Members Council Meeting Meeting Date: 26 April 2012 Agenda Item: 5 Title: Purpose: Summary: CHIEF EXECUTIVE S REPORT To provide a report on current performance and issues Patient and staff satisfaction has moved to an average rating Emergency care reorganisation is producing sustained improvements from the initial phase Patient safety and mortality are improving Cancer targets remain a challenge At Month 11 the financial position is sound Recommendation: To note the report. Author: Presented by: Gordon Coutts, Chief Executive Gordon Coutts, Chief Executive Page 1 of 6
Staff and Patients Staff Satisfaction Survey: The initial results showed progress with room for further improvement. In 2010 only 8% of responses were average or above average; in 2011, 42% were average or above. The national benchmark data is not available, but an estimate is that the Trust will have moved from the bottom 20% in the country to just below average. Patient Satisfaction Survey: The initial results indicate a significant improvement in patients feedback on their care. There is still more room for improvement and the comparative data will help to identify areas of focus for this year. Patient Safety: We continue to see improvements in our key safety indicators. Falls CQUIN Target/Cumulative Serious Harm Falls 2011/12 45 40 40 35 30 25 20 15 10 5 0 1 4 8 11 12 13 14 17 19 22 25 28 April May June July August September October November December January February March CQUIN Target YTD Cumulative Serious Harm Falls Page 2 of 6
Cardiac Arrests Pressure Ulcers Hospital Acquired Grade 3 & 4 Pressure Ulcers 2011 / 12 CQUIN Performance No. of Ulcers 20 15 10 5 0 7 17 8 4 15% Reduction Target 13 4 25% Reduction Target 5 3 4 4 35% Reduction Target Apr May Jun July Aug Sept Oct Nov Dec Jan Feb Mar 0 1 Monthly Rate Trajectory Mortality: There has been a sustained reduction in crude mortality and Hospital Standardised Mortality Rate (HSMR). Crude Mortality 2010/2011/2012 190 170 150 130 110 90 Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar 2009/10 2010/11 2011/12 Page 3 of 6
Crude Mortality (Rolling 12 month periods) 2010/2011/2012 Mortality 1850 1800 1750 1700 1650 160000 155000 150000 145000 140000 No. of Spells Crude Mortality Spells HSMR - Rolling 12 Month Periods 106.1 105.3 107.2 106.2 105.0 104.5 105.0 102.9 101.0 100.0 Relative Risk 100.0 95.0 98.5 95.8 95.7 90.0 At our Best: The patient driven values with the At our Best programme are one way in which we are improving patient satisfaction. The second round of awards attracted 107 nominations and the walkabouts on kind occurred in March. The celebration for all At our Best winners and runners-up and long service employees is being held on 26 th June. Infection Control: The Trust missed the C difficile target of 25 cases with a total of 28. There were zero cases of MRSA. Process A&E: The Trust has continued to meet the 4-hour standard throughout the winter period. ECRIT: The Standards Group has finalised the initial targets. These are ambitious and some will take some time to achieve. The 4 workstreams have now finalised their plans of how to achieve these goals. Standards 1-4 Time to initial assessment 15 minutes Clinician assessment: 60 minutes Time from arrival to start of definitive treatment by a ST3-6, SAS, Cons or ENP Time taken from requesting to receiving Diagnostics 30 minutes Time to Speciality review by ST3-6, SAS or Consultant 30 minutes once referral is made Page 4 of 6
Standards 5-8 Decision to discharge or admit after speciality review. Admission review to include: pathway streaming, ceiling of care, diagnosis/co-morbidities, EDD criteria Minimum frequency of Consultant Ward/Board rounds or Senior review within 30 mins of speciality review or 2.5 hours from arrival Daily Patients given EDS before leaving ward 100% Patients discharged in the morning 40% The A&E assessment and wait times continue to be met. TREATMENT TO WAIT WAIT ASSESSMENT 95TH PERCENTILE The hospital has had a larger than normal attendance and admission rate during February and March with an increase of 9% over the same period the previous year. For the week of 12 th March admissions were also 7% above the new year week. Traditionally and across the country, New Year week is the busiest period for providers. The long length of stay has re-emerged as an issue and this has contributed to the need to open contingency beds on Easthorpe for 6 days since February. Quality Hub: The functions of Risk Management, Governance, Clinical Area Assessment Programme (CAAP), Safeguarding, Infection Control and Audit, Complaints have been co-located in March. This will facilitate the triangulation of data to identify emerging risks and support improvements in quality across the Trust. Page 5 of 6
Radiotherapy: The plans for the new Radiotherapy Centre were submitted to the Council on 2 nd April. Plans have previously been shared with the Governors, Board and the Radiotherapy Steering Committee that includes patients from Colchester and Chelmsford areas. Cancer: The 62-day cancer standards continue to be a challenge with the Trust unlikely to achieve the position in Q4 and thus the year. A remedial plan has been put in place and the PCT and Monitor notified. Reputation CQC: The Chair and I visited the CQC as part of our informal meetings and met with Jo Williams, Chair and Cynthia Bowers, CEO. We had an unscheduled visit from the CQC as part of a national review on termination of pregnancy. We have not yet received their report. National Crohns & Colitis UK IBD Nursing Awards 2012: Sister Joy Mason was named as the overall winner of this prestigious award. Finances: Month 11 Summary : Statement of Comprehensive Income This Month (December) Year to Date All in 000 Budget Actual Fav / (Adv) Budget Actual Fav / (Adv) Income NHS Clinical Income 17,866 17,596 (270) 192,878 198,127 5,249 Non NHS Clinical Income 239 163 (76) 2,721 2,012 (709) Research & Training 70 82 12 1,003 1,041 38 Other 1,581 1,449 (132) 15,362 14,244 (1,118) Total Income 19,755 19,290 (466) 211,963 215,424 3,460 Expenditure Pay (12,384) (12,725) (340) (131,527) (132,073) (546) Drugs (1,551) (1,527) 24 (16,370) (16,653) (283) Clinical Services (1,908) (1,910) (2) (20,333) (20,210) 124 Other Non Pay (2,638) (2,439) 199 (28,750) (29,966) (1,216) Total Expenditure (18,480) (18,600) (120) (196,981) (198,902) (1,921) EBITDA 1,275 689 (586) 14,982 16,522 1,540 Non Operating (Dep'n/PDC etc.) (1,004) (934) 70 (11,579) (10,910) 669 Net Surplus / (Deficit) 271 (245) (516) 3,403 5,611 2,208 EBITDA % 6.5% 3.6% 7.1% 7.7% The Trust continues to deliver a solid financial performance. The SCIP target of 14.5m has been reached with 11m of recurrent savings. This compares to a total of 7m in 2010/11 of which 5m was recurrent. Page 6 of 6