CATEGORY OF PAPER Specific action required: Provides … · 2017-06-27 · 3. Operations Centre Headlines 3.1. The Operations Centre has faced a number of challenges in May including

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CATEGORY OF PAPER

Specific action required: Provides Assurance: For Information:

Trust Board – 29/06/2017

Report title: Integrated Quality and Performance Report – June 2017

Purpose of report: To provide the Board with an overview of key performance metrics for May 2017

Key issues: (key points of the paper, how this supports the achievement of the Trust’s corporate objectives, overview of risk implications, main risk details on page 2)

May 2017 saw decreases in emergency care performance. Red 2 performance decreased to 57.66% and Red 1 performance to 72.63%. Of the local CCGs, all were below 75% in May 2017 for overall Red performance. Decreases were also seen in performance against all Green and Urgent priorities.

Incident volumes have continued to increase in May 2017, with NEAS responding to 4.06% more incidents for the year to date than in 2016/17, with Red volumes increasing by 5.52% in May 2017. Hartlepool and Stockton-on-Tees CCG, in particular, has seen a significant increase in both red and overall incident volume, with incident volume in April and May 2017 17.3% higher than the same period in 2016.

The Operations Centre has faced a number of challenges in May including the continued high volume of 111 calls following service changes, the impact of the cyber-attack and two bank holidays. Call taking service levels have been affected as a result, with both 999 (93.3%) and 111(92.03%) missing the 95% target.

Issue previously considered by:

Recommended actions:

Board members are asked to note:

monthly performance in May 2017.

the ongoing actions being undertaken to improve response performance

Sponsor / approving director: Graham Tebbutt, Head of Strategy and Transformation

Report author: Hannah Winney, Planning and Performance Manager

Governance and assurance

Link to Trust Priorities: (please tick)

Organisational

Sustainability

Improving

Quality &

Safety

Workforce

& Investors

in People

Clinical Care

& Transport

NHS 111 &

Clinical

Assessment

Service

Comms &

Engagement

Link to CQC / KLOE: (please tick)

Caring Responsive Effective Well Led Safe

Link to Trust values: (please tick)

Pride Strive for

excellence Respect Compassion

Take

responsibility

& be

accountable

Make a

difference –

day in & day

out

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(Please explain how this paper supports the application of the Trust’s values in practice)

Any relevant legal / statutory issues? (Such as relevant acts, regulations, national guidelines or constitutional issues to consider)

Equality analysis completed

If this is not relevant please explain why:

Yes No Not Relevant

An equality analysis is a review of a policy, function or significant service change which establishes whether there is a positive or negative impact on particular social groups

Key considerations Details

Confirm whether any risks that have been identified have been recognized on a risk register and provide the reference number:

Please specify any Financial Implications

Please explain whether there are any associated efficiency savings or increased productivity opportunities?

Are any additional resources required e.g. staff capacity?

Is there any current or expected impact on patient outcomes/experience/quality?

Specify whether appropriate clinical and/or stakeholder engagement has been undertaken:

(stakeholders could include staff, other Trust departments, providers, CCGs, patients, carers or the general public)

Are there any aspects of this paper which need to be communicated to our stakeholders (internal or external)?

(Please tick – if ‘yes’ then please complete all boxes. Please briefly specify the key points for communication and ensure the Comms team are informed via mailto:[email protected])

Yes No Positive Negative

Proactive Reactive Internal External

mailto:[email protected]

Page 3 of 5

Trust Board

Integrated Quality and Performance Report – May 2017

29th June 2017

1. Executive Summary

1.1. May 2017 saw decreases in emergency care performance. Red 2 performance decreased to 57.66% and Red 1 performance to 72.63%. Of the local CCGs, all were below 75% in May 2017 for overall Red performance. Decreases were also seen in performance against all Green and Urgent priorities.

1.2. Incident volumes have continued to increase in May 2017, with NEAS responding to 4.06% more incidents for the year to date than in 2016/17, with Red volumes increasing by 5.52% in May 2017. Hartlepool and Stockton-on-Tees CCG, in particular, has seen a significant increase in both red and overall incident volume, with incident volume in April and May 2017 17.3% higher than the same period in 2016.

1.3. The Operations Centre has faced a number of challenges in May including the continued high volume of 111 calls following service changes, the impact of the cyber-attack and two bank holidays. Call taking service levels have been affected as a result, with both 999 (93.3%) and 111(92.03%) missing the 95% target.

2. Workforce Headlines

2.1. Overall the Trust-wide absence rate has remained at a similar level to April 2017, increasing by 0.01% to 6.19% for May 2017.

2.2. The frontline FTE turnover rate remains within target at 0.53%, an improvement on April 2017. Turnover has reduced across all service lines.

2.3. Due to ESR reconfigurations linked to the restructure it has not been possible to report on all Workforce metrics. Updates will be provided in next month's report.

3. Operations Centre Headlines

3.1. The Operations Centre has faced a number of challenges in May including the continued high volume of 111 calls following service changes, the impact of the cyber-attack and two bank holidays. Call taking service levels have been affected as a result, with both 999 (93.3%) and 111(92.03%) missing the 95% target. PTS call taking service level was achieved, however a drop in the proportion of calls within target was seen in May, as a result of extended sickness within the team.

3.2. The high levels of 111 call volume experienced in April 2017 has continued into May, as a result of media campaigns in Durham Dales, Easington and Sedgefield and North Tees areas, linked to the launch of urgent care services in the area. Call volumes in May 2017 have increased by 22.8% compared to May 2016.

3.3. The cyber-attack affected the 111 service from 12th May to 15th May. This resulted in an increase in call volume from a number of GPs and the media signposting patients to 111, as well as average handling time increasing as a result of manual processes needing to be established.

3.4. New PTS eligibility criteria is being trialled and early indications suggest that this will improve the experience for patients who currently successfully appeal against criteria decisions. It is also expected that this change will reduce call volume through avoiding duplicate calls following appeals.

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3.5. Hear and Treat rates for May 2017 (7.7%) has seen a slight increase compared to April 2017. Benchmarking data for April 2017 shows that we are below the national average of 9.87%.

3.6. Referrals from 111 to Emergency Department has seen recent improvements consolidated during May 2017, maintaining levels below 4%, reflecting the impact of the clinical hub and out of hours service.

3.7. 111 calls referred to 999 has increased slightly in May 2017 reaching 13.98%. This still represents an improvement on previous year performance and is largely due to the increased call volumes experienced during April 2017 which has led to a proportional drop in the number of calls transferred to 999.

4. Emergency Care Headlines

4.1. May 2017 saw decreases in emergency care performance. Red 2 performance decreased to 57.66% and Red 1 performance to 72.63%. Of the local CCGs, all were below 75% in May 2017 for overall Red performance. Decreases were also seen in performance against all Green and Urgent priorities.

4.2. National benchmarking data for April 2017 shows that NEAS is slightly above the national average for Red 1 performance that month. Of the eight trusts that are currently reporting performance against the three national standards, South Central Ambulance Service reported performance above the Red 1 and Red 19 national standards, London Ambulance Service were above the Red 2 and Red 19 standards, whilst Isle of Wight performed above all three.

4.3. The table below provides the current forecast performance figures against the three national performance standards, as set out in our Operational Plan 2017-19. They are subject to review as additional analysis is undertaken, and discussions continue with our commissioners regarding system improvement. Performance is highlighted blue where it has been above the forecast and orange where it is below.

4.4. NEAS was above its Red 1 forecast in May 2017, but failed to achieve either R2 or R19, missing the forecast position by 13.37% and 5.77% respectively. An RPIW is planned to review in depth Red 2 performance.

Table 1 – Performance Forecasts 2017/18

4.5. Overall incident volumes are higher than last year, with NEAS responding to 4.06% more incidents for the year to date than in 2016/17. There remains a high volume of Red demand in May 2017 of 567 per day, which is +5.52% (920 incidents) higher than the May 2016 volumes. Hartlepool and Stockton-on-Tees CCG, in particular, has seen a significant increase in both red and overall incident volume, with incident volume in April and May 2017 17.3% higher than the same period in 2016. Of the 920 increase in red demand experienced in May 2017, 486 were from Hartlepool and Stockton-on-Tees CCG.

4.6. Time lost to handover delays, average job cycle time and late finishes have all increased in May 2017 compared with April 2017, which have all contributed to the reduction in response times. Time lost to handover delays have continued to increase in May 2017, with 599 operational hours lost, this represents an improvement of 12.5% compared with May 2016. The volume of late finishes has increased to 3,615 hours, the highest level this reporting period outside of December and January.

4.7. The number of official diverts between hospitals was 25 in May 2017, an increase of 21 from April 2017. However this level is significantly lower than May 2016 when 69 diverts were recorded.

Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17 Jan-18 Feb-18 Mar-18 Qtr 1 Qtr 2 Qtr 3 Qtr 4 Year end

Original Forecast 68.93% 66.91% 65.82% 65.34% 68.49% 63.56% 66.49% 73.92% 69.33% 72.14% 72.10% 70.04% 77.89% 75.02% 64.65% 64.32% 69.84%

Actual 73.14% 72.11% 72.60% - - - 71.84%


Actual 60.69% 57.06% 58.82% - - - 62.24%


Actual 90.05% 87.59% 88.78% - - - 85.14%

Performance is above forecast

Performance is below forecast

Red 1

Red 2

Red 19

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4.8. NEAS was below the national average for 6 of the 8 National Clinical Indicators (current reporting month is January 2017), though saw a local increase from December 2016 in 5 indicators.

5. Patient Transport Headlines

5.1. PTS performance against key indicators continues to be maintained, with only on time arrival at treatment centre, marginally below target at 79.16% (80% target).

5.2. Patient satisfaction has continued to improve in May 2017 reaching 98.5%, the highest rate in the 13 month reporting period.

6. Fitness to practice statistics (including mandatory training)

6.1. The HCPC registration date for all paramedics is 1 September 2017. For frontline paramedic roles (Allied Health Professionals) is currently 99% match (1 EU paramedic who is currently going through the HCPC registration process).

6.2. NMC and GMC are showing as 100% match and in-date this month.

6.3. ESR is reporting 99.8% compliance level for all employees who require a DBS check based on the position their currently hold within ESR system. The exceptions are for 1 Stores drivers, who are awaiting a ‘Basic’ level check. Note; GMC, Allied Health Professionals and Nursing & Midwifery Council all remain at 100% compliant.

7. Assurances

7.1. Sustained improvement in 111 referral to Emergency Department dispositions and 111 calls transferred to 999.

8. Risks and Issues

8.1. National response targets not achieved and only R1 forecast achieved.

8.2. Continuing high levels of call volumes experienced by NHS111 services.

8.3. Increased 999 demand seen in North Tees area has increased pressure on services.

9. Recommendations

9.1. The Trust Board members are asked to note the following:

month and quarter position, and performance for year end.

the ongoing actions being undertaken to improve response performance.

Document Information

Author Name: Hannah Winney

Author Title: Planning and Performance Manager

Sponsor Name: Graham Tebbutt

Sponsor Title: Head of Strategy and Transformation

Last Saved 2017-06-27 08:52:00

Save Location N:\Public\Performance Management & Business Planning\IQPR Board Reports\14 - May 2017\IQPR Cover Report June 17.docx

Word Count 1819

Document Title

Company Name

Department

Financial Year

Reporting Month

Content

Strategic Aims

Performance at a Glance

Workforce Headlines

NEAS Operations Centre

ECS Operations

PTS

Note

Jun-17

IQPR Report - Correct as 17 June 2017

IQPR Report

North East Ambulance Service NHS Foundation Trust

Strategy, Transformation and Workforce

2017/2018

The IQPR uses the Data warehouse, ESR and Quality Dashboard as data sources.

Comments

As of October we have moved to reporting against the 5 themes of the NHS Improvement's Single Oversight Framework in place of the

Monitor Governance and Financial Sustainability Risk Rating.

Performance against control total metric - replaces the 'I&E Margin Variance from Plan' metric reported last year as of May 17. This metric

shows bottom line financial performance against plan, but excludes any STF funding received from the calculation

Due to ESR reconfigurations linked to the restructure it has not been possible to report on all Workforce metrics. Updates will be provided in

next month's report.

Statutory and Mandatory compliance reporting from April 17 has been updated to report on competencies rather than course completion.

This provides a more accurate picture of compliance rates.

The IQPR uses the Data warehouse, 111 Balance Scorecard and service line Operations Dashboards as data sources

Hear and Treat rates reflect the national AQI definition.

Appreciations and complaints figures are being reviewed for data quality.

111 Calls referred to 999 follows exisitng guidance and does not reflect whether an ambulance was dispatched.

The IQPR uses the Data warehouse, Validated Performance Reports, Ambulance Quality Indicators Report, Quality Dashboard and ESR as

data sources.

Page 1 of 9

Values May-16 Jun-16 Jul-16 Aug-16 Sep-16 Oct-16 Nov-16 Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17

No reduction in cumulative position

on last year

Cumulative reduction greater than

last year, <=2%

Growth in cumulative position on

last year by >2%Increase Hear and Treat Rates

No reduction in cumulative position

on last year

Cumulative reduction greater than

last year, <=2%

Growth in cumulative position on

last year by >2%Strategic Aim - Increase See and Treat Rates

Reduce Red 1 Variability (Quarterly Figures)*

Reduce Red 2 Variability (Quarterly Figures)*

Deterioration on previous month No change from previous monthAggregate improvement on previous

monthReduce Overall Attrition*

>8% >5-8% <=5%Reduce Sickness Absence to Below 5% Cumulative

YTD*

Area of Concern, Missed Deadline,

Overspend

Area of Increased Focus, Potential

area of Concern

All items are up to date

All metrics are indicating correctlyAchieve Establishment levels by September 2016

Qtr. targets breachedQtr. position behind target but still

recoverableQtr. position on target

Performance Against Strategic Aims

2 of 9

Category May-16 Jun-16 Jul-16 Aug-16 Sep-16 Oct-16 Nov-16 Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17

Formal Action Likely

Emerging concerns/ persistently

failing Operational targets/

financial issues/ breach or likely

breach

No Evident Concerns Monitor/NHSI - Governance Rating

Red 1 (Quarterly RAF Indicator)*

Red 2 (Quarterly RAF Indicator)*

<95%Either <95% & Recoverable OR

>95% & forecast to fail>95% Red 19 (Quarterly RAF Indicator)*

1 2 to 3 3.5+NHSI - Financial Sustainability Risk Rating (Reporting change as of Oct

16) 4 4 4 4 4 4 4 4 4 4

1 (<1.25x) 2* (1.25-1.75x) Capital service capacity (times) n/a

1 (<14 days) 2* (14-7 days) 3> (7-0 days) Liquidity days n/a

1 (-1%) 2* (-1-0%) 3> (>0%) I&E margin*

<=-1% <-1%, <1% >=1% Variance in I&E margin as a % of income*

<3 above national

performance

>3<5 above national

performance

>5 above national

performanceNational Clinical Indicators

PPCI 150

STEMI Care Bundle

ROSC

ROSC UTSTEIN

Survival to Discharge

UTSTEIN Survival to Discharge

Fast 60

Stroke Bundle

2+ RedAll Amber OR 1 Green 2

Amber OR 2 Green 1 Red3 Green National Standards

<75% >=75% Category Red 1*



3+ RedAll Amber OR

50% Green 50% Amber/Red>=50% Green Operational Performance

<60% >60%, <75% >75% Green 1 in 20*

<60% >60%, <75% >75% Green 2 in 30*

<60% >60%, <75% >75% Green 3 in 60*

<40% >40%, <60% >60% Urgent in 60*

<50% >50%, <70% >70% Urgent in 120*

<60% >60%, <80% >80% Urgent in 240*

4+ RedAll Amber OR 2/3 Green 3/2

Amber OR 3 Green 2 Red4+ Green Safe and Caring

Decreasing No change Increasing Incident Reporting Trend

>5% 1 - 4.9% <1% Incidents Reported Moderate or Higher

>0 NA 0 Serious Incidents

>0 NA 0 Never Event

>=10% 7 - 9.9% <7% Recontact Following S&T

1 NA 0 Assaults on Staff Actual

Increasing NA Decreasing Assaults on Staff Trend

Decreasing NA Increasing Patient FFT

3+ RedAll Amber OR 2/3 Green 3/2

Amber OR 3 Green 2 Red4+ Green NHS 111

<90% >=90%, <95% >=95% Call Answer Performance*

>10% >5%, <10% <5% ED Referrals*

>15% >10%, <15% <10% 111 - Ambulance Dispatch

<90% >=90%, <98% >=98% 111 Warm Transfers*

<95% >=95%, <100% 100% 111 Call Back Within 10*

2+ Red

All Amber OR 1

Green 2 Amber OR 2

Green 1 Red

3 Green Human Resources

>8% >5-8% <=5% Sickness Absence Rate*

<90% <=90%, <95% >=95% Occupied Rate

>=15% <15%, >=10%, <10% Turnover Rate

Performance At A Glance

<75%Either <75% & Recoverable OR

>75% & forecast to fail>75%

N/A Below National Average Above National Average

As of October we have moved to reporting against the 5 themes of the NHS Improvement's Single

Oversight Framework. No formal submission has been requested for the Performance theme.

March 2017 Quarterly Review Meeting with NHSI confirmed NEAS is within Segment 2 of the Single

Oversight Framework.

Delayed

due to end

of year

reporting

NA

Limited

reporting

due to year

end

Target Trend Overarching theme Service Line May-16 Jun-16 Jul-16 Aug-16 Sep-16 Oct-16 Nov-16 Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Grand Total

Operations Centre 101.69% 101.13% 103.58% 97.36% 98.05% 98.07% 99.57% 99.31% 99.49% 99.51% 100.36% 93.21% 99.28%

ECS 94.49% 94.04% 92.93% 92.69% 94.19% 95.27% 97.94% 96.87% 99.78% 98.01% 98.19% 96.50% 95.91%

PTS 94.50% 95.74% 95.74% 93.81% 93.97% 93.51% 92.80% 91.85% 91.36% 91.59% 91.93% 92.64% 93.29%

Operations Centre 7.18% 6.78% 6.87% 8.84% 8.37% 7.65% 7.40% 8.14% 7.64% 6.78% 6.72% 7.15% 7.46%

ECS 6.12% 6.16% 7.48% 7.50% 7.60% 7.43% 7.40% 8.44% 8.52% 7.45% 5.34% 5.91% 7.11%

PTS 6.97% 6.56% 8.39% 8.48% 8.85% 9.59% 10.13% 9.23% 9.76% 10.87% 11.19% 8.21% 9.02%

Operations Centre 1.53% 1.18% 1.88% 4.06% 2.88% 1.07% 2.42% 2.23% 1.51% 1.58% 1.71% 2.00% 1.26% 1.95%

ECS 0.25% 0.68% 0.98% 0.77% 0.37% 0.35% 0.35% 0.20% 0.53% 0.27% 0.65% 0.55% 0.36% 0.49%

PTS 0.23% 0.99% 0.23% 0.00% 2.75% 0.71% 0.68% 0.47% 0.00% 0.47% 1.05% 0.83% 0.24% 0.67%

Operations Centre 68.00% 73.00% 72.00% 73.00% 79.00% 80.00% 83.00% 84.15% 86.99% 85.57% 78.47%

ECS 82.00% 81.00% 82.00% 84.00% 87.00% 89.00% 91.00% 90.00% 95.00% 94.97% 87.60%

PTS 72.00% 75.00% 81.00% 82.00% 85.00% 86.00% 87.00% 84.15% 91.00% 92.18% 83.53%

Operations Centre 99.87% 99.53% 99.26% 99.41% 99.42% 99.76% 99.87% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 99.79%

ECS 99.63% 99.62% 99.62% 99.74% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 99.94%

PTS 100.00% 99.98% 99.82% 99.82% 99.82% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 99.95%

100-105% 95.58% 95.54% 95.42% 93.61% 94.65% 95.12% 96.89% 96.05% 97.61% 96.75% 96.89% 94.67% 95.77%

<=5% 5.85% 5.74% 6.64% 7.17% 7.00% 7.19% 7.22% 7.47% 7.54% 7.28% 6.32% 6.18% 6.19% 6.93%

<=1.25% 0.51% 0.84% 0.99% 1.38% 1.41% 0.58% 0.85% 0.68% 0.66% 0.51% 0.96% 0.92% 0.53% 0.86%

>=95% 77.00% 78.00% 80.00% 81.00% 85.00% 86.00% 88.00% 88.00% 93.00% 93.89% 91.26% 85.56%

57.20% 62.65% 62.43% 66.48% 66.48% 77.02% 70.34% 77.84% 79.77% 79.84% 70.01%

100% 99.77% 99.70% 99.60% 99.78% 99.90% 99.90% 99.74% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 99.90%

<=1.25% Front Line Turnover Rate (FTE)

Workforce Headlines

100-105% Front Line Occupied Rate

<=5%Front Line Sickness

Absence Rate (% FTE Days)

Total Front Line DBS Compliance

Workforce AnalysisOverall the Trust-wide absence rate has remained at a similar level to April 2017, increasing by 0.01% to 6.19% for May 2017.

The frontline FTE turnover rate remains within target at 0.53%, an improvement on April 2017. Turnover has reduced across all service lines.

Due to ESR reconfigurations linked to the restructure it has not been possible to report on all Workforce metrics. Updates will be provided in next month's report.

100% Front Line DBS Compliance

Total Front Line Occupied Rate

Trust-wide Sickness Absence Rate (% FTE Days)

Total Front Line Turnover Rate (FTE)

Total Front Line Stat & Mand Compliance

Total Trust Wide Appraisal Completion Rate (Rolling 12 Month)

>=95% Front Line Stat & Mand Compliance

0.00%

0.50%

1.00%

1.50%

2.00%

2.50%

3.00%

3.50%

4.00%

4.50%

Mar-16 Apr-16 May-16 Jun-16 Jul-16 Aug-16 Sep-16 Oct-16 Nov-16 Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17

Frontline Turnover Rate %

EC PTS OPS Target

0%

1%

2%

3%

4%

5%

6%

7%

8%

Apr-16 May-16 Jun-16 Jul-16 Aug-16 Sep-16 Oct-16 Nov-16 Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17

Sickness Absence Rate (% FTE Days Lost)

Sickness Absence Rate (% Calendar Days Trust Wide) Target

Value Target Trend May 16 Jun 16 Jul 16 Aug 16 Sep 16 Oct-16 Nov-16 Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Grand Total

>=80% FFT (% Recommending) 86.00% 90.00% 88.00% 82.20% 90.70% 83.70% 87.30% 88.60% 84.20% 89.40% 90.90% 88.10% 86.70% 87.37%

FFT Responses 73 68 59 73 43 49 111 79 95 123 93 67 83 1016

Duty of Candour 1 1 1 2 7 6 0 3 1 0 1 0 0 23

Number of Assaults/Aggression on Staff Reported 0 0 2 0 0 0 2 0 3 3 1 0 0 11

Number of Incidents Reported 132 96 68 89 48 47 76 79 87 69 74 96 59 1020

Number of Serious Incidents 1 2 0 1 2 1 2 1 1 0 0 3 2 16

Incidents Reported Moderate or Higher 1 1 1 3 3 3 3 3 3 3 3 3 3 33

Value Target Trend May - 16 Jun - 16 Jul - 16 Aug - 16 Sep - 16 Oct - 16 Nov - 16 Dec - 16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Grand Total

Calls Answered 41,629 40,247 42,528 40,377 40,357 42,610 39,409 44,111 40,919 36,461 37,165 35,624 40,736 522,173

ETA Calls 4,312 4,373 4,684 4,331 4,656 5,272 4,624 5,758 4,887 4,336 3,508 4,265 3,689 58,695

95% % 999 Calls Answered Within Target 98.40 % 97.13 % 95.48 % 98.85 % 95.68 % 96.06 % 96.60 % 94.45 % 94.49 % 95.47 % 97.17 % 95.45 % 93.30 % 96.04 %

<1% % Calls Abandoned 999 0.43 % 0.46 % 0.48 % 0.49 % 0.46 % 0.44 % 0.46 % 0.46 % 0.41 % 0.33 % 0.43 % 0.57 % 0.80 % 0.48 %

R1 % of Total Incidents MTD 3.34 % 3.08 % 3.26 % 3.08 % 3.10 % 3.39 % 3.21 % 3.34 % 3.33 % 3.51 % 3.02 % 3.09 % 3.35 % 3.24 %

R2 % of Total Incidents MTD 48.59 % 49.46 % 49.48 % 49.16 % 49.39 % 49.61 % 49.51 % 48.86 % 50.86 % 49.93 % 46.26 % 48.28 % 49.98 % 49.18 %

HCP Red Rate 16.22 % 16.32 % 16.27 %

111 Red Rate 28.58% 27.51% 25.88% 25.78% 23.27% 21.61% 22.06% 23.04% 15.88% 25.74% 22.51% 23.54% 23.81% 23.79 %

Hear and Treat (AQI) 7.2% 8.1% 8.2% 9.1% 8.4% 8.8% 9.1% 9.7% 8.7% 8.8% 7.2% 7.3% 7.7% 8.33 %

999 Contact Centre Appreciations 0 2 5 3 3 0 4 4 7 2 7 2 0 39

999 Contact Centre Complaints 17 36 31 40 36 34 28 26 22 18 15 11 8 322

999 Safeguarding Alerts 46 56 82 62 38 61 82 146 45 26 94 49 106 893

999 Patient Safety Incidents 15 16 7 13 13 15 16 18 13 9 9 17 10 171

Value Target Trend May - 16 Jun - 16 Jul - 16 Aug - 16 Sep - 16 Oct - 16 Nov - 16 Dec - 16 Jan - 17 Feb-17 Mar-17 Apr-17 May-17 Grand Total

Calls Answered 61,554 52,515 56,839 81,781 50,041 57,951 55,252 69,457 65,372 57,387 61,894 79,920 75,613 825,576

95% Calls Answered within 60 Seconds 98.10 % 96.30 % 95.00 % 96.20 % 95.40 % 94.80 % 95.80 % 92.50 % 93.20 % 93.80 % 95.82 % 91.93 % 92.03 % 94.7%

>60% 111 Call Triage Rate 88.00 % 88.00 % 87.90 % 87.00 % 87.10 % 87.60 % 88.60 % 88.00 % 88.00 % 87.40 % 87.96 % 87.53 % 87.70 % 87.8%

>95% 111 Warm Transfer Rate 64.15 % 55.51 % 52.76 % 51.97 % 48.37 % 47.31 % 61.69 % 57.58 % 65.22 % 62.86 % 46.10 % 41.22 % 43.27 % 53.7%

>95% 111 Call Back in 10 Performance 45.24 % 39.63 % 37.72 % 39.96 % 40.37 % 36.68 % 39.46 % 47.24 % 50.03 % 46.37 % 44.40 % 36.78 % 39.57 % 41.8%

<5% 111 Calls Referred to ED 6.30 % 6.43 % 6.22 % 5.57 % 5.73 % 5.48 % 5.74 % 5.06 % 5.14 % 4.88 % 4.74 % 3.68 % 3.98 % 5.3%

<10% 111 Calls Referred to 999 14.10 % 15.02 % 14.51 % 14.26 % 14.70 % 15.18 % 16.38 % 15.45 % 16.19 % 15.27 % 15.37 % 13.28 % 13.81 % 14.9%

111 Appreciations 2 5 4 2 1 1 0 0 7 2 6 0 0 30

111 Complaints 4 4 6 7 3 2 3 2 3 0 3 0 0 37

111 Safeguarding Alerts 153 141 137 143 134 118 132 121 112 85 57 68 78 1479

Safe 111 Patient Safety Incidents 31 11 11 11 11 8 20 9 14 5 36 31 11 209

Value Target Trend May - 16 Jun - 16 Jul - 16 Aug - 16 Sep - 16 Oct-16 Nov-16 Dec-16 Jan - 17 Feb-17 Mar-17 Apr-17 May-17 Grand Total

70% % PTS Calls Answered Within 60 seconds 94.46 % 93.74 % 93.50 % 96.49 % 96.28 % 90.66 % 88.11 % 90.26 % 93.70 % 90.52 % 94.38 % 94.97 % 88.38 % 92.73 %

% Calls Abandoned PTS 1.39 % 1.00 % 0.95 % 0.90 % 1.08 % 1.80 % 1.58 % 1.21 % 0.52 % 0.94 % 0.46 % 0.21 % 1.21 % 1.02 %

PTS Contact Centre Appreciations 2 3 1 2 1 1 1 1 0 0 0 4 0 16PTS Contact Centre Complaints 7 13 12 8 14 11 9 6 8 3 3 0 0 94

Caring

Effective In Development

Caring

Safe

NHS 111

Responsive

Effective

Patient Transport Service

Responsive

Caring

Operations Centre

Caring

Safe

999 Contact Centre

Responsive

The Operations Centre has faced a number of challenges in May including the continued high volume of 111 calls following service changes, the impact of the cyber-attack and two bank holidays. Call taking service levels have been affected as a

result, with both 999 (93.3%) and 111(92.03%) missing the 95% target. PTS call taking service level was achieved, however a drop in the proportion of calls within target was seen in May, as a result of extended sickness within the team.

The high levels of 111 call volume experienced in April 2017 has continued into May, as a result of media campaigns in Durham Dales, Easington and Sedgefield and North Tees areas, linked to the launch of urgent care services in the area. Call

volumes in May 2017 have increased by 22.8% compared to May 2016.

The cyber-attack affected the 111 service from 12th May to 15th May. This resulted in an increase in call volume from a number of GPs and the media signposting patients to 111, as well as average handling time increasing as a result of manual

processes needing to be established.

New PTS eligibility criteria is being trialled and early indications suggest that this will improve the experience for patients who currently successfully appeal against criteria decisions. It is also expected that this change will reduce call volume

through avoiding duplicate calls following appeals.

Hear and Treat rates for May 2017 (7.7%) has seen a slight increase compared to April 2017. Benchmarking data for April 2017 shows that we are below the national average of 9.87%. Referrals from 111 to Emergency Department has seen recent

improvements consolidated during May 2017, maintaining levels below 4%, reflecting the impact of the clinical hub and out of hours service. 111 calls referred to 999 has increased slightly in May 2017 reaching 13.98%. This still represents an

improvement on previous year performance and is largely due to the increased call volumes experienced during April 2017 which has led to a proportional drop in the number of calls transferred to 999.

Operations Centre Analysis

0.6%

13.1%

4.7% 7.3%

36.1%

0.3%

11.6%4.8% 7.2%

36.0%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Percentage of callsabandoned before being

answered

Re-contact occurs within 24hours following Hear & Treat

Re-contact occurs within 24hours following See & Treat

Calls resolved by telephoneadvice

Patients treated withoutconveyance to A&E

Operational Ambulance Quality Indicators - April 2017

Current month NEAS Previous Month England Average Best Trust Worst Trust

1

12

50

7.28

26.83

49.1

1

19

72

7.08

27.11

47.45

0

10

20

30

40

50

60

70

80

90

100

110

120

Time to answer call (inseconds) (Median)

Time to answer call (inseconds) (95th percentile)

Time to answer call (inseconds) (99th percentile)

Time to treatment for Cat Acalls (in minutes) (median)

Time to treatment for Cat Acalls (in minutes) (95th

percentile)

Time to treatment for Cat Acalls (in minutes) (99th

percentile)

999 Operational Ambulance Quality Indicators - April 2017

Previous Month Best Trust Worst Trust Current month NEAS

0%

1%

2%

3%

4%

5%

6%

7%

8%

9%

10%

Apr-16 May-16 Jun-16 Jul-16 Aug-16 Sep-16 Oct-16 Nov-16 Dec-16 Jan-17 Feb-17 Mar-17 Apr-17

Operations Centre Sickness Rate

Contact Centre % Target %

0.00%

20.00%

40.00%

60.00%

80.00%

100.00%

120.00%

0

50

100

150

200

250

300

350

400

450

500

May-16 Jun-16 Jul-16 Aug-16 Sep-16 Oct-16 Nov-16 Dec-16 Jan-17 Feb-17 Mar-17 Apr-17

Operations Centre Staff in Post, Establishment & Occupied Rate %

FTE Employee Establishment FTE Occupied Rate

Value Target Trend May 16 Jun 16 Jul 16 Aug 16 Sep 16 Oct-16 Nov-16 Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Grand Total

75% R1 Performance % MTD 67.10 % 65.74 % 65.23 % 68.07 % 63.29 % 64.94 % 64.86 % 67.40 % 69.36 % 72.01 % 72.16 % 73.14 % 72.11 % 68.11 %



75% G1 in 20 Performance % MTD 38.63 % 28.64 % 32.80 % 29.04 % 29.45 % 26.53 % 28.08 % 23.42 % 23.70 % 27.10 % 36.01 % 36.59 % 30.13 % 30.01 %

75% G2 in 30 Performance %: MTD 42.03 % 39.58 % 36.57 % 40.87 % 39.11 % 33.59 % 36.77 % 30.72 % 34.91 % 38.10 % 47.43 % 46.82 % 37.91 % 38.80 %

75% G3 in 60 Performance % MTD 63.46 % 62.53 % 61.00 % 65.81 % 66.81 % 62.90 % 59.94 % 54.85 % 60.27 % 57.57 % 66.67 % 64.75 % 62.30 % 62.22 %

60% Urgent in 60 Performance % MTD 34.46 % 37.91 % 34.62 % 37.77 % 32.23 % 33.45 % 33.86 % 29.91 % 33.60 % 34.94 % 40.22 % 36.14 % 35.78 % 34.99 %



Handover Delays Hours Lost (>15mins) 685:40:00 611:12:00 491:47:00 488:57:00 492:07:00 458:44:00 543:08:00 983:49:00 1384:09:00 834:57:00 424:37:00 477:39:00 599:23 7876:46:00

Handover < 15 Mins % 64.5% 66.4% 66.8% 67.0% 67.7% 66.2% 68.1% 64.8% 61.3% 66.3% 73.6% 72.5% 63.2% 66.80 %

Handover 15 to 30 Mins % 9.5% 9.2% 10.0% 10.4% 9.3% 10.5% 9.6% 13.0% 12.9% 12.3% 10.0% 10.5% 10.4% 10.58 %

Handover 30 to 60 Mins % 2.6% 2.5% 2.5% 2.6% 2.2% 2.6% 2.3% 3.0% 5.2% 4.1% 2.0% 2.7% 2.9% 2.86 %

Handover 60 to 120 Mins % 0.8% 0.6% 0.4% 0.5% 0.5% 0.5% 0.5% 1.2% 1.9% 1.0% 0.3% 0.3% 0.7% 0.71 %

See and Treat Incidents % 23.38 % 22.96 % 24.20 % 24.11 % 24.70 % 23.11 % 22.98 % 23.75 % 23.46 % 24.03 % 24.58 % 25.48 % 26.27 % 24.1%

Average Job Cycle Time 01:28:21 01:31:39 01:29:45 01:29:49 01:31:23 01:32:25 01:30:34 01:44:47 01:46:10 01:42:38 01:37:13 01:38:38 01:40:54 01:35:43

Late Finishes (Hours) 3515.00 3,331.57 3,466.67 3,353.83 3,149.30 3,349.03 3,461.07 4,281.67 4,228.00 3,577.00 3,383.00 3,470.00 3,615.00 46181.14

80% FFT (% Recommending) 96.90% 100.00% 96.70% 100.00% 100.00% 98.80% 95.70% 96.60% 93.80% 97.40% 96.80% 98.60% 97.00% 97.56%

FFT Responses 32 20 30 43 44 80 92 58 160 117 126 147 132 1081

Appreciation 44 47 44 43 56 33 51 40 68 53 60 65 65 669

Complaint 8 9 21 16 15 14 11 13 11 10 16 14 13 171

Safe Employer Liability Claim 0 1 2 0 1 0 0 0 0 0 0 0 0 4

Public Liability Claim 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Safeguarding Alerts 653 638 670 648 680 688 661 678 741 736 749 841 782 9165

Patient Safety Incidents 35 37 34 28 34 32 28 60 69 36 46 39 54 532

Assaults/Aggression on Staff Reported 31 25 23 15 26 35 30 38 31 28 39 36 18 375

Duty of Candour 0 2 2 2 1 1 2 6 4 0 0 0 0 20

Incidents Reported* 200 190 184 195 218 174 180 160 152 148 197 161 187 2346

Serious Incidents 0 3 1 1 0 0 0 1 1 0 2 1 0 10

Incidents Reported Moderate or Higher* 7 11 14 13 12 10 10 10 10 10 12 10 10 139

Emergency Care Service

Effective

Caring

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

0

5,000

10,000

15,000

20,000

25,000

May - 16 Jun - 16 Jul - 16 Aug - 16 Sep - 16 Oct - 16 Nov - 16 Dec - 16 Jan - 17 Feb - 17 Mar - 17 Apr - 17 May-17

Red Volume and Performance

R1 Incident R2 Incident R1 Performance % R2 Performance % R19 Performance % Red 8 Target Red 19 Target

0%

10%

20%

30%

40%

50%

60%

70%

80%

0

2,000

4,000

6,000

8,000

10,000

12,000

14,000

May - 16 Jun - 16 Jul - 16 Aug - 16 Sep - 16 Oct - 16 Nov - 16 Dec - 16 Jan - 17 Feb - 17 Mar - 17 Apr - 17 May-17

Green Volume and Performance

G1 Incident G2 Incident G3 Incident G1 in 20 Performance % G2 in 30 Performance % G3 in 60 Performance % Green Target

May 2017 saw decreases in emergency care performance. Red 2 performance decreased to 57.66% and Red 1 performance to 72.63%. Of the local CCGs, all were below 75% in May 2017 for overall Red performance. Decreases were also seen in performance against all Green and Urgent priorities.

Overall incident volumes are higher than last year, with NEAS responding to 4.06% more incidents for the year to date than in 2016/17. There remains a high volume of Red demand in May 2017 of 567 per day, which is +5.52% (920 incidents) higher than the May 2016 volumes. Hartlepool and

Stockton-on-Tees CCG, in particular, has seen a significant increase in both red and overall incident volume, with incident volume in April and May 2017 17.3% higher than the same period in 2016. Of the 920 increase in red demand experienced in May 2017, 486 were from Hartlepool and Stockton-on-

Tees CCG.

Time lost to handover delays, average job cycle time and late finishes have all increased in May 2017 compared with April 2017, which have all contributed to the reduction in response times. Time lost to handover delays have continued to increase in May 2017, with 599 operational hours lost, this

represents an improvement of 12.5% compared with May 2016. The volume of late finishes has increased to 3,615 hours, the highest level this reporting period outside of December and January.

NEAS was below the national average for 6 of the 8 National Clinical Indicators (current reporting month is January 2017), though saw a local increase from December 2016 in 5 indicators.

Emergency Care Service Analysis

81.82%

88.16%

26.04%

50.00%

6.91%

32.00%

49.26%

96.25%

80.00%

89.29%

22.68%

50.00%

5.29%

25.93%

40.17%

98.05%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

PPCI treatment within 150 minutes STEMi Care Bundle ROSC ROSC [Utstein] Survival to discharge Survival to discharge [Utstein] FAST positive within 60 minutes Stroke Care Bundle

Clinical Ambulance Quality Indicators - January 2017

Current month NEAS Previous Month England Average Best Trust Worst Trust

19645 20339 19020 19539 20584 20136 21627 21479 18766 20693 20192 20320

492.25 489.1 492.07458.36

543.08495.39

983.49

1384.15

834.57

424.37477.39

599.23

0

200

400

600

800

1000

1200

1400

0

5000

10000

15000

20000

25000

Jun-16 Jul-16 Aug-16 Sep-16 Oct-16 Nov-16 Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17

Ho

urs

Lo

st

Arr

ival

s

Arrivals and Time Lost to Handovers

Arrivals Hours Lost to Handover Linear (Hours Lost to Handover)

20762238 2161

2717 2710 2641 2734 2657

3145 3186

2500

19782112

0%

1%

2%

3%

4%

5%

6%

7%

8%

9%

0

500

1000

1500

2000

2500

3000

3500


Calendar Days Lost to Sickness & Sickness Rate %Emergency Care

Calendar Days Lost Sickness Absence Rate Calendar Days Lost Linear (Sickness Absence Rate Calendar Days Lost)

Value Target Trend May - 16 Jun - 16 Jul - 16 Aug - 16 Sep - 16 Oct - 16 Nov - 16 Dec - 16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Grand Total

Effective 90% Time On Vehicle < 60 % 93.83% 94.39% 94.66% 94.57% 94.10% 93.99% 93.32% 94.01% 94.52% 94.29% 93.80% 94.17% 93.15% 94.06%

80% On Time Arrival At Treatment Centre % 80.80% 80.45% 80.30% 79.98% 80.13% 80.08% 79.96% 79.12% 78.61% 79.33% 79.09% 79.78% 79.16% 79.75%

85% Treatment Centre Collection Within 60 % 86.34% 87.06% 88.15% 87.95% 87.59% 87.92% 85.75% 86.33% 87.29% 86.89% 87.57% 88.63% 88.30% 87.37%

95% Treatment Centre Collection Within 90 % 96.78% 96.78% 97.13% 97.15% 97.22% 97.25% 96.42% 96.76% 97.19% 96.56% 97.24% 97.50% 97.54% 97.04%

80% PTS FFT (% Recommending) 88.40% 93.80% 87.20% 94.50% 90.90% 95.20% 93.00% 92.90% 94.90% 97.10% 94.40% 97.40% 98.50% 93.71%

PTS FFT Responses 499 385 474 384 263 333 341 169 494 102 337 153 68 4,002

PTS Appreciation 9 10 4 5 9 4 6 9 11 9 10 11 7 104

PTS Complaint 2 3 0 7 3 6 6 5 4 8 0 4 4 52

PTS Employer Liability Claim 0 0 2 0 1 0 0 0 0 0 0 0 0 3

PTS Public Liability Claim 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Number of Assaults/Aggression on Staff Reported - PTS 3 5 4 3 1 3 3 3 1 4 6 8 4 48

Duty of Candour 1 2 1 0 0 0 0 0 0 0 0 0 0 4

PTS Safeguarding Alerts 19 17 11 17 8 15 7 10 7 11 11 6 11 150

Number of Incidents Reported - PTS 35 39 40 33 34 30 38 30 41 48 51 25 37 481

Number of Incidents Reported Moderate or Higher - PTS 5 3 4 0 5 2 2 0 0 0 0 0 0 21

Patient Transport Service Analysis

PTS performance against key indicators continues to be maintained, with only on time arrival at treatment centre, marginally below target at 79.16% (80% target).

Patient satisfaction has continued to improve in May 2017 reaching 98.5%, the highest rate in the 13 month reporting period.

Patient Transport Service

Responsive

Caring

Safe

0

0.2

0.4

0.6

0.8

1

1.2

0

50

100

150

200

250

300

350

400

450

500

May 16 Jun 16 Jul 16 Aug 16 Sep 16 Oct 16 Nov 16 Dec 16 Jan 17 Feb 17 Mar 17 Apr 17

PTS Staff in Post, Establishment & Occupied Rate %

49004 51278 48426 50118 50719 48981 5286345041

49811 4731554138

4414650200

67536525

6547 6405 6392 65187414

78037770

7037

8026

7573

8171

0

10000

20000

30000

40000

50000

60000

70000

May - 16 Jun - 16 Jul - 16 Aug - 16 Sep - 16 Oct - 16 Nov - 16 Dec - 16 Jan - 17 Feb - 17 Mar - 17 Apr - 17 May - 17

Co

mp

lete

d J

ou

rney

s

PTS Journeys by Contract

Planned Bookings Same Day Bookings

0

10000

20000

30000

40000

50000

60000

May - 16 Jun - 16 Jul - 16 Aug - 16 Sep - 16 Oct - 16 Nov - 16 Dec - 16 Jan - 17 Feb - 17 Mar - 17 Apr - 17 May - 17

Co

mp

lete

d J

ou

rney

s

PTS Activity By Vehicle

Ambulance Invalid Third Party Providers Unknown - Inferred Winter Pressure Vehicles

0.00%

2.00%

4.00%

6.00%

8.00%

10.00%

12.00%


PTS Centre Sickness Rate

Patient Transport Service % Target %

Documents

CATEGORY OF PAPER Specific action required: Provides … · 2017-06-27 · 3. Operations Centre Headlines 3.1. The Operations Centre has faced a number of challenges in May including