FINCOM Sep v3...days for Sep 2017 the level of admissions continues to cause patient flow...

Trust Board Date 26th October 2017

Agenda item number 6.1

Title of paper Performance Report

Confidential

Suitable for public access

Papers which this paper relates to?

Strategic objective(s):

Best outcomes

To achieve the highest possible quality of care and treatment for our patients, in terms of outcome, safety and experience.

Excellent experience

Skilled & motivated teams

Top productivity

ASPH value(s):

Patients first Patient expectations in terms of access are reflected in NHS performance targets.

Personal responsibility

Passion for excellence

Pride in our team

Executive summary The Trust missed the 4 hour A&E NHSI standard in September with performance recorded at 93.69%. This was a 1.53% improvement on last month (92.16%) and 0.16% above the agreed recovery trajectory of 93% for Q2. Attendances were 3.1% higher than September 2016, although admissions were 1.3% lower. On a number of occasions during the month, (a) surges in admissions & (b) reduced staff availability due to vacancies creating delays in A&E as well as slow flow to the wards. Total attendances in September (at 8,417) were 2.7% higher than August’s attendances (8,196) and 3.1% higher than September 2016 (8,163). Admissions during September (at 2,013) were 2.5% higher than August’s admissions (1,963) although 1.3% lower than September 2016 (2,040). We have in place an Urgent Care Improvement Programme which includes implementing the SAFER CARE bundle and RED & GREEN patient days to promote patient flow. The Trust remained compliant for the 18 weeks Incomplete Pathway Performance recorded at 92.4%. However, 7 specialties; General Surgery, Urology, ENT, Oral & MaxFacs, Plastic Surgery, General Medicine & Neurology were non-compliant at specialty level.

The Trust continues with a high risk of aggregate RTT non-compliance if; (a) Capacity or demand management schemes cannot address the significant increase being seen in Ophthalmology, Dermatology, Neurology & Endoscopy demand, & (b) Growth in demand for both routine and TWR outpatient appointments continues. The Trust is expected to report compliance for 5 of 7 Cancer standards for September. The failing standards were;

(1) TWR; breach patients due to (a) patient choice to delay, & (b) increased demand on diagnostic capacity.

(2) 62 Day Screening with 1 breach recorded due to late referral from the screening service.

Recommendation: Review the paper and discuss the contents seeking additional assurance as necessary.

Specific issues checklist:

Quality and safety issues

Patient impact issues?

Employee issues?

Other stakeholder issues?

Equality & diversity issues?

Finance issues?

Legal issues?

Risk issues? Link to relevant BAF item number if so

Author name/role Julian Ruse, Associate Director of Performance

Presented by director name/role

Tom Smerdon, Director of Operations (Urgent Care) & James Thomas, Director of Operations (Planned Care)

Date 20th October 2017

Board action For Assurance

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May‐17 Jun‐17 Jul‐17 Aug‐17 Sep‐17 SparklineTotal 8725 8464 8688 8196 8417Avg Att per day 281 282 280 264 281Total 2114 1996 2015 1963 2013Avg Adm per day 68 67 65 63 65

Breaches Total 1185 1086 866 1005 821% Breaches late Specialty Total 8.6% 10.6% 10.5% 13.0% 12.7%% Breaches late Dr/ENP Total 8.5% 5.0% 4.8% 2.8% 3.0%Number of Breaches by Minors Total 219 225 114 125 131Medically Optimised Delays Total 1996 1574 1313 1178 1338A&E 4hr Performance % (NHSI) Total 91.24% 91.51% 93.61% 92.16% 93.69%A&E 4hr Performance % (St Peters site) Total 88.48% 88.93% 91.45% 89.41% 91.48%

The Trust missed the 4 hour A&E NHSI 95% standard in September with performance recorded at 93.69%. This was a 1.53% improvement on last month (92.16%) and 0.16% above the agreed recovery trajectory of 93% for Q2.

Attendances were 3.1% higher than September 2016, although admissions were 1.3% lower. On a number of occasions during the month, (a) surges in admissions & (b) reduced staff availability due to vacancies creating delays in A&E as well as slow flow to the wards.

The charts in Appendix B identify a number of daily snapshots of system indicators where activity has continued to exceed expectations identified by the CCG to support flow within ED & the Trust’s hospitals. In line with recent NHSI/NHSE communication, the CCG‐led Local A&E Delivery Board are undertaking a full review of system commissioning requirements to achieve the hospital flow required to deliver the A&E 4hr & DTOC targets.

Total attendances in September (at 8,417) were 2.7% higher than August’s attendances (8,196) and 3.1% higher than September 2016 (8,163). Admissions during September (at 2,013) were 2.5% higher than August’s admissions (1,963) although 1.3% lower than September 2016 (2,040).

A&E PERFORMANCE UPDATE

A&E A&E

INPUTSAttendances

Admissions

CONTROLS

OUTPUTS

Performance:

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The 75+yr age groups shows the highest FY2017/18 increase at 2.6%, although an overall 1.1% decrease (139 patients) in admissions compared to last FY.

Comparing FY2017 A&E attendances (50,401) to FY2016 (49,652) confirms a similar level of demand attending the emergency department, with a corresponding level also seen in the number of admissions via A&E FY2017 (12,009) versus FY2016 (12,148).

Ambulance Handover Delays

When the hospital experiences patient flow difficulties A&E can become congested which causes delays in handing patients over from the care of ambulance crews to that of the Accident and Emergency Department. During September 2017 the Trust recorded 31 incidents where the handover took between 30 and 60 minutes, and 0 waits in excess of 60 minutes. There has been a 22.7% reduction in ambulance delays FY17 vs FY16.

Performance:

0-15 16-59 60-74 75+ Grand Total 0-15 16-59 60-74 75+ Grand TotalApr 2.5% -0.3% -3.1% 0.6% 0.2% Apr 45 -9 -32 9 13May 0.3% -0.7% 2.0% -3.1% -0.6% May 6 -29 22 -51 -52June 3.1% 1.1% 2.1% 8.7% 3.1% June 59 42 21 130 252July -0.9% 0.7% -6.3% 7.7% 0.7% July -18 29 -71 117 57August -0.3% 5.8% -2.0% 2.1% 2.8% August -5 218 -23 34 224September 12.5% -2.2% 1.1% 7.9% 3.1% September 219 -88 11 112 254Grand Total 2.8% 0.7% -1.1% 3.8% 1.5% Grand Total 306 163 -72 351 748

Additional Attendances 2017 vs 2016 Additional Attendances 2017 vs 2016(Age Group) (Age Group)

0-15 16-59 60-74 75+ Grand Total 0-15 16-59 60-74 75+ Grand TotalApr -8.0% -2.4% 5.8% 1.9% 0.3% Apr -18 -12 20 16 6May -7.0% -6.0% 16.5% -6.3% -2.8% May -21 -34 55 -61 -61June -23.7% 0.4% -2.8% 7.3% -0.8% June -71 2 -10 62 -17July -33.6% 4.4% -8.6% 11.8% -0.7% July -100 22 -34 98 -14August -17.2% 2.2% -2.4% 0.7% -1.3% August -34 11 -9 6 -26September 1.3% -5.3% -4.0% 1.6% -1.3% September 4 -30 -14 13 -27Grand Total -14.8% -1.3% 0.4% 2.6% -1.1% Grand Total -240 -41 8 134 -139

Additional Admissions 2017 vs 2016(Age Group) (Age Group)

Additional Admissions 2017 vs 2016

Month FY2017 FY2016Daily Var 2016

FY2015Daily Var 2015

Month FY2017 FY2016Daily Var 2016

FY2015Daily Var 2015

Apr 7911 7898 0 7630 9 Apr 1908 1902 0 1847 2May 8725 8776 ‐2 8030 22 May 2114 2175 ‐2 1946 5Jun 8464 8212 8 7795 22 Jun 1996 2013 ‐1 1798 7Jul 8688 8631 2 8064 20 Jul 2015 2029 0 1855 5Aug 8196 7972 7 7601 19 Aug 1963 1989 ‐1 1877 3Sep 8417 8163 8 7859 19 Sep 2013 2040 ‐1 1905 4Oct 8767 8312 Oct 2106 1993Nov 8509 8102 Nov 2029 1913Dec 8574 8134 Dec 2234 2000Jan 8219 8088 Jan 2100 2085Feb 7498 7863 Feb 1890 1937Mar 8355 8848 Mar 1994 2021

50,401 99,574 96,326 12,009 24,501 23,177

A&E Attendances A&E Admissions

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Performance:

Elective Procedure Cancellations due to Non‐Elective Demand

The Trust had to postpone 7 elective procedures during September due to no beds being available.

In accordance with the NHSI requirement, all non‐urgent surgery at the St Peters Hospital site was suspended 19th December 2016 to 15th January 2017 to provide additional bed stock to cater for the non‐elective winter demand.

Overnight Waits in the Accident and Emergency Department

Although the Trust has seen a substantial improvement in the non‐elective length of stay from an average of 7.25 days during April 2015 down to 6.09 days for Sep 2017 the level of admissions continues to cause patient flow difficulties through the hospital creating a backlog within A&E. This is evidenced by the number of patients waiting in A&E overnight with a decision to admit (DTA).

During September the Trust recorded DTA patients waiting in A&E overnight on 21 days. On 12 days in September, 5 or more patients were waiting to be transferred (average 9 on these days).

Cancellations (no bed)

Specialty Feb 2017 Mar 2017 Apr 2017 May 2017 Jun 2017 Jul 2017 Jul 2017 Sep 2017

Breast SurgeryColo-Rectal 1 1

Obstetrics and Gynaecology 4 2 1 1

Maxillofacial and Oral SurgeryOpthamology

Radiology 1 1

Trauma and Orthopaedics 2 1 3 5 6

Upper GI 15 2 1 1

Urology 1 3 2 2 1

Vascular Surgery 3 1 225 7 5 4 2 5 8 7

FY2016/17 FY2017

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Performance:

Delayed Discharges

Overall the combined DTOC & MFFD delays displayed a decreasing trend since the beginning of FY17, although have shown a slight increase during September.

A number of initiatives have been underway which include;• Inreach support ‐ dedicated support in wards to assist with case managing patients throughout their hospital stay as well as facilitating discharge. • Board round improvements ‐ to improve the quality and content of board rounds on medical wards.• Supporting community hospitals ‐ to reduce their length of stay in rehab beds, creating additional capacity.• Discharge to assess (D2A) started on 1st September ‐ creating system support to enable a reduction in delayed discharges.• CCG led system provider reboot weeks to reduce delayed transfers of care to support discharges (& patient flow) at Community Hospitals & at the St Peters Hospital site.• CCG led action plan to reduce DTOC to less than 4.5% from October 2017.

Internal ED Metrics

Delayed Discharges Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb MarFY2015 2152 2172 1916 1568 1542 1372 1481 1330 1258 1445 1298 1354FY2016 1500 1713 1808 1813 1968 2084 1946 1554 1451 1228 1778 1966FY2017 1574 1405 1275 1313 1178 1338

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Performance:

A&E Performance (National Position)The Trust's A&E performance compared to other Trusts is included as Appendix A. ‐ When comparing the Trust including Ashford WiC (NHSI position), for September (the most recent data published), the Trust is positioned 27th of 137 Trusts. ‐ During September only 16 Trusts reported a compliant performance greater than 95%, with 50 Trusts reporting an improvement, 82 Trusts reporting a decline, and 7 remaining the same.

Urgent Care Improvement ProgrammeWe have in place an Urgent Care Improvement Programme which includes changes to our governance and clinical engagement. The improvement plan has now been revised following publication of the Rapid Implementation Guidance and reflects key improvement actions. The three key programmes of work are outlined below;

1. ED Streaming At The Front DoorThe objective is to create and run pathways that decompress the Emergency Department by streaming patients to other inpatient services including assessment areas & preventing attendance through telephone management. Since June 2017 we have a senior nurse supporting streaming from the Urgent Care walk in centre to ensure patients requiring speciality review are directly streamed to the specialty assessment areas, bypassing ED where appropriate.

2. Patient FlowThis objective is aimed at improving and ensuring the safe and effective flow of patients into the hospital from ED at the point of referral to beyond discharge from the acute hospital. We have expanded our ambulatory care service to seven days per week with an enhanced workforce to meet the increase in demand to support a reduction in admissions. The Trust is piloting use of the SAFER care bundle and Red & Green patient days to support proactive patient flow.

3. Improving Discharge ProcessesThe key requirement for this objective is to reduce in‐patient delays, overall length of stay and bed days lost due to medically fit patients waiting to discharge. We are working closely with partner organisations to reduce the number of patients remaining in hospital beyond their date of medical fitness. On a daily basis, patient & process delays are scrutinised to address, escalate & improve resolutions to mitigate & prevent future patient delays.

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May‐17 Jun‐17 Jul‐17 Aug‐17 Sep‐17 SparklineINPUTS Referrals Total 1019 1045 1005 933 918

Breaches due to Patient Choice Total 32 31 39 46 70% Breaches ‐ Patient Choice Total 3.1% 3.0% 3.9% 4.9% 7.6%Breaches due to Hospital Capacity Total 19 20 22 20 17% Breaches ‐ Hospital Capacity Total 1.9% 1.9% 2.2% 2.1% 1.9%

OUTPUTS 2 Week Wait % Target = 93% 95.00% 95.12% 93.93% 92.93% 90.52%

Performance:

TWR performance position for September is recorded non‐compliant at 90.5% with 70 of the 87 breaches (81%) due to patient choice.

The Trust is working with NWS CCG colleagues to support the engagement of patients attendance within 14 days.

CANCER UPDATE

CANCERCancer: two week

wait from referral to date first seen

CONTROLS

Dec Jan Feb Mar Apr May Jun Jul Aug SepReferrals Seen 850 834 853 993 908 1019 1045 1005 936 918Referrals Seen Within Standard 812 757 811 933 851 968 994 944 870 831

Performance Trajectory 94.7% 94.7% 94.7% 94.7% 93.0% 93.0% 93.0% 93.0% 93.0% 93.0%Performance Actual 95.5% 90.8% 95.1% 94.0% 93.7% 95.0% 95.1% 93.9% 92.9% 90.5%

2 Week Referral

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May‐17 Jun‐17 Jul‐17 Aug‐17 Sep‐17 SparklineINPUTS Treatments Total 76 69 65 50.5 53.5

Breaches ‐ ASPH Total 5 12 3 5 1Breaches ‐ Shared Total 3.5 4 4.5 3.5 5Total Breaches Total 15 5.5 6.5 8.5 6

OUTPUTS 62 Day GP Referral to Treatment % Target = 85% 80.3% 92.0% 90.0% 83.2% 88.8%

CANCER UPDATE

Performance:

The Trust has recorded a compliant performance for September at 88.8%.

Delays have been recorded due to complex pathways (5 patients), tertiary capacity (4 patients), patient choice (1 patient) & patient fitness (1 patient). These breaches are undergoing clinical validation by the tumour group leads.

The Trust with tertiary partners are undertaking a shadow performance monitoring excercise aimed at assessing the impact of the proposed 38 day tertiary referral guidance and the ASPH Cancer Timed Pathway Analysis to review the effectiveness of the outcomes of the existing action plan and to enhance improvement activities to address current areas of concern.

The Trust continues to deliver its Cancer Improvement Action Plan in conjunction with NWS CCG which aims to address recent issues regarding cancer performance.

CANCER

All cancers: 62‐day wait for first treatment

(GP Referral)

CONTROLS

ModalityTreatments

in the Period

<62 days

>62 days

Breach %

Brain 0 0 0 0%Breast 8 8 0 0%Breast Symptomatic 2 2 0 0%Colorectal 7 5.5 1.5 21%Gynaecology 4 3.5 0.5 13%Haematology 1 1 0 0%Head and Neck 2 0.5 1.5 75%Lung 2 1.5 0.5 25%Other 0 0 0 0%Sarcoma 0 0 0 0%Skin 9 9 0 0%Upper GI 4 3 1 25%Urology 14.5 13.5 1 7%Total 53.5 47.5 6 11.2%

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May‐17 Jun‐17 Jul‐17 Aug‐17 Sep‐17 SparklineINPUTS Total 41 27 30 35 36

Proportion of patients admitted to stroke ward <4hrs Target = 90% 68% 44% 71% 57% 58%Proportion of patients spending 90% on stroke ward Target = 80% 88% 82% 76% 76% 77%Proportion of patients scanned within 1hr Target = 50% 63% 59% 72% 69% 57%

Target = 100% 98% 100% 100% 100% 100%Target = 100% 100% 100% 100% 100% 100%Target = 100% 100% 100% 100% 100% 100%Target = 60% 55% 67% 95% 64% 50%

Performance:

Stroke performance 'Proportion of patients admitted to a stroke ward within 4hrs' standard for September is recorded at 58%. The Trust continues to experience difficulty meeting this KPI due to ; Disruption in stroke pathway = 7 patientsNo acute bed being immediately available due to non‐elective bed pressures = 1 patientsMedical need = 1 patientOther = 7 patients

Multi‐disciplinary team review of all breaches has been scheduled to understand root causes and improve performance.

Proportion of patients spending 90% of their stay on a stroke ward was recorded at 77%.8 breaches reported; 3 x Short Stay <48hrs, 1 x Medical need ITU, & 4 Other (complex cases).

Urgent TIA (High risk) cases to be seen assessed within 24 hours of referral was recorded at 50%.7 breaches reported; 6 x No Clinic Slot available (offered next available & 1 Other (GP did not send information or patient).

OUTPUTS

Total stroke discharges

STROKE PERFORMANCE UPDATE

STROKE Proportion of patients scanned within 12hrsPatients eligible & receiving thrombolysisNon‐urgent TIA cases assessed within 7 daysHigh‐risk TIA cases treated within 24hrs

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Diagnostic Tests

The Trust failed the DM01 diagnostic standard, with September performance recorded at 98.12%, however this was a 1.16% improvement on August’s performance of 96.96%.

This has been due to a number of reasons in;‐Neurophysiology due to staff sickness creating a reporting & wait list backlog‐Echocardiography stress test & Cystoscopy due to insufficient capacity to meet demand & an increase in delays through patient choice over the summer period. Additional capacity has been arranged with compliance estimated within 2 months.

RTT Forward View

The Trust remained compliant against the 92% standard with September's performance recorded at 92.4%. However 7 specialties, General Surgery, Urology, ENT, Oral & MaxFacs, Plastic Surgery, General Medicine & Neurology were non‐compliant at specialty level.

Specific specialty issues have been;General Surgery ‐ historic capacity issues & ongoing financial constraints. Urology ‐ historic capacity issues due to gaps in consultant staffing. Now recruited with recovery underway.Oral & MaxFacs ‐ historic capacity issues due to a lack of surgeon cover & ongoing financial constraints.ENT ‐ historic capacity issues due to emergency consultant absence & bank holiday downtime.Plastic Surgery ‐ low volume PTL with 4 backlog patients, tolerance of no more than 2 pathways.General Medicine ‐ respiratory subspecialty breaches due to high demand versus capacity for sleep study diagnostics.Neurology ‐ the specialty has been impacted by staff capacity issues providing Neurophysiology diagnostic tests and reporting.Endoscopy ‐ capacity issues due to an ongoing increase in TWR demand. The new endoscopy suite is now operational (from July 2017) providing additional capacity.

RTT 52 Week Waiter ExceedancesThe Trust reviewed 2 patients that exceeded a wait of 52 weeks before receiving treatment. Root Cause Analysis investigations identified;Patient 1 (child) ‐ exceeded 52 weeks due to considerable parent initiated appointment cancellations. Recommendations: (i) Enhanced patient communications, (ii) Enhanced training & application of staff operating procedures & (iii) Stricter application of the Joint Access PolicyPatient 2 ‐ exceeded 52 weeks due to administration error.Recommendations: (i) Enhanced training & application of staff operating procedures (for inter‐specialty referrals), & (ii) Introduction of an electronic clinic outcome formFor both patients, no harm was caused due to the delay for treatment.

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RTT Trends

Jul‐17 Aug‐17 Sep‐17Start 15/16

Start 16/17

Start 17/18

WL Sep17

WL High

WL Low

WL % change

Trend

Aggregate WL volume change impact

Start 15/16

Start 16/17

Start 17/18

BL Sep17

BL High

BL Low

BL % change

TrendAggregate WL

volume change

General Surgery 89.3% 88.9% 88.8% 2,559 2,802 2,988 3,242 3,346 2,395 ‐6.4% ‐149 243 273 459 364 493 143 4.9% ‐114Urology 84.4% 86.8% 87.2% 838 908 945 1,175 1,229 757 4.6% ‐49 76 83 119 150 183 26 ‐24.6% ‐8Trauma & Orthopaedics 96.0% 94.6% 94.5% 2,304 4,292 4,076 5,038 5,109 2,271 ‐1.2% 115 100 403 296 277 470 59 34.6% 11ENT 89.5% 90.4% 90.1% 1,294 1,254 1,386 1,499 1,541 970 5.0% 72 46 36 95 148 151 16 5.9% 29Ophthalmology 95.7% 94.3% 95.1% 2,871 3,875 3,995 3,937 4,145 2,684 7.2% ‐212 76 150 106 195 250 30 13.7% 49Oral and Maxillofacial Surgery 82.2% 83.7% 84.0% 1,259 1,328 2,037 1,957 2,093 1,259 3.7% 57 30 60 311 314 353 23 0.0% 9Plastic Surgery 66.7% 93.9% 88.9% 6 10 24 36 37 5 114.3% ‐7 0 1 7 4 7 0 ‐33.3% 2Pain 92.1% 92.2% 90.1% 658 1,081 769 436 1,252 436 ‐6.9% 14 19 54 71 43 254 4 7.5% ‐11General Medicine 95.9% 94.3% 91.5% 725 857 952 1,268 1,268 681 8.3% 68 29 25 58 108 108 7 101.8% 64Gastroenterology 95.3% 96.1% 94.7% 895 735 750 1,044 1,204 583 6.7% ‐174 30 42 41 55 70 21 61.4% 17Cardiology 97.6% 97.4% 98.0% 770 953 862 1,087 1,087 680 18.4% 185 21 45 35 22 77 14 ‐23.3% 2Dermatology 98.7% 98.4% 92.4% 1,201 1,605 1,623 1,926 2,213 1,176 35.6% 157 51 28 114 146 160 12 471.0% 46Neurology 92.5% 89.7% 91.6% 567 580 770 749 879 458 ‐10.2% ‐31 31 17 51 63 86 12 ‐33.3% 9Rheumatology 97.6% 97.8% 94.4% 322 244 449 408 480 224 10.6% 2 5 5 2 23 35 0 4.3% 20Paediatrics 99.5% 99.3% 98.5% 684* 945 833 731 966 644 ‐2.1% ‐27 8 22 29 11 59 0 83.3% ‐10Geriatric Medicine 99.2% 99.2% 97.6% 126 166 103 126 183 78 ‐3.2% ‐32 1 5 3 3 9 0 100.0% 0Gynaecology 96.2% 95.8% 97.0% 1,098 1,097 1,095 1,069 1,389 1,016 ‐5.1% ‐22 64 49 71 32 96 32 ‐21.7% ‐31Other 95.0% 87.1% 75.9% 57 101 15 29 121 3 ‐26.5% ‐3 5 0 1 7 11 0 ‐ 4Grand Total 93.2% 92.8% 92.4% 17,586 22,833 23,672 25,757 25,834 17,586 0.0% 862 829 1,298 1,869 1,965 2,024 607 16.3% 88

Rolling Quarter Trend(12 weeks)

SPECIALTY

Performance Waitlist Size & Range (FY15‐FY17)


Backlog Size & Range (FY15‐FY17)

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APPENDIX A

NHSI A&E Performance [September 2017] - All Trusts with Type 1 Attendances

Code Region Name Type 1 Departments - Major A&E

Total attendances

Percentage in 4 hours or less (all)

Total Emergency Admissions via A&E

Other Emergency admissions (i.e not via A&E)

Total Emergency Admissions

Number of patients spending >4 hours from decision to admit to admission


1 RC9 Midlands And East Of England Region Luton And Dunstable University Hospital NHS Foundation Trust 8,691 12,248 98.5% 2,485 1,340 3,825 0 02 RBD South Of England Commissioning Region Dorset County Hospital NHS Foundation Trust 3,671 7,843 98.0% 1,237 398 1,635 7 03 RA4 South Of England Commissioning Region Yeovil District Hospital NHS Foundation Trust 4,138 4,138 97.7% 1,285 261 1,546 3 04 RTR North Of England Commissioning Region South Tees Hospitals NHS Foundation Trust 10,518 12,501 97.3% 2,088 2,348 4,436 124 05 RCU North Of England Commissioning Region Sheffield Children's NHS Foundation Trust 4,610 4,610 97.2% 705 335 1,040 0 06 RE9 North Of England Commissioning Region South Tyneside NHS Foundation Trust 4,930 5,629 97.0% 1,201 16 1,217 16 07 RVW North Of England Commissioning Region North Tees And Hartlepool NHS Foundation Trust 3,711 12,796 96.9% 1,979 1,966 3,945 30 08 RXP North Of England Commissioning Region County Durham And Darlington NHS Foundation Trust 10,874 17,204 96.8% 3,254 1,618 4,872 94 09 RR7 North Of England Commissioning Region Gateshead Health NHS Foundation Trust 7,317 9,690 96.1% 1,622 375 1,997 67 0

10 RQX London Commissioning Region Homerton University Hospital NHS Foundation Trust 9,964 9,964 95.6% 1,599 182 1,781 47 011 RA2 South Of England Commissioning Region Royal Surrey County Hospital NHS Foundation Trust 5,850 5,850 95.6% 2,016 491 2,507 30 012 RYR South Of England Commissioning Region Western Sussex Hospitals NHS Foundation Trust 11,599 13,562 95.4% 3,318 1,366 4,684 49 013 RTF North Of England Commissioning Region Northumbria Healthcare NHS Foundation Trust 7,803 16,296 95.4% 4,025 586 4,611 0 014 RFS Midlands And East Of England Region Chesterfield Royal Hospital NHS Foundation Trust 6,760 6,760 95.3% 1,906 1,048 2,954 32 015 RVR London Commissioning Region Epsom And St Helier University Hospitals NHS Trust 12,183 12,668 95.2% 3,266 174 3,440 50 016 RBS North Of England Commissioning Region Alder Hey Children's NHS Foundation Trust 4,623 4,623 95.0% 925 276 1,201 0 017 RFF North Of England Commissioning Region Barnsley Hospital NHS Foundation Trust 6,930 6,930 94.6% 2,568 647 3,215 94 018 RDZ South Of England Commissioning Region The Royal Bournemouth And Christchurch Hospitals NHS Foundat 6,588 7,977 94.5% 1,938 1,186 3,124 72 019 RTD North Of England Commissioning Region The Newcastle Upon Tyne Hospitals NHS Foundation Trust 10,631 16,618 94.4% 2,231 2,345 4,576 75 020 RCD North Of England Commissioning Region Harrogate And District NHS Foundation Trust 4,065 4,952 94.2% 959 602 1,561 18 021 RLN North Of England Commissioning Region City Hospitals Sunderland NHS Foundation Trust 7,637 12,817 94.1% 2,626 772 3,398 35 022 RTP South Of England Commissioning Region Surrey And Sussex Healthcare NHS Trust 8,159 8,159 94.1% 2,423 394 2,817 218 023 RBT North Of England Commissioning Region Mid Cheshire Hospitals NHS Foundation Trust 5,556 7,023 94.0% 1,850 1,048 2,898 1 024 RP5 North Of England Commissioning Region Doncaster And Bassetlaw Teaching Hospitals NHS Foundation Tru 10,847 13,717 93.7% 3,581 1,018 4,599 160 025 RQM London Commissioning Region Chelsea And Westminster Hospital NHS Foundation Trust 16,776 24,545 93.7% 3,680 754 4,434 311 026 RD8 Midlands And East Of England Region Milton Keynes University Hospital NHS Foundation Trust 7,404 11,781 93.7% 1,469 1,019 2,488 93 027 RTK South Of England Commissioning Region Ashford And St Peter's Hospitals NHS Foundation Trust 8,417 12,999 93.7% 2,111 252 2,363 167 028 RCX Midlands And East Of England Region The Queen Elizabeth Hospital, King's Lynn, NHS Foundation Trust 5,258 5,258 93.5% 2,061 804 2,865 104 129 RJC Midlands And East Of England Region South Warwickshire NHS Foundation Trust 5,607 6,305 93.4% 1,763 293 2,056 4 030 RN7 South Of England Commissioning Region Dartford And Gravesham NHS Trust 8,365 10,248 93.4% 2,427 247 2,674 48 031 RGP Midlands And East Of England Region James Paget University Hospitals NHS Foundation Trust 6,373 6,379 93.4% 1,213 469 1,682 30 032 RHM South Of England Commissioning Region University Hospital Southampton NHS Foundation Trust 8,580 11,746 93.3% 2,977 1,773 4,750 53 033 RCF North Of England Commissioning Region Airedale NHS Foundation Trust 5,538 5,538 93.2% 1,128 784 1,912 40 034 RD3 South Of England Commissioning Region Poole Hospital NHS Foundation Trust 5,586 7,047 92.9% 1,697 1,393 3,090 0 035 RMP North Of England Commissioning Region Tameside And Glossop Integrated Care NHS Foundation Trust 7,192 11,700 92.8% 1,658 261 1,919 183 036 RBA South Of England Commissioning Region Taunton And Somerset NHS Foundation Trust 5,887 5,887 92.7% 1,905 1,324 3,229 38 037 RGT Midlands And East Of England Region Cambridge University Hospitals NHS Foundation Trust 9,385 12,519 92.4% 3,225 494 3,719 108 038 RK5 Midlands And East Of England Region Sherwood Forest Hospitals NHS Foundation Trust 8,105 12,147 92.3% 2,513 435 2,948 63 039 RW3 North Of England Commissioning Region Central Manchester University Hospitals NHS Foundation Trust 12,539 25,336 92.3% 4,119 490 4,609 409 040 RJF Midlands And East Of England Region Burton Hospitals NHS Foundation Trust 5,319 9,634 92.2% 1,824 633 2,457 116 041 RJ1 London Commissioning Region Guy's And St Thomas' NHS Foundation Trust 11,559 15,159 91.9% 3,015 692 3,707 94 042 RNL North Of England Commissioning Region North Cumbria University Hospitals NHS Trust 7,821 9,848 91.9% 2,030 896 2,926 204 043 RAX London Commissioning Region Kingston Hospital NHS Foundation Trust 8,697 9,756 91.7% 1,921 479 2,400 91 144 RNZ South Of England Commissioning Region Salisbury NHS Foundation Trust 3,822 4,069 91.7% 1,042 763 1,805 55 045 RL4 Midlands And East Of England Region The Royal Wolverhampton NHS Trust 10,884 18,740 91.4% 2,579 977 3,556 211 046 RDD Midlands And East Of England Region Basildon And Thurrock University Hospitals NHS Foundation Trust 11,470 11,470 91.3% 2,504 239 2,743 272 047 RWY North Of England Commissioning Region Calderdale And Huddersfield NHS Foundation Trust 12,732 12,732 91.2% 2,977 1,223 4,200 59 048 RLT Midlands And East Of England Region George Eliot Hospital NHS Trust 6,680 6,680 91.1% 1,177 43 1,220 67 049 RGQ Midlands And East Of England Region Ipswich Hospital NHS Trust 7,292 7,832 91.1% 2,013 750 2,763 34 050 RWW North Of England Commissioning Region Warrington And Halton Hospitals NHS Foundation Trust 6,814 10,677 90.9% 2,551 480 3,031 504 051 RJ6 London Commissioning Region Croydon Health Services NHS Trust 6,488 15,156 90.9% 2,302 372 2,674 245 052 RA7 South Of England Commissioning Region University Hospitals Bristol NHS Foundation Trust 9,004 10,876 90.8% 2,749 849 3,598 166 053 RQ3 Midlands And East Of England Region Birmingham Women's And Children's NHS Foundation Trust 4,775 4,775 90.8% 1,074 244 1,318 0 054 RBZ South Of England Commissioning Region Northern Devon Healthcare NHS Trust 3,821 7,741 90.8% 1,218 606 1,824 182 055 RDU South Of England Commissioning Region Frimley Health NHS Foundation Trust 19,468 19,468 90.7% 5,908 1,287 7,195 277 056 RH8 South Of England Commissioning Region Royal Devon And Exeter NHS Foundation Trust 8,537 9,468 90.6% 1,927 1,497 3,424 85 257 RA3 South Of England Commissioning Region Weston Area Health NHS Trust 3,897 3,897 90.6% 1,026 92 1,118 0 058 RQ8 Midlands And East Of England Region Mid Essex Hospital Services NHS Trust 8,176 8,412 90.5% 2,371 917 3,288 71 159 R1F South Of England Commissioning Region Isle Of Wight NHS Trust 3,792 4,478 90.5% 876 162 1,038 83 060 RHW South Of England Commissioning Region Royal Berkshire NHS Foundation Trust 9,645 11,156 90.5% 3,115 393 3,508 150 061 RC1 Midlands And East Of England Region Bedford Hospital NHS Trust 5,996 6,080 90.2% 1,814 285 2,099 78 062 RJ7 London Commissioning Region St George's University Hospitals NHS Foundation Trust 12,763 14,070 90.0% 3,875 737 4,612 0 063 RWF South Of England Commissioning Region Maidstone And Tunbridge Wells NHS Trust 12,109 14,292 90.0% 3,794 236 4,030 538 064 RKE London Commissioning Region The Whittington Hospital NHS Trust 8,052 8,052 89.9% 1,348 97 1,445 206 365 RJ2 London Commissioning Region Lewisham And Greenwich NHS Trust 17,862 23,753 89.9% 4,292 639 4,931 394 066 RA9 South Of England Commissioning Region Torbay And South Devon NHS Foundation Trust 6,434 9,230 89.9% 2,586 472 3,058 188 067 RHQ North Of England Commissioning Region Sheffield Teaching Hospitals NHS Foundation Trust 9,172 17,196 89.8% 2,920 2,556 5,476 333 068 RM3 North Of England Commissioning Region Salford Royal NHS Foundation Trust 8,413 8,455 89.5% 2,716 398 3,114 254 069 RTX North Of England Commissioning Region University Hospitals Of Morecambe Bay NHS Foundation Trust 7,033 8,818 89.4% 2,050 1,079 3,129 110 170 RBN North Of England Commissioning Region St Helens And Knowsley Hospital Services NHS Trust 9,042 14,423 89.0% 3,683 575 4,258 295 071 RGR Midlands And East Of England Region West Suffolk NHS Foundation Trust 5,743 5,743 88.9% 2,103 363 2,466 14 072 RXR North Of England Commissioning Region East Lancashire Hospitals NHS Trust 8,706 16,967 88.6% 3,072 1,325 4,397 311 173 RAE North Of England Commissioning Region Bradford Teaching Hospitals NHS Foundation Trust 12,241 12,241 88.3% 2,780 1,404 4,184 137 074 RN5 South Of England Commissioning Region Hampshire Hospitals NHS Foundation Trust 9,236 10,346 88.2% 2,254 1,226 3,480 676 175 RK9 South Of England Commissioning Region Plymouth Hospitals NHS Trust 8,286 12,415 88.2% 3,009 1,290 4,299 111 076 RAS London Commissioning Region The Hillingdon Hospitals NHS Foundation Trust 5,361 13,031 88.0% 2,053 146 2,199 187 077 RRV London Commissioning Region University College London Hospitals NHS Foundation Trust 10,973 10,973 87.9% 1,828 747 2,575 144 078 RTG Midlands And East Of England Region Derby Teaching Hospitals NHS Foundation Trust 11,021 15,036 87.9% 3,367 1,326 4,693 187 479 RXK Midlands And East Of England Region Sandwell And West Birmingham Hospitals NHS Trust 14,266 17,804 87.9% 3,064 621 3,685 208 080 RNA Midlands And East Of England Region The Dudley Group NHS Foundation Trust 8,563 13,057 87.7% 2,290 885 3,175 118 081 RXC South Of England Commissioning Region East Sussex Healthcare NHS Trust 9,859 9,859 87.7% 2,784 627 3,411 324 082 RQ6 North Of England Commissioning Region Royal Liverpool And Broadgreen University Hospitals NHS Trust 7,610 19,397 87.7% 2,499 806 3,305 478 083 REF South Of England Commissioning Region Royal Cornwall Hospitals NHS Trust 6,303 16,925 87.6% 2,624 749 3,373 652 084 RAJ Midlands And East Of England Region Southend University Hospital NHS Foundation Trust 8,205 8,205 87.5% 2,397 732 3,129 2 085 RJL North Of England Commissioning Region Northern Lincolnshire And Goole NHS Foundation Trust 11,159 12,523 87.4% 2,615 450 3,065 262 086 RN3 South Of England Commissioning Region Great Western Hospitals NHS Foundation Trust 6,123 14,027 87.3% 2,079 1,338 3,417 567 087 RBL North Of England Commissioning Region Wirral University Teaching Hospital NHS Foundation Trust 7,651 10,196 87.3% 2,504 1,626 4,130 491 088 RNS Midlands And East Of England Region Northampton General Hospital NHS Trust 8,698 9,683 87.0% 2,600 991 3,591 408 089 RDE Midlands And East Of England Region Colchester Hospital University NHS Foundation Trust 7,538 11,509 87.0% 2,316 879 3,195 278 090 RF4 London Commissioning Region Barking, Havering And Redbridge University Hospitals NHS Trust 19,992 23,226 87.0% 4,773 45 4,818 70 091 RYJ London Commissioning Region Imperial College Healthcare NHS Trust 9,582 23,637 86.9% 3,354 1,095 4,449 602 492 RR8 North Of England Commissioning Region Leeds Teaching Hospitals NHS Trust 16,952 19,751 86.7% 4,868 1,500 6,368 740 093 RM2 North Of England Commissioning Region University Hospital Of South Manchester NHS Foundation Trust 8,227 8,227 86.7% 2,594 801 3,395 420 094 R1H London Commissioning Region Barts Health NHS Trust 28,070 39,319 86.6% 6,676 1,675 8,351 1,191 095 RXQ South Of England Commissioning Region Buckinghamshire Healthcare NHS Trust 7,003 11,918 86.5% 3,090 806 3,896 462 096 RWA North Of England Commissioning Region Hull And East Yorkshire Hospitals NHS Trust 10,857 12,097 86.5% 2,996 1,269 4,265 394 097 RTE South Of England Commissioning Region Gloucestershire Hospitals NHS Foundation Trust 11,814 11,814 86.1% 3,675 720 4,395 267 098 RAP London Commissioning Region North Middlesex University Hospital NHS Trust 13,579 13,579 85.8% 2,712 248 2,960 158 299 RRF North Of England Commissioning Region Wrightington, Wigan And Leigh NHS Foundation Trust 7,320 7,320 85.8% 2,237 451 2,688 8 0

100 RVY North Of England Commissioning Region Southport And Ormskirk Hospital NHS Trust 6,195 9,476 85.7% 1,763 32 1,795 359 0101 RXF North Of England Commissioning Region Mid Yorkshire Hospitals NHS Trust 19,453 19,453 85.5% 3,959 1,003 4,962 835 0102 RJR North Of England Commissioning Region Countess Of Chester Hospital NHS Foundation Trust 6,155 6,474 85.5% 2,023 571 2,594 369 0103 RJZ London Commissioning Region King's College Hospital NHS Foundation Trust 16,887 23,571 85.1% 4,408 533 4,941 535 0104 RW6 North Of England Commissioning Region Pennine Acute Hospitals NHS Trust 22,676 26,749 85.0% 5,951 1,412 7,363 762 6105 RMC North Of England Commissioning Region Bolton NHS Foundation Trust 8,490 9,411 84.5% 2,290 765 3,055 341 0106 REM North Of England Commissioning Region Aintree University Hospital NHS Foundation Trust 7,034 13,399 84.5% 2,723 720 3,443 715 0107 RNQ Midlands And East Of England Region Kettering General Hospital NHS Foundation Trust 7,215 7,215 84.4% 2,330 440 2,770 527 0108 RAL London Commissioning Region Royal Free London NHS Foundation Trust 17,528 20,482 84.3% 3,643 610 4,253 899 0109 RXH South Of England Commissioning Region Brighton And Sussex University Hospitals NHS Trust 11,981 13,015 84.3% 3,397 501 3,898 731 6110 RXN North Of England Commissioning Region Lancashire Teaching Hospitals NHS Foundation Trust 5,501 12,032 84.1% 1,940 1,180 3,120 527 2111 RJN North Of England Commissioning Region East Cheshire NHS Trust 4,059 4,197 84.0% 874 322 1,196 130 0112 RWE Midlands And East Of England Region University Hospitals Of Leicester NHS Trust 17,762 19,394 84.0% 4,360 3,957 8,317 384 0113 RXL North Of England Commissioning Region Blackpool Teaching Hospitals NHS Foundation Trust 7,098 16,610 83.9% 2,182 913 3,095 857 1114 RPA South Of England Commissioning Region Medway NHS Foundation Trust 10,012 10,012 83.8% 2,257 1,021 3,278 941 1115 RGN Midlands And East Of England Region North West Anglia NHS Foundation Trust 11,392 12,169 83.3% 2,998 1,108 4,106 179 0116 RCB North Of England Commissioning Region York Teaching Hospital NHS Foundation Trust 9,112 15,979 83.1% 3,435 1,494 4,929 473 1117 RTH South Of England Commissioning Region Oxford University Hospitals NHS Foundation Trust 11,000 12,562 82.8% 2,927 3,208 6,135 654 3118 RM1 Midlands And East Of England Region Norfolk And Norwich University Hospitals NHS Foundation Trust 8,464 10,828 82.7% 2,517 1,877 4,394 512 0119 RX1 Midlands And East Of England Region Nottingham University Hospitals NHS Trust 14,199 15,801 82.7% 3,697 2,396 6,093 624 0120 RRK Midlands And East Of England Region University Hospitals Birmingham NHS Foundation Trust 9,693 9,693 82.6% 2,801 1,132 3,933 491 0121 RWP Midlands And East Of England Region Worcestershire Acute Hospitals NHS Trust 9,817 15,270 82.2% 2,921 735 3,656 898 0122 RBK Midlands And East Of England Region Walsall Healthcare NHS Trust 6,235 9,642 81.8% 2,089 707 2,796 445 1123 RFR North Of England Commissioning Region The Rotherham NHS Foundation Trust 7,759 7,759 81.8% 1,522 373 1,895 267 0124 RWG Midlands And East Of England Region West Hertfordshire Hospitals NHS Trust 7,713 11,561 81.6% 2,859 575 3,434 816 0125 R1K London Commissioning Region London North West Healthcare NHS Trust 11,272 26,767 81.4% 4,664 577 5,241 1,224 0126 RD1 South Of England Commissioning Region Royal United Hospitals Bath NHS Foundation Trust 6,009 6,895 80.9% 2,280 1,014 3,294 579 0127 RR1 Midlands And East Of England Region Heart Of England NHS Foundation Trust 18,926 22,468 80.0% 7,336 2,020 9,356 1,374 0128 RLQ Midlands And East Of England Region Wye Valley NHS Trust 4,596 4,990 80.0% 1,156 409 1,565 129 0129 RVJ South Of England Commissioning Region North Bristol NHS Trust 7,213 7,213 80.0% 2,381 1,454 3,835 386 0130 RWJ North Of England Commissioning Region Stockport NHS Foundation Trust 8,019 8,019 79.7% 2,535 871 3,406 560 0131 RKB Midlands And East Of England Region University Hospitals Coventry And Warwickshire NHS Trust 11,362 15,731 78.6% 4,236 616 4,852 493 0132 RXW Midlands And East Of England Region Shrewsbury And Telford Hospital NHS Trust 10,133 10,133 77.6% 2,220 1,911 4,131 686 0133 RHU South Of England Commissioning Region Portsmouth Hospitals NHS Trust 9,193 12,010 77.0% 2,943 1,381 4,324 986 32134 RWD Midlands And East Of England Region United Lincolnshire Hospitals NHS Trust 12,605 12,605 76.7% 3,481 1,125 4,606 730 0135 RJE Midlands And East Of England Region University Hospitals Of North Midlands NHS Trust 13,705 20,407 76.5% 4,463 2,593 7,056 1,332 4136 RVV South Of England Commissioning Region East Kent Hospitals University NHS Foundation Trust 13,457 17,259 70.5% 4,731 2,827 7,558 554 0137 RQW Midlands And East Of England Region The Princess Alexandra Hospital NHS Trust 8,312 8,312 70.3% 1,528 464 1,992 552 0

Emergency AdmissionsA&E attendances

P a g e | 1

APPENDIX A

NHSI A&E Performance [September 2017] - Local Trusts with Type 1 Attendances

NHSI A&E Performance [September 2017] - Foundation Trusts with Type 1 Attendances


Total attendances







11 RA2 South Of England Commissioning Region Royal Surrey County Hospital NHS Foundation Trust 5,850 5,850 95.6% 2,016 491 2,507 30 012 RYR South Of England Commissioning Region Western Sussex Hospitals NHS Foundation Trust 11,599 13,562 95.4% 3,318 1,366 4,684 49 022 RTP South Of England Commissioning Region Surrey And Sussex Healthcare NHS Trust 8,159 8,159 94.1% 2,423 394 2,817 218 027 RTK South Of England Commissioning Region Ashford And St Peter's Hospitals NHS Foundation Trust 8,417 12,999 93.7% 2,111 252 2,363 167 055 RDU South Of England Commissioning Region Frimley Health NHS Foundation Trust 19,468 19,468 90.7% 5,908 1,287 7,195 277 081 RXC South Of England Commissioning Region East Sussex Healthcare NHS Trust 9,859 9,859 87.7% 2,784 627 3,411 324 0

109 RXH South Of England Commissioning Region Brighton And Sussex University Hospitals NHS Trust 11,981 13,015 84.3% 3,397 501 3,898 731 6

A&E attendances Emergency Admissions


Total attendances







1 RC9 Midlands And East Of England Region Luton And Dunstable University Hospital NHS Foundation Trust 8,691 12,248 98.5% 2,485 1,340 3,825 0 02 RBD South Of England Commissioning Region Dorset County Hospital NHS Foundation Trust 3,671 7,843 98.0% 1,237 398 1,635 7 03 RA4 South Of England Commissioning Region Yeovil District Hospital NHS Foundation Trust 4,138 4,138 97.7% 1,285 261 1,546 3 04 RTR North Of England Commissioning Region South Tees Hospitals NHS Foundation Trust 10,518 12,501 97.3% 2,088 2,348 4,436 124 05 RCU North Of England Commissioning Region Sheffield Children's NHS Foundation Trust 4,610 4,610 97.2% 705 335 1,040 0 06 RE9 North Of England Commissioning Region South Tyneside NHS Foundation Trust 4,930 5,629 97.0% 1,201 16 1,217 16 07 RVW North Of England Commissioning Region North Tees And Hartlepool NHS Foundation Trust 3,711 12,796 96.9% 1,979 1,966 3,945 30 08 RXP North Of England Commissioning Region County Durham And Darlington NHS Foundation Trust 10,874 17,204 96.8% 3,254 1,618 4,872 94 09 RR7 North Of England Commissioning Region Gateshead Health NHS Foundation Trust 7,317 9,690 96.1% 1,622 375 1,997 67 0

10 RQX London Commissioning Region Homerton University Hospital NHS Foundation Trust 9,964 9,964 95.6% 1,599 182 1,781 47 011 RA2 South Of England Commissioning Region Royal Surrey County Hospital NHS Foundation Trust 5,850 5,850 95.6% 2,016 491 2,507 30 012 RYR South Of England Commissioning Region Western Sussex Hospitals NHS Foundation Trust 11,599 13,562 95.4% 3,318 1,366 4,684 49 013 RTF North Of England Commissioning Region Northumbria Healthcare NHS Foundation Trust 7,803 16,296 95.4% 4,025 586 4,611 0 014 RFS Midlands And East Of England Region Chesterfield Royal Hospital NHS Foundation Trust 6,760 6,760 95.3% 1,906 1,048 2,954 32 015 RBS North Of England Commissioning Region Alder Hey Children's NHS Foundation Trust 4,623 4,623 95.0% 925 276 1,201 0 016 RFF North Of England Commissioning Region Barnsley Hospital NHS Foundation Trust 6,930 6,930 94.6% 2,568 647 3,215 94 017 RDZ South Of England Commissioning Region The Royal Bournemouth And Christchurch Hospitals NHS Foundat 6,588 7,977 94.5% 1,938 1,186 3,124 72 018 RTD North Of England Commissioning Region The Newcastle Upon Tyne Hospitals NHS Foundation Trust 10,631 16,618 94.4% 2,231 2,345 4,576 75 019 RCD North Of England Commissioning Region Harrogate And District NHS Foundation Trust 4,065 4,952 94.2% 959 602 1,561 18 020 RLN North Of England Commissioning Region City Hospitals Sunderland NHS Foundation Trust 7,637 12,817 94.1% 2,626 772 3,398 35 021 RBT North Of England Commissioning Region Mid Cheshire Hospitals NHS Foundation Trust 5,556 7,023 94.0% 1,850 1,048 2,898 1 022 RP5 North Of England Commissioning Region Doncaster And Bassetlaw Teaching Hospitals NHS Foundation Tru 10,847 13,717 93.7% 3,581 1,018 4,599 160 023 RQM London Commissioning Region Chelsea And Westminster Hospital NHS Foundation Trust 16,776 24,545 93.7% 3,680 754 4,434 311 024 RD8 Midlands And East Of England Region Milton Keynes University Hospital NHS Foundation Trust 7,404 11,781 93.7% 1,469 1,019 2,488 93 025 RTK South Of England Commissioning Region Ashford And St Peter's Hospitals NHS Foundation Trust 8,417 12,999 93.7% 2,111 252 2,363 167 026 RCX Midlands And East Of England Region The Queen Elizabeth Hospital, King's Lynn, NHS Foundation Trust 5,258 5,258 93.5% 2,061 804 2,865 104 127 RJC Midlands And East Of England Region South Warwickshire NHS Foundation Trust 5,607 6,305 93.4% 1,763 293 2,056 4 028 RGP Midlands And East Of England Region James Paget University Hospitals NHS Foundation Trust 6,373 6,379 93.4% 1,213 469 1,682 30 029 RHM South Of England Commissioning Region University Hospital Southampton NHS Foundation Trust 8,580 11,746 93.3% 2,977 1,773 4,750 53 030 RCF North Of England Commissioning Region Airedale NHS Foundation Trust 5,538 5,538 93.2% 1,128 784 1,912 40 031 RD3 South Of England Commissioning Region Poole Hospital NHS Foundation Trust 5,586 7,047 92.9% 1,697 1,393 3,090 0 032 RMP North Of England Commissioning Region Tameside And Glossop Integrated Care NHS Foundation Trust 7,192 11,700 92.8% 1,658 261 1,919 183 033 RBA South Of England Commissioning Region Taunton And Somerset NHS Foundation Trust 5,887 5,887 92.7% 1,905 1,324 3,229 38 034 RGT Midlands And East Of England Region Cambridge University Hospitals NHS Foundation Trust 9,385 12,519 92.4% 3,225 494 3,719 108 035 RK5 Midlands And East Of England Region Sherwood Forest Hospitals NHS Foundation Trust 8,105 12,147 92.3% 2,513 435 2,948 63 036 RW3 North Of England Commissioning Region Central Manchester University Hospitals NHS Foundation Trust 12,539 25,336 92.3% 4,119 490 4,609 409 037 RJF Midlands And East Of England Region Burton Hospitals NHS Foundation Trust 5,319 9,634 92.2% 1,824 633 2,457 116 038 RJ1 London Commissioning Region Guy's And St Thomas' NHS Foundation Trust 11,559 15,159 91.9% 3,015 692 3,707 94 039 RAX London Commissioning Region Kingston Hospital NHS Foundation Trust 8,697 9,756 91.7% 1,921 479 2,400 91 140 RNZ South Of England Commissioning Region Salisbury NHS Foundation Trust 3,822 4,069 91.7% 1,042 763 1,805 55 041 RDD Midlands And East Of England Region Basildon And Thurrock University Hospitals NHS Foundation Trust 11,470 11,470 91.3% 2,504 239 2,743 272 042 RWY North Of England Commissioning Region Calderdale And Huddersfield NHS Foundation Trust 12,732 12,732 91.2% 2,977 1,223 4,200 59 043 RWW North Of England Commissioning Region Warrington And Halton Hospitals NHS Foundation Trust 6,814 10,677 90.9% 2,551 480 3,031 504 044 RA7 South Of England Commissioning Region University Hospitals Bristol NHS Foundation Trust 9,004 10,876 90.8% 2,749 849 3,598 166 045 RQ3 Midlands And East Of England Region Birmingham Women's And Children's NHS Foundation Trust 4,775 4,775 90.8% 1,074 244 1,318 0 046 RDU South Of England Commissioning Region Frimley Health NHS Foundation Trust 19,468 19,468 90.7% 5,908 1,287 7,195 277 047 RH8 South Of England Commissioning Region Royal Devon And Exeter NHS Foundation Trust 8,537 9,468 90.6% 1,927 1,497 3,424 85 248 RHW South Of England Commissioning Region Royal Berkshire NHS Foundation Trust 9,645 11,156 90.5% 3,115 393 3,508 150 049 RJ7 London Commissioning Region St George's University Hospitals NHS Foundation Trust 12,763 14,070 90.0% 3,875 737 4,612 0 050 RA9 South Of England Commissioning Region Torbay And South Devon NHS Foundation Trust 6,434 9,230 89.9% 2,586 472 3,058 188 051 RHQ North Of England Commissioning Region Sheffield Teaching Hospitals NHS Foundation Trust 9,172 17,196 89.8% 2,920 2,556 5,476 333 052 RM3 North Of England Commissioning Region Salford Royal NHS Foundation Trust 8,413 8,455 89.5% 2,716 398 3,114 254 053 RTX North Of England Commissioning Region University Hospitals Of Morecambe Bay NHS Foundation Trust 7,033 8,818 89.4% 2,050 1,079 3,129 110 154 RGR Midlands And East Of England Region West Suffolk NHS Foundation Trust 5,743 5,743 88.9% 2,103 363 2,466 14 055 RAE North Of England Commissioning Region Bradford Teaching Hospitals NHS Foundation Trust 12,241 12,241 88.3% 2,780 1,404 4,184 137 056 RN5 South Of England Commissioning Region Hampshire Hospitals NHS Foundation Trust 9,236 10,346 88.2% 2,254 1,226 3,480 676 157 RAS London Commissioning Region The Hillingdon Hospitals NHS Foundation Trust 5,361 13,031 88.0% 2,053 146 2,199 187 058 RRV London Commissioning Region University College London Hospitals NHS Foundation Trust 10,973 10,973 87.9% 1,828 747 2,575 144 059 RTG Midlands And East Of England Region Derby Teaching Hospitals NHS Foundation Trust 11,021 15,036 87.9% 3,367 1,326 4,693 187 460 RNA Midlands And East Of England Region The Dudley Group NHS Foundation Trust 8,563 13,057 87.7% 2,290 885 3,175 118 061 RAJ Midlands And East Of England Region Southend University Hospital NHS Foundation Trust 8,205 8,205 87.5% 2,397 732 3,129 2 062 RJL North Of England Commissioning Region Northern Lincolnshire And Goole NHS Foundation Trust 11,159 12,523 87.4% 2,615 450 3,065 262 063 RN3 South Of England Commissioning Region Great Western Hospitals NHS Foundation Trust 6,123 14,027 87.3% 2,079 1,338 3,417 567 064 RBL North Of England Commissioning Region Wirral University Teaching Hospital NHS Foundation Trust 7,651 10,196 87.3% 2,504 1,626 4,130 491 065 RDE Midlands And East Of England Region Colchester Hospital University NHS Foundation Trust 7,538 11,509 87.0% 2,316 879 3,195 278 066 RM2 North Of England Commissioning Region University Hospital Of South Manchester NHS Foundation Trust 8,227 8,227 86.7% 2,594 801 3,395 420 067 RTE South Of England Commissioning Region Gloucestershire Hospitals NHS Foundation Trust 11,814 11,814 86.1% 3,675 720 4,395 267 068 RRF North Of England Commissioning Region Wrightington, Wigan And Leigh NHS Foundation Trust 7,320 7,320 85.8% 2,237 451 2,688 8 069 RJR North Of England Commissioning Region Countess Of Chester Hospital NHS Foundation Trust 6,155 6,474 85.5% 2,023 571 2,594 369 070 RJZ London Commissioning Region King's College Hospital NHS Foundation Trust 16,887 23,571 85.1% 4,408 533 4,941 535 071 RMC North Of England Commissioning Region Bolton NHS Foundation Trust 8,490 9,411 84.5% 2,290 765 3,055 341 072 REM North Of England Commissioning Region Aintree University Hospital NHS Foundation Trust 7,034 13,399 84.5% 2,723 720 3,443 715 073 RNQ Midlands And East Of England Region Kettering General Hospital NHS Foundation Trust 7,215 7,215 84.4% 2,330 440 2,770 527 074 RAL London Commissioning Region Royal Free London NHS Foundation Trust 17,528 20,482 84.3% 3,643 610 4,253 899 075 RXN North Of England Commissioning Region Lancashire Teaching Hospitals NHS Foundation Trust 5,501 12,032 84.1% 1,940 1,180 3,120 527 276 RXL North Of England Commissioning Region Blackpool Teaching Hospitals NHS Foundation Trust 7,098 16,610 83.9% 2,182 913 3,095 857 177 RPA South Of England Commissioning Region Medway NHS Foundation Trust 10,012 10,012 83.8% 2,257 1,021 3,278 941 178 RGN Midlands And East Of England Region North West Anglia NHS Foundation Trust 11,392 12,169 83.3% 2,998 1,108 4,106 179 079 RCB North Of England Commissioning Region York Teaching Hospital NHS Foundation Trust 9,112 15,979 83.1% 3,435 1,494 4,929 473 180 RTH South Of England Commissioning Region Oxford University Hospitals NHS Foundation Trust 11,000 12,562 82.8% 2,927 3,208 6,135 654 381 RM1 Midlands And East Of England Region Norfolk And Norwich University Hospitals NHS Foundation Trust 8,464 10,828 82.7% 2,517 1,877 4,394 512 082 RRK Midlands And East Of England Region University Hospitals Birmingham NHS Foundation Trust 9,693 9,693 82.6% 2,801 1,132 3,933 491 083 RFR North Of England Commissioning Region The Rotherham NHS Foundation Trust 7,759 7,759 81.8% 1,522 373 1,895 267 084 RD1 South Of England Commissioning Region Royal United Hospitals Bath NHS Foundation Trust 6,009 6,895 80.9% 2,280 1,014 3,294 579 085 RR1 Midlands And East Of England Region Heart Of England NHS Foundation Trust 18,926 22,468 80.0% 7,336 2,020 9,356 1,374 086 RWJ North Of England Commissioning Region Stockport NHS Foundation Trust 8,019 8,019 79.7% 2,535 871 3,406 560 087 RVV South Of England Commissioning Region East Kent Hospitals University NHS Foundation Trust 13,457 17,259 70.5% 4,731 2,827 7,558 554 0


P a g e | 2

APPENDIX A

NHSI A&E Performance [September 2017] - Foundation Trusts with Type 1 Attendances

[Sorted by %>4hrs DTA to Admit]


Total attendances







% >4hrs DTA to Admit

77 RPA South Of England Commissioning Region Medway NHS Foundation Trust 10,012 10,012 83.8% 2,257 1,021 3,278 941 1 29%76 RXL North Of England Commissioning Region Blackpool Teaching Hospitals NHS Foundation Trust 7,098 16,610 83.9% 2,182 913 3,095 857 1 28%74 RAL London Commissioning Region Royal Free London NHS Foundation Trust 17,528 20,482 84.3% 3,643 610 4,253 899 0 21%72 REM North Of England Commissioning Region Aintree University Hospital NHS Foundation Trust 7,034 13,399 84.5% 2,723 720 3,443 715 0 21%56 RN5 South Of England Commissioning Region Hampshire Hospitals NHS Foundation Trust 9,236 10,346 88.2% 2,254 1,226 3,480 676 1 19%73 RNQ Midlands And East Of England Region Kettering General Hospital NHS Foundation Trust 7,215 7,215 84.4% 2,330 440 2,770 527 0 19%84 RD1 South Of England Commissioning Region Royal United Hospitals Bath NHS Foundation Trust 6,009 6,895 80.9% 2,280 1,014 3,294 579 0 18%75 RXN North Of England Commissioning Region Lancashire Teaching Hospitals NHS Foundation Trust 5,501 12,032 84.1% 1,940 1,180 3,120 527 2 17%43 RWW North Of England Commissioning Region Warrington And Halton Hospitals NHS Foundation Trust 6,814 10,677 90.9% 2,551 480 3,031 504 0 17%63 RN3 South Of England Commissioning Region Great Western Hospitals NHS Foundation Trust 6,123 14,027 87.3% 2,079 1,338 3,417 567 0 17%86 RWJ North Of England Commissioning Region Stockport NHS Foundation Trust 8,019 8,019 79.7% 2,535 871 3,406 560 0 16%85 RR1 Midlands And East Of England Region Heart Of England NHS Foundation Trust 18,926 22,468 80.0% 7,336 2,020 9,356 1,374 0 15%69 RJR North Of England Commissioning Region Countess Of Chester Hospital NHS Foundation Trust 6,155 6,474 85.5% 2,023 571 2,594 369 0 14%83 RFR North Of England Commissioning Region The Rotherham NHS Foundation Trust 7,759 7,759 81.8% 1,522 373 1,895 267 0 14%82 RRK Midlands And East Of England Region University Hospitals Birmingham NHS Foundation Trust 9,693 9,693 82.6% 2,801 1,132 3,933 491 0 12%66 RM2 North Of England Commissioning Region University Hospital Of South Manchester NHS Foundation Trust 8,227 8,227 86.7% 2,594 801 3,395 420 0 12%64 RBL North Of England Commissioning Region Wirral University Teaching Hospital NHS Foundation Trust 7,651 10,196 87.3% 2,504 1,626 4,130 491 0 12%81 RM1 Midlands And East Of England Region Norfolk And Norwich University Hospitals NHS Foundation Trust 8,464 10,828 82.7% 2,517 1,877 4,394 512 0 12%71 RMC North Of England Commissioning Region Bolton NHS Foundation Trust 8,490 9,411 84.5% 2,290 765 3,055 341 0 11%70 RJZ London Commissioning Region King's College Hospital NHS Foundation Trust 16,887 23,571 85.1% 4,408 533 4,941 535 0 11%80 RTH South Of England Commissioning Region Oxford University Hospitals NHS Foundation Trust 11,000 12,562 82.8% 2,927 3,208 6,135 654 3 11%41 RDD Midlands And East Of England Region Basildon And Thurrock University Hospitals NHS Foundation Trust 11,470 11,470 91.3% 2,504 239 2,743 272 0 10%79 RCB North Of England Commissioning Region York Teaching Hospital NHS Foundation Trust 9,112 15,979 83.1% 3,435 1,494 4,929 473 1 10%32 RMP North Of England Commissioning Region Tameside And Glossop Integrated Care NHS Foundation Trust 7,192 11,700 92.8% 1,658 261 1,919 183 0 10%36 RW3 North Of England Commissioning Region Central Manchester University Hospitals NHS Foundation Trust 12,539 25,336 92.3% 4,119 490 4,609 409 0 9%65 RDE Midlands And East Of England Region Colchester Hospital University NHS Foundation Trust 7,538 11,509 87.0% 2,316 879 3,195 278 0 9%62 RJL North Of England Commissioning Region Northern Lincolnshire And Goole NHS Foundation Trust 11,159 12,523 87.4% 2,615 450 3,065 262 0 9%57 RAS London Commissioning Region The Hillingdon Hospitals NHS Foundation Trust 5,361 13,031 88.0% 2,053 146 2,199 187 0 9%52 RM3 North Of England Commissioning Region Salford Royal NHS Foundation Trust 8,413 8,455 89.5% 2,716 398 3,114 254 0 8%87 RVV South Of England Commissioning Region East Kent Hospitals University NHS Foundation Trust 13,457 17,259 70.5% 4,731 2,827 7,558 554 0 7%25 RTK South Of England Commissioning Region Ashford And St Peter's Hospitals NHS Foundation Trust 8,417 12,999 93.7% 2,111 252 2,363 167 0 7%23 RQM London Commissioning Region Chelsea And Westminster Hospital NHS Foundation Trust 16,776 24,545 93.7% 3,680 754 4,434 311 0 7%50 RA9 South Of England Commissioning Region Torbay And South Devon NHS Foundation Trust 6,434 9,230 89.9% 2,586 472 3,058 188 0 6%51 RHQ North Of England Commissioning Region Sheffield Teaching Hospitals NHS Foundation Trust 9,172 17,196 89.8% 2,920 2,556 5,476 333 0 6%67 RTE South Of England Commissioning Region Gloucestershire Hospitals NHS Foundation Trust 11,814 11,814 86.1% 3,675 720 4,395 267 0 6%58 RRV London Commissioning Region University College London Hospitals NHS Foundation Trust 10,973 10,973 87.9% 1,828 747 2,575 144 0 6%37 RJF Midlands And East Of England Region Burton Hospitals NHS Foundation Trust 5,319 9,634 92.2% 1,824 633 2,457 116 0 5%44 RA7 South Of England Commissioning Region University Hospitals Bristol NHS Foundation Trust 9,004 10,876 90.8% 2,749 849 3,598 166 0 5%78 RGN Midlands And East Of England Region North West Anglia NHS Foundation Trust 11,392 12,169 83.3% 2,998 1,108 4,106 179 0 4%48 RHW South Of England Commissioning Region Royal Berkshire NHS Foundation Trust 9,645 11,156 90.5% 3,115 393 3,508 150 0 4%59 RTG Midlands And East Of England Region Derby Teaching Hospitals NHS Foundation Trust 11,021 15,036 87.9% 3,367 1,326 4,693 187 4 4%46 RDU South Of England Commissioning Region Frimley Health NHS Foundation Trust 19,468 19,468 90.7% 5,908 1,287 7,195 277 0 4%39 RAX London Commissioning Region Kingston Hospital NHS Foundation Trust 8,697 9,756 91.7% 1,921 479 2,400 91 1 4%24 RD8 Midlands And East Of England Region Milton Keynes University Hospital NHS Foundation Trust 7,404 11,781 93.7% 1,469 1,019 2,488 93 0 4%60 RNA Midlands And East Of England Region The Dudley Group NHS Foundation Trust 8,563 13,057 87.7% 2,290 885 3,175 118 0 4%26 RCX Midlands And East Of England Region The Queen Elizabeth Hospital, King's Lynn, NHS Foundation Trust 5,258 5,258 93.5% 2,061 804 2,865 104 1 4%53 RTX North Of England Commissioning Region University Hospitals Of Morecambe Bay NHS Foundation Trust 7,033 8,818 89.4% 2,050 1,079 3,129 110 1 4%22 RP5 North Of England Commissioning Region Doncaster And Bassetlaw Teaching Hospitals NHS Foundation Tru 10,847 13,717 93.7% 3,581 1,018 4,599 160 0 3%9 RR7 North Of England Commissioning Region Gateshead Health NHS Foundation Trust 7,317 9,690 96.1% 1,622 375 1,997 67 0 3%

55 RAE North Of England Commissioning Region Bradford Teaching Hospitals NHS Foundation Trust 12,241 12,241 88.3% 2,780 1,404 4,184 137 0 3%40 RNZ South Of England Commissioning Region Salisbury NHS Foundation Trust 3,822 4,069 91.7% 1,042 763 1,805 55 0 3%16 RFF North Of England Commissioning Region Barnsley Hospital NHS Foundation Trust 6,930 6,930 94.6% 2,568 647 3,215 94 0 3%34 RGT Midlands And East Of England Region Cambridge University Hospitals NHS Foundation Trust 9,385 12,519 92.4% 3,225 494 3,719 108 0 3%4 RTR North Of England Commissioning Region South Tees Hospitals NHS Foundation Trust 10,518 12,501 97.3% 2,088 2,348 4,436 124 0 3%

10 RQX London Commissioning Region Homerton University Hospital NHS Foundation Trust 9,964 9,964 95.6% 1,599 182 1,781 47 0 3%38 RJ1 London Commissioning Region Guy's And St Thomas' NHS Foundation Trust 11,559 15,159 91.9% 3,015 692 3,707 94 0 3%47 RH8 South Of England Commissioning Region Royal Devon And Exeter NHS Foundation Trust 8,537 9,468 90.6% 1,927 1,497 3,424 85 2 2%17 RDZ South Of England Commissioning Region The Royal Bournemouth And Christchurch Hospitals NHS Foundat 6,588 7,977 94.5% 1,938 1,186 3,124 72 0 2%35 RK5 Midlands And East Of England Region Sherwood Forest Hospitals NHS Foundation Trust 8,105 12,147 92.3% 2,513 435 2,948 63 0 2%30 RCF North Of England Commissioning Region Airedale NHS Foundation Trust 5,538 5,538 93.2% 1,128 784 1,912 40 0 2%8 RXP North Of England Commissioning Region County Durham And Darlington NHS Foundation Trust 10,874 17,204 96.8% 3,254 1,618 4,872 94 0 2%

28 RGP Midlands And East Of England Region James Paget University Hospitals NHS Foundation Trust 6,373 6,379 93.4% 1,213 469 1,682 30 0 2%18 RTD North Of England Commissioning Region The Newcastle Upon Tyne Hospitals NHS Foundation Trust 10,631 16,618 94.4% 2,231 2,345 4,576 75 0 2%42 RWY North Of England Commissioning Region Calderdale And Huddersfield NHS Foundation Trust 12,732 12,732 91.2% 2,977 1,223 4,200 59 0 1%6 RE9 North Of England Commissioning Region South Tyneside NHS Foundation Trust 4,930 5,629 97.0% 1,201 16 1,217 16 0 1%

11 RA2 South Of England Commissioning Region Royal Surrey County Hospital NHS Foundation Trust 5,850 5,850 95.6% 2,016 491 2,507 30 0 1%33 RBA South Of England Commissioning Region Taunton And Somerset NHS Foundation Trust 5,887 5,887 92.7% 1,905 1,324 3,229 38 0 1%19 RCD North Of England Commissioning Region Harrogate And District NHS Foundation Trust 4,065 4,952 94.2% 959 602 1,561 18 0 1%29 RHM South Of England Commissioning Region University Hospital Southampton NHS Foundation Trust 8,580 11,746 93.3% 2,977 1,773 4,750 53 0 1%14 RFS Midlands And East Of England Region Chesterfield Royal Hospital NHS Foundation Trust 6,760 6,760 95.3% 1,906 1,048 2,954 32 0 1%12 RYR South Of England Commissioning Region Western Sussex Hospitals NHS Foundation Trust 11,599 13,562 95.4% 3,318 1,366 4,684 49 0 1%20 RLN North Of England Commissioning Region City Hospitals Sunderland NHS Foundation Trust 7,637 12,817 94.1% 2,626 772 3,398 35 0 1%7 RVW North Of England Commissioning Region North Tees And Hartlepool NHS Foundation Trust 3,711 12,796 96.9% 1,979 1,966 3,945 30 0 1%

54 RGR Midlands And East Of England Region West Suffolk NHS Foundation Trust 5,743 5,743 88.9% 2,103 363 2,466 14 0 1%2 RBD South Of England Commissioning Region Dorset County Hospital NHS Foundation Trust 3,671 7,843 98.0% 1,237 398 1,635 7 0 0%

68 RRF North Of England Commissioning Region Wrightington, Wigan And Leigh NHS Foundation Trust 7,320 7,320 85.8% 2,237 451 2,688 8 0 0%27 RJC Midlands And East Of England Region South Warwickshire NHS Foundation Trust 5,607 6,305 93.4% 1,763 293 2,056 4 0 0%3 RA4 South Of England Commissioning Region Yeovil District Hospital NHS Foundation Trust 4,138 4,138 97.7% 1,285 261 1,546 3 0 0%

61 RAJ Midlands And East Of England Region Southend University Hospital NHS Foundation Trust 8,205 8,205 87.5% 2,397 732 3,129 2 0 0%21 RBT North Of England Commissioning Region Mid Cheshire Hospitals NHS Foundation Trust 5,556 7,023 94.0% 1,850 1,048 2,898 1 0 0%1 RC9 Midlands And East Of England Region Luton And Dunstable University Hospital NHS Foundation Trust 8,691 12,248 98.5% 2,485 1,340 3,825 0 0 0%5 RCU North Of England Commissioning Region Sheffield Children's NHS Foundation Trust 4,610 4,610 97.2% 705 335 1,040 0 0 0%

13 RTF North Of England Commissioning Region Northumbria Healthcare NHS Foundation Trust 7,803 16,296 95.4% 4,025 586 4,611 0 0 0%15 RBS North Of England Commissioning Region Alder Hey Children's NHS Foundation Trust 4,623 4,623 95.0% 925 276 1,201 0 0 0%31 RD3 South Of England Commissioning Region Poole Hospital NHS Foundation Trust 5,586 7,047 92.9% 1,697 1,393 3,090 0 0 0%45 RQ3 Midlands And East Of England Region Birmingham Women's And Children's NHS Foundation Trust 4,775 4,775 90.8% 1,074 244 1,318 0 0 0%49 RJ7 London Commissioning Region St George's University Hospitals NHS Foundation Trust 12,763 14,070 90.0% 3,875 737 4,612 0 0 0%


P a g e | 3

APPENDIX A

NHSI A&E Performance Trends [Jan 16 to September 17] - All Trusts with Type 1 Attendances

Region Name

JanPercentage in 4 hours or

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FebPercentage in 4 hours or

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MarPercentage in 4 hours or

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AprPercentage in 4 hours or

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MayPercentage in 4 hours or

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JunePercentage in 4 hours or

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JulyPercentage in 4 hours or

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AugPercentage in 4 hours or

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SepPercentage in 4 hours or

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SparklineSep

vs Aug Var

1 North of England Commissioning Region Wirral University Teaching Hospital NHS Foundation Trust 80.3% 77.6% 81.3% 82.2% 79.8% 81.1% 76.9% 79.3% 87.3% 8.0%2 Midlands and East Of England Mid Essex Hospital Services NHS Trust 77.2% 88.2% 84.0% 90.4% 85.6% 81.0% 84.3% 83.6% 90.5% 6.9%3 South of England Commissioning Region North Bristol NHS Trust 75.3% 81.7% 88.3% 86.2% 78.8% 79.1% 75.7% 73.2% 80.0% 6.8%4 North of England Commissioning Region Bolton NHS Foundation Trust 79.2% 85.8% 83.6% 82.5% 86.4% 84.7% 84.8% 78.3% 84.5% 6.2%5 London Commissioning Region North Middlesex University Hospital NHS Trust 76.0% 82.3% 85.6% 82.4% 83.7% 82.1% 81.9% 80.3% 85.8% 5.5%6 South of England Commissioning Region University Hospital Southampton NHS Foundation Trust 84.4% 82.1% 89.7% 89.4% 87.4% 86.7% 91.4% 89.5% 93.3% 3.9%7 Midlands and East Of England The Queen Elizabeth Hospital, King's Lynn, NHS Foundation Trust 86.3% 90.5% 90.7% 91.3% 91.0% 83.6% 84.1% 89.8% 93.5% 3.7%8 Midlands and East Of England Chesterfield Royal Hospital NHS Foundation Trust 79.0% 88.0% 90.8% 91.0% 89.2% 92.1% 91.9% 92.1% 95.3% 3.3%9 North of England Commissioning Region Blackpool Teaching Hospitals NHS Foundation Trust 84.7% 83.6% 86.6% 88.7% 85.0% 87.2% 83.3% 80.9% 83.9% 3.1%

10 South of England Commissioning Region Portsmouth Hospitals NHS Trust 73.7% 75.3% 78.1% 79.1% 75.0% 81.6% 78.6% 74.0% 77.0% 3.0%11 North of England Commissioning Region Wrightington, Wigan And Leigh NHS Foundation Trust 76.6% 83.9% 87.9% 92.7% 90.7% 85.7% 89.4% 82.9% 85.8% 2.9%12 South of England Commissioning Region Weston Area Health NHS Trust 63.9% 69.5% 77.7% 82.6% 91.0% 89.3% 90.5% 87.7% 90.6% 2.8%13 North of England Commissioning Region University Hospitals Of Morecambe Bay NHS Foundation Trust 79.5% 81.2% 83.4% 86.6% 85.5% 88.7% 85.2% 86.7% 89.4% 2.8%14 Midlands and East Of England Worcestershire Acute Hospitals NHS Trust 77.3% 77.9% 82.6% 81.2% 82.7% 82.9% 82.4% 79.8% 82.2% 2.4%15 Midlands and East Of England Walsall Healthcare NHS Trust 75.7% 81.2% 80.5% 85.8% 81.6% 85.0% 82.3% 79.5% 81.8% 2.3%16 South of England Commissioning Region Dartford And Gravesham NHS Trust 77.1% 85.8% 91.5% 86.4% 85.3% 89.3% 93.2% 91.2% 93.4% 2.2%17 North of England Commissioning Region Aintree University Hospital NHS Foundation Trust 79.3% 86.4% 89.9% 86.1% 78.8% 78.4% 80.8% 82.3% 84.5% 2.1%18 North of England Commissioning Region Barnsley Hospital NHS Foundation Trust 87.1% 85.0% 92.5% 89.0% 91.1% 91.8% 95.2% 92.5% 94.6% 2.1%19 North of England Commissioning Region Gateshead Health NHS Foundation Trust 93.6% 95.5% 96.0% 96.5% 96.5% 96.3% 96.1% 94.0% 96.1% 2.1%20 Midlands and East Of England Kettering General Hospital NHS Foundation Trust 70.4% 77.2% 79.8% 83.9% 86.3% 88.5% 89.7% 82.7% 84.4% 1.8%21 North of England Commissioning Region Mid Yorkshire Hospitals NHS Trust 77.1% 82.3% 92.6% 91.4% 86.6% 87.6% 85.4% 83.8% 85.5% 1.7%22 North of England Commissioning Region County Durham And Darlington NHS Foundation Trust 87.5% 91.6% 96.5% 94.8% 90.8% 93.2% 93.7% 95.1% 96.8% 1.7%23 Midlands and East Of England Burton Hospitals NHS Foundation Trust 87.3% 93.9% 97.3% 96.3% 93.2% 91.7% 93.0% 90.5% 92.2% 1.6%24 Midlands and East Of England Ipswich Hospital NHS Trust 85.1% 89.4% 92.9% 93.6% 92.2% 91.6% 94.4% 89.6% 91.1% 1.5%25 South of England Commissioning Region Ashford And St Peter's Hospitals NHS Foundation Trust 87.2% 87.5% 89.6% 91.0% 91.2% 91.5% 93.6% 92.2% 93.7% 1.4%26 South of England Commissioning Region Taunton And Somerset NHS Foundation Trust 91.3% 93.0% 94.2% 95.6% 94.6% 93.7% 94.2% 91.2% 92.7% 1.4%27 North of England Commissioning Region North Cumbria University Hospitals NHS Trust 80.4% 86.1% 83.7% 90.2% 89.8% 92.6% 93.2% 90.6% 91.9% 1.4%28 London Commissioning Region Epsom And St Helier University Hospitals NHS Trust 94.6% 95.2% 96.4% 95.2% 95.6% 95.0% 95.2% 94.0% 95.2% 1.3%29 South of England Commissioning Region Poole Hospital NHS Foundation Trust 90.1% 93.0% 94.8% 95.0% 92.7% 92.0% 92.8% 91.7% 92.9% 1.3%30 London Commissioning Region Guy's And St Thomas' NHS Foundation Trust 87.9% 89.5% 87.0% 87.2% 86.6% 90.5% 83.4% 90.7% 91.9% 1.2%31 North of England Commissioning Region South Tees Hospitals NHS Foundation Trust 92.5% 93.2% 96.4% 97.2% 94.9% 96.8% 96.4% 96.2% 97.3% 1.1%32 Midlands and East Of England Shrewsbury And Telford Hospital NHS Trust 73.8% 75.8% 81.6% 84.5% 77.5% 79.6% 78.6% 76.6% 77.6% 1.0%33 South of England Commissioning Region Royal Surrey County Hospital NHS Foundation Trust 86.2% 93.8% 96.5% 97.7% 97.8% 97.5% 96.1% 94.6% 95.6% 0.9%34 North of England Commissioning Region South Tyneside NHS Foundation Trust 86.8% 94.3% 98.3% 97.2% 96.6% 97.2% 96.1% 96.2% 97.0% 0.8%35 London Commissioning Region Barking, Havering And Redbridge University Hospitals NHS Trust 78.3% 87.2% 88.3% 86.1% 83.0% 87.6% 88.0% 86.2% 87.0% 0.8%36 Midlands and East Of England University Hospitals Of Leicester NHS Trust 78.1% 83.8% 83.9% 81.0% 76.3% 77.6% 79.8% 83.2% 84.0% 0.7%37 London Commissioning Region Croydon Health Services NHS Trust 85.0% 84.4% 86.1% 88.4% 91.2% 90.6% 88.3% 90.1% 90.9% 0.7%38 South of England Commissioning Region Western Sussex Hospitals NHS Foundation Trust 91.1% 93.8% 95.8% 94.9% 95.2% 93.8% 93.8% 94.7% 95.4% 0.7%39 South of England Commissioning Region Brighton And Sussex University Hospitals NHS Trust 77.1% 80.3% 84.4% 85.3% 87.9% 86.5% 81.9% 83.6% 84.3% 0.7%40 Midlands and East Of England Cambridge University Hospitals NHS Foundation Trust 80.0% 81.1% 94.1% 97.3% 95.0% 94.7% 95.5% 91.9% 92.4% 0.6%41 Midlands and East Of England The Dudley Group NHS Foundation Trust 87.7% 92.3% 95.6% 91.7% 92.0% 93.5% 89.1% 87.2% 87.7% 0.6%42 South of England Commissioning Region East Kent Hospitals University NHS Foundation Trust 70.6% 75.9% 80.2% 76.9% 76.8% 78.2% 70.1% 70.0% 70.5% 0.5%43 Midlands and East Of England Sandwell And West Birmingham Hospitals NHS Trust 84.2% 82.3% 85.3% 84.9% 81.6% 83.5% 86.0% 87.5% 87.9% 0.4%44 South of England Commissioning Region Buckinghamshire Healthcare NHS Trust 86.9% 88.8% 92.6% 90.8% 91.5% 91.5% 90.9% 86.1% 86.5% 0.4%45 South of England Commissioning Region Salisbury NHS Foundation Trust 84.8% 84.7% 92.7% 95.0% 93.1% 95.7% 95.7% 91.3% 91.7% 0.4%46 South of England Commissioning Region Frimley Health NHS Foundation Trust 84.7% 91.2% 91.4% 92.3% 90.2% 91.3% 91.5% 90.4% 90.7% 0.4%47 London Commissioning Region Kingston Hospital NHS Foundation Trust 82.6% 87.0% 90.7% 90.4% 89.0% 90.2% 92.9% 91.3% 91.7% 0.3%48 North of England Commissioning Region Northumbria Healthcare NHS Foundation Trust 90.0% 90.9% 95.6% 92.0% 92.6% 95.7% 95.0% 95.1% 95.4% 0.2%49 North of England Commissioning Region Lancashire Teaching Hospitals NHS Foundation Trust 82.6% 83.8% 83.6% 90.3% 89.4% 91.7% 88.8% 84.0% 84.1% 0.2%50 North of England Commissioning Region Doncaster And Bassetlaw Teaching Hospitals NHS Foundation Tru 85.1% 88.7% 92.6% 90.4% 91.4% 92.5% 93.2% 93.6% 93.7% 0.2%51 North of England Commissioning Region Pennine Acute Hospitals NHS Trust 76.7% 78.1% 81.3% 80.9% 86.4% 83.5% 84.5% 85.0% 85.0% 0.0%52 Midlands and East Of England Hinchingbrooke Health Care NHS Trust 75.2% 77.2% 89.2% not available not available not available not available not available not available 0.0%53 Midlands and East Of England East And North Hertfordshire NHS Trust 83.4% 83.8% 83.9% 89.2% 84.1% 87.5% 87.8% 85.1% not available 0.0%54 North of England Commissioning Region East Lancashire Hospitals NHS Trust 63.3% 79.9% 82.4% 81.8% 83.4% 83.6% 78.6% 88.6% 88.6% 0.0%55 North of England Commissioning Region Airedale NHS Foundation Trust 88.4% 94.5% 93.1% 93.3% 93.7% 95.2% 95.6% 93.2% 93.2% 0.0%56 London Commissioning Region St George's University Hospitals NHS Foundation Trust 86.6% 90.6% 88.6% 90.5% 89.7% 92.1% 89.8% 90.0% 90.0% 0.0%57 North of England Commissioning Region Bradford Teaching Hospitals NHS Foundation Trust 86.8% 90.1% 92.4% 87.4% 81.9% 86.3% 88.1% 88.3% 88.3% 0.0%58 South of England Commissioning Region Dorset County Hospital NHS Foundation Trust 97.2% 96.9% 99.1% 98.7% 98.4% 98.1% 98.7% 98.1% 98.0% -0.1%59 South of England Commissioning Region The Royal Bournemouth And Christchurch Hospitals NHS Foundat 90.9% 93.5% 94.5% 95.4% 93.7% 92.4% 92.3% 94.6% 94.5% -0.1%60 South of England Commissioning Region Northern Devon Healthcare NHS Trust 94.2% 92.0% 91.1% 91.8% 91.4% 93.7% 95.7% 90.9% 90.8% -0.2%61 South of England Commissioning Region Royal Devon And Exeter NHS Foundation Trust 91.0% 91.9% 93.1% 91.9% 92.8% 93.5% 95.1% 90.8% 90.6% -0.2%62 Midlands and East Of England Luton And Dunstable University Hospital NHS Foundation Trust 98.5% 98.2% 98.7% 98.8% 98.9% 99.2% 99.0% 98.7% 98.5% -0.2%63 London Commissioning Region The Hillingdon Hospitals NHS Foundation Trust 79.4% 82.1% 86.4% 86.8% 86.1% 87.5% 86.5% 88.2% 88.0% -0.2%64 South of England Commissioning Region Surrey And Sussex Healthcare NHS Trust 87.0% 90.9% 95.1% 92.9% 92.6% 92.8% 93.6% 94.4% 94.1% -0.3%65 South of England Commissioning Region University Hospitals Bristol NHS Foundation Trust 80.4% 80.7% 83.3% 82.3% 84.2% 87.9% 90.5% 91.3% 90.8% -0.4%66 South of England Commissioning Region Yeovil District Hospital NHS Foundation Trust 95.8% 96.1% 98.4% 98.1% 98.7% 97.6% 97.8% 98.2% 97.7% -0.5%67 London Commissioning Region Homerton University Hospital NHS Foundation Trust 92.9% 94.2% 93.8% 94.2% 92.9% 95.0% 97.5% 96.1% 95.6% -0.5%68 North of England Commissioning Region Countess Of Chester Hospital NHS Foundation Trust 82.7% 87.7% 86.0% 87.6% 84.6% 88.1% 84.8% 86.0% 85.5% -0.5%69 London Commissioning Region The Whittington Hospital NHS Trust 82.9% 86.6% 88.4% 91.1% 93.5% 92.4% 92.2% 90.5% 89.9% -0.5%70 North of England Commissioning Region The Newcastle Upon Tyne Hospitals NHS Foundation Trust 91.0% 93.4% 93.3% 95.1% 93.1% 95.6% 95.7% 95.0% 94.4% -0.6%71 Midlands and East Of England Derby Teaching Hospitals NHS Foundation Trust 84.2% 89.8% 89.1% 88.6% 89.3% 83.0% 88.0% 88.5% 87.9% -0.6%72 North of England Commissioning Region The Rotherham NHS Foundation Trust 82.2% 85.1% 90.1% 87.2% 88.1% 87.2% 81.2% 82.4% 81.8% -0.6%73 Midlands and East Of England The Royal Wolverhampton NHS Trust 86.5% 89.7% 91.3% 92.5% 94.1% 93.4% 93.8% 92.1% 91.4% -0.7%74 North of England Commissioning Region Central Manchester University Hospitals NHS Foundation Trust 88.9% 89.6% 92.1% 93.7% 93.6% 93.4% 94.7% 92.9% 92.3% -0.7%75 North of England Commissioning Region North Tees And Hartlepool NHS Foundation Trust 91.5% 92.6% 96.6% 98.0% 98.5% 99.0% 98.3% 97.6% 96.9% -0.7%76 South of England Commissioning Region Royal Berkshire NHS Foundation Trust 88.3% 91.3% 94.5% 93.3% 90.1% 95.8% 95.6% 91.3% 90.5% -0.9%77 Midlands and East Of England West Hertfordshire Hospitals NHS Trust 75.4% 77.6% 78.1% 76.5% 84.0% 89.0% 82.9% 82.5% 81.6% -1.0%78 Midlands and East Of England United Lincolnshire Hospitals NHS Trust 75.7% 75.4% 79.1% 82.2% 76.9% 81.5% 78.0% 77.6% 76.7% -1.0%79 London Commissioning Region University College London Hospitals NHS Foundation Trust 86.4% 89.2% 89.6% 90.9% 90.2% 92.1% 88.2% 88.9% 87.9% -1.0%80 North of England Commissioning Region Leeds Teaching Hospitals NHS Trust 81.8% 84.0% 90.9% 91.7% 88.3% 91.8% 87.7% 87.7% 86.7% -1.0%81 London Commissioning Region King's College Hospital NHS Foundation Trust 78.2% 81.4% 82.6% 85.0% 85.8% 85.4% 87.8% 86.2% 85.1% -1.1%82 Midlands and East Of England Basildon And Thurrock University Hospitals NHS Foundation Trust 87.6% 91.7% 91.0% 92.1% 91.5% 89.7% 88.2% 92.4% 91.3% -1.1%83 Midlands and East Of England West Suffolk NHS Foundation Trust 87.3% 83.9% 92.9% 95.2% 94.7% 95.5% 92.5% 90.1% 88.9% -1.1%84 North of England Commissioning Region Tameside And Glossop Integrated Care NHS Foundation Trust 76.7% 86.9% 88.2% 81.7% 84.5% 90.7% 93.6% 94.0% 92.8% -1.1%85 North of England Commissioning Region East Cheshire NHS Trust 71.4% 78.5% 83.5% 77.3% 86.3% 87.9% 91.2% 85.2% 84.0% -1.2%86 North of England Commissioning Region Mid Cheshire Hospitals NHS Foundation Trust 84.5% 93.3% 97.2% 93.4% 90.7% 94.2% 92.6% 95.3% 94.0% -1.3%87 North of England Commissioning Region St Helens And Knowsley Hospital Services NHS Trust 81.2% 83.9% 87.4% 88.9% 85.1% 86.6% 89.4% 90.5% 89.0% -1.5%88 London Commissioning Region Chelsea And Westminster Hospital NHS Foundation Trust 86.8% 90.4% 91.6% 94.1% 92.3% 95.0% 95.4% 95.3% 93.7% -1.6%89 North of England Commissioning Region City Hospitals Sunderland NHS Foundation Trust 86.7% 89.1% 93.8% 94.8% 93.8% 94.9% 95.3% 95.7% 94.1% -1.6%90 North of England Commissioning Region Sheffield Children's NHS Foundation Trust 98.3% 97.4% 95.8% 97.0% 98.2% 98.3% 98.5% 98.9% 97.2% -1.7%91 North of England Commissioning Region Northern Lincolnshire And Goole NHS Foundation Trust 80.1% 75.8% 84.7% 78.8% 85.2% 82.8% 83.5% 89.2% 87.4% -1.8%92 Midlands and East Of England Colchester Hospital University NHS Foundation Trust 86.2% 92.7% 94.6% 87.2% 87.6% 88.4% 80.7% 88.9% 87.0% -1.9%93 London Commissioning Region Imperial College Healthcare NHS Trust 86.3% 87.8% 88.6% 89.7% 90.4% 90.1% 90.5% 88.8% 86.9% -1.9%94 Midlands and East Of England James Paget University Hospitals NHS Foundation Trust 87.6% 87.3% 95.0% 93.4% 95.3% 94.9% 93.8% 95.3% 93.4% -1.9%95 North of England Commissioning Region Harrogate And District NHS Foundation Trust 93.9% 94.8% 97.2% 97.6% 95.7% 97.0% 97.4% 96.2% 94.2% -2.0%96 South of England Commissioning Region Oxford University Hospitals NHS Foundation Trust 84.8% 82.2% 87.1% 88.8% 86.4% 82.8% 80.8% 84.8% 82.8% -2.0%97 South of England Commissioning Region Gloucestershire Hospitals NHS Foundation Trust 74.6% 77.0% 77.8% 82.8% 80.0% 79.9% 83.5% 88.1% 86.1% -2.0%98 South of England Commissioning Region Plymouth Hospitals NHS Trust 79.5% 85.4% 85.1% 83.6% 84.0% 86.6% 84.4% 90.2% 88.2% -2.0%99 North of England Commissioning Region Sheffield Teaching Hospitals NHS Foundation Trust 83.8% 81.4% 87.9% 91.9% 91.1% 93.1% 91.0% 91.9% 89.8% -2.0%

100 London Commissioning Region Barts Health NHS Trust 81.3% 82.6% 85.7% 81.8% 84.9% 89.5% 88.4% 88.7% 86.6% -2.1%101 Midlands and East Of England Norfolk And Norwich University Hospitals NHS Foundation Trust 76.3% 77.7% 87.6% 90.1% 92.2% 91.4% 91.3% 85.1% 82.7% -2.3%102 Midlands and East Of England Sherwood Forest Hospitals NHS Foundation Trust 92.3% 94.4% 95.2% 95.9% 95.5% 96.7% 95.5% 94.6% 92.3% -2.4%103 North of England Commissioning Region Stockport NHS Foundation Trust 70.5% 75.2% 79.8% 85.3% 86.7% 85.3% 78.3% 82.1% 79.7% -2.4%104 North of England Commissioning Region Calderdale And Huddersfield NHS Foundation Trust 92.2% 93.5% 97.4% 95.1% 85.1% 92.0% 93.4% 93.6% 91.2% -2.4%105 London Commissioning Region Lewisham And Greenwich NHS Trust 80.3% 85.3% 87.4% 90.2% 89.4% 94.1% 91.8% 92.5% 89.9% -2.6%106 Midlands and East Of England Milton Keynes University Hospital NHS Foundation Trust 86.2% 88.6% 92.8% 92.9% 92.0% 91.2% 90.3% 96.3% 93.7% -2.6%107 Midlands and East Of England South Warwickshire NHS Foundation Trust 93.1% 95.7% 96.8% 95.7% 94.5% 96.5% 95.4% 96.1% 93.4% -2.7%108 North of England Commissioning Region University Hospital Of South Manchester NHS Foundation Trust 84.1% 87.0% 91.9% 94.6% 92.6% 90.1% 91.0% 89.4% 86.7% -2.7%109 Midlands and East Of England Northampton General Hospital NHS Trust 81.4% 78.1% 86.8% 87.4% 85.3% 88.8% 88.8% 89.7% 87.0% -2.7%110 North of England Commissioning Region Southport And Ormskirk Hospital NHS Trust 88.6% 88.0% 88.1% 91.1% 89.4% 90.3% 88.3% 88.4% 85.7% -2.7%111 Midlands and East Of England Nottingham University Hospitals NHS Trust 77.6% 79.3% 81.4% 82.3% 80.1% 82.8% 83.8% 85.5% 82.7% -2.8%112 Midlands and East Of England Heart Of England NHS Foundation Trust 77.1% 80.1% 84.0% 86.6% 83.2% 83.5% 83.6% 82.8% 80.0% -2.8%113 Midlands and East Of England Bedford Hospital NHS Trust 90.8% 92.0% 95.2% 95.0% 95.1% 95.9% 93.0% 93.0% 90.2% -2.8%114 North of England Commissioning Region Royal Liverpool And Broadgreen University Hospitals NHS Trust 86.4% 86.9% 89.6% 90.9% 87.7% 90.2% 87.7% 90.6% 87.7% -2.9%115 Midlands and East Of England North West Anglia NHS Foundation Trust 72.2% 85.3% 88.5% 87.7% 84.8% 91.2% 90.0% 86.4% 83.3% -3.1%116 South of England Commissioning Region Hampshire Hospitals NHS Foundation Trust 80.3% 88.4% 96.0% 95.6% 95.1% 90.8% 93.9% 91.4% 88.2% -3.2%117 South of England Commissioning Region Maidstone And Tunbridge Wells NHS Trust 76.4% 85.1% 89.6% 87.0% 87.0% 92.5% 93.2% 93.2% 90.0% -3.2%118 North of England Commissioning Region Alder Hey Children's NHS Foundation Trust 97.3% 97.0% 96.0% 96.4% 95.6% 96.0% 93.1% 98.3% 95.0% -3.3%119 Midlands and East Of England University Hospitals Of North Midlands NHS Trust 75.3% 78.0% 79.8% 84.7% 79.5% 81.1% 80.9% 79.8% 76.5% -3.3%120 South of England Commissioning Region Royal Cornwall Hospitals NHS Trust 80.1% 79.7% 77.7% 81.7% 84.5% 85.5% 93.0% 90.9% 87.6% -3.3%121 South of England Commissioning Region Torbay And South Devon NHS Foundation Trust 86.9% 89.2% 94.2% 94.3% 90.1% 92.3% 93.9% 93.2% 89.9% -3.3%122 North of England Commissioning Region Warrington And Halton Hospitals NHS Foundation Trust 85.9% 84.5% 90.7% 91.4% 92.8% 90.4% 92.8% 94.4% 90.9% -3.5%123 North of England Commissioning Region Salford Royal NHS Foundation Trust 76.7% 77.3% 84.8% 89.9% 82.1% 83.7% 91.6% 93.0% 89.5% -3.5%124 Midlands and East Of England Southend University Hospital NHS Foundation Trust 81.4% 85.3% 92.1% 95.3% 91.7% 90.7% 91.7% 91.1% 87.5% -3.6%125 South of England Commissioning Region Great Western Hospitals NHS Foundation Trust 82.3% 79.8% 84.4% 86.7% 91.9% 87.9% 87.9% 90.9% 87.3% -3.7%126 South of England Commissioning Region Medway NHS Foundation Trust 72.0% 76.2% 77.5% 80.8% 87.7% 91.1% 88.5% 87.7% 83.8% -3.9%127 Midlands and East Of England University Hospitals Birmingham NHS Foundation Trust 73.2% 81.1% 84.6% 82.7% 84.6% 87.5% 86.7% 86.8% 82.6% -4.2%128 Midlands and East Of England George Eliot Hospital NHS Trust 77.9% 82.1% 88.1% 93.1% 96.1% 95.0% 89.8% 95.3% 91.1% -4.2%129 London Commissioning Region London North West Healthcare NHS Trust 78.9% 81.3% 82.7% 83.5% 84.3% 85.9% 88.0% 85.7% 81.4% -4.2%130 South of England Commissioning Region Isle Of Wight NHS Trust 81.4% 85.3% 84.2% 86.5% 80.1% 80.8% 88.2% 94.9% 90.5% -4.3%131 London Commissioning Region Royal Free London NHS Foundation Trust 83.0% 87.1% 85.4% 87.6% 90.3% 87.0% 86.1% 88.7% 84.3% -4.4%132 Midlands and East Of England The Princess Alexandra Hospital NHS Trust 62.6% 67.9% 77.9% 79.0% 78.1% 75.0% 73.3% 74.9% 70.3% -4.6%133 South of England Commissioning Region East Sussex Healthcare NHS Trust 73.4% 76.1% 80.7% 80.1% 81.4% 88.0% 87.7% 92.5% 87.7% -4.8%134 Midlands and East Of England Wye Valley NHS Trust 85.4% 85.4% 88.1% 91.8% 88.6% 88.8% 84.0% 84.9% 80.0% -4.9%135 North of England Commissioning Region York Teaching Hospital NHS Foundation Trust 78.2% 81.4% 89.3% 92.9% 88.0% 91.9% 87.0% 88.1% 83.1% -5.0%136 North of England Commissioning Region Hull And East Yorkshire Hospitals NHS Trust 82.8% 82.0% 94.6% 93.8% 92.5% 93.6% 91.7% 92.0% 86.5% -5.5%137 Midlands and East Of England University Hospitals Coventry And Warwickshire NHS Trust 77.4% 79.6% 79.9% 85.1% 79.8% 83.0% 82.3% 84.4% 78.6% -5.8%138 Midlands and East Of England Birmingham Women's And Children's NHS Foundation Trust 95.2% 96.0% 97.0% 95.0% 94.0% 96.5% 95.3% 97.7% 90.8% -6.9%139 South of England Commissioning Region Royal United Hospitals Bath NHS Foundation Trust 73.7% 79.6% 80.6% 88.4% 80.8% 90.3% 94.2% 90.4% 80.9% -9.5%

A&E Attendances

P a g e | 4

APPENDIX B – SYSTEM PERFORMANCE INDICATORS

System Performance The Trust missed the 4 hour A&E NHSI 95% standard in September with performance recorded at 93.69%. This was a 1.53% improvement on last month (92.16%) and 0.16% above the agreed recovery trajectory of 93% for Q2. Attendances were 3.1% higher than September 2016, although admissions were 1.3% lower. On a number of occasions during the month, (a) surges in admissions & (b) reduced staff availability due to vacancies creating delays in A&E as well as slow flow to the wards. The following charts identify a number of daily snapshots of system indicators where activity has continued to exceed expectations identified by the CCG to support flow within ED & the Trust’s hospitals. In line with recent NHSI/NHSE communication, CCG-led LAEDB are undertaking a full review of system commissioning requirements to achieve the hospital flow required to deliver the A&E 4hr & DTOC targets. Number of Patients Medically Fit For Discharge Waiting Complex Discharge Requirements

Number of Patients Medically Fit For Discharge Waiting a Package of Care

Number of Delayed Transfers of Care Patients at Community Hospitals

APPENDIX B – SYSTEM PERFORMANCE INDICATORS

Number of Patients Medically Fit For Discharge Waiting Nursing Home

Number of Patients Medically Fit For Discharge Waiting Health Assessment

ASPH NHSI Performance September & Q2 2017 Tom Smerdon - Director of Operations (Urgent Care) James Thomas - Director of Operations (Planned Care)

ASPH NHSI Performance - September & Q2 2017

A&E

Cancer 62 Day Screening to Treatment

Cancer Two Week Wait to 1st OPA/STT

Domain Compliance threshold

Q3 16/17

Q4 16/17

Q1 17/18

Q2 16/17

Monthly Sparkline

Aug Sep

Radiotherapy 94% n/a n/a n/a n/a n/a n/a n/a

100%

85.7%

86.0%

CANCER

CANCER

CANCER

NHSI - 2017 SEPTEMBER & Q2 PERFORMANCE UPDATE

93.9%

96.0%

83.2%

83.2%

88.8%

NHS Cancer Screening Service referral

90%

Urgent GP referral for suspected cancer

85%

100%

100%

Drug Treatment 98%

96.6%

All cancers: 31-day wait for second or subsequent treatment

Surgery 94%

100%

100%

92.9%

95.7%

CANCERAll cancers: 31-day wait from diagnosis to first treatment 96%

97.8%

98.7%

98.8%

96.9%

97.7%

92.8%

92.4%

CANCERCancer: two week wait from referral to date first seen

All urgent referrals 93%

93.1%

92.3%

93.3%

92.9%

90.5%

Symptomatic breast patients 93%

RTTMaximum time of 18 weeks from point of referral to treatment in aggregate (INCOMPLETE PATHWAYS)

92%

98.3%

82.1%

100%

100%

All cancers: 62-day wait for first

treatment

A&EMaximum waiting time of four hours from arrival to admission/transfer/discharge

95%92.2%

93.7%

90.7%

88.1%

91.3%

93.2%

Standard

96.0%

92.8%

92.5%

95.2%

98.0%

93.9%

100%

87.0%

93.9%

93.2%

94.6%

95.4%

98.8%

94.4%

100%

87.7%

96.2%

ASPH NHSI Performance - A&E

A&E

A&E NHSI Performance was recorded at 93.7% for September. This was a 1.5% improvement on August & 0.16% above the agreed recovery trajectory of 93% for Q2.

Attendances were 3.1% higher than September 2016, although admissions were 1.3% lower. On a number of occasions during the month, (a) surges in admissions & (b) reduced staff availability due to vacancies and leave created delays in A&E as well as slow flow to the wards.

We have an Urgent Care Improvement Programme which includes implementing the SAFER CARE bundle and RED & GREEN Days to promote patient flow.

The Trust was placed 27th of 137 Trusts for A&E performance (September 2017).

Trust performance for September = 93.7% [National performance = 89.7%].


Q3 16/17

Q4 16/17

Q1 17/18

Q2 16/17

Monthly Sparkline

Aug Sep


A&EMaximum waiting time of four hours from arrival to admission/transfer/discharge

95%92.2%

93.7%

90.7%

88.1%

91.3%

93.2%

Standard

ASPH NHSI Performance - A&E vs National

ASPH NHSI Performance - Cancer 2 Week Wait

Cancer TWW is recorded non-compliant for September at 90.5% for Urgent Referrals.

Of the 87 breaches recorded for Urgent Referrals, patient choice accounted for 81%, STT capacity at 3% & OPA capacity at 16%.

The Trust is working with NWS CCG & local GPs, encouraging & supporting patient attendance within 14 days.

Cancer Two Week Wait to 1st OPA/STT


Q3 16/17

Q4 16/17

Q1 17/18

Q2 16/17

Monthly Sparkline

Aug Sep

CANCER


All urgent referrals 93%

93.3%

92.9%

90.5%

Standard

96.0%

Cancer: two week

wait from referral to date first seen

92.5%

94.6%

ASPH NHSI Performance - 62 Day Screening to Treatment

Cancer 62 Day NHS Screening Service Referrals wait for first treatment is recorded at 85.7% for September.

This was due to 1 patient breach due to being referred late from the Screening Centre.

Cancer 62 Day Screening to Treatment


Q3 16/17

Q4 16/17

Q1 17/18

Q2 16/17

Monthly Sparkline

Aug Sep

All cancers: 62-day wait for first treatment

100%

85.7%

CANCER


93.9%

96.0%

NHS Cancer Screening Service referral

90%

Standard

93.9%

96.2%

RTT - Performance & Waitlist Trend

Jul-17 Aug-17 Sep-17Start 15/16

Start 16/17

Start 17/18

WL Sep17

WL High

WL Low

WL % change

Trend

Aggregate WL volume change impact

General Surgery 89.3% 88.9% 88.8% 2,559 2,802 2,988 3,242 3,346 2,395 -6.4% -149Urology 84.4% 86.8% 87.2% 838 908 945 1,175 1,229 757 4.6% -49Trauma & Orthopaedics 96.0% 94.6% 94.5% 2,304 4,292 4,076 5,038 5,109 2,271 -1.2% 115ENT 89.5% 90.4% 90.1% 1,294 1,254 1,386 1,499 1,541 970 5.0% 72Ophthalmology 95.7% 94.3% 95.1% 2,871 3,875 3,995 3,937 4,145 2,684 7.2% -212Oral and Maxillofacial Surgery 82.2% 83.7% 84.0% 1,259 1,328 2,037 1,957 2,093 1,259 3.7% 57Plastic Surgery 66.7% 93.9% 88.9% 6 10 24 36 37 5 114.3% -7Pain 92.1% 92.2% 90.1% 658 1,081 769 436 1,252 436 -6.9% 14General Medicine 95.9% 94.3% 91.5% 725 857 952 1,268 1,268 681 8.3% 68Gastroenterology 95.3% 96.1% 94.7% 895 735 750 1,044 1,204 583 6.7% -174Cardiology 97.6% 97.4% 98.0% 770 953 862 1,087 1,087 680 18.4% 185Dermatology 98.7% 98.4% 92.4% 1,201 1,605 1,623 1,926 2,213 1,176 35.6% 157Neurology 92.5% 89.7% 91.6% 567 580 770 749 879 458 -10.2% -31Rheumatology 97.6% 97.8% 94.4% 322 244 449 408 480 224 10.6% 2Paediatrics 99.5% 99.3% 98.5% 684* 945 833 731 966 644 -2.1% -27Geriatric Medicine 99.2% 99.2% 97.6% 126 166 103 126 183 78 -3.2% -32Gynaecology 96.2% 95.8% 97.0% 1,098 1,097 1,095 1,069 1,389 1,016 -5.1% -22Other 95.0% 87.1% 75.9% 57 101 15 29 121 3 -26.5% -3Grand Total 93.2% 92.8% 92.4% 17,586 22,833 23,672 25,757 25,834 17,586 0.0% 862

SPECIALTY

Performance Waitlist Size & Range (FY15-FY17)


RTT - Performance & Backlog Trend

Jul-17 Aug-17 Sep-17Start 15/16

Start 16/17

Start 17/18

BL Sep17

BL High

BL Low

BL % change

TrendAggregate WL

volume change

General Surgery 89.3% 88.9% 88.8% 243 273 459 364 493 143 4.9% -114Urology 84.4% 86.8% 87.2% 76 83 119 150 183 26 -24.6% -8Trauma & Orthopaedics 96.0% 94.6% 94.5% 100 403 296 277 470 59 34.6% 11ENT 89.5% 90.4% 90.1% 46 36 95 148 151 16 5.9% 29Ophthalmology 95.7% 94.3% 95.1% 76 150 106 195 250 30 13.7% 49Oral and Maxillofacial Surgery 82.2% 83.7% 84.0% 30 60 311 314 353 23 0.0% 9Plastic Surgery 66.7% 93.9% 88.9% 0 1 7 4 7 0 -33.3% 2Pain 92.1% 92.2% 90.1% 19 54 71 43 254 4 7.5% -11General Medicine 95.9% 94.3% 91.5% 29 25 58 108 108 7 101.8% 64Gastroenterology 95.3% 96.1% 94.7% 30 42 41 55 70 21 61.4% 17Cardiology 97.6% 97.4% 98.0% 21 45 35 22 77 14 -23.3% 2Dermatology 98.7% 98.4% 92.4% 51 28 114 146 160 12 471.0% 46Neurology 92.5% 89.7% 91.6% 31 17 51 63 86 12 -33.3% 9Rheumatology 97.6% 97.8% 94.4% 5 5 2 23 35 0 4.3% 20Paediatrics 99.5% 99.3% 98.5% 8 22 29 11 59 0 83.3% -10Geriatric Medicine 99.2% 99.2% 97.6% 1 5 3 3 9 0 100.0% 0Gynaecology 96.2% 95.8% 97.0% 64 49 71 32 96 32 -21.7% -31Other 95.0% 87.1% 75.9% 5 0 1 7 11 0 - 4Grand Total 93.2% 92.8% 92.4% 829 1,298 1,869 1,965 2,024 607 16.3% 88

SPECIALTY

Performance Backlog Size & Range (FY15-FY17)


RTT - 2 x 52 Week Wait Exceedances

The Trust reviewed 2 patients that exceeded a wait of 52 weeks before receiving treatment. Root Cause Analysis investigations identified;

Patient 1 (child) - exceeded 52 weeks due to considerable parent initiated appointment cancellations.

• Recommendations: (i) Enhanced patient communications, (ii) Enhanced training & application of staff operating procedures & (iii) Stricter application of the Joint Access Policy

Patient 2 - exceeded 52 weeks due to administration error

• Recommendations: (i) Enhanced training & application of staff operating procedures (for inter-specialty referrals), & (ii) Introduction of an electronic clinic outcome form

For both patients, no harm was caused due to the delay for treatment


Q3 16/17

Q4 16/17

Q1 17/18

Q2 16/17

Monthly Sparkline

Aug Sep


92.8%

92.4%

93.1%

92.3%

RTTMaximum time of 18 weeks from point of referral to treatment in aggregate (INCOMPLETE PATHWAYS)

92%

Standard

92.8%

93.2%

DM01 Diagnostic Performance

The Trust failed the DM01 diagnostic standard with September performance recorded at 98.12%, however this was a 1.16% improvement on August’s performance of 96.96%.

This has been due to a number of reasons in;

Neurophysiology due to staff sickness creating a reporting & wait list backlog

Echocardiography Stress Tests & Cystoscopy due to insufficient capacity to meet demand & an increase in delays through patient choice over the summer period.

Additional capacity has been arranged with compliance estimated within 2 months.

<6wks >6wks <6wks >6wks <6wks >6wks <6wks >6wks <6wks >6wks <6wks >6wks5781 56 6051 36 5428 48 4863 119 4689 147 5941 114

98.12%1.88%

Sep-17Jun-17 Jul-17 Aug-17Apr-17 May-17

99.41% 99.12% 97.61% 96.96%99.04%3.04%0.96% 0.59% 0.88% 2.39%

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FINCOM Sep v3...days for Sep 2017 the level of admissions continues to cause patient flow...

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