key performance indicator summary dec 17...performance appriasal compliance our people statutory and...

Our TrustKey Performance Indicator Summary – Dec 17Key Performance Indicator Oct 17 Nov 17 Dec 17

Qu

alit

y

Incident Reporting Trend* 307 336 394

Incidents reported moderate or higher* 3.6% 7.1% 6.3%

Serious Incidents* 0 2 2

Assaults on Staff (Scheduled and Unscheduled Care)

45 38 38

FFT – 111 91.1% 91.2% 84.6%

FFT – 999 97.9% 98.5% 94.4%

FFT – Scheduled Care 99.3% 92.6% 94.9%

data reported 4 months in arrears Jun 17 Jul 17 Aug 17

Cardiac Arrest ROSC 32.67% 29.10% 33.3%

Cardiac Arrest ROSC Utstein 76.92% 71.43% 64.0%

Cardiac Arrest Survival 10.20% 10.00% 11.84%

Cardiac Arrest Survival Utstein 52.63% 42.11% 44.0%

Stroke FAST 60 48.09% 55.00% 47.14%

Stroke Care Bundle 99.05% 99.65% 99.38%

STEMI PPCI 150 85.07% 84.85% 94.62%

STEMI Care Bundle 95.77% 87.67% 85.14%

Key Performance Indicator Oct 17 Nov 17 Dec 17

Perf

orm

ance

999 Calls answered in 5 seconds 93.68% 95.35% 90.7%

111 Calls answered in 60 seconds 91.4% 90.94% 81.00%

111 Referrals to ED 3.48% 3.13% 2.45%

111 Referrals to 999 (response on scene) 12.28% 11.3% 9.69%

C1 Mean - 0:06:40 0:6:57

C1 90th Centile - 0:11:23 0:12:10

C2 Mean - 0:19:41 0:28:52

C2 90th Centile - 0:40:15 1:00:23

C3 90th Centile - 3:50:14 5:17:41

C4 90th Centile - 3:58:14 3:36:38

Hear and Treat (ARP AQI) 7.2% 7.0% 8.1%

See and Treat (ARP AQI) 24.8% 24.4% 24.5%

See and Convey (ARP AQI) 67.9% 68.5% 67.4%

Job cycle Time (Unscheduled Care) 1:22:41 1:26:51 1:33:52

Time on Vehicle < 60 mins (Scheduled Care) 93.2%

On time arrival (Scheduled Care) 79.0%

Collection within 60 mins (Scheduled Care) 85.5%


Wo

rkfo

rce

Sickness (Trust) 7.15% 6.71% 8.06%

Vacancy Rate (Trust) 5.81% 5.55% 5.2%

Turnover Rate (Trust) 0.64% 1.1% 0.77%

Statutory and Mandatory Training Compliance 83.74% 82.62% 82.12%

Performance Appraisal Compliance 75.32% 71.51% 68.85%


Fin

ance

Capital service capacity (times) 4.18 4.09 4.02

Liquidity days 20.58 18.11 17.03

I&E margin 0.72% 0.33% 0.07%

Performance against control total metric 0.22% 0.09% 0.08%

Agency spend cap % -85.94% -87.24% -87.66%

Use of Resources Rating 1.0 1.0 1.0

The RAG status is calculated against targets/thresholds where available. All data reported reflects December 2017 position unless otherwise stated.*Trust wide Quality data reported in Quality Dashboard.

1

Establishment In post Vacancy wte

Vacancy %

EOC 370.75 352.25 -18.5 5.0%

Scheduled Care 438.73 439.73 1.00 6.7%

Unscheduled Care 1272.65 1187.83 -84.82 -0.2%

Operational Management

157.37 158.61 1.24 -0.8%

Support Services 325.31 292.35 -32.96 10.1%

Trust Total 2564.81 2430.77 -134.04 5.2%

Sickness – sickness for December 2017 has increased by 1.35% and exceeds December 2016. • EOC – 8.41%, • Operations North and South – 8.41%• Support Services – 4.92%

Staff Turnover – turnover for December 2017 continues to stay within target at 0.77% for the month:• EOC – 1.89%• Operations North and South – 0.58%• Support Services – 0.25%

Vacancies – Uncheduled Care continues to carry the highest volume of vacancies at 84.82, followed by Support Services with 32.96 vacancies as of 27 Dec 17. Paramedic vacancies are at -50.29 for this reporting period with -41.88 forecast for year end.

6.18% 6.19% 6.49%6.98% 6.92% 6.59%

7.15%6.71%

8.06%

3%

4%

5%

6%

7%

8%

9%

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

Sickness - all staff

2016/17 2017/18 Target

Our PeopleWorkforce - Sickness, Turnover and Vacancies

94.80%

85%

90%

95%

100%

Staff in Post

0.77%

0.0%

0.5%

1.0%

1.5%


Staff Turnover

2016/17 2017/18 Target

2

Workforce - Statutory and Mandatory/Appraisal Compliance

93.89% 91.26% 89.55% 88.51% 87.40%83.70% 83.74% 82.62% 82.12%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Stat and Mand Training Compliance

79.77% 79.84% 79.02% 77.36% 75.00% 74.53% 75.32%71.51% 68.85%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Performance Appriasal Compliance

Our People

Statutory and Mandatory Compliance Dec 17:• EOC – 68.47%• Operations North and South – 85.53%• Support Services – 77.40%

Performance Appraisal Compliance Dec 17:• EOC – 83.72%• Operations North and South – 64.12%• Support Services – 71.90%

3

Our PerformanceOperations Centre – Summary

December 2017 saw a 7.88% increase in 999 call volume. 999 call taking service level was not achieved, reaching 90.7% for the month. However despite the additional volume NEAS continues to benchmark well nationally for call answer times ranking 2nd for mean answer times and 1st for 99th centile answer times.

Hear and Treat performance increased in December 2017 to 8.1% with over 3000 calls resolved without the need for ambulance dispatch. This was as a result of additional clinical capacity within the CAS.

NHS111 call volumes saw a significant increase in December with a 37% increase compared to December 2016. The increase in demand has impacted on call taking service level with 81% of calls answered in 60 seconds.

Despite the increase in call volume referrals from 111 to ED and to 999 have continued to reduce, with referrals to ED achieving our stretch target of 3% for the first time, as well as achieving the 10% target for the first time for referrals to 999 where a resource arrives on scene.

December has seen a rise in incident reporting is to be expected with the increase in call volume experienced. The proportion of incidents rated moderate or above has also increased.

While the proportion of friends and family recommending the service has seen a reduction, the rate of complaints continues its downward trend.

4

47,588

20,000

30,000

40,000

50,000


999 Call Demand

2016/17 2017/18

90.70%

70%

80%

90%

100%


999 Call Answer in 5 seconds

2016/17 2017/18 Target

8.1%

0%

2%

4%

6%

8%

10%

0

500

1000

1500

2000

2500

3000

3500

Jan

-16

Feb

-16

Mar

-16

Ap

r-16

May

-16

Jun

-16

Jul-

16

Au

g-16

Sep

-16

Oct

-16

No

v-16

Dec

-16

Jan

-17

Feb

-17

Mar

-17

Ap

r-17

May

-17

Jun

-17

Jul-

17

Au

g-17

Sep

-17

Oct

-17

No

v-17

Dec

-17

Hear and Treat

hear and treat hear and treat %

7%

4% 4%5%

6%7%

8% 8%9% 9%

10%

0%

2%

4%

6%

8%

10%

12%

Hear & Treat Benchmark

Our PerformanceOperations Centre – 999

0

50

100

150

200

250

Call Answer Times (seconds)

Mean 95th centile 99th centile

Call Volume

Change from same month last year

+7.88%

YTD change from last year

-0.1%

20.80%

0%

5%

10%

15%

20%

25%

0

1000

2000

3000

4000

5000

6000

7000

8000

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

Revalidations

Revalidation Volume Ambulance no longer required % 5

95,142

20,000

70,000

120,000


111 Call Demand

2016/17 2017/18

81.00%

70%

80%

90%

100%


111 Call Answer in 60 seconds

2016/17 2017/18 Target

Our PerformanceOperations Centre- 111

Call Volume


+37.0%

YTD change from last year

+24.6%

3,9

80

24

20

6.30 %

2.45%

0%

1%

2%

3%

4%

5%

6%

7%

0

1,000

2,000

3,000

4,000

5,000

May

-16

Jun

-16

Jul-

16

Au

g-1

6

Sep

-16

Oct

-16

No

v-1

6

Dec

-16

Jan

-17

Feb

-17

Mar

-17

Ap

r-1

7

May

-17

Jun

-17

Jul-

17

Au

g-1

7

Sep

-17

Oct

-17

No

v-1

7

Dec

-17

NHS111 Referrals to ED

Monthly Volume

12.93%

9.69%

0%

5%

10%

15%

20%

NHS111 Referrals to 999

111 Calls Referred to 999 111 Calls Referred to 999 (Responded) Target

39.50%

34%

36%

38%

40%

42%

44%

46%

48%

Clinical Advisory Service (CAS) Clinical Contacts

54.65%

20%

40%

60%

80%

100%

Warm Transfer Rate

111 Warm Transfer Rate 111 Warm Transfer Rate Target 6

0.10

0.00

0.00

0.05

0.10

0.15

0.20

0.25

Complaints and Appreciations per 1000 calls

Complaints Appreciations

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

Incidents Reported 79 87 69 74 96 59 98 78 124 90 50 65 129

Incidents Reported Moderate or Above

2 0 1 0 3 2 2 1 4 0 0 1 7

Serious Incidents 1 1 0 0 3 2 1 1 3 3 0 1 1

5.43%

0%

1%

2%

3%

4%

5%

6%

0.00

0.01

0.01

0.02

0.02

0.03

0.03

0.04

0.04

0.05

% In

cid

ents

Mo

der

ate

or

Avo

ve

Inci

den

ts p

er 1

,00

0 c

alls

Incidents Moderate or Above

84.60%

78%80%82%84%86%88%90%92%94%

0

20

40

60

80

100

120

140

NHS 111 FFT

FFT Responses FFT % Recommending

Our PatientsOperations Centre – Quality and Safety

7

Our PerformanceUnscheduled Care – Summary

December 2017 has seen an increase in incident volume of 3.2% compared to December 2016. This increase was seen across the monthwith demand only increasing by 1.5% during the festive period (23 Dec – 1 Jan).

Handover delays have also increased pressure on services, with significant increases seen in the number of hours lost to handover, up 51% compared to December 2016. 78% of all time lost to handover was attributed to University Hospital N Durham, NSECH, Darlington Memorial and Sunderland Royal.

Despite increased demand and significant delays we have achieved both the mean and 90th centile standards for Category 1 patients, achieving the highest ranked position for C1 mean, the only Trust nationally to do so. Improvements were also seen in Category 4 response times. Category 2 and 3 remain challenging representing the highest volume of patients, with Category 3 the worst performing nationally.

Conveyance rates have continued to reduce, with volumes of patients conveyed down 2% compared to December 2016, despite the increase in overall incident volume. However, national benchmark data shows that further improvements in both see and treat and see and convey rates should be possible.

Latest published data (Aug 2017) shows good performance against our clinical indicators with 7 out of 8 performing above the national average. The percentage of FAST positive patients arriving at a hyperacute stroke unit within 60 minutes remains a challenge.

December 2017 has seen an increase in incidents reported moderate or higher. This includes incidents that have yet to have the harm level confirmed and is subject to change. The rate of complaints per attended incident remains unchanged, appreciations have dropped for a third consecutive month, but remain higher than the rate of complaints. The percentage of patients recommending the service has dropped in December 2017, still achieving a high satisfaction rate with 94.4% recommending the service.

8

NEAS Mean NEAS 90th Centile England Average Mean England Average 90th Centile National Standard

Our PerformanceUnscheduled Care – Response Times

C1 – M C1 – 90th C2 – M C2 – 90th C3 – M C3 – 90th C4 – M C4 – 90th

Variance from target (Dec 17) -0:00:03 -0:2:50 0:10:52 0:20:23 - 3:17:41 - 0:36:38

Change from previous month 0:0:17 0:00:43 0:09:11 0:20:08 00:37:16 1:27:27 -0:0:58 -0:21:36

National Ranking Position (out of 10)

1st 2nd 6th 5th 10th 10th 4th 4th

6:40 6:57 6:38

11:23 12:10 11:31

00:00

00:02

00:05

00:08

00:11

00:14

00:17

Nov-17 Dec-17 Jan-18* Feb-18 Mar-18

Monthly C1 Response Times

19:4128:52 24:23

0:40:15

1:00:2351:28

00:00

00:14

00:28

00:43

00:57

01:12



1:36:502:14:06

1:33:17

3:50:14

5:17:41

3:39:19

-

1:12:00

2:24:00

3:36:00

4:48:00

6:00:00



1:33:31 1:32:33 1:16:06

3:58:14 3:36:383:09:56

-

1:12:00

2:24:00

3:36:00

4:48:00



*unvalidated January 2018 response times as of 23 Jan 2018

9

Our PerformanceUnscheduled Care – See and Treat/Convey

10%

15%

20%

25%

30%

0

2000

4000

6000

8000

10000

See and Treat

see and treat see and treat %

30%

23% 24% 25% 26% 28%30%

34% 34% 36%39%

0%5%

10%15%20%25%30%35%40%45%

See & Treat Benchmark

63%55%

60% 60% 60% 61% 63% 65% 67% 69% 72%

0%10%20%30%40%50%60%70%80%

See & Convey Benchmark

67.4%

50%

55%

60%

65%

70%

75%

10000

15000

20000

25000

30000

See and Convey

see and convey see and convey %

34,997

20000

25000

30000

35000

40000


Incident Demand

2016/17 2017/18

Incident Volume


+3.2%

YTD change from last year +2.9%

10

21627 21479 18766 20693 20192 20320 19221 19735 19278 19231 20391 19653 20507

983.49

1384.15

834.57

424.37477.39

599.23

346.43 329.31 334.21 315.39366.39

439.59

1487.57

0

200

400

600

800

1000

1200

1400

1600

0

5000

10000

15000

20000

25000

Ho

urs

Lo

st

Arr

ival

s

Arrivals and Time Lost to Handovers

Arrivals Hours Lost to Handover Linear (Hours Lost to Handover)

Hospital Handovers Dec 17 % Completed in 15 mins

Hours Lost

Darlington Memorial 55.3% 242:31

James Cook 40.7% 86:58

NSECH 51.4% 341:49

Queen Elizabeth 83.3% 52:09

RVI 64.6% 63:48

South Tyneside 29.9% 84:50

Sunderland Royal 42.6% 228:32

University Hsp of North Durham 47.5% 346:56

University Hsp of North Tees 49.8% 40:20

Trust 52.4% 1487:57

Our PerformanceUnscheduled Care – Handovers

11

Cardiac Arrest ROSC Cardiac Arrest Survival to Discharge

Stroke STEMI

ROSC ROSC Utstein Survival to Discharge

Survival to Discharge Utstein

FAST 60 Care Bundle PPCI 150 Care Bundle

Aug 17 33.3% 64% 11.84% 44.00% 47.14% 99.38% 94.62% 85.14%

YTD 29.46% 59.38% 9.86% 37.61% 49.66% 98.85% 89.33% 91.00%

National Ranking (out of 11)

5th 2nd 5th 2nd 9th 2nd 2nd 3rd

0%

20%

40%

60%

80%

100%

Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17

Cardiac Arrest - ROSCs

Overall Utstein England Overall England Utstein

0%

10%

20%

30%

40%

50%

60%


Cardiac Arrest Survival

Overall Utstein England Overall England Utstein

0%

20%

40%

60%

80%

100%


Stroke

FAST 60 Care Bundle England FAST 60 England Care Bundle

0%

20%

40%

60%

80%

100%


STEMI

PPCI 150 Care Bundle England PPCI 150 England Care Bundle

Clinical Ambulance Indicators (data produced in arrears)

Our PatientsUnscheduled Care – Clinical Indicators

Our PatientsUnscheduled Care – Quality and Safety

94.40%

75%

80%

85%

90%

95%

100%

0

50

100

150

200

Unscheduled Care FFT


0.04%

0.09%

0.00%

0.05%

0.10%

0.15%

0.20%

0.25%

0.30%

Complaints and Appreciations per attened incident

Complaints as a proportion of incidents attended

Appreciations as a proportion of incidents attended

6.50%

0%1%2%3%4%5%6%7%

02468

101214


Incidents Reported Moderate or Higher

Incidents Moderate or Above as a proportion of Incidents Reported

35

0

10

20

30

40

50

60

Number of Reported Assaults/ Aggression Towards Staff

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



12 7 5 12 3 5 8 7 7 7 6 3 13


13

Our PerformanceScheduled Care – Timeliness Indicators

79.00%

70%

72%

74%

76%

78%

80%

82%

84%

On time arrival

On time arrival Target

93.20%

88%

89%

90%

91%

92%

93%

94%

95%

Time on Vehicle < 60 mins

Time spent on vehicle (<60 minutes) Target

85.60%

80%

82%

84%

86%

88%

90%

Collection within 60 mins

Collection within 60 mins Target

Time on vehicle and collection within 60 minutes continues to perform well, both achieving the local target. On time arrival has narrowly missed the 80% target by 1% in December 2017.

Complaints and appreciations have both increased in November and December 2017, with the proportion of incidents reported moderate or higher also showing an increase in these months.

14

Our PatientsScheduled Care – Quality and Safety

8.16%

0%

2%

4%

6%

8%

10%

12%

0

1

2

3

4

5

6


Incidents Reported Moderate or Higher

Incidents Moderate or Above as a proportion of Incidents Reported

7.31%

9.14%

0%

5%

10%

15%

20%

25%

Complaints and Appreciations per 1,000 Journeys

Complaints as a proportion of journeys (per 1000 journeys)

Appreciations as a proportion of journeys (per 1000 journeys)

94.90%

75%

80%

85%

90%

95%

100%

0

100

200

300

400

500

600

Scheduled Care FFT


3

0

2

4

6

8

10

12

Reported Assaults/Aggression Towards Staff

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



2 1 5 2 0 1 4 3 2 4 0 5 4


15

key performance indicator summary dec 17...performance appriasal compliance our people statutory and...

Documents