NHS FIFE - Balanced Scorecard 2013/14

NHS FIFE - Balanced Scorecard 2013/14 Improving Health - 1 Patient & Staff Experience - 2 Planning for Service Improvement - 3 Delivery & Efficiency - 4 Smoking Cessation 01 Delayed Discharge Dementia Support 07 Financial Performance National (HEAT) s Child Fluoride Varnish HAI 11 IVF Waiting Times 10 A & E Waiting Times 06 Child Healthy Weight 12 Detect Cancer Early 14 A & E Attendance Rate 15 CAMHS Waiting Times 10 Suicide Rate 13 Emergency Inpatient Bed Days 16 Environment 11 Ante-Natal Care 17 Psychological Therapies National (HEAT) Standards Local Priorities Alcohol Brief Interventions 06 Sick Absence 12 Cancer Waiting Times 13 18 Weeks RTT 14 Drug and Alcohol Waiting Times 09 Childhood Immunisation Equality & Diversity Patient Safety Child Protection Health & Safety 06 Regional and National Planning 19 Treatment Time Guarantee 08 Staff Governance 10 Health Improvement Programme Community Planning 12 Health Inequalities and Physical Activity 14 Stronger and Safer Communities, and Offending 15 Employment 13 Early Years and Early Prevention 18 Economic Recovery and Growth Total 8 10 7 11 NHS FIFE BALANCED SCORECARD FOR 2013-14 Page 1 of 18 ver. 2013.01

1. Alcohol Brief Interventions - we will aim to deliver 4,5, at least 90% of which (4,5) will be in priority settings National Standard: 01 NHS Boards and Alcohol and Drug Partnerships (ADPs) will sustain and embed alcohol brief interventions (ABI) in the three priority settings (primary care, A&E, antenatal), in accordance with the SIGN74 Guideline. In addition, they will continue to develop delivery of alcohol brief interventions in wider settings. NS S Number of Interventions Monitor / scope ABI activity in Primary Care, Antenatal and A & E settings Pursue opportunities with partner agencies for embedding ABI activity in other settings Monitoring and review of training schedule in order to meet identified needs Monitor and review ABI activity in other settings Mary Porter KL CHP Smoking Cessation (SIMD) - we will aim to deliver 3,550 1-month smoking quits in the 40% most-deprived areas of Fife Mar-14 Number of Quits National : 01 Monitor Lost-to-follow-up (LTFU) rates and provide support to stakeholders where these are high 1. 1. NHSScotland to deliver universal smoking cessation services to achieve at least 80,000 successful quits (at one month post quit) including 48,000 in the 40% most-deprived within-board SIMD areas over the three years ending March 2014 Child Fluoride Varnish Applications (SIMD) - we will aim to give 60% of 3 and 4 year old children two applications of fluoride varnish per year National : 01 At least 60% of 3 and 4 year olds in each SIMD quintile to have fluoride varnishing twice a year by March 2014 Mar-14 Delivery of a healthy health service, ensuring front line staff are trained in promoting smoking cessation within all delivery divisions Board, Ops Division and CHP oversight of the smoking cessation target implementation Support independent pharmacy to provide smoking cessation support and submit the subsequent relevant data Build smoking cessation capacity within the wider workforce in primary care & community pharmacy Ensure effective implementation of the Fife Dental Early Years Pathways across all GDP's, Health Visitors, Childsmile and CDS staff Support all dental practices with education, advice and practice visits as required Childsmile to be fully embedded into the 6-8 week and 27-30 month Child Health Review process, and integrated with the Fife Dental Early Years Pathway % children receiving two applications of fluoride varnish in 12-month period Eddie Coyle Eddie Coyle DWF CHP KL CHP GNEF CHP Child Healthy Weight Interventions - we will aim to deliver 1,060 interventions Mar-14 Number of Interventions 1.06 National : 01 To achieve 14,910 completed child healthy weight interventions over the three years ending March 2014 Agreement to be reached to ensure that the service is delivered in a sustainable way utilising the skills and knowledge of the centralised team With regard to ensuring target delivery to mostdeprived areas, consider producing an Equality Impact Assessment (EQIA) in order to highlight areas where plans to target possibly marginalised groups could be undertaken Susan Manion DWF CHP Childhood Immunisation - we will improve the NHS Fife uptake of MMR1 at Age 2, against the standard of 95% LP Mar-14 MMR1 Uptake, Age 2 NHS FIFE BALANCED SCORECARD FOR 2013-14 Page 2 of 18 ver. 2013.01

1.09 NHS Fife will take action to ensure that the uptake of the MMR1 vaccine by children aged 2 improves against the national standard Ensure availability of a robust knowledge base for MMR uptake within Fife to identify and understand local trends and target support to GP practices and Public Health Nursing Teams as required Increase the uptake of MMR rates through health promotion and additional support to families that have not had their children immunised Conduct an assessment of the quality of data exchange between our local Child Health System and ISD, taking steps to imrpove this if required Eddie Coyle DWF CHP Suicide Rate - we will achieve a 20% reduction in suicide rate based on 20 figures Dec-13 Rate per 100,000 Population 1.10 National : 01 Reduce suicide rate between 20 and 2013 by 20% The local multidisciplinary Choose Life Group will continue to deliver on the local evidence-based suicide prevention action plan which focuses on high-risk groups for suicide Choose Life publicity will focus on signposting those in high-risk groups for suicide to appropriate sources of help, and in encouraging individuals to seek help early Eddie Coyle KL CHP Ante-Natal Care - by March 2015, at least 80% of pregnant women in each SIMD quintile will have booked for antenatal care by the 12th week of gestation Mar-15 % Booked within 12 Weeks 1.11 National : 01 At least 80% of pregnant women in each NHS Board deprivation quintile will have booked for antenatal care by the 12th week of gestation by March 2015 so as to ensure improvements in breast feeding rates and other important health behaviours Work with e-health colleagues to undertake and determine the efficiency and effectiveness of the use of hand-held data entry devices for midwives Participate in national roll-out of maternity manpower tool Ensure that information about booking early (and the benefits of this) is available in a format suitable to all groups, with interpreting and translation services provided as necessary Through service and workforce planning, identify a way of ensuring the sustainability of this part of the ante-natal service Susan Manion DWF CHP Health Inequalities and Physical Activity CP Mar-14 None Community Planning: 01 Integration of physical activity to the NHS clinical pathways Increase level of physical activity in teenage girls 1.12 We will work with partners to improve the health of Fifers, narrow the health inequalities gap and increase opportunities and awareness of the importance of being physically active Increase attendance at physical activity Continuous Professional Development for NHS staff Increase the number of walkers (including the elderly) attending Bums off Seats Health Walks Increase the number of volunteers supporting physical activity programmes Eddie Coyle DWF CHP GNEF CHP KL CHP NHS FIFE BALANCED SCORECARD FOR 2013-14 Page 3 of 18 ver. 2013.01

06 Increase participation at health classes for Active Options 2 within Fife Sports and Leisure Trust NHS FIFE BALANCED SCORECARD FOR 2013-14 Page 4 of 18 ver. 2013.01

Delayed Discharges - we will aim to achieve no waits over 2 weeks Apr-15 Number DD > 2 weeks 2.01 National : 01 Monitor demand and flow, adjusting plans if required No people will wait more than 28 days to be discharged from hospital into a more appropriate care setting once treatment is complete, from April 2013; followed by a 14 day maximum wait from April 2015 Equality & Diversity - we will improve the of Healthcare Services through strict adherence to the principles of Equality & Diversity LP Mar-14 Improve early assessment and discharge planning by ensuring roles and responsibilities in this process are clearly understood by staff, patients and carers Review and enhance services provided within our local Intermediate Care model % Ethnicity Data Collection (SMR00 and SMR01) Vicky Irons DWF CHP GNEF CHP KL CHP OD Ensure that the new model of engagement for all 9 strands of Equality & Diversity is working effectively and improving engagement 2. Ensure service users are treated with dignity and respect, and that the principles of human rights and equality provide the foundation for delivery of the highest quality healthcare services Demonstrate that there is no discrimination and that members of protected characteristics can access health services Patient ethnicity equality monitoring information to be collected for SMR00 and SMR01 throughout NHS Fife Employee information to be gathered and used to better perform the general equality duty around workforce Susan Manion DWF CHP Comply with meeting the three aims of the public sector equality duty (PSED) HAI - we will aim to reduce the rate of staphylococcus aureus bacteraemia (including MRSA) to 0.24 and the rate of C diff infection in the over 15s to 0.25 Mar-15 Rate of Sabs cases (per 1,000 AOBD) Rate of C diff cases (per 1,000 TOBD) National : 01 Working with Health Protection Scotland's support team, develop new initiatives for both hospital and community SABs, maintain the focus on preventing device related SABs in hospital and develop initiatives to help reduce community SABs cases All hospital and community SAB and CDI cases to be investigated (REI for selected cases) to identify likely cause and any gaps in practice, with detailed feedback to wards and units and wider sharing of key learning points 2. Safe Further reduce healthcare associated infections so that by 2014/15 NHS Boards staphylococcus aureus bacteriamia (including MRSA) cases are 0.24 or less per 1000 acute occupied bed days; and the rate of Clostridium difficile infections in patients aged 15 and over is 0.25 cases or less per 1000 total occupied bed days Support and monitor delivery of MRSA screening Key Performance Indicators (KPIs) for acute admissions in order to identify and manage patients potentially at risk of MRSA SABs Further integration of Infection Control into Scottish Patient Safety activity, particularly in regard to Catheter Associated Urinary Tract Infection (CAUTI) Gordon Birnie OD CRR 32 - Infection Control NHS FIFE BALANCED SCORECARD FOR 2013-14 Page 5 of 18 ver. 2013.01

Maintain systematic monitoring of antibiotic prescribing, particularly for urinary tract infections and the use of broad-spectrum antibiotics, and link the findings to targeted prescriber education 06 Hand Hygiene promotion through a National Programme and the Scottish Patient Safety Programme (SPSP) Health & Safety - we will ensure that local action plans for Health and Safety are in place, monitored and are continuously reviewed LP Mar-14 Number of Staff Incidents Number of Staff Injuries Number of RIDDOR Incidents SCART Performance Level Support local groups to move key areas from the NHS Fife health and safety workplan over to local plans and support activities that will systematically review and capture any new or emerging risks Maintain wider awareness of health and safety through quarterly reports on NHS Fife as a whole, and on local workplan progress 2. 2.06 Safe Clinically E NHS Fife will ensure that local action plans for Health and Safety are in place, monitored and are continuously reviewed Sick Absence - we will aim to achieve and sustain a sickness absence rate of no more than 4% National Standard: 01 06 07 Undertake a review of Violence & Aggression incidents to date, assess the effectiveness of training and other initiatives and develop improvement plans Review selected RIDDOR reports to identify and rectify any gaps in practice and share from lessons learnt Monthly analysis of incident trends in order to direct support arrangements and reduce the likelihood of recurrence Ensure a programme is in place to review all Health Surveillance needs Establish an audit programme for SCART (Statutory Compliance Audit & Risk Tool) to ensure that appropriate support is being provided as required 08 Review First Aid arrangements across NHS Fife NS S % Sickness Absence Rate Develop, implement and evaluate a sustainable attendance management rolling training and refresher programme Utilise the reporting capability of SSTS to its full capacity to support management in producing meaningful reports on sickness absence to target appropriate action and assist in the identification of absence patterns Review and improve OHSAS Management Referral processes to minimise occurrence of DNA and cancellation rates Rona King Rona King HS SG CRR 1280 - Legionella Precautions CRR 30 - Health & Safety CRR 1890 - Staff Governance, Sickness Absence NHS FIFE BALANCED SCORECARD FOR 2013-14 Page 6 of 18 ver. 2013.01

Effective NHS Boards to achieve a sickness absence rate of 4% Consolidate the activity of the NHS Fife Attendance Management Group to share best practice, organisational learning and to monitor attendance management performance within NHS Fife Sickness Absence Establish local Attendance Management Groups within each operational unit to share best practice, organisational learning and to monitor local attendance management performance 06 Develop, implement and evaluate the Management of Attendance Review and Improvement Panels within NHS Fife Staff Governance - we will aim to ensure staff governance strategy setting and action planning processes are in place LP Mar-14 None Consider local implementation of emerging PIN Guidelines as these become available 2.08 We will aim to ensure staff governance strategy setting and action planning processes are in place Implement eess (e: Employee Support System) within Phase 1 of the national implementation programme (eess is a NHS Scotland Management Information System) Review local reporting arrangements in line with the revised SGHSCD template to be used for completion of the Staff Governance Self Assessment Audit tool Contribute to the National consultation on the revised Staff Governance Standard to ensure that it is fit for purpose, and review local arrangements as appropriate Rona King SG CRR 910 - Workforce Modernisation & Development CRR 938 - Implementation of MMC Ensure that the outcome of the Staff Survey results are incorporated into both the coporate NHS Fife and Local Action Plans Detect Cancer Early - by 2014/15, at least 20% of cancer patients will be diagnosed and treated in the first stage of breast, colorectal and lung cancer Mar-15 Cancer Detection Rate (Stage 1) 2.12 National : 01 To increase the proportion of people diagnosed and treated in the first stage of breast, colorectal and lung cancer by 25% by 2014/2015 Reduction in Emergency Bed Day Rates for Patients Aged 75+ - by 2014/15, we will aim to reduce the bed days rate to 4,8 National : 01 The implementation group, which will include GPs, lead clinicians, Primary Care and community staff will lead the programme and implement the project plan with involvement from all sectors Maintain high case ascertainment in cancer audit and current level of collection of staging data Monitor the proportion of patients following different routes to diagnosis, and consider clinical pathways when analysing this Continue local initiatives on cancer symptom awareness Revision of pathways to extend direct access to diagnostics for GPs Bed Day Rate per 1,000 Mar-15 Population Aged 75+ Complete the implementation of Hospital at Home (H@H) across Fife Brian Montgomery CG NHS FIFE BALANCED SCORECARD FOR 2013-14 Page 7 of 18 ver. 2013.01

2.13 NHS Boards and partners will reduce the rate of emergency inpatient bed days for people aged 75 and over per 1,000 population, by at least 12% between 2009/10 and 2014/15 Conduct a review of performance and monitoring arrangements by Partnership Management Group (PMG) as an integral component of change fund plans Develop, with service managers, a joint workforce monitoring tool to ensure that appropriately skilled staff are available to the Integrated Community Assessment and Support Service (ICASS) Vicky Irons GNEF CHP Stronger and Safer Communities, and Offending CP Mar-14 None 2.14 Safe Community Planning: 01 We will work with partners to prevent crime, antisocial behaviour and offending and to reduce reoffending Forensic Mental Health Team (FMHT) and Forensic Learning Disabilities Service -continue to provide care and treatment for mentally disordered offenders/learning disability Forensic Mental Health Team (FMHT) also to continue to provide a court liaison service providing appropriate care for individuals who are experiencing serious mental health problems with the aim of reducing remands Susan Manion Mary Porter Anne Buchanan Continue NHS Fife's contribution to Multi-Agency Risk Assessment Conferencing (MARAC) to address very high risk cases of domestic abuse Employment CP Mar-14 None 2.15 Community Planning: 01 We will work with partners to improve employment outcomes for all age groups, including tackling the specific challenge of youth unemployment Get Britain Working (2-8 weeks work experience for 16-24 year olds) - 30+ potential places to be made available in a variety of roles during 13-14 Triage Work Placements (supporting the delivery of the Government Work Programme by providing unpaid work placements - number of referrals available for 13-14 to be confirmed Internships (to support the One Year Job Guarantee Scheme) - plans to continue support into 13-14 - to be confirmed Rona King NHS FIFE BALANCED SCORECARD FOR 2013-14 Page 8 of 18 ver. 2013.01

Dementia - we will aim to have a QOF-registered proportion of diagnosed patients consistent with the European measure of prevalence, all of whom will have a minimum of a year's post-diagnostic support and a personcentred support plan Mar-16 % Dementia Patients Registered on QOF % Demential Patients with Support Plan 3. National : 01 To deliver expected rates of dementia diagnosis and by 2015/16, all people newly diagnosed with dementia will have a minimum of a year s worth of post-diagnostic support coordinated by a link worker, including the building of a person-centred support plan Work with Scottish Government and other Health Boards in order to access external expertise and ideas, and inform the development of small tests of change Explore the possibility of getting Alzheimer s Scotland and/or Scottish Dementia Working Group to send representatives to Fife to speak to key staff Engage fully with the SG support team in exploring the future requirements for patient pathway developments (around diagnosis and post diagnostic support) and in agreeing and implementing any ensuing recovery plan Mary Porter KL CHP Patient Safety (including SPSP): we will aim to reduce mortality as measured by HSMR in a reliable and sustainable way, thus contributing to the national aim of reduced HSMR by 20% by December 2015 LP Mar-14 HSMR 3. Safe Acute Patient Safety Programme activities A key aim of the national patient safety programme is to reduce mortality, as measured by HSMR, by 20% by December 2015. Methods to achieve this include the adoption, spread and sustainability of the core patient safety programme activities, and the locally developed preventing harm action plan. Progressing Preventing Harm Action Plan Brian Montgomery CG Regional & National Planning - we will work with our Regional & National Planning Partners to deliver identified services for the population of Fife LP Mar-14 None Obesity Treatments: We will develop a Comprehensive Weight Management Service for the population of NHS Fife that meets the National 'Obesity Treatment; Best Practice Guidance' Vascular Services: We will develop pathways of care that meet the requirements of the National Framework for Vascular services 3.06 We will work with our Regional & National Planning Partners to deliver identified services for the population of Fife Spinal Services: We will work locally and Regionally to further develop and implement pathways of care that are consistent with the recommendations of the National Spinal Review Group Neonatal Services: We will work with the SEAT Regional planning group to deliver the recommendations of the Neonatal Care in Scotland Framework when published Brian Montgomery SR Breast Screening: We will work with NSD and Regional partners on the Review of Service Delivery - Breast Screening Programme NHS FIFE BALANCED SCORECARD FOR 2013-14 Page 9 of 18 ver. 2013.01

06 Scottish Ambulance Service (SAS): We will work with the SAS to develop and deliver joint services Health Improvement Programme - we will deliver the NHS Fife Health Improvement Programme LP Mar-14 None Work with Improvement Hub and the Programme Management Office (PMO) to deliver the objectives of the Healthcare Improvement Plan 3.10 Brian Montgomery SR Work with the Improvement Hub and PMO to deliver the aims of "Getting Better in Fife" IVF - we will reduce the waiting time for IVF treatment to ensure that nobody will wait longer than 12 months for the first cycle by March 2015 Mar-15 The Healthcare Improvement Plan will be reviewed at each meeting of the Redesign Number Waiting more than 12 Months for First Cycle Local monitoring of Service Level Agreement with NHS Tayside, and maintaining effective communication with that Health Board in order to identify and address any drop in performance in a 3.11 timely fashion Eddie Coyle 3.13 3.14 We will deliver the NHS Fife Health Improvement Programme Eligible patients will commence IVF treatment within 12 months by 31 March 2015 Early Years and Early Intervention - we will improve outcomes for the children of Fife by ensuring a shift in resource deployment and delivery to prevention and early intervention We will improve outcomes for the children of Fife by ensuring a shift in resource deployment and delivery to prevention and early intervention Rate of Attendance at Accident and Emergency - we will aim to reduce the rate of attendance at Victoria Hospital, Kirkcaldy to 1,311 National : 01 To support shifting the balance of care, NHS Boards will achieve agreed reductions in the rates of attendance at A&E between 2009/10 and 2013/14 Implementation of findings of National Infertility Group report when published by Scottish Government, as directed by Ministers Addressing recurring and non-recurring funding levels to meet demand and waiting time targets in line with 1 and 2 above LP Mar-14 None Mar-14 Secure the ambitions of the Early Years Task Force, measured against the 10 Core Indicators of the Early Years Framework Progress against Change Fund objectives in a coherent fashion across the partnership Ensure targeted support to vulnerable families with infants through the delivery of evidence based programmes such as: Family Health Project, Vulnerable In Pregnancy and Family Nurse Partnership Programme Refresh patient flow mapping to identify the impact on services to which specific groups of patients may be diverted Development of agreed service boundaries with SAS and other professional bodies Staff education around service definition, alternatives and processes for patient redirection together with public education Attendance Rate, per 100,000 Population Susan Manion Brian Montgomery NHS FIFE BALANCED SCORECARD FOR 2013-14 Page 10 of 18 ver. 2013.01 CG DWF CHP SR

PFPI leads to be invited to participate in developing public information materials NHS FIFE BALANCED SCORECARD FOR 2013-14 Page 11 of 18 ver. 2013.01

Child Protection - we will ensure that information is shared appropriately to support Child Protection LP Mar-14 % Inter-Agency Referral Discussions (IRD) Completed within 6 Working Days 4. Safe Achieve a performance of 95% or more IRDs completed within 6 working days by end of December 2013 Progress multi-agency Child Plans Anne Buchanan CG DWF CHP CR 922 - Child Protection Ensure that information is shared appropriately to support Child Protection As part of our work on 'Getting It Right For Every Child' (GIRFEC), pursue the development of a multiagency chronology Financial performance - we will aim to i) operate within our RRL, ii) operate within our CRL, iii) meet our cash requirement Mar-14 Evaluation of the effectiveness of the online Child Protection Register and messaging system Deficit/Surplus for End FY against Total RRL 4.07 National : 01 NHS Boards to operate within their agreed revenue resource limit; operate within their capital resource limit; meet their cash requirement Monthly monitoring and reporting of the financial position including both the revenue and capital position to relevant committees including the Finance and Resources and the Board Robust process of year-end forecasting of out-turn position from mid-year review and high level forecasting from the first quarter Regular budget review meetings with key budget holders to monitor progress and agree actions to ensure year-end targets are met Chris Bowring F&R CRR 2124 - Prescribing and Medicines Management CRR 37 - Financial s A&E Waiting Time - we will aim to have 95% of attendees seen within 4 hours, as a step towards a sustainable performance standard of 98% Sep-14 % Waiting <= 4 hours National : 01 Consistently achieve 100% compliance in the Emergency Department minors flow Highlight delays within flows in the Emergency Department, acute receiving units (medical, surgical and orthopaedics), specialty wards and community hospitals to inform improvements around demand, capacity and queue across the 7 day week 4.10 95% of patients will wait less than 4 hours from arrival to admission, discharge or transfer for accident and emergency treatment by year ending September 2014 Deliver standard by ensuring clear roles, responsibilities, communication, escalation mechanisms, structured meetings with appropriate attendance and agreed actions, and by monitoring effect on quality of patient care Ensure operational data supports whole system management of and improvement against the 4 hour emergency access standard George Cunningham OD CRR 35 - Capacity Planning Develop strategies for ensuring that delivery of the target is synonymous, to partners and stakeholders internal and external to NHS Fife, with delivery of quality and improved patient outcomes 06 Build capacity for the delivery of improvement within clinical teams NHS FIFE BALANCED SCORECARD FOR 2013-14 Page 12 of 18 ver. 2013.01

07 Work with health and social care partners to standardise access arrangements to community health and social care teams across Fife (process and timescale) Cancer Waiting Times - we will aim to; i) treat any patient urgently referred with a suspicion of cancer within 62 days ii) treat any cancer patient within 31 days of decision to treat NS S i) Cancer: % RTT within 62 days ii) Cancer: % DTT within 31 days National Standards: 01 Work with the clinical teams and directorate management to ensure enough surgical, outpatient and diagnostic capacity for cancer patients 4.12 95% of all patients diagnosed with cancer to begin treatment within 31 days of decision to treat, and 95% of those referred urgently with a suspicion of cancer to begin treatment within 62 days of receipt of referral Monitor and analyse the steps in pathways for patients transferred to other health boards, to identify areas for improvement Develop acute oncology pathways for patients admitted with an oncological emergency Working closely with Primary Care colleagues, continue to review all care pathways from referral to treatment,including the pathways for screening patients, and undertake re-design as appropriate Brian Montgomery OD 18 Weeks RTT - we will aim to deliver a maximum 18 weeks referral to treatment National Standards: 01 06 NS S Review the Central Cancer Referral unit processes and performance and implement changes identified to improve the service Develop improvement measures and outcomes and report cancer waiting times through the Elective Flow Improvement Programme % Patients Treated within 18 Weeks of Referral Implement effective capacity plan and monitor impact on stage of treatment waiting times 4.13 90% of planned/elective patients to commence treatment within 18 weeks of referral Develop and monitor capacity plans for inpatient and daycase, outpatients and diagnostic capacity Continue to develop and implement prospective monitoring and reporting of 18 week RTT and ensure timely transfer of information between health boards George Cunningham OD CRR 35 - Capacity Planning Ensure the Elective Flow improvement programme delivers the aims and identified improvements Achieve and maintain 85% of outpatient appointments with clinical outcome 4.14 Drug and Alcohol Waiting Times - we will aim to have 90% of clients wait no longer than 3 weeks from referral to treatment National : 01 NS S Monitor and review current joint working arrangements, processes, performance and capacity % Clients Referred for Drug/Alcohol Treatment treated within 3 weeks from date referral received Mary Porter KL CHP NHS FIFE BALANCED SCORECARD FOR 2013-14 Page 13 of 18 ver. 2013.01

e 90% of clients will wait no longer than 3 weeks from referral received to appropriate drug or alcohol treatment that supports their recovery Monitor / scope current service provision, particularly in Primary Care Faster Access to Mental Health Services - we will aim to have 90% of patients wait no longer than 18 weeks from referral to treatment for specialist CAMHS services Mar-15 % Patients Treated within 18 Weeks of Referral National : 01 Use improvement methodologies to inform small tests of change aimed at reducing DNAs as a mechanism for increasing delivery capacity 4.15 Deliver faster access to mental health services by delivering 26 weeks referral to treatment for specialist Child and Adolescent Mental Health Services (CAMHS) services from March 2013, reducing to 18 weeks by December 2014 Convert two child psychotherapy training posts to substantive posts at the end of the current training period Work with key partner agencies through all levels of management to ensure a high level of awareness of the contribution of CAMH Service outcomes to the Single Outcome Agreement and Local Children s Services Plan Provide a regular feedback of information to key patient pathway managers about specific patients and their waits in order to improve the targeted allocation of resources and a focus on the planning of future assessments Mary Porter KL CHP Environment - we will aim to reduce: i) CO² emissions, from the consumption of fossil fuels, by 3% per year ii) Energy consumption by 1% per year Mar-15 i) CO² Emissions ii) Energy Consumption 4.16 National : 01 NHSScotland to reduce energy-based carbon emissions and to continue a reduction in energy consumption to contribute to the greenhouse gas emissions reduction targets set in the Climate Change (Scotland) Act 2009 Provide monthly monitoring reports to appropriate groups New build projects to be designed to meet good practice benchmarks and incorporate renewable energy technologies Internal temperatures, building controls and time clocks to be set appropriately and reviewed on a regular basis Consumption of fossil fuels to be monitored on a monthly basis Jim Leiper OD Implementation of energy/carbon reduction projects Faster Access to Mental Health Services - we will aim to have 90% of patients waiting no longer than 18 weeks from referral to treatment for Psychological Therapies Mar-15 % Patients Treated within 18 Weeks of Referral 4.17 National : 01 Deliver faster access to mental health services by delivering 18 weeks referral to treatment for Psychological Therapies from December 2014 Ensure that the best possible use is made of the e- Health systems currently available, and continue with preparations for adopting MIDAS (initially for clinical psychology services) Implement a comprehensive scoping and mapping process to identify all relevant services Undertake detailed workforce and service provision audits to identify gaps and to inform service redesign and decisions about future staff training Mary Porter KL CHP NHS FIFE BALANCED SCORECARD FOR 2013-14 Page 14 of 18 ver. 2013.01

Use the link established with NES through the Psychological Therapies Training Coordinator to identify training opportunities Economic Recovery and Growth CP Mar-14 None 4.18 Community Planning: 01 We will work with partners to improve the performance of the Fife economy Continued use of local companies and services where possible Glenwood Health Centre New Build - deliver planned work placements and apprenticeships Glenwood Health Centre New Build - 60% (significant proportion of which will be local) of work delivered by Small and Medium Enterprises (SMEs)/Third Sector Organisations (TSOs) Rona King Glenwood Health Centre New Build - 80% work package tender opportunities for local SMEs/TSOs 4.19 Treatment Time Guarantee - we will deliver the Treatment Time Guarantee under the Patient Rights (Scotland) Act 2011 We will ensure that all eligible patients receive Inpatient or Day Case Treatment within 12 weeks of such treatment being agreed LP Mar-14 Ensure effective monitoring and escalation processes in place for Treatment Time Guarantee and stage of treatment targets and action taken to deliver against standards % Patients Treated within 12- Week TTG George Cunningham OD NHS FIFE BALANCED SCORECARD FOR 2013-14 Page 15 of 18 ver. 2013.01

NHS FIFE - Balanced Scorecard List of abbreviations CG - CHP - CP - DWF - F&R - GNEF - HS - HSCP - KL - LP - NS - - OD - SG - SR - Clinical Governance Community Health Partnership Community Planning Dunfermline & West Fife Finance & Resources Glenrothes & North East Fife Health & Safety Health & Social Care Partnership Kirkcaldy & Levenmouth Local Priority National Standard National Operational Division Staff Governance Service Redesign NHS FIFE BALANCED SCORECARD FOR 2013-14 Page 16 of 18 ver. 2013.01

NHS Scotland Strategy The s In 2010, the Healthcare Strategy for NHSScotland set out the overarching aim of achieving world-leading quality healthcare services across Scotland, underpinned by the 3 Healthcare s; Healthcare s - Mutually beneficial partnerships between patients, their families and those delivering healthcare services which respect individual needs and values and which demonstrate compassion, continuity, clear communication and shared decision-making. Safe - There will be no avoidable injury or harm to people from healthcare they receive, and an appropriate, clean and safe environment will be provided for the delivery of healthcare services at all times. - The most appropriate treatments, interventions, support and services will be provided at the right time to everyone who will benefit, and wasteful or harmful variation will be eradicated. The Strategy included a commitment to develop a Measurement Framework to support our shared vision of healthcare quality. It was proposed that progress towards the three s would be assessed by reference to a number of Outcome Measures, and that these measures would be based on a combination of patient and staff perspectives, alongside measures of safety and effectiveness. These measures would be used to assess direction of travel, and would not be set as targets. As part of the proposal for the Measurement Framework, the Strategy made a commitment that the HEAT targets would be aligned to the s. The HEAT targets would therefore reflect the agreed areas for specific accelerated improvement each year, contributing to progress towards the s. NHS FIFE BALANCED SCORECARD FOR 2013-14 Page 17 of 18 ver. 2013.01

NHS Fife Balanced Scorecard - audit trail of changes ID Nature Change / Comment Version 2013.01 Baselined for April 2013 Board Meeting 15//2013 N/A N/A Final draft approved by SMT Jan to Apr Various changes to draft BSC, as per decisions made by N/A N/A 2013 SMT Draft created NHS FIFE BALANCED SCORECARD FOR 2013-14 Page 18 of 18 ver. 2013.01