hsc board performance report september 2018) purpose

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HSC BOARD PERFORMANCE REPORT – 2018/19 (Month 6 – September 2018)

Purpose

This paper provides Board members with an assessment of performance against the

standards and targets set out in the draft Commissioning Plan Direction (CPD) (Northern

Ireland) 2018/19. The position regionally and by Trust at the end of September 2018 for

the targets and standards that the HSCB is responsible for monitoring and where

monitoring information is currently available is set out in Annex A.

Performance

The key performance challenges, including the reasons for the current performance and

the actions being taken to address these, largely remain as reported at previous Board

meetings. An update on performance in a number of these areas is provided below – full

details are provided in Annex A. Further to discussion at the October board meeting, a

detailed update on mental health services will be provided in December.

1. Elective Care (including Diagnostics)

At the end of September 2018, 25% of patients waiting for a first outpatient appointment

were waiting less than nine weeks.

29% 28% 28% 27% 25% 25% 26% 26% 24% 23% 25% 27%

27% 26% 27% 26% 24% 25%

0%

20%

40%

60%

80%

100%

Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar

Outpatients - % waiting <9 weeks

2017/18 2018/19

Trust Apr-18 May-18 Jun-18 Jul-18 Aug-18 Sep-18

Belfast 27% 27% 28% 27% 26% 27%

Northern 29% 28% 28% 28% 26% 27%

South Eastern 21% 21% 22% 21% 20% 19%

Southern 28% 28% 29% 27% 25% 26%

Western 30% 29% 30% 29% 26% 27%

Regional 27% 26% 27% 26% 24% 25%

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There has been a slight reduction in the number of patients waiting longer than nine

weeks for a first outpatient appointment – at the end of September 2018, 212,990

patients were waiting longer than nine weeks compared to 214,300 at the end of August

(-1,310). However, the number waiting longer than 52 weeks has increased from

92,070 at the end of August to 94,222 at the end of September (+2,152). The increase

in the longest waiting patients (normally routine) is not unexpected as Trusts prioritise

referrals to ensure that the clinically urgent patients (red flag/urgent) are seen first.

184,305 189,158 189,289196,348

202,697 203,478 200,213 200,494206,983 206,248 200,189 198,296

199,881 202,054 202,081 206,963214,300 212,990

0

30,000

60,000

90,000

120,000

150,000

180,000

210,000

240,000


Outpatients - Numbers waiting >9 weeks

2017/18 2018/19


Belfast 68,204 68,882 67,945 69,067 70,693 69,950

Northern 26,527 27,121 27,520 28,189 29,179 28,723

South Eastern 49,501 49,804 49,951 51,472 53,851 53,711

Southern 31,374 31,995 32,437 33,468 34,749 34,837

Western 24,275 24,252 24,228 24,767 25,828 25,769

Regional 199,881 202,054 202,081 206,963 214,300 212,990

57,57160,427

64,074 66,67769,935

73,380 75,311 77,68380,651 80,767 80,675 83,392

83,739 85,957 88,598 90,082 92,070 94,222

0

20,000

40,000

60,000

80,000

100,000



2017/18 2018/19

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Belfast 31,415 31,769 32,189 32,063 32,113 32,928

Northern 10,308 10,597 10,952 11,151 11,340 11,291

South Eastern 21,730 22,616 23,566 24,496 25,754 26,355

Southern 9,077 9,403 9,983 10,204 10,439 11,022

Western 11,209 11,572 11,908 12,168 12,424 12,626

Regional 83,739 85,957 88,598 90,082 92,070 94,222

At the end of September 2018, 33% of patients were waiting less than 13 weeks for

inpatient or daycase treatment.

42% 42% 41% 41% 39% 38% 37%41% 39% 37% 37% 38%

38% 37% 37% 36% 34% 33%

0%

20%

40%

60%

80%

100%


Inpatient/Daycase - % waiting <13 weeks

2017/18 2018/19


Belfast 31% 29% 29% 28% 26% 25%

Northern 64% 63% 63% 63% 61% 59%

South Eastern 44% 44% 46% 46% 45% 43%

Southern 40% 41% 41% 39% 37% 37%

Western 35% 35% 36% 35% 33% 33%

Region 38% 37% 37% 36% 34% 33%

The number of patients waiting longer than 13 and 52 weeks for inpatient or daycase

treatment has increased – at the end of September 2018, 57,665 patients were waiting

longer than 13 weeks compared to 56,100 at the end of August (+1,565) and, 19,727

patients were waiting longer than a year for surgery compared to 18,991 at the end of

August (+736).

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41,163 42,064 42,732 43,58545,624 47,009 46,111 45,383

48,00350,317 51,046 50,228

51,235 52,429 52,872 54,183 56,10057,665

0

10,000

20,000

30,000

40,000

50,000

60,000

70,000


Inpatient/Daycase - Numbers waiting >13 weeks

2017/18 2018/19


Belfast 24,825 25,925 26,592 27,299 28,388 29,202

Northern 2,547 2,606 2,660 2,720 2,828 3,045

South Eastern 5,794 5,668 5,605 5,617 5,618 5,829

Southern 7,133 7,224 7,150 7,432 7,766 7,784

Western 10,936 11,006 10,865 11,115 11,500 11,805

Region 51,235 52,429 52,872 54,183 56,100 57,665

10,134 10,670 11,261 11,62112,371

13,17613,935 14,391 14,979

15,955 16,389 16,454

16,814 17,43618,080 18,466 18,991

19,727

0

5,000

10,000

15,000

20,000

25,000



2017/18 2018/19


Belfast 7,674 8,158 8,669 8,907 9,337 9,934

Northern 337 323 311 335 340 353

South Eastern 1,803 1,872 1,935 1,950 1,933 1,982

Southern 2,393 2,422 2,390 2,426 2,504 2,510

Western 4,607 4,661 4,775 4,848 4,877 4,948

Region 16,814 17,436 18,080 18,466 18,991 19,727

As previously advised, it is unacceptable that any patient has to wait longer than they

should for assessment or treatment and ensuring that patients have access to safe,

quality and timely care remains a key priority for the HSC. However, as demand for

elective care services continues to exceed health service capacity for both new

outpatients and inpatient/daycase treatments, regrettably it is inevitable that waiting

times will increase. While waiting times for elective care have increased it should be

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noted that there was an increase in activity during Q1 of this year compared to the same

period in 2017/18 – outpatient attendances increased by 5.5% and inpatient/daycase

treatments increased by 1.1%.

Trusts are continuing to undertake the additional activity associated with the allocation

of £30m non-recurrent funding from the Confidence and Supply (C&S) Transformation

Fund for additional elective care activity in 2018/19 to reduce hospital waiting times.

As previously reported, this funding is being utilised in the first instance to see and treat

patients with the highest clinical priority (red flag and urgent) and thereafter to target

those patients who have been waiting the longest (normally routine patients). In

addition, funding is being targeted to reduce the number of patients waiting longer than

26 weeks for a diagnostic test and 13 weeks for AHP treatment.

Robust monitoring arrangements are in place to enable the HSCB to monitor Trusts’

progress to ensure that the approved volumes of additional activity associated with the

C&S funding are delivered and the agreed outcomes achieved. Monthly updates on

progress are provided to the Department’s Top Management Group.

To date, good progress has been made in relation to reducing the backlog of patients

waiting longer than 13 weeks at the end of March 2018 for AHP treatment and 26

weeks for a diagnostic test. At the end of August 2018, the number of patients who had

been waiting longer than 13 weeks for AHP treatment at 31 March 2018 (23,375) had

reduced by more than 17,500. While this represents a significant reduction in this target

cohort of patients and has enabled the waiting list growth to be stabilised, the total

number of waiters has not materially reduced. In relation to diagnostics, regionally at

the end of August 2018, the number of patients waiting longer than 26 weeks at the end

of March 2018 had reduced by 6,700.

With regard to assessment and treatment, regionally in the five months to the end of

August 2018, approximately 20,850 patients who would otherwise still have been

waiting to be seen or treated had benefited as a result of the additional investment.

While non-recurrent funding to enable Trusts to undertake additional activity benefits

large numbers of patients and reduces waiting lists in the short term, the long-term

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solution is to reform elective care services to meet current and future demand through

the transformation of secondary, primary and community care services as set out in the

Department of Health’s Elective Care Plan. Since its publication, despite the challenging

financial environment, a number of initiatives have been taken forward consistent with the

direction of travel set out in the Plan and non-recurrent funding has been made available

to continue to take forward a range of these transformation initiatives in 2018/19 –

examples of these were provided at the board meeting in September.

In addition, the Department has recently announced new regional centres for day

surgery. From December 2018, the new prototype elective care centres will undertake

routine day surgery for cataracts and treatment of varicose veins.

This initiative represents a significant step forward in the transformation of health care,

and clearly demonstrates the benefits to patients of that process.

It is expected that the development of prototype elective care centres will have a

significant impact on the number of patients treated. For cataracts, this could mean up

to 2,000 additional treatments annually and for varicose veins, this could mean up to

500 more treatments – an increase in productivity of up to 30% in both cases.

With this improvement in productivity, combined with additional waiting list activity

currently ongoing to stabilise waiting times, it is the Department’s expectation that, for

patients who have been assessed as requiring treatment for cataracts and varicose

veins:

By December 2019, no patient will wait longer than 1 year;

By December 2020, no patient will wait longer than 26 weeks;

By December 2021, all patients will be treated within the ministerial target of 13

weeks.

The prototypes for varicose veins will be based at Lagan Valley Hospital and Omagh

Hospital and Primary Care Complex; and those for cataracts will operate from three

locations - Mid-Ulster Hospital, Downe Hospital, and South Tyrone Hospital. In all

cases, the prototypes will serve patients from across Northern Ireland.

The prototypes, will help inform the development of regional daycase elective care

centres for all appropriate specialties. Regional centres for routine day case surgery will

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secure important progress in the efficiency and effectiveness of care. Crucially, they will

operate on separate sites from urgent and emergency hospital care meaning they will

not be competing for operating rooms and other resources, leading to fewer

cancellations of operations. While some patients may be asked to travel further for their

treatment, they will be seen faster and have a better experience.

There has been a continued improved in relation to the delivery of commissioned

volumes of core activity compared to last year. For new outpatient assessments,

regionally during the first six months of 2018/19, there has been a 10.7% (21,914)

underdelivery of core activity compared to -12.2% during the same period last year. In

relation to delivery of commissioned volumes of inpatient/daycase volumes, there has

been an 8.6% (6,773) underdelivery of core activity during the first half of this year (April

to September 2018) compared to 11.0% during the same period last year.

Trusts have submitted Performance Improvement Trajectories (PITs) for a range of

elective specialties detailing the expected delivery of core position for 2018/19. In the

majority of cases, Trusts’ plans forecast an improvement on last year’s position. With

the exception of the Northern Trust, progress against the PITs at the end of September

2018 is broadly in line with or ahead of the Trusts’ planned position. The HSCB is

continuing to work with all Trusts to ensure that the delivery of funded core elective

capacity is maximised particularly in the context of the financial position and workforce

challenges.

Trust CPD Target Area

Delivery of

Core 2017/18

(full year)

Planned

Delivery of

Core

2018/19

(full year)

PITs - Planned

Delivery of

Core Position

2018/19

(Apr-Sep)

Actual Delivery

of Core Position

2018/19

(Apr-Sep)

New OP -12.6% -13.8% -14.6% -14.6%

IPDC -13.8% -11.4% -11.6% -11.0%

New OP -5.9% -4.9% -6.9% -10.1%

IPDC -11.3% -12.2% -11.0% -18.4%

New OP -4.2% -3.6% -5.4% -4.4%

IPDC -6.7% -3.9% -1.6% 1.7%

New OP -6.2% -4.5% -7.1% -5.5%

IPDC -10.0% -6.2% -7.4% -7.0%

New OP -16.8% -11.1% -13.0% -13.1%

IPDC -11.5% -7.6% -8.9% -10.0%Western

Belfast

Northern

South Eastern

Southern

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The proportion of patients waiting less than nine weeks for a diagnostic test has

increased slightly – at the end of September 2018, 50% of patients were waiting less

than nine weeks compared to 49% at the end of August.

60%57% 57% 54%

50% 52% 53% 55% 53% 53%58% 60%

57% 56% 55% 53%49% 50%

0%

20%

40%

60%

80%

100%


Diagnostics - % waiting <9 weeks(Imaging and Physiological Measurement)

2017/18 2018/19


Belfast 42% 43% 44% 45% 42% 42%

Northern 72% 66% 63% 57% 52% 51%

South Eastern 64% 61% 63% 58% 53% 56%

Southern 53% 50% 49% 47% 43% 46%

Western 84% 83% 83% 80% 76% 78%

Region 57% 56% 55% 53% 49% 50%

Regionally the number of patients waiting longer than nine weeks for a diagnostic test

has reduced – at the end of September 2018, 50,948 patients were waiting longer than

nine weeks compared to 52,997 at the end of August (-2,049). However, the number

waiting longer than 26 weeks has increased from 19,178 at the end of August to 19,772

at the end of September (+594).

35,953

40,473 41,486

46,23249,138

45,77847,962

43,70447,786

45,014

38,077 36,423

40,78843,924

46,198 46,313

52,99750,948

0

10,000

20,000

30,000

40,000

50,000

60,000


Diagnostics - number waiting >9 weeks(Imaging and Physiological Measurement)

2017/18 2018/19

9


Belfast 18433 17963 18,863 15,787 18,592 16,707

Northern 5229 6955 7,890 9,570 11,425 12,197

South Eastern 5121 5973 5,980 6,888 7,713 7,471

Southern 10646 11481 11,929 12,368 13,294 12,701

Western 1359 1552 1,536 1,700 1,973 1,872

Region 40,788 43,924 46,198 46,313 52,997 50,948

8,4549,535

10,569

12,377

14,386 14,817

16,994

15,110

18,83517,572 17,615

14,867

16,377 16,96817,845

16,305

19,178 19,772

0

5,000

10,000

15,000

20,000

25,000


Diagnostics Numbers waiting >26 weeks(Imaging and Physiological Measurement)

2017/18 2018/19


Belfast 11028 10732 11482 9,039 10,615 9,968

Northern 931 1148 1358 1,651 2,153 3,330

South Eastern 1004 1142 933 1,065 1,035 995

Southern 3264 3768 3847 4,194 4,867 5,008

Western 150 178 225 356 508 471

Region 16,377 16,968 17,845 16,305 19,178 19,772

Given that diagnostics are essential in diagnosing patient conditions and enabling a

treatment plan to be put in place for patients, and recognising the increased demand

(both scheduled and unscheduled), recurrent funding has been allocated to Trusts in

2018/19 to expand health service capacity for MRI, CT and non-obstetric ultrasound.

This funding will provide an additional 44,000 examinations and close the capacity gap

to the end of March 2019. In addition, recurrent funding has been allocated to the

Southern Trust for a second CT scanner in Craigavon Area Hospital.

Trusts have also been allocated additional non-recurrent funding from the C&S Fund to

clear the backlog of patients waiting longer than 26 weeks for a diagnostic test at the

end of March 2018 and an update on progress in this regard is provided above (page

5).

The HSCB/PHA will continue to work with Trusts during 2018/19 to take forward a range

of measures to ensure that the expertise of consultant radiologists can be directed to

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those tasks which only they can do and examples of developments in imaging have

been provided in previous reports.

2. Emergency Department (ED) (4-hour and 12-hour standards)

Regionally during the month of September 2018, 1,716 patients waited longer than 12

hours in ED – this is an increase on the previous month (1,499) and also on the same

month last year (919).

702555

296 293448

919 1,0101,190

2,369

3,932

2,467

3,161

1,4141,157

1,366

1,872

1,4991,716

0 0 0 0 0 00

500

1,000

1,500

2,000

2,500

3,000

3,500

4,000

4,500


ED - Number Waiting >12 hours

2017/18 2018/19

Trust Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 2017/18

Belfast 62 152 31 14 22 104 385

Northern 186 38 28 89 158 355 854

South Eastern 204 182 120 110 186 250 1,052

Southern 222 157 104 39 56 115 693

Western 28 26 13 41 26 95 229

Region 702 555 296 293 448 919 3,213


Belfast 299 250 172 263 243 261 1,488

Northern 332 174 294 436 559 563 2,358

South Eastern 462 464 551 545 345 397 2,764

Southern 237 240 285 500 282 310 1,854

Western 84 29 64 128 70 185 560

Region 1,414 1,157 1,366 1,872 1,499 1,716 9,024

In particular, 12-hour performance this year shows a system under considerable

pressure ahead of the winter period. This position is largely related to emerging issues

in the nursing/residential/domiciliary care systems which have been experiencing staff

shortages with a significant number of homes having to close or re-register from nursing

to residential homes because of their inability to recruit the necessary nursing staff.

In relation to the 4-hour standard, regionally during September 2018, 71% of patients

were treated and discharged, or admitted within four hours – this is a slight increase on

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the previous month (70%) however, it is a notable reduction compared to the same

month last year (74%).

75% 77%81% 81% 78%

74% 74% 74%68% 66% 67% 65%

72% 73% 73% 72% 70% 71%

0%

20%

40%

60%

80%

100%


ED - % seen within 4 hours

2017/18 2018/19


Belfast 72% 73% 83% 83% 80% 74% 77%

Northern 71% 77% 75% 72% 70% 64% 71%

South Eastern 78% 79% 81% 83% 80% 79% 80%

Southern 73% 74% 83% 86% 84% 78% 80%

Western 80% 85% 84% 76% 76% 76% 79%

Region 75% 77% 81% 81% 78% 74% 78%


Belfast 67% 67% 69% 68% 66% 69% 68%

Northern 71% 72% 71% 69% 66% 68% 69%

South Eastern 75% 76% 76% 76% 76% 76% 76%

Southern 73% 73% 73% 72% 70% 70% 72%

Western 74% 80% 78% 78% 76% 74% 77%

Region 72% 73% 73% 72% 70% 71% 72%

The delivery of safe and effective unscheduled care remains a challenge for

commissioners and providers and making improvements to the current service provision

and unscheduled care performance remains a key focus for the HSC system. A

detailed update on the issues impacting on unscheduled care services and the

measures being put in place to address these, including for this winter period, was

provided at the October board meeting.

At the start of the year, Trusts submitted PITs for 4-hour ED performance which forecast

the expected performance for 2018/19. Overall, Trusts forecast an improvement in 4-

hour performance for 2018/19 compared to 2017/18 or, in the case of South Eastern

Trust, to maintain last year’s performance (77%). However, in the year to date (April to

September 2018), Trusts’ performance is not in line with the forecast position set out in

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their trajectories for this period – see table below. This was raised by the HSCB at the

recent round of performance meetings with Trusts and they have reported that the

deviation from the planned position is largely as a result of increased demand, longer

length of stay and delays in discharging patients.

Trust/site

% <4 hours

2017/18

(full year)

Planned % <4

hours 2018/19

(full year)

Planned

% <4 hours

2018/19

(Apr-Sep)

Actual

% <4 hours

2018/19

(Apr-Sep)

Belfast (RVH) 67% 70% 70% 59%

Belfast (Mater) 72% 75% 75% 71%

Northern 68% 69% 71% 69%

South Eastern 77% 77% 80% 76%

Southern 75% 78% 81% 72%

Western 76% 78% 80% 77%

3. Cancer Services

Breast Cancer (14 days)

Regionally during September 2018, 74.5% of urgent breast cancer referrals were seen

within 14 days compared to 79.5% in August.

82%88% 85%

89%

88%

76%

81% 81% 81%

98% 100% 100%

100% 96%94% 92%

80%74%

0%

20%

40%

60%

80%

100%


By March 2019, all urgent breast cancer referrals should be seen within 14 days

2017/18 2018/19


Belfast 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0%

Northern 100.0% 84.3% 80.6% 59.2% 19.2% 11.9% 58.3%

South Eastern 100.0% 100.0% 99.5% 100.0% 100.0% 100.0% 99.9%

Southern 99.6% 98.8% 97.6% 97.9% 100.0% 100.0% 99.0%

Western 100.0% 100.0% 99.3% 100.0% 100.0% 100.0% 99.9%

Region 99.9% 96.3% 94.2% 92.1% 79.5% 74.5% 89.8%

In relation to individual Trusts, it should be noted that 100% of urgent referrals were

seen within 14 days during September in Belfast, South Eastern, Southern and Western

Trusts.

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The regional position in September (74.5%) is as a result of a further deterioration in

performance in the Northern Trust – during September 2018, only 11.9% of urgent

referrals were seen within 14 days. Where patients were not seen within 14 days

during September, the longest wait was 44 days.

68%

95% 94%100% 97% 99% 99%

71%

48%

93%100% 100%100%

84% 81%

59%

19%12%0%

20%

40%

60%

80%

100%

120%


Northern Trust Breast Cancer - % of urgent referrals seen <14 days

2017/18 2018/19

Given the seriousness of this position and the need to improve access to the breast

service for women with suspect cancer as a matter of urgency, the HSCB has met with

the Trust to understand the reasons for the deterioration in performance and to agree

actions to improve waiting times in both the short and long term.

As previously reported, the decline in the Trust’s performance in recent months is due to

a shortfall in capacity to meet patient demand. For some time, the Trust has been

undertaking additional activity to meet patient demand however, due to bank holidays

and staff annual leave over the summer period, capacity was insufficient to meet

demand and a backlog of patients has accumulated as a result. There was also a

material impact on the availability of general surgeons (as breast surgeons are part of

general surgery rota) which has contributed to the backlog of patients. The Trust has a

recovery plan in place to address this position and has secured additional in-house

capacity and also capacity from other Trusts to clear the backlog of patients waiting. As

a result of these measures, the Trust expects a significant improvement in 14-day

performance from October.

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In relation to Trusts’ performance improvement trajectories for the 14-day breast cancer

access standard, all Trusts have forecast an improvement in performance in 2018/19

compared to last year. At the end of September, performance in four Trusts is in line

with or ahead of the planned position for this period. However, performance in the

Northern Trust (58%) is well below the planned position (92%) for the reasons set out

above.

Trust

Actual

% <14 days

2017/18

(full year)

Planned

% <14 days

2018/19

(full year)

Planned

% <14 days

2018/19

(Apr-Sep)

Actual

% <14 days

2018/19

(Apr-Sep)

Belfast 96% 98% 97% 100%

Northern 89% 91% 92% 58%


Southern 47% 99% 99% 99%

Western 99% 100% 100% 100%

In relation to the future configuration of breast assessment services regionally, the

Breast Assessment Project Board held a final meeting in September to agree revisions

to the consultation document in light of the outcome of the Project Assessment Review

(PAR) commissioned by DoH. The consultation document is in the process of being

revised with the intention being to present it to the HSCB Board before the end of the

year with submission to DoH early in the New Year. Public consultation on the

consolidation of assessment services will commence thereafter, subject to

Departmental approval.

Cancer (31 days)

Regionally during September 2018, 92% of cancer patients commenced treatment

within 31 days of the decision to treat (standard: 98%).

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95%

93%

95%

95% 94% 92%95% 93% 92% 92% 93%

97%95%

93%

95%

94% 93% 92%

0%

20%

40%

60%

80%

100%


By March 2019, at least 98% of patients diagnosed with cancer should receive their first definitive treatment within 31 days of a decision to treat

2017/18 2018/19

The continued strong performance in the Southern and Western Trusts should be

acknowledged – in the year to date (April to September 2018), 99.5% of patients in both

Trusts have commenced treatment within 31 days.


Belfast 91.6% 87.5% 92.5% 90.3% 90.7% 87.5% 90.1%

Northern 95.2% 91.7% 94.8% 90.2% 81.3% 82.6% 88.9%

South Eastern 96.1% 94.2% 94.2% 95.2% 94.5% 96.0% 95.0%

Southern 96.6% 100.0% 100.0% 100.0% 100.0% 100.0% 99.5%

Western 100.0% 100.0% 100.0% 99.3% 99.2% 98.5% 99.5%

Region 94.9% 93.3% 95.4% 93.9% 93.0% 91.9% 93.7%

While regionally performance continues to be below the required level (98%), there has

been an increase in the number of patients who commenced their first treatment for

cancer following a decision to treat – 5,091 patients during the first six months of

2018/19 (April to September) compared to 4,897 during the same period in 2017/18.

In relation to Trusts’ performance improvement trajectories, three of the five Trusts plan

to maintain 2017/18 levels of performance in 2018/19 however, two Trusts (Northern

and South Eastern) have forecast a deterioration in 31-day performance compared to

last year. In the year to date (April to September 2018), performance in four Trusts is

broadly in line with, or ahead of, the planned position. The HSCB will continue to work

with the Trusts to ensure that funded capacity is fully maximised.

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Trust

Actual

% <31 days

2017/18

(full year)

Planned

% <31 days

2018/19

(full year)

Planned

% <31 days

2018/19

(Apr-Sep)

Actual

% <31 days

2018/19

(Apr-Sep)

Belfast 90% 90% 91% 90%

Northern 93% 91% 92% 89%


Southern 97% 97% 98% 100%

Western 100% 100% 100% 100%

Cancer (62 days)

Regionally during September 2018, 61% of patients urgently referred with a suspected

cancer began their first definitive treatment within 62 days (standard: 95%).

68% 68%

69%

64%

64%

62%68% 66% 67% 67% 67%

74%

68% 67%

71%

62%

66%

61%

0%

20%

40%

60%

80%

100%


By March 2019, at least 95% of patients urgently referred with a suspected cancer should begin their first definitive treatment within 62 days

2017/18 2018/19


Belfast 59.9% 55.0% 65.3% 48.7% 60.0% 47.8% 56.4%

Northern 72.4% 76.0% 70.0% 60.6% 66.9% 55.5% 67.0%

South Eastern 58.3% 60.4% 60.1% 52.9% 48.2% 48.4% 55.0%

Southern 69.4% 74.2% 79.0% 78.9% 74.2% 81.2% 76.1%

Western 90.8% 81.8% 84.7% 83.7% 84.1% 84.4% 84.8%

Region 68.2% 67.5% 70.8% 62.3% 65.8% 61.3% 66.0%

Similar to the position for 31-day cancer, there has been an increase in activity

compared to last year – during the first six months of 2018/19 (April to September),

2,240 patients commenced their first treatment for cancer following an urgent GP

referral for suspect cancer, compared with 2,143 in 2017/18.

In relation to the performance improvement trajectories for 2018/19, two Trusts

(Southern and Western) plan to deliver an improvement on, or maintain, last year’s 62-

17

day performance and this is welcomed. The remaining three Trusts expect

performance to deteriorate compared to last year. In the year to date (April to

September), performance in four Trusts is behind the planned position.

Trust

Actual

% <62 days

2017/18

(full year)

Planned

% <62 days

2018/19

(full year)

Planned

% <62 days

2018/19

(Apr-Sep)

Actual

% <62 days

2018/19

(Apr-Sep)

Belfast 58% 57% 57% 56%

Northern 73% 71% 70% 67%


Southern 74% 80% 78% 76%

Western 88% 88% 87% 85%

Given the lack of progress towards achievement of the 62-day cancer access standard

regionally, the HSCB is continuing to hold Director-level cancer performance meetings

with each Trust with a focus on the longest waits and to seek assurances from Trusts

that the longest waiting patients are treated as efforts continue to improve performance

to the required standard. There is also a continued focus on ensuring that where

treatment does not commence within 62 days no patient waits longer than 85 days.

4. Child and Adolescent Mental Health Services (CAMHS)

Regionally, the number of patients waiting longer than nine weeks to access CAMHS

has increased from 190 at the end of August 2018 to 201 at the end of September.

106 107

138

196 195

115 12072

116

160

132

66

69

10290

155

190201

0

50

100

150

200

250


CAMHS - By March 2019, no patient waits longer than 9 weeks to access child and adolescent mental health services

2017/18 2018/19

The continued strong performance in the South Eastern and Southern Trusts should be

noted.

18

Trust Mar-18 Apr-18 May-18 Jun-18 Jul-18 Aug-18 Sep-18

Belfast 56 33 28 29 57 26 20

Northern 0 0 0 0 0 70 119

South Eastern 0 0 0 0 0 0 0

Southern 0 0 0 0 0 0 0

Western 10 36 74 61 98 94 62

Region 66 69 102 90 155 190 201

More than half (59%) of the patients waiting longer than nine weeks at the end of

September 2018, were waiting to access the CAMHS Step 2 service in the Northern

Trust which manages routine referrals for children and young people who are

experiencing mild/moderate mental health difficulties. The Trust has advised that the

service experienced an unusually high number of referrals in June and July which,

combined with summer leave, has resulted in an increase in waiting times. The position

has been further compounded by a loss of community/voluntary service capacity. The

Trust is undertaking a review of the service to identify opportunities to improve the

waiting time position.

The Western Trust had advised that it expected the CAMHS waiting time positon to

deteriorate during the first half of 2018/19 due to a shortfall in capacity as a result of

vacant posts however, it expects the position to improve in the second half of the year

and it remains confident that it will have no patients waiting longer than nine weeks by

March 2019.

Trusts’ performance improvement trajectories for 2018/19 indicated that all Trusts

planned to achieve the target to have no patients waiting longer than nine weeks by

March 2019. Four of the five Trusts remain confident that they will achieve the target

outcome however, the Northern Trust has been asked to review its planned position

given the recent deterioration in performance.

Trust

No waiting >9

weeks for

CAMHS at

31.3.18

Planned

No waiting >9

weeks for

CAMHS at

31.3.19

Planned

No waiting >9

weeks for

CAMHS at

30.9.18

Actual

No waiting >9

weeks for

CAMHS at

30.9.18

Belfast 56 0 29 20

Northern 0 0 0 119

South Eastern 0 0 0 0

Southern 0 0 0 0

Western 10 0 0 62

19

5. Adult Mental Health Services (9 weeks)

Regionally the number of people waiting longer than nine weeks to access adult mental

health services has increased slightly – at the end of September 2018, 1,305 patients

were waiting longer than nine weeks compared to 1,232 at the end of August 2018

(+73).

1,0181,067

1,027

1,237

1,224

1,017849

696

837

710642 648

744 772 800892

1,2321,305

0

200

400

600

800

1,000

1,200

1,400


Mental Health - By March 2019, no patients wait > 9 weeks to access adult mental health services

2017/18 2018/19


Belfast 179 222 138 118 80 121 49

Northern 0 0 0 0 0 0 4

South Eastern 43 38 20 18 4 16 20

Southern 108 117 159 211 368 547 659

Western 318 367 455 453 440 548 573

Region 648 744 772 800 892 1,232 1,305

The number of patients waiting longer than nine weeks in the Southern Trust has

increased from 108 at the end of March to 659 at the end of September (+551). The

Trust has advised that performance has been impacted by unexpected and continuing

staff absences and, vacancies and peaks in demand.

Regionally, the majority of patients waiting longer than nine weeks at the end of

September, 1,230 (94%), are waiting to access primary care mental health services

(1,077) and addiction services (153).

20

Service Belfast NorthernSouth

EasternSouthern Western

Region

Total

Addiction Services 3 0 0 126 24 153

Community Mental Health Teams 1 0 20 9 0 30

Community Mental Health Teams for Older People 0 0 0 0 1 1

Eating Disorder Services 4 4 0 36 0 44

Forensic Services 0 0 0 0 0 0

Personality Disorder Services 0 0 0 0 0 0

Primary Care Mental Health Team 41 0 0 488 548 1,077

Trust Total 49 4 20 659 573 1,305

Mental Health Services - Breach Analysis September 2018

All Trusts have submitted PITs setting out the forecast waiting time position for 2018/19.

Trust

No. waiting >9

weeks for adult

mental health

services at

31.3.18

Planned

no. waiting >9

weeks for adult

mental health

services at

31.3.19

Planned

no. waiting >9

weeks for adult

mental health

services at

30.9.18

Actual

no. waiting >9

weeks for adult

mental health

services at

30.9.18

Belfast 179 0 122 49

Northern 0 0 0 4


Southern 108 533 395 659

Western 318 484 542 573

The Southern and Western Trusts have forecast a deterioration in the waiting time

position during 2018/19, in particular in primary care mental health and addiction

services – Southern (+425) and Western (+166). Both Trusts have advised that the

increased waiting times for these services are due to a combination of factors including

increased demand and workforce issues (sickness absence, maternity leave,

retirements and recruitment difficulties).

In relation to addiction services, the Southern Trust has indicated that the number of

patients waiting longer than nine weeks will increase from four at the end of March 2018

to 273 by 31 March 2019 (+269). The Trust has advised that in order to address the

growth in demand and increasing capacity gap for treatment/intervention (secondary

waits) it has transferred existing resources from new assessments to treatment/

intervention activities. The Trust is initiating a review/service improvement process to

streamline the existing pathway including a review of strategies to reduce DNA/CNA

rates and remodelling assessment processes to allow for additional clinics.

21

The Western Trust has advised that it will be undertaking a review of its mental health

service pathways to identify any issues and to redesign and streamline pathways to

improve patient experience and reduce waiting times.

6. Dementia Services (9 weeks)

Regionally there has been a continued reduction in the number of patients waiting

longer than nine weeks for dementia services – at the end of September 2018, 293

patients were waiting longer than nine weeks, a reduction of 25 from the previous

month.

68

109131 141 147 154 143 144

190

145

195183

399378

337 334318

293

0

50

100

150

200

250

300

350

400

450


Dementia - By March 2019, no patients wait >9 weeks to access dementia services

2017/18 2018/19

The continued strong performance in Northern Trust should be acknowledged – only

one patient waiting longer than nine weeks at 30 September 2018.


Belfast 77 66 49 40 33 40 34

Northern 0 0 0 0 0 0 1

South Eastern 9 203 211 185 206 213 207

Southern 15 31 30 16 12 12 10

Western 82 99 88 96 83 53 41

Region 183 399 378 337 334 318 293

Four of the five Trusts have forecast an improvement in waiting times for dementia

services by March 2019 and are on track to deliver this outcome. The South Eastern

Trust, which accounts for the majority of the patients waiting longer than nine weeks

regionally (71% at end of September), expects the waiting time position to deteriorate

during 2018/19 due to patient demand exceeding funded capacity and vacant posts.

The HSCB raised this performance issue with the Trust at the recent HSCB/Trust

22

service issues and performance meeting and the Trust has agreed to consider a

number of options to reduce waiting times for this service including enhancing its

psychiatric liaison service.

Trust

No. waiting >9

weeks for

Dementia

services at

31.3.18

Planned

no. waiting >9

weeks for

Dementia

services at

31.3.19

Planned

no. waiting >9

weeks for

Dementia

services at

30.9.18

Actual

no. waiting >9

weeks for

Dementia

services at

30.9.18

Belfast 77 40 40 34

Northern 0 0 0 1


Southern 15 59 42 10

Western 82 195 183 41

7. Psychological Therapies (13 weeks)

Regionally, the number of patients waiting longer than 13 weeks for psychological

therapy services has increased – at the end of September 2018, 2,027 patients were

waiting longer than 13 weeks compared to 1,829 at the end of August 2018 (+198).

1,242 1,262 1,319 1,3071,398 1,418 1,388 1,415

1,572 1,578 1,5681,474

1,5161,591 1,626

1,7611,829

2,027

0

300

600

900

1,200

1,500

1,800

2,100

2,400


Psychological Therapies - By March 2019, no patients wait >13 weeks to access Psycholgical therapies services

2017/18 2018/19


Belfast 577 586 592 604 691 682 731

Northern 31 62 123 147 128 123 102

South Eastern 228 245 252 224 252 286 383

Southern 84 96 105 118 142 161 171

Western 554 527 519 533 548 577 640

Region 1,474 1,516 1,591 1,626 1,761 1,829 2,027

23

More than two thirds (68%) of the patients waiting longer than 13 weeks regionally at

the end of September 2018 for psychological therapy services were in the Belfast (731)

and Western (640) Trusts.

Service Belfast NorthernSouth

EasternSouthern Western

Region

Total

Adult Mental Health 107 0 251 122 385 865

Primary Care Hub 0 0 0 0 0 0

Older People-Functional Services 0 0 28 0 1 29

Adult Learning Disability 14 35 26 1 118 194

Children's Learning Disability 26 16 11 1 36 90

Adult Health Psychology 314 50 67 47 10 488

Children's Psychology 71 1 0 0 90 162

Psychosexual Services 199 0 0 0 0 199

Neurodisability Services 0 0 0 0 0 0

Specialist Trauma Care 0 0 0 0 0 0

Trust Total 731 102 383 171 640 2,027

Psychological Therapies Services - Breach Analysis September 2018

The majority of patients waiting longer than 13 weeks in Belfast Trust were waiting to

access adult health psychology (314), adult mental health (107) and psychosexual

services (199). In the Western Trust, the majority of patients were waiting longer than

13 weeks in adult mental health (385) and adult learning disability (118) services.

All Trusts have submitted PITs setting out the expected performance against the target

to have no patients waiting longer than 13 weeks for psychological therapies (any age)

by 31 March 2019.

Trust

No. waiting

>13 weeks for

Psychological

Therapies at

31.3.18

Planned

no. waiting

>13 weeks for

Psychological

Therapies at

31.3.19

Planned

no. waiting

>13 weeks for

Psychological

Therapies at

30.9.18

Actual

no. waiting

>13 weeks for

Psychological

Therapies at

30.9.18

Belfast 577 801 686 731

Northern 31 102 129 102


Southern 84 80 63 171

Western 554 617 618 640

With the exception of the Southern Trust, Trusts have forecast a significant deterioration

in waiting times over the course of the year, in particular for adult mental health and

adult health psychology services. Trusts have identified the need for additional

24

investment, an increase in demand and complexity for psychological therapy services

and recruitment difficulties as the reasons for the forecast increase in waiting times.

At the end of September 2018, performance in four of the five Trusts is broadly in line

with their respective PITs however, this should be viewed in the context of a forecast

increase in the number of patients waiting longer than 13 weeks over the course of the

year – regionally, 2,250 waiting longer than 13 weeks at 31 March 2019 compared to

1,474 at the end of March 2018 (+776). Performance in the Southern Trust is currently

not on track to deliver the forecast outcome – 171 patients waiting longer than 13 weeks

at the end of September against a target profile of 63. The Trust has advised that

performance continues to be impacted by ongoing workforce challenges and it is

continuing to work to address these.

The Department has recently confirmed that non-recurrent funding from the C&S

Funding for mental health services should be targeted at psychological therapies. The

HSCB is working with Trusts to agree how this funding can best be utilised to reduce

waiting times.

Conclusion

More detail on the actions being taken in relation to these and other performance areas

will be provided by the relevant Directors at the board meeting.

Lisa McWilliams Interim Director of Performance Management and Service Improvement November 2018

25

Annex A SUMMARY OF PERFORMANCE AGAINST 2018/19 DRAFT COMMISSIONING PLAN DIRECTION STANDARDS AND TARGETS

STANDARD / TARGET Trend Analysis Comments

Outcome 1: Reduction of health inequalities

Supporting Children and Young People

Children in care 1 (target) – by March 2019, the proportion of children in care for 12 months or longer with no placement change is at least 85%.

Trust 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017

Belfast 81% 79% 83% 84% 84% 79% 84% 84% 83% 85%

Northern 81% 78% 78% 78% 75% 77% 78% 82% 83% 82%

South Eastern 80% 82% 78% 81% 81% 82% 79% 82% 83% 82%

Southern 71% 59% 73% 66% 72% 78% 81% 81% 78% 80%

Western 85% 83% 83% 82% 86% 80% 81% 79% 83% 84%

Region 80% 77% 79% 79% 79% 79% 81% 82% 82% 83% Source: CIB (OC2 Community Information Return) 'Year' is school year not financial year)

Performance against this target is reported annually in arrears. Regionally during 2017 (school year), the proportion of children in care for 12 months or longer with no placement change was 83%.

Children in care 2 (target) – by March 2019, 90% of children who are adopted from care, are adopted within a three year time frame (from date of last admission).

Trust 2007/08 2009/10 2011/12 2012/13 2013/14 2014/15 2015/16 2016/17 2017/18

Belfast 75% 31% 59% 41% 78% 63% 92% 43% 42%

Northern 33% 38% 29% 44% 61% 50% 52% 60% 40%

South Eastern 20% 33% 57% 64% 52% 69% 80% 94% 32%

Southern 63% 42% 50% 50% 56% 25% 32% 53% 69%

Western 20% 100% 60% 19% 57% 25% 38% 36% 68%

Region 47% 40% 47% 42% 61% 47% 54% 56% 50% Source: CIB (these figures are based on Dept’l returns). “Year” is school year not financial year

Performance against this target is reported annually in arrears. During 2017/18 (school year), there was a 3-year timeframe for 50% of children adopted from care.

26


Outcome 2: People using health and social care services are safe from avoidable harm

Safe in Hospital Settings

Healthcare acquired infections 1 (target) – by 31 March 2019 secure an aggregate reduction of 11% of Escherichia coli, Klebsiella spp. and Pseudomonas aeruginosa bloodstream infections acquired after two days of hospital admission, compared to 2017/18.

211 216

0

50

100

150

200

250

Jan-00

Number of episodes of HCAGNBSI (Regional)(Target: no more than 422 during 2018/19)

Target Profile (Apr-Sep 18) Actual no of episodes (Apr-Sep 18)

HAGNBSI2017/18

Actual

2018/19

Target

Maximum

2018/19

Target

Profile

(Apr-Sep)

2018/19

Actual

(Apr-Sep)

Variance

(actual vs

target

profile)

(Apr-Sep)

Belfast 208 201 101 119 19

Northern 80 75 38 15 -23

South Eastern 64 39 20 27 8

Southern 71 58 29 29 0

Western 50 49 25 26 2

Region 473 422 211 216 5

39

27

3835

32

45

0

5

10

15

20

25

30

35

40

45

50

Apr-18 May-18 Jun-18 Jul-18 Aug-18 Sep-18 Oct-18 Nov-18 Dec-18 Jan-19 Feb-19 Mar-19

Monthly No of cases of HAGNBSI against run-rate (regional)

No of cases of HAGNBSI Monthly run-rate

This is a new target for 2018/19. Trusts are required to have no more than 422 episodes of Escherichia coli (E-coli), Klebsiella spp. and Pseudomonas aeruginosa bloodstream infections acquired after two days of hospital admission during 2018/19. Regionally during the first six months of 2018/19 (April to September), there have been 216 Healthcare Associated Gram-negative Bloodstream Infections (HAGNBSI) against a 6-month target profile to have had no more than 211. With regard to performance in individual Trusts, at the end of September 2018 performance in the Northern and Southern Trusts is in line with, or ahead of, their 6-month target profiles however, the remaining three Trusts (Belfast, South Eastern and Western) have exceeded their target profiles for this period.

27


Healthcare acquired infections 2 (target) – by 31 March 2019, to secure a reduction of 7.5% in the total number of in-patient episodes of Clostridium difficile infection in patients aged 2 years and over.

160

179

0

20

40

60

80

100

120

140

160

180

200

Number of episodes of C. Difficile (Regional)(Target: no more than 320 during 2018/19)


C. Difficile2017/18

Actual

2018/19

Target

Maximum

2018/19

Target

Profile

(Apr-Sep)

2018/19

Actual

(Apr-Sep)

Variance

(actual vs

target

profile)

(Apr-Sep)

Belfast 113 110 55 60 5

Northern 49 49 25 29 5


Southern 50 50 25 20 -5

Western 64 56 28 28 0

Region 337 320 160 179 19

21

27

39

27 28

37

0

5

10

15

20

25

30

35

40

45


Monthly No of cases of C. difficile against run-rate (regional)

No of cases of C. difficile Monthly run-rate

Trusts are required to have no more than 320 inpatient episodes of Clostridium difficile infection in patients aged 2 years and over during 2018/19. Regionally during the first six months of 2018/19 (April to September), there have been 179 episodes of C. difficile against a 6-month target profile to have had no more than 160. This position is largely as a result of the high number of episodes in June (40) and September (37). With regard to performance in individual Trusts, at the end of September 2018 performance in Southern and Western Trusts is in line with, or ahead of, their 6-month target profiles however, the remaining three Trusts (Belfast, Northern and South Eastern) have exceeded their target profiles for this period.

28


Healthcare acquired infections 3 (target) – by 31 March 2019, to secure a reduction of 7.5% in the total number of in-patient episodes of Methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infection compared to 2017/18.

17

31

0

5

10

15

20

25

30

35

Number of episodes of MRSA (Regional)(Target: no more than 34 during 2018/19)


MRSA2017/18

Actual

2018/19

Target

Maximum

2018/19

Target

Profile

(Apr-Sep)

2018/19

Actual

(Apr-Sep)

Variance

(actual vs

target

profile)

(Apr-Sep)

Belfast 19 12 6 11 5

Northern 14 7 4 7 4


Southern 4 5 3 0 -3

Western 4 5 3 6 4

Region 46 34 17 31 14

5

4

3

10

2

7

0

1

2

3

4

5

6

7

8

9

10

11


Monthly No of cases of MRSA against run-rate (regional)

No of cases of MRSA Monthly run-rate

Trusts are required to have no more than 34 inpatient episodes of MRSA bloodstream infection during 2018/19. Regionally during the first six months of 2018/19 (April to September), there have been 31 episodes of MRSA against a 6-month target profile to have had no more than 17. This position is largely as a result of the high number of episodes in July (10) and September (7). With regard to performance in individual Trusts, at the end of September 2018 performance in the Southern Trust is ahead of their 6-month target profile however, the remaining four Trusts have exceeded their target profiles for this period and South Eastern Trust has exceeded its annual target maximum of five.

29


Outcome 4: Health and social care services are centred on helping to maintain or improve the quality of life of people who use them

Primary Care Setting

GP out-of-hours (target) – by March 2019, to have 95% of acute/urgent calls to GP OOH triaged within 20 minutes.

89% 90% 91% 91% 92% 92% 93% 91%

84%87% 89% 88%

86% 86% 87% 84%87% 87%

0%

20%

40%

60%

80%

100%


By March 2019, 95% of acute / urgent calls to GP OOH should be triaged within 20 minutes.

2017/18 2018/19


Belfast 87% 87% 88% 88% 89% 91% 88%

Northern 92% 94% 94% 93% 96% 93% 94%

South Eastern 84% 87% 86% 87% 84% 80% 85%

Southern 80% 80% 80% 73% 78% 82% 79%

Western 88% 86% 89% 87% 91% 89% 88%

Region 86% 86% 87% 84% 87% 87% 86%

During September 2018, 87% of acute/urgent calls to GP OOH were triaged within 20 minutes.

Ambulance Response Time (standard) – from April 2018, 72.5% of Category A (life threatening) calls responded to within eight minutes, 67.5% in each LCG area.


Belfast 51% 50% 47% 44% 47% 52% 48%

Northern 35% 33% 36% 33% 30% 27% 32%

South Eastern 36% 35% 34% 27% 29% 34% 33%

Southern 37% 36% 33% 33% 32% 36% 35%

Western 56% 47% 47% 44% 42% 48% 47%

Region 43% 41% 39% 37% 37% 40% 39%

Regionally during September 2018, 40% of Category A calls were responded to within eight minutes. Increasing demand for emergency ambulance services has placed considerable pressure on NIAS to deliver against the 8-minute Category A response standard. The Trust’s proposal on the introduction of a new Clinical Response Model (CRM) has been issued for public consultation – closing date of 20 December 2018. As reported previously, through the new model, which has been successfully introduced in the rest of the UK without any adverse impact, NIAS would seek to identify the patients with potentially life-threatening conditions and aim to ensure that, on average, these calls are reached within eight minutes and that 90% are reached within 15 minutes.

In addition to the above, as part of the Trust’s programme of reform and modernisation, NIAS is continuing to take forward the implementation of Appropriate Care Pathways which provide

30


access to a range of new services to offer alternatives to bringing patients to an Emergency Department through treatment in the community or offering an alternative destination.

Hospital Care Setting – Acute Care

Unscheduled care 1 (target) – by March 2019, 95% of patients attending any Type1, 2 or 3 Emergency Department are either treated and discharged home, or admitted, within four hours of their arrival in the Department; and no patient attending any emergency department should wait longer than 12 hours.


Belfast 67% 67% 69% 68% 66% 69% 68%

Northern 71% 72% 71% 69% 66% 68% 69%

South Eastern 75% 76% 76% 76% 76% 76% 76%

Southern 73% 73% 73% 72% 70% 70% 72%

Western 74% 80% 78% 78% 76% 74% 77%

Region 72% 73% 73% 72% 70% 71% 72%

702555

296 293448

919 1,0101,190

2,369

3,932

2,467

3,161

1,4141,157

1,366

1,872

1,4991,716

0

1,000

2,000

3,000

4,000

5,000


ED - Number Waiting >12 hours

2017/18 2018/19


Belfast 299 250 172 263 243 261 1,488

Northern 332 174 294 436 559 563 2,358

South Eastern 462 464 551 545 345 397 2,764

Southern 237 240 285 500 282 310 1,854

Western 84 29 64 128 70 185 560

Region 1,414 1,157 1,366 1,872 1,499 1,716 9,024

Regionally during September 2018, 71% of patients were treated and discharged, or admitted within four hours – this is a slight improvement on the previous month (70%) and is a deterioration compared to the same month last year (74%). Regionally during the month of September 2018, 1,716 patients waited longer than 12 hours in ED – this is an increase on the previous month (1,499) and a material increase on the same month last year (919). Further details are provided at pages 10-12 above.

31


Unscheduled care 2 (target) – by March 2019, at least 80% of patients to have commenced treatment, following triage, within 2 hours.

82%82%

85% 86% 85%82% 82% 82% 79% 80% 78% 76%

81% 80% 80% 80% 80% 81%

0%

20%

40%

60%

80%

100%


By March 2019, at least 80% of patients to have commenced treatment, following triage, within 2 hours

2017/18 2018/19


Belfast 72% 72% 75% 74% 74% 75% 74%

Northern 81% 79% 76% 76% 74% 79% 77%

South Eastern 87% 87% 86% 87% 89% 90% 88%

Southern 80% 77% 77% 77% 75% 76% 77%

Western 85% 90% 87% 89% 89% 90% 88%

Region 81% 80% 80% 80% 80% 81% 80%

Regionally during September 2018, 81% of patients commenced treatment, following triage, within 2 hours.

Hip fractures (target) – by March 2019, 95% of patients, where clinically appropriate, wait no longer than 48 hours for inpatient treatment for hip fractures.


Belfast 86% 77% 71% 74% 81% 82% 78%

Northern

South Eastern 56% 68% 67% 64% 70% 79% 67%

Southern 87% 91% 94% 95% 86% 96% 92%

Western 75% 91% 90% 86% 97% 82% 87%

Region 79% 80% 77% 79% 84% 83% 80%

Regionally during September 2018, 83% of patients, where clinically appropriate, received inpatient treatment for hip fractures within 48 hours.

Thrombolysis (target) – by March 2019, ensure that at least 15% of patients with confirmed ischaemic stroke receive thrombolysis treatment, where clinically appropriate.

Trusts are permitted three months to complete clinical coding – regionally at the end of June 2018, 83% of episodes had been coded. On the basis of this level of coding, during Q1 of this year (Apr-Jun), 17% of patients with confirmed ischaemic stroke received thrombolysis treatment, where clinically appropriate.

32


Diagnostic Reporting (target) – by March 2019, all urgent diagnostic tests should be reported on within two days.

85% 88% 90%85% 87% 87% 86% 88% 86% 86% 86% 84%

83%87%

84% 83%87%

84%

0%

20%

40%

60%

80%

100%


DRTT - Urgent within 2 days (inc Plain Film)

2017/18 2018/19

Trust Apr-18 May-18 Jun-18 Jul-18 Aug-18 Sep-1818/19

Cum

Belfast 77% 84% 79% 80% 85% 80% 81%

Northern 84% 92% 82% 81% 87% 81% 84%

South Eastern 91% 93% 92% 91% 90% 88% 91%

Southern 82% 81% 84% 82% 83% 84% 83%

Western 87% 90% 92% 89% 91% 91% 90%

Region 83% 87% 84% 83% 87% 84% 85%

Regionally during September 2018, 84% of urgent diagnostic tests were reported on within two days.

Cancer care services 1 (standard) – during 2018/19, all urgent suspected breast cancer referrals should be seen within 14 days.


Belfast 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0%

Northern 100.0% 84.3% 80.6% 59.2% 19.2% 11.9% 58.3%

South Eastern 100.0% 100.0% 99.5% 100.0% 100.0% 100.0% 99.9%

Southern 99.6% 98.8% 97.6% 97.9% 100.0% 100.0% 99.0%

Western 100.0% 100.0% 99.3% 100.0% 100.0% 100.0% 99.9%

Region 99.9% 96.3% 94.2% 92.1% 79.5% 74.5% 89.8%

Regionally during September 2018, 74.5% of urgent breast cancer referrals were seen within 14 days compared to 79.5% in August. Further details are provided at pages 12-14 above.

33


Cancer care services 2 (standard) – during 2018/19, at least 98% of patients diagnosed with cancer should receive their first definitive treatment within 31 days of a decision to treat.

95%

93%

95%

95% 94% 92%95% 93% 92% 92% 93%

97%95%

93%

95%

94% 93% 92%

0%

20%

40%

60%

80%

100%


By March 2019, at least 98% of patients diagnosed with cancer should receive their first definitive treatment within 31 days of a decision to treat

2017/18 2018/19


Belfast 91.6% 87.5% 92.5% 90.3% 90.7% 87.5% 90.1%

Northern 95.2% 91.7% 94.8% 90.2% 81.3% 82.6% 88.9%

South Eastern 96.1% 94.2% 94.2% 95.2% 94.5% 96.0% 95.0%

Southern 96.6% 100.0% 100.0% 100.0% 100.0% 100.0% 99.5%

Western 100.0% 100.0% 100.0% 99.3% 99.2% 98.5% 99.5%

Region 94.9% 93.3% 95.4% 93.9% 93.0% 91.9% 93.7%

Regionally during September 2018, 92% of cancer patients commenced treatment within 31 days of the decision to treat. Further details are provided at pages 14-16 above.

Cancer care services 3 (standard) – during 2018/19, at least 95% of patients urgently referred with a suspected cancer should begin their first definitive treatment within 62 days.

68% 68%

69%

64%

64%

62%68% 66% 67% 67% 67%

74%

68% 67%

71%

62%

66%

61%

0%

20%

40%

60%

80%

100%


By March 2019, at least 95% of patients urgently referred with a suspected cancer should begin their first definitive treatment within 62 days

2017/18 2018/19


Belfast 59.9% 55.0% 65.3% 48.7% 60.0% 47.8% 56.4%

Northern 72.4% 76.0% 70.0% 60.6% 66.9% 55.5% 67.0%

South Eastern 58.3% 60.4% 60.1% 52.9% 48.2% 48.4% 55.0%

Southern 69.4% 74.2% 79.0% 78.9% 74.2% 81.2% 76.1%

Western 90.8% 81.8% 84.7% 83.7% 84.1% 84.4% 84.8%

Region 68.2% 67.5% 70.8% 62.3% 65.8% 61.3% 66.0%

Regionally during September 2018, 61% of patients urgently referred with a suspected cancer began their first definitive treatment within 62 days. Further details are provided at pages 16-17 above.

34


Hospital Care Setting – Elective Care

Outpatient assessment (target) – by March 2019, 50% of patients should be waiting no longer than 9 weeks for an outpatient appointment and no patient waits longer than 52 weeks.

29% 28% 28% 27% 25% 25% 26% 26% 24% 23% 25% 27%

27% 26% 27% 26% 24% 25%

0%

20%

40%

60%

80%

100%


Outpatients - % waiting <9 weeks

2017/18 2018/19


Belfast 27% 27% 28% 27% 26% 27%

Northern 29% 28% 28% 28% 26% 27%

South Eastern 21% 21% 22% 21% 20% 19%

Southern 28% 28% 29% 27% 25% 26%

Western 30% 29% 30% 29% 26% 27%

Region 27% 26% 27% 26% 24% 25%

184,305 189,158 189,289196,348

202,697 203,478 200,213 200,494206,983 206,248 200,189 198,296

199,881 202,054 202,081 206,963214,300 212,990

0

30,000

60,000

90,000

120,000

150,000

180,000

210,000

240,000



2017/18 2018/19


Belfast 68,204 68,882 67,945 69,067 70,693 69,950

Northern 26,527 27,121 27,520 28,189 29,179 28,723

South Eastern 49,501 49,804 49,951 51,472 53,851 53,711

Southern 31,374 31,995 32,437 33,468 34,749 34,837

Western 24,275 24,252 24,228 24,767 25,828 25,769

Region 199,881 202,054 202,081 206,963 214,300 212,990

At the end of September 2018:

25% of patients were waiting less than nine weeks for a first outpatient appointment;

212,990 people were waiting longer than nine weeks; and

94,222 were waiting longer than a year. Further details are provided at pages 1-7 above.

35


57,57160,427

64,07466,677

69,93573,380 75,311 77,683

80,651 80,767 80,67583,392

83,739 85,95788,598 90,082 92,070 94,222

0

20,000

40,000

60,000

80,000

100,000



2017/18 2018/19


Belfast 31,415 31,769 32,189 32,063 32,113 32,928

Northern 10,308 10,597 10,952 11,151 11,340 11,291

South Eastern 21,730 22,616 23,566 24,496 25,754 26,355

Southern 9,077 9,403 9,983 10,204 10,439 11,022

Western 11,209 11,572 11,908 12,168 12,424 12,626

Region 83,739 85,957 88,598 90,082 92,070 94,222 Diagnostic tests (target) – by March 2019, 75% of patients should wait no longer than 9 weeks for a diagnostic test and no patient waits longer than 26 weeks.


Belfast 42% 43% 44% 45% 42% 42%

Northern 72% 66% 63% 57% 52% 51%

South Eastern 64% 61% 63% 58% 53% 56%

Southern 53% 50% 49% 47% 43% 46%

Western 84% 83% 83% 80% 76% 78%

Region 57% 56% 55% 53% 49% 50%


50% of patients were waiting less than nine weeks for a diagnostic test;

50,948 patients were waiting longer than nine weeks; and

19,772 were waiting longer than 26 weeks. Further details are provided at pages 8-10 above.

36



Belfast 18,433 17,963 18,863 15,787 18,592 16,707

Northern 5,229 6,955 7,890 9,570 11,425 12,197

South Eastern 5,121 5,973 5,980 6,888 7,713 7,471

Southern 10,646 11,481 11,929 12,368 13,294 12,701

Western 1,359 1,552 1,536 1,700 1,973 1,872

Region 40,788 43,924 46,198 46,313 52,997 50,948


Belfast 11,028 10,732 11,482 9,039 10,615 9,968

Northern 931 1,148 1,358 1,651 2,153 3,330

South Eastern 1,004 1,142 933 1,065 1,035 995

Southern 3,264 3,768 3,847 4,194 4,867 5,008

Western 150 178 225 356 508 471

Region 16,377 16,968 17,845 16,305 19,178 19,772

37


Inpatient/daycase treatment (target) – by March 2019, 55% of patients should wait no longer than 13 weeks for inpatient/daycase treatment and no patient waits longer than 52 weeks.


Belfast 31% 29% 29% 28% 26% 25%

Northern 64% 63% 63% 63% 61% 59%

South Eastern 44% 44% 46% 46% 45% 43%

Southern 40% 41% 41% 39% 37% 37%

Western 35% 35% 36% 35% 33% 33%

Region 38% 37% 37% 36% 34% 33%

41,163 42,064 42,732 43,58545,624 47,009 46,111 45,383

48,00350,317 51,046 50,228

51,235 52,429 52,872 54,183 56,10057,617

0

10,000

20,000

30,000

40,000

50,000

60,000

70,000



2017/18 2018/19


Belfast 24,825 25,925 26,592 27,299 28,388 29,193

Northern 2,547 2,606 2,660 2,720 2,828 3,044

South Eastern 5,794 5,668 5,605 5,617 5,618 5,812

Southern 7,133 7,224 7,150 7,432 7,766 7,784

Western 10,936 11,006 10,865 11,115 11,500 11,784

Region 51,235 52,429 52,872 54,183 56,100 57,617


33% of patients were waiting less than 13 weeks for inpatient or daycase treatment;

57,617 patients were waiting longer than 13 weeks; and

19,715 were waiting longer than a year. Further details are provided at pages 1-7 above.

38


10,134 10,670 11,261 11,62112,371

13,17613,935 14,391 14,979

15,955 16,389 16,454

16,814 17,43618,080 18,466 18,991

19,715

0

5,000

10,000

15,000

20,000

25,000



2017/18 2018/19


Belfast 7,674 8,158 8,669 8,907 9,337 9,933

Northern 337 323 311 335 340 352

South Eastern 1,803 1,872 1,935 1,950 1,933 1,979

Southern 2,393 2,422 2,390 2,426 2,504 2,510

Western 4,607 4,661 4,775 4,848 4,877 4,941

Region 16,814 17,436 18,080 18,466 18,991 19,715 CAMHS (target) – by March 2019, no patient waits longer than nine weeks to access child and adolescent mental health services (CAMHS).


Belfast 56 33 28 29 57 26 20

Northern 0 0 0 0 0 70 119

South Eastern 0 0 0 0 0 0 0

Southern 0 0 0 0 0 0 0

Western 10 36 74 61 98 94 62

Region 66 69 102 90 155 190 201

At the end of September 2018, 201 patients were waiting longer than nine weeks to access CAMHS. It should be noted that no patients were waiting longer than nine weeks in the South Eastern and Southern Trusts at the end of September. Further details are provided at pages 17-18 above.

39


Adult Mental Health (target) – by March 2019, no patient waits longer than nine weeks to access adult mental health services.


Belfast 179 222 138 118 80 121 49

Northern 0 0 0 0 0 0 4

South Eastern 43 38 20 18 4 16 20

Southern 108 117 159 211 368 547 659

Western 318 367 455 453 440 548 573

Region 648 744 772 800 892 1,232 1,305

Regionally at the end of September 2018, 1,305 patients were waiting longer than nine weeks compared to 648 at the end of March (+657). Further details are provided at pages 19-21 above.

Dementia services (target) – by March 2019, no patient waits longer than nine weeks to access dementia services.

68

109131 141 147 154 143 144

190

145

195183

399378

337 334318

293

0

50

100

150

200

250

300

350

400

450


Dementia - By March 2019, no patients wait >9 weeks to access dementia services

2017/18 2018/19


Belfast 77 66 49 40 33 40 34

Northern 0 0 0 0 0 0 1

South Eastern 9 203 211 185 206 213 207

Southern 15 31 30 16 12 12 10

Western 82 99 88 96 83 53 41

Region 183 399 378 337 334 318 293

At the end of September 2018, 293 patients were waiting longer than nine weeks for dementia services. The continued strong performance in Northern Trust should be acknowledged. Further details are provided at pages 21-22 above.

40


Psychological Therapies (target) – by March 2019, no patient waits longer than 13 weeks to access psychological therapies (any age).

1,242 1,262 1,319 1,3071,398 1,418 1,388 1,415

1,572 1,578 1,5681,474

1,5161,591 1,626

1,7611,829

2,027

0

300

600

900

1,200

1,500

1,800

2,100

2,400


Psychological Therapies - By March 2019, no patients wait >13 weeks to access Psycholgical therapies services

2017/18 2018/19


Belfast 577 586 592 604 691 682 731

Northern 31 62 123 147 128 123 102

South Eastern 228 245 252 224 252 286 383

Southern 84 96 105 118 142 161 171

Western 554 527 519 533 548 577 640

Region 1,474 1,516 1,591 1,626 1,761 1,829 2,027

Regionally at the end of September 2018, 2,027 patients were waiting longer than 13 weeks compared to 1,829 at the end of August (+198). Further details are provided at pages 22-24 above.

Outcome 5: People, including those with disabilities, long term conditions, or who are frail, receive the care that matters to them

Increased Choice

Direct payments (target) – by March 2019, secure a 10% increase in the number of direct payments to all service users. 4,514

4,796

0

1,000

2,000

3,000

4,000

5,000

6,000

Apr-Sep 18

Number of Direct Payments in place for all Service Users (Regional)(Target: 4,729 by March 2019)

Target Profile Actual no of direct payments in place

In order to secure the 10% target increase, Trusts are required to have 4,729 direct payments in place for all service users by March 2019. Performance against this target area will be reported quarterly during 2018/19. Regionally at the end of Q2, 4,796 direct payments were in place against a straight line target profile to have 4,514 at the end of September 2018 (+282).

41


Trust

No. of DPs

in place at

QE Mar 18

Target

number by

31.3.19

(+10%)

Target

profile

(Apr-Sep)

Actual DPs

in place at

end of Q2

Variance

(target

profile vs

actual)

Belfast 763 839 801 802 1

Northern 790 869 830 857 28

South Eastern 990 1,089 1,040 1,056 17

Southern 777 855 816 805 -11

Western 979 1,077 1,028 1,276 248

Region 4,299 4,729 4,514 4,796 282

Note: end of Q1 position as Q2 monitoring return o/s

Access to Services

Allied Health Professionals (AHP) (target) – by March 2019, no patient should wait longer than 13 weeks from referral to commencement of treatment by an allied health professional. 21,408

22,875 23,503

24,14525,545

27,40325,543

23,92924,978 24,607 24,159 23,37523,541 23,920 23,837

23,006 23,583 23,456

0

4,000

8,000

12,000

16,000

20,000

24,000

28,000

32,000


AHP (>13 weeks) - By March 2019, no patient waits longer than 13 weeks from referral to commencement of AHP treatment.

2017/18 2018/19


Belfast 4,169 4,370 4,367 4,549 4,633 5,038 5,208

Northern 10,256 10,107 10,371 10,278 9,836 9,963 9,461

South Eastern 240 435 574 677 575 661 785

Southern 3,952 3,862 3,918 3,945 3,588 3,878 4,266

Western 4,758 4,767 4,690 4,388 4,374 4,043 3,736

Region 23,375 23,541 23,920 23,837 23,006 23,583 23,456

At the end of September 2018, 23,456 patients were waiting longer than 13 weeks from referral to commencement of AHP treatment. Regionally, more than half (12,823) of the patients waiting longer than 13 weeks at the end of September were waiting for physiotherapy. Trusts have been allocated non-recurrent funding in 2018/19 from the Confidence and Supply Transformation Fund to reduce the backlog of patients waiting longer than 13 weeks for AHP treatment at the end of March 2018.

42


Profession Mar-18 Apr-18 May-18 Jun-18 Jul-18 Aug-18 Sep-18

Physio 15,078 15,147 15,182 14,868 13,542 13,412 12,823

OT 3,454 3,480 3,682 3,891 4,150 4,673 4,881

Dietetics 1,081 1,127 1,188 1,074 1,101 1,198 1,298

SLT 2,534 2,543 2,552 2,552 2,560 2,458 2,457

Podiatry 1,040 1,074 983 916 1,094 1,180 1,113

Orthoptics 188 170 333 526 559 662 884

2017/18 23,375 23,541 23,920 23,827 23,006 23,583 23,456

Care in Acute Setting

Patient discharge 1 (standard) – during 2018/19, ensure that 99% of all learning disability discharges take place within seven days of the patient being assessed as medically fit for discharge, with no discharge taking more than 28 days.

5

0

3

2

5

1

4 4

5

3

1

3

1 1

3 3

0

1

0

2

4

6

8

10


Delayed Discharges (Learning Disability) During 2018/19, ensure no discharge takes more than 28 days (Numbers > 28 days)

2017/18 2018/19

Regionally during September 2018, 92% (11 out of 12) of learning disability discharges took place within seven days of the patient being assessed as medically fit for discharge, and only one took more than 28 days.

43


Patient discharge 2 (standard) – during 2018/19, ensure that 99% of all mental health discharges take place within seven days of the patient being assessed as medically fit for discharge, with no discharge taking more than 28 days.

97%98%

96%98%

95% 96%

97% 96% 96%

98%

95%

99%95% 97% 95%

98%

97% 97%

0%

20%

40%

60%

80%

100%


Delayed Discharges (Mental Health) - During 2018/19, ensure 99% of discharges take place within 7 days

2017/18 2018/19

Regionally during September 2018, 97% (392 out of 406) of mental health discharges took place within seven days of the patient being assessed as medically fit for discharge, and eight took more than 28 days.

44


Outcome 6: Supporting those who care for others

Carers’ assessments (target) – by March 2019, secure a 10% increase (based on 2017/18 figures) in the number of carers’ assessments offered to carers for all service users.

4,081 4,079

0

500

1,000

1,500

2,000

2,500

3,000

3,500

4,000

4,500

Apr-Jun 18

Number of Carers' Assessments offered to carers for all service users(Regional)

(Target: 16,324 by March 2019)

Target Profile Actual no of CAs offered

Trust

Total no. of

CAs offered

during 17/18

Target

number by

31.3.19

(+10%)

Target

profile

(Apr-Jun 18)

Total CAs

offered

(Apr-Jun 18)

Variance

(target

profile vs

actual)

Belfast 3,407 3,748 937 855 -82

Northern 5,015 5,517 1,379 1,286 -93

South Eastern 1,697 1,867 467 491 24

Southern 3,145 3,460 865 976 111

Western 1,576 1,734 433 471 38

Region 14,840 16,324 4,081 4,079 -2

In order to secure the 10% target increase by March 2019, Trusts are required to offer a total of 16,324 carers’ assessments to carers for all service users during 2018/19. Regionally at the end of Q1, 4,079 carers’ assessments were in place against a straight line target profile to have 4,081 at the end of June 2018 (+2). It is not possible to provide an update at this time on the Q2 position as a number of Trusts have not yet submitted monitoring returns for this period. An update on performance at end of September 2018 will be provided in a future report.

45


Short Breaks (target) – by March 2019, secure a 5% increase (based on 2017/18 figures) in the number of community based short break hours (i.e. non-residential respite) received by adults across all programmes of care.

465,697 455,043

0

50,000

100,000

150,000

200,000

250,000

300,000

350,000

400,000

450,000

500,000

Apr-Jun 18

Number of Community based short break hours received by adults across all PoCs (Regional)

(Target: 1,862,789 by March 2019)

Target Profile Actual no of short break hours received

Trust

Total no. of

short break

hours

received

during 17/18

Target

number by

31.3.19

(+5%)

Target

profile

(Apr-Jun 18)

Total short

breaks

received

(Apr-Jun 18)

Variance

(target

profile vs

actual)

Belfast 240,495 252,520 63,130 62,725 -405

Northern 788,677 828,111 207,028 197,858 -9,170

South Eastern 166,452 174,775 43,694 45,595 1,901

Southern 500,658 525,691 131,423 125,283 -6,140

Western 77,802 81,692 20,423 23,581 3,158

Region 1,774,084 1,862,788 465,697 455,042 -10,655

In order achieve the target to secure a 5% increase in the number of community based short break hours (i.e. non-residential respite) received by adults across all programmes of care, Trusts are required to provide 1,862,789 short break hours during 2018/19. Regionally at the end of Q1, 455,043 community based short break hours had been received by adults across all programmes of care against a straight line target profile to have 465,697 at the end of June 2018 (-10,654). It is not possible to provide an update at this time on the Q2 position as a number of Trusts have not yet submitted monitoring returns for this period. An update on performance at end of September 2018 will be provided in a future report.

Outcome 7: Ensure the sustainability of health and social care services provided.

Hospital Setting

Cancellations (target) – by March 2019, to establish a baseline of the number of hospital cancelled, consultant led, outpatient appointments in the acute programme of care which resulted in the patient waiting longer for their appointment and by March 2020 seek a reduction of 5%.

This is a new target for 2018/19. The HSCB will work with Trusts and the Department of Health to establish (by March 2019) a baseline of the number of hospital cancelled, consultant led, outpatient appointments in the acute programme of care which resulted in the patient waiting longer for their appointment.

Delivery of funded capacity (target) - by March 2019, to reduce the percentage of funded activity associated with elective care service that remains undelivered.

There has been a continued improved in relation to the delivery of commissioned volumes of core activity compared to last year. For new outpatient assessments, regionally during the first six months of 2018/19, there has been a 10.7% (21,914) underdelivery of core activity compared to -12.2% during the

46


same period last year. In relation to delivery of commissioned volumes of inpatient/daycase volumes, there has been an 8.6% (6,773) underdelivery of core activity during the first half of this year (April to September 2018) compared to 11.0% during the same period last year. Further details are provided at page 7 above.

Complex discharges (target) – by March 2019, ensure that 90% of complex discharges from an acute hospital take place within 48 hours, with no complex discharge taking more than seven days.

77%

78%

76% 77% 78%72% 73%

77%80%

74% 75% 76%

77%

76%

81%78%

81%78%

0%

20%

40%

60%

80%

100%


Delayed Discharges (Complex Discharges) - from April 2018 ensure that 90% of complex discharges <48 hours

2017/18 Region

Trust of

Residence

(ToR)

2017/18

CumApr-18 May-18 Jun-18 Jul-18 Aug-18 Sep-18

2018/19

Cum

Belfast 52% 66% 63% 74% 72% 72% 69% 70%

Northern 81% 79% 72% 77% 77% 84% 77% 78%

South Eastern 75% 76% 84% 80% 84% 85% 84% 82%

Southern 92% 92% 90% 95% 91% 92% 92% 92%

Western 81% 79% 77% 86% 75% 77% 74% 79%

No ToR 80% 75% 94% 100% 80% 62% 77% 82%

Region 76% 77% 76% 81% 78% 81% 78% 79%

Regionally during September 2018, 78% of complex discharges from an acute hospital took place within 48 hours and 150 took more than seven days.

47


Trust of

Residence

(ToR)

2017/18


2018/19

Cum

Belfast 874 62 76 56 61 49 63 367

Northern 250 20 33 26 30 20 35 164

South Eastern 336 37 18 42 21 26 19 163

Southern 36 7 6 5 2 4 4 28

Western 406 40 24 28 38 45 28 203

No Trust of Residence 8 2 0 0 1 1 1 5

Region 1,910 168 157 157 153 145 150 930 Non-complex discharges (target) – by March 2019, ensure that all non-complex discharges from an acute hospital take place within six hours.

94%93%

94% 95% 94% 94% 94% 94% 93% 94% 94% 94%

94% 94% 94% 94% 93% 94%

0%

20%

40%

60%

80%

100%


Delayed Discharges (NON Complex Discharges) - from April 2018 ensure that all non-complex discharges <6 hours

2017/18 Region

Trust

2017/18


2018/19

Cum

Belfast 96% 97% 97% 97% 97% 97% 96% 97%

Northern 93% 92% 92% 92% 92% 90% 91% 92%

South Eastern 87% 88% 87% 87% 87% 88% 89% 88%

Southern 94% 95% 95% 94% 94% 93% 93% 94%

Western 97% 98% 97% 97% 97% 97% 96% 97%

Region 94% 94% 94% 94% 94% 93% 94% 94%

Regionally during September 2018, 94% of non-complex discharges from an acute hospital took place within six hours.

hsc board performance report september 2018) purpose

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