Performance Management report - Category A 8 Minute Response Time (East of England SHA)

Transcription

1 Performance Management report - Category A 8 Minute Response Time (East of England SHA) Ambulance Clinical Quality - Category A 8 Minute Response Time PHQ01 Preventing people dying prematurely data collected via Unify East of England SHA + NHS Norfolk % of Cat A incidents with an emergency response arriving at the scene within 8 minutes 80% 75% 70% 65% 60% 55% 50% 2012/13 EoE 2011/12 EoE Target 2012/13 NHS Norfolk 2011/12 NHS Norfolk Year East of England 2012/ % 74.6% 74.4% 78.0% 77.0% 72.7% 73.9% 74.8% 69.2% 71.8% 69.8% 2011/ % 75.2% 75.1% 74.8% 76.9% 76.1% 77.6% 75.3% 73.2% 76.1% 72.7% 76.2% NHS Norfolk 2012/ % 64.7% 65.3% 66.7% 65.0% 59.4% 63.5% 62.5% 59.0% 58.3% 57.5% 2011/ % 65.9% 60.7% 61.3% 67.8% 69.2% 71.3% 61.9% 60.0% 61.3% 59.6% 63.8% Purpose / rationale: Category A incidents: presenting conditions, which may be immediately life threatening and should receive an emergency response within 8 minutes irrespective of location in 75% of cases. The "clock stops" when the first emergency response vehicle arrives at the scene of the incident. A legitimate clock stop position can include the vehicle arriving at a pre-arrival rendezvous point when one has been determined as appropriate for the safety of ambulance staff in agreement with the control room. Faster response times improve health outcomes and experience for patients with immediately life-threatening conditions. Comments: Reasonably static level of performance from April to August this year. There has been a general downward trend in performance since August, with the last six months failing to hit the 75% target for the East of England region. EEast are only contractually required to meet the 75% target regionally, but they are not currently achieving this for the year to date.

2 Performance Management report - Category A 19 Minute Transportation Time (East of England SHA) Ambulance Clinical Quality - Category A 19 Minute Transportation Time PHQ02 Preventing people dying prematurely data collected via Unify East of England SHA + NHS Norfolk % of Cat A incidents resulting in an ambulance arriving at the scene within 19 minutes 100% 98% 96% 94% 92% 90% 88% 86% 84% 82% 80% 2012/13 EoE 2011/12 EoE Target 2012/13 NHS Norfolk 2011/12 NHS Norfolk Year East of England 2012/ % 94.4% 94.2% 95.0% 94.8% 92.8% 93.5% 94.3% 92.2% 92.8% 92.3% 2011/ % 95.5% 94.8% 94.7% 94.8% 94.8% 94.8% 94.7% 93.7% 94.8% 93.7% 95.3% NHS Norfolk 2012/ % 88.6% 88.4% 89.0% 88.1% 84.3% 86.4% 86.4% 85.9% 83.3% 82.9% 2011/ % 91.4% 88.5% 88.0% 89.5% 90.9% 90.8% 88.3% 87.7% 87.7% 85.4% 89.3% Purpose / rationale: Category A incidents: presenting conditions, which may be immediately life threatening and should receive an ambulance response at the scene within 19 minutes irrespective of location in 95% of cases. The "clock stops" when the first emergency response vehicle able to transport the patient arrives at the scene of the incident. A legitimate clock stop position can include the vehicle arriving at a pre-arrival rendezvous point when one has been determined as appropriate for the safety of ambulance staff in agreement with the control room. Patient outcomes can be improved by ensuring patients with immediately life-threatening conditions receive a response at the scene which is able to transport the patient in a clinically safe manner, if they require such a response. Comments: Reasonably static level of performance from April to August this year. There has been a general downward trend in performance since August, with the last seven months failing to hit the 95% target for the East of England region. EEast are only contractually required to meet the 95% target regionally they are currently slightly below this target for the year to date.

3 Performance Management report - Improved Access to Psychological Services Mental Health Measure - Improved Access to Psychological Services PHQ13_1 Enhancing quality of life for people with long-term conditions NHS Information Centre Omnibus Survey NHS Norfolk (all) People that enter psychological therapy treatment against the level of need in the general population 1,200 1, /13 Target Year 2012/ , /12* N/a N/a N/a N/a N/a N/a N/a N/a N/a N/a N/a N/a Purpose / rationale: This indicator focuses on improved access to psychological therapies, in order to address the enduring unmet need. Around one in six adults in England suffer from a common mental health problem, such as depression or an anxiety disorder. Collecting this indicator will demonstrate the extent to which this need is being met. Numerator: the number of people who receive psychological therapies. Comments: Consistent underperformance for the year to date, with only three months out of twelve achieving the 922 per month target (target of 11,064 for full year). *This is a new indicator for 2012/13, so complete data is not available for 2011/12.

4 Performance Management report - Improved Access to Psychological Services Mental Health Measure - Improved Access to Psychological Services PHQ13_2 Enhancing quality of life for people with long-term conditions NHS Information Centre Omnibus Survey NHS Norfolk (all) The proportion of people who complete treatment who are moving to recovery 60% 50% 40% 30% 20% 10% 0% 2012/13 Target Year 2012/ % 49.2% 46.1% 47.2% 42.6% 40.3% 41.8% 46.7% 42.0% 43.6% 46.7% 52.5% 2011/12* N/a N/a N/a N/a N/a N/a N/a N/a N/a N/a N/a N/a Purpose / rationale: The primary purpose of this indicator is to measure improved access to psychological therapies (IAPT) for people with depression and/or anxiety disorders. This is done using two indicators: PHQ13_1 - The number of people that enter treatment against the level of need in the general population (the level of prevalence addressed or captured by referral routes); and PHQ13_2 - The proportion of people who complete treatment who are moving to recovery. Numerator: The number of people who have completed treatment having attended at least two treatment contacts and are moving to recovery (those who at initial assessment achieved "caseness and at final session did not) Denominator: The number of people who have completed treatment within the reporting quarter, having attended at least two treatment contacts. Comments: Consistent underperformance for the year to date, with only three months out of twelve achieving the 50% target. However, performance for the most recent month (March 2013) was above target. *This is a new indicator for 2012/13, so no data is available for 2011/12.

5 Performance Management report - Unplanned hospitalisation for chronic ambularoty care sensitive conditions (adults) Unplanned hospitalisation for chronic ambulatory care sensitive conditions (adults) PHQ15 Helping people to recover from episodes of ill health or following injury Hospital Episode Statistics (HES) NHS Norfolk (all) 600 The number of persons aged over 18 with chronic conditions admitted to hospital as an emergency admission /13 Target (11/12) Year 2012/ / Purpose / rationale: Healthcare contribution: Earlier and more accurate diagnosis, making optimal use of referral pathways and available interventions, support after primary treatment. Better support to people to self-manage their condition. Public health and social care contribution: Public health interventions that may mitigate disease progression including reducing tobacco use, alcohol consumption, illicit drug use, obesity, increasing physical activity. Other contributions include prevention, early identification and management of risk factors, including high cholesterol and blood pressure, diabetes and chronic kidney disease; the level and quality of support received from social care; TIA interventions; the quality of care received whilst living at home or in residential care e.g. recognition of the symptoms of stroke, medication compliance, mitigation of social isolation. The NHS has a responsibility to engage with social care and public health services to increase the effectiveness of its work for people who suffer from these chronic conditions. Drivers of the outcome beyond NHS control: Socio economic status, prevalence of co-morbidities.. Comments: The target for this indicator is for the number of admissions to be equal to or less than the previous year. Overall for this financial year to date, the number of admissions is 2% higher than the equivalent months for 2011/12 (4,623 for 2012/13, 4,516 for 2011/12).

6 Performance Management report - Unplanned hospitalisation for asthma, diabetes and epilepsy in under 19s Unplanned hospitalisation for asthma, diabetes and epilepsy in under 19s PHQ16 Helping people to recover from episodes of ill health or following injury Hospital Episode Statistics (HES) NHS Norfolk (all) 70 Number of emergency admission episodes in people under 19 (0 18 years) for asthma, diabetes or epilepsy /13 Target (11/12) Year 2012/ / Purpose / rationale: Healthcare contribution: Earlier and more accurate diagnosis, making optimal use of referral pathways and available interventions, support after primary treatment. Better support to people to self-manage their condition. Public health and social care contribution: Public health interventions that may mitigate disease progression including reducing tobacco use, alcohol consumption, illicit drug use, obesity, increasing physical activity. Other contributions include prevention, early identification and management of risk factors, including high cholesterol and blood pressure, diabetes and chronic kidney disease. The level and quality of support received from social care. The quality of care received whilst living at home or in residential care e.g. recognition of the symptoms of stroke, medication compliance, mitigation of social isolation. The NHS has a responsibility to engage with social care and public health services to increase the effectiveness of its work for people who suffer from these chronic conditions Drivers of the outcome beyond NHS control: Socio economic status, prevalence of co-morbidities. Comments: Performance for this indicator has been volatile throughout the year. This is largely due to the small number of patients that are included in the calculation for the indicator, with numbers ranging from 22 patients in August to 64 patients in September for NHS Norfolk. Overall for this financial year to date, the number of admissions is 4% higher than the equivalent months for 2011/12 (514 for 2012/13, 494 for 2011/12).

7 Performance Management report - Emergency admissions for acute conditions that should not usually require hospital admission Unplanned hospitalisation for asthma, diabetes and epilepsy in under 19s PHQ17 Helping people to recover from episodes of ill health or following injury Hospital Episode Statistics (HES) NHS Norfolk (all) Number of emergency admissions to hospital for persons with acute conditions (ENT infections, kidney/uti, heart failure) usually managed in primary care. 2012/13 Target (11/12) Year 2012/ / Purpose / rationale: Healthcare contribution: Ensuring that the appropriate level of care is provided for these conditions in the community and unnecessary hospital admissions are avoided. Public health and social care contribution: Public health contributions to encouraging healthy behaviours, including reduced use of tobacco, alcohol and illicit drugs, quality of social care at home and in care homes, mitigation of social isolation. Drivers of the outcome beyond NHS control: Fuel poverty, prevalence of long-term conditions and co-morbidities.. Comments: The target for this indicator is for the number of admissions to be equal to or less than the previous year. Overall for this financial year to date, the number of admissions is 1% higher than the equivalent months for 2011/12 (7,296 for 2012/13, 7,198 for 2011/12).

8 Performance Management report - Referral to Treatment (RTT) Pathway for Admitted Pathways Admitted RTT PHQ19 Ensuring that people have a positive experience of care Consultant-led Referral to Treatment Waiting Times data collection (National Statistics) Norfolk and Norwich University Hospital (NNUH) - all patients The percentage of Referral to Treatment (RTT) pathways within 18 weeks for patients on completed admitted pathways 100% 90% 80% 70% 60% 50% 40% 2012/13 all specialties 2011/12 all specialties Target 2012/13 Orthopaedics 2011/12 Orthopaedics Year All specialties 2012/ % 85.1% 85.5% 91.4% 89.2% 90.2% 91.4% 90.5% 91.6% 90.5% 90.1% 2011/ % 88.9% 92.3% 90.3% 89.3% 90.7% 91.5% 91.6% 88.7% 83.7% 82.1% 78.3% Orthopaedics only 2012/ % 54.8% 62.0% 68.9% 69.2% 63.8% 64.6% 64.4% 65.2% 64.3% 57.1% 2011/ % 64.1% 66.7% 69.8% 70.0% 62.8% 69.6% 70.7% 64.6% 56.2% 46.1% 51.5% Purpose / rationale: As set out in the NHS Operating Framework for 2012/13, the operational standards of 90 per cent for admitted and 95 per cent for non-admitted completed waits as set out in the NHS Constitution remain. In order to sustain the delivery of these standards, trusts will need to ensure that 92 per cent of patients on an incomplete pathway should have been waiting no more than 18 weeks. The referral to treatment (RTT) operational standards should be achieved in each specialty by every organisation and this will be monitored monthly.. Comments: Persistent underperformance for Orthopaedics. A steady improvement from February until August, although performance levelled out between September and January. However, February's performance has reduced further to 57%. The NNUH have agreed to send the CCG a weekly Orthopaedic patient tracking list to enable practices to review the lists and, if appropriate, use the Referral Management Centre to offer patients who look likely to breach the 18 week target an alternative provider.

9 Performance Management report - PHQ23 A&E wait times A&E wait time - percentage of patients who spent 4 hours or less in A&E PHQ23 Ensuring that people have a positive experience of care A&E activity reports - DoH website Weekly Norfolk and Norwich University Hospital (NNUH) - all patients % of patients who spent 4 hours or less in A&E at NNUH (inc Cromer MIU) 100% 95% 90% 85% 80% 75% 70% 2012/ /12 Target Year 2012/ % 96.9% 96.3% 97.0% 97.0% 94.0% 93.4% 95.9% 96.0% 95.3% 93.7% 2011/ % 96.6% 96.5% 96.8% 96.2% 94.4% 97.5% 96.4% 95.2% 91.3% 88.4% 93.9% Purpose / rationale: Longer lengths of stay in the emergency department are associated with poorer health outcomes and patient experience as well as transport delays, treatment delays, ambulance diversion, patients leaving without being seen, and financial effects. It is critical that patients receive the care they need in a timely fashion, so that patients who require admission are placed in a bed as soon as possible, patients who need to be transferred to other healthcare providers receive transport with minimal delays, and patients who are fit to go home are discharged safely and rapidly. There is professional agreement that some patients need prolonged times in A&E. However, these exceptions are rare and unlikely to account for more than 5% of attendances. International literature suggests increases in adverse outcomes for patients who have been in the A&E for more than 4-6 hours. Comments: Static level of performance, above the 95% target from April to August this year. Performance dropped below target for September and October, and has again dropped below target in February 2013.