2014/15 CORE PERFORMANCE DASHBOARD April - June 2014 Published for Governing Body Meeting 7th August 2014

Transcription

1 ` 214/15 CORE PERFORMANCE DASHBOARD April - June 214 Published for Governing Body Meeting 7th August 214

2 Reducing years of life lost from causes amenable to healthcare Glossary Key Trend Performance against Target (R/A/G) Symbols and acronyms = Increase from last period On or better than target > Greater than, >= Greater than or equal to = Remained the same as last period Between target and 5% below < Less than, <= Less than or equal to = Decrease from last period Worse than target minus 5% TD = ear to date QTD = Quarter to date Column Key CCG = In CCG Outcome Indicator Set (Monitored at CCG Level and contribute to the overarching aims of the five domains in the NHS Outcomes Framework) NHS CR = Constitutional Requirements BCF = Better Care Fund Metric QP = Either a Quality Premium measure or a constitutional requirement where under performance will reduce the Quality Premium CTR = Contractual Requirement / Provider Performance Frequency A = Annual 6m = 6 monthly Q = Quarterly M = Monthly Denotes Data will not be published for the period Potential years of life lost from causes considered amenable to healthcare Target description Difference between expected life expectancy and age at death where death relates to specific (listed) conditions per 1, population Under 75 mortality rate from cardiovascular disease Number of deaths relating to cardiovascular disease per 1, GP registered population under the age of 75 Under 75 mortality rate from respiratory disease Number of deaths relating to respiratory disease per 1, GP registered population under the age of 75 Under 75 mortality rate from liver disease Number of deaths relating to liver disease per 1, GP registered population under the age of 75 Under 75 mortality rate from cancer Number of deaths relating to cancer per 1, GP registered population under the age of 75 Emergency admissions for alcohol-related liver disease Adult emergency admissions for alcohol-related liver disease (Rate per 1,) Unplanned hospitalisation for chronic ambulatory care sensitive Unplanned hospital admissions for chronic ambulatory sensitive conditions (ACS) conditions (Rate per 1,) Unplanned hospitalisation for asthma, diabetes and epilepsy (under 19s) Unplanned hospital admissions for asthma, diabetes and epilepsy for - 19 year olds (Rate per 1,) Adult emergency admissions for acute conditions (ear/nose/throat Emergency admissions for acute conditions that should not usually infections, kidney/urinary tract infections, heart failure) that should not require hospital admission usually require hospital admission (rate per 1,) Emergency admissions for children with lower respiratory tract infections Emergency admissions for children with the preliminary diagnosis of (Rate per 1, population) respiratory tract infection. (Rate per 1,) Basis of Target 12% reduction from 212 to 218/19. Straight line trajectory to achieve that reduction. Reduction in the numbers of patient deaths from cardiovascular disease Reduction in the numbers of patient deaths from respiratory disease Reduction in the numbers of patient deaths from liver disease Reduction in the numbers of patient deaths from cancer disease Reduction in the numbers of patient emergency admissions from alcohol-related liver disease Reduction in the numbers of unplanned admissions for chronic ambulatory sensitive conditions Reduction in the numbers of unplanned admissions for under 19's for asthma, diabetes and epilepsy Reduction in the numbers of emergency admissions for acute conditions where they would not normally incur a hospital admission Reduction in the numbers of emergency admissions for children with lower respiratory tract infections A&E waiting time - total time in the A&E department: HARROGATE A&E waiting time - total time in the A&E department: ORK Percentage of patients treated, discharged, or transferred within 4 hours at Harrogate Hospital Percentage of patients treated, discharged, or transferred within 4 hours at ork Hospital 95% threshold (nationally mandated) 95% threshold (nationally mandated) Page 2

3 t Safety Urgent Care Response Target description The percentage of Category A Red 1 incidents (presenting conditions that may be immediately life -threatening and the most time critical), which resulted in an emergency response arriving at the scene of the incident Ambulance: Cat A (Red 1) - 8 minute response time (AS Trust Level) within 8 minutes. At Ambulance Provider level - the CCG will have its Quality Premium Reduced if the orkshire Ambulance Trust does not meet the target The percentage of Category A Red 2 incidents (presenting conditions which may be life threatening but less time critical than Red 1), which resulted in an emergency response arriving at the scene of the incident Ambulance: Cat A (Red 2) - 8 minute response time (AS Trust Level) within 8 minutes. At Ambulance Provider level - the CCG will have its Quality Premium Reduced if the orkshire Ambulance Trust does not meet the target The percentage of Category A Red 1 incidents resulting in an ambulance Ambulance: Cat A (Red 1) - 19 minute response time (AS Trust Level) arriving at the scene within 15 minutes The percentage of Category A Red 2 incidents resulting in an ambulance Ambulance: Cat A (Red 2) - 19 minute response time (AS Trust Level) arriving at the scene within 15 minutes Handovers between ambulance and A&E taking place within 15 minutes, The number of instances where handover of a patient's care from the no one waiting more than 3 minutes ambulance crew to A&E takes longer then 3 minutes Handovers between ambulance and A&E taking place within 15 minutes, The number of instances where handover of a patient's care from the no one waiting more than 6 minutes ambulance crew to A&E takes longer then 6 minutes Following handover ambulance crew should be ready to accept new calls within 15 minutes The number of instances where an ambulance crew, following handover of a patient, is not ready to accept new calls within 3 minutes Basis of Target 75% threshold (nationally mandated) 75% threshold (nationally mandated) 95% threshold (nationally mandated) 95% threshold (nationally mandated) > threshold (nationally mandated) > threshold (nationally mandated) > threshold (nationally mandated) Following handover ambulance crew should be ready to accept new calls within 15 minutes Trolley waits in A&E not longer than 12 hours Avoidable emergency admissions (Composite Indicator for the Quality Premium) Avoidable emergency admissions per 1, population (average per month) BCF Area Friends and Family test for A&E - Harrogate and District The number of instances where an ambulance crew, following handover of a patient, is not ready to accept new calls within 6 minutes The number of instances where a patient who has been assessed in A&E has waited longer than 12 hours to be admitted following the decision to admit being made. Number of emergency admissions deemed avoidable (list of conditions) per 1, population. Composite indicator built using unplanned admissions for asthma, lower respiratory tract infections, diabetes and epilepsy. Average number of emergency admissions deemed avoidable per month per 1, population (The composite measure will match that used in the Quality Premium except it will be based on Local authority (using resident population) rather than CCG geography (GP registered population). It will also be the crude rate rather than the indirectly standardised rate used in the Quality Premium. The Friends and Family Test (FFT) is a single question survey which asks patients whether they would recommend the NHS service they have received to friends and family who need similar treatment or care > threshold (nationally mandated) > threshold (nationally mandated) To earn the QP, this must be a % change or a reduction on the baseline Agreed with CCG and local Health and Well Being Board. Improvement in year from 213/14 and full roll out at Provider level. Friends and Family test for A&E - ork The Friends and Family Test (FFT) is a single question survey which asks patients whether they would recommend the NHS service they have received to friends and family who need similar treatment or care Improvement in year from 213/14 and full roll out at Provider level. Mixed Sex Accommodation Breaches (Rate per 1 FCEs) Incidence of healthcare associated infection (HCAI): MRSA Incidence of healthcare associated infection (HCAI): Clostridium difficile Total number of breaches of the same sex accommodation guidelines per Nationally Mandated (Zero tolerance) 1 Finished Consultant Episodes Total number of patients of that acquired MRSA as a result of a Nationally Mandated reduction on baseline (set nationally for each healthcare intervention provider and for each CCG) Total number of patients of that acquired Clostridium Difficile as a result of Nationally Mandated reduction on baseline (target to be defined - from a healthcare intervention for the whole year. NHS England) Page 3

4 Waiting Times Quality & Patient Patient Safety Incidents reported Increased reporting of medication errors VTE risk assessment: all inpatient Service Users undergoing risk assessment for VTE - Harrogate VTE risk assessment: all inpatient Service Users undergoing risk assessment for VTE - ork Target description Total number of safety incidents (ie, any unintended or unexpected incident which could have or did lead to harm for one or more patients receiving NHS care) reported within the reporting period Actual number of reported medication errors, to maximise learning and provide guidance on minimising harm for both medication and medical device errors Actual numbers of inpatient service users (adults) that are risk assessed for Venous thromboembolism Actual numbers of inpatient service users (adults) that are risk assessed for Venous thromboembolism Basis of Target Expect to see increased reporting. Expect to see increased reporting. 95% threshold (nationally mandated) 95% threshold (nationally mandated) Referral to Treatment pathways: admitted Referral to Treatment pathways: non admitted Referral to Treatment pathways: incomplete Number of >52 week Referral to Treatment in Admitted, Non-Admitted & Incomplete Pathways Diagnostic test waiting times All Cancer 2 week waits Breast Cancer 2 week waits Cancer 31 day waits: first definitive treatment Cancer 31 day waits: subsequent cancer treatments - surgery CCG Position Cancer 31 day waits: subsequent cancer treatments - anti cancer drug regime Cancer 31 day waits: subsequent cancer treatment - radiotherapy CCG Position Cancer 62 day waits: % receiving first definitive treatment within two months of an urgent GP referral for suspect cancer (incl 31 day Rare cancers) Cancer 62 day waits: % receiving first definitive treatment for cancer within 62 days of referral from an NHS Cancer Screening Service CCG Position Cancer 62 day waits: % receiving first definitive treatment for cancer within 62 days of a consultant decision to upgrade their priority status Actual numbers of patients whose treatment started during the period and 9% threshold (nationally mandated) involved admission to hospital Actual numbers of patients whose treatment started during the period and 95% threshold (nationally mandated) did not involve admission to hospital Actual numbers of patients waiting to start treatment at the end of the 92% threshold (nationally mandated) month. Total numbers of patients on RTT pathways for either Admitted, Non Admitted or Incomplete pathways that have been waiting longer than 52 > threshold (nationally mandated) weeks. Total numbers of patients that have received Diagnostic Test results 99% threshold (nationally mandated) within 6 weeks Actual numbers of patients urgently referred for suspected cancer by their 93% threshold (nationally mandated) GP were seen by a specialist within 14 days of referral Actual numbers of patients urgently referred by their GP with exhibited breast symptoms (where cancer was not initially suspected) were seen by 93% threshold (nationally mandated) a specialist within 14 days of referral. Actual numbers of patients, who have had their first definitive treatment for cancer within 31 days of a cancer diagnosis (also known as their 96% threshold (nationally mandated) 'Decision to Treat') Actual numbers of patients, who waited 31 days or less for a second or 94% threshold (nationally mandated) subsequent treatment, where the treatment modality was surgery Actual numbers of patients, who waited 31 days or less for a second or subsequent treatment, where the treatment modality was an anti-cancer 98% threshold (nationally mandated) regime Actual numbers of patients, who waited 31 days or less for a second or subsequent treatment, where the treatment modality was radiotherapy Actual numbers of patients, who have had their first definitive treatment for cancer within 62 days of an urgent GP referral for suspected cancer. This is inclusive of 31 day rare cancer cases. Actual numbers of patients, who have had their first definitive treatment for cancer within 62 days of an NHS Cancer Screening Service having referred them for treatment Actual numbers of patients, who have had their first definitive treatment for cancer within 62 days of a consultants decision to upgrade their priority status 94% threshold (nationally mandated) 85% threshold (nationally mandated) 9% threshold (nationally mandated) 9% threshold (nationally mandated) Breast feeding prevalence at 6-8 weeks Antenatal assessments < 13 weeks Actual number of patient prevalence of breastfeeding at 6 to 8 weeks. NB Quarterly dataset, delayed (first data available December 214 due to indicator construction. I.e. Babies born and monitored for 8 weeks, plus a month for data collection = one quarter delay ) A measure of the number of maternities compared with how many antenatal assessments were carried out before 13 weeks gestation An increase in the prevalence of new mothers breastfeeding at 6 to 8 weeks An increase in the % volume of antenatal assessments, when compared with the number of maternities Page 4

5 Community / Primary Care and Integrated Care Inpatient Care Total health gain as assessed by patients for elective procedures a) hip replacement b) knee replacement c) groin hernia d) varicose veins Cancelled Operations - Harrogate and District Cancelled Operations - ork No Urgent Operation should be cancelled for a second time - Harrogate No Urgent Operation should be cancelled for a second time - ork Patient experience of hospital care - Harrogate and District Patient experience of hospital care - ork Friends and Family Test for inpatient acute - Harrogate and District Friends and Family Test for inpatient acute - ork Delayed transfers of care (delayed days) from hospital per 1, population (average per month) Better Care Fund Area Target description Patient reported outcomes for their inpatient care in one (or more) of the 4 procedural areas (hip replacement / knee replacement / groin hernia / varicose vein) Assessment of the overall actual number of procedures that have been cancelled within the period Assessment of the overall actual number of procedures that have been cancelled within the period Assessment of the actual number of urgent procedures that have been cancelled on more than one occasion within the period Assessment of the actual number of urgent procedures that have been cancelled on more than one occasion within the period Assessment of patient experience across a range of inpatient hospital care questions (communications, cleanliness, information, etc ) for patients aged 16 and over Assessment of patient experience across a range of inpatient hospital care questions (communications, cleanliness, information, etc ) for patients aged 16 and over The Friends and Family Test (FFT) is a single question survey which asks patients whether they would recommend the NHS service they have received to friends and family who need similar treatment or care The Friends and Family Test (FFT) is a single question survey which asks patients whether they would recommend the NHS service they have received to friends and family who need similar treatment or care Measure of effective joint working of local partners, and is a measure of the effectiveness of the interface between health and social care services. Basis of Target An increase in the overall total health gain assessments from patients in relation to at least one of the following, hip replacement, knee replacement, groin hernia or varicose vein procedures. A reduction in the actual numbers of procedures cancelled A reduction in the actual numbers of procedures cancelled Nationally Mandated Nationally Mandated Based on a.1% improvement year on year Based on a.1% improvement year on year Achievement of FFT is based on improved score from to and full roll out at Provider level. Achievement of FFT is based on improved score from to and full roll out at Provider level. The level of ambition set as part of the Better Care Fund planning as agreed by the Health and Well Being Board Falls in the over 65s - CCG Area Measure for those aged 65 years and over identifying all hospital admissions due to unintentional (accidental) fall Based on a 1.4% reduction Falls in the over 65s - Better Care Fund Area Measure for those aged 65 years and over identifying all hospital admissions due to unintentional (accidental) fall Based on a 1.4% reduction Improved health related quality of life for people with long-term conditions A measure to show the health status score for individuals aged 18 and over that have a LTC This measure is an assessment of the status that leads towards the avoiding of permanent placements in residential and nursing care homes Permanent admissions of older people (aged 65 and over) to residential and is a good indication of delaying dependency on local health and and nursing care homes, per 1, population. Better Care Fund Area social care services who work together to reduce avoidable admissions. Uses the BCF area Population. Proportion of older people (aged 65 and over) who were still at home 91 days after discharge from hospital into reablement / rehabilitation services. Better Care fund Area Patient experience of Primary Care - GP services Patient experience of Primary Care - GP Out of Hours Services This measures the benefit to individuals from reablement, intermediate care and rehabilitation following a hospital episode, by determining whether an individual remains living at home 91 days following discharge. Performance at a Local Authority level for the BCF metric Patient experience of GP services, measured by scoring the results of one question from the GP Patient Survey (GPPS) Patient experience of GP out-of-hours services, measured by scoring the results of one question from the GP Patient Survey (GPPS) Based on an 8% increase from /19. 1% per year improvement. Level of ambition set as part of the Better Care Fund planning as agreed by the Health and Well Being Board Level of ambition set as part of the Better Care Fund planning as agreed by the Health and Well Being Board A reduction in the numbers of patients reporting a poor overall experience of GP services CCG PR says.1% is this correct?.1% reduction of patients reporting a poor experience of GP Care in relation to OOH services. % of people who are moving to recovery The number of people who are moving to recovery as a proportion of those who have completed a course of psychological treatment National suggested level of achievement is 5% Locally agreed target of 5% Page 5

6 Locally Monitored Mental Health Increasing Access to Psychological Therapies: Proportion of people entering therapy Dementia Diagnosis Rate % of those patients on a Care Programme Approach (CPA) discharged from inpatient care who are followed up within 7 days Target description The number of people who have been referred into IAPT service in the period. Whole year, quarterly target is phased. A measure to assess the improvement in the numbers of people diagnosed with dementia in the period A measure to reduce risk in key groups which includes early follow up by mental health providers of people discharged from in-patient care Basis of Target National expectation of increased numbers with a target of 15% by the end of Locally agreed minimum of 6% for 214/15 National expectation of 67% by 215 Locally agreed minimum of 55% for 214/15 95% threshold (nationally mandated) % Stroke patients that spend at least 9% of their time in hospital on a dedicated stroke ward % non-admitted patients who have a Transient Ischaemic Attack and a higher risk of stroke, who are treated (including all relevant investigations) within 24 hours of contacting a healthcare professional % patients seen in the month who have not waited longer than 9 weeks for first appointment - Adult Mental Health Services % patients seen in the month who have not waited longer than 9 weeks for first appointment - Adult Learning Disability Services % patients seen in the month who have not waited longer than 9 weeks for first appointment - Children & oung Peoples Services % patients seen in the month who have not waited longer than 9 weeks for first appointment - Mental Health Services for Older People Patient Transport Service Pick up prior to appointment (within 12 mins) AS North Consortium Patient Transport Service Arrival on time for appointment AS North Consortium Patient Transport Service Pick up after appointment within 9 mins (planned journey only) AS North Consortium Number of people being picked up within 12 minutes of their appointment time Number of people arriving within 12 minutes of their appointment time Number of people being collected for their homeward journey within 9 minutes of being 'marked ready' 8% threshold (locally monitored indicator) 6% threshold (locally monitored indicator) 9% threshold (locally monitored indicator) 9% threshold (locally monitored indicator) 9% threshold (locally monitored indicator) 9% threshold (locally monitored indicator) Threshold 9% Green rating= >9% threshold Amber rating less than 9% to 83% Red rating < 83% of patients Threshold 82% Green rating = >82% Amber rating less than 82% to 71% Red rating <71% Threshold 9% Green rating => 9% of patients should be collected for their homewards journey within 9 minutes of being marked ready If less than 9% but more than 83% of patients are collected within 9 minutes the performance will be rated amber If less than 83% of patients are collected within 9 minutes the performance will be rated red Patient Transport Service Pick up after appointment within 12 mins (SN and OD journeys only) AS North Consortium Number of people whose discharge/transfer journey has been booked on the day who are collected within 12 minutes of being 'marked ready' Threshold 99% Green rating =>99% of patients should be collected within 12 minutes of being 'marked ready' If less than 99% but more than 98.5% of patients are collected within 12 minutes the performance will be rated ''amber'' if less than 98.5% of patients are collected within 12 minutes the performance will be rated ''red'' Page 6

7 Number of Indicators Red Amber Green Quality Premium Constitutional Indicators Percentage of quality premium achieved translatable to eligible quality premium funding Preventing people from dying prematurely 15% Improving access to psychological therapies 15% Avoidable emergency admissions 25% Friends and family test and patient experience 15% Improved reporting of medication safety incidents 15% Falls in the Over 65s 15% Urgent Care Quality and Patient Safety 5 Mental Health Community / Integrated Care NHS Constitution rights and pledges - Measure(s) achieved adjustment to Quality premium funding, minus 25% per measure not met Referral to treatment times (18 weeks) -25% A&E waits -25% Cancer waits 14 days -25% Category A Red 1 ambulance calls -25% Page 7

8 Performance Period Exception applies to Contract Sanctions / Levers Commentary TD13/14 A&E waiting time - total time in the A&E department: ORK 95% 94.1% Declining position over first three months of 14/15. An action plan is in place and being monitored by the lead commissioner. Less than 1% of the A&E attendances at ork are for HaRD registered patients. TD13/14 Ambulance: Cat A (Red 1) - 8 minute response time (AS Trust Level) 75% 69.1% CCG level TD performance is above target at 78.2%. TD Demand for combined Red 1 & 2 at Trust level has seen an increase of 14.8% and at CCG level the increase is 2%. A recovery plan is in place which is being closely monitored by commissioners with work underway with the provider to understand the reasons for increase in demand and impact on performance. TD13/14 Ambulance: Cat A (Red 2) - 8 minute response time (AS Trust Level) 75% 69.5% CCG performance (TD) is slightly below target at 74.6%. The aforementioned recovery plan is being closely monitored by commissioners. TD13/14 TD13/14 Handovers between ambulance and A&E taking place within 15 minutes, no one waiting more than 3 minutes (HDFT trust level) Following handover ambulance crew should be ready to accept new calls within 15 minutes. Number between 3 and 6 mins (AS at Harrogate District Hospital) Financial, 2 per wait over 3 min Financial, 2 per event > 3 minutes 5 This relates to 5 breaches at HDFT. Patients handed over between minutes. 19 There were 9 breaches in the June. However, the average time taken for crew to be clear was 9 minutes 46. In the same month, 85.3% of handovers met target (721 occasions). Although TD performance stands at 19 against a zero tolerance, this is an improvement on the average monthly figure for 13/14. TD13/14 Following handover ambulance crew should be ready to accept new calls within 15 minutes. Number > 6 mins (AS at Harrogate District Hospital) Financial, 1 per event > 6 minutes 1 Represents 1 breach in June between 1-2 hours. Page 8

9 Performance Period Exception applies to Contract Sanctions / Levers Commentary TD13/14 Friends and Family test for A&E - Harrogate and District CQUIN Whilst HDFT s TD performance is currently 14% below target, in May performance was only 2% below national average (52 against national average of 54). The Harrogate score was compiled from a sample size of 838 respondents, equating to HDFT requiring a positive response from an additional 17 respondents to match national average. TD13/14 Friends and Family test for A&E - ork CQUIN Performance for ork Hospital is below target for both TD and shows a downward trend in month (May). Performance remains significantly below national average in month (4 against target of 59). An action plan is in place and being managed by the lead commissioner. Page 9

10 Performance Period Exception applies to Contract Sanctions / Levers Commentary TD13/14 Breast Cancer 2 week waits Financial - 2 for each breach above 93% 91.1% TD performance is below target at 91.1%, which relates to 5 breaches in May (total of 4 of 45 patients were seen within 2 weeks; a total of 42 of 45 patients would have to be seen in 2 weeks to achieve performance target). 4 of these occurred at ork Hospital and 1 at Leeds Teaching Hospitals. Page 1

11 Performance Period Exception applies to Contract Sanctions / Levers Commentary TD13/14 Delayed transfers of care (delayed days) from hospital per 1, population (average per month) BCF Area Significant increase in delayed days from April to May (147.8 to 34.5) mainly in awaiting a residential placement and waiting further NHS non-acute care. Future monitoring required to understand if May is an exception or a trend. Page 11

12 Performance Period Exception applies to Contract Sanctions / Levers Commentary May-14 % non-admitted patients who have a Transient Ischaemic Attack and a higher risk of stroke, who are treated (including all relevant investigations) within 24 hours of contacting a healthcare professional 6% 56.3% Low patient numbers has affected May reporting. TD position remains above target (7.6% against 6% target). TD 13/14 % patients seen in the month who have not waited longer than 9 weeks for first appointment - Adult Mental Health Services 9% 73.1% Improvement in May, and as of June, there are no 9 week waits. TD 13/14 % patients seen in the month who have not waited longer than 9 weeks for first appointment - Adult Learning Disability Services 9% 55.6% TD performance is below target (55.6% against target of 9%). May figures show improvement from 5% to 57.1%. Of the 3 breaches, 1 due to patient choice and 2 due to data quality issues. TD 13/14 % patients seen in the month who have not waited longer than 9 weeks for first appointment - Mental Health Services for Older People 9% 82.1% TD performance affected by underachievement of target in May (75.3%) which relates 23 patients. The issue relates to staff capacity. TD 13/14 Patient Transport Service Arrival on time for appointment AS North Consortium 82% 79.7% TD performance for HaRD CCG is 71.9%. Work underway with provider to understand performance and reasons for breaches across all performance indicators. TD 13/14 TD 13/14 Patient Transport Service Pick up after appointment within 9 mins (planned journey only) AS North Consortium Patient Transport Service Pick up after appointment within 12 mins (SN and OD journeys only) AS North Consortium 9% 89.1% TD performance for HaRD CCG is above target at 91.8%. 99% 96.7% TD performance for HaRD CCG is above target at 99.6%. Page 12

13 Reducing years of life lost from causes amenable to healthcare CCG NHS CR BCF QP CTR Frequency Date Updates Due / Data Expected Links and Contract Sanctions / Levers Latest Data / Outturn Quarter To Date TD Month, Trend ( Increase Remained the same Decrease) and Performance against Target (On Target Within 5% Worse than 5%) Apr-14 May-14 Jun-14 Jul-14 Aug-14 Oct-14 Nov-14 Dec-14 Jan-15 Feb-15 Mar-15 Potential years of life lost from causes considered amenable to healthcare A 13/14 data PLL Awaiting 13/14 outturn 27.7 Under 75 mortality rate from cardiovascular disease A 13/14 data PLL Awaiting 13/14 outturn 6.22 Under 75 mortality rate from respiratory disease A 13/14 data PLL Awaiting 13/14 outturn Under 75 mortality rate from liver disease A 13/14 data PLL Awaiting 13/14 outturn Under 75 mortality rate from cancer A 13/14 data PLL Awaiting 13/14 outturn Emergency admissions for alcohol-related liver disease Q Q4 13/14 data PLL Reduction in admission s 1.9 Unplanned hospitalisation for chronic ambulatory care sensitive conditions (ACS) Q Q4 13/14 data PLL Reduction in admission s Unplanned hospitalisation for asthma, diabetes and epilepsy (under 19s) Q Q4 13/14 data PLL Reduction in admission s Emergency admissions for acute conditions that should not usually require hospital admission Q Q4 13/14 data PLL Reduction in admission s Emergency admissions for children with lower respiratory tract infections (Rate per 1, population) Q Q4 13/14 data PLL Reduction in admission s 552. Page 13

14 Urgent Care Response CCG NHS CR BCF QP CTR Frequency Date Updates Due / Data Expected Links and Contract Sanctions / Levers Latest Data / Outturn Quarter To Date TD Month, Trend ( Increase Remained the same Decrease) and Performance against Target (On Target Within 5% Worse than 5%) Apr-14 May-14 Jun-14 Jul-14 Aug-14 Oct-14 Nov-14 Dec-14 Jan-15 Feb-15 Mar-15 A&E waiting time - total time in the A&E department: HARROGATE A&E waiting time - total time in the A&E department: ORK M 95% 97.3% 97.7% 96.5% Financial, 2 per breach beyond threshold M 95% 94.9% 94.7% 94.1% 97.4% 97.1% 97.1% 93.3% 94.1% 94.1% Ambulance: Cat A (Red 1) - 8 minute response time (AS Trust Level) M 75% 77.4% 69.8% 69.6% 68.% 69.1% 69.1% Ambulance: Cat A (Red 2) - 8 minute response time (AS Trust Level) Ambulance: Cat A (Red 1) - 19 minute transportation time (AS Trust Level) Withholding of 2% of monthly M contract value, 75% 75.% 7.6% 69.5% with annual reconciliation and total M withholding of 95% 96.9% 97.2% 97.% 2% if targets not met (no interest) 68.4% 69.5% 69.5% 96.7% 97.% 97.% Ambulance: Cat A (Red 2) - 19 minute transportation time (AS Trust Level) M 95% 97.3% 96.1% 95.8% 95.5% 95.8% 95.8% Handovers between ambulance and A&E taking place within 15 minutes, no one waiting more than 3 minutes (HDFT trust level) M Financial, 2 per wait over 3 min Handovers between ambulance and A&E taking place within 15 minutes, no one waiting more than 6 minutes (HDFT trust level) M Financial, 1 per wait over 6 min 7 Following handover ambulance crew should be ready to accept new calls within 15 minutes. Number between 3 and 6 mins (AS at Harrogate District Hospital) M Financial, 2 per event > 3 minutes Following handover ambulance crew should be ready to accept new calls within 15 minutes. Number > 6 mins (AS at Harrogate District Hospital) M Financial, 1 per event > 6 minutes Trolley waits in A&E not longer than 12 hours M Financial 1 per incident Avoidable emergency admissions per 1, of the population (Composite Indicator for the Quality Premium) M Reduction of 13/14 position (1682) Page 14

15 CCG NHS CR BCF QP CTR Frequency Date Updates Due / Data Expected Links and Contract Sanctions / Levers Latest Data / Outturn Quarter To Date TD Month, Trend ( Increase Remained the same Decrease) and Performance against Target (On Target Within 5% Worse than 5%) Avoidable emergency admissions per 1, population (average per month) BCF Area M Awaiting Q1 position from NCC to Sep to Mar Apr-14 May-14 Jun-14 Jul-14 Aug-14 Oct-14 Nov-14 Dec-14 Jan-15 Feb-15 Mar-15 Friends and Family test for A&E - Harrogate and District M CQUIN Friends and Family test for A&E - ork M CQUIN Page 15

16 Quality & Patient Safety CCG NHS CR BCF QP CTR Frequency Date Updates Due / Data Expected Links and Contract Sanctions / Levers Latest Data / Outturn Quarter To Date TD Month, Trend ( Increase Remained the same Decrease) and Performance against Target (On Target Within 5% Worse than 5%) Apr-14 May-14 Jun-14 Jul-14 Aug-14 Oct-14 Nov-14 Dec-14 Jan-15 Feb-15 Mar-15 Mixed Sex Accommodation Breaches (Rate per 1 FCEs) M Financial, 25 per day per service user..1.. Incidence of healthcare associated infection (HCAI): MRSA M Financial, 1k per incidence in month 5 Incidence of healthcare associated infection (HCAI): Clostridium difficile M Financial, Quarterly 1k per incidence beyond threshold Patient Safety Incidents reported 6M Should be investigated RCA as appropriate Increase in reporting Increased reporting of medication errors 6M Should be investigated RCA as appropriate Increase in reporting VTE risk assessment: all inpatient Service Users undergoing risk assessment for VTE - Harrogate M Financial - 2 for each breach above threshold 95% 97.1% 97.5% 97.5% 97.5% VTE risk assessment: all inpatient Service Users undergoing risk assessment for VTE - ork M Financial - 2 for each breach above threshold 95% 96.5% 95.8% 95.8% 95.8% Page 16

17 Waiting Times CCG NHS CR BCF QP CTR Frequency Date Updates Due / Data Expected Links and Contract Sanctions / Levers Latest Data / Outturn Quarter To Date TD Month, Trend ( Increase Remained the same Decrease) and Performance against Target (On Target Within 5% Worse than 5%) Referral to Treatment pathways: admitted M By Provider, Specialty Level 4 per breach beyond threshold 9% 93.5% 93.1% Apr % May % Jun-14 Jul-14 Aug-14 Oct-14 Nov-14 Dec-14 Jan-15 Feb-15 Mar % 93.9% Referral to Treatment pathways: non admitted M By Provider, Specialty Level 1 per breach beyond threshold 95% 97.4% 97.1% 96.9% 97.% 97.% 97.% Referral to Treatment pathways: incomplete M At Provider, Specialty Level 1 per breach beyond threshold 92% 96.1% 97.1% 97.1% 96.9% 96.9% 96.9% Number of >52 week Referral to Treatment in Admitted, Non-Admitted & Incomplete Pathways M Financial, 5 per breach 3 Diagnostic test waiting times M Financial - 2 for each breach above threshold 99% 99.7% 99.6% 99.5% 99.7% 99.7% 99.7% All Cancer 2 week waits M Financial - 2 for each breach above threshold 93% 98.7% 98.% 98.6% 98.3% 98.3% Breast Cancer 2 week waits M Financial - 2 for each breach above threshold 93% 97.1% 93.3% 88.9% 91.1% 91.1% Cancer 31 day waits: first definitive treatment M Financial - 1 for each breach above threshold 96% 98.9% 1.% 1.% 1.% 1.% Cancer 31 day waits: subsequent cancer treatments - surgery M Financial - 1 for each breach above threshold 94% 99.1% 1.% 94.1% 97.1% 97.1% Cancer 31 day waits: subsequent cancer treatments - anti cancer drug regime M Financial - 1 for each breach above threshold 98% 1.% 1.% 1.% 1.% 1.% Cancer 31 day waits: subsequent cancer treatment - radiotherapy M Financial - 1 for each breach above threshold 94% 97.6% 96.7% 1.% 98.2% 98.2% Cancer 62 day waits: % receiving first definitive treatment within two months of an urgent GP referral for suspect cancer (incl 31 day Rare cancers) M Financial - 1 for each breach above threshold 85% 88.5% 92.3% 88.9% 9.7% 9.7% Page 17

18 CCG NHS CR BCF QP CTR Frequency Date Updates Due / Data Expected Links and Contract Sanctions / Levers Latest Data / Outturn Quarter To Date TD Month, Trend ( Increase Remained the same Decrease) and Performance against Target (On Target Within 5% Worse than 5%) Cancer 62 day waits: % receiving first definitive treatment for cancer within 62 days of referral from an NHS Cancer Screening Service Cancer 62 day waits: % receiving first definitive treatment for cancer within 62 days of a consultant decision to upgrade their priority status. CCG Position M Financial - 1 for each breach above threshold 9% 95.1% 1.% Apr-14 May-14 Jun-14 Jul-14 Aug-14 Oct-14 1.% 1.% 1.% M 9% 1.% 1.% 1.% 1.% 1.% Nov-14 Dec-14 Jan-15 Feb-15 Mar-15 Page 18

19 Inpatient Care CCG NHS CR BCF QP CTR Frequency Date Updates Due / Data Expected Links and Contract Sanctions / Levers Latest Data / Outturn Quarter To Date TD Month, Trend ( Increase Remained the same Decrease) and Performance against Target (On Target Within 5% Worse than 5%) Apr-14 May-14 Jun-14 Jul-14 Aug-14 Oct-14 Nov-14 Dec-14 Jan-15 Feb-15 Mar-15 Breast feeding prevalence at 6-8 weeks Q Q1 due Dec % Antenatal assessments < 13 weeks Q Q1 due Dec % Total health gain as assessed by patients for elective procedures a) hip replacement b) knee replacement c) groin hernia d) varicose veins M M1 due Oct 14 PROMS Link to Best Practice Tariff An Increase in overall health gain Cancelled Operations - Harrogate and District Q Q1 due Aug 14 Financial Sanction.%.% Cancelled Operations - ork Q Q1 due Aug 14 Financial Sanction 6.%.2% No Urgent Operation should be cancelled for a second time - Harrogate M Financial - 5 per incidence in month No Urgent Operation should be cancelled for a second time - ork M Financial - 5 per incidence in month Patient experience of hospital care - Harrogate and District A CQUIN Patient experience of hospital care - ork A CQUIN Friends and Family Test for inpatient acute - Harrogate and District M CQUIN Friends and Family Test for inpatient acute - ork M CQUIN Delayed transfers of care (delayed days) from hospital per 1, population (average per month) BCF Area M Page 19

20 Community / Primary Care and Integrated Care CCG NHS CR BCF QP CTR Frequency Date Updates Due / Data Expected Links and Contract Sanctions / Levers Latest Data / Outturn Quarter To Date TD Month, Trend ( Increase Remained the same Decrease) and Performance against Target (On Target Within 5% Worse than 5%) Apr-14 May-14 Jun-14 Jul-14 Aug-14 Oct-14 Nov-14 Dec-14 Jan-15 Feb-15 Mar-15 Falls in the over 65s - CCG Area M Aug-14 QP Falls in the over 65s - BCF Area M Awaiting Q1 position from NCC LOCAL BCF 1% reduction 1696 Improved health related quality of life for people with long-term conditions A 13/14 data due June 14 1% improvem ent (78.2 people in year) 79.4 Permanent admissions of older people (aged 65 and over) to residential and nursing care homes, per 1, population - NORTH ORKSHIRE A 13/14 data due July 14 < 476 (annual figure) Proportion of older people (aged 65 and over) who were still at home 91 days after discharge from hospital into reablement / rehabilitation services - NORTH ORKSHIRE A Patient experience of Primary Care - GP services A Patient experience of Primary Care - GP Out of Hours Services A 13/14 data due July 14 Awaiting data from GP Patient Survey Awaiting data from GP Patient Survey 85.9% 85.5% Reduction in the numbers of patients reporting.1% reduction of patients reporting a poor Page 2

21 Mental Health CCG NHS CR BCF QP CTR Frequency Date Updates Due / Data Expected Links and Contract Sanctions / Levers Latest Data / Outturn Quarter To Date TD Month, Trend ( Increase Remained the same Decrease) and Performance against Target (On Target Within 5% Worse than 5%) Apr-14 May-14 Jun-14 Jul-14 Aug-14 Oct-14 Nov-14 Dec-14 Jan-15 Feb-15 Mar-15 % of people who are moving to recovery M Jul-14 5% 54.4% Increasing Access to Psychological Therapies: Proportion of people entering therapy Q Oct-14 15% 5.2% Dementia Diagnosis Rate A 13/14 data in Oct 14 55% % of those patients on a Care Programme Approach (CPA) discharged from inpatient care who are followed up within 7 days Q Aug-14 95% 97.9% Page 21

22 Locally Monitored CCG NHS CR BCF QP CTR Frequency Date Updates Due / Data Expected Links and Contract Sanctions / Levers Latest Data / Outturn Quarter To Date TD Month, Trend ( Increase Remained the same Decrease) and Performance against Target (On Target Within 5% Worse than 5%) Apr-14 May-14 Jun-14 Jul-14 Aug-14 Oct-14 Nov-14 Dec-14 Jan-15 Feb-15 Mar-15 % Stroke patients that spend at least 9% of their time in hospital on a dedicated stroke ward % non-admitted patients who have a Transient Ischaemic Attack and a higher risk of stroke, who are treated (including all relevant investigations) within 24 hours of contacting a healthcare professional % patients seen in the month who have not waited longer than 9 weeks for first appointment - Adult Mental Health Services M 8% 88.7% 9.5% 8.% 91.7% 87.9% 87.9% M 6% 69.4% 73.3% 56.3% 82,4% 7.6% 7.6% M 9% 81.7% 72.3% 73.8% 73.1% 73.1% % patients seen in the month who have not waited longer than 9 weeks for first appointment - Adult Learning Disability Services M 9% 95.7% 5.% 57.1% 55.6% 55.6% % patients seen in the month who have not waited longer than 9 weeks for first appointment - Children & oung Peoples Services M 9% 99.7% 1.% 1.% 1.% 1.% % patients seen in the month who have not waited longer than 9 weeks for first appointment - Mental Health Services for Older People M 9% 96.5% 89.% 75.3% 82.1% 82.1% Patient Transport Service Pick up prior to appointment (within 12 mins) AS North Consortium M 9% 91.5% 93.4% 92.% 92.3% 92.3% Patient Transport Service Arrival on time for appointment AS North Consortium M 82% 78.1% 8.4% 8.8% 79.7% 79.7% Patient Transport Service Pick up after appointment within 9 mins (planned journey only) AS North Consortium M 9% 89.6% 89.4% 88.3% 89.1% 89.1% Patient Transport Service Pick up after appointment within 12 mins (SN and OD journeys only) AS North Consortium M 99% 98.7% 95.9% 95.7% 96.7% 96.7% Page 22

23 Potential years of life lost from causes considered amenable to healthcare 2,1. 2,5. 2,. 1,95. 1,9. 1,85. 1, Calendar ear Potential years of life lost from causes considered amenable to healthcare Target Calendar ear Under 75 mortality rate from cardiovascular disease Target Calendar ear Under 75 mortality rate from respiratory disease Target Under 75 mortality rate from liver disease Target Under 75 mortality rate from cancer Target Emergency admissions for alcohol-related liver disease Calendar ear Calendar ear Quarter Unplanned 2 hospitalisation for 15 chronic ambulatory care 1 sensitive conditions 5 (ACS) Unplanned hospitalisation for asthma, diabetes and epilepsy (under 19s) Emergency admissions for acute conditions that should not usually require hospital admission Quarter Quarter Quarter Emergency admissions for children with lower respiratory tract infections (Rate per 1, population) Quarter Page 23

24 Urgent Care Response Charts 99.% 99.% 85.% 85.% 97.% 97.% 8.% 8.% 95.% 93.% 95.% 93.% 75.% 75.% 91.% 89.% 87.% 91.% 89.% 87.% 7.% 65.% 7.% 65.% 85.% A&E waiting time - total time in the A&E department: HARROGATE 85.% A&E waiting time - total time in the A&E department: ORK 6.% Ambulance: Cat A (Red 1) - 8 minute response time (AS Trust Level) 6.% Ambulance: Cat A (Red 2) - 8 minute response time (AS Trust Level) 1.% 99.% 98.% 97.% 96.% 95.% 94.% 93.% 92.% Ambulance: Cat A (Red 1) - 19 minute transportation time (AS Trust Level) 1.% 99.% 98.% 97.% 96.% 95.% 94.% 93.% 92.% 91.% Ambulance: Cat A (Red 2) - 19 minute transportation time (AS Trust Level) 85.% 8.% 75.% 7.% 65.% 6.% Ambulance: Cat A (Red 2) - 8 minute response time (AS Trust Level) Handovers between ambulance and A&E taking place within 15 minutes, no one waiting more than 3 minutes (HDFT trust level) Handovers between ambulance and A&E taking place within 15 minutes, no one waiting more than 6 minutes (HDFT trust level) Following handover ambulance crew should be ready to accept new calls within 15 minutes. Number between 3 and 6 mins (AS at Harrogate District Hospital) Following handover ambulance crew should be ready to accept new calls within 15 minutes. Number > 6 mins (AS at Harrogate District Hospital) Trolley waits in A&E not longer than 12 hours Avoidable emergency admissions per 1, of the population (Composite Indicator for the Quality Premium) Avoidable emergency admissions per 1, population (average per month) BCF Area Friends and Family test for A&E - Harrogate and District Friends and Family test for A&E - ork Page 24

25 Quality and Patient Safety Charts Mixed Sex Accommodation Breaches (Rate per 1 FCEs) Incidence of healthcare associated infection (HCAI): MRSA Incidence of healthcare associated infection (HCAI): Clostridium difficile Cumulative 1 1.% 1.% % 98.% 97.% 96.% 95.% 94.% 93.% 99.% 98.% 97.% 96.% 95.% 94.% 93.% 92.% 91.% Incidence of healthcare associated infection (HCAI): Clostridium difficile VTE risk assessment: all inpatient Service Users undergoing risk assessment for VTE - Harrogate VTE risk assessment: all inpatient Service Users undergoing risk assessment for VTE - ork Page 25

26 Waiting Times Charts 1.% 98.% 96.% 94.% 92.% 9.% 88.% 86.% Referral to Treatment pathways: admitted 1.% 99.% 98.% 97.% 96.% 95.% 94.% 93.% Referral to Treatment pathways: non admitted 1.% 99.% 98.% 97.% 96.% 95.% 94.% 93.% 92.% 91.% 9.% Referral to Treatment pathways: incomplete 2 1 Number of >52 week Referral to Treatment in Admitted, Non-Admitted & Incomplete Pathways 1.% 99.% 98.% 97.% 96.% 95.% 94.% 93.% 92.% Diagnostic test waiting times 1.% 99.% 98.% 97.% 96.% 95.% 94.% 93.% 92.% 91.% All Cancer 2 week waits 1.% 98.% 96.% 94.% 92.% 9.% 88.% 86.% 84.% 82.% 8.% Breast Cancer 2 week waits 1.% 99.% 98.% 97.% 96.% 95.% 94.% 93.% 92.% Cancer 31 day waits: first definitive treatment 1.% 99.% 98.% 97.% 96.% 95.% 94.% 93.% 92.% 91.% 9.% Cancer 31 day waits: subsequent cancer treatments - surgery 1.% 99.5% 99.% 98.5% 98.% 97.5% 97.% Cancer 31 day waits: subsequent cancer treatments - anti cancer drug regime 1.% 99.% 98.% 97.% 96.% 95.% 94.% 93.% 92.% 91.% 9.% Cancer 31 day waits: subsequent cancer treatment - radiotherapy 1.% 98.% 96.% 94.% 92.% 9.% 88.% 86.% 84.% 82.% 8.% Cancer 62 day waits: % receiving first definitive treatment within two months of an urgent GP referral for suspect cancer (incl 31 day Rare cancers) 1.% 98.% 96.% 94.% 92.% 9.% 88.% 86.% 84.% 82.% 8.% Cancer 62 day waits: % receiving first definitive treatment for cancer within 62 days of referral from an NHS Cancer Screening Service 12.% 1.% 8.% 6.% 4.% 2.%.% Cancer 62 day waits: % receiving first definitive treatment for cancer within 62 days of a consultant decision to upgrade their priority status. Page 26

27 Inpatient Care Charts 5.% 12.% 1.% 48.% 46.% 44.% 42.% 4.% 1.% 8.% 6.% 4.% 9.% 8.% 7.% 6.% 5.% 4.% 3.% 38.% 36.% Q1 Q2 Q3 Q4 Breast feeding prevalence at 6-8 weeks 2.%.% Q1 Q2 Q3 Q4 Antenatal assessments < 13 weeks 2.% 1.%.% Q1 Q2 Q3 Q4 Cancelled Operations - Harrogate and District 7.% 6.% 5.% 4.% 3.% 2.% 1.%.% Q1 Q2 Q3 Q4 Cancelled Operations - ork 1.% 9.% 8.% 7.% 6.% 5.% 4.% 3.% 2.% 1.%.% No Urgent Operation should be cancelled for a second time - Harrogate Mar-11 Mar-12 Mar-13 Mar-14 Mar-15 Patient experience of hospital care - Harrogate and District Jan-11 Jan-12 Jan-13 Jan-14 Jan Patient experience of hospital care - ork Friends and Family Test for inpatient acute - Harrogate and District Friends and Family Test for inpatient acute - ork Delayed transfers of care (delayed days) from hospital per 1, population (average per month) BCF Area Page 27