System Resilience Dashboard

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1 NHS Dorset Clinical Commissioning Group - Business Intelligence System Resilience Dashboard Produced by: Phil Dove Data source: SUS/National Data Date published: 28/1/215 Supporting people in Dorset to lead healthier lives Supporting people in Dorset to lead healthier lives

2 NHS DORSET CLINICAL COMMISSIONING GROUP SYSTEM RESILIENCE DASHBOARD CONTENTS 1 Headlines.. 3 Page 2 Dashboard Service 5 4 Ambulance Service 6 5 Emergency Department (A&E) Emergency Admissions Referrals and Waiting List.. 9

3 NHS DORSET CLINICAL COMMISSIONING GROUP SYSTEM RESILIENCE DASHBOARD Headlines:- Note: December updates for SUS data are currently unavailable Weekly Sit Rep Comparison - w/e 18-Jan-15 Delayed discharges remain high across all local providers when compared to the same week last year. Number of escalation beds open is significantly higher at & SFT. No Urgent Ops cancelled 2nd time, 1 cancelled in the previous week 111 Service (Whole Dorset Service) 1% increase in calls received and triaged by 111 service with a 39% increase in ambulance dispatches compared to 213/14. The total number of Ambulances dispatched by the 111 service in week ending 25th January is slightly up, rate of conveyance remains the same (5.2%) compared to the same period in January 214 Current recommendations to attend A&E remain consistent. Recommendations to attend primary care has dropped back down to early December levels. Calls answered within 6 seconds was notably below target in December 214, whilst performance has improved this is still notably below target. Ambulance Service Hear & Treat outcomes continue to be significantly above last years levels (up 36%). Total calls are 9% above the same period in 213/14. See & Conveys have increased by 9% resulting in on average an extra 5 conveyances per month compared to same period in 213/14. However as a percentage of total calls, See & Convey is only slightly higher (5.2%) than in 213/14 (49.8%). See and Treat up 3%. Red 1 performance is above Target at 82.6% for Dec-14 for Dorset CCG patients. SWAST has dropped below the 75% target for the year to date period to December 214 at 74.7% National benchmarking indicates excellent levels of Non Conveyance. Emergency Department Delivery of the 95% seen in 4 hours standard in Quarter 3 was met by (96.4%), with attaining 92.% & 92.3%. Attendances year to date 214/15 remain above levels seen in 213/14 ( 1%, 8%, 2%) however comparison with the last 6 weeks from 213/14 and 214/15 show a larger increase of ( 11%, 13%, 9%). Conversion rate of A&E attendances to Emergency Admissions are marginally higher than the National average. attendances in hours are up 8% whilst is -2.5% under last year's figures. OOH attendances are up at all 3 providers - 8%; 4%; 4% Emergency Admissions Emergency admissions remain significantly higher than 213/14 levels - 1%; 7%; 14%. There has been a significant increase in emergency admissions Via A&E at of 21%. Comparison of Emergency Admissions in the past six weeks (compared to 213) show increases at (12.6%) and (14.9%), decreases by.8% Short stay admissions via A&E (defined as zero length of stay) are up 35% at and 23% at. Overall length of stay as a result is down by just under 1 day at both providers. Increased same day treatment of patients with ambulatory care conditions is contributing to this trend. Delayed Transfers of Care Oct to Dec 214, local Providers reported on average approximately 5, bed days lost a month due to DToC. Residential home placements account for the majority of delays followed by Care Packages in Own Home & Patient/Family Choice. All providers are failing to achieve the 3.5% benchmark standard. Referrals and Waiting List Referrals have increased at all local providers in 214/15 with up 6%, 5% and 4% higher than the same period last year. Overall GP referrals are up 5% with a third of this increase related to Fast Track referrals. 18 Week RTT positions are beginning to improve following the NHS England backlog clearing exercise and performance improved further in November 214. Non-admitted 18 week RTT backlog at has increased in recent weeks - related mainly to Neurology & Paediatric Ophthalmology. Trajectory now agreed and in place to recover this position for Neurology. 3

4 Triage & Conveyance Dec-14 Emergency Admission Conversion Rates 4hr Breaches SWAST Red 1 (8) 77.6% 75.1% 74.7% 69.6% England Week ending 4-Jan 11-Jan 18-Jan 25-Jan Q3 213/14 32% 32% 26% 28% 111 Calls (6 secs) 62.6% 77.% 9.4% 83.1% Q3 214/15 31% 29% 28% 28% Routes into ED:- Data up to End unless otherwise stated ED Attendances by Referral Source - % Difference to 213/14 (Dorset CCG Patients) 111 Service Ave. Diff per Week 213/14 V 214/15 YTD SWASFT Comparison of 13/14 YTD v 14/15 YTD % Diff % Diff % Diff % Diff % Diff As at 25/1/15 % Diff Diff As at end Dec-14 % Diff Diff All Attendances 1% 232 8% 319 2% 834 1% 335.3% 1 Calls Triaged 9% 326 Calls 9% 8,395 Self Referral -2% % 116 % -117 Ambulance Dispatches 39% 115 Hear & Treat 36% 2,57 Emergency Services - 15% % -512 Recommended to Attend A&E Recommended to Attend Primary Care Emergency Admissions (data up to End ) Data up to End unless otherwise stated Emergency Admissions Via A&E with days Length of Stay 23% 42 Conveyances 9% 4,617 OOHs Attendances 4% 599 9% 216 5% 21 See & Treat 3% 1,271 6% 132 ED Outcome SCASFT Jul-Oct 1314 to Jul-Oct 1415 % Diff Diff % Diff % Diff % Diff Conveyances to 6% 7 Discharged-No GP Follow U 4% % % 218 (213/14 only available from ) Admitted % 19 1% % 1337 Transferred -17% % -65 5% 21 Emergency Admissions by Source Comparison - Apr-Nov 13/14 to Apr-Nov 14/15 Comparison - Apr-Nov 13/14 to Apr-Nov 14/15 YTD 13/14 YTD 14/15 Diff % Diff % Diff % Diff % Diff % All EM Admiss 1% 995 7% % % Via ED 5% 345 6% % % Via GP 13% 27 3% 177 3% 158 Delayed Transfers of Care Emerg Admiss with LoS - Diff to Ave. per Month 214/15 YTD Conditions Respiratory Skin Circulation Neurological SYSTEM RESILIENCE DASHBOARD Referrals Data up to : Trend %: 28 12%: 34 16%: 267 *All providers includes,,, SFT, YDH, BMI, Ramsey 12%: 187 4%: %: 39 12%: 139 %: 6 21%: 4 1%: 26 6%: 212-1%: -21 Weekly Sit Rep Comparison Q3 14/ % 92.% 92.3% Provider 4-Jan % 85.1% 82.5% Diff to YTD 213/14 All Providers* 7484 % Diff % Jan % 91.4% 93.9% MIU 5% 4% 6% 18-Jan % 91.7% 92.4% Walk In Centre* *Boscombe & Springbourne KPI Provider (Mar14 figure) Dec-14 Number of Beds Days Lost in Month Dorset County (158) Poole (561) Royal Bournemouth (299) Salisbury (555) Yeovil (25) Ave. Escalation Beds Open per day Ave. No. of Delayed Discharges per day Norovirus - Ave. No. Beds Closed each day Elective Ops Cancelled (weekly total) Urgent Ops Cancelled (weekly total) Week Ending Jan Jan Jan Jan Jan , SFT DHUFT (1,269) 1,583 1,25 1,335 1,57 1,423 1,811 1,549 1,363 YDH

5 May-12 May-12 May-12 12/5/13 26/5/13 May-12 23/6/13 14/7/13 4/8/13 1/9/13 22/9/13 2/1/13 1/11/13 1/12/13 19/1/14 16/2/14 9/3/14 May-12 Attendances Activity data = Dept Type ED; First & Unplanned Follow Up attendances Emergency Department (A&E) Emergency Departments Weekly Attendances 4 Hour Wait in ED 14-Dec Dec Dec-14 4-Jan Jan Jan-15 % Seen in 4 Hours Week Ending 21-Dec Dec-14 4-Jan Jan Jan-15 1,225 1,31 1,226 1,23 1,97 1, % 94.4% 93.3% 88.9% 92.4% 1,65 1,596 1,538 1,539 1,459 1, % 83.% 85.1% 91.4% 91.7% 86.6% 9.5% 82.5% 93.9% 92.4% ,141 1,11 1,5 1,29 1,32 1,38 1,491 1,398 1,34 1,353 1,376 1,457 Comparison of 214/15 YTD to 213/14 (data up to end ) Difference to Previous Year 13/14 YTD 14/15 YTD Diff % Diff 24,583 24, % 25 % Diff to Prev Year (6 week total) Provider 14 % 38,539 41, % 37,848 38, % % % 9% 14-Dec Dec Dec-14 4-Jan Jan Jan Emergency Department Attendances (Monthly SUS data) /15 YTD & 213/14 YTD 319; 8.3% ;.9% 834; 2.2% Average(mean) ED Self Attendances Referral ED - Attendances Self Referral /15 YTD & 213/14 YTD -337; -2.3% 116; 4.4% -117; -.4% ED Attendances In Hours - Diff 213/14 V 214/15 YTD -367; - 3.6% 1174; 7.4% -159; - 1.% ED Attendances - Out of Hours 3 599; 4.2% 216; 8.9% 993; 4.5% Diff 213/14 V 214/15 YTD ED Attendances - Discharged - No GP Follow Up Difference 213/14 V 214/15 561; 4.3% 1453; 23.5% 218; 2.3% Weymouth Wimborne Bridport Swanage Shaftesbury Memorial Yeatman, Sherborne MIU First Attendances per Hour (Apr-Nov14) Portland ph; 4,14 1st atts 1.2 ph; 2,227 1st atts 1.1 ph; 1,971 1st atts.9 ph; 1,868 1st atts 1.8 ph; 3,29 1st atts 1.8 ph; 4,717 1st atts Adjusted for Opening hours ph = per hour 2.6 ph; 9,3 1st atts Blandford.8 ph; 1,531 1st atts 7

6 Days Via A&E Emerg Admiss Emergency Admission Conversion Rates Emergency Admissions (from A&E Type 1 attendances) England 14-Dec Dec Dec-14 4-Jan Jan Jan-15 Q3 213/ % 32.% 26.4% 27.6% Q4 213/ % 31.5% 27.9% 27.7% Q1 214/15 3.2% 28.2% 28.% 26.4% Q2 214/ % 27.4% 26.2% 26.4% Emergency Admissions Q3 214/ % 29.3% 28.1% 27.6% Latest Week 18-Jan % 28.8% 29.5% 29.9% Data Source: Sitreps Comparison of 214/15 YTD to 213/14 Data Source :- SUS 15 (data up to end 13/14 14/ % Diff to 17- Prev Year ) YTD YTD Diff % Diff (6 week total) Provider % % Difference to Previous Year 15% % % % % 3, 2,5 2, 1,5 1, % 14% 22% 13% 15% 24% 2% % - -3% 6% 2% 4% -9% -5% % 14-Dec Dec-14 15% 28-Dec-14 23% 4-Jan-15 9% 11-Jan-15 12% 18-Jan-15 15% 2% -5 All Emergency Admissions (Data source SUS) Emergency Admissions Via A&E /15 YTD & 213/14 YTD 995; 1% 214/15 YTD & 213/14 YTD 1824; 21% 345; 5% 119; 7% 662; 6% 295; 14% Emergency Admissions Via A&E with a Length of Stay of Zero Days /15 YTD & 213/14 YTD 988; 34% ; 21% -84; -3% Emergency Admissions Average Length Of Stay /15 YTD & 213/14 YTD.; 1.2% ; -16.4% -.9; -15.2% 8

7 26/5/13 23/6/13 14/7/13 4/8/13 1/9/13 22/9/13 2/1/13 1/11/13 1/12/13 19/1/14 16/2/14 9/3/14 13/7/14 2/7/14 27/7/14 3/8/14 1/8/14 17/8/14 24/8/14 31/8/14 7/9/14 14/9/14 21/9/14 28/9/14 5/1/14 12/1/14 19/1/14 26/1/14 2/11/14 9/11/14 23/11/14 3/11/14 7/12/14 21/12/14 4/1/15 11/1/15 18/1/15 25/1/15 26/5/13 23/6/13 14/7/13 4/8/13 1/9/13 22/9/13 2/1/13 1/11/13 1/12/13 19/1/14 16/2/14 9/3/14 13/7/14 2/7/14 27/7/14 3/8/14 1/8/14 17/8/14 24/8/14 31/8/14 7/9/14 14/9/14 21/9/14 28/9/14 5/1/14 12/1/14 19/1/14 26/1/14 2/11/14 9/11/14 23/11/14 3/11/14 7/12/14 21/12/14 4/1/15 11/1/15 18/1/15 25/1/15 26/5/13 23/6/13 14/7/13 4/8/13 1/9/13 22/9/13 2/1/13 1/11/13 1/12/13 19/1/14 16/2/14 9/3/14 13/7/14 2/7/14 27/7/14 3/8/14 1/8/14 17/8/14 24/8/14 31/8/14 7/9/14 14/9/14 21/9/14 28/9/14 5/1/14 12/1/14 19/1/14 26/1/14 2/11/14 9/11/14 23/11/14 3/11/14 7/12/14 21/12/14 4/1/15 11/1/15 18/1/15 25/1/15 26/5/13 23/6/13 14/7/13 4/8/13 1/9/13 22/9/13 2/1/13 1/11/13 1/12/13 19/1/14 16/2/14 9/3/14 13/7/14 2/7/14 27/7/14 3/8/14 1/8/14 17/8/14 24/8/14 31/8/14 7/9/14 14/9/14 21/9/14 28/9/14 5/1/14 12/1/14 19/1/14 26/1/14 2/11/14 9/11/14 23/11/14 3/11/14 7/12/14 21/12/14 4/1/15 11/1/15 18/1/15 25/1/15 14/7/13 22/9/13 2/1/13 1/12/13 9/3/14 13/7/14 27/7/14 1/8/14 24/8/14 7/9/14 21/9/14 5/1/14 19/1/14 2/11/14 3/11/14 11/1/15 25/1/15 14/7/13 22/9/13 2/1/13 1/12/13 9/3/14 13/7/14 27/7/14 1/8/14 24/8/14 7/9/14 21/9/14 5/1/14 19/1/14 2/11/14 3/11/14 11/1/15 25/1/ Service Calls Answered within 6 seconds Week Ending 4/1/15 11/1/15 18/1/15 25/1/15 % Calls 5.7% 62.6% 77.% 9.4% 83.1% 11% % 9% 8% 7% 6% 5% 4% % Calls Answered within 6 Seconds Target Comparison of 214/15 YTD to 213/14 Weekly Ave. Ave. 13/14 Ave. 14/15 Diff % Diff Calls Answered % Calls Triaged % Ambulance dispatches % Attend A&E % Attend primary care % Attend Other Service % Not recommended to attend another service % 14% 12% 1% 8% 6% 4% 2% % Week Ending % Of Triaged Calls Resulting in Ambulance Dispatch/Conveyance Conveyance 8.5% 4.9% Week Ending 12.2% 6.% Average(mean) No. Calls Triaged Upper Limit: 4743 Average: Average(mean) Ambulance Dispatches Upper Limit: 51 Average: 347 Lower Limit: Average(mean) Recommended to Attend A&E Upper Limit: 263 Average: 23 Lower Limit: Average(mean) Recommended to attend primary care Upper Limit: 2883 Average: 2325 Lower Limit:

8 Handovers Over 3 mins Dec-14 SWAST Red 1 Performance (Target 75%) Dec-14 Dorset CCG 84.9% 85.6% 85.% 82.6% SWAST 77.6% 75.1% 74.7% 69.6% Ambulance Service 95% 9% 85% 8% 75% 7% 65% 6% SWAST Red 1 Performance Target Dorset CCG SWAST Comparison of 214/15 YTD to 213/14 YTD Monthly Averages 12/13 YTD 13/14 YTD 14/15 YTD Diff 14/15 V 13/14 % Diff Calls 97,866 98,567 16,962 8,395 9% Hear & Treat 6,166 6,999 9,56 2,57 36% See & Treat 41,86 42,473 43,744 1,271 3% See & Convey 5,614 49,95 53,712 4,617 9% % Percentage of Calls Categorised as See & Convey % Total Calls See & Convey % See & Convey % 213/14 13,936 65, % 214/15 YTD 16,962 53, % 6% 5% 4% 3% 2% 1% % 53% 5% 43% 42% 42% SW IoW SE Cost East of Eng Non-Conveyances % of Total Incidents - 38% 37% 35% 32% 32% 31% 27% SC W Mids Eng London Yorkshire E Mids NE NW 14, Average (mean) Total Calls Upper Limit: 12,513 Average: 11,143 Lower Limit: 9,772 13, 12, 11, 1, 9, 8, May-12 Dec-14 7, Average (mean) See and Convey Upper Limit: 6,235 Average: 5,643 6,5 6, 5,5 5, 4,5 4, 3,5 3, May-12 Dec-14 5,5 Average (mean) See & Treat Upper Limit: 5,212 Average: 4,673 Lower Limit: 4,133 5, 4,5 4, 3,5 3, May-12 Dec-14 2, 1,8 1,6 1,4 1, 1, Average (mean) Hear & Treat Upper Limit: 1,257 Average: 827 Lower Limit: 396 May-12 Dec-14 9

9 No. Referrals No. Referrals No. Referrals No. Referrals 25, 2, 15, 1, 5, Referrals & Waiting List Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar 213/ / , Referrals to Main Providers (,,, SFT, YDH, BMI, Ramsey) Dorset County Hospital NHS Foundation Trust Year to Date Variance 14/15 vs 13/14: 7484 (5%) Year to Date Variance 14/15 vs 13/14: 1172 (5%) 3,5 3, 2,5 2, 1,5 1, 5 Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar 213/ / The Royal Bournemouth & Christchurch Hospitals Foundation Trust Year to Date Variance 14/15 vs 13/14: 3724 (6%) 1, 9, 8, 7, 6, 5, 4, 3, 2, 1, Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar 213/ / % 9% 8% 7% 6% 5% 4% 3% 2% 1% % % 9% 8% 7% 6% 5% 4% 3% 2% 1% % % 9% 8% 7% 6% 5% 4% 3% 2% 1% % % Split by Referral Source - Year to date 1% 1% 11% 11% 2% 21% 59% 58% 213/14 214/15 Financial Year 8% 1% 5% 5% 11% 11% 76% 73% 213/14 214/15 12% 11% 6% 5% 25% 26% 58% 58% 213/14 214/15 Other Urgent Care Consultant GP Other Urgent Care Consultant GP Other Urgent Care Consultant GP 8, 7, 6, 5, 4, 3, 2, 1, Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar 213/ / Pathway Performance (Dorset CCG Patients) Poole Hospital NHS Foundation Trust Year to Date Variance 14/15 vs 13/14: 185 (4%) Planned Care % 9% 8% 7% 6% 5% 4% 3% 2% 1% Diagnostic Performance (Dorset CCG Patients) % 9% 8% 23% 22% 2% 22% 48% 48% 213/14 214/15 Other Urgent Care Consultant GP Admitted Adjusted Non Admitted Incomplete Pathways Total Waiting List Over 6 Weeks % Seen in 6 Weeks 85% 98% 95% % 94% 97% 98% % 89% 97% 95% % DHUFT 96% 98% 99% DHUFT 1212.% SFT YDH 95% % 94% 89% 95% 94% SFT YDH %.% 18 Week RTT Backlog - Week Ending 3 November 214 Total PTL Admitted Backlog Total PTL Non-Admitted Backlog Dorset County Hospital NHS Foundation Trust 3-Mar 21-Sep 28-Sep 5-Oct 12-Oct 19-Oct 26-Oct 2-Nov 9-Nov 16-Nov 23-Nov 3-Nov Total PTL Admitted Backlog Total PTL Non-Admitted Backlog Total Combined PTL Backlog Poole Hospital NHS Foundation Trust 3-Mar 21-Sep 28-Sep 5-Oct 12-Oct 19-Oct 26-Oct 2-Nov 9-Nov 16-Nov 23-Nov 3-Nov Royal Bournemouth Hospital NHS Foundation Trust 3-Mar 21-Sep 28-Sep 5-Oct 12-Oct 19-Oct 26-Oct 2-Nov 9-Nov 16-Nov 23-Nov 3-Nov

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