nhs rotherham clinical commissioning group body papers... · m34 deliver the required number of bed...
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NHS Rotherham Clinical Commissioning Group
Operational Executive 22 September 2017
Strategic Clinical Executive 27 September 2017
GP Members Committee 27 September 2017
Governing Body 4 October 2017
Commissioning Plan Performance Report: Quarter 1
Lead Executive: Ian Atkinson, Deputy Chief Officer
Lead Officer: Lydia George, Planning and Assurance Manager
Alex Henderson-Dunk, Performance and Intelligence Manager
Lead GP: N/a
Purpose:
For members to note the progress with delivery of the CCGs Commissioning Plan as at the end of Quarter 1.
Background:
In 2013 a performance framework for the Commissioning Plan was developed so that the CCG could assess its progress against key priorities and on its implementation of the plan.
In 2016/17, in line with the new CCG Improvement and Assessment Framework and the
revision of the GB overall performance report, the Commissioning Plan Performance Report
was revised to provide a fuller picture of delivery and includes milestones, KPIs, QIPP position
and any associated risks for each priority.
The current Commissioning Plan was produced 2 years ago, the landscape has changed
significantly over this time and significant progress has been made on the CCGs priorities. As
a result work has begun to refresh the Commissioning Plan.
This Performance Report has therefore been revised for 2017/18 to cover remaining actions in
the current Plan and, where possible, to cover content that will be in the refreshed
Commissioning Plan which is due for completion February/March 2018.
It should be noted that once the Commissioning Plan has been refreshed this Performance
Report will be revisited and where necessary changes will be made to ensure it is fully aligned
with the new Plan.
The performance framework will be reported 4 times a year and received at Governing Body in
October, December, February and a final year- end report in May.
Analysis of key issues and of risks
Lead officers have provided commentary against the milestones where performance is off track. From quarter 2 officers will be asked to identify any milestones where the direction of travel has the potential to deteriorate or improve.
Milestones
There are 57 milestones in total, 41 of these are new milestones for 2017/18, see breakdown of RAG rate below:
RAG rate Number of milestones
%
Red 0 0
Amber 7 12
Green 50 88
Total 57 100
The number of milestones on track is 88% compared to 82% for the same period in 2016/17.
There are no red milestone, amber milestones are summarised below:
RAG rate Milestone description Commentary Q1 Q2 Q3 Q4
Amber Medicines Management
M23 Potential savings have been identified (financial value tbc) by the introduction of a range of branded generic drugs. This figure will be adjusted as further schemes evolve. A target of 90% compliance has been set – annual savings tbc.
Started but potential savings figure to be confirmed.
Amber Medicines Management
M24 12 projects to be delivered over the financial year and savings are to be identified. This figure will evolve as schemes are still being evaluated.
Started but potential savings figure to be confirmed.
Amber Mental Health
M27 RDaSH to produce a delivery plan including milestones and timescales for the delivery of the Adult Transformation Plan.
Assurance being monitored at the QIPP committee
Amber Mental Health
M31 Review MH Social prescribing delivery trajectory.
Green/amber - improvements in trajectory noted but further work required.
Amber Learning Disability
M34 Deliver the required number of bed reductions as per Rotherham element of the plan.
Remedial action plan in place to achieve both trajectories by July 2017.
Amber End of Life Care
M44 Involvement of the Care Co-ordination Centre in the EOLC pathway
Started but not on track – ongoing work taking place with CCG lead clinical lead
Amber End of Life Care
M45 Achieve 40% implementation of the Case Management Palliative Care Template in Primary Care
Data set still being developed, uptake of palliative care within case management continues to be embedded data.
Key Performance Indicators (KPIs)
There are 46 KPI’s in total, of which 2 are new, see breakdown of RAG rate below:
RAG Rate Number of
KPIs %
Red 6 13
Amber 5 11
Green 18 39
WD 17 37
Total 46 100
Overall there are approximately 39% of KPIs on track compared to 27% for the same period last year. There remains a significant number of KPIs still awaiting national data / or the data available is several years old.
Below is a list of the red and amber KPIs, commentary on performance can be found in the Governing Body Performance Report or Governing Body Quality Report.
RAG rate
No. Key Performance Indicator Description Q1 Q2 Q3 Q4
Red (6)
K4 Contain growth in the number of non-elective admissions
K6 Achieve 4 hour access standard for A&E
K9 Delayed transfers of care from hospital
K12 Response to category A (Red1) ambulance calls within 8mins
K16 Reduction in the number of antibiotics prescribed in primary care
K18 Number of finance and quality “green” indictors
RAG rate
No. Key Performance Indicator Description Q1 Q2 Q3 Q4
Amber (5)
K2 Utilise NHS e-referral service to enable choice at 1st routine elective
referral
K14 Contain growth in elective activity
K15 Achievement of outpatient follow up ratios
K28 Reduce the number of people admitted in line with the South Yorkshire and North Lincolnshire LD TCP trajectory
K45 Percentage seen within 62 days after a referral by GP (I&AF 122b)
Finance
The position in terms of QIPP savings is shown below as at October, further information can be found in the Finance and Contracting Governing Body report:
Area Scheme Financial Rating
Operational Rating
YTD FOT YTD FOT Urgent Care Reduce the level of growth in A&E,
assessments and non-elective admission activity in line with local trend analysis
Clinical referrals Reduction in follow-ups where TRFT are above peer average
Clinical referrals
Clinical thresholds – TRFT
Clinical referrals
Clinical thresholds – other
Medicines Management
Roll out medicines waste reduction programme to all GP practices
Medicines Management
Branded generics – switch range of drugs to specific brands at below drug tariff price
Medicines Management
Projects and product switch – introduction of guidelines, switches to more cost effective products etc
Medicines Management
Self- management of a range of identified drugs
Medicines Management
Waste reduction scheme, expand into Care Homes
Mental Health
Reduction in demand for Ferns
Continuing Care / Funded Nursing Care
Review of CHC cases against frameworks and legislation
Continuing Care / Funded Nursing Care
Review of assessment tool for determining care packages
Continuing Care / Funded Nursing Care
Ongoing clinical review of high cost placement packages
Continuing Care / Funded Nursing Care
Further development of personal health budgets
Risk
Risks associated with the delivery of the Commissioning Plan are set out below, further details can be found within the GB Assurance Framework. A review of risks is currently taking place and will be reflected in the Q2 report.
Risk Score Number
16 2
12 6
9 1
Total 9
Approval history:-
OE 22 09 2017
SCE 27 09 2017
GPMC 27 09 2017
CCG GB 04 10 2017
Recommendations:
Members are asked to note the report and that: 1. The Q1 position in term of milestones is positive compared to the same period last year.
2. The Q1 position in terms of KPIs is positive compared to the same positional last year.
3. There are still a number of KPIs which are waiting for national data, or the data available is
several years old.
4. Further information on the QIPP position can be found in the QIPP Plan Monitoring report
received at Governing Body.
5. Further information on the risk position can be found in the Governing Body Assurance
Framework received at Governing Body.
Commissioning Plan Performance
Report: 2017/18
Q1
Meeting Date
Operational Executive 22 September 2017
Strategic Clinical Executive 27 September 2017
GP Members Committee 27 September 2017
CCG Governing Body 4 October 2017
Definitions for RAG Ratings:
Red KPI Milestones QIPP
Less than 2% achieved Not started or significant issues Not started or Started but still high risk
Amber
KPI Milestones QIPP
Within 2% achieved Started but not on track OK with medium risk
Green
KPI Milestones QIPP
Achieved or complete On track Achieving as planned
Please note
That there are a number of KPIs from the new Improvement and Assessment Framework where data is not available yet.
1 Primary Care Lead GP: Avanthi Gunasekera Lead Officer: Jacqui Tufnell
Deliverable Milestones for 2017/18 Source 2017/18 Target
Q4 16/17
Q1 Q2 Q3 Q4 Comments
M1 Primary Care Quality Contract – implement and monitor 5 standards for 2017/18.
Com / primary care plan
Q4 New for 17-
18
G On track
M2 Primary Care Quality Contract – develop and implement performance monitoring arrangements.
Com / primary care plan
Q4 New for 17-
18
G On track
M3 General Practice Forward View – provide training and implement care navigation in first 10 practices.
Com / primary care plan
Q4 New for 17-
18
G On track
M4 Primary Care Self-care pilot – roll out telehealth to all practices.
Com / primary care plan
Q4 New for 17-
18
G On track
M5 Plan and implement access arrangements to meet NHSE delivery requirements of all population receiving extended access (weekday) and Saturday/Sundays by March 2018.
Com / primary care plan
Q4 New for 17-
18
G On track
Key Performance Indicators (KPIs) Source 2017/18 Target
Q4 16/17
Q1 Q2 Q3 Q4
K1 Patient experience of GP services (I&AF 128b)
I&A Framework
Quality premium
74.6% In July 2018 Publicatio
n
WD G 85.7%
Published Bi-annually.
K2 Utilise NHS e-referral service to enable choice at 1
st routine elective referral
(I&AF 105a)
I&A Framework
80% by end of Q2 2017/18
and 100% by end of Q2 2018/19
A 74.2%
A 77%
Agreed action plan in place with TRFT which we continue to monitor. There has been significant improvement across specialities, but 2 remain challenging. IT team are working with GPs to increase utilitsation.
K3 Diabetes patients that have achieved all the NICE recommended treatment targets. Three (HbA1c, cholesterol and blood pressure) for adults and one (HbA1c) for children (I&AF103a)
I&A Framework
TBC New for 17-
18
TBC Latest available data is 2015/16
QIPP £ Finance Operational Rating
as at October
YTD FOT YTD FOT
None. QIPP Plan
Risks Risk Description Risk Score Delivery of new model in pressured environment. Lack of skill and capacity to roll out.
GB Assurance Framework
Delivery – leading system wide efficiency programmes that consistently achieve measurable improvements whilst meeting our financial targets.
16
2 Unscheduled Care Lead GP: David Clitherow Lead Officer: Sarah Lever / Claire Smith
Deliverable Milestones for 2017/18 Source 2017/18 Target
Q4 16/17
Q1 Q2 Q3 Q4 Comments
M6 Implementation of directly bookable GP appointments from NHS111.
NHS 5Yr Forward
STP
Q3 New for 17-
18
G On track
M7 Implementation of revised pathways of care in UECC.
Com Plan STP
Q4 New for 17-
18
G On track
M8 Design of collaborative commissioner and provider arrangements to support delivery of national UTC specification.
STP Q3 New for 17-
18
G On track
M9 Expand role of the Care Co-ordination Centre (CCC) to manage the interface between acute /community.
Com Plan STP
Q3 G G On track
M10 Full implementation of new service model including deflection pathways.
Com Plan Q3 New for 17-
18
G On track
M11 New pathways paediatrics, frailty and interface with CCC agreed and implemented.
Com Plan Q4 New for 17-
18
G On track
Key Performance Indicators (KPIs) Source 2017/18 Target
Q4 16/17
Q1 Q2 Q3 Q4 Key Performance Indicators
(KPIs) K4 Contain growth in the number of non-
elective admissions Contractual
target
Meet contracted
levels
R R Emergency admissions as at June 17 YTD (flex position) were £334k over plan. Emergency assessments were £111k over plan. RFT only.
K5 Contain growth in A&E attendances Contractual target
Meet contracted
levels
G G A&E attendances as at June 17 YTD (flex position) were £240k under plan. RFT only. February provisional data.
K6 Achieve 4 hour access standard for A&E Constitutional
GB Report
95% by March 18
R 88.6% 16/17 Full Year
R 84.1%
Aug 17
Month to Date
The new Urgent and Emergency Care Centre opened on the 06th July. The WIC also closed on this date. Workforce challenges within the department continue to present as the main factor in delivering sustainable performance, during June TRFT continued to receive support from the National A&E improvement team. GP streaming has been implemented within the department, which has had an impact. The CCG continue to work closely with partners through the A&E delivery board to realise improvement. National performance against this standard remains challenged. The national position for England for May 17 was 90%.
K7 Reduce unplanned hospitalisation for chronic Ambulatory Care Sensitive conditions (I&AF 106a)
I&A Framework GB Report
TBC WD TBC Data has been published as part of the IAF year-end assessment – RCCG was in the worst quartile nationally for this indicator.
QIPP £ Finance Operational Rating
as at October
YTD FOT YTD FOT
Reduce levels of growth in A&E assessments and non-elective admission activity in line with local trend analysis
QIPP Plan 1,932,000
n/a See GB QIPP Dashboard
Risks Risk Description Risk Score Activity growth in A&E. Failure to deliver system wide efficiency programme for unscheduled care. Suboptimal care for patients resulting in poor outcomes.
GB Assurance Framework
Quality – improving safety, patient experience and outcomes and reducing variations.
12
3 Community Services Lead GP: Phil Birks Lead Officer: Claire Smith
Deliverable Milestones for 2017/18 Source 2017/18 Target
Q4 16/17
Q1 Q2 Q3 Q4 Comments
M12 Evaluation of the Integrated Locality Pilot to be completed.
Com Plan Q3 New for
17-18
G On track
M13 Begin roll out of the Integrated Locality across the borough.
Com Plan Q4 New for
17-18
G On track
M14 Integration of IRR with Mental Health & integration of CCC with Mental Health.
Com Plan Q3 New for
17-18
G On track
M15 Completion of the Business Care for the Re-ablement Village
Com Plan Q4 G
G On track
Key Performance Indicators (KPIs) Source 2017/18 Target
Q4 16/17
Q1 Q2 Q3 Q4 Key Performance Indicators
(KPIs) K8 Emergency readmissions within 28 days
of discharge from hospital Contract
TBC G
Feb 17 YTD = 12.1%
WD Awaiting data becoming available from national system
K9 Delayed transfers of care from hospital (I&AF 127e)
I&A Framework
BCF GB Report
3.5% of acute
occupied bed days delayed /
226 DTOCs in month per 100,000
population (Nov 17
Requirements)
R Feb 17 YTD = 2698.7
R May 17 = 503
DTOCs per
100,000 populati
on
The position in relation to DTOCs has deteriorated in recent months. A significant part of this change is the result of improvements in processes to support better communication across partners and improve identification of DTOCs. TRFT and RMBC commissioned an external review of DTOC pathways via the Local Government Association, the findings of this work have been reported to A&E delivery board with proposed actions for improvement. Partners have now agreed the improvement action plan.
K10 Number of unscheduled admissions of patients > 65 years out of hours.
Contractual Threshold 8760
G G On track
K11 Number of A&E attendances by care home residents.
Contractual Threshold 3400
WD G On track
QIPP £ Finance Operational Rating
as at October
YTD FOT YTD FOT
None. QIPP Plan
Risks Risk Description Risk Score
Services commissioned do not appropriately deliver to vulnerable people.
GB Assurance Framework
Assurance – having robust internal constitutional and governance arrangements, ensuring that providers’ services are safe and ensuring vulnerable people have effective safeguarding.
12
4 Ambulance and Patient Transport Services
Lead GP: David Clitherow Lead Officer: Julia Massey
Deliverable Milestones for 2017/18 Source 2017/18 Target
Q4 16/17
Q1 Q2 Q3 Q4 Comments
M16 Monitor and report on the new Ambulance Quality Indicators, including the revised Clinical Quality Indicators
National Requirement
Q3 New for 17-
18
G On track
M17 Increase the number of ambulance patients referred to an alternative level of care or managed through the “Hear/See and Treat” routes
National Drivers
Q4 New for 17-
18
G On track
M18 Improve the utilisation of the Eligibility Criteria for Non Urgent Patient Transport
Com Plan Q4 New for 17-
18
G On track
Key Performance Indicators (KPIs) Source 2017/18 Target
Q4 16/17
Q1 Q2 Q3 Q4 Key Performance Indicators
(KPIs) K12 Response to category A (Red1)
ambulance calls within 8mins (I&AF 127d) I&A
Framework GB report
75% R Mar = 63.9%
R Jun 17
= 63.8%
YAS are currently participating in an NHS England-led Ambulance Response Programme (ARP), which went live from the 21st April 2016. The pilot ran for 3 months initially and has subsequently been extended. This programme resulted in a change to call category classifications.
QIPP £ Finance Operational Rating
as at October
YTD FOT YTD FOT
None. QIPP Plan - -
Risks Risk Description Risk Score Activity growth in A&E. Failure to deliver system wide efficiency programme for unscheduled care. Suboptimal care for patients resulting in poor outcomes.
GB Assurance Framework
Quality – improving safety, patient experience and outcomes and reducing variations.
12
5 Clinical Referrals
Lead GP: Anand Barmade Lead Officer: Janet Sinclair-Pinder
Deliverable Milestones for 2017/18 Source 2017/18 Target
Q4 16/17
Q1 Q2 Q3 Q4 Comments
M19 Implement Phase 2 of clinical thresholds Com Plan Q4 New for
17-18
G On track
M20 Delivery of agreed audit programme and implementation of recommendations for clinical thresholds
Com Plan Q4 New for
17-18
G On track
M21 Review of MSK service and implementation of recommendations which includes a Single Point of Access and Physiotherapy First.
Com Plan Q4 New for
17-18
G On track
M22 Review of Dermatology GPwSI service and implementation of recommendations
Com Plan Q4 New for
17-18
G On track
Key Performance Indicators (KPIs) Source 2017/18 Target
Q4 16/17
Q1 Q2 Q3 Q4 Key Performance Indicators
(KPIs) K13 Patients waiting 18 weeks or less from
referral to hospital treatment (I&AF 129a) Constitution /
I&A Framework GB Report
92% G 94.5% 1617 Full Year
G Jun 17
= 95.1%
Performance remains positive in 2017/18.
K14 Contain growth in elective activity Contractual Meet contracted levels
G A 85k above plan for elective activity – RFT only, June YTD flex position.
K15 Achievement of outpatient follow up ratios Contractual Meet contracted ratios
G A RFT are above the follow up ratios with an estimated June YTD reduction in payment of £200k.
QIPP £ Finance Operational Rating
as at October
YTD FOT YTD FOT
Reduction in follow-ups where TRFT are above peer average
QIPP Plan 488,000 n/a See GB QIPP Dashboard
Clinical thresholds – TRFT QIPP Plan 2,453,000 n/a See GB QIPP Dashboard
Clinical thresholds – other contracts QIPP Plan 738,000 n/a See GB QIPP Dashboard
Risks Risk Description Risk Score Delivery model in pressured environment. Lack of skill and capacity to roll out.
GB Assurance Framework
Delivery – leading system wide efficiency programmes that consistently achieve measurable improvements whilst meeting our financial targets.
16
6 Medicines Management Lead GP: Sophie Holden Lead Officer: Stuart Lakin
Deliverable Milestones for 2017/18 Source 2017/18Target
Q4 16/17
Q1 Q2 Q3 Q4 Comments
M23 Potential savings have been identified (financial value tbc) by the introduction of a range of branded generic drugs. This figure will be adjusted as further schemes evolve. A target of 90% compliance has been set – annual savings tbc.
Meds Management
Priority
90% G A Started but potential savings figure to be confirmed.
M24 12 projects to be delivered over the financial year and savings are to be identified. This figure will evolve as schemes are still being evaluated.
Meds Management
Priority
12 projects
G A Started but potential savings figure to be confirmed.
M25 29 of our 31 practices have redesigned their repeat dispensing processes to reduce medicines waste.
Meds Management
Priority
Q1 G G Complete.
M26 A self-care initiative/programme has been launched.
Meds Management
Priority
Q4 New for 17-
18
G On track
Key Performance Indicators (KPIs) Source 2017/18 Target
Q4 16/17
Q1 Q2 Q3 Q4 Key Performance Indicators
(KPIs) K16 Reduction in the number of antibiotics
prescribed in primary care (I&AF 107a)
Quality premium /
I&A Framework GB Report
1.161 items per STAR-
PU
R 1.244 Jan 17
R 1.250
Mar 17
Rotherham has a historically high use of antibiotics, and whilst our use of broad spectrum antibiotics is coming down, our overall volume is not. We have identified the practices with the highest use of antibiotics and are working with them to help them reduce.
K17 Appropriate prescribing of broad spectrum antibiotics in primary care (I&AF 107b)
I&A Framework / GB Report
11.3 G 7.1 Jan
17
G 7.1 Mar
17
On track
K18 Number of finance and quality “green” indictors
Meds Management
65% of 589 indicators
to be Green (383)
New target for 17-
18
R 50% achievement for Q1.
QIPP £ Finance Operational Rating as at October
YTD FOT YTD FOT
Roll out Medicines Waste reduction programme to all GP practices
QIPP Plan 1,400,000 n/a See GB QIPP Dashboard
Branded Generics – switch range of drugs to specific brands at below drug tariff price
QIPP Plan 750,000 n/a See GB QIPP Dashboard
Projects and products switch – introduction of guidelines, switches to more cost effective products etc
QIPP Plan 350,000 n/a See GB QIPP Dashboard
Self management of a range of identified drugs QIPP Plan 151,000 n/a See GB QIPP Dashboard
Waste reduction scheme – expand in to care homes
QIPP Plan 500,000 n/a See GB QIPP Dashboard
Risks Risk Description Risk Score Added costs in prescribing, planned care, unscheduled care, resulting in higher levels of expenditure and higher risk to financial balance.
Risk Register (RR28)
Failure to deliver QIPP programme for 2017/18. 12
7 Mental Health (Mental Health and Dementia are clinical priorities within the I&A
Framework)
Lead GP: Russell Brynes (Adults) Jason Page (Children) Lead Officer: Kate Tufnell (Adults) Nigel Parkes
(Children)
Deliverable Milestones for 2017/18 Source 2017/18 Target
Q4 16/17
Q1 Q2 Q3 Q4 Comments
M27 RDaSH to produce a delivery plan including milestones and timescales for the delivery of the Adult Transformation Plan.
Com Plan Q4 G A Assurance being monitored at the QIPP committee
M28 Children and Young People - All children and young people will follow the agreed process in transitioning to adult services and all will have a transition plan in place.
Com Plan STP
Q4 G G RDaSH continue to focus on the transition pathway and improves have been noted throughout the year.
M29 Continue roll-out of the Dementia diagnosis LES.
Com Plan STP
Q4 New for 17-
18
G Number of Dementia diagnosis increasing.
M30 Core 24 (Adult Mental Health) Transformation funding Delivery plan agreed with partners.
Com Plan STP
Q4 New for 17-
18
G On track
M31 Review MH Social prescribing delivery trajectory.
Com Plan STP
Q4 New for 17-
18
A Green/amber - improvements in trajectory noted but further work required.
M32 Ferns Ward evaluation completed. Com Plan STP
Q4 New for 17-
18
G On track
M33 Delivery of CAMHS LTP against plan. Com Plan CAMHS LTP
Q4 New for 17-
18
G Some areas of work are behind schedule but commissioned services are in place.
Key Performance Indicators (KPIs) Source 2017/18 Target
Q4 16/17
Q1 Q2 Q3 Q4 Key Performance Indicators
(KPIs) K19 People with 1
st episode of psychosis
starting treatment with a NICE- recommended package of care treated within 2 weeks of referral (I&AF 123b)
I& A Framework
STP GB report
50% G Jan-17
= 100%
G May-17 = 60%
Performance on track.
K20 Percentage of people who are "moving to recovery" of those who have completed IAPT treatment (I&AF 123a)
I&A Framework GB Report
Quality Premium Health
Outcomes
50% A 16/17 Full
Year = 50.5%
G Apr-17
= 55.7%
Performance on track.
K21 Diagnosis rate for people with dementia, as a percentage of the estimated prevalence (I&AF 126a)
GB Report I&A
Framework
66.7% G 1617 Year End = 75.9%
G Jun-17
= 80.9%
Performance on track.
K22 Proportion of people waiting 6 weeks or less from referral to entering a course of IAPT treatment
GB Report Health
Outcomes
75% R 1617 Full
Year = 70.7%
G Aug
YTD = 84.4%
Performance has improved in 17/18 and is now meeting the national standard.
K23 95% of children and young people who present at A&E in crisis will be seen within 1 hour
STP Com plan
No existing
data
WD WD No data available
K24 95% of adults who present at A&E in crisis will be seen within 1 hour
STP Com plan
No existing
data
WD WD No data available
QIPP £ Finance Operational Rating
as at October
YTD FOT YTD FOT
Reduction in demand for Ferns QIPP Plan 800,000 n/a See GB QIPP Dashboard
Risks Risk Description Risk Score Activity growth in A&E. Failure to deliver system wide efficiency programme for unscheduled care. Suboptimal care for patients resulting in poor outcomes.
GB Assurance Framework
Quality – improving safety, patient experience and outcomes and reducing variations.
12
8 Learning Disability (Learning Disabilities is a clinical priority within the I&A
Framework) Lead GP: : Russell Brynes (Adults) Jason Page
(Children) Lead Officer: Garry Parvin (Adults) Nigel Parkes
(Children)
Deliverable Milestones for 2017/18 Source 2017/18Target
Q4 16/17
Q1 Q2 Q3 Q4 Comments
M34 Deliver the required number of bed reductions as per Rotherham element of the plan.
Com plan LD TCP
Q4 A A Remedial action plan in place to achieve both trajectories by July 2017.
M35 Delivery of CETR Expert by Experience training.
Com plan LD TCP
Q3 New for 17-
18
G On track
M36 Rotherham CETR process in place (CYP). Com plan LD TCP
Q4 New for 17-
18
G On track
M37 Rotherham ‘at risk of admissions’ process in place (including CYP and Autism).
Com plan LD TCP
Q4 New for 17-
18
G On track
Key Performance Indicators (KPIs) Source 2017/18 Target
Q4 16/17
Q1 Q2 Q3 Q4 Key Performance Indicators
(KPIs) K25 Ensure that patients receive a CTR prior to
a planned admission to an Assessment and Treatment Unit or mental health inpatients - adults
Com Plan STP
95% G G On track.
K26 Ensure that patients receive a CETR prior to a planned admission to an Assessment and Treatment Unit or mental health inpatients - children
Com Plan STP
95% G G On track.
K27 Ensure that patients in an Assessment and Treatment Unit receive a Care and Treatment Review (CTR) every 6 months
Com Plan STP
100% G G On track
K28 Reduce the number of people admitted in line with the South Yorkshire and North Lincolnshire LD TCP trajectory
Local Reporting
Target = 3 – CCG funded LD beds /5 – NHSE funded
secure LD beds
A A Q1 local and TCP trajectories are off track. Ongoing review with association of NHSE regarding increased admissions of individuals from outside the Rotherham area.
QIPP £ Finance Operational Rating as at October
YTD FOT YTD FOT
None. QIPP Plan
Risks Risk Description Risk Score Services commissioned do not appropriately deliver to vulnerable people.
GB Assurance Framework
Assurance – having robust internal constitutional and governance arrangements, ensuring that providers’ services are safe and ensuring vulnerable people have effective safeguarding.
12
9 Maternity and Children’s Services (Maternity is a clinical priorities within the I&A Framework)
Lead GP: Jason Page Lead Officer: Mark Chambers
Deliverable Milestones for 2017/18 Source 2017/18 Target
Q4 16/17
Q1 Q2 Q3 Q4 Comments
M38 Engage at SY&B level to support strategic direction for the national requirements around maternity ( Better Births)
Com Plan
Q4 New for 17-
18
G Gap analysis completed, now working at SY&B level to develop strategies for maternity services
M39 Ensure delivery of the SEND Joint Commissioning Action Plan
Com Plan
Q4 New for 17-
18
G CCG has undertaken 2 self-assessment exercises. Input into the CCG SEND Strategy Commissioning Group. Self-assessment identified ongoing gaps in provision.
M40 Develop new community services specifications for children’s community nursing and specialist nurses to support the Care Closer to Home work-stream
Com Plan
Q4 G G On track -Parent Carers Forum consultation exercise ongoing. Draft Spec for Childrens Community Services completed and shared internally. Draft service spec for CCN shared with TRFT and comments received. TRFT looking at CCN models around the country, following this the spec will be agreed.
Key Performance Indicators (KPIs) Source 2017/18 Target
Q4 16/17
Q1 Q2 Q3 Q4 Key Performance Indicators
(KPIs) K29 Reduce the number of neonatal mortality
and still births (I&AF 125a) I&A
Framework GB Report
6.7 stillbirths per births
WD WD Latest published position is 4.6 (2015 data). The IAF year-end assessment puts RCCG in the best quartile in England.
K30 % of children aged 10-11 classified as overweight or obese (I&AF 102a)
I&A Framework GB Report
TBC WD WD Latest position is 35.8% in 2015/16. IAF year-end assessment used data from 12/13 to 14/15, giving RCCG a value of 35.5%. For the year-end assessment RCCG were in the inter quartile range, i.e. not in the worst or the best quartiles nationally.
K31 Maternal smoking at delivery (I&AF 101a) I&A Framework GB Report
TBC WD WD Latest available position – Q4 16/17 – 17%. Q3 position was 19.9% which was used for the IAF year-end assessment, where RCCG where in the worst quartile nationally.
K32 Improve Women’s experience of maternity services (national maternity services survey) (I&AF 125b)
I&A Framework GB Report
TBC WD WD 2015 score of 79.8 is latest available position. This was used for the IAF year-end assessment, where RCCG was neither in the best nor the worst quartiles nationally.
K33 Emergency admissions for children with lower respiratory tract infections
Health Outcomes GB Report
541.8 WD WD Latest position is 372.3 in 2015/16
K34 Unplanned hospitalisation for asthma, diabetes and epilepsy in under 19’s
Health Outcomes GB Report
364 WD WD Latest position is 272 in 2015/16
QIPP £ Finance Operational Rating
as at October
YTD FOT YTD FOT
None.
Risks Risk Description Risk Score
None identified.
10 Continuing Care and Funded Nursing Care Lead GP: Richard Cullen Lead Officer: Alun Windle
Deliverable Milestones for 2017/18 Source 2017/18 Target
Q4 16/17
Q1 Q2 Q3 Q4 Comments
M41 To approve and implement an alternative discharge process for patients in the acute setting that will ensure that they are optimised in the appropriate placement prior to full Continuing Health Care assessment.
CHC Standards
AQuA Assurance
Report
Q3 New for 17-
18
G On track
M42 To implement a shortened assessment tool for reviews of Continuing Health Care eligibility.
CHC Standards
AQuA Assurance
Report
End Q2 New for 17-
18
G On track
M43 To implement a shortened review tool for reviews of children’s Continuing Health Care eligibility.
CHC Standards
AQuA Assurance
Report
Q2 New for 17-
18
G On track
Key Performance Indicators (KPIs) Source 2017/18 Target
Q4 16/17
Q1 Q2 Q3 Q4 Key Performance Indicators
(KPIs) K35 People eligible for standard NHS
continuing healthcare (I&AF 135a)
I&A Framework GB report
TBC WD WD Waiting for data
K36 Personal Health Budgets (I&AF 105b) I&A Framework GB report
TBC G WD Waiting for data
K37 Less than 15% of all full NHS Continuing Health Care assessments to take place in an acute hospital setting. By Q4.
CHC Key Performance
Indicators
<15% New for 17-18 30%
On track
K38 25% reduction in assessments beyond 28 days for adults (currently 22%) to meet the 28 day national policy guidance. By Q4.
CHC Key Performance
Indicators
Adults 25%
reduction
New for 17-18
22%
On track
K39 Overall 15% reduction in outstanding reviews (61% current target 46%). By Q4. Adults
CHC Key Performance
Indicators
Adults 15%
reduction
New for 17-18 60.34%
On track
K40 Overall 15% reduction in outstanding reviews (50% current target is 35%). By Q4.
CHC Key Performance
Indicators
Children 15%
reduction
New for 17-18 50%
On track
QIPP £ Finance Operational Rating
as at October
YTD FOT YTD FOT
Review of CHC cases against frameworks and legislation
QIPP Plan 207,000 n/a See GB QIPP Dashboard
Review of assessment tool for determining care packages
QIPP Plan 200,000 n/a See GB QIPP Dashboard
Ongoing clinical review of high cost placement packages
QIPP Plan 50,000 n/a See GB QIPP Dashboard
Further development of personal health budgets
QIPP Plan 200,000 n/a See GB QIPP Dashboard
Risks Risk Description Risk Score
None identified.
11 End of Life Care (EOLC) Lead GP: Avanthi Gunasekera Lead Officer: Ian Atkinson
Deliverable Milestones for
2017/18 Source
2017/18 Target
Q4 16/17
Q1 Q2 Q3 Q4 Comments
M44 Involvement of the Care Co-ordination Centre in the EOLC pathway
Com Plan Q4 A A Started but not on track – ongoing work taking place with CCG lead clinical lead
M45 Achieve 40% implementation of the Case Management Palliative Care Template in Primary Care
Com Plan Q4 A A Data set still being developed, uptake of palliative care within case management continues to be embedded data.
Key Performance Indicators (KPIs) Source 2017/18 Target
Q4 16/17
Q1 Q2 Q3 Q4 Key Performance Indicators
(KPIs) K41 Percentage of deaths which take place in
hospital (I&AF 105c)
I&A Framework GB Report
TBC WD WD Latest position, Q2 16/17 – 46.1%. This indicator was not allocated to a quartile in the IAF year-end assessment.
K42 Percentage of deaths not in hospital Public health TBC WD WD Latest data = July- September 2016 – 53.9%
QIPP £ Finance Operational Rating
as at October
YTD FOT YTD FOT
None.
Risks Risk Description Risk Score None identified.
12 Specialised Services Lead GP: Richard Cullen Lead Officer: Jacqui Tufnell
Deliverable Milestones for
2017/18 Source
2017/18 Target
Q4 16/17
Q1 Q2 Q3 Q4 Comments
M46 Respond to any national expectations for specialised commissioning.
Com Plan Q4 New for 17-
18
G Complete
Key Performance Indicators (KPIs) 2017/18 Target
Q4 16/17
Q1 Q2 Q3 Q4 Key Performance Indicators
(KPIs) - n/a No KPIs
QIPP £ Finance
Operational Rating
as at October
YTD FOT YTD FOT
None.
Risks Risk Description Risk Score None identified.
13 Joint Work – local and Regional
Lead GP: Richard Cullen Lead Officer: Ian Atkinson/Wendy Allott
Deliverable Milestones for
2017/18 Source
2017/18 Target
Q4 16/17
Q1 Q2 Q3 Q4 Comments
M47 Deliver the IH&SC Place Plan in partnership with other Rotherham organisations
IH&SC Place Plan
Q4 New for 17-
18
G On track
M48 Align IH&WC Place Plan with the H&WB Strategy
H&WBB Q3 New for 17-
18
G On track
M49 Oversee the implementation of the BCF with RMBC
Com Plan / BCF Plan
Q4 G G On track
Key Performance Indicators (KPIs) Source 2017/18 Target
Q4 16/17
Q1 Q2 Q3 Q4 Key Performance Indicators
(KPIs) - Achievement of BCF KPIs – see BCF Plan Com Plan /
BCF Plan Q4 Please see BCF page of GB report
QIPP £ Finance
Operational Rating
as at October
YTD FOT YTD FOT
None.
Risks Risk Description Risk Score
None identified.
14 Sexual Exploitation
Lead GP: Lee Oughton Lead Officer: Catherine Hall
Deliverable Milestones for
2017/18 Source
2017/18 Target
Q4 16/17
Q1 Q2 Q3 Q4 Comments
M50 As part of the safeguarding update for GPs and practice staff, ensure level 3 training is delivered.
Com Plan Q1-Q4 G G On track
M51 Offer the same training as above to the remainder of primary care, social care and providers to ensure collaborative working.
Com Plan Q1-Q4 G G On track
M52 Provide ongoing support to current and emerging SYP and NCA historic investigations
Com Plan Q1-Q4 G G On track
M53 Provide 2 members to be part of the Multi Agency Safeguarding Hub team
Com Plan Q1- Q4 G G On track
M54 Ensure safeguarding standards are included in all commissioned services contracts and that these are monitored.
Com Plan Q1-Q4 New for 17-
18
G On track
Key Performance Indicators (KPIs) Source 2017/18 Target
Q4 16/17
Q1 Q2 Q3 Q4 Key Performance Indicators
(KPIs) - None.
QIPP £ Finance
Operational Rating
as at October
YTD FOT YTD FOT
None identified.
Risks Risk Description Risk Score
Partnership working with RMBC and other agencies.
GB Assurance Framework
Safeguarding – ensuring all children and vulnerable adults are protected from harm, including implementing all actions on Child Sexual Exploitation from the Jay and Casey reports.
9
15 Cancer (Cancer is a clinical priorities within the I&A Framework) Lead GP: Richard Cullen Lead Officer: Janet Sinclair-Pinder
Deliverable Milestones for
2017/18 Source
2017/18 Target
Q4 16/17
Q1 Q2 Q3 Q4 Comments
M55 Work with the STP Cancer Alliance to improve early diagnosis and cancer prevention:
- Increasing awareness of signs and symptoms of cancer.
- Focused work on targeting populations. - Reviewing capacity and demand across
diagnostic services. - Developing quality standards across Primary
Care.
Com Plan STP
Q4 New for
17-18
G On track
M56 Develop pathways of care for vague symptoms.
Com Plan STP
Q4 New for
17-18
G On track
M57 Fully engage with the Macmillan Living With and Beyond Cancer (LWABC) Programme to implement the agreed actions outlined in the project initiation document.
Com Plan STP
Q4 New for
17-18
G On track
Key Performance Indicators (KPIs) Source 2016/17 Target
Q4 16/17
Q1 Q2 Q3 Q4 Key Performance Indicators
(KPIs) K43 Cancer (all) diagnosed at stage 1 and 2
(I&AF 122a) I&A
Framework Quality
Premium
>60% or 4 % point improvem
ent
R WD Off track, RCCG in worst quartile nationally but inconclusive as the latest reporting period was 2014.
K44 Percentage seen within 2 weeks following an urgent referral by GP for suspected cancer
Constitution GB Report
93% G Mar = 96.5%
G May 17
= 96.8%
On track
K45 Percentage seen within 62 days after a referral by GP (I&AF 122b)
Quality Premium
I&A Framework
85% R Mar = 78.2%
A May 17
= 86.6%
May 17 performance met standard but previous months have missed standard.
K46 Patient satisfaction rates >89% (Secondary care) (I&AF 122d)
I&A Framework Com Plan GB Report
TBC WD WD 2015 Annual data was used for the IAF year-end assessment. RCCG value was 8.7 which is neither in the worst nor best quartile nationally.
QIPP £ Finance
Operational Rating
as at October
YTD FOT YTD FOT
None.
Risks Risk Description Risk Score
None identified.
Glossary
APMS Alternative Provider Medical Services BCF Better Care Fund CCC Care Co-ordination Centre CHC Continuing Healthcare
CAMHS Child and Adolescent Mental Health Services
CQC Care Quality Commission
EOLC End of Life Care GB Governing Body IFR Individual Funding Request I&A Improvement and Assessment LES Local Enhanced Services ‘Q’ ‘Quarter’ QIPP Quality Innovation Productivity and
Prevention RMBC Rotherham Metropolitan Borough Council
STP Sustainability and Transformation Plan TRFT The Rotherham Foundation Trust WIC Walk in Centre IHAM Indicative hospital activity model