integrated performance report - haringeyccg.nhs.uk papers/20180315/item 5.2b... · haringey ccg...

Haringey CCG Performance and Quality Report

February 2018

Contents

Item Page

Haringey CCG Quality and Performance Dashboards3

4 - 5

Haringey CCG Performance and Quality Summary 6 – 7

North Middlesex University Hospital Performance and Quality Dashboards 8 – 10

Whittington Health Quality and Performance Dashboards

Whittington Health Performance and Quality Summary

12 – 15

11

Barnet, Enfield and Haringey Mental Health Trust Performance and Quality Dashboard 16

Barnet, Enfield and Haringey Mental Health Trust Performance and Quality Summary 17 - 19

NCL Integrated Urgent Care Service (IUC) Summary 20 - 22

LAS Summary 23 - 24

Glossary of Terms and Data Sources 25 - 26

2

Haringey CCG Quality and Performance

Dashboard

RTT and Diagnostic CCG data for December 2017 is provisional (waiting).

Data Source: Unify2 and Open Exeter via NELIE

Theme KPI / Measure Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-172017-18

YTD2017-18 Target

A&E A&E All Types Performance 83.0% 80.4% 85.3% 87.4% 86.6% 88.1% 87.0% 86.7% 85.6% 87.9% 88.9% 86.3% 79.6% 86.3% 95%

18 W

eeks R

efe

rral to

tre

atm

en

t an

d D

iag

no

sti

cs

18 W eeks RTT Admitted 83.6% 81.9% 79.1% 80.4% 79.9% 78.4% 78.2% 79.4% 78.9% 79.6% 79.6% 79.5% 82.0% 79.4% N/A

18 W eeks RTT Non-Admitted 93.5% 94.1% 93.3% 93.5% 93.6% 92.9% 92.1% 90.4% 91.7% 91.8% 91.1% 90.4% 90.5% 91.6% N/A

18 W eeks RTT Incomplete Pathways 93.5% 93.5% 93.6% 93.5% 92.8% 93.1% 92.9% 92.7% 91.8% 91.2% 91.6% 92.4% 92.2% 92.3% 92%

6 W eeks Diagnostic Waits 1.4% 1.3% 0.4% 0.6% 1.0% 0.8% 0.9% 0.6% 0.9% 0.9% 0.7% 0.4% 0.6% 0.7% 1%

>52 week waits Admitted 3 9 9 8 1 6 4 5 4 1 4 2 4 31 -

>52 week waits Non Admitted 2 5 6 2 7 11 9 12 2 1 1 2 2 47 -

>52 week waits Incomplete 1 1 1 0 1 0 0 1 3 4 8 10 9 36 0

Can

cer

Wait

s

2 W eek Cancer W ait 94.3% 93.4% 96.5% 94.0% 94.3% 95.5% 95.7% 95.4% 95.1% 93.6% 94.0% 94.7% 94.8% 93%

2 W eek Cancer W ait:Breast Symptoms

94.0% 91.7% 99.3% 90.1% 96.7% 96.1% 97.1% 94.5% 96.6% 99.1% 100.0% 99.3% 97.4% 93%

31 day Cancer W ait:1st definitive treatment

97.7% 98.8% 97.2% 98.9% 96.8% 96.0% 94.4% 100.0% 95.8% 93.5% 100.0% 98.8% 96.8% 96%

31 Day Cancer W ait: Subsequent treatment (Surgery)

100.0% 100.0% 95.0% 81.3% 100.0% 100.0% 92.3% 88.9% 87.5% 92.3% 100.0% 93.3% 93.9% 94%

31 Day Cancer W ait: Subsequent treatment (Chemotherapy)

100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 95.2% 100.0% 100.0% 100.0% 99.4% 98%

31 Day Cancer W ait: Subsequent treatment (Radiotherapy)

100.0% 100.0% 100.0% 97.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 94%

62 Day Cancer W ait: GP Referral

85.7% 91.4% 81.5% 85.4% 76.7% 84.4% 76.7% 87.9% 82.4% 86.5% 92.9% 78.4% 83.1% 85%

62 Day Cancer W ait: Screening service

83.3% 90.0% 85.7% 83.3% 100.0% 100.0% 42.9% 100.0% 83.3% 100.0% 100.0% 82.8% 90%

62 Day Cancer W ait: Consultant Upgrade

85.0% 88.2% 86.7% 83.3% 85.7% 80.0% 87.5% 93.3% 100.0% 73.3% 94.7% 89.5% 86.8% No Threshold

Qu

ality

MRSA reported infections 0 0 0 0 0 0 1 3 1 0 0 0 5 0

C. Difficile reported infections 3 7 0 3 6 5 6 3 8 3 4 2 37 50

Mixed Sex Accommodation (MSA) (Number of breaches)

4 3 1 4 2 2 1 3 4 3 3 4 3 25 0

3

Key Messages

A&E

In December 2017, Haringey A&E performance overall was 79.55%, against the national target of 95%. The primary contributor to this was poor performance at North Middlesex University Hospital. This was due to staff shortages, high number of ambulance conveyances and bunching of ambulances (which make prompt offloads difficult), and poorly implemented pathways. The Trust continue to implement the ‘Safer, Faster Better’ Improvement plan and ‘Red to Green’ on the wards. The middle-grade A&E rota is being reviewed following the implementation of the new consultant rota in October 2017 and the Trust are working closely with GPs in primary care to ensure a smooth transition of paper to e-referrals.

As a result of the on-going performance pressures, Commissioner support has increased, with operational and executive leads supporting a range of initiatives – including, weekly Multi- Agency Discharge Events (MADE), supporting individual patient discharges, weekend on-call rotas and daily escalation calls.

The NMUH A&E system received resilience funding of £606,000 on the condition that the local system will deliver at least 90% of the performance by quarter four 2017/2018

Whittington Health NHS Trust A&E four hour performance dipped in December to 86.5%. This deterioration in performance was causedby the influenza outbreak (which increased admissions in the over 75’s), increased ambulance conveyances and an increased number of complex discharges. The increased complexity and age profile of admitted patients has an effect on the increased complexity of discharge arrangements as evidenced by the increased delayed discharge numbers.

Daily escalation discussions between the Provider, CCG and local authorities are now being held to address issues such as delayed discharges. Funding for winter resilience schemes was confirmed in December 2017 – these are:Three extra intermediate care beds, additional mental health bed capacity and increased mental health support to A&E. Progress on implementation is regularly reviewed by the local A&E Delivery Board and through weekly calls with NHS England.

Referral To Treatment (RTT)

The 18 Weeks Referral To Treatment Incomplete Pathways standard was met by Haringey CCG in November 2017 with performance reported at 92.4%, overall. Provisional data for December 2017 indicates that Haringey CCG met the standard with a performance of 92.22%.

Performance against the national target for 52 week waits has been poor since July 2017 and the number of breaches have been steadily increasing since then, with 9 breaches in December 2017. Five of these were at the Royal Free London, two at Imperial College Healthcare NHS Trust, one at University College London Hospital and the remaining one at Kings College London Hospital. Systems are in place to receive feedback from trusts about clinical reviews, treatment plans and clinical harm reviews.

Haringey CCG

Performance and Quality Summary

4

Haringey CCG

Performance and Quality Summary

Key Messages

Cancer access standards

Haringey CCG failed to achieve all of the national cancer standards in November 2017 due to a dermatology backlog across the sector.

6 Week Diagnostic waits

Haringey CCG achieved the diagnostic target in November 2017 with performance of 0.4%. Provisional data indicates that Haringey CCG met the standard

in December 2017 with a performance of 0.6% against the 1% standard. Performance in this area has been consistent since May 2017. North Middlesex

University Hospital as a non-specialist Trust are performing well because unlike specialist Trusts who deal with more complex patients, North Middlesex

University Hospital are able to manage the flow of patients requiring CT and MRI scans well .

North Middlesex University Hospital –Never Events

Since 1 April 2017, five Never Events have been reported – three wrong site surgery and two retained foreign objects. This is an increase of reported Never Events from 2016/17 when three Never Events had been reported. Haringey CCG are undertaking a thematic analysis of the learning from previous Never Events of the same type and are planning an assurance visit with a focus on root causes and action plans for March 2018.

North Middlesex University Hospital Dermatology clinic

North Middlesex University Hospital have served notice to commissioners on their dermatology clinic. Concordia has been awarded a contract to deliver the dermatology service from 15 January 2018 for 12 months with a 6 month break clause and is offering eleven sessions per week. This exceeds the number previously offered by North Middlesex Hospital and is aimed to address the current waiting list backlog.

5

NHS Digital data published by NHS Digital

Local data derived from Provider reports to NHS England

Haringey CCG

IAPT Performance Dashboard

Theme KPI/Measure SourceReporting

PeriodActual Standard

Current Month and Previous Month's Trend

Blue = NHS Digital Green = Local Data Red = Target

NHS Digital Oct-17 95.00%

Local Data Nov-17 97.50%


Reliable Recovery Rate NHS Digital Oct-17 49.00%


Local Data Nov-17 53.00%

NHS Digital 2017-18 Q2 54.00%

Local Data 2017-18 Q2 54.63%

NHS Digital Oct-17 330

NHS Digital 2017-18 Q2 1380

BME % of Numbers Entering

Treatment - QUARTERLYNHS Digital 2017-18 Q2 53.99%

HARINGEY

IAPT

% Waited less than 6 weeks for a

course of treatment (for those

finishing a course of treatment)

75%

% Waited less than 18 weeks for a

course of treatment (for those

finishing a course of treatment)

95%

Recovery Rate 50.00%

Recovery Rate - QUARTERLY 50.00%

Numbers entering into Treatment 388

Numbers entering into Treatment -

Quarterly

95.24% 93.33% 95.00% 97.00%93.00% 92.00%

96.00% 96.00% 94.00% 93.00%97.00% 98.00%

95.00%

94.40% 94.30% 97.20% 97.20%93.60% 93.30%

97.50% 96.50% 94.70% 94.70% 97.30% 98.80% 95.00% 97.50%

Oct-16 Nov-16 Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17

100.00%98.33% 99.00% 99.00% 100.00% 99.00% 98.00%

100.00% 99.00% 99.00% 100.00%100.00%100.00%


40.54% 42.86% 48.00% 51.00% 47.00% 47.00% 47.00% 47.00% 52.00% 47.00% 50.00% 54.00% 49.00%


45.00% 46.00%

50.00%52.00%

50.00% 49.00% 48.00%50.00%

55.00%

50.00%

54.00%56.00%

51.00%45.74% 47.13%

52.41%50.44% 49.12% 48.40%

50.30%53.00% 56.40% 52.30% 56.50% 55.10%

50.80%53.00%


440480

440385

500450

375

595550

395430

545

330

477 482 439387

495


46.56%51.00% 51.00%

54.00%

48.43% 49.32%53.23% 54.63%

2016-17 Q3 2016-17 Q4 2017-18 Q1 2017-18 Q2

1360 1335

1520

13801398

2016-17 Q3 2016-17 Q4 2017-18 Q1 2017-18 Q2

55.15%60.30%

55.92% 53.99%

2016-17 Q3 2016-17 Q4 2017-18 Q1 2017-18 Q2

6

Haringey CCG

Mental Health Performance Dashboard

*Latest data is provisional and unpublished

NHS Digital data published by NHS DigitalLocal data derived from Provider reports to NHS England

Theme KPI/Measure SourceReporting

PeriodActual Standard


Blue = Actual Red = Target

Dementia Diagnosis Rate (Age

65+)NHS Digital Dec-17 67.80% 66.7%

The percentage of RTT First

Episode Psychosis (FEP) periods

within 2 weeks of referral. *

NHS Digital Dec-17 100.00% 50%

Proportion of patients on CPA who

were followed up within 7 days after

discharge from psychiatric inpatient

care*

NHS Digital 2017-18 Q3 100.00% 95%

Proportion of admissions to acute

wards that were gate kept by the

CRHT teams*

NHS Digital 2017-18 Q3 100.00% 95%

Proportion of Children and Young

people with eating disorders

(routine cases) that wait 4 weeks or

less from referral to start of NICE-

approved treatment *

NHS Digital 2017-18 Q3 100.00% 95%

Proportion of Children and Young

people with eating disorders (urgent

cases) that wait 1 week or less from

referral to start of NICE-approved

treatment *

NHS Digital 2017-18 Q3 100.00% 95%

HARINGEY

CCG

MENTAL

HEALTH

80.59% 78.64% 79.31% 80.19%

69.04% 68.22% 68.60% 68.50% 67.67% 67.20% 67.82% 68.27% 67.80%

Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17

42.86%20.00% 27.27% 41.67%

83.33% 80.00%50.00% 62.50% 75.00% 80.00% 77.78% 62.50%

100.00%

Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17

99.28% 97.81% 99.28% 99.33% 100.00%

2016-17 Q3 2016-17 Q4 2017-18 Q1 2017-18 Q2 2017-18 Q3

100.00%

96.03% 96.12%99.32% 100.00%

2016-17 Q3 2016-17 Q4 2017-18 Q1 2017-18 Q2 2017-18 Q3

80.00%100.00% 100.00% 100.00% 100.00%

2016-17 Q3 2016-17 Q4 2017-18 Q1 2017-18 Q2 2017-18 Q3

100.00% 100.00%

2016-17 Q3 2016-17 Q4 2017-18 Q1 2017-18 Q2 2017-18 Q3

7

North Middlesex University Hospital

Performance Dashboard

Data Source: Unify2, Open Exeter and LAS via NELIE

18 Weeks RTT Admitted - 80.03% 80.08%

18 Weeks RTT Non-Admitted - 93.49% 95.23%

18 Weeks RTT Incomplete Pathways 92% 94.68% 95.47%

>52 week waits Admitted - 0 0

>52 week waits Non Admitted - 0 0

>52 week waits Incomplete 0 0 0

6 Weeks Diagnostic Waits 1% 0.25% 0.51%

Cancelled Operations (2017-18 Q2) 100% 96.88% 96.83%

2 Week Cancer Wait 93% 90.45% 94.56%

2 Week Cancer Wait:

Breast Symptoms93% 100.00% 97.80%

31 day Cancer Wait:

1st definitive treatment96% 100.00% 98.69%

31 Day Cancer Wait:

Subsequent treatment (Surgery)94% 100.00% 97.83%

31 Day Cancer Wait:

Subsequent treatment (Chemotherapy)98% 100.00% 100.00%

31 Day Cancer Wait: Subsequent

treatment (Radiotherapy)94% 100.00% 99.56%

62 Day Cancer Wait:

GP Referral85% 69.05% 81.90%

62 Day Cancer Wait:

Screening service90% 55.56% 85.71%

62 Day Cancer Wait:

Consultant Upgrade- 87.30% 89.58%

KPI/Threshold

NORTH MIDDLESEX UNIVERSITY

HOSPITAL NHS TRUST

Nov-17 YTD

Nov-17 YTD

KPI/Threshold

NORTH MIDDLESEX UNIVERSITY

HOSPITAL NHS TRUST

A&E All Types Performance 95% 82.03% 83.21%

No of waits from decision to admit to

admission (Trolley waits - over 12 hours)0 0 2

% Ambulance Handovers within 15 mins:

KPI 1100% 41.30% 39.20%


KPI 2100% 96.00% 93.70%

Number of Ambulance Handover - 30

minute breaches0 95 1065



% Patient Records Captured

Electronically: KPI 490% 93.10% 92.60%

NORTH MIDDLESEX UNIVERSITY HOSPITAL

NHS TRUST

Nov-17

Nov-17

KPI/Threshold

NORTH MIDDLESEX UNIVERSITY HOSPITAL

NHS TRUST

YTD

YTD

KPI/Threshold

8


Quality Dashboard

Data Source: Unify2, NHS Digital, STEIS and local Trust Data via NELIE

Theme KPI/MeasureReporting

PeriodActual

2017-18

YTD

2016-17

YTD

Current Month and Previous 12 Months Trend

Blue = Actual

Red = Target

SHMI rate - rolling 12 month average

(received quarterly)

July 2016 -

Jun 201782.4 N/A N/A

New Number of acquired pressure ulcers:

Grades 3 & 4

(Safety Thermometer)

Nov-17 4 8 10

Old Pressure ulcers that are present on

admission 3 & 4

(Safety Thermometer)

Nov-17 4 25 80

The number of patients falls with severe harm

(as per NPSA definition - Safety Thermometer) Nov-17 0 0 0

Number of Never Events Nov-17 1 4 3

Serious Incidents (SIs) Number Reported Dec-17 10 73 83

Number of MRSA Bacteraemia Nov-17 0 1 2

Number of Clostridium Difficile Nov-17 1 18 33


PeriodActual

2017-18

YTD

2016-17

YTD


Blue = Actual

Red = Target

Mandatory training (%) Nov-17 79.00% N/A

Average fill rate - Registered

nurses/midwives (Day)Nov-17 97.80% N/A

Average fill rate - Registered

nurses/midwives (Night)Nov-17 95.61% N/A

Average fill rate - Care staff (Day) Nov-17 116.23% N/A

Average fill rate - Care staff (Night) Nov-17 114.31% N/A

Patient Safety

Patient Safety

90.1 88.9 88.9 84.9

21 1 1 1

23

1

4

57 6

46 5

2

119

4 36 5

3 31

4

9 97 8

11

5

13

7 8 710

85

10

1 1 1

35 6

3 42

42 2 3

1

12

12

1

95% 98% 96% 103%113% 107% 107% 108% 107% 107%

95% 98%

108% 110% 103% 96% 107% 92%125% 128% 126% 123%

92% 96%

83% 91% 92% 99% 99%117% 102% 100% 99% 107% 110% 116%

97% 104% 110%90%

116% 132% 121% 120% 121% 134% 107% 114%

78% 81%86% 86% 87% 86% 84% 83% 81% 82% 80% 77% 78% 79% 81% 81%79%

9


Quality Dashboard

Data Source: Unify2, NHS Digital, STEIS and local Trust Data via NELIE


PeriodActual

2017-18

YTD

2016-17

YTD


Blue = Actual

Red = Target

VTE - % patients who have had a VTE

assessment within 24 hours of admissionSep-17 95.17% N/A

Cancelled operations - Provider cancellation

of Elective Care operation for non-clinical

reasons either before or after Patient

2017-18

Quarter 21 2 1

Stroke - % patients spent 90% of time on

stroke unitQuarter 1 99.20% 84.40%

Emergency - C-Section rate Sep-17 18.40% N/A

Friends & Family test (FFT) - % Recommend

InpatientsNov-17 92.33% N/A

Friends & Family test (FFT) - Response Rate -

InpatientsNov-17 18.28% N/A


A&ENov-17 65.58% N/A


A&ENov-17 30.50% N/A


OutpatientNov-17 87.87% N/A


OutpatientNov-17 5.32% N/A


PeriodActual

2017-18

YTD

2016-17

YTD


Blue = Actual

Red = Target

Maternity Friends & Family test (FFT) -

Question 1 % Recommend (Antenatal Care)Oct-17 N/A

Maternity Friends & Family test (FFT) - Score

Question 2 % Recommend (Birth)Oct-17 92.93%


Question 3 % Recommend (Post Natal Ward)Oct-17 89.47%


Question 4 % Recommend (Post Natal

Community Provision)

Oct-17 98.94%

Staff Friends & Family test (FFT) - %

Recommended as a place to workQuarter 2 70.17%

Staff Friends & Family test (FFT) - % Not

Recommended as a place to workQuarter 2 11.60%

Staff Friends & Family test (FFT) - %

Recommended as a place for CareQuarter 2 71.98%

Staff Friends & Family test (FFT) - % Not

Recommended as a place for Care Quarter 2 14.92%

Complaints - Number of formal complaints Nov-17 32 185 540

Mixed sex Accommodation - breaches Dec-17 0 0 10

Patient

Experience

Clinical

Effectiveness

Patient

Experience

0

1

0 0

1

99%

15% 17% 13% 17% 21% 21% 20% 21% 18%22% 20% 18% 22%

13%18% 18%

94% 95% 96% 95% 96% 96% 97% 96% 96% 92% 94% 92%

21% 20% 22%26% 31% 26%

19% 17% 19% 19% 21% 18%

09%19%

24% 28%22% 25%

17% 19%24%

15%19%

30%

95% 73% 78% 80% 75% 75% 82% 93% 91% 88% 82% 88% 84% 85% 88% 91% 93%

49 6237 41 31 21

48 41 4258 48 43 44 37 29 29 30

87% 80% 78% 84%67% 57%

86% 100%80% 93%

71%89% 76% 89%

100% 100% 100%98% 98% 97%

99% 98% 98% 98%95%

98%100% 99% 100% 100% 99%

61% 66% 71%

96% 95% 96%94%

96% 96% 95% 95% 95% 95% 95% 96% 96% 95%

12% 17% 13%

16%14%

16%

70%

65%

72%

93% 77% 91% 85% 86% 100% 95% 100% 97% 100% 97% 91% 100%

58%45% 48% 46% 46% 48% 48% 46% 51% 59% 58% 66%

4.84% 5.05% 5.70% 5.80%4.92%

6.43%4.43% 4.95%

3.89% 3.70% 4.05%5.32%

75.68% 77.69% 75.54%78.93% 76.99%

84.91% 85.13% 84.86% 85.34% 87.43%83.23%

87.87%

10

Key Messages

Accident and Emergency

• Whittington Health NHS Trust A&E four hour performance dipped in December to 86.5% from a consistent 90% for last four months• Reasons for the dip in performance include increased cases of influenza, increased admissions in the over 75’s, increased amb ulance

presentations and increased numbers of complex discharges• All of the above point to an increased acuity and complexity of cases Whittington Health NHS Trust which put pressure on acut e and

community capacity• All A&E Delivery Board winter schemes are under regular review by the A&E Delivery Board. Progress on all these schemes is r eviewed

at the A&E Delivery Board and weekly calls with NHS England.

Referral to Treatment Time and DiagnosticsThe percentage of patients waiting less than 18 weeks for treatment remains above the operational standard of 92% and Whittin gton Health

NHS Trust also achieved the standard of 99% of patients waiting less than six weeks for a diagnostic test in November 2017. At the end of October 2017 no patients were waiting over 52 weeks for treatment at Whittington Health NHS Trust and the number of patients waiting more

than 18 weeks for treatment reduced between October and November 2017.

Cancer ServicesWhittington Health NHS Trust met all of its cancer access waiting time standards for November 2017 apart from the 62 day refe rral to

treatment standard which was missed by half a case (ie a breach shared with another NHS provider). Whittington Health NHS Tr ustachieved 83% against the 85% standard; the fact that Whittington Health NHS Trust missed the standard by half a case is indicative of the

fact that, due to the small numbers of cases reported by Whittington Health NHS Trust, the smallest possible variation in per formance can result in achievement or not of the operational standard.

Community Services

The Whittington Community Service Improvement Steering Group met for the first time in January 2018. A Request for Quotation document has been issued by the Haringey and Islington Wellbeing Board outlining a tender document for project management support to t ake forward

an analysis of current provision, reporting, future provision and strategy for the development of Whittington Health NHS Trus t Community Services starting in February 2018 and concluding in May 2018.

Whittington Health NHS Trust

Provider Key Messages

11


Performance DashboardElective Care (RTT, Diagnostics & CWT);

Non Elective (A&E & London Ambulance Service )

A&E All Types Performance 95% 86.53% 90.84%

No of waits from decision to admit to

admission (Trolley waits - over 12 hours)0 0 24


KPI 1100% 53.20% 38.00%


KPI 2100% 97.00% 97.50%





% Patient Records Captured

Electronically: KPI 490% 93.00% 91.00%

Dec-17 YTD

KPI/Threshold

THE WHITTINGTON HOSPITAL NHS

TRUST

Dec-17 YTD

KPI/Threshold


TRUST

18 Weeks RTT Admitted - 77.15% 71.44%

18 Weeks RTT Non-Admitted - 87.78% 89.80%

18 Weeks RTT Incomplete Pathways 92% 92.21% 92.18%

>52 week waits Admitted - 0 2

>52 week waits Non Admitted - 0 0

>52 week waits Incomplete 0 0 5

6 Weeks Diagnostic Waits 1% 0.76% 0.91%

Cancelled Operations (2017-18 Q2) 100% 100.00% 95.12%

2 Week Cancer Wait 93% 96.08% 94.46%

2 Week Cancer Wait:

Breast Symptoms93% 100.00% 97.78%

31 day Cancer Wait:

1st definitive treatment96% 100.00% 100.00%

31 Day Cancer Wait:

Subsequent treatment (Surgery)94% 100.00% 100.00%

31 Day Cancer Wait:

Subsequent treatment (Chemotherapy)98% 100.00% 100.00%

31 Day Cancer Wait: Subsequent

treatment (Radiotherapy)94%

62 Day Cancer Wait:

GP Referral85% 83.08% 87.81%

62 Day Cancer Wait:

Screening service90% 100.00%

62 Day Cancer Wait:

Consultant Upgrade- 84.91% 82.75%

KPI/Threshold


TRUST

Nov-17 YTD

KPI/Threshold


TRUST

Nov-17 YTD

12

Whittington Health rust

Quality and Performance DashboardCommunity Services

Note: Whittington Health NHS Trust Community Service Access Rate performance is measured against a 95% seen in 6 weeks target above, it should be noted that this is not a standard

target applicable to all community services, and targets vary depending upon service type as defined with service specificati ons.

KPI Measure Threshold Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17

DNA Rate % <10% 7.9% 7.6% 7.5% 6.9% 7.1% 7.0% 7.6% 7.3% 7.8% 7.7% 8.2% 8.0% 6.8%

Face to Face Contacts 53867 60467 56369 66464 52666 62912 61529 59794 51845 57405 57507 60419 50126

FFT % Positive >90% 98.7% 98.0% 96.8% 96.0% 98.5% 94..9% 93.9% 94.8% 96.7% 96.5% 95.3% 94.8% 96.0%

FFT Responses >1500 549 697 1095 1169 752 1192 970 1224 858 940 731 633 6

End of Life % Patients Dying in Pref Place of Care >70% 83.3% 90.9% 90.7% 89.5% 83.3% 87.0% 91.1%

Haringey IAPT Moving to Recovery >50% 52.4% 50.4% 49.1% 48.4% 50.3% 53.0% 56.4% 52.3% 56.5% 55.1% 50.8% 53.0%

Haringey IAPT Waiting for Treatment >75% 97.2% 97.2% 93.6% 93.3% 97.5% 96.5% 94.7% 94.7% 97.3% 98.8% 95.0% 97.5%

Haringey New Birth Visits - % within 2 Weeks >95% 91.6% 91.3% 93.3% 87.5% 88.6% 93.8% 91.9% 88.7% 89.3% 89.4% 91.6% 89.2%

Islington New Birth Visits - % within 2 Weeks >95% 94.6% 94.8% 93.3% 90.7% 90.3% 94.1% 96.1% 91.7% 94.6% 94.8% 92.1% 96.4%

District Nursing - Response Times within 48hrs95% in 2

days79.5% 100.0% 100.0% 89.6% 100.0% 97.1% 100.0% 77.8%

District Nursing - Urgent Referrals within 2Hrs80% in 2

hours100.0% 97.0% 100.0% 84.6% 84.2% 88.2% 93.7% 77.7%

Audiology 82.46% 72.54% 91.79% 65.68% 74.70% 72.90% 79.00% 57.30%

CAMHS 58.40% 53.70% 53.30% 54.20%

Psychology Services 60.50%

Child Development Services 52.00% 48.00% 22.22% 35.00% 40.74% 73.68% 70.50% 59.00% 56.30% 55.30%

Community Children's Nursing 98.43% 92.68% 94.29% 94.87% 96.81% 97.25% 94.90% 91.40% 92.00% 92.50%

Community Paediatrics Services 43.59% 43.37% 51.39% 56.64% 53.95% 37.70% 47.60% 48.80% 50.50% 52.10%

Family Nurse Partnership 76.00% 77.30% 78.30% 80.60%

Haematology Service 95.45% 92.31% 100.00% 97.50% 100.00% 100.00% 97.20% 96.50% 96.60% 96.70%

Health Visiting 92.03% 90.28% 93.10% 95.08% 93.35% 93.56% 88.00% 87.30% 94.80% 95.00%

Looked After Children 93.75% 67.86% 90.00% 92.31% 76.92% 90.91% 79.00% 81.70% 86.70% 87.00%

Occupational Therapy 33.33% 38.24% 27.27% 33.33% 42.86% 39.13% 32.90% 32.00% 40.70% 40.00%

Physiotherapy 70.00% 65.48% 69.32% 72.04% 74.16% 62.71% 69.70% 67.70% 69.60% 69.70%

PIPS 75.00% 62.50% 72.22% 90.00% 36.36% 73.30% 68.10% 68.40% 71.20% 72.60%

School Nursing 84.54% 81.40% 74.14% 85.82% 76.60% 84.31% 77.70% 76.80% 77.70% 79.00%

Speech and Language Therapy 68.30% 60.09% 57.06% 47.33% 58.91% 54.83% 55.80% 53.80% 34.80% 34.40%

Community Matron 98.94% 93.10% 98.96% 100.00% 98.28% 96.72% 94.30% 92.40% 96.50% 97.20%

District Nursing 96.77% 96.00% 97.11% 97.62% 96.39% 94.84% 93.20% 91.80% 96.70% 96.70%

Adult Wheelchair Service 93.30% 89.90% 88.30% 86.50%

Paediatric Wheelchair Service 100.00% 100.00% 92.50% 90.70%

Adults Speech and Language Therapy 98.20% 98.30%

Cardiology Service 77.27% 82.35% 96.43% 83.87% 88.00% 91.89% 83.50% 82.30% 92.30% 92.70%

Care Co-ordination Service 100.00% 100.00% 40.00% 100.00% 92.40% 92.10% 95.30% 95.30%

Community Rehabilitation 88.75% 78.24% 84.23% 78.75% 78.24% 79.84% 75.60% 73.80% 74.60% 74.60%

Diabetes Service 86.18% 88.60% 92.55% 79.75% 72.34% 69.57% 73.20% 77.00% 85.30% 85.90%

Intermediate Care 75.74% 78.53% 86.73% 80.93% 78.31% 87.80% 83.60% 80.30% 83.10% 82.30%

Respiratory Service 42.77% 67.09% 74.36% 62.32% 54.41% 59.46% 51.00% 49.00% 53.10% 53.50%

Bladder And Bowel Management 39.22% 37.61% 26.71% 35.39% 19.40% 14.18% 21.80% 25.40% 27.00% 27.50%

Lymphodema Care 25.00% 37.50% 38.46% 57.14% 60.00% 50.00% 45.20% 31.70% 42.20% 38.50%

Musculoskeletal Service - CATS 31.60% 30.80% 40.70% 44.80%

Musculoskeletal Service - Routine 43.80% 44.30% 52.00% 52.50%

Nutrition and Dietetics 30.77% 30.13% 34.23% 42.29% 36.61% 38.38% 34.30% 34.90% 36.20% 35.40%

Podiatry (Foot Health) 47.75% 40.31% 52.98% 56.56% 47.66% 43.18% 51.90% 48.40% 47.70% 47.30%

Tissue Viability Service 89.01% 90.65% 97.12% 96.49% 99.08% 98.15% 96.50% 92.90% 96.70% 96.30%R

eport

ing S

uspended p

endin

g o

utc

om

e o

f re

port

ing r

evie

w

86.0%

Com

mun

ity

Hea

lth

Trust agreed with

CCGs that there

will be no

report ing for

April

Access R

ate

s

95% seen in

6 weeks

59.82%64.93%58.39%63.01%73.20% 58.80%

100.00%96.43%97.83%100.00%100.00%100.00%

92.0%

34.60%44.40%44.15%48.87%42.69%41.70%

13


Quality Dashboard


PeriodActual YTD



SHMI rate - rolling 12 month average

(received quarterly)

Jul 2016 -

Jun 201772.6

Proportion of Patients New Pressure Ulcers

(Safety Thermometer) Dec-17 7 47

Proportion of Patients Falls With Severe Harm

(as per NPSA definition - Safety Thermometer) Dec-17 0 0

Number of Never Events Dec-17 0 1

Serious Incidents (SIs) Reports Submitted Dec-17 0 26

Number of MRSA Bacteraemia Nov-17 1 3

Number of Clostridium Difficile Nov-17 0 11

Mandatory Training rate 2017-18 Q3 80%

Average fill rate - Registered nurses/midwives (Day) Nov-17 81%

Average fill rate - Registered nurses/midwives (Night) Nov-17 91%

Average fill rate - Care staff (Day) Nov-17 130%

Average fill rate - Care staff (Night) Nov-17 144%

Patient Safety

69.0 69.1 70.8 72.6

116

26 7

36 6 7

0 0 0 0 0 0 0 0 0

2 3 4 36

25

20

21

2 2 31

2 3

0 0 0 0

1

0 0 0 0

88% 86% 87% 86% 87% 86% 80% 85% 81%

93% 92% 94% 92% 92% 92% 103% 96% 91%

115% 117% 121% 111% 114% 111% 123% 133% 130%

122% 122% 124% 118% 128% 114% 137% 146% 144%

81% 82% 82% 81% 80%

14


Quality Dashboard


PeriodActual YTD



VTE - % patients who have had a VTE assessment within 24 hours of

admissionSep-17 96.0% 95.4%

Cancelled operations - Number of patients not treated within 28 days of

last minute elective cancellation2017-18 Q2 0 2

Overall Maternity - C-Section rate (Trust Data) Dec-17 27.6%

Friends & Family test (FFT) - % Recommend Inpatients Nov-17 98.3%

Friends & Family test (FFT) - Response Rate % Inpatients Nov-17 18.2%

Friends & Family test (FFT) - % Recommend A&E Nov-17 83.3%

Friends & Family test (FFT) - Response Rate % A&E Nov-17 12.3%

Maternity Friends & Family test (FFT) - Question 1 % Recommend

(Antenatal Care)Oct-17 100.0%

Maternity Friends & Family test (FFT) - Score Question 2 % Recommend

(Birth)Oct-17 96.4%


(Post Natal Ward)Oct-17 92.0%


(Post Natal Community Provision)Oct-17 100.0%

Friends & Family test (FFT) - % Recommended Outpatients Nov-17 91.9%

Friends & Family test (FFT) - Response Rate % Outpatients Nov-17 3.4%

Staff Friends & Family test (FFT) - % Recommended as a place to work 2017-18 Q2 53.3%

Staff Friends & Family test (FFT) - % Not Recommended as a place to

work2017-18 Q2 34.2%

Staff Friends & Family test (FFT) - % Recommended as a place for Care 2017-18 Q2 69.4%

Staff Friends & Family test (FFT) - % Not Recommended as a place for

Care 2017-18 Q2 13.0%

Friends & Family test (FFT) - % Recommended Community Nov-17 94.8%

Friends & Family test (FFT) - Response Rate % Community Nov-17 2.1%

Mixed sex Accommodation - Breaches Dec-17 0 0

Complaints - Number of formal complaints (Trust data) 2017-18 Q3 68 233

Clinical

Effectiveness

Patient

experience

0 0 0

2

0

94%98%

94%97%

96% 95%98% 98% 98%

27% 22% 23% 20% 21% 15% 16% 18% 18%

15% 17% 16% 14% 13% 14% 13% 13% 12%

95% 96% 95% 89% 97% 93% 96% 96%

86% 88%81% 80% 84% 84% 86%

92%

97%100% 100% 98% 98%

94%97%

100%

60% 61%54% 53%

95% 96% 97% 95% 95% 96% 95% 97% 96%

9% 9% 13% 13%

28% 23% 32% 34%

76% 75% 69% 69%

100% 100%90%

100% 97% 100% 96% 100%

83% 84% 87% 84% 85% 83% 80% 82% 83%

96%98%

95% 94% 95%97% 96% 95% 95%

4% 3% 4% 3% 4% 3% 3% 3% 2%

76 94 84 81 68

30% 25% 25% 31% 28% 27% 33% 37%28%

3.19%2.07%

3.60% 3.14% 2.80% 1.93% 2.47%3.25% 3.40%

93%92% 93% 94% 93%

91% 91%93% 92%

15

Barnet, Enfield and Haringey Mental Health Trust

Quality Dashboard


PeriodActual

2017-18

YTD



Friends & Family test (FFT) - % Recommend (Mental Health) Nov-17 89.52%

Friends & Family test (FFT) - Response Rate (Mental Health) Nov-17 7.72%

Friends & Family test (FFT) - % Recommend (Community) Nov-17 94.25%

Friends & Family test (FFT) - Response Rate (Community) Nov-17 2.00%

Staff Friends & Family test (FFT) - % Recommended as a place to work 2017-18 Q1 55.88%

Staff Friends & Family test (FFT) - % Not Recommended as a place to work 2017-18 Q1 25.74%

Staff Friends & Family test (FFT) - % Recommended as a place for Care 2017-18 Q1 62.50%

Staff Friends & Family test (FFT) - % Not Recommended as a place for Care 2017-18 Q1 14.71%

Complaints - Number of formal complaints Nov-17 24 134

Mixed sex Accommodation - breaches Nov-17 0 0

Patient

experience

83.71%86.60% 85.69% 85.35% 85.18% 85.64% 87.61% 86.20% 86.29% 87.36% 86.13% 89.52%

7.78% 7.75% 8.50% 7.36%10.30%

8.11% 9.28% 7.25% 8.28% 7.47% 8.65% 7.72%

2.77%1.51% 1.49% 2.62% 1.38% 2.57% 2.98% 2.68% 2.45% 2.53% 1.95% 2.00%

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

14 1812 17

10

2317 17 13 14 19 15

2114 17

24

46.72% 60.22% 67.98% 53.37% 58.37% 55.88%

Q2 15/16 Q3 15/16 Q4 15/16 Q1 1617 Q2 16/17 Q3 16/17 Q4 16/17 Q1 17/18

26.28%8.06% 10.34% 15.34% 11.96% 14.71%

Q2 15/16 Q3 15/16 Q4 15/16 Q1 1617 Q2 16/17 Q3 16/17 Q4 16/17 Q1 17/18

28.47%17.74% 16.26% 24.54% 16.27%

25.74%

Q2 15/16 Q3 15/16 Q4 15/16 Q1 1617 Q2 16/17 Q3 16/17 Q4 16/17 Q1 17/18

48.18%74.73% 70.44% 60.74% 65.07% 62.50%

Q2 15/16 Q3 15/16 Q4 15/16 Q1 1617 Q2 16/17 Q3 16/17 Q4 16/17 Q1 17/18

99.24%97.55% 97.22%

98.27% 99.23%97.07% 97.13%

98.90%97.22%

94.05% 93.69% 94.25%

16

Enfield CCG

Performance & Quality Summary

Key Messages

Barnet Enfield and Haringey Mental Health Trust

• Barnet Enfield and Haringey Mental Health Trust continue to achieve the target for those with First Episode Psychosis being treated with a

National Institute for Health and Care Excellence (NICE) approved package of care within two weeks of referral on a trust-wide level. The national figures show 84.62% for December 2017 (90.48% in October 2017) against a target of 50%. At a commissioner level Enf ield

CCG, has decreased to 33% in December 2017 against the First Episode Psychosis standard due to two extended assessments. Commissioners are working with Barnet Enfield and Haringey Mental Health Trust to finalise the impact of the agreed £800k investment in

Early Intervention in Psychosis (EIP) services in terms of evidencing National Institute for Health and Care Excellence compliant treatments and timely access.

• Commissioners continue to seek assurance about improved access to assessment and timely treatment for Children and AdolescentMental Health Services (CAMHS). The waiting lists in the three boroughs have all increased since April 2017 from 557 patient s to 1,061

patients with Barnet by 38%, Enfield by 54% and Haringey by 44%. Barnet Enfield and Haringey Mental Health Trust are report ing staff shortages within the Barnet and Enfield for Children and Adolescent Mental Health Services which has led to an increase in lo ng waits.

There are 22 children (Barnet 4, Enfield 17 and Haringey 1) in December 2017 who are waiting more than 22 weeks for treatmentcompared to 15 children in November 2017. (see the graph on slide 8)

• Reporting against the Five Year Forward Improving Access Rate to Children and Young People Mental Health is now published nat ionally via NHS Digital.. A slide has been produced using local data to calculate the percentage of children and young people aged 0 -18 with a

diagnosable mental health condition who have received treatment (two attendances). The national standard for 2017/2018 is 30%, rising to 35% by 2020/2021. The services are treating approximately half the required children and young people month at 18.4% in December

2017 (17.1% November 2017).

17


Quality and Performance Summary

NEL CSU

Quality

Assurance and

Performance

Management

assessment of:

Description of Quality and Performance Management

IssueRemedial actions undertaken NEL CSU recommendations

Care Quality

Commission

(CQC)

Barnet Enfield and Haringey Mental

Health Trust was subject to a

second comprehensive Care

Quality Commission (CQC)

inspection the week commencing

25 September 2017.

Eight core mental health services

and Children and Young People’s

community services were

inspected.

The Trust was awarded an overall

rating of ‘Requires Improvement’

although the Care Quality

Commission noted that it

anticipated services reaching a

‘Good’ standard overall in the near

future.

Two of the Trust’s mental health

services were awarded a rating of

‘Outstanding’, three were rated as

‘Good’ and three were rated as

‘Requires Improvement’. 18 Must

Do recommendations were made.

The Trust received face to face feedback

from the Care Quality Commission in

November 2017. The Trust was not issued

with any warning notices but some

immediate action was required with adult

community mental health services within

Haringey.

An action plan relating to Haringey (West)

community mental services has been

submitted to the Care Quality Commission.

Barnet Enfield and Haringey Mental Health

Trust is currently producing a Trust wide

action plan to address the Must Do and

Should Do recommendations.

The post inspection the Care Quality

Commission summit is scheduled for 28

February 2018.

• Clinical Quality Review Group will receive

and review the CQC Improvement Plan at

the beginning of quarter one 2018/19.

• Thereafter commissioners will receive

Improvement Plan progress reports at least

quarterly at the monthly quality assurance

meetings.

18


Quality and Performance Summary

NEL CSU Quality

Assurance and

Performance

Management

assessment of:

Description of Quality and Performance Management Issue

Remedial actions undertaken NEL CSU recommendations

Early Intervention in

Psychosis (EIP)

Performance

There are concerns about Barnet

Enfield and Haringey Mental Health

Trust evidencing compliance with

the NICE Standards for Early

Intervention in Psychosis.. The

Enfield service failed the standard for

the first time this year (one out of

three patients starting a NICE

recommended package of care. The

two patients received extended

assessments due to their

presentations.

CCG to monitor the standard.

Final Draft Cluster 10 service

specification awaiting outcome of

CCG governance approval.

Commissioners agreed an £800k

investment plan for EIP Services.

• Cluster 10 Service Specification to be approved within CCG governance arrangements

• Implement agreed Cluster 10 Service Specification when approved

• Develop and implement a Child and Adolescent Mental Health Service service specification to include the Early Intervention in Psychosis standard.

• Commissioners to agree the measures for assessing the impact on access and National Institute for Health and Care Excellence compliance of the additional £800k investment.

Early Intervention in

Psychosis (EIP)

Data Quality

There are continuing issues with the

assurance about reporting of the

Barnet Enfield and Haringey Mental

Health Trust data related to Early

Intervention in Psychosis

performance standards.

A revised Data Quality

Improvement Plan has been

agreed for 2017/18

Enfield CCG are working with

NHS England and the trust on an

updated action plan.

• Continue to monitor Data Quality Improvement Plan for consistent reporting with Barnet Enfield and Haringey Mental Health Trust

• Barnet Enfield and Haringey Mental Health Trust Data Quality Improvement Plan for the introduction of SNOMED classification codes to assess National Institute for Health and Care Excellence compliance needs to be assessed by commissioners.

19

Data Source: LCW Reports

NCL Integrated Urgent Care Service (IUC)

Performance against Quality and Performance KPIs

Data Source: LCW ReportsThere is a similar pattern to the types of call response for each CCG with most patients being supported by speaking to the call advisor.

Types of activity by CCG

Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17

NCL-IUC NCL-IUCNCL-IUCNCL-IUC NCL-IUC NCL-IUC NCL-IUC NCL-IUC NCL-IUC

Engaged calls Performance 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0%

Abandoned calls Performance 0.4% 0.9% 0.8% 1.4% 1.5% 3.0% 3.2% 4.8% 3.5%

Answer Time Performance 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0%

Call waiting time Performance 95.6% 91.0% 91.2% 86.3% 88.3% 81.6% 80.5% 73.3% 77.4%

Life threatening referrals Quality 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0%

Meeting individuals needs Quality 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0%

Safeguarding Quality 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0%

Triage rate Quality 106.6% 108.1% 108.2% 106.4% 104.9% 104.0% 109.1% 106.8% 104.2%

Transfer to 999 Performance 9.6% 9.7% 10.3% 10.4% 10.9% 11.7% 11.5% 11.6% 11.7%

Attend Accident & Emergency Department Performance 9.4% 9.8% 10.1% 10.5% 9.4% 10.1% 10.0% 9.8% 9.0%

Referred to Primary Care and other dispositions Performance 55.5% 52.8% 52.5% 52.9% 51.9% 51.0% 51.5% 51.9% 55.4%

Warm Transfers Performance 68.1% 66.0% 68.0% 71.6% 73.8% 66.5% 73.3% 72.2% 72.4%

Time taken for call back Performance 10.6% 13.1% 10.8% 54.6% 54.0% 53.5% 49.1% 48.7% 46.9%

Notifications Quality 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0%

Patient Education Quality 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0%

Qrt 2Qrt 1Quality and Performance Indicators KPI Type

Qrt3

20

Data Source: LCW Reports

IUC Activity Outcomes by Type

and Patient Age Profile

9 IUC Outcomes

9.1 Count of outcomes of ambulance dispatch 3562

9.2 Count of outcomes of recommended to attend A&E 3537

9.3 Count of outcomes of recommended primary or community care 11077

9.4 Count of outcomes of recommended to contact primary medical care 4428

9.5 Count of outcomes of recommended to contact community care 169

9.6 Count of outcomes of recommended to dental 994

9.7 Count of outcomes of recommended to pharmacy 340

9.8 Count of outcomes of recommended to attend other service 623

9.9 Count of outcomes of not recommended to attend other service 4977

9.1 Count of outcomes of given health information 3562

9.11 Count of outcomes of home care recommend 3311

9.12 Count of outcomes of non-clinical 411

9.13 Count of outcomes of mental health service 60

Caller Group

Volume % Volume % Volume % Volume % Volume % Volume %

Group 1 (total) 9038 5291 7495 6190 5167 33181

SPNs 16 0.2% 24 0.5% 13 0.2% 19 0.3% 21 0.4% 93 0.3%

Patients 80

Years and Older * 1619 17.9% 435 8.2% 706 9.4% 441 7.1% 359 6.9% 3560 10.7%

Patients under 5

years old ** 1321 14.6% 724 13.7% 1292 17.2% 1052 17.0% 896 17.3% 5285 15.9%

All other

patients 5042 55.8% 3528 66.7% 4622 61.7% 3966 64.1% 3282 63.5% 20440 61.6%

Repeat callers 1040 11.5% 580 11.0% 862 11.5% 712 11.5% 609 11.8% 3803 11.5%

Haringey Islington TotalBarnet Camden Enfield

21

NCL Integrated Urgent Care Service (IUC)

Key Issues Priority Actions

A Serious Incident (SI) occurred at London Central West Unscheduled Care

Collaborative (LCW.) in April 2017. An undercover journalist from The Sun newspaper made a number of allegations about the integrated urgent care

service.

LCW are meeting all of the agreed national and local KPIs apart from call waiting time. This is due to LCW having faced a number of staffing challenges

with 25 call handlers and trainers having either resigned or being dismissed due to the April SI. There has not been any clinical risk to patients, however

there have on some shifts been fewer staff resulting in call waiting times increasing above the nationally agreed target.

It is important to note that although LCW is not meeting the national KPI, it has

been agreed as part of the roadmap that the KPI is reduced to 85%, with a transition to average answer time. LCW are still not meeting this average,

however they are reporting an improvement of 4% from the previous month. LCW continues to be impacted by rostering issues and a shortfall in overall

WTE, however their workforce plan is progressing to trajectory.

LCW’s escalation process has been reviewed and updated and will be formally agreed at the January CQRG.

NHSE requested a commissioner initiated external review

in addition to the provider SI root cause analysis investigation. The external review is being led by

Professor David Colin Thome. Due to the complexity of this investigation and time limitations by the external team,

this investigation has taken longer than planned. An Extraordinary CQRG has been scheduled for 16th

February 2018 to review the independent investigation report, which will be followed by a steering group meeting

with NHSE.

A Contract Technical Group (CTG) has been set up, with the objectives of assessing and reviewing the suite of

national and local KPIs, for implementation in April 2018. Financial penalties will also be applied to agreed KPIs.

The group will also report and analyse Finance & Activity.

The cost improvement roadmap has been progressing, with weekly meetings with commissioners and LCW.

Current areas of focus include the soft closure of the PCC bases at weekends and the deployment of black pear

interface, to allow appointments to be booked directly into hubs.

22

New Ambulance Response Programme

The four new patient categories are:

Category 1 – Life Threatening (8% of calls)

Category 2 – Emergencies (48% of calls) Category 3 – Urgent (34% of calls)

Category 4 – Less Urgent (10% of calls).

Reports on the performance of the new Ambulance Response Programme have yet to be agreed by the London Ambulance Service

and commissioners and there will be no performance management of the new measures until April 2018..

Initial reports suggest underperformance in Category 2 and Category 3 measures across London with the London Ambulance Service also not meeting the Category 4 measure in North Central London. The performance meetings will begin to understand the

performance issues with each of the categories and the actions being taken.

London wide report for December 2017

C1 Mean C1 90th Percentile C2 Mean C2 90th Percentile C3 90th Percentile C4 90th Percentile

00:07:00 00:15:00 00:18:00 00:40:00 02:00:00 03:00:00

London 00:07:25 00:12:04 00:24:14 00:51:14 02:58:23 02:51:44

North Central 00:07:27 00:12:21 00:26:58 00:58:19 03:41:46 03:21:55

North East 00:07:21 00:11:45 00:24:51 00:52:24 03:04:08 02:56:23

North West 00:07:18 00:11:55 00:24:15 00:51:23 03:05:37 02:56:27

South East 00:07:25 00:12:07 00:21:50 00:45:37 02:28:56 02:33:41

South West 00:07:34 00:12:06 00:23:08 00:48:49 02:37:18 02:40:28

LAS Performance of Ambulance Response Programme - December 2017

23

NCL Ambulance Service Quality and

Performance

Key Issues Priority Actions

Following the introduction of the Ambulance Response

Programme, performance reporting is under review across the organisation and in conjunction with commissioners. Due to

this on-going review the new formal contract reports have not yet been formally agreed.

Feedback on Vehicle Tethering project remains outstanding

and is now expected in February 2018.

A new Tri-Partite report will continue to measure activity by category

and record hospital conveyances. Four key reports will contribute to data for the Tri-Partite. To be shared.

NEL Commissioning Support Unit will continue to attend Contract

and Performance meetings to activity monitor performance of the Ambulance Review Programme and other key KPI’s.

Both local and Trust wide actions will be managed to resolution via a new burndown process.

There are a small number of problems that will be shared with local

management teams to decide/agree on resolution. Commissioners and NEL Commissioning Support Unit will continue to monitor and

feedback on progress.

NEL Commissioning Support Unit to report on formal review of the

pilot when available.

24

Data Sources and Glossary of Terms

Part 1 of 2

Abbreviation Term DefinitionA&E/ED Accident and Emergency Accident and Emergency department.

C.Diff Clostridium Difficile Clostridium Difficile is an infection that may occur within a healthcare environment, leading to diarrhoea.

CCG Clinical Commissioning GroupClinical Commissioning Groups (CCGs) are clinically-led statutory NHS bodies responsible for the planning and commissioning of health

care services for their local area.

CSU Commissioning Support Unit The CSU provide services such as contract management, service redesign, finance & analytical support & other professional services.

FOT Forecast Outturn An assumption at a point in time of what the end of year position will be.

FY Financial Year The financial year runs from 1st April until 31st March, every year.

HCAI Healthcare Associated Infections Healthcare-Associated Infections (HCAI) are those infections that develop as a direct result of any contact in a healthcare setting.

HAS Hospital Alert System The Hospital Alert System is an electronic replacement to the paper forms used for documenting patient handover.

KPI Key Performance Indicator KPIs help you define and measure progress towards organisational goals. http://www.england.nhs.uk/everyonecounts/

MRSAMethicillin-resistant Staphylococcus

aureusMRSA is a type of bacterial infection that is resistant to a number of widely used antibiotics.

MSA Mixed Sex Accommodation Mixed sex accommodation is when members of the opposite sex are placed on the same ward/unit. This should not occur.

NELIENorth East London Information

ExchangeNELIE is the system and process of information exchange between personnel across various organisations within North East Lond on.

NHS ConstitutionThe NHS constitution for England is a formal constitution which, in one document, lays down the objectives of the National He alth

Service. Full details can be found at https://www.gov.uk/government/publications/the-nhs-constitution-for-england

NHSI NHS ImprovementNHS Improvement support foundation trusts and NHS trusts to give patients consistently safe, high quality, compassionate care within

local health systems that are financially sustainable.

OP Outpatients A patient who receives medical treatment without being admitted to a hospital: "attending a clinic as an outpatient".

PAS Patient Administration System A PAS records the patient's demographics (e.g. name, home address, date of birth) and details all patient contact with the ho spital.

Data sources Appendices Finance & Performance

Unify2 - RTT, Diagnostic Waits, A&E, LAS Data, FFT, VTE,

MSA As listed here.

LAS Portal - LAS Data

Open Exeter - Cancer Waits

Provider returns – IAPT

STEIS System - Serious Incidents

HSCIC - NHS Safety Thermometer

Public Health England - C.Difficile & MRSA

Provider returns / Omnibus and Unify - Mental Health Data

Provider returns - Community Data

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https://www.gov.uk/government/publications/the-nhs-constitution-for-england

Data Sources and Glossary of Terms

Part 2 of 2

Abbreviations of Trust NamesBCF Barnet and Chase Farm Hospitals NHS Trust

BEH Barnet, Enfield and Haringey Mental Health Trust

BARTS Barts Health NHS Trust

C&I Camden and Islington NHS Foundation Trust

CLCH Central London Community Healthcare NHS Trust

CNWL Central and North West London NHS Foundation Trust

CHEL WEST Chelsea and Westminster Hospital NHS Foundation Trust

ELFT East London NHS Foundation Trust

GOS Great Ormond Street Hospital for Children NHS Foundation Trust

HOM Homerton University Hospital NHS Foundation Trust

LAS London Ambulance Service NHS Trust

MEH Moorfields Eye Hospital NHS Trust

NORTH MID North Middlesex University Hospital NHS Trust

RFL Royal Free London NHS Foundation Trust

RNOH Royal National Orthopaedic Hospital NHS Trust

T&P The Tavistockand Portman NHS Foundation Trust

UCLH University College London Hospitals NHS Foundation Trust

WHITT The Whittington Hospital NHS Trust

Abbreviation Term Definition

PIR Post Infection ReviewAs of 1 April 2013, all NHS organisations reporting positive cases of Methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia via

the Healthcare Associated Infections Data capture system (HCAI DCS) will be required to complete a Post Infection Review (PIR).

QIPPQuality, Innovation, Productivity and

Prevention

Quality, Innovation, Productivity and Prevention (QIPP) is a set of 'stretch' targets, varying from Trust to Trust, which aim to achieve more

efficient commissioning and higher levels of productivity

Quality PremiumThe ‘quality premium’ is intended to reward Clinical Commissioning Groups (CCGs) for improvements in the quality of the servi cesthat

they commission. http://www.england.nhs.uk/wp-content/uploads/2013/05/qual-premium.pdf

RTT Referral to TreatmentThe RTT data measures referral to treatment (RTT) waiting times in weeks, split by treatment function. The length of the RTT peri od is

reported for patients whose RTT clock stopped during the month.

SI Serious IncidentA serious incident is defined by the National Patient Safety Agency as an incident that occurs in NHS -funded services and care resulting

in various levels of harm.

SLA Service Level Agreement A Service Level Agreement outlines specific services and products delivered by the CSU.

SUS Secondary Users Service The Secondary User Service is designed to provide anonymous patient based data for purposes including direct clinical care.

VTE Venous Thromboembolism Venous Thromboembolism (VTE) is a disease that includes both deep vein thrombosis (DVT) and pulmonary embolism (PE).

YTD Year to Date Year-to-date is a period, starting from the beginning of the current financial year.

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To know more

If you would like to discuss any elementof this presentation, please contact:

Jasmine SternTel: 0203 688 1120

Email: [email protected]

mailto:[email protected]

http://www.nelcsu.nhs.uk/

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