APPENDICES FOR THE CORPORATE PERFORMANCE REPORT Final Report for September Board The following appendices are attached for information: Key Targets Appendix 1 Key Targets - Summary LDP Activity / Waiting Times Appendix 2 Analysis of Elective (Inpatient and Daycase) Waiting Lists Appendix 3 Analysis of Outpatient Waiting Lists and Outpatient Waiters Appendix 4 6+ Weeks Diagnostic Waits (15 Tests) Appendix 5 Cancer – 14, 31 and 62 Day Targets Appendix 6 % of A & E Attendances Southport & Ormskirk Trust within 4 hours % of A & E Attendances for Aintree Trust including Litherland Town Hall Health Centre (LTHHC) and 36% activity of Knowsley Walk in Centre (WIC) within 4 hours Appendix 7 Ambulance Data Cat A and Cat B Performance Appendix 8 Referral to Treatment (RTT) Admitted and Non Admitted Patient Care Appendix 9 MRSA and targets for Aintree Trust and Southport & Ormskirk Trust Author: Ally Dwyer/Jackie Cole Jones, Version 1 dated 20-8-07 path s/info/board reports 5nj/ DRAFT Appendices Sept 2007 Version 1.doc
Transcript
APPENDICES FOR THE CORPORATE PERFORMANCE REPORTFinal Report for September Board
The following appendices are attached for information:
Key Targets
Appendix 1 Key Targets - Summary
LDP Activity / Waiting Times
Appendix 2 Analysis of Elective (Inpatient and Daycase) Waiting Lists
Appendix 3 Analysis of Outpatient Waiting Lists and Outpatient Waiters
Appendix 4 6+ Weeks Diagnostic Waits (15 Tests)
Appendix 5 Cancer – 14, 31 and 62 Day Targets
Appendix 6 % of A & E Attendances Southport & Ormskirk Trust within 4 hours% of A & E Attendances for Aintree Trust including Litherland Town Hall Health Centre (LTHHC) and 36% activity of Knowsley Walk in Centre (WIC) within 4 hours
Appendix 7 Ambulance Data Cat A and Cat B Performance
Appendix 8 Referral to Treatment (RTT) Admitted and Non Admitted Patient Care
Appendix 9 MRSA and targets for Aintree Trust and Southport & Ormskirk Trust
Author: Ally Dwyer/Jackie Cole Jones, Version 1 dated 20-8-07 path s/info/board reports 5nj/ DRAFT Appendices Sept 2007 Version 1.doc
Waiters 11+ Week InPatient Waiters LDP Trajectory Target (Plan) March 2008 1506 1508 1382 1275 1224 108511+ Week InPatient Waiters (actual) 606 540 445 359 Variance between Actual and Plan -900 -968 -937 -916 % variance between Actual and Plan -59.8% -64.2% -67.8% -71.8% 5+ Week OutPatient Waiters LDP Trajectory Target (Plan) March 2008 4911 4832 4187 3594 3162 29685+ Week OutPatient waiters (actual) 2024 1928 2030 1748 Variance between Actual and Plan -2887 -2904 -2157 -1846 % variance between Actual and Plan -58.8% -60.1% -51.5% -51.4% 6+ Weeks Diagnostic Waits (15 Tests) LDP Trajectory Target (Plan) March 2008 1875 1642 1433 1223 1016 8116+ Weeks Diagnostic Waits (15 Tests) (actual) 849 487 440 396 Variance between Actual and Plan -1026 -1155 -993 -827 % variance between Actual and Plan -54.7% -70.3% -69.3% -67.6% Cancer (see Appendix 5) 2 Week Target (% of patients seen within 14 days urgently referred by a GP/GDP for suspected Cancer) 100% 100% 100% 100% 100%
31 Day Target (% of patients treated within 31 days from decision to treat to first definitive treatment) 98% 100% 100% 99% 99%
62 Day Target (% of patients treated within 62 days from urgent GP referrals to first definitive treatment) 95% 98% 94% 100% 100%
A&E (see Appendix 6) A&E - 4 hours or less (Southport & Ormskirk NHS Trust) 98% 98.08% 99.21% 98.85% 99.32% A&E - 4 hours or less (Aintree Trust including LTHHC and 36% of activity at Knowsley WIC) 98% 98.90% 98.81% 98.81% 99.64%
Ambulance Performance (see Appendix 7) Category A calls responded to within 8 minutes of details being recorded - North West Ambulance Service Performance 75% 76.5% 74.0% 74.9% 75.8%
Category A calls responded to within 8 minutes of call being connected - North West Ambulance Service Performance 75% 62.8% 61.0% 61.1% 66.6%
Category B calls responded to within 19 minutes - North West Ambulance Service Performance 95% 94.8% 91.8% 93.0% 93.4%
Referral to Treatment (RTT) Targets (see Appendix 8)
Admitted Patient Care(Patients treated within 18 weeks from referral to treatment) LDP Trajectory Target (Plan)
85% by Oct 07
(Local Target)
333 599 832 1332 1998 2832
Admitted Patient Care(Patients treated within 18 weeks from referral to treatment) actual 525 587 776 810
% of Admitted Patient Care 56% 58% 48% 54%
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Variance between Actual and Plan 192 -12 -56 -522 % variance between Actual and Plan 57.7% -2.1% -6.8% -39.2%
Non Admitted Patient Care(Patients treated within 18 weeks from referral to treatment not involving an admission ) LDP Trajectory Target (Plan)
90% by Oct 07
(Local Target)
914 1645 2284 3655 5940 8238
Non Admitted Patient Care(Patients treated within 18 weeks from referral to treatment not involving an admission ) actual 2838 4032 4422 4935
% of Non Admitted Patient Care 63% 61% 59% 62% Variance between Actual and Plan 1924 2387 2138 1280 % variance between Actual and Plan 210.6% 145.1% 93.6% 35.0% Health care associated infections (see Appendix 9) MRSA* Bacteraemias Cumulative to Date - Aintree Trust 19 5 10 14 16 Trajectory to date 1 3 4 6 8 10MRSA* Bacteraemias Cumulative to Date - Southport & Ormskirk Trust 10 3 5 6 10
Clostridium Difficile Actual - Southport & Ormskirk TrustTo not
exceed last years levels
9 5 5 11
Sexual Health
Access to GUM services within 48 Hours - Sefton Residents100% by
2008 97.6% 99.6% 98.92% Not on Uniify yet
Access to GUM services within 48 Hours (Southport & Ormskirk Trust Open Access Service)
100% by 2008 95.6% 99.5% 98.60% Not on
Unify yet
Mental Health
New cases of psychosis served by Early Intervention Teams 43 1 5 6 expected
27/8/2007
Number of people with newly diagnosed cases of first episode psychosis receiving early intervention (EI) in psychosis services
86 by Mar 08 130 by Mar
0948 53 54 expected
27/8/2008
Number of patients on enhanced Care Programme Approach (CPA) who were followed up either by face to face contact or by phone discussion within 7 days of discharge
Choose And Book (CAB) PCT % forecast through Choose and Book (CAB) 90% - 100% 97% 97% 97% 97% 97% 97%Actual % through CAB (Actual CAB referrals/Total Actual Referrals (%)) 21% 20% 24% 27%
GP Referral Rates (per 1000) 15.55 19.42 18 expected 10/9/07
Workforce Full Knowledge and Skills Framework (KSF) Outlines 100% by Mar Finance and Resource Committee will report at the end of the year on the numbers of
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08Performance Review Discussions conducted between 1 April 07 and 31 March 08Staff having had an Annual Performance Review Discussion 100% by Mar
08Black and Ethnic minority workers (working in Mental Health Services)
December 07 3wte 0 1wte 1wte 1wte
Mental Health Mersey Care has agreed to deliver the Crisis Resolution Home Treatment target in full within the current financial year, ahead of the outcomes of the Community Specialist Review. It is anticipated that this
will be met through service re-design and pump priming arrangements. The Trust will be expected to develop a case that demonstrates ongoing sustainability within existing resources for the future. The Community Specialist Review will support this.
Merseycare are committed to achieving the target for Early Intervention within the 2007/8 financial year. Black and Ethnic Minority Workers- the PCT have appointed a Community Development Coordinator. Recruitment for two further posts will now commence in partnership with key stakeholders which will
meet the December 2007 target.
KSF and PRD’s As part of the annual Training Plan document it was agreed at Finance and Performance Committee that we would report at the end of the year on the numbers of Performance Review discussions
conducted between 1 April 07 and 31 March
Choose and Book (CAB) By the end of July 2007, Seftons CAB utilization had increased to 27% Sefton PCT has put in place a dedicated Choose and Book Project Team for 6 months to identify and resolve issues at GP Practices GPs are being encouraged to use Choose and Book (CAB) for all their referrals to secondary care in order to support the 18 weeks pathway work and practice-based commissioning Main issues affecting utilisation are still technical problems with GP Integrated Clinical Systems Choice and Booking DES being rolled forward for 2007-2008 to reward GPs who’s utilisation increases between Sept 2007 and Feb 2008
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Appendix 2 – Analysis of Elective (Inpatient and Daycase) Waiting Lists
Analysis of Elective (Inpatient and Daycase) Waiting List 2007/08 Inpatient Waiting List 11+ Week Waiters against LDP Targets
Despite a reduction in over 11 week waiters the total waiting list remains fairly static
Of our two main providers, Aintree Hospital Foundation Trust’s waiting list is reducing against profile. Southport and Ormskirk Trust is showing a down ward trend but is above profile. We are working with the Trust to identify the impact of this against delivery of the 18 week target
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Appendix 3 - Analysis of Outpatient Waiting Lists and Outpatient Waiters
Analysis of Outpatient Waiting List Waiting 5+ weeks against LDP Targets 2007/08
The total outpatient waiters for first appointment have fallen by 1380 from July 2006 to July 2007
Between March 2007 and July 2007 the list size has increased by 109 waiters. The increase has occurred primarily at Aintree were GP referrals are 4.8% higher than the same period last year along with 2% more GP referrals seen
The number of patients waiting 5+ weeks for an outpatient appointment at July 2007 is 1748 which is 276 fewer than April 2007.This would suggest that Trusts are addressing this category in order to meet the waiting list milestone target
There are two outpatient waiters at the end of July reported as waiting 11-12 weeks for a first appointment at Aintree and The Royal Liverpool Teaching Hospital. Both patients have subsequently been treated / discharged
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Appendix 4 – 6+ Weeks Diagnostic Waits (15 Tests)
6+ Weeks Diagnostic Waits (15 Tests) against LDP Target 2007/08
6+ weeks diagnostic waits for the reportable 15 diagnostics (including MRI/CT)
The diagnostic waiting list continues to reduce.
Neurophysiology tests remain the only modality to report waits above 13 weeks.
We are continuing to work with our local providers to ensure that progress against target is sustained and the impact of additional inpatient and outpatient activity does not adversely affect progress
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Appendix 5 – Cancer
All Cancers 2 Week Target (% of Patients seen within 14 Days urgently referred by a GP/GDP for suspected Cancer)
Despite performing well the PCT recently discovered an issue where urgent gynaecology referrals were not received by the provider Trust within the accepted 24 hour period. This affected 7 patients, however all patients were seen within the 14 day target. Systems have been put in place to ensure that any changes to referral mechanisms are communicated to all GP practices and any referral received out side the accepted period will be routinely investigated by the PCT cancer team.
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Appendix 6 – A & E Attendances Southport and Ormskirk NHS Trust within 4 hours
Percentage of Southport & Ormskirk Trust A & E attendances seen within 4 hours 2006/07
A & E Attendances for Aintree Trust including Litherland Town Hall Health Centre (LTHHC) and 36% of activity of Knowsley Walk in Centre (WIC) within 4 hours
Percentage of A&E attendances seen within 4 hours for Aintree Trust including LTHHC and 36% of activity of Knowsley WIC 2006/07
Aintree and Southport and Ormskirk NHS Hospital Trusts are both achieving the operating standards of 98% of AED attendances seen within 4 hours.
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Appendix 7 – Ambulance Data Cat A and Cat B Performance
England
0
10,000
20,000
30,000
40,000
50,000
09/0
4/20
06
04/0
6/20
06
30/0
7/20
06
24/0
9/20
06
19/1
1/20
06
14/0
1/20
07
11/0
3/20
07
06/0
5/20
07
01/0
7/20
07
26/0
8/20
07
21/1
0/20
07
16/1
2/20
07
10/0
2/20
08
06/0
4/20
08
Cat
A V
olum
e
35%40%45%50%55%60%65%70%75%80%85%90%
Cat
A P
erfo
rman
ce
Cat A Volume Cat A Performance New Cat A Performance
Planned performance Performance Target
North West Ambulance Service NHS Trust
0
1,000
2,000
3,000
4,000
5,000
6,000
7,000
09/0
4/20
06
04/0
6/20
06
30/0
7/20
06
24/0
9/20
06
19/1
1/20
06
14/0
1/20
07
11/0
3/20
07
06/0
5/20
07
01/0
7/20
07
26/0
8/20
07
21/1
0/20
07
16/1
2/20
07
10/0
2/20
08
06/0
4/20
08
Cat
A V
olum
e
35%40%45%50%55%60%65%70%75%80%85%90%
Cat
A P
erfo
rman
ce
Cat A Volume England Cat A Performance
New Cat A Performance Planned performance Performance Target
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England
0
7,500
15,000
22,500
30,000
37,500
45,000
52,500
60,000
67,500
75,000
09/0
4/20
06
04/0
6/20
06
30/0
7/20
06
24/0
9/20
06
19/1
1/20
06
14/0
1/20
07
11/0
3/20
07
06/0
5/20
07
01/0
7/20
07
26/0
8/20
07
21/1
0/20
07
16/1
2/20
07
10/0
2/20
08
Cat
B V
olum
e
70%
75%
80%
85%
90%
95%
100%
Cat
B P
erfo
rman
ce
Cat B Volume Cat B Performance Performance Target
North West Ambulance Service NHS Trust
0
1,000
2,000
3,000
4,000
5,000
6,000
7,000
8,000
9,000
10,000
09/0
4/20
06
04/0
6/20
06
30/0
7/20
06
24/0
9/20
06
19/1
1/20
06
14/0
1/20
07
11/0
3/20
07
06/0
5/20
07
01/0
7/20
07
26/0
8/20
07
21/1
0/20
07
16/1
2/20
07
10/0
2/20
08
Cat
B V
olum
e
70%
75%
80%
85%
90%
95%
100%
Cat
B P
erfo
rman
ce
Cat B Volume England Cat B Performance Performance Target
Category A calls responded to within 8 minutes of details being recorded:Currently the ambulance service is performing at the standard of 75%, when we drill down to the Sefton level the service has been achieving the response time for Cat A of 8 minutes.
Category A calls responded to within 8 minutes of call to connect:This is the response standard that is due to be delivered by the ambulance service from April 2008, currently the service needs to make significant gains in order to achieve the standard.
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Appendix 8 – Referral to Treatment (RTT)
Referral to treatment (RTT) Admitted Patient Care
(The number of patients treated within 18 weeks from referral to treatment) against LDP Trajectory Target
Progress is being made against target. Work is focusing on pathways in particular ENT, Ophthalmology and Orthopaedics whilst providers continue to work on improving the data quality of Referral to Treatment information
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Appendix 9 – MRSA – Aintree and Southport & Ormskirk NHS Trusts Monthly MRSA Bacteraemias Aintree from April 2007 with Target of 19 and Trajectory until March 2008
Aintree has experienced 2 cases of MRSA Bacteraemia during July. The trust has reinforced its measures to improve aseptic procedures. The Trust has accepted an offer of assistance from the Department of Health’s MRSA Task Force and has submitted proposals to the SHA to access additional funding to enable it to improve screening and isolation measures. These proposals have been developed in conjunction with the PCT. The PCT continues to work closely with the Foundation Trust, SHA and the Department of Health Task Force to improve
Southport recorded 4 MRSA bacteraemia during July, its highest figure for a single month. However one of these cases should be reassigned to Clatterbridge Hospital as the Southport DGH had no direct involvement in this patient care. Senior staff at the trust are reviewing the current action plan in conjunction with Sefton PCT. Proposals have been submitted to the SHA to access additional funding to enable the trust to improve its screening and intervention measures. These proposals have been support by Sefton PCT and Central Lancashire PCT
Merseyside PCTs and Hospital Trusts within the area are meeting on the 6 th of September to agree a common approach to screening and decolonisation measures
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