Cover Sheet for Report for a Public Trust Board Meeting, to be held on 28 April 2011 at 10:30 in Tutorial Room 4, Education

Centre, Upper Maudlin Street, Bristol, BS2 8AE

Title of Report & Agenda Item Number

Q4 Compliance Framework Monitoring Report

Item 17

Purpose To consider the Quarterly Governance and Financial self-

Certification to Monitor for Quarter 4 of 2010/11

Abstract NHS Foundation Trusts must confirm compliance with their

Authorisation in relation to all healthcare targets and indicators

listed in Appendix B of Monitor‟s „Compliance Framework

2010-11‟ issued in March 2010.

The Trust‟s Quarter 4 declaration is due for submission to

Monitor by 30 April 2011.

Recommendations Once satisfied as to the current position, the Board is

recommended to:

Approve Declaration 2 and a Governance Risk Rating of 1.5 –

“Amber-green”, and, to

Approve a declaration to Monitor that the Board anticipates that

the Trust will continue to maintain a financial risk rating of at

least 3 over the next 12 months.

Report Sponsor Chief Executive

Other Author Trust Secretary

Appendices The following Appendices are included in this report:

Appendix A – Quarter 4 Financial Performance

Commentary for Monitor Return

Appendix B – Quarter 4 Governance Targets and Indicators

Previous Meetings The matters discussed in this report were considered in the following Trust corporate fora:

Executive Management Team

Trust Executive Group

Finance Committee

Quality and Outcomes Committee

Audit Committee

Other

21 April 2011 26 April 2011 27 April 2011

451

Page 2 of 2 of Item 17 - Q4 Compliance Framework Monitoring Report for a Trust Board Meeting, to be held on 28 April 2011 at 10:30 in Tutorial Room4,

Education Centre, Upper Maudlin Street, Bristol, BS2 8AE

Purpose The purpose of this report is to present the Quarter 4 position against the Monitor Compliance

Framework and recommend that the Trust Board approves Declaration 21.

Background

The Trust Executive will have considered the Trust‟s current and future position at its

Executive‟s meeting on 20 April.

The Finance Committee will have considered the Report of the Finance Director and the Quarter

4 Performance Commentary for Monitor Return on behalf of the Board on 26 April.

The Quality and Outcomes Committee will have considered the Quality and Performance Report

on behalf of the Board on 26 April.

The Trust Board of Directors will have considered the Corporate Risk Register in the course of

the meeting of the Board on 28 April.

There are no adverse governance risk implications associated with the personnel changes to the

Membership Council and the Trust Board of Directors in the period.

Previous Declaration and Indicated Position

The Trust‟s Quarter 3 declared position and indicated Quarter 4 position are set out below:

Q3 Declared Position Indicated Q4 Position

Finance Risk Rating 4 (in accordance with plan) 4 (in accordance with plan)

Governance Risk Rating Green Amber-green

Mandatory Services Green Green

Other Non-Financial Submission

The information set out below is also required to be submitted to Monitor:

a) Any change to NHS Litigation Authority CNST rating (General or Maternity)

– No change

b) Any change to auditors

– No change

c) Any planned or unplanned Care Quality Commission inspections

– None

d) Any Health and Safety Improvement notices issued

– None

e) Any adverse Coroner‟s report

– None

1 For one or more targets the Board cannot make Declaration 1 and has provided relevant details on worksheet

“Targets and Indicators” in this return. The Board confirms that all other healthcare targets and indicators have been

met over the period (after the application of thresholds) and that sufficient plans are in place to ensure that all known

targets and national core standards that will come into force will also be met.

452

For consideration and approval by

Finance Committee 26th

April 2011 – Agenda Item 6

Trust Board 28th

April 2011 – Agenda Item 18

To be Received by

Membership Council 4th

May 2011 – Agenda Item 8

QUARTER 4 PERFORMANCE COMMENTARY FOR MONITOR RETURN

Director of Finance

April 2011

453

1

1. EXECUTIVE SUMMARY

This commentary covers the results for the year ended 31st March 2011..

The Trust reports an EBITDA1 surplus for the year of £40.443m. This is £4.746m higher than the Annual Plan for the year of £35.697m. EBITDA is at

113% of Plan. The summary income and expenditure statement shows a surplus of £12.186m (EBITDA and financing costs).

The financial risk rating is 4, which is in line with the Annual Plan.

Weighting

31st March

2011 5 4 3 2 1

EBITDA

Margin % 25 8.01 11 9 5 1 <1

Achievement of Plan 10 113% 100 85 70 50 <50

Return on Assets 20 7.44 6 5 3 -2 <-2

I&E surplus margin 20 2.77% 3 2 1 -2 <-2

Liquid ratio (days) 25 40.7 60 25 15 10 <-10

Overall rating 4 (actual weighted score = 4.05)

1 Earnings Before Interest Taxation Depreciation and Amortisation

454

2

2. NHS CLINICAL INCOME

NHS Clinical income is £4.628m higher than the Monitor Annual Plan,

standing at £389.334m for the year. Clinical income includes income

from NHS commissioners and also income from territorial bodies,

mainly Health Commission Wales.

The variance for the year is explained in table 1 below:

Table 1 – Clinical Income – Quarter 4 Year to Date Variance from Plan

£m

Monitor Plan 384.706

Other Changes To The Plan 0.225

Current Plan 384.931

Over Performance (See Table 2 Below) 4.403

Year To Date Income 389.334

Activity and Income by Worktype

Performance against Service Level Agreement income budgets for the

year is summarised below by worktype.

i. Elective – Long stay

Overall Elective Long stay is £3.3m behind plan. The under-

performance is across a number of specialties, particularly Cardiac

Surgery, Cardiology, Medical Oncology, and Urology.

ii. Elective – Short stay

Elective Short Stay activity is £0.5m ahead of plan. The two main areas

of over-performance are Trauma and Orthopaedics and Thoracic

Surgery.

iii. Non-Elective

Non-Elective, Emergency Short Stay and Emergency Long Stay are

£5.7m over plan for the year. The over-performance is across a number

of areas, particularly Obstetrics, Cardiology, General Medicine and

Paediatric Surgery.

iv. Planned Same Day

Day Cases are £1.3m over plan for the year to date, the key areas of

over-performance are Ophthalmology, Clinical Oncology and Medical

Oncology.

v. Outpatients

Outpatient activity is over-performing by £1.8m; the key areas of over-

performance are Sleep Studies, Cardiology and Genitourinary

Medicine.

vi. Accident and Emergency

A&E is over-performing by £0.4m.

vii. Other Activity

Other activity includes Direct Access, Radiotherapy, Critical Care, PbR

Excluded Drugs & Devices and specialised services such as Bone

Marrow Transplants.

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3

Table 2 – Clinical Income by Worktype

Worktype Plan Actual Variance

£m £m £m

Elective revenue, long stay 38.734 35.456 -3.278

Elective revenue, short stay 8.709 9.221 0.512

Non-Elective revenue 97.823 103.531 5.708

Planned Same day (Day cases) 36.166 37.504 1.338

Outpatient 59.400 61.215 1.815

A&E 10.852 11.240 0.388

Direct Access 4.886 4.659 -0.227

Critical Care 33.424 32.762 -0.662

PbR Exclusion 13.108 11.862 -1.247

NICE College 19.915 20.405 0.490

At Cost Contracts 4.037 3.374 -0.662

Radiotherapy Courses 7.789 8.061 0.273

Excess Bed days 9.477 9.832 0.355

Bone Marrow Transplants 9.607 8.208 -1.399

Prior Year Income - 1.596 1.596

Other NHS 31.004 30.407 -0.597

Grand Total 384.931 389.334 4.403

Over Performance by Commissioner

During the Local Delivery Plan process the Trust agreed to reduce

Service Level Agreement values for demand management schemes put

forward by Primary Care Trusts that the Trust believed were over

optimistic. Because the Trust did not expect these activity reductions to

materialise the clinical income budgets were not reduced, and an

income budget was created for a dummy commissioner -Variable

Estimates. Table 3 below shows the cumulative income variances by

commissioner and how the Variable Estimates income target then

adjusts this for the overall position.

Table 3 Over Performance by Commissioner

Commissioner Variance

£’m

Variance

%

NHS Bristol 5.102 4%

NHS North Somerset 3.961 14%

NHS South Gloucestershire 2.786 13%

NHS Wiltshire 0.194 4%

South West Specialised Commissioning 1.249 2%

NHS Somerset 0.219 2%

NHS Gloucestershire 1.354 27%

Prior Year Income 1.596 N/A

Variable Estimates -10.613 N/A

Other (including Exceptional Funding) -1.444 N/A

Total

3. NON-NHS CLINICAL INCOME

Overall Non NHS clinical income is £0.043m lower than planned for

the year to date.

4. OTHER OPERATING INCOME

Overall other income is £6.251m higher than planned for the year. The

main reasons are:

Higher than planned levels of Education and Training income of

£1.840m due to changes in the contracts for SIFT and MADEL.

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4

Lower than planned income received to date with regards to

Skills for Health £2.168m due to income being deferred to the

next financial year.

Higher than planned income from charitable sources £0.567m

Non recurring bowel cancer screening income £0.335m

Other non recurring income not in the original plan £3.135m

Changes to original planned income £2.059m

Lower than planned income for research and development

£0.146m

Higher than planned Patient Transport Service Income £0.629m

5. EXPENDITURE

Overall operating costs of £464.704m for the year were £6.089m higher

than plan. Trust pay costs are £5.240.m greater than plan and non pay

costs are £0.849m higher than plan.

5.1 Pay Costs

Pay costs for the year were £5.240m, higher than plan. The main

reasons for this are an underachievement against the planned CIP

savings target and higher than planned spend within Skills for Health

offset by underspending on various staff groups including scientific and

technical staff and other clinical staff.

5.2 Drugs

Drug costs for the year were £6.310m greater than plan. This is due to

higher than planned activity.

5.3 Clinical supplies and services

Clinical supplies and services costs for the year were £3.836m greater

than plan. This is mainly driven by lower than planned delivery of CIP

savings and higher than planned activity.

5.4 Other Costs

Other costs for the year were £9.297m lower than plan. This is due

mainly to.

Higher than planned spend on premises and fixed plant and

establishment expenses £1.418m;

Lower than planned spend on Skills for Health £4.578m; This is

due to work being deferred to the next financial year.

Greater than expected CRES achievement £3.040m

Lower than planned spend on other expenditure £4.371m;

Higher than planned spend on non clinical supplies £1.274m.

5.5 Non Operating Expenses

Minor financial variances are shown against PDC dividend expense and

bank interest. Lower depreciation charges reflect slippage on the capital

programme and a lower level of indexation on asset values. Impairment

charges are £563k greater than planned mainly because of the review

taken on the economic loss associated with the planned disposal of the

Bristol General Hospital in 2012.

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5

6. CAPITAL

Actual expenditure for the year totals £25.415m. This represents net

expenditure performance of 81% when compared with the Annual Plan

assumption of £31.377m. The slippage on schemes this year will be

funded in 2011/12 by the use of the carry forward of cash balances at

the year end.

Financial Year 2010/11

Approved

Plan Outturn

Variance

Fav/ (Adv)

£’000 £’000 £’000

Sources of Funding

Donations 3,581 2,155 1,426

Asset Disposals - - -

Retained Depreciation 16,905 16,090 815

Cash balances 15,981 7,170 8,811

Total Funding 36,467 25,415 11,052

Expenditure

Strategic Schemes (16,277) (9,712) 6,565

Medical Equipment (5,651) (4,380) 1,271

Information Technology (5,432) (3,841) 1,591

Roll Over Schemes (2,016) (1,601) 415

Refurbishments (4,928) (2,274) 2,654

Operational / Other (8,869) (3,607) 5,262

Anticipated Slippage 6,706 - (6,706)

Total Expenditure (36,467) (25,415) 11,052

7. STATEMENT OF FINANCIAL POSITION (Balance Sheet)

The significant balance movements and variances are explained below.

7.1 Non Current Assets

The balance of £295.289m at the end of March is broadly in line with

the plan of £292.934m.

7.2 Inventories (formerly referred to as Stock)

At the end of March the value of inventories held totalled £7.168m. The

increase above the forecast given in the Annual Plan (£5.898m) relates

primarily to cardiac services.

7.3 Receivables (formerly Debtors) and Accrued Income

The Trade and Other Receivables balance at the end of March is

£17.580m, which is £4.168m below plan of £21.748m. This is mainly

due to NHS Trade Receivables being £5.674m lower than plan offset

and an increase in Non NHS Trade Receivables and Other Receivables

of £1.506m.

The reduction in debtor balances reflects the concerted efforts made by

the Trust to improve its management of debtor balances.

7.4 Accrued Income

At the end of March the value of Accrued Income was £4.760m against

a plan of £1.652m. Within this total £3.728m related to Skills for

Health balances.

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6

7.5 Prepayment

The prepayment balance at the end of March is £1.579m. This is mainly

due to payments for maintenance contracts for servicing of equipment.

This is broadly in line with the plan of £1.203m.

7.6 Deferred Income

Deferred income of £12.240m is £4.832m higher than plan of £7.408m.

£6.811m of this balance relates to Skills for Health.

7.7 Trade Creditors / Other Creditors / Capital Creditors

Trade Creditors and Other Creditors are £2.470m higher than the

planned position of £21.321m. The creditor balance at the start of the

year was particularly low as part of the Trust’s plans to prepare for the

move to a new suite of core financial systems. This has now been fully

implemented and payment performance for the year has been in line

with that achieved in previous years. The new system and the review of

processes planned for 2011/12 should see further improvements in

payment performance and forecasting.

The Trust aims to pay at least 90% of undisputed invoices within 30

days. In December, the Trust achieved 96% and 93% compliance

against the Better Payment Practice Code for NHS and Non NHS

creditors. The cumulative position is 90% and 89% respectively.

The improvement in payment performance in recent months reflects the

benefits of making better use of information and functionality offered

by the new accounts payable system.

7.8 Accruals

The accruals balance of £23.257m is £12.396m higher than the planned

value of £10.861m. The variance is due to £10.540m for Skills for

Health transactions. Timing differences can account for the

classification of liabilities as either Creditors or Accruals.

7.9 Summary Statement of Financial Position

A summary statement is given below showing the balances as at 31st

March together with comparative information taken from the Trust’s

Annual Plan.

-

20

40

60

80

100

09-

10

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

% N

um

ber

of

Cre

dit

or

invoic

es p

aid

wit

hin

30 d

ays

Creditor Payment PerformanceNon NHS Creditors NHS Creditors

459

7

Summary Statement of Financial Position (Balance Sheet)

Position as at 31

st March 2011

Plan Actual

Variance

Fav/ (Adv)

£’000 £’000 £’000

Non Current Assets

Intangible 1,791 3,084 1,293

Property, Plant and

Equipment 291,143 292,205 1,062

292,934 295,289 2,355

Current Assets

Inventories 5,898 7,178 1,280

Current Tax Receivables 683 542 (141)

Trade and Other

Receivables

21,748 17,580 (4,168)

Other Financial Assets 1,810 509 (1,301)

Prepayments 1,203 1,579 376

Cash and Cash

Equivalents 30,807 53,014 22,207

Non Current Assets held

for sale - 1,470 1,470

Assets Current Totals 62,149 81,872 19,723

ASSETS TOTALS 355,083 377,161 22,078

Current Liabilities

Deferred Income (7,408) (12,270) (4,862)

Provisions (638) (784) (146)

Current Tax Payables (6,561) (6,948) (387)

Trade and Other Payables (21,321) (23,791) (2,470)

Other Financial Liabilities (11,078) (10,497) 581

Other Liabilities (5,408) (5,423) (15)

Liabilities Current

Totals (52,414) (59,713) (7,299)

NET CURRENT

ASSETS/(LIABILITIES) 9,735 22,159 12,424

Position as at 31

st March 2011

Plan Actual

Variance

Fav/ (Adv)

£’000 £’000 £’000

Liabilities Non Current

Provisions (292) (256) 36

Finance Leases (6,142) (6,142) -

Liabilities Non Current

Totals (6,434) (6,398) 36

TOTAL ASSETS

EMPLOYED 296,235 311,050 14,815

Taxpayers’ and Others’

Equity

Public Dividend Capital 191,011 191,011 -

Retained Earnings 26,420 35,554 9,134

Donated Asset Reserve 11,827 12,984 1,157

Revaluation Reserve 66,892 71,416 4,524

Other Reserves 85 85 -

TAXPAYERS’

EQUITY TOTALS 296,235 311,050 14,815

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8

8. Cash and Cash Flow

The Trust held cash balances at the end of March of £53.014m. This is

£22.207m greater than the plan of £30.807m. The graph shown below

provides a comparison of actual compared with planned month-end

cash balances throughout 2010/11. The year-end cash balance is higher

than plan reflecting the slippage on the Trust’s capital programme, a

higher than planned income and expenditure surplus for the year and

improvements made in managing debtor and creditor balances..

The Trust has a working capital facility of £37.5m. This has been

agreed with Barclays Bank for an initial period of 2 years from 1st

September 2010. The facility was not used in 2010/11.

9. Potential Financial Risk Indicators

Monitor has identified 10 potential financial risk indicators. The Trust’s

position against each of these is summarised below.

9.1 Unplanned decrease in quarterly EBITDA margin in two

consecutive quarters.

UH Bristol reports an EBITDA margin of 9.0% compared with

the Plan for the fourth quarter of 7.1%. The Trust has also

achieved a cumulative better than Plan EBITDA performance

for the yea.

9.2 Quarterly self-certification by the Trust that the Financial Risk

Rating may be less than 3 in the next 12 months.

UH Bristol = The Board anticipates that the Trust will

continue to maintain a financial risk rating of at least 3 over the

next 12 months.

9.3 Financial Risk Rating 2 (or less) for any one quarter.

UH Bristol = Not applicable.

9.4 Working capital facility agreement includes default clause.

UH Bristol = The following default events are specified: failure

to pay on the due date any amount payable pursuant to the

facility; any representation made that proves to be misleading

in any material respect; the borrower is unable to pay its debts;

value of assets is less than its liabilities; the borrower ceases or

threatens to cease operations or its operations become

20

25

30

35

40

45

50

55

60

65

70

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

Monthly Closing Cash Balance 2010-11 (£'m)

Plan Actual

461

9

unlawful; any legislation or regulation or official directive that

materially affect the Bank’s ability to recover the Loan.

9.5 Debtors over 90 days past due account for more than 5% of total

debtor balances.

UH Bristol = 17% of the Trust’s total debtor balances exceed

90 days. A provision has been made for all potential bad or

doubtful debts as at 31st March. The Trust has made good

progress in resolving a number of long standing debtor issues

over the second half of 2010/11. Further progress is anticipated

in the coming months to minimise debtor balances over 90 days.

9.6 Creditors greater than 90 days past due account for more than

5% of total creditor balances.

UH Bristol =Not applicable.

9.7 Two or more changes in Finance Director in a twelve month

period.

UH Bristol = Not applicable.

9.8 Interim Finance Director in place over more than one quarter

end.

UH Bristol = Not applicable.

9.9 Quarter end cash balance less than 10 days of annualised

operating expenses.

UH Bristol = Not applicable.

9.10 Capital expenditure outside the range 75 – 125% of Plan for the

year to date.

UH Bristol = The Trust’s capital expenditure of £25.4m is

equivalent to 81% of the Annual Plan forecast for the year. The

Trust held a correspondingly higher cash balance at the year

end to fund slippage on the 2010/11 capital programme where

costs will be incurred in 2011/12.

10. Other

10.1 Submission of Annual Accounts

The Trust submitted its Draft Annual Accounts and the Foundation

Trust Consolidated Schedules (FTCs) by the designated deadline of

5pm Thursday 21st April.

The Trust will submit its Audited Accounts, Audited FTCs, final text of

the Annual Report and a copy of the Auditor’s final ISA 260 report by

5pm Tuesday 7th

June.

10.2 Foundation Trust Financing Facility Loan

University Hospitals Bristol has secured an offer of a loan in the sum of

£70m from the Foundation Trust Financing Facility to partially fund the

capital costs of the scheme to facilitate the centralisation of specialist

paediatric services and the Redevelopment of the BRI. Take up of the

loan is subject to approval by the Trust Board of the Full Business Case

for the BRI Redevelopment project and completion of the Monitor due

diligence process. The Full Business Case for the Centralisation of

Specialist Paediatrics was approved by the Board in March 2011. The

loan is available for staged drawdown in 2012/13 and 2013/14.

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University Hospitals Bristol

NHS Foundation TrustExtract of Targets and Indicators for Quarter 4 2010/11

These targets and indicators are set out in Appendix B on page 45 of the 2010-11 Compliance Framework Key: input always required.

input MAY BE required if relevant to your FT

Threshold2010/11 CF

Weighting

Annual Plan

2010/11

Q4 Service

Performance

Score

Result Details (if required) Performance

C.difficile year on year reduction enter your Board approved YTD target here> 180 1.0 No risk Achieved Trajectory: Q1 45, Q2 42, Q3 45, Q4 48 94 0.0

MRSA - meeting the MRSA objective enter your Board approved YTD target here> 9 1.0 No risk Achieved Trajectory: Q1 2, Q2 2, Q3 3, Q4 2 5 0.0

Anti Cancer Drug Treatments 98% 1.0 No risk Achieved Cancer performance figures: Jan/Feb confirmed and draft for March 100.0%

Surgery 94% 1.0 No risk Achieved Cancer performance figures: Jan/Feb confirmed and draft for March 94.9%0.0

Radiotherapy (from 1 January 2011) 94% 1.0 No risk Achieved Cancer performance figures: Jan/Feb confirmed and draft for March 99.6%

From Consultant Screening Service Referral 90% 1.0 Declared risk Failed to Meet 2.5 breaches more than 90% standard for the quarter. 84.4%1.0

Urgent GP Referral To Treatment 85% 1.0 Declared risk Achieved Cancer performance figures: Jan/Feb confirmed and draft for March 85.5%

95% 0.5 No risk Failed to MeetSignificant outbreak of norovirus put significant pressure on bed availability in

January and February; 95% standard met in March.94.2% 0.5

31-Day (Diagnosis To Treatment) Wait For First Treatment All cancers 96% 0.5 No risk Achieved Cancer performance figures: Jan/Feb confirmed and draft for March 97.1% 0.0

All cancers 93% 0.5 No risk Achieved Cancer performance figures: Jan/Feb confirmed and draft for March 95.6%

For symptomatic breast patients (cancer not initially suspected) 93% 0.5 Declared risk Achieved Cancer performance figures: Jan/Feb confirmed and draft for March 100.0%

68% 0.5 No risk Achieved No thrombolysis cases 100.0% 0.0

100% 0.5 No risk AchievedElective screening performance shown. Performance for emergency

admissions above the commssioned threshold of 90%.100.0% 0.0

Follow up contact within 7 days of discharge 95% 0.5 No risk Not relevant 0.0% 0.0

Having formal review within 12 months 95% 0.5 No risk Not relevant 0.0% 0.0

<=7.5% 1.0 No risk Not relevant 0.0% 0.0

90% 1.0 No risk Not relevant 0.0% 0.0

95% 0.5 No risk Not relevant 0.0% 0.0

Data completeness: identifiers 99% 0.5 No risk Not relevant 0.0% 0.0

Data completeness: outcomes 50% 0.5 No risk Not relevant 0.0% 0.0

Ambulance FTs - Category A call – emergency response within 8 minutes 75% 1.0 No Risk Not relevant 0.0% 0.0

Ambulance FTs - Category A call – ambulance vehicle arrives within 19 minutes 95% 1.0 No Risk Not relevant 0.0% 0.0

Ambulance FTs - Category B call – a response within 19 minutes 95% 1.0 No Risk Not relevant 0.0% 0.0

Self certification against compliance with requirements regarding access to healthcare for people with a learning disability N/A 0.5 No risk Achieved Standards continue to be met. n/a 0.0

Moderate CQC concerns regarding the safety of healthcare provision N/A 1.0 No risk No n/a

Major CQC concerns regarding the safety of healthcare provision N/A 2.0 No risk No n/a

N/A 4.0 No risk No n/a 0.0

Does the Trust have outstanding compliance actions applied by the CQC ? No No 1.5

Does the Trust have outstanding enforcement actions applied by the CQC No No

Registration conditions imposed by Care Quality Commission No risk No conditions 0

Restrictive registration conditions imposed by Care Quality Commission No risk No conditions 0 1.5

1.5 0 Results left to complete Total Score 1.5

Non- scoring rated overrideOveride

Rating

Overide

Reasonif overridden please explain why here

Overide

Rating

10/11 Plan Governance risk rating AMBER-GREEN Indicative Governance risk rating AMBER-GREEN

0.0

Failure to rectify a compliance or restrictive condition(s) by the date set by CQC within the condition(s) (or as

subsequently amended with the CQC’s agreement)

Declaration of performance against healthcare targets and indicators for Q4 for BRISTOL

0.0

Care Programme Approach (CPA) patients

Minimising delayed transfer of care

Admissions had access to crisis resolution home treatment teams

Meeting commitment to serve new psychosis cases by early intervention teams

Targets as per Compliance Framework 2010/11 as amended June 2010 Q4 2010/11 Performance

All cancers: 31-Day Wait For Second Or Subsequent Treatment

Two week wait from referral to date first seen

Thrombolysis within 60 minutes (where this is the preferred local treatment)

Screening all elective in-patients for MRSA

All cancers: 62-Day Wait For First Treatment

4 hours A&E wait from arrival to admission, transfer, or discharge

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