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NHS Information Environment
Policy 02 Performance Management
Linda BlenkinsoppOctober 2008
Format of the session
• Recap of Key Reforms• Feedback on Patient Choice• Performance Management• The Annual Healthcheck• Scores on the Doors• Group work• Linking Performance and Choice• Choice Indicators• Recap/Next session
Key Reforms
Performance Management
• What is it ?
• Why bother?
• Pulling these together - A working definition
Performance Management Defined
“ Performance management is an organisations systems, processes and culture, aimed at establishing, measuring, monitoring and reporting indicators of service quality and resource usage to ensure effective patient care”
Group WorkIn care sector groups you have 10 minutes to:
• Identify 3 strengths in your organisations performance system
• Identify 3 opportunities for improvement
• Identify 3 benefits of effective performance management
• Appoint spokesperson (different to last week) to feed back
Annual Healthcheck
• Annual Declaration
• New Targets
• Existing Targets
• Improvement Reviews
• Use of Resources
Annual Healthcheck Framework
Core Standards
Existing Targets
New Targets
Use ofResources
Improvement Reviews
Quality Rating
Use of Resources Rating
Assessment ReviewAssessment Review
Annual Declaration• Self Assessment• Core standards - 7 domains, • First Domain - Safety • Second Domain – Clinical and Cost Effectiveness • Third Domain – Governance • Fourth Domain - Patient Focus • Fifth Domain - Accessible and Responsive Care • Sixth Domain - Care Environment and Amenities • Seventh Domain - Public Health
• 24 standards, 400+ prompts• Evidence portfolio• Met, unmet, insufficient assurance• Subject to scrutiny
Existing Targets
• Familiar areas
• Split by care sector
• Composite indicators
• Score 0,2,3
• weak, fair, good, excellent
• 49/54 to be “excellent”
Existing targets - AcuteAll cancers: one month diagnosis (decision to treat) to treatment
All cancers: two month GP urgent referral to treatment
All cancers: two week wait
Cancelled operations and those not admitted within 28 days
Convenience and choice - provider information on nhs.uk and availability of
slots
Delayed transfers of care comparative indicator
Number of inpatients waiting longer than the standard
Number of outpatients waiting longer than the standard
Patients waiting longer than three months for revascularisation
Thrombolysis - 60 minute call to needle time
Total time in A&E: four hours or less
Waiting times for rapid access chest pain clinic
Existing targets – Mental HealthCrisis resolution team implementation
Existing targets – Ambulance
Category A calls meeting 19 minute target
Category A calls meeting eight minute target
Category B calls meeting national 19 minute target
Thrombolysis - 60 minute call to needle time
Existing targets – Primary CareAccess to a GPAccess to a primary care professionalAll cancers: one month diagnosis (decision to treat) to treatmentAll cancers: two month GP urgent referral to treatmentAll cancers: two week waitCategory A calls meeting 19 minute targetCategory A calls meeting eight minute targetCategory B calls meeting national 19 minute targetCommissioning a comprehensive child and adolescent mental health serviceCommissioning of crisis resolution/home treatment servicesConvenience and choice - PCT bookingConvenience and choice - PCT facilities in place to support choiceDelayed transfers of careDiabetic retinopathy screeningNumber of inpatients waiting longer than the standardNumber of outpatients waiting longer than the standardPatients waiting longer than three months for revascularisationPractice based registers - patients called for reviewThrombolysis - 60 minute call to needle timeTotal time in A&E: four hours or less
New Targets• Developmental in nature
• 11 targets
• Composite indicators
• Score 0,2,3 (last year 34 to be “Excellent”)
4 main areas: – Improve health of the population– Support people with long illnesses– Improved access– Improved user experience
Improvement Reviews• Comprehensive review of service
pathways-multiagency/Multidisciplinary
• 4 in 2006/07 - 11 in 2007/08
• Major burden and not included in overall ratings
08/09 include:– Health care in prisons, Managing medicines, IG in
organisations, LD (services and commissioning)
Use of ResourcesNon Foundation trusts• Financial stability, Finance process, Deliver break even,
Value for Money• Risk Management
Foundation Trusts• Monitor determine a risk rating - three components:
finance, governance and mandatory services.• The finance component looks at four criteria:
achievement of plan, underlying performance, financial efficiency, and liquidity.
Overall Rating CalculationOverall
Score
Core
Standards
Existing
Targets
New
Targets
Improvement
Reviews
WEAK Not Met Not met
GOODAt least
Almost Met
At Least
Almost Met
At Least
Good
EXCELLENT Fully Met Fully Met ExcellentNo weak,
2 good or
1 excellent
Fair Any other combination not covered above
Scores on the Doors
• How did your trusts do?
Linking Performance and Choice
Teams of 4 or 5 you have 10 minutes to:
• Identify your top 5 current indicators to support Choice
• Identify 5 New Indicators you would put in place
• Now decide the top 4
• Important considerations about Indicators
• Spokesperson to feed back
Choice Indicators
• Agreeing the top 5
• Which is important
• What does this tell us
• Top 5 for each patient group
Recap/Next Week
• Importance of Performance Management• Annual Healthcheck• Further research www.healthcarecommission.org.uk• Next week PBR – Dr Helen Byworth
