Faye Nicholls, Head of Performance and Information

Transcription

1 Report to: TRUST BOARD Date: 10 April 2018 Paper No. PB/18/058 Report Title: Author: Presented by: Integrated Board Report Faye Nicholls, Head of Performance and Information Will Legge, Director of Strategy and Transformation Purpose of Report The purpose of this report is to present an overview of the Trust s performance for February Type of Report Decision-making Assurance X Discussion: Executive Summary The Integrated Board Report (IBR) outlines Trust performance against the new Ambulance Response Programme (ARP) categories and indicates some of the benefits that the Trust has seen following the move to ARP, such as meal break compliance and resources per incident. The report also includes the usual metrics relating to quality, workforce, hospital handovers and the Derbyshire Patient Transport Service. Over the winter period the Trust saw an increase in activity, long delays during the pre-clinical handover of patients at hospitals and a reduction in performance across all four response categories. This trend has continued into February Following feedback from the Trust Board in March 2018 additional information has been included in relation to the serious incident and compliments data. Strategic Fit: Strategic Objective Our Quality - We will respond to our patients with a high quality service exceeding national ambulance target quality indicators. Our Reputation - We will be recognised nationally as a reliable provider of high quality out of hospital and community based care across the East Midlands. Innovation ambition - We will be recognised nationally as a leading innovator in community based and out of hospital care. Relevant X X X Page 1 of 3

2 Integration - We will work in partnership with our local health care, social care, and voluntary sector partners to deliver and enable integrated patient services and care pathways across the East Midlands. Our People - We will consistently develop and support our people to be highly skilled, highly motivated, caring and compassionate professionals. Efficiency - We will make the most effective use of all our resources, delivering upper quartile performance on our indicators for money, staff, premises, and fleet. X X X Impact: Quality The report includes performance results against key quality indicators and targets Financial Position None Operational Performance The report includes information on operational performance and statutory performance measures Workforce including Equality Issues The report includes information relating to workforce indicators and targets Reputation of the Trust Organisational reputation and adverse media Other None State in the box below the committees or groups which this report has already been presented to: None Risk Management: Board Assurance Framework: Not applicable Details of any new risk(s) identified which may result from the recommended decision or action: None Details of mitigation of identified risk(s): Consequence (A) Not applicable Risk Assessment Likelihood Score (A x B) (B) Page 2 of 3

3 Recommendations That the Trust Board: CONSIDERS the Integrated Board Report; NOTES the deterioration in performance against response standards during the winter period as a result of increased demand and increased hospital handover delays; and TAKES ASSURANCE that performance management arrangements are in place through the Performance Management Reviews in order to manage performance at a divisional and operational level. Page 3 of 3

4 Integrated Board Report April 2018 (reporting on February 2018 data)

5 Integrated Board Report National changes to ambulance performance reporting standards: On 19 July 2017 East Midlands Ambulance Service (EMAS) became a national pilot site for the Ambulance Response Programme (ARP). This fundamentally changed how incidents (events that result in a 999 call) are coded, prioritised, responded to and measured. The national performance standard changes under the ARP focus on making sure the most appropriate response is provided for each patient first time. The new standards are designed to give more opportunity to do the right thing for the patient. There are four main categories with additional sub-categories: Category 1 is for people with a life-threatening injury or illness. Category 1 T is a sub-set of Category 1 relating to those patients who were transported in emergency vehicles to a hospital or other place of care. Category 2 is for emergency calls. Category 3 is for urgent calls. In some instances the patient may be treated by ambulance staff in their own home. Category 4 is for less urgent calls. In some instances patients may be given advice over the telephone or referred to another service such as a GP or pharmacist. There are also four categories for call received from Health Care Professionals (HCP) requesting a response within an agreed time scale (one, two, three to four hours) for a patient to be conveyed to a hospital or other place of care. Previously these were included in the Category 4 grouping and therefore were not published in the Intergrated Board Report (IBR). Following changes on national guidance these are now counted separately. These are shown as HCP incidents and response times as follows: HCP 1 hour HCP 2 hour HCP 3 hour HCP 4 hour This redesigned system for English ambulance services is strongly endorsed by expert organisations such as the Royal College of Emergency Medicine, the Stroke Association, and the College of Paramedics. More detail can be found on the NHS England website at including short animations and an easy read guide to the change. Reporting February 2018 Since EMAS moved to ARP on 19 July 2017, information in the IBR now relates to ARP where relevant. As ARP is not directly comparable to the previous performance measures this data is not included in the new IBR. Measures under ARP are based on a mean average, for Category 1 and Category 2 incidents and also a 90th percentile. The mean average relates to the average time it took the ambulance service to respond to a patient. The 90th percentile gives the time by which 9 out of 10 of patients received a response, or quicker. Category 3 and Category 4 are also measured using a 90th percentile. The national move towards averages and percentile reporting is designed to report the spread of responses and highlight any lengthy delays by using measures of the 90th percentile. Whilst the overall number of incidents remains below contract there was an increase of over 9 percent in activity in February 2018 compared to the same month the previous year. Demand across all categories remained high in February 2018 (especially when considering there are less days in the month), which is consistent with the time of year and the high demand across all categories (1-4) experienced in December 2017 and January Whilst over the summer and autumn of 2017 pre-clinical handover delays at hospital were significantly lower than the previous year, the delays experienced so far this winter have been similar to those experienced in the winter of 2016/17. In February 2018 hospital delays exceeded those of the previous year (February 2017) with an additional 1389 hours lost in pre-clinical handover. The pre-clinical delays that were over an hour also increased for the first time when compared to the previous year, with 2208 delays at hospital which took over an hour. Whilst increased delays were experienced at all of the main hospitals attended by the Trust, these delays were not evenly split across the region with hospital handovers in Lincolnshire, Leicestershire and Northamptonshire proving particularly challenging. National comparators show that EMAS had two hospitals in the top three nationally for ambulance lost hours (over 30 minutes) per journey. In February 2018 the Trust went into its highest Capacity Management Level (CMP 4) on three occasions and overall spent the majority of time in CMP 3. This was mainly due to a high volume of calls waiting for a response as a result of increased demand from 999 and 111 as well as the inability to release ambulances from acute Accident and Emergency departments. The pattern is similar to that experienced by the Trust in December 2017 and January 2018 indicating that winter pressures are continuing, and has had a negative effect on performance across the main incident categories. Page 2

6 EMAS Integrated Board Report Incidents & Response Times by Category (ASI) Category 1 Expected Standards Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Incidents 4,426 4,612 4,778 5,642 6,833 6,729 6,370 Responses 4,195 4,402 4,588 5,476 6,568 6,568 6,186 Resources Per Response Mean Performance 7 Minutes 00:08:01 00:08:15 00:08:25 00:08:45 00:09:38 00:09:17 00:09:28 90th Percentile Performance 15 Minutes 00:14:08 00:14:52 00:14:52 00:15:41 00:17:13 00:16:39 00:16:31 Category 1T (transported) Expected Standards Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Incidents 2,712 2,922 3,102 3,679 4,383 4,349 4,114 Responses 2,712 2,922 3,102 3,679 4,383 4,349 4,114 Resources Per Response Mean Performance 00:19:29 00:20:19 00:21:53 00:22:54 00:22:16 00:21:46 00:21:40 90th Percentile Performance 00:44:21 00:47:16 00:50:40 00:54:52 00:53:10 00:51:18 00:53:00 Category 2 Expected Standards Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Incidents 33,470 34,712 36,891 36,981 43,691 41,500 37,347 Responses 30,553 31,626 33,615 33,835 39,046 37,288 33,333 Resources Per Response Mean Performance 18 Minutes 00:23:47 00:26:40 00:29:08 00:33:04 00:39:29 00:37:10 00:41:29 90th Percentile Performance 40 Minutes 00:50:44 00:56:35 01:02:33 01:10:55 01:26:09 01:22:13 01:30:35 Category 3 Expected Standards Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Incidents 17,758 17,463 17,324 16,535 16,940 16,353 14,646 Responses 14,012 13,072 12,747 11,678 10,704 10,809 9,348 Resources Per Response Mean Performance 01:01:25 01:15:52 01:24:24 01:27:08 01:40:51 01:24:19 01:43:10 90th Percentile Performance 2 Hours 02:25:07 03:02:38 03:24:25 03:27:07 04:00:09 03:22:46 04:05:53 Category 4 Expected Standards Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Incidents 3,935 4,110 3,983 3,513 4,179 3,657 3,346 Responses Resources Per Response Mean Performance 00:55:31 01:25:33 01:16:21 01:19:31 01:31:41 01:21:28 01:21:25 90th Percentile Performance 3 Hours 02:17:58 04:16:55 04:20:22 03:49:11 04:42:22 03:15:08 03:04:21 Category 4 H Expected Standards Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Incidents 3,625 3,782 3,689 3,253 3,867 3,352 3,048 Responses Resources Per Response Mean Performance 00:25:43 00:28:29 00:30:47 00:40:42 00:21:23 00:26:05 00:29:09 90th Percentile Performance 01:09:57 00:46:13 01:09:00 01:52:55 00:47:35 01:20:13 01:06:26 Page 3

7 HCP Incidents & Response Times by Category (ASI) HCP 1 Hour Expected Standards Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Incidents 1, Responses Resources Per Response Mean Performance 01:29:54 01:51:29 01:56:27 02:01:58 02:27:22 02:02:42 02:08:09 90th Percentile Performance 02:50:29 03:26:48 03:41:56 04:08:01 05:34:41 03:57:21 04:45:20 HCP 2 Hours Expected Standards Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Incidents 1, Responses 1, Resources Per Response Mean Performance 02:07:00 02:22:17 02:29:08 02:41:57 02:39:09 02:23:03 01:56:48 90th Percentile Performance 03:42:28 03:59:37 04:09:20 04:57:03 04:37:35 04:20:25 03:36:04 HCP 3 Hours Expected Standards Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Incidents Responses Resources Per Response Mean Performance 03:11:24 01:50:14 04:27:51 01:39:40 01:47:32 02:01:11 01:21:35 90th Percentile Performance 04:02:57 04:22:27 05:28:33 02:43:49 02:28:13 02:33:17 02:20:18 HCP 4 Hours Expected Standards Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Incidents 1,855 2,128 2,205 2,037 2,226 2,532 1,829 Responses 1,699 1,916 1,927 1,731 1,845 2,192 1,536 Resources Per Response Mean Performance 03:21:39 03:52:41 04:10:06 04:37:10 04:28:38 03:55:08 03:40:31 90th Percentile Performance 06:07:29 06:54:02 07:10:20 07:39:11 08:04:53 07:25:04 06:52:41 EMAS All Standards Year Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar 2016/ Resources Per Response 2017/ Difference Lost Hours at Hospital & Cases Over 1 Hour (Pre-clinical handover) EMAS All Standards Year Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar 2016/ Lost Hours Pre Clinical Handover 2017/ Difference / Cases Over 1 Hour 2017/ Difference Lost hours at Hospital (EMAS) 2017/ / Cases Over 1 Hour (EMAS) 2017/ / Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar 0 Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Page 4

8 Incident Outcomes (National Tariff) Year Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar 2016/17 62,338 67,180 65,594 69,035 65,979 63,746 67,690 66,032 72,320 69,261 59,886 66,013 Incidents 2017/18 63,234 65,856 63,843 66,766 65,009 65,771 67,994 66,885 76,059 72,929 65,147 Difference 1.44% -1.97% -2.67% -3.29% -1.47% 3.18% 0.45% 1.29% 5.17% 5.30% 8.79% Contracted 17/18 63,654 68,866 67,211 70,892 67,407 65,316 71,490 70,995 74,693 75,144 70,120 77, /17 8,554 10,690 11,367 13,213 11,500 10,679 12,420 12,355 14,531 11,965 9,899 10,736 Hear & Treats 2017/18 9,884 10,853 10,294 11,934 11,792 12,841 13,173 12,797 16,680 14,745 13,819 Difference 15.55% 1.52% -9.44% -9.68% 2.54% 20.25% 6.06% 3.58% 14.79% 23.23% 39.60% Contracted 17/18 9,672 12,009 12,668 14,969 12,842 12,018 14,425 14,818 14,935 15,160 13,696 16, /17 15,836 16,525 15,755 16,069 15,697 15,148 15,745 15,245 17,244 16,968 14,480 15,720 See & Treats 2017/18 15,581 15,634 15,522 15,812 15,393 15,229 15,499 15,550 18,010 17,420 15,535 Difference -1.61% -5.39% -1.48% -1.60% -1.94% 0.53% -1.56% 2.00% 4.44% 2.66% 7.29% Contracted 17/18 16,453 17,064 16,285 16,559 16,200 15,736 17,215 16,526 17,779 17,765 16,995 18, /17 37,948 39,965 38,472 39,753 38,782 37,919 39,525 38,432 40,545 40,328 35,507 39,557 See, Treat & Conveys 2017/18 37,769 39,369 38,027 39,020 37,824 37,701 39,322 38,538 41,369 40,764 35,793 Difference -0.47% -1.49% -1.16% -1.84% -2.47% -0.57% -0.51% 0.28% 2.03% 1.08% 0.81% Contracted 17/18 37,529 39,793 38,258 39,364 38,365 37,562 39,850 39,651 41,979 42,219 39,429 41,814 Page 5

9 Capacity Management Plan Level (%) CMP Level Year Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar 2016/ % 25.94% 30.45% 31.00% / % 30.69% 33.98% 28.80% 28.13% 21.70% 14.02% 10.00% 2.82% 2.96% 2.38% Difference -4.71% % % 2016/ % 25.40% 26.57% 21.29% / % 23.55% 27.99% 24.90% 24.90% 13.21% 11.86% 12.50% 6.85% 12.23% 5.21% Difference -7.53% % % 2016/ % 20.43% 27.61% 36.52% / % 32.17% 23.40% 29.61% 35.80% 20.72% 17.52% 18.06% 17.20% 19.35% 16.82% Difference -7.40% -1.08% % 2016/ % 27.42% 15.37% 11.19% / % 13.59% 14.62% 16.69% 11.17% 44.37% 56.60% 59.44% 71.37% 61.69% 72.32% Difference 17.88% 34.27% 56.95% 2016/ % 0.81% 0.00% 0.00% / % 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 1.75% 3.76% 3.27% Difference 1.75% 2.95% 3.27% Page 6

10 EMAS Stand-Downs EMAS Year Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Stand - Downs 2016/17 23,116 23,895 21,932 23,465 21,226 21,044 20,364 19,581 21,133 19,301 17,359 18, /18 17,259 18,330 17,547 16,289 14,716 14,778 15,609 15,942 18,732 17,710 15,849 Difference % % % % % % % % % -8.24% -8.70% Meal Break Compliance (%) EMAS Year Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Meal Break Compliance (%) 2016/ % 41.78% 41.50% 45.04% 52.52% 48.28% 49.41% 47.41% 41.52% 45.82% 51.38% 54.13% 2017/ % 55.73% 60.32% 65.51% 80.70% 76.03% 72.17% 64.26% 44.57% 55.81% 57.08% Difference 11.57% 13.95% 18.82% 20.48% 28.18% 27.75% 22.76% 16.85% 3.05% 9.99% 5.70% Late Finish (Events > 1hr) EMAS Year Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Late Finish *Less than 5 Hrs *2016/ ,310 4,239 4,892 4,704 3,796 4,006 *2017/ ,936 4,050 4,225 4,320 4,069 Difference -1.69% 3.46% % % % -9.69% -8.68% -4.46% % -8.16% 7.19% Page 7

11 Clinical Cardiac arrest ACQI ROSC at hospital Special Cause Flag % of all patients who had resuscitation commenced/ continued by EMAS following an out-of-hospital cardiac arrest who had return of spontaneous circulation (ROSC) on arrival at hospital (January 2016 until December 2017). Data source: EMAS patient report forms (PRFs) % of all patients who had resuscitation commenced/ continued by EMAS following an out-of-hospital cardiac arrest who were discharged from hospital alive (January 2016 until December 2017). Data source: EMAS PRFs / NHS Summary Care Record data extracted and analysed by EMAS STEMI ACQI PPCI within 150 mins Special Cause Flag Jan-16 Feb-16 Mar-16 Apr-16 May-16 Jun-16 Jul-16 Aug-16 Sep-16 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 Jan-16 Feb-16 Mar-16 Apr-16 May-16 Jun-16 Jul-16 Aug-16 Sep-16 Oct-16 Nov-16 Dec-16 % ROSC Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17 Month Cardiac arrest ACQI Survival to discharge Special Cause Flag Jan-16 Feb-16 Mar-16 Apr-16 May-16 Jun-16 Jul-16 Aug-16 Sep-16 Oct-16 Nov-16 Dec-16 % survival Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17 Month % receiving PPCI within 150 mins Month % of all STEMI patients who received primary percutaneous coronary intervention (PPCI) following direct admission to a PPCI centre whose PPCI treatment took place within 150 minutes of call (January 2016 until October 2017). Data source: Myocardial Infarction National Audit Project (MINAP) data, extracted and analysed by EMAS Page 8

12 Clinical Continued STEMI AQCI care bundle Special Cause Flag Jan-16 Feb-16 Mar-16 Apr-16 May-16 Jun-16 Jul-16 Aug-16 Sep-16 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 % compliance Dec-17 Jan-18 Feb-18 Month % of all patients suffering a ST elevation myocardial infarction (STEMI) who received an appropriate care bundle (aspirin, GTN and analgesia administered and two pain scores recorded) (January 2016 until February 2018). February's result only contains eprf data and should be treated as provisional until it has been updated to include paper PRFs. Data source: EMAS PRFs Stroke ACQI Care bundle Special Cause Flag % compliance Jan-16 Feb-16 Mar-16 Apr-16 May-16 Jun-16 Jul-16 Aug-16 Sep-16 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 Dec-17 Jan-18 Feb-18 Month % of all of patients with suspected new stroke or transient ischaemic attack (TIA) who received an appropriate care bundle (FAST assessment, blood pressure and blood glucose measurement) (January 2016 until February 2018). February's result only contains eprf data and should be treated as provisional until it has been updated to include paper PRFs. Data source: EMAS PRFs Stroke ACQI Time to HASU within 60 mins Special Cause Flag 100 % arrived at HASU within 60 mins Jan-16 Feb-16 Mar-16 Apr-16 May-16 Jun-16 Jul-16 Aug-16 Sep-16 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 Month % of all Face Arm Speech Test (FAST) positive stroke patients potentially eligible for stroke thrombolysis (within local guidelines) who arrived at a hyper acute stroke centre (HASU) within 60 minutes of call (January 2016 until November 2017). Data source: EMAS PRFs / CAD data Page 9

13 Quality (A&E) Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar IR1 Serious Incidents Raising Concerns Complaints Compliments PALS Deep Clean % Locally Agreed % 98% 98% 99% 99% 99% 99% 99% 97% 100% 100% Quality (Derbyshire PTS) Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar IR1 Serious Incidents Raising Concerns Complaints Compliments PALS Deep Clean % Locally Agreed % 100% 100% 100% 100% 99% 100% 100% 100% 100% 100% Explanation of the Quality Data Serious Incidents in the IBR reflects the number of incidents reported on STEIS each month. This does not take into account any subsequent downgrading of Serious Incidents. The number of compliments reported in the IBR for each month is based upon the amount processed within each month, rather than the actual number received. A full review of the compliments recieved by the Trust is included in the patient experience annual report. Page 10

14 Workforce Group/Target Category Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Substantive FL Establishment Vacancy Gap 0% 0% 0% 0% 0% -1% 0% 0% 0% 0% 0% Qualified 82% 82% 82% 83% 83% 83% 83% 83% 83% 83% 83% Skill Mix Unqualified 18% 18% 18% 17% 17% 17% 17% 17% 17% 17% 17% Registered 44% 43% 43% 43% 43% 43% 43% 42% 42% 43% 42% Unregistered 56% 57% 57% 57% 57% 57% 57% 57% 57% 57% 58% ESR Sickness % (Short Term) 1.70% 1.65% 1.47% 1.90% 1.71% 1.84% 1.97% 2.04% 2.40% 2.55% 2.27% ESR Sickness % (Long Term) 3.90% 3.99% 4.48% 4.62% 4.80% 3.94% 4.03% 4.42% 4.80% 3.98% 4.08% 5.3% Validated ESR Sickness % 5.59% 5.64% 5.95% 6.53% 6.51% 5.78% 5.99% 6.46% 7.20% 6.54% 6.36% 33% GRS Operational Abstractions 29.3% 29.1% 30.3% 32.5% 33.6% 32.7% 33.4% 32.9% 31.1% 31.3% 32.8% Key: Unvalidated EMAS Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar 17/18 YTD - Appraisal Completions 17/18 Rolling 12 month - Appraisal Completions % Resus (YTD) % Resus (Rolling 12 Month, inc. EOC) % Safeguarding Children/Adults (YTD) % Safeguarding Children/Adults (Rolling 3 Years) % Moving & Handling (Frontline YTD) % Moving & Handling(Rolling 3 Years, Front Line) % Equality & Diversity (YTD) % Equality & Diversity (Rolling 3 Years) % Risk Management (YTD) % Risk Management (Rolling 3 Years) % Fire Safety (YTD) % Fire Safety (Rolling 2 Years) % IPC (Frontline YTD) % IPC (Rolling 12 months, front line staff only) % IG (YTD) % IG (Rolling 1 Year) 6.63% 28.48% 33.47% 42.64% 47.45% 56.28% 60.01% 65.46% 71.21% 72.07% 69.05% 65.48% 75.28% 77.04% 75.95% 72.72% 73.04% 72.71% 73.10% 75.25% 21.20% 30.55% 37.24% 46.08% 61.45% 70.28% 75.10% 79.90% 85.83% 85.00% 83.55% 74.16% 72.77% 63.16% 74.93% 81.41% 89.24% 81.95% 84.42% 87.30% 4.68% 6.16% 8.02% 10.18% 20.86% 22.52% 23.47% 23.95% 23.72% check 86.73% 86.45% 83.95% 81.71% 79.62% 76.82% 77.55% 75.10% 73.92% 71.73% 68.55% 19.17% 27.13% 32.36% 50.57% 61.94% 71.24% 76.38% 81.19% 86.81% 80.46% 79.14% 80.51% 80.76% 82.10% 82.64% 83.35% 85.03% 88.25% 2.70% 6.91% 8.23% 8.23% 12.71% 19.62% 21.77% 23.83% 29.40% 69.89% 69.64% 69.38% 70.59% 64.03% 70.40% 72.02% 73.61% 74.34% 74.66% 75.65% 3.90% 7.27% 12.46% 14.20% 16.59% 20.28% 21.20% 23.98% 29.34% 36.47% 35.39% 35.36% 37.91% 39.87% 41.31% 42.50% 44.74% 45.13% 46.82% 50.09% 7.71% 12.77% 16.18% 19.81% 26.66% 53.12% 33.58% 35.66% 41.58% 70.80% 68.76% 68.99% 70.53% 67.13% 71.09% 73.43% 74.41% 75.09% 75.90% 76.55% 20.19% 30.16% 34.40% 51.50% 62.46% 69.44% 76.42% 81.44% 87.30% 35.90% 81.63% 81.35% 83.43% 82.70% 81.32% 83.47% 85.51% 88.74% 3.60% 5.23% 6.09% 10.00% 13.32% 17.27% 19.65% 22.17% 27.57% 83.73% 83.12% 76.96% 72.00% 62.02% 55.93% 48.69% 42.65% 39.59% 33.45% 32.71% Green - rolling position expected to achieve 95% by 31/03/18. Year to Date on track to achieve target. Amber - rolling position expected to achieve between 80% and 94% by 31/03/18. Year to date expected to be within ten percentage points of target. Red - rolling position expected to achieve lower than 80% by 31/03/18. Year to date expected to be more than ten percentage points below target. Page 11

15 Derbyshire Patient Transport Services - Travel & Departure Times Travel under and equal to 10 miles spend <1hr on vehicle Travel between 11 and 34 miles within 90 minutes 95.00% 85.00% KPI 2a % Target % 84.95% 83.09% 83.42% 83.52% 83.97% 85.01% 82.38% 95.00% 85.00% 65.00% 55.00% KPI 2b % Target 93.16% 93.21% 91.06% 90.67% 91.18% 91.98% 92.83% Collected within 120 mins of booked collection time Collected within 150mins of booked collection 95.00% 85.00% 65.00% 55.00% KPI 3a % Target % 67.58% 70.46% 71.39% 73.03% 74.90% 74.27% 71.41% 95.00% 85.00% 65.00% 55.00% KPI 3b % Target % 75.82% 78.64% 79.47% 81.32% 82.03% 82.66% 78.72% Aug-17 Sep-17 Oct-17 Nov-17 Dec-17 Jan-18 Feb-18 Mar-18 Apr-18 May-18 Jun-18 Page 12

16 Derbyshire Patient Transport Services - Departure Times % Patients collected within 30 mins of booked collection % Patients collected within 80mins of Booked Collection KPI 3c % Target % KPI 3d % Target % 65.00% 55.00% 61.42% 59.84% 62.41% 62.53% 58.03% 61.13% 60.41% 95.00% 85.00% 65.00% 86.83% 86.58% 86.69% 87.40% 86.02% 87.02% 86.49% 45.00% 40.00% 55.00% Fast Track Journerys: % Collected within an agreed time frame (1hr Window) KPI 3e % Target % 95.00% 85.00% 65.00% 65.71% 83.33% 72.73% 72.73% 66.67% 81.40% 65.71% 55.00% Page 13

17 Derbyshire Patient Transport Services - Renal Patient arrival time 10 to 30mins prior to appointment time Patient transported no more than 30 mins after appointment KPI Renal 1 % Target % KPI Renal 2 % Target % 95.00% 85.00% 73.04% 76.96% 81.70% 79.39% 79.80% 81.09% 79.60% 40.00% 30.00% 37.80% 36.84% 37.36% 36.25% 36.42% 34.13% 34.36% 65.00% 55.00% 20.00% Patient travel time <10miles within 60 mins Patient travel time 11 to 34 miles within 90 mins 95.00% 85.00% 89.54% 90.86% 91.13% 89.81% KPI Renal 3a % Target % 91.35% 91.77% 92.28% 95.00% 85.00% KPI Renal 3b % Target % 97.38% 98.26% 96.65% 96.74% 97.36% 98.48% 97.56% 65.00% 65.00% 55.00% 55.00% Page 14

18 Derbyshire Patient Transport Services - Renal Arrival Data Renal Patients Arrival Data 0.79% 1.02% 2.01% 1.27% 1.71% 2.08% 2.13% 1.87% 1.85% 1.99% 3.07% 4.10% 5.59% 5.14% 5.34% 4.82% 4.86% 4.83% 5.48% 5.63% 9.94% 10.04% 11.03% 10.87% 10.12% Renal Patients Arrival Data 40.00% 37.36% 36.30% 36.45% 34.13% 34.28% 30.00% 20.00% 37.84% 35.75% 34.24% 37.95% 35.46% 10.00% 0.00% 4.47% 4.40% 3.68% 4.78% 5.33% -60 mins to -29 mins -30 to -9 mins -10 to 0 mins + 1 to 10 mins +11 to 30 mins +31 to 60 mins +Over 60 minutes Page 15