Report to the Sutton Clinical Commissioning Group Governing Body

Report to the Sutton Clinical Commissioning Group Governing Body Date of Meeting: Thursday 9 th May 2013 Agenda No: 9.2 ATTACHMENT 6 Title of Document: Purpose of Report: Performance Report Month 12 For Review Report Author: Lead Director: Siân Hopkinson, Head of Performance Jonathan Bates, Chief Operating Officer Contact details: nhsswl.suttonccg@nhs.net Executive Summary: This report highlights the key performance issues for April 2013 and outlines the action plans in place. CCG performance against national indicators for Month 12 of 2012/13 (March 2013) is summarised in the scorecards contained in Appendix 1 for those indicators reported at CCG level and Appendix 2 for those reported for NHS Sutton and Merton overall. The Board should note that this is the final report for 2012/13, and the final time of reporting combined figures for NHS Sutton and Merton. Month 12 has been reported (rather than Month 11) as the figures were available in time for the May Board due to the meeting taking place a week later than usual. Issues are: Measles the Director of Public Health for Sutton has provided a briefing on measles in response to the current outbreak in South Wales. 111 Service issues have been experienced, particularly over Easter, which are being addressed with the provider. GP Out of Hours The provider has been asked to address some quality issues and progress will be monitored in the monthly contract meetings. A&E wait times Epsom and St Helier Trust met the target for 95% of patients to spend less than 4 hours in A&E in 2012/13, despite significant pressures on urgent care services across London in March. Rapid Response Service Actions are in place to improve performance of the Rapid Response Service at St Helier, and will be monitored by the Clinical Quality Review Group. Healthcare Acquired Infections Epsom & St Helier Trust breached both the Clostridium Difficile and MRSA thresholds for 2012/13. Child & Adolescent Mental Health Services (CAMHS) Children s Improvement Board agreed an action plan following the multiagency review of services. Key sections for particular note (paragraph/page), areas of concern etc: Focus is on the issues highlighted above Recommendation(s): The Clinical Commissioning Group Governing Body is requested to review the report and agree actions where relevant to address performance concerns. Committees which have previously discussed/agreed the report: None Financial Implications: Activity levels in excess of those contracted will result in unbudgeted expenditure Page 1 of 8

Implications for the Sutton CCG Board: The Board will seek reassurance that action is being taken to address performance concerns Other Implications: (including patient and public involvement/legal/governance/ Risk/ Diversity/ Staffing) Equality Impact Assessment: N/A Information Privacy Issues: None Communication Plan: (including any implications under the Freedom of Information Act or NHS Constitution) Summary performance data is published via the web Performance Summary The Month 12 (March 2013) performance scorecard shows NHS Sutton and Merton has met the following key targets: All cancer waiting time targets Mental health targets for early intervention, crisis resolution, Care Programme Approach follow up and psychological therapies outcomes All secondary care referral to treatment (RTT) targets, including diagnostic wait times Stroke care indicators Screening coverage for breast, bowel and cervical Cervical screening result turnaround times NHS Health Checks, invitations and completions Performance Pressures and Progress Not all the issues below are contained within the performance scorecards, however these are the areas currently of particular priority to the CCG: Measles (briefing from Dr Ellis Friedman, Director of Public Health, Sutton) Measles is an unpleasant infectious disease. It rarely can lead to death and less uncommonly leads to permanent health problems. It is predominantly a disease of childhood. As measles is a highly contagious infection, it tends to spread rapidly in unvaccinated populations causing epidemics. Such an epidemic is currently occurring in South Wales. Where populations have a high level of immunity to measles, usually because very high levels of immunisation have been achieved, the population is said to have herd immunity. In layman s terms, this means that the infection is unlikely to spread to cause an epidemic because the individual with measles is unlikely to come into contact with a non-immune individual. Herd immunity is particularly important for the very small numbers of people who aren t able to be immunised and who, because of their underlying medical condition, are particular likely to have a serious illness if they contracted measles. It is also very important for new born babies who, whilst they are too young to be vaccinated, remain susceptible to the disease. Children can be protected by having the MMR (Mumps, Measles & Rubella) vaccination. There is now complete medical expert agreement that this is a safe and effective vaccination. One dose of the vaccine offers about 95% protection and two doses virtually 100% protection. However, a few years ago, doubt regarding the safety of MMR was made by a now discredited paediatrician. Unfortunately, this health scare led to some parents not vaccinating their children. In Sutton, as in the rest of the country, the proportion of the population immunised is lowest in children now aged 10-14 years, as a result of this health scare. Unfortunately, the immunisation rates in Sutton remain well below herd immunity levels for all age groups. The latest available figures for children aged 2 with Sutton GPs is that only Page 2 of 8

83% have had an MMR vaccination. Whilst the rates are even lower in Merton, the rates in Sutton are amongst the lowest in London. Our aim must be to seek to achieve herd immunity as quickly as possible by encouraging all unvaccinated children to receive MMR vaccination. Whilst there is no epidemic in or near Sutton at present, our local childhood population is particularly vulnerable to a measles epidemic currently. There is a plentiful supply of vaccine and all GPs should be able to offer MMR vaccination to unvaccinated children. Parents are urged to have their children vaccinated as soon as possible. The Department of Health has launched a catch-up programme and have prioritised improvement of MMR coverage in 10-14 year olds. This catch-up programme will involve unvaccinated children being invited to be immunised either at their school or at their GP s surgery. Responsibility for the catch-up programme and indeed for the commissioning of all vaccination services rests with NHS England who respond to expert guidance from Public Health England. The role of the Local Authority with its new public health responsibilities is to monitor the local MMR rates and to challenge the NHS England if it is concerned about local performance. GP practices in Sutton are aware of local performance and of the catch-up programme. Whilst the average MMR coverage in Sutton at 2 years is 83%, this hides a big variation in performance at GP practice level. Some practices achieve 100% whilst others are achieving much lower rates. This is likely to reflect geographical variation in support for the vaccination, rather than problems with the GP service. 111 The 111 service for urgent medical help, provided by NHS Direct (NHSD), has been operational in Sutton since December 2012. The initial period is described as soft launch where full services are available but the numbers of callers are regulated, as there is no formal communication of the launch of the service. This allows the service to settle and any teething problems can be resolved. Given the time of Sutton CCG service go-live this was particularly pertinent, as the Christmas bank holiday period fell two weeks after launch. In January 2013 the service moved to full launch and local advertising of the service was undertaken. The service settled and, although there have been issues occasionally with calls not being answered in 60 seconds and call backs to patients not being within 10 minutes, the service provided was safe and of an acceptable standard. In February and March however service levels dipped. The reasons initially were indicated as being a result of additional contracts going live, including contracts in London and nationally. Prior to the Easter break, the NHS Direct 0845 telephone number was switched off as a planned closure of the service. This, in addition to the Easter extended bank holiday, led to significant dips in performance by NHS Direct locally and nationally. This resulted in longer answering times for calls, longer waits for callers to receive a call back and an increased rate of abandoned calls. Sutton CCG commissions the South London Commissioning Support Unit (CSU) to monitor the contract and the CCG and CSU meet with NHSD monthly to monitor performance. NHS England has raised the issue of the March performance with the Chief Executive office at NHSD. NHSD has provided each locally commissioned service with a recovery plan for the service going forward to ensure service quality is maintained. The CCG remains concerned that the service provider has sufficient capacity in terms of call handling Page 3 of 8

and in particular clinical advisors to manage demand. This has been raised as part of our performance meetings and as a result the CCG is considering the issue of a performance notice to the provider to ensure the agreed contract is delivered going forward. The 111 service is being monitored via the Quality Committee and the commissioners will present to the June committee. GP Out of Hours Service (OOH) The OOH service is currently meeting the national quality requirements associated with the service, however the CCG was recently made aware of some service quality issues. These have been raised directly with the provider and are currently being addressed through a range of agreed actions. Monitoring of this contract continues to takes place monthly. Additionally the CCG highlighted these issues to the NHS England Local Area Team. A&E Wait Times Despite significant pressure on St Helier s A&E department in in the first week of March, Epsom and St Helier NHS Trust did achieve the annual target for at least 95% of patients to wait less than 4 hours in A&E, reporting 96.9%. Performance between 7 and 22 April remained under 95% and a multi-agency review meeting is being arranged, chaired by Sutton CCG s Clinical Lead for Urgent Care. Rapid Response Service at St Helier The rapid response team (RRT) is provided by Sutton and Merton Community Services (SMCS), and has a target to see 90% of referrals from A&E within 30 minutes. The team has only met this target in one month of 2012/13, and this has been discussed at the Clinical Quality Review Group meeting (CQRG). The providers responded that this was the result of a combination of factors including staffing issues and increased complexity of the patient s presentation, which affects the throughput of referrals. The Clinical Quality Review Group will monitor the actions in place to improve the performance of this service. Healthcare Acquired Infections (HCAIs) Epsom & St Helier Trust reported 70 cases of Clostridium-Difficile in 2012-13, against an annual threshold of 52 (note this is the number of infections for the trust overall across all commissioners). Epsom & St Helier Trust also breached their annual threshold for MRSA infections, reporting 8 cases in 2012-13 (for the trust overall, across all commissioners) against an annual threshold of 4. The trust will be expected to reduce the number of HCAIs in 2013-14, and improvements will be closely monitored by the Epsom & St Helier Trust Clinical Quality Review Group (CQRG) which is chaired by Dr Chris Elliott, and by the Sutton CCG Quality Committee and the Sutton CCG Board. Child and Adolescent Mental Health Services (CAMHS) Review The multi-agency comprehensive review of CAMHS pathways is now complete. The report and recommendations were shared with the Children s Services Improvement Board (CSIB) in April 2013. Dr Hudson and Carol Lambe, with LBS colleagues, have undertaken a map of current provision against specialist and acute CAMHS criteria (tiers 3 & 4) and universal and targeted CAMHS criteria (tiers 1 & 2) and shared the report with CAMHS providers. The following recommendations were agreed by the CSIB: o o o Design and implement an interim single point of access and signposting process for CAMHS referrals. Develop interim threshold criteria for all current CAMHS services and prepare a factsheet for sharing with referrers, pending development of new commissioning intentions. Develop CAMHS pathway and share with referrers. Page 4 of 8

o Commissioners to work with current service providers so that activity data and performance data is reviewed or developed where none is available. o Complete the mapping of CAMHS provision in Tier 1 (universal) settings. o Investigate what training is provided in universal settings to develop skills in assessing emotional and mental wellbeing, such as in schools and primary care. o Develop new commissioning intentions for CAMHS. o The CAMHS Review Team to progress the above recommendations and be renamed as a task and finish group. o Update the Improvement Board on progress in December 2013. Performance Scorecards (Exception reporting) Collation of performance data into scorecards is undertaken by the South London Commissioning Support Unit (CSU) and indicators have been split according to the future responsible organisation from April 2013. Those indicators which relate only to Sutton CCG activity are shown at Appendix 1. The majority of indicators for 2012/13 are reported as NHS Sutton and Merton combined and are shown at Appendix 2. CCG Indicators GP Written referrals to Hospital and First Outpatient Attendances (Sutton and Merton combined data) Most performance data relating to outpatient referrals and appointments were in excess of target for 2012/13. Reducing variation in referral rates between practices is a priority for the locality teams during 2013/14 and practice specific targets are included within the practice incentive scheme for 2013/14. Elective Admissions (Sutton and Merton combined data) Elective admissions were above target for the year, however this has not impacted on waiting times. Diagnostic Tests (Sutton and Merton combined data) Combined Sutton and Merton volumes of diagnostic tests were ahead of target, however this has not had an adverse effect on waiting times. All trusts are seeing an increase in referrals for endoscopies related to the public health cancer campaigns. Choose and Book (Sutton and Merton combined data) This remains consistently below target. Public Health Indicators Smoking quitters (Sutton actual data) Smoking quitters are below target for 2012/13. The new combined LiveWell and Smoking Cessation service is expected to improve outcomes in 2013/14. NHS Commissioning Board Indicators Access to dental services (Sutton and Merton combined data) These are PCT level figures. The below target position is consistent with 2011/12. Page 5 of 8

Sutton CCG Board 09.05.13: Pt1: 8.2: Att 6 Appendix 1 Sutton CCG Performance Indicators (Disaggregated indicators only) NHS Sutton CCG Performance Scorecard 2012-13 Year to Date Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Calculation Actual Target Forecast Target Last Year PHQ27: MRSA Cumulative 7 G 10 0 G 2 R 0 G 0 G 1 G 1 G 0 G 1 G 1 G 1 G 8 G 10 PHQ28: C-Difficile Cumulative 36 G 76 1 G 5 G 4 G 4 G 2 G 3 G 7 G 4 G 2 G 4 G 44 G 90 Year End NHS Sutton Commissioning Board, Public Health and Other Performance Scorecard 2012-13 Year to Date Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Calculation Actual Target Forecast Target Last Year PUBLIC HEALTH VSB14: Drug misuse: Numbers of successful completions Most recent 336 R 436 362 R 358 R 351 R 349 R 347 R 343 R 340 R 336 R 322 R 436 Quarterly Indicators Quarter 1 Quarter 2 Quarter 3 Quarter 4 PHQ30: Smoking Quitters Cumulative 277 R 299 140 R 137 A 686 PHQ31: Eligible population offered an NHS health check Cumulative 15.0% 5.5% G 6.8% G 3.5% R x 20.0% PHQ31: Eligible population receiving an NHS health check Cumulative 7.5% 2.0% R 3.6% G 2.5% A x 10.0% VSB08: Under 18 conception rate per 1,000 female 15-17 population Average 33.4 R 22.1 18.8 G 35.0 R 35.4 R 33.4 R 22.1 27.2 R Annual Indicators VSB09: Childhood obesity, reception Most recent 8.4% G 13.0% 8.4% G 13.0% 8.3% G VSB09: Childhood obesity, year 6 Most recent 19.3% A 18.7% 19.3% A 18.7% 18.7% A Year End Page 6 of 8

Sutton CCG Board 09.05.13: Pt1: 8.2: Att 6 Appendix 2 NHS Sutton & Merton - All Performance Indicators NHS Sutton and Merton CCG Performance Scorecard 2012-13 Year to Date Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Calculation Actual Target Forecast Target Last Year PHQ03: Cancer first treatment 62 days wait: GP urgent referral Average 90.0% G 85.0% 91.7% G 98.1% G 93.8% G 92.9% G 93.4% G 80.0% A 87.2% G 85.5% G 87.9% G 86.0% G 88.5% G 85.0% 89.7% G PHQ04: Cancer first treatment 62 days wait: Screening referral Average 97.5% G 90.0% 100.0% G 90.0% G 100.0% G 100.0% G 88.9% A 100.0% G 100.0% G 100.0% G 100.0% G 100.0% G 98.4% G 90.0% 97.5% G PHQ06: Cancer first definitive treatment within 31 days of diagnosis Average 99.0% G 96.0% 100.0% G 99.2% G 100.0% G 100.0% G 97.3% G 100.0% G 99.1% G 98.4% G 98.1% G 98.0% G 98.8% G 96.0% 98.9% G PHQ07: Cancer subsequent treatment within 31 days: surgery Average 97.7% G 94.0% 96.4% G 100.0% G 100.0% G 94.1% G 95.0% G 100.0% G 100.0% G 100.0% G 95.5% G 95.7% G 97.6% G 94.0% 98.5% G PHQ08: Cancer subsequent treatment within 31 days: drug Average 100.0% G 98.0% 100.0% G 100.0% G 100.0% G 100.0% G 100.0% G 100.0% G 100.0% G 100.0% G 100.0% G 100.0% G 100.0% G 98.0% 99.8% G PHQ09: Cancer subsequent treatment within 31 days: radiotherapy Average 96.8% G 94.0% 95.5% G 93.3% A 96.6% G 98.0% G 98.2% G 91.3% A 100.0% G 98.1% G 100.0% G 97.8% G 97.3% G 94.0% 99.1% G PHQ19: RTT admitted patients compliant percent Average 91.9% G 90.0% 91.5% G 91.8% G 90.7% G 91.1% G 91.3% G 90.8% G 92.7% G 94.1% G 92.7% G 91.7% G 92.4% G 92.0% G 90.0% 90.3% G PHQ20: RTT non admitted patients compliant percent Average 97.1% G 95.0% 97.3% G 97.5% G 97.6% G 97.3% G 97.4% G 97.1% G 96.5% G 96.4% G 97.4% G 97.2% G 96.7% G 97.1% G 95.0% 97.2% G PHQ21: RTT incomplete pathway patients compliant percent Average 94.2% G 92.0% 93.0% G 94.1% G 93.8% G 94.1% G 94.3% G 94.1% G 94.3% G 94.4% G 94.5% G 94.3% G 94.8% G 94.2% G 92.0% PHQ22: Diagnostic tests waiting 6 weeks or more Average 0.14% G 1.00% 0.10% G 0.17% G 0.41% G 0.19% G 0.09% G 0.15% G 0.05% G 0.11% G 0.19% G 0.13% G 0.02% G 0.14% G 1.00% PHQ24: All cancer two week waits Average 96.6% G 93.0% 95.4% G 96.6% G 94.6% G 96.4% G 96.8% G 95.9% G 96.5% G 97.6% G 98.9% G 96.6% G 96.8% G 93.0% 96.7% G PHQ25: Breast symptoms (cancer not initially suspected) Average 96.1% G 93.0% 93.3% G 98.0% G 91.7% A 95.0% G 98.3% G 97.9% G 96.3% G 100.0% G 92.6% A 94.9% G 95.9% G 93.0% 96.4% G PHQ27: MRSA Cumulative 13 R 10 0 G 2 R 0 G 0 G 1 G 2 R 1 G 3 R 2 R 1 G 1 R 14 R 10 8 G PHQ28: C-Difficile Cumulative 80 G 83 4 G 8 G 6 G 10 R 6 G 7 G 11 R 9 R 7 G 7 G 5 G 90 R 90 112 R PHS06: Non-elective FFCEs Cumulative 32,484 A 32,452 2,592 G 2,808 R 2,552 G 2,932 R 2,720 R 2,681 G 2,763 A 2,733 G 2,754 G 2,842 R 2,439 G 2,668 G 32,452 31,344 G PHS07: GP written referrals to hospital Cumulative 93,572 R 83,691 7,549 R 8,621 R 7,129 G 8,045 A 7,599 R 7,001 G 8,763 R 8,042 R 6,438 R 8,663 R 7,821 R 7,901 A 83,691 85,855 G PHS08: Other referrals for a first outpatient appointment Cumulative 27,090 G 28,147 2,137 G 2,634 R 2,177 G 2,662 R 2,562 R 2,230 G 2,225 G 2,235 G 1,837 G 2,361 R 1,899 G 2,131 G 28,147 27,041 G PHS09: First outpatient attendances following GP referral Cumulative 74,066 R 65,321 5,493 R 6,824 R 5,139 G 6,602 R 6,048 R 5,795 G 7,126 R 6,490 R 5,444 R 6,716 R 6,361 R 6,028 G 65,321 68,496 G PHS10: All first outpatient attendances Cumulative 121,367 R 109,917 9,084 R 11,159 R 8,714 G 10,754 R 10,134 R 9,635 G 11,428 R 10,455 A 8,903 R 11,049 R 10,124 R 9,928 G 109,917 114,707 G PHS11: Elective FFCEs Cumulative 43,736 R 40,787 3,456 R 4,165 R 3,410 A 3,720 R 3,734 R 3,534 G 3,911 R 3,949 A 3,097 R 3,761 R 3,382 G 3,617 G 40,787 43,278 G PHS14: Diagnostic tests, endoscopy Cumulative 11,146 R 9,586 900 R 1,085 R 878 G 988 R 816 G 799 R 1,057 R 1,113 R 499 R 1,027 R 958 R 1,026 R 9,586 PHS15: Diagnostic tests, non-endoscopy Cumulative 99,963 R 91,986 8,069 R 9,334 R 8,208 G 9,023 R 8,932 R 7,990 G 9,250 R 8,807 R 3,726 R 9,219 R 8,324 R 9,081 G 91,986 PHS16: Numbers waiting on incomplete RTT Most recent 20,408 R 13,887 20,705 R 21,599 R 21,977 R 21,812 R 21,380 R 21,334 R 21,356 R 20,771 R 20,181 R 20,296 R 20,408 R 20,300 R 13,887 19,968 G PHF08: GP Referrals to first OP appointments booked using Choose and Average 22.7% R 90.0% 27.2% R 26.2% R 24.8% R 24.3% R 22.3% R 21.5% R 23.9% R 21.7% R 16.6% R 22.3% R 21.5% R 19.9% R 90.0% 26.8% R Quarterly Indicators PHQ10: Early intervention in psychosis - new cases Cumulative 126 G 56 Quarter 1 34 G Quarter 2 16 G Quarter 3 32 G Quarter 4 44 G 56 80 G PHQ11: Crisis resolution home treatment episodes - cumulative from Cumulative 940 G 691 238 G 234 G 224 G 244 G 691 806 G PHQ12: Care Programme Approach followup within seven days Average 98.1% G 95.0% 98.2% G 97.5% G 97.5% G 99.2% G 95.0% 97.9% G PHQ13: IAPTS proportion of relevant population Cumulative 10.7% G 7.3% 2.7% G 2.7% G 2.4% G 2.9% G 7.3% 10.5% R PHQ13: IAPTS proportion of people moving to recovery Average 37.9% G 37.6% 37.4% G 40.2% G 36.4% G 37.8% G 37.6% SQU06: Percent of stoke patients with 90% of time on stroke unit Average 94.8% G 80.0% 92.7% G 92.5% G 92.9% G 96.5% G 80.0% 93.9% G SQU06: Percent of TIA cases assessed and treated within 24 hours Average 64.2% G 60.0% 74.2% G 47.8% R 69.2% G 63.2% G 60.0% 72.2% G SQU12: Percentage of women seeing professional within 13 weeks of p Average 90.1% G 90.0% 87.9% A 90.1% G 95.3% G 87.1% A 90.0% 91.4% G SQU19: Breastfeeding at 6-8 weeks prevalence Average 59.7% A 64.2% 61.5% A 58.8% R 58.6% R 60.1% A 64.2% 61.5% A SQU19: Breastfeeding at 6-8 weeks coverage Average 95.2% A 97.1% 99.8% G 94.2% A 91.5% R 95.7% A 97.1% 96.3% A Year End Page 7 of 8

Sutton CCG Board 09.05.13: Pt1: 8.2: Att 6 NHS Sutton and Merton Commissioning Board, Public Health and Other Performance Scorecard 2012-13 Year to Date Apr May Jun Jul Aug Sep Oct Nov Dec Jan Calculation Actual Target Forecast Target Last Year NHS COMMISSIONING BOARD PHS17: Health visitor numbers Most recent 58.42 G 51.44 61.40 G 60.70 G 59.65 G 58.15 G 58.15 G 58.42 G 53.57 G 51.44 62.00 G SQU09: Access to dental services Most recent 196,548 A 204,420 195,309 A 196,319 A 196,358 A 196,304 A 196,045 A 196,330 A 196,116 A 196,624 A 196,960 A 196,475 A 196,460 A 196,548 A 204,420 195,969 A SQU22: Cervical screening results within two weeks Average 99.5% G 98.0% 99.6% G 99.6% G 99.4% G 99.4% G 99.6% G 99.6% G 99.7% G 99.6% G 99.3% G 99.6% G 99.6% G 99.4% G 98.0% 87.1% R VSB10: Immunisation girls aged 12-13: HPV one dose Most recent 86.9% 89.2% 89.3% 89.4% 85.8% 14.4% 85.0% 86.2% 86.6% 86.7% 86.9% VSB10: Immunisation girls aged 12-13: HPV two doses Most recent 84.0% 84.0% 85.5% 85.6% 84.8% 0.0% 0.0% 0.0% 82.6% 83.7% 84.0% VSB10: Immunisation girls aged 12-13: HPV three doses Most recent 0.1% 29.6% 81.2% 83.0% 81.1% 0.0% 0.0% 0.0% 0.0% 0.1% 0.1% Quarterly Indicators Quarter 1 Quarter 2 Quarter 3 Quarter 4 SQU20: Breast screening age 47-49 and 71-73 Most recent 22.5% 28.4% 26.0% 22.5% 28.9% G SQU21: Bowel screening invitations age 70-74 Most recent 85.8% 67.5% 73.4% 79.5% 85.8% 60.4% G SQU23: Diabetic retinopathy screening Most recent 102.6% G 95.0% 106.1% G 105.9% G 95.0% 114.0% G VSB10: Immunisation age 1, all 3 doses of DTaP/IPV/Hib Average 81.9% R 95.0% 83.2% R 82.3% R 80.3% R 81.2% R 95.0% 85.8% A VSB10: Immunisation Age 2: Hib/MenC booster Average 78.4% R 95.0% 74.2% R 83.2% R 77.5% R 79.2% R 95.0% 77.1% R VSB10: Immunisation Age 2: All PCV booster Average 78.7% R 95.0% 74.7% R 82.8% R 78.2% R 79.4% R 95.0% 75.7% R VSB10: Immunisation Age 2: One dose of MMR Average 78.8% R 91.0% 75.2% R 82.6% A 78.5% R 79.6% R 91.0% 79.9% R VSB10: Immunisation Age 5: All 4 doses of DTaP/IPV/Hib Average 66.3% R 90.0% 69.4% R 63.5% R 66.0% R 65.4% R 90.0% 71.0% R VSB10: Immunisation Age 5: Two doses of MMR Average 68.8% R 89.8% 73.9% R 67.6% R 64.8% R 66.5% R 89.8% 77.6% R VSB13: Chlamydia screening coverage Cumulative 11.0% R 16.8% 4.8% R 6.2% R 35.9% 24.3% R VSB13: Chlamydia screening diagnosis rate per 100,000 Most recent 1,931 A 2,000 1,561 R 1,931 A 2,000 2,001 G VSB13: Chlamydia screening positivity rate Average 8.8% G 7.0% 8.1% G 9.3% G 7.0% 8.2% WCC25: Cervical screening, women age 25-49 in last 3½ years Most recent 69.0% A 70.0% 71.2% G 70.0% A 69.0% A 69.5% A 70.0% 71.3% G WCC25: Cervical screening, women age 50-64 in last 5 years Most recent 75.9% G 75.0% 75.3% G 75.5% G 75.9% G 75.7% G 75.0% 75.6% G PUBLIC HEALTH VSB14: Drug misuse: Numbers of successful completions Most recent 631 R 832 670 R 665 R 649 R 645 R 639 R 635 R 634 R 631 R 604 R 832 694 R Quarterly Indicators Quarter 1 Quarter 2 Quarter 3 Quarter 4 PHQ30: Smoking Quitters Cumulative 779 R 915 247 R 255 R 277 R 1,041 R 1,380 1,250 R PHQ31: Eligible population offered an NHS health check Cumulative 18.7% R 20.0% 4.0% R 5.4% G 3.9% R 5.6% G 20.0% 11.2% R PHQ31: Eligible population receiving an NHS health check Cumulative 10.3% G 6.0% 1.9% G 3.0% G 2.4% G 3.2% G 6.0% 4.6% R VSB08: Under 18 conception rate per 1,000 female 15-17 population Average 22.1 27.2 R Annual Indicators VSB09: Childhood obesity, reception Most recent 9.1% G 13.0% 9.1% G 13.0% 8.3% G VSB09: Childhood obesity, year 6 Most recent 19.1% A 18.7% 19.1% A 18.7% 18.7% A Feb Mar Year End Page 8 of 8