Balanced Score Card Review of September 2016 Data
Balanced Scorecard
Finance Patient Access
Quality
&
Safety
Human Resource
Management
Patient and Service User
Finance
Finance Report- September 2016
Actual outturn September 2016- CUH
Gross pay & non pay budget €256.4m (2015
:€246.3m)
Actual pay & non pay €263.9m (2015: €254.6m)
Actual Deficit €7.5m (-2.9%) (2015 :€8.3m /3.4%)
Less Drug costs refunded by PCRS €3.44m.
Expenditure on transitional care €548k
Adjusted Deficit €3.51m (-1.4%)
Income Outturn September - 2016 – CUH
Income budget €60.3m (2015 :€47.8m)
Actual Income €58.9m (2015 :€55.6m)
Actual Deficit €1.4m (-2.2%)
Less accelerated income target €2.58m
Adjusted Surplus €1.24m (2.1%) (2015 :€7.8m /16%)
Patient Income outturn September 2016- CUH
Income budget €48.7m (2015 :€39.9m)
Actual Income €48.6m (2015 :€45.6m)
Actual Deficit €102k (-0.3%) (2015 Surplus :€6.1m/15%)
CUH Revised Expenditure limit 2016-PAY
7
CUH Revised Expenditure limit 2016-NON PAY
8
CUH Revised Expenditure limit 2016- TOTAL
9
10
Cost Containment Initiatives update at 7/10/16
TARGET 23/9
30/9
07/10
14/10
21/10
28/10
04/11
11/11
18/11
25/11
02/12
09/12
16/12
23/12
30/12 ACTUAL
1 Reduce stock issues by 15%
200 15 15 15 15 15 15 15 15 15 15 15 15 15
171 19 50 25 77
2 Cut-off for Dec stock issues
300 150 150
3 Discretionary travel, training
50 10 20 20
4 Blood Science project savings
200 50 70 80
40 40
5 Recode donated funds expenditure
150 75 75
92 92
6 Recode Clinical trials expenditure
200 200
200 200
7 Defer high cost drug treatments
50 15 15 20
8
Defer TAVI programme to 2017
25 25
9 Defer Pipeline procedures
65 20 20 25
10 Intrathecal pumps , stimulators
100 30 35 35
11 Reduce MRI Spend
100 10 30 30 30
0
12 Add drugs funding; GTD ;Oncology
200 200
TOTAL-Target 1,640 15 15 300 15 15 15 170 15 15 15 205 15 15 150 560
TOTAL- Actual 503 19 50 317 117
CUH Group Summary – Budget v Actual Expenditure September 2016
Pay €k Non-Pay €k Total Gross Income €k Net €k
CUH (inc SMOH) -187 -761 -949 -43 -992
Less adj 0 476 476 283 759
CUH adj -187 -286 -473 240 -233
Mallow 34 62 96 -12 84
Total Group adj -153 -224 -377 228 -149
CUH Group Summary Budget v Actual expenditure – YTD September 2016
Pay €k Non-Pay €k Total Gross Income €k Net €k
CUH (incl SMOH) -1,999 -5,501 -7,500 -1,350 -8,850
Less Adj 0 3,987 3,987 2,587 6,574
CUH (adj) -1,999 -1,514 -3,513 1,237 -2,275
Mallow 34 -25 9 -162 -153
Total Group (adj) -1,965 -1,539 -3,503 1,075 -2,428
CUH Budget v Actual Pay YTD September 2016
Budget €k Actual €k Variance €k % Variance 2015 Actual €k Variance €k
Medical/Dental 48,819 50,416 - (1,597) -3% 48,694 -(1,721)
Nursing/Midwifery 67,202 66,405 797 1% 65,674 - (731)
Paramedical 24,406 25,148 - (742) -3% 24,069 - (1,080)
Housekeeping 5,279 5,497 - (218) -4% 5,034 - (463)
Care Assistants 5,279 5,243 36 1% 5,034 - (209)
Catering 3,203 3,243 - (39) 1% 3,041 - (202)
Portering 4,410 4,571 - (162) -4% 4,336 - (235)
Administration 14,004 13,973 31 0% 13,529 - (444)
Other Staff 2,385 2,490 - (105) -4% 2,697 207
Total 174,987 176,986 - (1,999) -1% 172,109 - (4,877) 13
CUH –Pay & Nonpay Budget Surplus/(Deficit) %
14
CUH – Patient Income Budget Surplus %
CUH Budget v Actual Pay YTD July 2016
CUH AGENCY WTE – 2016
Jul-14 Sep-14 Dec-14 Jan-15 Mar-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Nov-15 Dec-15 Jan-16 Feb-16 Mar-16 Apr-16 May-16 Jun-16 Jul-16 Aug-16 Sep-16
Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual
Radiotherapist 9.40 4.00 4.87 2.78 0.95 0.95 0.9 0.95 0.24
Radiographer 0.09 0.05 0.06
Labs 12.04 13.40 11.0 12.19 1.0 1.0
Cardiac Techs 3.80 3.80 1.0
Physio 1.60 1.50
Pharmacy 2.00 1.00
Admin 23.40 9.08 9.36 14.1 9.3 0.93
Nursing 46.20 33.0 34.7 37.8 40.0 32.8 30.4 31.0 28.4 28.6 29.3 31.2 26.1 35.2 32.9 33.8 34.2 31.8 31.6 32.1 28.7 27.6
HCA 34.80 16.2 22.7 23.2 24.4 31.0 29.8 34.7 32.7 30.8 32.4 34.5 38.2 37.2 35.2 37.7 36.9 41.1 38.4 45.7 52.1 52.1
House-Keeping 10.40 0.16
Physics 4.30 2.6 1.6 1.09 0.92 0.92 0.75 0.59 0.62 0.66 0.25 0.5 0.46 0.46 0.47 0.47 0.47 1 0.83 0.83 0.83 0.83
Catering 3.00 8.5 2.0 2.7 1.8 2.7 6.9 8.4 8.4 3.9 1.2 1.1 0.9 1.2 1.2 1.2 1.4 1.1 1.2 1.0 1.0 1.0
Social Work 1.00 0.5
Occ Therapy 1.00 0.37
Dietician 0.50 0.3
Medical 11.00 5.27 4.77 4.4 6.35 5.1 5.86 3.39 5.79 7.97 14.34 10.35 15.73 9.0
Consultan 0.72 1.74 1.72 0.5 0.25 0.95 4.44 0
NCHD 10.28 8.53 6.08 3.27 2.47 4.45 5.13 6.7
164.5 99.7 91.1 98.26 84.7 75.4 74.6 79.0 76.2 71.9 77.5 77.7 81.4 83.1 80.8 83.4 80.8 78.77 76.75 85.03 92.20 88.23
CUH AGENCY COSTS €k 2014-16
Acute Nursing Agency WTE 2014 to 2016
Acute HCA Agency WTE 2014 to 2016
19
CUH Average Nursing & HCA Agency WTE’s per Week 2014-16
CUH Average Specials /Other Nursing & HCA Agency WTE’s per Week 2015-16
20
21
NON-PAY -YTD 2016 Budget Actual Variance Actual YTD 15 Diff 2016-15
Medicines (see note) 19,743 23,448 -(3,705) 19,249 -(4,199) Medical & Surgical 21,160 21,698 -(538) 20,707 -(991) Blood 3,422 3,824 -(402) 3,558 -(266) Medical Gases 317 319 -(2) 288 -(31) Medical equipment 3,412 3,513 -(101) 3,127 -(386) Radiology 3,949 4,008 -(58) 3,906 -(102) Provisions 1,436 1,493 -(57) 1,394 -(99) Catering 265 384 -(119) 259 -(125) Cleaning/Waste 2,775 2,894 -(119) 2,728 -(166) Laundry 1,398 1,382 16 1,371 -(11) Energy 2,555 2,400 156 2,847 447 Bedding/ clothing 288 324 -(36) 310 -(14) Furniture 214 204 10 182 -(22) Pathology 8,459 8,677 -(218) 8,473 -(204) Maintenance /Grounds 531 614 -(82) 623 9 Transport /staff travel 1,385 1,517 -(132) 1,355 -(162) Office expenses 1,596 1,465 131 1,621 156 Telecommunications 351 354 -(3) 356 2 Computer 945 905 39 870 -(35) Admin expenses incl bad debts 5,511 5,617 -(107) 7,202 1,585 Staff recruitment/training 644 540 105 744 204 Miscellaneous 1,029 1,290 -(261) 1,357 67 TOTAL NON-PAY 81,387 86,871 -(5,484) 82,527 -(4,344)
Less PCRS drugs /Ward 2A -3,511 3,511 3,511
TOTAL NON-PAY 81,387 83,359 -(1,972) 82,527 -(832)
Note :Bad debts in Admin exps 1,400 848 552 3,712 2,864
CUH Actual Non-pay expenditure €k YTD 2016 v 2015
Patient Income 2014 –2016
Consultant Claims O/s Consultant claims at 31st September 2016
24
Directorate Value €k Prev
Value €k Current
Diagnostics 10 11
Medicine 3,837 3,832
Surgery 2,249 2,105
Women and Children CUH 402 142
Total-CUH Primary 6,498 6,227
Women & Children CUMH 1,000 1,300
Total-CUH /CUMH Primary
7,498 7,527
Consultants > €100K at 13th Oct
No of claims Value €k
REIDY, DECLAN 38 265,991
HARTY, JAMES 78 239,479
MCFADDEN, EUGENE 72 205,897
DODDAKULA, KISHORE 29 205,625
HARNEDY, NORMA 29 204,901
O'HALLORAN, D. J. 23 198,091
MCSWEENEY, NIAMH 33 175,810
O'MAHONY, DEIRDRE 91 163,619
SWEENEY, BRIAN 170 163,420
KEARNEY, PETER 21 153,083
ANDREWS, EMMET J. 18 150,539
DUGGAN, CLEONA 10 150,288
KELLY, LOUISE 34 143,843
MCGIBNEY, CAROL 19 143,058
GALLAGHER, PAUL 4 135,828
POWER, DEREK 81 132,278
TAYLOR, COLM 58 129,988
COSTELLO, DANIEL J. 6 125,229
PLANT, BARRY 9 124,536
BAMBURY, RICHARD 92 124,517
BORAN, SINEAD 35 121,375
O'SULLIVAN, MARTIN 15 102,618
GUERIN, SHANE 22 101,213
3,661,226
CUH Debtor days Consultant Claims September 2016
25
Mallow Finance Report –September 2106
Budget €k Actual €k Variance €k %Variance
Pay 11,401 11,365 34 0.3%
Non - Pay 3,616 3,641 -25 -0.7%
Gross Expend 15,018 15,008 9 0.1%
Income 2,883 2,720 -162 -5.6%
Total 12,135 12,288 -153 -1.3%
Patient Access
Weekly INMO Trolley Report Week ending 7th October 2016
ED – 6hr & 9hr Target – All Patients (Quarter 4 2015 Jan –September 2016)
ED – 6hr & 9hr Target – Admitted Patients (Quarter 4 2015 Jan – September 2016)
ED – 6hr & 9hr Target – Non admitted Patients (Quarter 4 2015 Jan – September 2016)
PET > 24hrs - Weekly – 10th – 17th October
Outpatient Waiting Lists
Total Medical Patients to be seen by 15 Month Target
end of September 2016
Total Surgical Patients to be seen by 15 Month Timeline end of September 2016
Women and Children Patients to be seen by 15 Month Timeline end of September 2016
Patients Currently Waiting Longer Than 12 Months as of 09/08/2016
Patients to be seen by 15 Month Target
End of current month October 2016
Scope Waiting List
Scopes Urgent – August 2016 G
Scopes Routine - August 2016 R
Inpatient Waiting List
Total Inpatient & Day case Waiting List (13th October 2016)
43
Wait category
Hospital name wl type ACTIVE PREADMIT SUSPENSION Grand Total
Cork University Hospital Adult 1924 363 45 2332
Child 75 52 3 130
GI Scope 171 161 8 340
Cork University Hospital Total 2170 576 56 2802
Grand Total 2170 576 56 2802
Patients to be treated by 23rd December 2016 (412)
Patients to be treated by 23rd December Consultant Breakdown
Patients to be treated by 23rd December 2016 weekly comparison
Quality & Safety
Surgical ALOS – August 2016 A
Medical ALOS – June 2016 G
ALOS All Inpatients - September A
Risk Management – September KPI data
• Serious Reportable Events reported - 2
• Medication Safety Incidents reported - 9
• Complaints – 16 complaints raised in September with 31% closed within 30 day timeframe
• New claims notified to hospital – 2
Risk Register
Risk Register updated in June - 0 new risks added
Cancer KPI – Breast-Lung-Prostate January – September 2016
Quality and Safety
Lean Review of Endoscopy Service Patient Pathway
The key findings were presented to the Endoscopy Service Users Group
Housekeeping Services Project Group
Post of Health Care Assistant - interviews completed and 25 panelled.
Health Care Assistant Facilitator Work programme agreed
10 places in Dementia Care training assigned to CUH
Human Resource Management
Sick Leave – August 2016
4.01 3.79
3.74
3.16 3.073.86
3.75
3.91
3.72 3.81 4.084.324.65 4.59 4.53
3.913.39
4.27 3.783.77
0
2
4
6
Jan Feb Mar April May June July August Sept Oct Nov Dec
%
CUH – Total % Sick Leave 2015 v 2016
2015% 2016% % Target
28
27.39
34.06
32.07
37.99
28.8924.99
36.59
34.31
27.64
28.89
35.06
35.640.76
0
10
20
30
40
50
Jul-15
Aug-15
Sep-15
Oct-15
Nov-15
Dec-15
Jan-16
Feb-16
Mar-16
Apr-16
May-16
Jun-16
Jul-16
Aug-16
WTE’s
CUH Long Term Sick Leave – WTE’s
Support Services Sick Leave (Oct ’15 – Aug ’16)
7.14
7.56
6.65
5.46
5.37
6.12
7.116.818.16
6.734.81
2.381.92
2.171.50
2.612.26
1.692.40
1.44
2.45 2.68
6.62
8.84
10.75
7.90 8.00
10.17
12.34
9.74
13.04
9.95
11.44
0
2
4
6
8
10
12
14
Oct-15 Nov-15 Dec-15 Jan-16 Feb-16 Mar-16 Apr-16 May-16 Jun-16 Jul-16 Aug-16
Month
%
Housekeeping Portering Catering Target
Nursing Sick Leave (Oct ‘15 – Aug ’16)
5.93
3.763.69
5.925.62
6.345.95
4.414.34.27
3.78
4.63
5.52
4.58
3.15
4.334.84
5
5.445.45.06
4.16
0
1
2
3
4
5
6
7
Oct-15 Nov-15 Dec-15 Jan-16 Feb-16 Mar-16 Apr-16 May-16 Jun-16 Jul-16 Aug-16
%
HCA's Nursing Target
EWTD Compliance –January - September 2016
Capital Projects Project Status
Paediatric Unit Phase 1 - build programme to be completed by
November 2016
Phase 2 – funding received to progress to Design stage
Radiation Oncology Unit
Planning permission granted
Enabling work have commenced
Equipment replacement
Education and Training Centre Draft Statement of Need completed
Meeting held with UCC
Blood Sciences Project
Design Team appointed
Funding for interim infrastructural works approved
Oncology Service
Expansion of Day Unit – plan signed off –
submitted for Philanthropic funding (ACT)
Refurbishment of Ward 2D – capital funding in
place
Medical Oncology Centre – developing Statement
of Need
Ophthalmology Transfer – Phase 2
Project group in place
Application for planning permission submitted
Helipad
Interim helipad in place – preferred site identified –
contractor notified
Replacement Autoclaves & RO Project Commenced
Key Issues
• Retention of 30 inpatient beds (Transitional Care Unit)
• Dependence on patient income
• Potential loss of €300,000 income
• Undergraduate Training costs - €6.5m per annum
• Management of Unscheduled Care/Scheduled Care
• Implementation of Change Programme Initiatives