Balanced Score Card Report Review of June 2017 Data

Balanced Score Card Report Review of June 2017 Data

Finance

Finance Report June 2017 CUH Actual outturn 1H 2017 PAY & NONPAY Gross pay & non pay budget 176.7m (2016 : 170.5m) Actual pay & non pay 181.9m (2016: 174.4m) Actual Deficit 5.2m (-3%) (2016 : 3.9m/-2.3%) Less Adjustments 3.87m increase in Bad debts provision 2.1m PCRS Drugs 0.85m LRA Restoration unfunded 0.94m Adjusted Deficit 1.34m(-0.76%) (2016 : 1.8m/-1%) INCOME Income budget 39.74m (2016 : 40m) Actual Income 38.97m (2016 : 39.1m) Actual Deficit 0.77m (-2%) (2016 : 0.9m/-2%)

1.0% 0.5% CUH Pay & Non pay Budget Surplus/(Deficit) % Jan Feb Mar April May June July Aug Sept Oct Nov Dec 0.51% 0.0% -0.18% -0.5% -1.0% -1.5% -0.40% -0.81% -1.14% -0.91% -0.84% -0.66% -0.75% -0.76% -1.01% -0.72% -1.22% -1.04% -0.85% -1.32% -1.36% -0.85% -0.28% -0.52% -2.0% -2.5% -1.86% -2.01% -1.94% -1.96% -2.03% -2.42% -2.27% -2.30% -2.27% -2.43% -3.0% -2.88% -2.95% -2.86% -2.92% -3.5% 2017(adj) 2017 2016(adj) 2016

CUH AGENCY WTE 2014-7 Jul-14 Sep-14 Dec-14 Jan-15 Mar-15 Jun-15 Sep-15 Dec-15 Jun-16 Jul-16 Aug-16 Sep16 Oct 16 Nov-16 Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 June-17 Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Radiotherapist 9.40 4.00 4.87 2.78 0.95 0.9 Radiographer 0.09 0.05 0.06 Labs 12.04 13.40 11.0 12.19 1.0 Cardiac Techs 3.80 3.80 1.0 Physio 1.60 1.50 Pharmacy 2.00 1.00 Admin 23.40 9.08 9.36 14.1 9.3 Nursing 46.20 33.0 34.7 37.8 40.0 30.4 28.6 26.1 31.6 32.1 28.7 27.6 29.6 31.5 25.5 33.3 33.3 32.7 31.7 34.3 37.3 HCA 34.80 16.2 22.7 23.2 24.4 29.8 30.8 38.2 38.4 45.7 52.1 52.1 56.9 32.1 17.7 26.1 25.3 34.5 34.5 33.9 36.6 House-Keeping 10.40 0.16 Physics 4.30 2.6 1.6 1.09 0.92 0.75 0.66 0.46 0.83 0.83 0.83 0.83 0.83 0.83 0.83 0.83 0.83 0.23 Catering 3.00 8.5 2.0 2.7 1.8 6.9 3.9 0.9 1.2 Social Work 1.00 0.5 Occ Therapy 1.00 0.37 Dietician 0.50 0.3 1 1 1 1 1 1 1 1 1 1 1 1 1 Medical 11.00 5.27 4.77 4.4 6.35 5.86 7.97 15.73 Consult 0.25 0.95 4.44 0 0.38 1.62 0.6 0.34 NCHD 2.47 4.45 5.13 6.7 2.99 2.84 1.87 1.82 2.83 2.94 2.15 2.34 1.54 164.5 99.7 91.1 98.26 84.7 74.6 71.9 81.4 76.75 85.03 92.20 88.23 91.70 69.89 46.9 63.05 63.26 71.37 69.95 71.88 5 76.4

CUH AGENCY COSTS k 2015-2017

50 Acute Nursing Agency WTE 2015 to 2017 40 30 40 32.9 35.9 31.7 32.6 34.4 34.2 31.1 31.4 31.3 30.7 29.8 32.2 30.8 31.3 33.8 30.5 30.4 30.5 30.5 27.8 26.8 27.6 29.3 25.2 27.6 30.4 29.5 25.5 23.8 20 10 0 Jan Feb Mar April May June July Aug Sept Oct Nov Dec 2017 2016 2015 Acute HCA Agency WTE 2015 to 2017 70 60 50 40 30 20 10 37.2 35.2 26.1 25.3 23.2 19.3 37.7 36.9 34.5 34.5 24.4 26.8 41.1 38.4 36.6 45.7 33.9 29.8 34.7 31.0 52.1 56.9 52.1 32.1 32.7 30.8 32.4 34.5 17.7 38.2 0 Jan Feb Mar April May June July Aug Sept Oct Nov Dec 2017 2016 2015 7

CUH Average Nursing & HCA Agency WTE s per Week 2015-17 90 80 70 60 50 40 71.4 59.1 57.4 70.4 66.9 70.4 68 71.6 68.8 65.2 64.2 56.6 64.6 64.4 61.2 63.2 52.2 59.9 76.2 65.1 79.9 77.3 59.3 58.4 84.5 61.7 61.6 64.9 63.7 41.5 30 20 10 0 Jan Feb Mar April May June July Aug Sept Oct Nov Dec 2017 2016 2015 CUH Average Specials /Other Nursing & HCA Agency WTE s per Week 2016-17 70 60 50 40 51.9 51.3 45.6 29 28.9 33.3 43.1 48.2 33.7 34.1 57.8 37.5 43.7 50.4 49.2 52.4 32.4 30 20 10 0 28.5 27.6 31.9 30.6 30.5 32.8 32.4 29.5 32.2 29.2 20.9 28.1 24.9 23.4 20 21.3 20.5 18.7 11 Jan Feb Mar April May June July Aug Sept Oct Nov Dec Specials 2016 Specials 2017 Other 2016 Other 2017 8

CUH Non-Pay Budget v Actual June 2017

CUH Actual Non-pay expenditure k June 2017 v 2016

Jan Feb Mar Apr May Jun Jul Aug Sep 12th Oct 19th Oct 26th Oct 2nd Nov 9th Nov 16th Nov 23rd Nov 30th Nov 7th Dec 14th Dec 21st Dec CUH Private Bed Occupancy 2017 v 2016 160 CUH Bed Occupancy 2017 v 2016 150 147 145 151 140 139 130 120 110 128 130 115 113 111 114 110 111 120 123 125 124 115 111 114 120 126 118 121 111 110 2016 2017 100 102

Patient Income 2015 2017

CUH Debtor Days Consultant Claims June 2017 50 49.0 45 40 44 44 44 44 42 42 41 40 40 40 46 42.0 42.0 42 44 42 41 44 43 43 41 44 39 41 43 43 41 35 35 30 30 25 20 Jan Feb Mar April May June July Aug Sept Oct Nov Dec 2016 2017 Target (old) 2015

MGH - Finance Report June 2017 Mallow YTD June 2017 outturn Gross pay & non pay budget 10.03m (2016: 10m) Actual pay & non pay 10.32m (2016: 10.1m) Actual deficit 287k (-2.9%) (2016: 118k -1.2%) Less Adjustments 246k increase in Bad debts provision 186k LRA Restoration unfunded 60k Adjusted deficit 41k (-0.4%) Mallow Income outturn Income budget 1.77m (2016: 1.92m) Actual Income 2.09m(2016: 1.91m) Actual surplus 315k (18%) (2016:Surplus 91k 6%)

BGH - Finance Report June 2017 Bantry YTD June 2017 outturn Gross pay & non pay budget 10.3m Actual pay & non pay 10.48m Actual deficit 181k (-1.8%) Less Adjustments 199k increase in Bad debts provision 41k St. Josephs ward 111k LRA Restoration unfunded 45k Waiting list initiative 2k Adjusted surplus 18k (0.2%) Bantry Income outturn Income budget 1.79m Actual Income 1.81m Actual surplus 23k (1%)

Relocation of HBS Storage to the National Distribution Centre CUH Project-go live 12 th June 17

CUH - NDC Implementation Committee The CUH - NDC Implementation Committee is being established to: Oversee the implementation of residual actions set out in HBS Local project plan Address the specific service issues arising from the project Monitor the achievement of the HBS Cost Containment target of 700k Monitor the introduction of barcode/scanning to all stock locations Develop the suite of appropriate user reports for all levels of Management

CUH - NDC Implementation Committee This committee will operate on behalf of the EMB The core membership will comprise: Mr. Brendan O Reilly, Operations Manager Mr. Terry Kiely,Finance Manager Mr. Stephen Lynch,Assistant Head of Logistics & Inventory Management Mr. Michael Coleman, Logistics Operations Manager.Cork City & County A/ Director of Nursing Nominee Other individuals and departments will be called on as required

Patient Access Emergency Department

CUH 30 Day Moving Average 2016-2017 (14/07/2017)

30 Day Moving Average (21/07/2017)

6 Hour PET & 8AM TrolleyGAR per 100 ED Attends 23

PET Monthly Comparison (Non Admitted)

PET Monthly Comparison (Admitted)

PET > 24hrs PET >24 hours 350 300 250 320 316 328 200 264 150 100 50 85 97 57 0 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17

>75 years Bed Wait >9 hours >75yrs Bed Wait >9 hrs (2017) 250 200 150 **Up to 18th July 100 218 199 200 215 50 129 120 46 0 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17

Delayed Discharges April June 2017

Bed Days Used by inpatients for Associated Date with LOS > 14 days

>14 Day Target Reduction 31

Overview of CUH In-Patients Awaiting Cardiac Surgery Numbe r Ward Adm. Date Patients in Hospital in excess of 14 days Referring Consultant Cardiologist Intended Surgical Procedure & Consultant Surgeon Current Status Patient 1. SDU 21/06/ 2016 Dr. E. McFadden AVR TA Surgery Date Wednesday 19/07/2017 Patient 2. SDU 10/07/ 2017 Dr. P. Kearney CABG KD Surgery Date (TBC) Referral rec d 17/07/17 Patient 3. 3D Card. Ward 17/07/ 17 Dr. E. McFadden CABG - KD Referral received @ 4.00pm this afternoon referral on Mr Doddakula desk for his attention

Patient Flow Improvement Plan - PF 17 Whiteboards (completed) >14 Day Patient Review Discharge Coordinator Staffing (completed) Weekly >14 Day Review(work in progress) Delayed Discharges (18 patients >100 days) Long Term Care Process (MUH Meeting 20 th June) Early identification of patients with LOS >14 days (work in progress) Acute Surgical Pathway (work in progress) Cardiothoracic Pathway (completed) Orthopaedic Pathway (to be progressed) Integrated Care Pathways (work in progress) Acute Floor Interface Group (work in progress) Communication Plan (work in progress)

Patient Access - Outpatient Waiting Lists

Total Medical Patients to be seen by 15 Month Target (as of June 2017) (205) 70 64 60 50 40 30 31 28 20 20 18 14 10 9 6 4 3 2 2 1 1 1 1 0

Total Surgical Patients to be seen by 15 Month Target (as of June 2017) (3398) 600 500 546 532 400 401 353 300 309 200 192 184 164 154 147 146 100 111 107 0 22 20 3 3 1 1 1 1

2500 Patients Currently Waiting Longer Than 12 Months as of June 2017 (6719) () 2298 2000 1633 1500 1000 717 643 500 0 277 260 194 149 138 103 90 83 35 34 23 16 10 7 7 2

Ophthalmology Waiting List Validation (Sample) Number of Patients validated 101 Request to stay on list 52 Request removal from list 3 RIP 2 Return not known 1 Attended 1 Cancelled 1 No Response 41

Patient Access - Inpatient Waiting List

Patients to be treated by October 2017 (20/072017)

Patients to be treated by 15/10/2017 (373) (as of 20/07/2017)

Urology Waiting List

Plastic Surgery Waiting List

General Surgery Waiting List

Scope Breaches Gastroenterology 25 have a Pre admit date Surgery - 5 have a Pre admit date

Quality & Safety

ALOS All Inpatients May 2017 R

Hand Hygiene May 2017 G

National Early Warning Score May 2017 G

Cancer KPI Breast-Lung-Prostate January June 2017

Risk Management June KPI data Serious Reportable Events reported 2 Medication Safety Incidents reported - 6 Complaints 8 complaints raised in October with 38% closed within 30 day timeframe New claims notified to hospital 10 Risk Register Risk Register updated in June no new risks added Updated Risk Register to be submitted to the Group

Quality and Safety Pressure Ulcer Working Group meetings are on-going with the group quality and Safety Manager System Analysis Review commence review of implementation of the recommendations Falls Prevention Introduce on a trial basis fall prevention socks National Patient Satisfaction Survey CUH 45% response rate as of 7 th July one immediate trend is the Discharge process (national response rate 47%) Quality Survey - survey patients accessing our services

Human Resource Management

WTE s CUH Sick Leave 2016 v 2017 CUH Total % Sick Leave 2016 v 2017 % 6 4 2 4.77 4.53 3.84 3.92 4.65 4.59 4.22 4.17 3.91 3.39 3.9 4.27 3.78 3.77 3.94 4.04 4.08 4.98 0 Jan Feb Mar April May June July August Sept Oct Nov Dec 2016% 2017% % Target 50 40 30 20 10 0 35.06 Jun-16 35.6 Jul-16 CUH Long Term Sick Leave WTE s 40.76 38.81 43.96 44.55 41.8 35.76 32.49 34.55 Mar-17 Feb-17 Jan-17 Dec-16 Nov-16 Oct-16 Sep-16 Aug-16 28.89 Apr-17 31.14 May-17 35.38 Jun-17

EWTD Compliance January - May 2017

Paediatric Unit Project Capital Projects Status Phase 1 - build programme completed Phase 2 funding received Radiation Oncology Unit Builder commenced on site on Monday 20 th February Education and Training Centre Blood Sciences Project Draft Statement of Need completed and discussion ongoing with UCC Meeting held with UCC Design Team appointed infrastructural works are near completion Oncology Service Expansion of Day Unit plan signed off submitted for Philanthropic funding (ACT) Refurbishment of Ward 2D capital funding in place Medical Oncology Centre developing Statement of Need Ophthalmology Transfer Phase 2 Project group in place Application for planning permission submitted Tender Pack being prepared Helipad Interim helipad in place preferred site identified Meeting with the IAA to be arranged

Key Issues Finance Patient Access Implementation of SAP Structured Overtime Pay controls clearly working Need for change in accounting for PCRS funded drugs Bad Debts PF17 working well challenge with complex discharges Ophthalmology service risk Plastic Surgery/SIVUH Lung Cancer CT's /Calculation of KPI's CAMHS Patient and Service User Pharmacy Review Quality Strategy Early Indications form National Quality Survey Complaints Register Unscheduled Care Process Day Surgery Unit Cardio Thoracic Surgery Waiting Lists No outstanding third party hearings INMO relations working well Implementation of change programme in Catering/Housekeeping Sick Leave Focus HR recruitment workload Grading of staff must be addressed Quality & Safety Human Resource