NHS Rotherham Clinical Commissioning Group Body Papers... · M34 Deliver the required number of bed reductions as per Rotherham element of the plan. Remedial action plan in place

NHS Rotherham Clinical Commissioning Group

Operational Executive 22 September 2017

Strategic Clinical Executive 27 September 2017

GP Members Committee 27 September 2017

Governing Body 4 October 2017

Commissioning Plan Performance Report: Quarter 1

Lead Executive: Ian Atkinson, Deputy Chief Officer

Lead Officer: Lydia George, Planning and Assurance Manager

Alex Henderson-Dunk, Performance and Intelligence Manager

Lead GP: N/a

Purpose:

For members to note the progress with delivery of the CCGs Commissioning Plan as at the end of Quarter 1.

Background:

In 2013 a performance framework for the Commissioning Plan was developed so that the CCG could assess its progress against key priorities and on its implementation of the plan.

In 2016/17, in line with the new CCG Improvement and Assessment Framework and the

revision of the GB overall performance report, the Commissioning Plan Performance Report

was revised to provide a fuller picture of delivery and includes milestones, KPIs, QIPP position

and any associated risks for each priority.

The current Commissioning Plan was produced 2 years ago, the landscape has changed

significantly over this time and significant progress has been made on the CCGs priorities. As

a result work has begun to refresh the Commissioning Plan.

This Performance Report has therefore been revised for 2017/18 to cover remaining actions in

the current Plan and, where possible, to cover content that will be in the refreshed

Commissioning Plan which is due for completion February/March 2018.

It should be noted that once the Commissioning Plan has been refreshed this Performance

Report will be revisited and where necessary changes will be made to ensure it is fully aligned

with the new Plan.

The performance framework will be reported 4 times a year and received at Governing Body in

October, December, February and a final year- end report in May.

Analysis of key issues and of risks

Lead officers have provided commentary against the milestones where performance is off track. From quarter 2 officers will be asked to identify any milestones where the direction of travel has the potential to deteriorate or improve.

Milestones

There are 57 milestones in total, 41 of these are new milestones for 2017/18, see breakdown of RAG rate below:

RAG rate Number of milestones

%

Red 0 0

Amber 7 12

Green 50 88

Total 57 100

The number of milestones on track is 88% compared to 82% for the same period in 2016/17.

There are no red milestone, amber milestones are summarised below:

RAG rate Milestone description Commentary Q1 Q2 Q3 Q4

Amber Medicines Management

M23 Potential savings have been identified (financial value tbc) by the introduction of a range of branded generic drugs. This figure will be adjusted as further schemes evolve. A target of 90% compliance has been set – annual savings tbc.

Started but potential savings figure to be confirmed.

Amber Medicines Management

M24 12 projects to be delivered over the financial year and savings are to be identified. This figure will evolve as schemes are still being evaluated.

Started but potential savings figure to be confirmed.

Amber Mental Health

M27 RDaSH to produce a delivery plan including milestones and timescales for the delivery of the Adult Transformation Plan.

Assurance being monitored at the QIPP committee

Amber Mental Health

M31 Review MH Social prescribing delivery trajectory.

Green/amber - improvements in trajectory noted but further work required.

Amber Learning Disability

M34 Deliver the required number of bed reductions as per Rotherham element of the plan.

Remedial action plan in place to achieve both trajectories by July 2017.

Amber End of Life Care

M44 Involvement of the Care Co-ordination Centre in the EOLC pathway

Started but not on track – ongoing work taking place with CCG lead clinical lead

Amber End of Life Care

M45 Achieve 40% implementation of the Case Management Palliative Care Template in Primary Care

Data set still being developed, uptake of palliative care within case management continues to be embedded data.

Key Performance Indicators (KPIs)

There are 46 KPI’s in total, of which 2 are new, see breakdown of RAG rate below:

RAG Rate Number of

KPIs %

Red 6 13

Amber 5 11

Green 18 39

WD 17 37

Total 46 100

Overall there are approximately 39% of KPIs on track compared to 27% for the same period last year. There remains a significant number of KPIs still awaiting national data / or the data available is several years old.

Below is a list of the red and amber KPIs, commentary on performance can be found in the Governing Body Performance Report or Governing Body Quality Report.

RAG rate

No. Key Performance Indicator Description Q1 Q2 Q3 Q4

Red (6)

K4 Contain growth in the number of non-elective admissions

K6 Achieve 4 hour access standard for A&E

K9 Delayed transfers of care from hospital

K12 Response to category A (Red1) ambulance calls within 8mins

K16 Reduction in the number of antibiotics prescribed in primary care

K18 Number of finance and quality “green” indictors

RAG rate

No. Key Performance Indicator Description Q1 Q2 Q3 Q4

Amber (5)

K2 Utilise NHS e-referral service to enable choice at 1st routine elective

referral

K14 Contain growth in elective activity

K15 Achievement of outpatient follow up ratios

K28 Reduce the number of people admitted in line with the South Yorkshire and North Lincolnshire LD TCP trajectory

K45 Percentage seen within 62 days after a referral by GP (I&AF 122b)

Finance

The position in terms of QIPP savings is shown below as at October, further information can be found in the Finance and Contracting Governing Body report:

Area Scheme Financial Rating

Operational Rating

YTD FOT YTD FOT Urgent Care Reduce the level of growth in A&E,

assessments and non-elective admission activity in line with local trend analysis

Clinical referrals Reduction in follow-ups where TRFT are above peer average

Clinical referrals

Clinical thresholds – TRFT

Clinical referrals

Clinical thresholds – other

Medicines Management

Roll out medicines waste reduction programme to all GP practices


Branded generics – switch range of drugs to specific brands at below drug tariff price


Projects and product switch – introduction of guidelines, switches to more cost effective products etc


Self- management of a range of identified drugs


Waste reduction scheme, expand into Care Homes

Mental Health

Reduction in demand for Ferns

Continuing Care / Funded Nursing Care

Review of CHC cases against frameworks and legislation


Review of assessment tool for determining care packages


Ongoing clinical review of high cost placement packages


Further development of personal health budgets

Risk

Risks associated with the delivery of the Commissioning Plan are set out below, further details can be found within the GB Assurance Framework. A review of risks is currently taking place and will be reflected in the Q2 report.

Risk Score Number

16 2

12 6

9 1

Total 9

Approval history:-

OE 22 09 2017

SCE 27 09 2017

GPMC 27 09 2017

CCG GB 04 10 2017

Recommendations:

Members are asked to note the report and that: 1. The Q1 position in term of milestones is positive compared to the same period last year.

2. The Q1 position in terms of KPIs is positive compared to the same positional last year.

3. There are still a number of KPIs which are waiting for national data, or the data available is

several years old.

4. Further information on the QIPP position can be found in the QIPP Plan Monitoring report

received at Governing Body.

5. Further information on the risk position can be found in the Governing Body Assurance

Framework received at Governing Body.

Commissioning Plan Performance

Report: 2017/18

Q1

Meeting Date

Operational Executive 22 September 2017

Strategic Clinical Executive 27 September 2017

GP Members Committee 27 September 2017

CCG Governing Body 4 October 2017

Definitions for RAG Ratings:

Red KPI Milestones QIPP

Less than 2% achieved Not started or significant issues Not started or Started but still high risk

Amber

KPI Milestones QIPP

Within 2% achieved Started but not on track OK with medium risk

Green

KPI Milestones QIPP

Achieved or complete On track Achieving as planned

Please note

That there are a number of KPIs from the new Improvement and Assessment Framework where data is not available yet.

1 Primary Care Lead GP: Avanthi Gunasekera Lead Officer: Jacqui Tufnell

Deliverable Milestones for 2017/18 Source 2017/18 Target

Q4 16/17

Q1 Q2 Q3 Q4 Comments

M1 Primary Care Quality Contract – implement and monitor 5 standards for 2017/18.

Com / primary care plan

Q4 New for 17-

18

G On track

M2 Primary Care Quality Contract – develop and implement performance monitoring arrangements.


Q4 New for 17-

18

G On track

M3 General Practice Forward View – provide training and implement care navigation in first 10 practices.


Q4 New for 17-

18

G On track

M4 Primary Care Self-care pilot – roll out telehealth to all practices.


Q4 New for 17-

18

G On track

M5 Plan and implement access arrangements to meet NHSE delivery requirements of all population receiving extended access (weekday) and Saturday/Sundays by March 2018.


Q4 New for 17-

18

G On track

Key Performance Indicators (KPIs) Source 2017/18 Target

Q4 16/17

Q1 Q2 Q3 Q4

K1 Patient experience of GP services (I&AF 128b)

I&A Framework

Quality premium

74.6% In July 2018 Publicatio

n

WD G 85.7%

Published Bi-annually.

K2 Utilise NHS e-referral service to enable choice at 1

st routine elective referral

(I&AF 105a)

I&A Framework

80% by end of Q2 2017/18

and 100% by end of Q2 2018/19

A 74.2%

A 77%

Agreed action plan in place with TRFT which we continue to monitor. There has been significant improvement across specialities, but 2 remain challenging. IT team are working with GPs to increase utilitsation.

K3 Diabetes patients that have achieved all the NICE recommended treatment targets. Three (HbA1c, cholesterol and blood pressure) for adults and one (HbA1c) for children (I&AF103a)

I&A Framework

TBC New for 17-

18

TBC Latest available data is 2015/16

QIPP £ Finance Operational Rating

as at October

YTD FOT YTD FOT

None. QIPP Plan

Risks Risk Description Risk Score Delivery of new model in pressured environment. Lack of skill and capacity to roll out.

GB Assurance Framework

Delivery – leading system wide efficiency programmes that consistently achieve measurable improvements whilst meeting our financial targets.

16

2 Unscheduled Care Lead GP: David Clitherow Lead Officer: Sarah Lever / Claire Smith


Q4 16/17


M6 Implementation of directly bookable GP appointments from NHS111.

NHS 5Yr Forward

STP

Q3 New for 17-

18

G On track

M7 Implementation of revised pathways of care in UECC.

Com Plan STP

Q4 New for 17-

18

G On track

M8 Design of collaborative commissioner and provider arrangements to support delivery of national UTC specification.

STP Q3 New for 17-

18

G On track

M9 Expand role of the Care Co-ordination Centre (CCC) to manage the interface between acute /community.

Com Plan STP

Q3 G G On track

M10 Full implementation of new service model including deflection pathways.

Com Plan Q3 New for 17-

18

G On track

M11 New pathways paediatrics, frailty and interface with CCC agreed and implemented.


18

G On track


Q4 16/17

Q1 Q2 Q3 Q4 Key Performance Indicators

(KPIs) K4 Contain growth in the number of non-

elective admissions Contractual

target

Meet contracted

levels

R R Emergency admissions as at June 17 YTD (flex position) were £334k over plan. Emergency assessments were £111k over plan. RFT only.

K5 Contain growth in A&E attendances Contractual target

Meet contracted

levels

G G A&E attendances as at June 17 YTD (flex position) were £240k under plan. RFT only. February provisional data.

K6 Achieve 4 hour access standard for A&E Constitutional

GB Report

95% by March 18

R 88.6% 16/17 Full Year

R 84.1%

Aug 17

Month to Date

The new Urgent and Emergency Care Centre opened on the 06th July. The WIC also closed on this date. Workforce challenges within the department continue to present as the main factor in delivering sustainable performance, during June TRFT continued to receive support from the National A&E improvement team. GP streaming has been implemented within the department, which has had an impact. The CCG continue to work closely with partners through the A&E delivery board to realise improvement. National performance against this standard remains challenged. The national position for England for May 17 was 90%.

K7 Reduce unplanned hospitalisation for chronic Ambulatory Care Sensitive conditions (I&AF 106a)

I&A Framework GB Report

TBC WD TBC Data has been published as part of the IAF year-end assessment – RCCG was in the worst quartile nationally for this indicator.


as at October

YTD FOT YTD FOT

Reduce levels of growth in A&E assessments and non-elective admission activity in line with local trend analysis

QIPP Plan 1,932,000

n/a See GB QIPP Dashboard

Risks Risk Description Risk Score Activity growth in A&E. Failure to deliver system wide efficiency programme for unscheduled care. Suboptimal care for patients resulting in poor outcomes.


Quality – improving safety, patient experience and outcomes and reducing variations.

12

3 Community Services Lead GP: Phil Birks Lead Officer: Claire Smith


Q4 16/17


M12 Evaluation of the Integrated Locality Pilot to be completed.

Com Plan Q3 New for

17-18

G On track

M13 Begin roll out of the Integrated Locality across the borough.

Com Plan Q4 New for

17-18

G On track

M14 Integration of IRR with Mental Health & integration of CCC with Mental Health.

Com Plan Q3 New for

17-18

G On track

M15 Completion of the Business Care for the Re-ablement Village

Com Plan Q4 G

G On track


Q4 16/17


(KPIs) K8 Emergency readmissions within 28 days

of discharge from hospital Contract

TBC G

Feb 17 YTD = 12.1%

WD Awaiting data becoming available from national system

K9 Delayed transfers of care from hospital (I&AF 127e)

I&A Framework

BCF GB Report

3.5% of acute

occupied bed days delayed /

226 DTOCs in month per 100,000

population (Nov 17

Requirements)

R Feb 17 YTD = 2698.7

R May 17 = 503

DTOCs per

100,000 populati

on

The position in relation to DTOCs has deteriorated in recent months. A significant part of this change is the result of improvements in processes to support better communication across partners and improve identification of DTOCs. TRFT and RMBC commissioned an external review of DTOC pathways via the Local Government Association, the findings of this work have been reported to A&E delivery board with proposed actions for improvement. Partners have now agreed the improvement action plan.

K10 Number of unscheduled admissions of patients > 65 years out of hours.

Contractual Threshold 8760

G G On track

K11 Number of A&E attendances by care home residents.

Contractual Threshold 3400

WD G On track


as at October

YTD FOT YTD FOT

None. QIPP Plan

Risks Risk Description Risk Score

Services commissioned do not appropriately deliver to vulnerable people.


Assurance – having robust internal constitutional and governance arrangements, ensuring that providers’ services are safe and ensuring vulnerable people have effective safeguarding.

12

4 Ambulance and Patient Transport Services

Lead GP: David Clitherow Lead Officer: Julia Massey


Q4 16/17


M16 Monitor and report on the new Ambulance Quality Indicators, including the revised Clinical Quality Indicators

National Requirement

Q3 New for 17-

18

G On track

M17 Increase the number of ambulance patients referred to an alternative level of care or managed through the “Hear/See and Treat” routes

National Drivers

Q4 New for 17-

18

G On track

M18 Improve the utilisation of the Eligibility Criteria for Non Urgent Patient Transport


18

G On track


Q4 16/17


(KPIs) K12 Response to category A (Red1)

ambulance calls within 8mins (I&AF 127d) I&A

Framework GB report

75% R Mar = 63.9%

R Jun 17

= 63.8%

YAS are currently participating in an NHS England-led Ambulance Response Programme (ARP), which went live from the 21st April 2016. The pilot ran for 3 months initially and has subsequently been extended. This programme resulted in a change to call category classifications.


as at October

YTD FOT YTD FOT

None. QIPP Plan - -




12

5 Clinical Referrals

Lead GP: Anand Barmade Lead Officer: Janet Sinclair-Pinder


Q4 16/17


M19 Implement Phase 2 of clinical thresholds Com Plan Q4 New for

17-18

G On track

M20 Delivery of agreed audit programme and implementation of recommendations for clinical thresholds

Com Plan Q4 New for

17-18

G On track

M21 Review of MSK service and implementation of recommendations which includes a Single Point of Access and Physiotherapy First.

Com Plan Q4 New for

17-18

G On track

M22 Review of Dermatology GPwSI service and implementation of recommendations

Com Plan Q4 New for

17-18

G On track


Q4 16/17


(KPIs) K13 Patients waiting 18 weeks or less from

referral to hospital treatment (I&AF 129a) Constitution /


92% G 94.5% 1617 Full Year

G Jun 17

= 95.1%

Performance remains positive in 2017/18.

K14 Contain growth in elective activity Contractual Meet contracted levels

G A 85k above plan for elective activity – RFT only, June YTD flex position.

K15 Achievement of outpatient follow up ratios Contractual Meet contracted ratios

G A RFT are above the follow up ratios with an estimated June YTD reduction in payment of £200k.


as at October

YTD FOT YTD FOT

Reduction in follow-ups where TRFT are above peer average

QIPP Plan 488,000 n/a See GB QIPP Dashboard

Clinical thresholds – TRFT QIPP Plan 2,453,000 n/a See GB QIPP Dashboard

Clinical thresholds – other contracts QIPP Plan 738,000 n/a See GB QIPP Dashboard

Risks Risk Description Risk Score Delivery model in pressured environment. Lack of skill and capacity to roll out.


Delivery – leading system wide efficiency programmes that consistently achieve measurable improvements whilst meeting our financial targets.

16

6 Medicines Management Lead GP: Sophie Holden Lead Officer: Stuart Lakin

Deliverable Milestones for 2017/18 Source 2017/18Target

Q4 16/17


M23 Potential savings have been identified (financial value tbc) by the introduction of a range of branded generic drugs. This figure will be adjusted as further schemes evolve. A target of 90% compliance has been set – annual savings tbc.

Meds Management

Priority

90% G A Started but potential savings figure to be confirmed.

M24 12 projects to be delivered over the financial year and savings are to be identified. This figure will evolve as schemes are still being evaluated.

Meds Management

Priority

12 projects

G A Started but potential savings figure to be confirmed.

M25 29 of our 31 practices have redesigned their repeat dispensing processes to reduce medicines waste.

Meds Management

Priority

Q1 G G Complete.

M26 A self-care initiative/programme has been launched.

Meds Management

Priority

Q4 New for 17-

18

G On track


Q4 16/17


(KPIs) K16 Reduction in the number of antibiotics

prescribed in primary care (I&AF 107a)

Quality premium /


1.161 items per STAR-

PU

R 1.244 Jan 17

R 1.250

Mar 17

Rotherham has a historically high use of antibiotics, and whilst our use of broad spectrum antibiotics is coming down, our overall volume is not. We have identified the practices with the highest use of antibiotics and are working with them to help them reduce.

K17 Appropriate prescribing of broad spectrum antibiotics in primary care (I&AF 107b)

I&A Framework / GB Report

11.3 G 7.1 Jan

17

G 7.1 Mar

17

On track

K18 Number of finance and quality “green” indictors

Meds Management

65% of 589 indicators

to be Green (383)

New target for 17-

18

R 50% achievement for Q1.

QIPP £ Finance Operational Rating as at October

YTD FOT YTD FOT

Roll out Medicines Waste reduction programme to all GP practices

QIPP Plan 1,400,000 n/a See GB QIPP Dashboard

Branded Generics – switch range of drugs to specific brands at below drug tariff price


Projects and products switch – introduction of guidelines, switches to more cost effective products etc


Self management of a range of identified drugs QIPP Plan 151,000 n/a See GB QIPP Dashboard

Waste reduction scheme – expand in to care homes


Risks Risk Description Risk Score Added costs in prescribing, planned care, unscheduled care, resulting in higher levels of expenditure and higher risk to financial balance.

Risk Register (RR28)

Failure to deliver QIPP programme for 2017/18. 12

7 Mental Health (Mental Health and Dementia are clinical priorities within the I&A

Framework)

Lead GP: Russell Brynes (Adults) Jason Page (Children) Lead Officer: Kate Tufnell (Adults) Nigel Parkes

(Children)


Q4 16/17


M27 RDaSH to produce a delivery plan including milestones and timescales for the delivery of the Adult Transformation Plan.

Com Plan Q4 G A Assurance being monitored at the QIPP committee

M28 Children and Young People - All children and young people will follow the agreed process in transitioning to adult services and all will have a transition plan in place.

Com Plan STP

Q4 G G RDaSH continue to focus on the transition pathway and improves have been noted throughout the year.

M29 Continue roll-out of the Dementia diagnosis LES.

Com Plan STP

Q4 New for 17-

18

G Number of Dementia diagnosis increasing.

M30 Core 24 (Adult Mental Health) Transformation funding Delivery plan agreed with partners.

Com Plan STP

Q4 New for 17-

18

G On track

M31 Review MH Social prescribing delivery trajectory.

Com Plan STP

Q4 New for 17-

18

A Green/amber - improvements in trajectory noted but further work required.

M32 Ferns Ward evaluation completed. Com Plan STP

Q4 New for 17-

18

G On track

M33 Delivery of CAMHS LTP against plan. Com Plan CAMHS LTP

Q4 New for 17-

18

G Some areas of work are behind schedule but commissioned services are in place.


Q4 16/17


(KPIs) K19 People with 1

st episode of psychosis

starting treatment with a NICE- recommended package of care treated within 2 weeks of referral (I&AF 123b)

I& A Framework

STP GB report

50% G Jan-17

= 100%

G May-17 = 60%

Performance on track.

K20 Percentage of people who are "moving to recovery" of those who have completed IAPT treatment (I&AF 123a)


Quality Premium Health

Outcomes

50% A 16/17 Full

Year = 50.5%

G Apr-17

= 55.7%


K21 Diagnosis rate for people with dementia, as a percentage of the estimated prevalence (I&AF 126a)

GB Report I&A

Framework

66.7% G 1617 Year End = 75.9%

G Jun-17

= 80.9%


K22 Proportion of people waiting 6 weeks or less from referral to entering a course of IAPT treatment

GB Report Health

Outcomes

75% R 1617 Full

Year = 70.7%

G Aug

YTD = 84.4%

Performance has improved in 17/18 and is now meeting the national standard.

K23 95% of children and young people who present at A&E in crisis will be seen within 1 hour

STP Com plan

No existing

data

WD WD No data available

K24 95% of adults who present at A&E in crisis will be seen within 1 hour

STP Com plan

No existing

data

WD WD No data available


as at October

YTD FOT YTD FOT

Reduction in demand for Ferns QIPP Plan 800,000 n/a See GB QIPP Dashboard




12

8 Learning Disability (Learning Disabilities is a clinical priority within the I&A

Framework) Lead GP: : Russell Brynes (Adults) Jason Page

(Children) Lead Officer: Garry Parvin (Adults) Nigel Parkes

(Children)

Deliverable Milestones for 2017/18 Source 2017/18Target

Q4 16/17


M34 Deliver the required number of bed reductions as per Rotherham element of the plan.

Com plan LD TCP

Q4 A A Remedial action plan in place to achieve both trajectories by July 2017.

M35 Delivery of CETR Expert by Experience training.

Com plan LD TCP

Q3 New for 17-

18

G On track

M36 Rotherham CETR process in place (CYP). Com plan LD TCP

Q4 New for 17-

18

G On track

M37 Rotherham ‘at risk of admissions’ process in place (including CYP and Autism).

Com plan LD TCP

Q4 New for 17-

18

G On track


Q4 16/17


(KPIs) K25 Ensure that patients receive a CTR prior to

a planned admission to an Assessment and Treatment Unit or mental health inpatients - adults

Com Plan STP

95% G G On track.

K26 Ensure that patients receive a CETR prior to a planned admission to an Assessment and Treatment Unit or mental health inpatients - children

Com Plan STP

95% G G On track.

K27 Ensure that patients in an Assessment and Treatment Unit receive a Care and Treatment Review (CTR) every 6 months

Com Plan STP

100% G G On track

K28 Reduce the number of people admitted in line with the South Yorkshire and North Lincolnshire LD TCP trajectory

Local Reporting

Target = 3 – CCG funded LD beds /5 – NHSE funded

secure LD beds

A A Q1 local and TCP trajectories are off track. Ongoing review with association of NHSE regarding increased admissions of individuals from outside the Rotherham area.

QIPP £ Finance Operational Rating as at October

YTD FOT YTD FOT

None. QIPP Plan

Risks Risk Description Risk Score Services commissioned do not appropriately deliver to vulnerable people.


Assurance – having robust internal constitutional and governance arrangements, ensuring that providers’ services are safe and ensuring vulnerable people have effective safeguarding.

12

9 Maternity and Children’s Services (Maternity is a clinical priorities within the I&A Framework)

Lead GP: Jason Page Lead Officer: Mark Chambers


Q4 16/17


M38 Engage at SY&B level to support strategic direction for the national requirements around maternity ( Better Births)

Com Plan

Q4 New for 17-

18

G Gap analysis completed, now working at SY&B level to develop strategies for maternity services

M39 Ensure delivery of the SEND Joint Commissioning Action Plan

Com Plan

Q4 New for 17-

18

G CCG has undertaken 2 self-assessment exercises. Input into the CCG SEND Strategy Commissioning Group. Self-assessment identified ongoing gaps in provision.

M40 Develop new community services specifications for children’s community nursing and specialist nurses to support the Care Closer to Home work-stream

Com Plan

Q4 G G On track -Parent Carers Forum consultation exercise ongoing. Draft Spec for Childrens Community Services completed and shared internally. Draft service spec for CCN shared with TRFT and comments received. TRFT looking at CCN models around the country, following this the spec will be agreed.


Q4 16/17


(KPIs) K29 Reduce the number of neonatal mortality

and still births (I&AF 125a) I&A

Framework GB Report

6.7 stillbirths per births

WD WD Latest published position is 4.6 (2015 data). The IAF year-end assessment puts RCCG in the best quartile in England.

K30 % of children aged 10-11 classified as overweight or obese (I&AF 102a)


TBC WD WD Latest position is 35.8% in 2015/16. IAF year-end assessment used data from 12/13 to 14/15, giving RCCG a value of 35.5%. For the year-end assessment RCCG were in the inter quartile range, i.e. not in the worst or the best quartiles nationally.

K31 Maternal smoking at delivery (I&AF 101a) I&A Framework GB Report

TBC WD WD Latest available position – Q4 16/17 – 17%. Q3 position was 19.9% which was used for the IAF year-end assessment, where RCCG where in the worst quartile nationally.

K32 Improve Women’s experience of maternity services (national maternity services survey) (I&AF 125b)


TBC WD WD 2015 score of 79.8 is latest available position. This was used for the IAF year-end assessment, where RCCG was neither in the best nor the worst quartiles nationally.

K33 Emergency admissions for children with lower respiratory tract infections

Health Outcomes GB Report

541.8 WD WD Latest position is 372.3 in 2015/16

K34 Unplanned hospitalisation for asthma, diabetes and epilepsy in under 19’s

Health Outcomes GB Report

364 WD WD Latest position is 272 in 2015/16


as at October

YTD FOT YTD FOT

None.


None identified.

10 Continuing Care and Funded Nursing Care Lead GP: Richard Cullen Lead Officer: Alun Windle


Q4 16/17


M41 To approve and implement an alternative discharge process for patients in the acute setting that will ensure that they are optimised in the appropriate placement prior to full Continuing Health Care assessment.

CHC Standards

AQuA Assurance

Report

Q3 New for 17-

18

G On track

M42 To implement a shortened assessment tool for reviews of Continuing Health Care eligibility.

CHC Standards

AQuA Assurance

Report

End Q2 New for 17-

18

G On track

M43 To implement a shortened review tool for reviews of children’s Continuing Health Care eligibility.

CHC Standards

AQuA Assurance

Report

Q2 New for 17-

18

G On track


Q4 16/17


(KPIs) K35 People eligible for standard NHS

continuing healthcare (I&AF 135a)

I&A Framework GB report

TBC WD WD Waiting for data

K36 Personal Health Budgets (I&AF 105b) I&A Framework GB report

TBC G WD Waiting for data

K37 Less than 15% of all full NHS Continuing Health Care assessments to take place in an acute hospital setting. By Q4.

CHC Key Performance

Indicators

<15% New for 17-18 30%

On track

K38 25% reduction in assessments beyond 28 days for adults (currently 22%) to meet the 28 day national policy guidance. By Q4.

CHC Key Performance

Indicators

Adults 25%

reduction

New for 17-18

22%

On track

K39 Overall 15% reduction in outstanding reviews (61% current target 46%). By Q4. Adults

CHC Key Performance

Indicators

Adults 15%

reduction

New for 17-18 60.34%

On track

K40 Overall 15% reduction in outstanding reviews (50% current target is 35%). By Q4.

CHC Key Performance

Indicators

Children 15%

reduction

New for 17-18 50%

On track


as at October

YTD FOT YTD FOT

Review of CHC cases against frameworks and legislation


Review of assessment tool for determining care packages


Ongoing clinical review of high cost placement packages


Further development of personal health budgets



None identified.

11 End of Life Care (EOLC) Lead GP: Avanthi Gunasekera Lead Officer: Ian Atkinson

Deliverable Milestones for

2017/18 Source

2017/18 Target

Q4 16/17


M44 Involvement of the Care Co-ordination Centre in the EOLC pathway

Com Plan Q4 A A Started but not on track – ongoing work taking place with CCG lead clinical lead

M45 Achieve 40% implementation of the Case Management Palliative Care Template in Primary Care

Com Plan Q4 A A Data set still being developed, uptake of palliative care within case management continues to be embedded data.


Q4 16/17


(KPIs) K41 Percentage of deaths which take place in

hospital (I&AF 105c)


TBC WD WD Latest position, Q2 16/17 – 46.1%. This indicator was not allocated to a quartile in the IAF year-end assessment.

K42 Percentage of deaths not in hospital Public health TBC WD WD Latest data = July- September 2016 – 53.9%


as at October

YTD FOT YTD FOT

None.

Risks Risk Description Risk Score None identified.

12 Specialised Services Lead GP: Richard Cullen Lead Officer: Jacqui Tufnell


2017/18 Source

2017/18 Target

Q4 16/17


M46 Respond to any national expectations for specialised commissioning.


18

G Complete

Key Performance Indicators (KPIs) 2017/18 Target

Q4 16/17


(KPIs) - n/a No KPIs

QIPP £ Finance

Operational Rating

as at October

YTD FOT YTD FOT

None.

Risks Risk Description Risk Score None identified.

13 Joint Work – local and Regional

Lead GP: Richard Cullen Lead Officer: Ian Atkinson/Wendy Allott


2017/18 Source

2017/18 Target

Q4 16/17


M47 Deliver the IH&SC Place Plan in partnership with other Rotherham organisations

IH&SC Place Plan

Q4 New for 17-

18

G On track

M48 Align IH&WC Place Plan with the H&WB Strategy

H&WBB Q3 New for 17-

18

G On track

M49 Oversee the implementation of the BCF with RMBC

Com Plan / BCF Plan

Q4 G G On track


Q4 16/17


(KPIs) - Achievement of BCF KPIs – see BCF Plan Com Plan /

BCF Plan Q4 Please see BCF page of GB report

QIPP £ Finance

Operational Rating

as at October

YTD FOT YTD FOT

None.


None identified.

14 Sexual Exploitation

Lead GP: Lee Oughton Lead Officer: Catherine Hall


2017/18 Source

2017/18 Target

Q4 16/17


M50 As part of the safeguarding update for GPs and practice staff, ensure level 3 training is delivered.

Com Plan Q1-Q4 G G On track

M51 Offer the same training as above to the remainder of primary care, social care and providers to ensure collaborative working.


M52 Provide ongoing support to current and emerging SYP and NCA historic investigations


M53 Provide 2 members to be part of the Multi Agency Safeguarding Hub team

Com Plan Q1- Q4 G G On track

M54 Ensure safeguarding standards are included in all commissioned services contracts and that these are monitored.

Com Plan Q1-Q4 New for 17-

18

G On track


Q4 16/17


(KPIs) - None.

QIPP £ Finance

Operational Rating

as at October

YTD FOT YTD FOT

None identified.


Partnership working with RMBC and other agencies.


Safeguarding – ensuring all children and vulnerable adults are protected from harm, including implementing all actions on Child Sexual Exploitation from the Jay and Casey reports.

9

15 Cancer (Cancer is a clinical priorities within the I&A Framework) Lead GP: Richard Cullen Lead Officer: Janet Sinclair-Pinder


2017/18 Source

2017/18 Target

Q4 16/17


M55 Work with the STP Cancer Alliance to improve early diagnosis and cancer prevention:

- Increasing awareness of signs and symptoms of cancer.

- Focused work on targeting populations. - Reviewing capacity and demand across

diagnostic services. - Developing quality standards across Primary

Care.

Com Plan STP

Q4 New for

17-18

G On track

M56 Develop pathways of care for vague symptoms.

Com Plan STP

Q4 New for

17-18

G On track

M57 Fully engage with the Macmillan Living With and Beyond Cancer (LWABC) Programme to implement the agreed actions outlined in the project initiation document.

Com Plan STP

Q4 New for

17-18

G On track


Q4 16/17


(KPIs) K43 Cancer (all) diagnosed at stage 1 and 2

(I&AF 122a) I&A

Framework Quality

Premium

>60% or 4 % point improvem

ent

R WD Off track, RCCG in worst quartile nationally but inconclusive as the latest reporting period was 2014.

K44 Percentage seen within 2 weeks following an urgent referral by GP for suspected cancer

Constitution GB Report

93% G Mar = 96.5%

G May 17

= 96.8%

On track

K45 Percentage seen within 62 days after a referral by GP (I&AF 122b)

Quality Premium

I&A Framework

85% R Mar = 78.2%

A May 17

= 86.6%

May 17 performance met standard but previous months have missed standard.

K46 Patient satisfaction rates >89% (Secondary care) (I&AF 122d)

I&A Framework Com Plan GB Report

TBC WD WD 2015 Annual data was used for the IAF year-end assessment. RCCG value was 8.7 which is neither in the worst nor best quartile nationally.

QIPP £ Finance

Operational Rating

as at October

YTD FOT YTD FOT

None.


None identified.

Glossary

APMS Alternative Provider Medical Services BCF Better Care Fund CCC Care Co-ordination Centre CHC Continuing Healthcare

CAMHS Child and Adolescent Mental Health Services

CQC Care Quality Commission

EOLC End of Life Care GB Governing Body IFR Individual Funding Request I&A Improvement and Assessment LES Local Enhanced Services ‘Q’ ‘Quarter’ QIPP Quality Innovation Productivity and

Prevention RMBC Rotherham Metropolitan Borough Council

STP Sustainability and Transformation Plan TRFT The Rotherham Foundation Trust WIC Walk in Centre IHAM Indicative hospital activity model

Documents

NHS Rotherham Clinical Commissioning Group Body Papers... · M34 Deliver the required number of bed reductions as per Rotherham element of the plan. Remedial action plan in place