TAMESIDE & GLOSSOP INTEGRATED CARE NHS FOUNDATION TRUST Report to Public Trust Board meeting of the 29 th June 2017 Agenda Item 7b Title Sponsoring Executive Director Author (s) Purpose Previously considered by Safe ing Report Tracey McErlain-Burns, Interim Chief Nurse Tracey McErlain-Burns, Interim Chief Nurse To note/receive n/a Executive Summary In-line with the Hard Truths Commitments regarding the publishing of ing Data, the Trust Board are required to review staffing data on a monthly basis. In summary there was little improvement in nursing and midwifery shift fill rates in May 2017. Overall the day time fill rate with Registered Nurses / Midwives was up slightly at 91.2%. This represents the second consecutive month of marginal improvement. Five wards achieved Registered Nurse / Midwife day time fill rates less than 80% and in the paper details are provided of a new pilot to commence on ward 31. This pilot will look at the impact of introducing a pharmacy technician to the ward to assist in medication administration and reconciliation. Details are provided of the vacancy levels in theatres and critical care. Both areas currently have high usage of bank and agency which will reduce, subject to all else including sickness absence levels not deteriorating, over the next three to four months. A successful recruitment event was held on 10 June and the next one is taking place on 19 July. In addition there has been a review of the Keep in Touch events. Finally the report included details for Q1 of the numbers of nurses and midwives subject to revalidation with the NMC. In conclusion the Board can be assured of the close monitoring and management of nurse staffing levels. The position is relatively unchanged and remains challenging every day. The NHS Employers workforce supply model has been included in the report and going forward this report will be further expanded to provide assurance that all aspects of that model are being addressed. Related Trust Objectives 1. All patients receive harm free care through the Trust s Patient Safety Programme. 2. To improve the quality of patient care through the implementation of the Trust s agreed Quality Strategy. 3. To improve the patient experience through a personalised, responsive, compassionate and caring approach to the delivery of patient care. 1
Risk Assurance risk impacted upon Legal implications/regulatory requirements Financial Implications Has a quality impact assessment been undertaken? How does this report affect Sustainability? CR734: Nurse vacancies, leadership and nurse staffing/ recruitment across medicine and the ability to provide safe care. AF3480: Failure to meet CQC registration requirements relating to staffing. AF3482: Failure to ensure adequate staffing levels to ensure patient safety and quality of services NHS England monthly requirement to publish and report ing Data The CQC report published 7 th February 2017 states that the Trust must ensure that there are appropriate numbers of nursing staff deployed to meet the needs of patients (medical services). There are no new immediate financial implications albeit the financial implications of international recruitment are being considered by the executive team. Yes where applicable in plans The Trust is required to ensure staffing levels are adequate to meet patient safety and quality requirements. Action required by the Board The Trust Board is requested to receive this update and note the actions described and the assertive monitoring and management in place. 2
Background This is a monthly report to the Trust Board following National Quality Board (NQB) guidance issued in November 2013 to optimise nursing, midwifery and care staffing capacity and capability: How to ensure the right people, with the right skills, are in the right place at the right time: A guide to nursing, midwifery and care staffing capacity and capability. The guidance clearly sets out the expectations and requirements of the Trust to meet the Hard Truth s commitments (following the Mid ordshire report). In July 2016, the NQB published an updated set of expectations for nursing and midwifery staffing to assist NHS Provider Boards to take local decisions which will deliver high quality care for patients within the available staffing resource (Supporting NHS providers to deliver the right staff, with the right skills, in the right place, at the right time Safe sustainable and Productive ing, NQB, July 2016). This updated guidance incorporates Lord Carter report findings, in setting out the key principles and tools that provider boards should use to measure and improve their use of staffing resources to ensure safe, sustainable and productive services. As advised in recent months the content of this report is evolving to ensure that the Board has a complete picture of matters relating to safe nurse staffing. This report includes the position regarding theatres and critical care nurse staffing. In addition a section has been added to the report on nursing and midwifery revalidation. The intention is to provide the Board with the revalidation data at the end of each quarter. This report includes data for quarter one. Safe ing Update May 2017 Data Each month the data collection compares the number of nurse staff hours Planned against the number of nurse staff hours used Actual. This is collected by ward, by shift, and is reported by calendar month as a % fill rate by day and by night. Please refer to the heat map (Appendix 1). This staffing information is published via NHS Choices. This data is currently available via our public website in a specific designated section Safe ing : (www.tamesidehospital.nhs.uk/nursestaffing.htm) Overall, Registered Nurse (RN) fill-rates remain constant (with minimal change) month on month, but unregistered (Healthcare Support Worker) fill rates fluctuate due to levels of enhanced care required (1:1 s) and additional support for RN shortfalls. The following graph highlights to the Board that unregistered fill rates for day and night shifts usually meet or exceed 100% and registered fill rates for night shifts have maintained consistency of over 95%. Senior Nurse leaders review nurse staffing levels (actual against planned) several times a day and a conscious decision has been taken to increase the levels of fundamental care support by unregistered staff when registered nurses are not available to fill shifts. The registered nurse fill rate for day shifts is currently running at 91.2% which demonstrates a marginal improvement in comparison to the rate of 90.2% for the month of April and an increase for the second consecutive month. The details in this report describe some of the actions being taken to address the continued shortfall. 3
% Fill Rate 120 115 110 105 100 95 90 85 Nurse & Midwifery ing - Average Fill Rates (%) Registered % of shifts filled DAY Registered % of shifts filled NIGHT Health Care Asst % of shifts filled DAY Health Care Asst % of shifts filled NIGHT Exception Report May 2017 There were 5 inpatient areas with registered nurse/midwife day fill rates <80% in May 2017 (Appendix 1 heat map). Those areas were: Ward 31 Ward 42 Ward 44 Ward 45 Ward 46 In addition to wards 42, 44 and 46 which continue to be featured in this section of the board report, wards 31 and 45 are also reporting day fill rates of less than 80% during the month of May. Fill rates (registered nurse) are higher at night in each of the five areas largely because it remains the case that bank and agency workers prefer night shifts for reasons of family flexibility and the enhanced pay rates. During the day time these areas are supported some Specialist Nurses, Matrons and other allied health professionals. As detailed in last month s report, 4 of the above wards now have two Band 3 Care and Quality Coordinators in post to support patient flow and ward coordination. Ward 42 have appointed to the position and are waiting for the new post holder to commence. Following the recent (10 June) recruitment event 2 registered nurses have been allocated to commence in post on Ward 42 in September 2017 along with one on Ward 31. There is also a band 7 ward manager post currently out to advert for Ward 31 and they have successfully recruited a registered nurse, band 6 additional to the band 5 referred to above. Ward 31 has strict admission criteria and the ward has lower levels of acuity than the other medical wards. In the past 8 weeks the staffing plan has been adjusted to increase the care support worker numbers to 6 per shift, on days. This has been achieved on the majority of days as demonstrated in the heat map. 4
Acknowledging that registered nurse vacancies exist in large numbers across the country creative ways of supporting registered nurses to achieve safe care continue to be explored. Specifically within the Division of Medicine and Clinical Support Services a paper is being prepared for consideration by the Executive Management Team within the two weeks. This paper will outline how the role of band 5 pharmacy technician could support the administration of medication at ward level. It is envisaged that a pilot will commence on ward 31 during July with an evaluation report to the Service Quality and Operational Governance Group in September 2017. The Chartered Physiotherapy pilot of ward 40 is currently being evaluated. An initial paper was reviewed by the Service Quality and Operational Governance Group in June and the final evaluation will be presented to the Executive Management Team within the next 4 weeks. The initial paper did not include enough post implementation points of measurement to conclude that the early benefits had been sustained. Further measurement had been captured but not included in the paper. Qualitative feedback has been positive. Since February 2017 this report has included details of the number of escalation beds open and the impact on nurse staffing. In the month of May there was an average of 13 additional beds opened across ambulatory care, the day care unit, surgical unit and the acute medical unit. Temporary nurse staffing totalling 739 hours (a combination of registered and unregistered) were requested of which 337 hours were filled via NHS Professionals and the remaining hours were redeployed from other areas within the Trust. Filled / Worked % Filled by NHSP Requested Unfilled Ambulatory Integrated Assessment Unit 78 32 47 40% Day Surgery Unit 573 220 354 38% Surgical Unit 38 37 1 99% Ward 30 H C U 13 12 1 96% Ward 31 Adult Medicine 38 37 1 97% Total 739 337 402 54% Care Hours per Patient per Day (CHpPD) In recent months the heat map attached at appendix 1 has included actual CHpPD; a measure used by NHS Improvement. This provides a consistent way of measuring the deployment of nurses and healthcare support workers and it needs to be used alongside acuity and skill mix. Planned CHpPD by ward and Trust has been added to the heat map from February 2017 to show the hours required (based on nurse staffing establishments) versus that available. This month s heat map draws attention to seven wards with actual registered CHpPD hours less than planned. Five of the seven areas demonstrate that they responded by increasing the levels of unregistered staff as their actual unregistered CHpPD hours are more than planned. In addition, ward 40 had the support in month of 287.5 hours of Band 7 Physiotherapy time working alongside nursing staff on long day shifts and these care hours are not included in the CHpPD calculation in line with NHS England requirements. The heat map also draws attention to areas such as critical care, the neonatal unit, children s unit, Stamford Unit and Shire Hill all of which exceeded their planned RN hours. This was due to reduced occupancy in those areas at times during the month of May, for example occupancy at Shire Hill for the month was 86%. 5
The graph below shows the trend in actual CHpPD, as a total of days and nights, registered and unregistered nursing/midwifery staff, since the methodology was introduced. It demonstrates an increase in CHpPD at the end of 2016 which has been sustained, with the exception of February 2017. 7.8 Care Hours Per Patient Day - Trust Total 7.7 7.6 7.4 7.2 7.0 7.0 7.2 7.1 7.0 7.0 7.3 7.5 7.2 7.5 7.4 7.5 6.8 6.6 6.7 6.6 6.5 6.5 6.4 6.2 6.0 Jun-16 Jul-16 Aug-16 Sep-16 Oct-16 Nov-16 Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 CHPPD Total Planned Safe Midwifery ing The Head of Midwifery is currently undertaking the required six monthly review of midwifery staffing and an update will be provided in the July Board paper. In relation to the development of the A-EQUIP model of employer led supervision of midwives the Head of Midwifery (HoM) is working with other HoMs across Greater Manchester at the request of the GM Directors of Nursing to negotiate some core standards that should feature in the model across all GM maternity services. Community Nursing (adult) Data has been collated for the capacity and demand exercise and is currently being analysed. There are currently no District Nurse vacancies. All positions have been recruited to and candidates are being screened via the recruitment team. Interest in band 5 community nursing positions remains strong during recruitment events and therefore rotation schemes are being discussed. Specifically the nursing leadership team are reviewing the opportunities to create rotation programmes that would run for 2 years and include a final placement incorporating band 6 competency assessment on the basis of growing our own talent. Children and Young People A review of children s and neonatal nurse staffing is currently underway and progress will be reported in the July Board report. 6
Critical Care There are currently a number of staffing shortfalls in critical care for various reasons including vacancies, long term sickness, newly appointed staff awaiting start dates and new starters on a supernumerary development programme. This amounts to 25% of the registered nurse establishment. As a consequence bank and agency usage has increased, however following successful recruitment and new starters progressing through the required specialty training, it is anticipated that reliance on temporary staffing will be significantly reduced by the end of August. An update will be provided in the September Board paper. Theatres, Anaesthetics & Recovery The current registered nurse / ODP vacancy position within Theatres, Anaesthetics and Recovery is 3.54 wte and 5.52 wte Scrub Team. Bespoke adverts and recruitment campaigns are currently active and at the recent recruitment event two positions were recruited to. Both new recruits are experienced registered nurses, within speciality. In common with critical care the service has a number of colleagues in training (7.0 wte). These colleagues are currently supernumerary and being trained by the practice based clinical educator. As with critical care there is reliance on NHSP bank and agency to achieve maximisation of theatre efficiency and Referral to Treatment Times. This reliance will reduce during quarter three of 2017/18 as new starters take up their position and those colleagues in training achieve competence. Red Flags There were a total of 48 incidents with 115 Red Flags recorded via the incident reporting system with regards to Nurse ing for May 2017 this is due to the fact multiple red flags can be reported on one incident. The number of red flags recorded can be broken down as follows:- 7
Department Missed breaks A shortfall of more than 8 hours or 25% of Registered Nurse time available compared with the actual requirement for the shift Delay of 30 minutes in providing pain relief Patient vital signs not assessed or recorded as outlined in the care plan Intentional rounding Unplanned omission in providing medication Ward 31 6 4 1 3 6 20 AMU 5 2 1 4 3 2 18 Acute Cardiology Unit (Ward 5) 1 1 1 1 4 Surgical Unit 3 3 3 3 1 2 15 Ward 41 6 1 4 1 12 Ward 46 1 1 2 1 1 7 A&E 1 1 Ambulatory Care Area 1 1 3 Dewsnap Lane Clinic 1 1 IAU (Integrated Assesment Unit) 3 5 1 1 1 12 Quality & Governance Unit 1 1 Shire Hill - Ludworth Ward 1 Ward 42 7 6 6 2 2 23 Ward 44 1 1 2 Total 36 26 18 15 13 7 115 Total 8
The table below captures that the number of incidents and red flags in month compared with previous months. March 2017 April 2017 May 2017 No of Incidents 69 54 48 Red Flags 163 147 115 As reported in the earlier section of this report a pharmacy technician pilot will be trialled on ward 31. One of the outcome measures will be achieving the administration of analgesia and other essential medications such as that required by patients living with Parkinson s disease on time and without delays exceeding 30 minutes. Last month there were 13 flags related to Intentional Rounds. At the Patient and Service User Experience Data Group in June several data sources highlighted concern regarding Intentional Rounds and therefore a task and finish group will be established, led by the Lead Nurse for Practice Development to standardise and relaunch the model of Intentional Rounds. In terms of Red Flags for midwifery services and community nursing separate pieces of work are being undertaken. In the interim both services are encouraged to use the generic flags. Strategies to Address Shortfalls in Nursing & Midwifery ing Levels The Trust has a range of strategies which include recruitment, workforce redesign through the creation of new roles, retention and flexible staffing solutions. This section of the report provides an update on some of those strategies. In June 2017 NHS Employers briefing on workforce supply included the following schematic. Whilst this report has detailed local actions relating to several of the dimensions in the model below not all have been covered in the context of achieving safe nursing and midwifery staffing levels. Going forward this section of this report will be developed to provide assurance to the Board that the partnership between HR and corporate nursing is maximising the achievement of a successful workforce supply strategy. 9
Recruitment During the month of May 11 registered nurses left the organisation; a total of 8.78 wte and 14 wte registered nurses commenced employment with the Trust. The recent registered nurse recruitment event took place on Saturday 10 th June. There were 13 successful appointments to the organisation. Six experienced registered nurses were successfully employed and allocated to work in theatres /anaesthetics, theatres scrub, ward 42 (x2) and ward 31. The sixth nurse has expressed an interest in a number of areas so the recruitment team are working with her to find the most appropriate vacant post. It is anticipated that these six nurses will commence in post within one to two months. The remaining appointees were student nurses with stated preferences for the Surgical Unit, Ward 42 and General Medical Wards (46 and 40). Advertising for the next recruitment event on 19 July commenced week ending 16 June. In addition the Interim Chief Nurse is making contact with the Greater Manchester Universities to request access to the students in order to promote the Tameside and Glossop ICFT. Keep in Touch Events The Keep in Touch events hitherto have been relatively informal. They have been very well supported by the nursing leadership team but attended by small numbers of appointees. Those who have attended have engaged well and had questions to ask but on balance it is thought that attendance could be improved by developing a programme of Keep in Touch Events designed around purposeful preparation for joining the ICFT team. The new programme commences on 18 July with a family event. Going forward the intention is to provide a copy of the programme when offers of appointment (subject to clearances) are made. 10
International Recruitment The Executive Management Team will receive the financial appraisal paper on 19 June. The paper will outline how the cost of international recruitment will be recovered within 12 months. Subject to approval a team will travel to the chosen country in July or August 2017. Temporary ing The Trust works with NHS Professionals to provide a temporary staffing solution. In May 2017 the overall temporary staffing fill rate was 76.3%, a slight reduction on the overall fill rate of 77.4% in April and the second consecutive monthly reduction. The top booking reasons remain vacancy, sickness, and 1-1 enhanced care. The graph below shows the fill rates and total requested hours split by registered and unregistered staff for the last 3 months. Demand for registered nurses has reduced over the three months by in excess of 6000 hours whilst at the same time fill rate has not improved. Working with NHSP several initiatives are being designed to attract existing nurses and care support workers to register with NHSP for bank shifts, the aim being to increase shift fill rates and reduce agency usage. Based on NHSP data fill rates at the Trust are better than national averages; nonetheless the Interim Chief Nurse is striving for 75% fill rates for Registered Nurses. As advised in last month s report the senior nursing leadership team have agreed a start date for tighter controls of agency usage using Golden keys which will be applied to all registered nurse requirements sent to NHS Professionals from Monday 19 th June 2017. The keys will be removed by senior nursing staff only, and only in line with agreed timescales. Removal of the key will release the shift to an agreed list of agencies. 11
Preceptorship Leavers One new registrant will be leaving the Trust. This colleague joined the Trust in April 2017 and will be leaving for personal reasons. An exit meeting has been arranged in order to understand the preceptees experience of nursing at the ICFT. Revalidation Registered Nurses and Midwives are required to revalidate with the Nursing and Midwifery Council every three years. Failure to revalidate means that the individual is no longer able to practice as a nurse or midwife and if employed by the Trust would be in breach of their contract of employment. The NMC will very rarely agree an extension to the timeframes for revalidation on the basis that they provide considerable notice of the revalidation dates for each registrant and it is the individuals responsibility to manage their license to practice as a registered nurse and / or midwife. The corporate nursing team provide support to nurses and midwives to ensure that they can manage the process of revalidation. In the context of this report failure to revalidate would impact on the number of registered nurses / midwives in practice which has the potential to worsen the existing challenges of staffing to agreed establishment levels. The table below provides a summary position for the first quarter 2017/18. All the registrants due to revalidate in April and May successfully revalidated despite a near miss with one nurse making a late submission to the NMC. On this occasion the NMC accepted the submission. April May June Number due to revalidate 16 31 18 Evidence of completion of revalidation 16 31 18 Late submission to NMC/registration 0 1 0 updated Registration updated 16 31 Information not yet available Exception given 0 1 0 Extension given 0 0 0 Percentage using HeART system 44% 58% 61% Not submitted/revalidated/registration lapse * 0 0 Information not yet available The number of nurses/midwives due to revalidate in the next 3 months are: July - 14 August - 14 September 87 There is always an increase in numbers in September due to the number of nurses & midwives who complete training at this time of year. The HeART system is an e-portfolio provided to registrants by the ICFT to enable them to compile their continued professional development evidence throughout their employment, assisting with the revalidation process. Summary In summary there was little improvement in nursing and midwifery shift fill rates in May 2017. Overall the day time fill rate with Registered Nurses / Midwives was up slightly at 91.2%. This represents the second consecutive month of marginal improvement. 12
Five wards achieved Registered Nurse / Midwife day time fill rates less than 80% and in the paper details are provided of a new pilot to commence on ward 31. This pilot will look at the impact of introducing a pharmacy technician to the ward to assist in medication administration and reconciliation. Details are provided of the vacancy levels in theatres and critical care. Both areas currently have high usage of bank and agency which will reduce, subject to all else including sickness absence levels not deteriorating, over the next three to four months. A successful recruitment event was held on 10 June and the next one is taking place on 19 July. In addition there has been a review of the Keep in Touch events. Finally the report included details for Q1 of the numbers of nurses and midwives subject to revalidation with the NMC. In conclusion the Board can be assured of the close monitoring and management of nurse staffing levels. The position is relatively unchanged and remains challenging every day. The NHS Employers workforce supply model has been included in the report and going forward this report will be further expanded to provide assurance that all aspects of that model are being addressed. Recommendations The Trust Board is asked to note the details of this report and the actions being taken. 13
Appendix 1 Inpatient Ward Compliments Complaints Moderate Harm + Incidents Falls with Harm MRSA C.Diff PU (+G2 only) FFT Positive (%) Registered Fill Rate - Days % of Temp Used Registered Fill Rate - Nights % of Temp Used Unregistered Fill Rate - Days % of Temp Used Unregistered Fill Rate - Nights % of Temp Used Planned Registered CHPPD Actual Registered CHPPD Planned Unregistered CHPPD Actual Unregistered CHPPD Planned Orthopaedic Unit 33 0 0 0 0 0 0 100.0% 94.7% 1.60% 92.5% 13.08% 108.0% 14.17% 132.3% 31.84% 3.45 4.0 2.93 3.9 7.9 Surgical Unit 70 0 0 0 0 0 1 100.0% 84.0% 4.75% 95.5% 23.09% 89.8% 35.81% 114.6% 54.38% 3.12 3.90 2.92 4.22 8.12 Emergency Orthopaedic Unit 15 0 0 0 0 0 0 97.1% 91.6% 1.33% 97.8% 25.32% 111.3% 23.06% 148.1% 41.56% 3.31 3.44 3.00 3.61 7.06 Critical Care - 0 0 0 0 0 0 100.0% 94.8% 11.56% 93.4% 26.35% 113.0% N/A - N/A 25.0 33.83 1.33 2.20 36.0 AMU 9 2 2 1 0 0 0 97.4% 104.6% 7.17% 92.8% 38.00% 100.4% 9.32% 96.3% 35.51% 3.85 3.91 4.27 4.32 8.23 Acute Cardiology Unit 12 0 0 0 0 0 0 100.0% Heart Care Unit 17 1 1 1 0 0 0 95.1% Heat map - Inpatient Ward Areas - May 2017 87.8% 24.28% 110.8% 38.40% 105.4% 10.74% 103.9% 32.99% 4.65 4.40 2.91 2.90 7.30 Ward 31 5 0 0 0 0 1 3 92.9% 79.7% 30.13% 94.9% 82.21% 112.0% 33.39% 108.3% 51.01% 2.40 2.39 3.60 4.73 7.12 Ward 40 35 0 0 0 0 0 0 95.6% 81.1% 1.15% 98.0% 26.57% 85.6% 6.01% 153.5% 34.74% 2.40 2.35 2.79 3.19 5.54 Ward 41 19 2 0 0 0 0 0 93.4% 88.2% 12.28% 96.9% 52.50% 105.8% 13.74% 103.6% 27.56% 2.47 2.48 3.00 3.28 5.77 Ward 42 8 0 0 0 0 0 1 86.2% 73.8% 5.98% 97.3% 44.47% 109.5% 20.75% 102.2% 19.99% 2.80 2.51 3.14 3.01 5.52 Ward 44 15 1 0 0 0 0 1 100.0% 73.1% 1.97% 101.7% 28.76% 145.0% 23.16% 131.9% 36.45% 2.59 2.26 3.31 4.57 6.83 Ward 45 8 0 1 1 0 0 0 88.9% 76.9% 14.79% 98.3% 39.51% 101.3% 23.79% 99.2% 26.25% 2.50 2.32 4.25 4.29 6.62 Ward 46 18 0 0 0 1 0 0 97.8% 74.0% 13.49% 81.3% 30.43% 135.3% 19.67% 173.7% 40.39% 2.81 2.39 2.50 3.84 6.23 Ward 27 (Maternity) 15 0 0 0 0 0 0 95.8% 99.6% 22.56% 95.2% 8.57% 86.9% 6.65% 100.0% 6.45% 2.57 3.98 1.65 1.75 5.73 NICU 28 1 0 0 0 0 0 100.0% 100.8% 18.25% 100.8% 18.46% 100.0% N/A - N/A 7.38 8.82 0.66 0.64 9.46 Children's Unit 30 0 0 0 0 0 0 98.3% 104.4% 10.35% 93.6% 2.48% 77.2% 17.25% - N/A 3.93 8.19 0.99 2.27 10.46 Stamford Unit 1 6 0 0 0 0 0 1 106.3% 13.91% 98.4% 16.46% 96.7% 10.59% 100.3% 43.12% 1.50 2.87 3.75 6.16 9.02 95.8% Stamford Unit 2 16 0 1 1 0 0 0 103.3% 11.32% 105.0% 20.63% 99.1% 15.33% 109.1% 51.04% 1.50 2.31 3.75 5.15 7.46 Shire Hill 19 0 0 0 0 0 1 100.0% 99.8% 17.47% 99.3% 24.32% 98.9% 17.61% 108.4% 58.33% 2.33 2.89 3.33 4.00 6.88 Inpatient Totals/Averages 378 7 5 4 1 1 8 91.8% 91.2% N/A 96.7% N/A 103.6% N/A 115.2% N/A 3.48 3.8 2.99 3.8 7.5 Actual CHPPD TOTAL KEY Complaints Moderate Harm + Falls with Harm MRSA CDIFF PU(+G2) ing Fill Rates 0 - Green 0 - Green 0 - Green 0 - Green 0 - Green 0 - Green > 90% - Green >1- Amber >1 - Amber >1 - Amber >1 - Red >1- Amber >1 - Amber 80-90% - Amber >2 - Red >2 - Red > 2 - Red >2 - Red >2 - Red < 80% - Red NB: Please note that Inpt FFT Total shown does not include Community areas. 14