braysher
Sue Braysher
BSUH
Date
27.07.09
04.08.09
11.08.09
11.08.09
11.08.09
11.08.09
Removed
Dominic Ellett
14.08.09
07.10.09
Dominic Ellett
14.08.09
07.10.09
Dominic Ellett
14.08.09
07.10.09
Dominic Ellett
14.08.09
Dominic Ellett
14.08.09
Dominic Ellett
14.08.09
Dominic Ellett
14.08.09
Dominic Ellett
14.08.09
Dominic Ellett
09.10.09
Dominic Ellett
09.10.09
22.10.09
24.11.09
24.11.09
27.10.09
07.10.09
9
Performance Notices (previous slide)
Two Performance Notices were issued by Surrey PCT to Surrey and Sussex NHS Trust in relation to concerns around
performance in both Stroke Care and Caesarian Sections
Lead: Bianca Kokkolas, Head of Performance and Programme Management
health and wellbeing, for life
10