(Paper No 12/111) Date: t 4h May 2012 Fiona MacKay, Head ...library.nhsggc.org.uk/mediaAssets/CHP Renfrewshire... · draft form and a few minor changes will be made before it is submitted

��

(Paper No 12/111) Renfrewshire Community Health Partnership Committee Date: 4th May 2012 Author: Fiona MacKay, Head of Planning and Health Improvement Agenda Item – Organisational Performance Review/Performance Reporting – Year to March 2012 1. Purpose

1.1 This paper is to share with the Committee Renfrewshire CHP’s submission for the

Organisational Performance Review (OPR) on 3rd May 2012. The submission is still in draft form and a few minor changes will be made before it is submitted to NHS Greater Glasgow and Clyde Board.

2. Background

2.1 Every six months, Renfrewshire CHP is held to account for performance at an Organisational Performance Review (OPR). A template with key performance indicators and agreed development plan actions is circulated before the event and is used as the basis for discussion. The CHP has the opportunity to raise any challenges or barriers and to highlight good practice.

2.2 Over the past few years quarterly performance reports have been presented to the CHP Committee. In order to cut duplication, in 2012/13 the Committee will be presented with two Organisational Performance Review Reports; mid year (April – September) and year end (April – March). In addition there will also be quarterly performance reports for quarter one (April – June) and quarter 3 (July – September).

3. Organisational Performance Review

3.1 The template that will be submitted for the 3rd May OPR is attached at Appendix 1. This is a final draft which is subject to minor amendments.

3.2 Key success areas identified include the reduction in smoking in pregnancy across Renfrewshire and in deprived areas, smoking cessation rates, suicide prevention training, referral to treatment times for alcohol and drug services, increased number of people in receipt of telecare and increased referrals to the Single Point of Access. In addition, all GP Practices are now trained to deliver the Liverpool Care Pathway.

3.3 Some of the expected improvements resulting from the Change Fund have not yet materialised. Performance in Alcohol Brief Interventions, staff sickness absence and long term conditions (bed days per 100,000 population) has proved challenging.

4. Recommendation

The Committee is asked to:

• Note this report and attachment and continue to receive performance reports as per 2.2 above.

Renfrewshire CHP – Wider management Responsibilities & Capital Projects– OPR Template- 3 May 2012

2

Renfrewshire CHPs Organisational Performance Review Template This template highlights the key strategic priorities and performance measures outlined in Renfrewshire CHPs 2011 – 12 Local Development Plan, Change Fund Plan and CHP directors lead areas of responsibility. In line with the previous years’ OPRs the draft template has been structured according to the Planning and Policy Frameworks and the content has been cross referenced with the Corporate Themes and Consolidated Outcomes as per the key below. CT

Corporate Themes

CT1 Improve Resource Utilisation CT2 Shift the Balance of Care CT3 Focus Resources on Greatest Need CT4 Modernise Services CT5 Improve Accessibility CT6 Improve Individual Health Status CT7 Effective Organisation CO

Consolidated Outcomes

CO1 Efficient and economic services are provided based on best practice and value for money CO2 Financial resources are allocated recognising the mutual interdependence of primary and secondary care services CO3 People are supported to live independently through the provision of a full range of care services available locally CO4 Early intervention is understood by staff, service users and carers and has begun to become the norm, facilitated through supporting services CO5 Resources are targeted at specific high risk groups in order to mitigate the risk of ill health CO6 Inequalities are addressed through effective planning, practice and service redesign CO7 Facilities are planned and invested in to reflect the services and patient requirements and are environmentally sustainable CO8 Services seek and are responsive to patients views CO9 Services are provided in a way which maximises quality and safety CO10 Patients can access services at a time they need in the appropriate location CO11 The public is informed on issues of public health to enable prevention and early detection of health problems CO12 Information is managed and disseminated effectively to support planning and service delivery CO13 The workforce is engaged, feels valued and is representative of the population


3

WIDER MANAGEMENT RESPONSIBILITIES

Areas of Lead Responsibility Progress Update Primary Care Planning Framework. DL

Primary Care Support. NZ

Phase 2 of Enhanced Service Review and the establishment of financial framework for GG&C.

NZ

Community Continence Redesign JB

Community Podiatry and community paediatric SLT AHP redesign processes

The podiatry service review and redesign plans fully completed within required timescales. Transition plan established following management appointments supporting effective move to new structures as of 1 April 2012. Savings target for 12/13 met. OD plan and service improvement plan in place. SLT - DL TO ADD

ACTIONS AGREED AT PREVIOUS OPR

PROGRESS UPDATE

Continence Redesign It was agreed that this would be followed up in relation to cost reduction.

DL/JB TO ADD

CAPITAL PROJECTS

Capital Project

Progress Update

New Sneddon Street

The works at New Sneddon Street Clinic have been carried out in two phases. Phase 1 involved improvements and redesign to the first floor to accommodate Sandyford Renfrewshire. Phase 2 of the works, which is currently underway, involves refurbishment of the ground floor to provide improved accommodation for podiatry services and additional clinical space for services including speech and language therapy and dietetics.

Dykebar – Refurb Arran and Bute wards and Reconfigure AAU Capital project within Acute Admissions Unit (AAU) completed in December 2011 and


4

patients transferred from temporary decant accommodation to refurbished AAU in December. Improved wad configuration allows revised staffing model to be fully implemented. Funding recently sourced to refurbish Arran ward and work is presently underway and due to complete early in July which will allow adult rehab and continuing care beds to relocate to Arran and Bute wards (Bute already refurbished) to much improved patient environment.

Renfrewshire CHPs contribution to Acute Services Planning Framework - OPR Template – 3 May 2012

5

RENFREWSHIRE CHP - ACUTE SERVICES

CT/CO Type Performance Measures As At Renfrew

Actual 2011/12

Renfrew Target 2011/12

Renfrew Status

GG&C Actual

GG&C Status

Renfrew Direction of Travel

CT1/CO1 KPI Reduce number of DNAs Jan - Dec 11 10.9% 11.3% GREEN 13.5% RED � CT2/CO4 HS A&E waits: max 4 hours (%) Feb 12 93.8 98 AMBER 94.4% AMBER � CT2/C04 KPI A&E attendances (per 100,000) Feb 12 3097 2994 AMBER 2839 GREEN � CT2/C04 KPI A&E attendances by GP (per 100,000) Feb 12 343 N/A N/A 276 N/A � CT2/CO4 KPI A&E attendances at MIUs (per 100,000) Feb 12 7 N/A N/A 233 N/A � CT5/CO4 HT Stroke Unit Feb 12 - - - 72% AMBER -

2011/12 PLANNED ACTIVITY

No 2011/12 Planned Activity Progress to Date 1 Work with partners to consider how we shift the balance of

care, including the resource implications. Reviewed community diabetes team structure and performance with Martin McIntyre and RAH service Following option appraisal agreed to move to one integrated service managed from acute. Community location and joint performance monitoring remain. Change fully implemented 1 April 2012.

2 Deliver on agreed diagnostic service improvements. Some work has been led through Clinical Governance to reduce the number of MSSU requests by GPs. Following revised guidelines to GPs, MSSU requests fell by 200 in a quarter – a saving of £68k.

3 Agree clear referral routes with agreed referral criteria with secondary care for patients requiring referral to and /or intervention from secondary care.

Headache, dyspepsia and knee pain pathways discussed with local GPs at QOF QIP event on 9 November 2011.

4 Plan and design care pathways between primary and secondary care in partnership including the resources required, with agreed feedback arrangements about utilisation and appropriateness in place.

Diabetes- care pathways have been reviewed and updated by primary and secondary care. SPOA was delayed to due to aforementioned management review now planned for summer 2012 – led by acute in partnership with GPs. Subsequent to discussions at local primary/secondary care clinician interface meetings respiratory early supported discharge rolled out at RAH in March 2012. Additionally all GPs have been made more aware of pulmonary rehabilitation and encouraged to refer patients there. 3 GP/secondary care educational meetings have been held covering colorectal surgery, cardiology and geriatrics. Consultants were able to explain care pathways and GPs had an opportunity to raise questions/problems.

Renfrewshire CHPs contribution to Acute Services Planning Framework - OPR Template – 3 May 2012

6


PROGRESS UPDATE

Interface Working The submission described a number of activities in relation to acute services and for the next OPR we need clarity on actual outcomes including: • providing an assessment of the improved working around

interface issues with the new QOF arrangements • confirming thresholds for the outpatient pathways and

timescales to actually deliver • confirming the date of the MRI pathway roll out across the

Board.

Discussions have taken place with the Director for ECMS around the responsiveness of gastro-enterology services locally as raised by GPs as part of the QOF/QIP feedback. Regular joint GP/secondary care discussions as described at 3 above. Review of practices’ external QOF QIP report returns detailed that only helicobacter pylori stoll testing as opposed to breath or serum testing as included within the dyspepsia pathway is available locally. This has been fed back to the QOF QIP steering group with a view to the pathway being amended. Direct access MRI knee to be rolled out across Clyde by end summer 2012 and presentation on this to take place at meeting of GP Forum on 31 May.

A&E Attendances The CHP agreed to work with Acute to improve performance in A&E attendances at the RAH.

Initial meeting has taken place with representatives from the RAH about having a GP based within A&E as a senior clinician resource with respect to the need to admit or otherwise. Further discussions diarised with A&E and acute medicine consultants. Meeting AM & RES Managers with ECHs Directorate Management and OOHs CD on 07/03/12 to explore potential and discuss options and governance issues. ECMs Manager to discuss with A&E Consultants and arrange a further meeting to explore future potential. Mtg date not yet advised.

CHP Directors brief assessment of overall performance in relation to Acute Services .

Renfrewshire CHPs contribution to Adult Mental Health Planning Framework - OPR Template 3 May 2012

7

RENFREWSHIRE CHP – ADULT MENTAL HEALTH


Actual 2011/12


Renfrew Status

GG&C Actual

GG&C Status


CT1 / CO1 KPI Reduction in anti-depressant prescribing (DDD per capita – GP list size)

TO FOLLOW

CT1 / CO1 KPI Anti-Depressant - Citalopram/Fluoxotine CT1 / CO1 KPI Anti-Depressant - Escitalopram CT6 / CO11 KPI Suicide Prevention Training Jan – Dec 11 79

0 GREEN 416 252 -

CT2/CO3 KPI Delayed Discharge Adult Mental Health: > 6 weeks Mar 12 0 0 GREEN 1 RED � < 6 weeks Mar 12 0 0 GREEN 3 RED � CT/CO3 KPI Doing Well Service PCMHT waiting

times March 2011 – Feb 2012

Mean 31 days

Median 37 days Mode

21days


No 2011/12 Planned Activity Progress to Date 1 Delivery of inpatient capital programme which will achieve

benchmark adult acute beds and improve physical environment for Rehab and Recovery patients.

Handover complete for adult Acute Admissions Unit, now re-opened and benchmark bed number achieved (42). Funding agreed and work underway to refurbish Arran ward - Rehab & Recovery client group due to move July 2012.

2 Participate in wider GGC review of Primary Care Mental health Services, Community Mental Health Teams and Inpatient bed configurations.

Primary Care Mental Health Team review due for full implementation in June 2012. Local action plan developed and implementation underway. Work ongoing re Community Services Review and In-patient bed configurations.

3 Develop action plan following completion of patient pathway project. Agreed actions included as part of agreed APIG work plan 4 Develop Exit Strategy following completion of REALise project. Exit strategy complete. Two FTC staff employed in Renfrewshire have now

secured alternative employment & project closed. National evaluation awaited from Warwick University. Local evaluation report in process of being completed.

5 Develop joint local authority / health agreed actions to achieve progress in the identified gap for patients who present with challenging behaviours who do not require continuing hospital care.

In-patient staff participate in community Priorities Allocation Meeting. Transfer of care handover process agreed for discharge of patients in this category to care home and/or supported accommodation.

Renfrewshire CHPs contribution to Adult Mental Health Planning Framework - OPR Template 3 May 2012

8

6 Agree and implement model of early intervention within the CMHTs.

Early Intervention Model being reviewed on a GG&C wide basis. If agreed will be rolled out to cover Renfrewshire by end of 2012.


PROGRESS UPDATE

Patients with Challenging Behaviours The CHP will establish a baseline on the number of patients with challenging behaviours in adult beds to ensure improvements can be measured at the next OPR.

Baseline has been established. Ward systems reviewed to ensure improved multi-disciplinary / multi/agency communicate as early as possible in in-patient stay with clear focus on purpose of admission, planned interventions and expected date of discharge as early in process as possible

Capital Project The CHP confirmed the capital project would allow for the improved management of inpatients; applying a consistent model and standard of care in a more cost effective way and will be evidenced at the next OPR.

Capital project within Acute Admissions Unit (AAU) completed in December 2011 and patients transferred from temporary decant accommodation to refurbished AAU in December. Improved wad configuration allows revised staffing model to be fully implemented. Funding recently sourced to refurbish Arran ward and work is presently underway and due to complete early in July which will allow adult rehab and continuing care beds to relocate to Arran and Bute wards (Bute already refurbished) to much improved patient environment.

Early Intervention Key findings from the audit to assess the impact of the early intervention arrangements will be reported at the next OPR.

A retrospective audit of new first presentation psychosis referrals will be carried out covering period Jan – Apr 12. Early Intervention Model (ESTEEM) being reviewed on a GG&C wide basis. If agreed will be rolled out to include Renfrewshire by end of 2012.

Psychological Therapies The CHP confirmed that demand for psychological services is being assessed to allow for better planning.

Audit of staff skills and training complete with analysis of that underway at present time to inform training plan for next 2 years. Initial work on understanding demand for psychology services has now expanded to include whole of community mental health team in a review of systems and processes with the joint aims of improving the patient pathway across community mental health services and better understanding and managing total demand (inc psychology)

CHP Directors brief assessment of overall performance in relation to Adult Mental Health .

Renfrewshire CHPs contribution to Alcohol and Drugs Planning Framework – OPR Template 3 May 2012

9

RENFREWSHIRE CHP – ALCOHOL AND DRUGS

CT/CO Type Performance Measures As At Renfrew Actual 2011/12


Renfrew Status

GG&C Actual

GG&C Status


CT6 / CO11 HT Drug and Alcohol: Referral To Treatment - 3 weeks

Oct – Dec 11 91.3% 90% GREEN 92.8% GREEN �

CT6 / CO11 KPI Alcohol Referral To Treatment - 3 weeks

Oct – Dec 11 92.6% 90% GREEN 93.2% GREEN �

CT6 / CO11 KPI Drug Referral To Treatment - 3 weeks Oct – Dec 11 88.5% 90% AMBER 91.7% GREEN � CT6 / CO11 HT Number of Alcohol Brief

Interventions Apr - Dec 11 481 842 RED 14181 GREEN �

CT6 / CO11 KPI Alcohol Fast Screening Tool Apr - Dec 11 3283 N/A N/A 42892 N/A �

CT6 / CO11 KPI Proportion of GP practices signed up to deliver ABIs

2011-12 24 (82.8%)

N/A N/A 79.2% N/A �

CT6/CO10 KPI Number of drug related deaths (per 100,000 pop)

2010 11.2 N/A N/A 13.9 N/A �

CT6/CO11 KPI Alcohol related deaths > 19 years (rate per 100,000 population)

2010 33.5 N/A N/A 37.1 N/A �

CT6 / CO11 KPI Reduce rate of alcohol related admissions

Jan - Dec 11 9.1 N/A N/A 10.7 N/A �


No 2011/12 Planned Activity Progress to Date 1 Generate specified recurrent cost savings as part of redesign

activities. Recurrent cost savings identified through changes in skill mix as part of redesign

2 In partnership with Renfrewshire Council explore options for further integration of addiction services.

See below.

3 Clear care pathways in place (and audited) between community-based services and specialist/acute services. • Development of care pathways for ARBD and Co-morbidity.

Care pathways agreed and implemented between CMHT and Addiction services. Second co-morbidity nurse appointed to support interface. Mental health and addiction protocol in development, draft due May 2012. ARBD care pathway development continues, working group membership extended to include Consultant from Addiction and Mental health and Acute hospital social work. Draft pathway has been developed and the working group are now progressing guidance to support the pathway.

4 Early identification of children and young people affected by or involved in substance misuse.

Audit of child care section of Assessment documentation underway in partnership with social work for integrated services.

5 Substance misuse services address unmet need and barriers to Review of Low Threshold service completed Jan 2011. The review


10

access through a range of targeted services: • Undertake access EQIA on Alcohol Problem Clinic and

Renfrewshire Drug Service; and • Review quick access low threshold service.

demonstrated positive outcomes including reduction and stopping of heroin use (95%), stopping injecting (74%). The LTC provides rapid induction of substitute treatment for high risk patients, who often present in social, physical and financial crisis. Assessment and health checks are completed within 3 days on average medical review and commencement on substitute medication undertaken within 12 days on average.

6 Further develop and maximise use of resource attached to Acute Alcohol Liaison Service as identified through Acute Addiction Action Plan.

Liaison service continues to develop. Staff now training and supporting screening in pre-assessment gynaecology and fracture clinic. Staff now delivering ABI in the new medical assessment unit and training staff to build capacity.


PROGRESS UPDATE

Integration of Addiction Services A new approach will be made in October with the Council regarding the integration of management arrangements. If unsuccessful, the CHP will draft a report on the benefits of further integration versus the risks of failure to integrate to inform a decision at Board level on how to proceed.

It is difficult to say whether renewed efforts since November 2011 have had any impact. DL

Alcohol Brief Interventions The CHP agreed to re-energise approach with GPs and will use evidence from the Cochrane report to support this. There are also plans to use Keep Well practices to increase the number of interventions.

To date, we only have figures for the first three quarters of 2011/12 (214, 141,125) which show a downward trend in interventions. The screening figure has remained constant. Low figures may reflect delayed claims – it would be useful to get more current data. Of the 24 participating practices, 9 have carried out less than 5 interventions in the three quarters.

Local data shows 667 Alcohol Brief Interventions (ABIs) were delivered in Renfrewshire; 265 in the 9 Keep Well practices and 402 in the remaining Practices. We will use the opportunity of increased communications with Keep Well practices to promote alcohol brief interventions and increase delivery. In addition to this, we are going to target practices signed up to the Local Enhanced Service (LES) where delivery could be improved through the use of resources and awareness raising materials. We are also going to use community forums such as Local Area Committees (LACs) and CHP Locality Groups to influence this agenda. – CW querying data

EQIAs Two EQIA’s have been undertaken within addiction services.


11

The four EQIAs completed in addictions will be updated and made available to CIT. It was also confirmed that gender issues in the EQIAs will be explored further.

The alcohol service EQIA involved both the Alcohol Problems Clinic and the Integrated Alcohol Team. It has been completed and published on the website. A review has been undertaken and progress made against the action plan. The Renfrewshire Drug service EQIA includes the Low Threshold service. This is nearing completion with service user feedback awaited for inclusion in final write up.

CHP Directors brief assessment of overall performance in relation to Alcohol and Drugs .

Renfrewshire CHPs contribution to Cancer Planning Framework - OPR Template – 3 May 2012

12

RENFREWSHIRE CHP – CANCER PLANNING FRAMEWORK


Actual 2011/12


Renfrew Status

GG&C Actual

GG&C Status


CT5/CO10 KPI Uptake of HPV vaccinations: School Routine Cohort (S2) 2010-11 79.6% N/A N/A 78.7% N/A � CT6/CO11 KPI Uptake of cancer screening programmes: Breast No data avail as round just started 68.9% AMBER - Bowel 54.9% 60% AMBER 51.2% RED - Bowel - SIMD 1 44.4% 60% RED 41.9% RED - Bowel - SIMD 2 51.9% 60% RED 48.5% RED - Bowel - SIMD 3 55.8% 60% AMBER 52.8% RED - Bowel - SIMD 4 60.7% 60% GREEN 58.0% AMBER - Bowel - SIMD 5

Apr 09 - Mar 11

61.6% 60% GREEN 62.7% GREEN - Cervical Dec 11 79.3% 80% AMBER 75.9% AMBER � CT2/CO3 KPI Number of patients on Liverpool Care

Pathway Dec 2011 57 45 GREEN �


No 2011/12 Planned Activity Progress to Date 1 Locally promote national cancer awareness campaigns (No

Smoking Day, Sun Awareness etc). The Health Improvement team has supported Cancer Research UK at two local events. We provided information to local people about bowel and prostrate cancer, oral health and smoking cessation. We plan to support their local event later in the year. The Health Improvement Team co-ordinated a very successful timetable of events for No Smoking Day with approx 64 events taking place across the area. This activity has resulted in 47 referrals to the Smokefree Community Service.

2 Develop the role of community pharmacy as lead care manager. Susan Love to provide

3 Deliver better end of life care through LCP.

Our work in this area continues to develop. 76 LCPs were initiated in community in 2011/12. Use of LCP has now been introduced to EMI inpatient services at the RAH and Dykebar following completion of the education programme for staff. LCPs are audited and feedback provided


13

to practices to support continuous improvement. The DNA CPR training has now been completed for all 29 GP practices.

4 Ensure 24 hour support through Community nursing, Home care and other services such as equipment to support people as near to home for as long as possible.

OOH Community Nursing, Ren 24 and Community RES services work to deliver this support to maintain people at home and where possible prevent hospital admission. As part of year 2 Change Fund plans we plan to extend RES service provision between 8pm – 11pm.

5 Further develop multidisciplinary/multi-agency joint planning arrangements and robust links with national and regional agenda.

Palliative Care JPPIG well established with work plan in place. SPAR now fully operational in 3 local authority and 1 private care home. Joint working progressed in private sector to roll this out to further 6 care homes in 2012/13. Living Well At The Library (LW@L) formally launched in January 2012. 14 volunteers have been recruited and trained to support the service across 3 libraries.

6 Deliver and review the National Patient Experience Programme Project.

LW@L – positive feedback from service users, demonstrates the value of this service in providing information and support to patients and their carers in a bespoke, non clinical environment. Also - refer to page 16, number 7 – DN Patient & Carer Experience Project will include feedback from palliative care patients and their carers. Report awaited.


PROGRESS UPDATE

Bowel Screening More up to date bowel cancer screening information will become available in November/December 2011 and the CHP have plans in place to take a more targeted approach focusing on groups with a poorer uptake rate.

The most recent data on Sharepoint is to March 2011, so it is difficult to know if recent efforts have had any impact. A resource for people with learning disabilities has been developed – Bowel Screening Made Easy – and will be launched this month. Uptake rates across all practices circulated to practices themselves with subsequent discussion at GP Forum on how individual practices might best support their patients in promoting bowel screening. As part of a more targeted approach, we have contacted two large local employers to promote health messages to their workforces.

Cervical Screening Feedback on the work with homeless women and LD in relation to women with the greatest need will be reported at the next OPR.

Cervical screening was the subject of our last clinical governance newsletter, circulated in early April 2012. This draws attention to positive progress and improved screening rates, but highlights the practices which are below the 80% target and with high levels of unsatisfactory smears.


14

The rates in Renfrewshire have increased every quarter to December 2011, which is the most recent performance we have on Sharepoint. No work has yet been done to target vulnerable groups of women.

CHP Directors brief assessment of overall performance in relation to Cancer .

Renfrewshire CHPs contribution to Child and Maternal Health Planning Framework - OPR Template – 3 May 2012

15

RENFREWSHIRE CHP – CHILD AND MATERNAL HEALTH PLANNING FRAMEWORK


Actual 2010/11


Renfrew Status

GG&C Actual

GG&C Status


CT7/CO12 KPI Number of children with completed IAF Dec 2011 229 - - � KPI Number of staff trained in child protection Feb 12 86 41 GREEN 11627 GREEN - CT5/CO10 A12 CAMHS waiting times (No. weeks) Dec 11 40 42 GREEN 58 RED � CT6/CO11 CMU Breastfeeding At birth: Paisley Maternity - - - 46.4% - - Princess Royal - - - 43.0% - - Rankin Memorial/IRH - - - 52.4% - - Southern General - - - 45.0% - - Vale of Leven

Jan 11 – Dec 11

- - - 50.7% - - CMU Breastfeeding At discharge - - - Paisley Maternity - - - 34.2% - - Princess Royal - - - 32.1% - - Rankin Memorial/IRH - - - 44.4% - - Southern General - - - 45.0% - - Vale of Leven

Jan 11 – Dec 11

- - - 40.3% - - CT6/CO11 H7 Breastfeeding: KPI At birth 48.6% NA N/A 49.2% N/A � KPI At discharge 36.0% N/A N/A 37.9% N/A � KPI At health visitors first visit 26.6% N/A N/A 30.3% N/A � H7 6-8 weeks

Jan 11 – Dec 11

20.2% 28.4% RED 22.9% RED National 6 – 8 week breastfeeding rate KPI deprived Jan 11 –

Dec 11 15.7% 28.4% RED 13.75% RED �

KPI Smoking in pregnancy 16.6% 20% GREEN 15.7% GREEN � KPI Smoking in pregnancy in deprived areas

Jan 11 – Dec 11 25.2% N/A N/A 24.7% N/A �

CT3/CO6 KPI Triple P: Number of interventions delivered 33 N/A N/A 3505 N/A - Number of parents attending

Nov 09 – Oct 11 344 N/A N/A 7721 N/A -

CT6/CO11 KPI % of P1 with no obvious decay experience 2009/10 57.77% 60% AMBER 58.2% AMBER - CT6/CO11 KPI % of 3 - 5 year olds registered with a dentist Sept 11 85.5% 76% GREEN 87.2% GREEN � CT6/CO11 Proportion of 3 year olds who have had 2 or

more fluoride varnish applications:

KPI SIMD 1 0.69% 0.0% GREEN 1.14% GREEN - SIMD 2

Sept 11 1.06% 0.0% GREEN 1.75% GREEN -


16

SIMD 3 1.02% 0.0% GREEN 1.43% GREEN - SIMD 4 1.11% 0.0% GREEN 1.67% GREEN - SIMD 5 0.61% 0.0% GREEN 1.49% GREEN - CT6/CO11 Proportion of 4 year olds who have had 2 or

more fluoride varnish applications:

SIMD 1 0.45% 0.0% GREEN 2.50% GREEN - SIMD 2 1.34% 0.0% GREEN 3.32% GREEN - SIMD 3 0.26% 0.0% GREEN 1.09% GREEN - SIMD 4 1.33% 0.0% GREEN 2.24% GREEN - SIMD 5

Sept 11

- 0.0% GREEN 0.97% GREEN - CT6/C011 HT Number of children completing Child Healthy

Weight Intervention programme 117 128 AMBER 792 AMBER -

CT6/CO11 KPI MMR: 24 months Dec 11 94.4% 95% AMBER 95.2% GREEN � 5 years Dec 11 96.5% 95% GREEN 96.4% GREEN �


No 2011/12 Planned Activity Progress to Date 1 In collaboration with GPs, midwives, Health Visitors and other

colleagues establish practice aligned Vulnerable Children and families’ processes.

An agreed care pathway is in place which promotes close liaison, information sharing and joint working between SNIPS and the Health Visiting Service.

A second care pathway has also been implemented in 2011 between Community Midwifery Services and Health Visiting and Primary Care to promote close liaison, information sharing and joint working. This pathway supports women who do not come within the SNIPS criteria but for whom there are concerns about their wellbeing. The vulnerable Women’s pathway is planned to be jointly evaluated in June 2012 by Children and Family Midwifery services.

2 Implement the review of Community Paediatric Services in each service cluster so as to establish: • Specified General Paediatric Clinics supported by skill • Mixed paediatric nursing teams; • An integrated behavioural paediatric service that includes

those assessments and interventions specified by CEL 16 for LAC; and

• Child Development Centres that function for all children with

The NHSGGC Community Paediatric Framework (Nursing Services) is in final draft and is due to be released for consultation following presentation to the Children’s Services Partnership Group on 1 May 2012. Staff consultation and engagement will follow with workgroups identified to support effective implementation of the workstreams. RCHP will link with Women & Children’s staff within our service cluster.


17

disabilities aged 0 – 19. Implemented

3 Implement the CAMHS redesign through: • implementation of the workforce model for CAMHS teams

reflecting skill mix based on national policy guidance.

Implementation of the NHSGGC workforce model has commenced with the appointment of Band 7 posts – this will be completed by 30 April 2012 and will be followed by appointment of the Band 6 posts. Consultant Psychiatrist posts will be advertised shortly and clinical psychology posts are being.

4 Achieve UNICEF Stage 3 accreditation.

Achieved June 2011. Finalised.

5 Implement the RAM(s) to ensure the matching of the children’s service workforce with local need.

Implemented.

6 Identify mechanisms for getting views and feedback from users and will identify changes made in response to these (local and acute).

Specialist Children’s Services staff have been provided with Patient Experience Manual for use in their service areas. CAMHS are in process of implementing CORC – which will provide opportunities to receive patient feedback at the end of each episode Through the Phase 3 UNICEF accreditation process, Health Visitors have consulted with antenatal and postnatal mothers (predominantly by telephone) with regard to information and support they have received throughout their journey by GPs, midwives and health visiting teams. The feedback from mothers indicated that the role of the peer support workers was extremely valuable in enhancing the quality of the breastfeeding experience. The CHP therefore decided to extend the funding for the peer support workers for another year.

7 Implement the recommendations from the School Nursing Review.

The CSM for Children’s Services is actively involved in this NHSGGC review and chairs the Vulnerable Children’s Sub-Group. The Review is yet to make final recommendations.


PROGRESS UPDATE

Breast feeding The CHP is hopeful that the peer support activity in hospitals alongside support workers for the HV teams visiting mothers at home before the 10 day transfer will make a difference to performance. It was agreed that data will be presented against the Breastfeeding Action Plan for the next OPR.

Progress against the Board-wide work done at the end of 2010 is available. 12 month rolling average rates for exclusive breastfeeding remain disappointing. After a couple of improved quarters, the figures to December 2011 remain close to those 18 months before, at 20.2% against a target of 28.4%. The CHP has developed a system to offer all breastfeeding women a home visit within the first 48 hours by the Infant Feeding Support Worker with funding for this secured for another year till end of March 2013;


18

Volunteer Peer Support is now in progress – 6 volunteer women have been trained and mentored by Health Visitors and now actively volunteering in the RAH Maternity. Three volunteers who recently completed training were awarded with completion certificates on 30 March 2012.

Triple P The CHP agreed to send Triple P performance data to the Corporate Performance Team.

We continue to support staff to improve completion and submission of the pre and post Triple P questionnaires. Of the 93 SDQ pre interventions completed (at level 3) 41 have completed the post intervention. 35 have shown an improvement and 1 has remained the same. The remaining 5 have shown a higher score, and parents have been offered additional support. Our main challenge is to increase the rates of document completion by staff, as anecdotally and, as shown by resource usage, staff are using the programme. Results at level 4 are also available. We have recently held a focus group with project managers and service leads to better understand barriers and agree an action plan to support improvement. It would be useful to agree across NHS GGC system what to report for Triple P, as data is captured at child/family level.

IAF The CHP confirmed that an electronic solution would not be ready until there is an integrated Children and Families Service in place. This does not seem to represent an acceptable timeline and we will pick this issue up separately.

Further discussion took place following the last OPR. Under the auspices of our multi agency GIRFEC Steering Group, the use of IAF in Renfrewshire commenced 1 May 2008 and has been rolled out on a phased basis with completion in April 2011. The IAF is an electronic document which is emailed to members of staff in each agency to allow contribution in an electronic format. Once completed the IAF is distributed and stored electronically. As health staff records are paper only at this time, a paper copied is stored with the record. The local partnership has undertaken work on an ongoing basis to simplify and improve the process to support practitioners. An electronic chronology is also in use. As there is currently no common IT portal in use, all interagency IAF transactions need to be directed via NHS net. While manageable this is less than ideal and we welcome the forthcoming development of the NHSGGC IT system for community children’s services. This will provide an electronic solution and more effectively support the processes around IAF within Renfrewshire. Since May 2008, 510 Integrated Assessments have been completed for


19

children in Renfrewshire. In the last 6 months 127 have been completed. Renfrewshire Children’s Partnership’s GIRFEC Group has agreed the need to evaluate the quality of Integrated Assessments. The initial planning for this will take place at the May 2012 meeting. The CSM for Children’s Services has been identified to join the GG&C short life group on IAF and an initial date for this group is awaited.

Review of Community Paediatric Services It was confirmed that the review had not been fully implemented and it is a whole system piece of work.

See Action 2 above.

RCHP Patient Experience Community of Action Resource It was confirmed that feedback from users is reported to Committee as part of the Clinical Governance arrangements.

Reports on Clinical Governance from the CHP Clinical Governance Group are provided to Committee. We have and continue to actively use this locally developed resource across service areas. NHSGGC has received NES funding to roll out use of this resource across all AHP services. Examples of outcomes to date are provided below: 1. SLT - The Patient Involvement Facilitator, has been working with SLT staff over the last year interviewing parents of children who have been through the SLT Triage system about their views and experiences of the system. A report on outcomes and future action is due May / June 2012. 2. Nutrition & Dietetics service - Feedback from referrals and patient referral process to Community Dietetic service has resulted in improved communications & processes to improve patient journey of care. 3. Diabetes service – Conversations with Patients March 2012 report has provided positive feedback on the service provided and a range of recommendations for action in 2012/13 to improve communication with patients and between specialities.

CHP Directors brief assessment of overall performance in relation to Child and Maternal Health .

Renfrewshire CHPs progress against Change Fund Plan commitments - OPR Template – 3 May 2012

20

CHANGE FUND PLAN INDICATORS – RENFREWSHIRE CHP

No Performance Measure 2009/10

Baseline 2010/11

Actual 2011/12 (Apr - Feb) Actual

2011/12 Target

2011/12 GGC

Actual

GGC Target

1 Number of acute bed days lost to delayed discharges 16,207 14,319 18,001 11,891 100,769 50,424 2 Number of acute bed days lost to delayed discharges for

Adults With Incapacity 2,128 1,190 1,522 1,562 22,493 13,607

4 Delayed Discharges (at census) TBC - 47 - - Delayed Discharge > 6 weeks – At Feb 2012 N/A - 1 0 6 - Delayed Discharge < 6 weeks – At Feb 2012 N/A - 40 - 200 - Delayed Discharge > 6 weeks exception codes – At Feb

2012 N/A - 6 - 75 -

Delayed Discharge < 6 weeks exception codes – At Feb 2012

N/A - 0 - 13 -

5 Unplanned acute bed days (65 +) 93,485 96,646 88,305 - 601,485 -

Unplanned acute bed days 65 + rate / 1,000 pop 3,314 3,426 3,131 - 3,457 -

6 Number of emergency admissions 65+ 7,386 7,501 7,619 - 48,430 -

Emergency admissions 65+ Rate /1,000 pop 262 266 269 - 278 -

7 Number of unplanned admissions by SIMD: - - SIMD Quintile 1 771 927 1,430 - 11,480 - SIMD Quintile 2 2,066 2,084 1,966 - 11,888 - SIMD Quintile 3 2,090 1,989 1,732 - 9,614 - SIMD Quintile 4 1,415 1,299 1,070 - 7,374 - SIMD Quintile 5 1,044 1,170 1,304 - 7,721 -

8 Reduce A&E attendances (65+) N/A 12,756 12,377 - - -

9 Reduce readmissions (65+) 1,534 1,583 1,590 - - -

12 Number of admissions to care homes 65 years+ 424 476 359 424 - -

16 Number of care home beds 1,019 1,030 1,067 1,019 - - 17 Number of Standard Shareable Assessments (65+) NA N/A 969 831 - -


21


PROGRESS UPDATE

Vacancies The CHP confirmed all posts were expected to be filled by the end of November and should translate into performance improvements thereafter. However, it was agreed that a contingency plan would need to be developed detailing the next steps if performance improvements failed to materialise. The panel expressed concern that despite some changes already implemented, performance has not improved.

All new CHP and Acute posts now recruited.(Consultant sessions commence August 2013.) SW recruitment and procurement processes took longer than anticipated, however over last 6 months Head of Adult Services SW has prioritised MHO and Home Care recruitment. Increased capacity in RES has targeted patients in acute service to promote earlier discharge and transfer to support from community teams, such as increased PEG feeding and palliative care. The impact of the in-reach DN approximately an additional 16 patients with complex care per week are being supported in to enable discharge on the expected date of discharge. Increased mental health nursing within the RES service has reduced the waiting times from 6 weeks to 1-2 weeks. Since implementation in May 2011, the RES service has seen a 64% increase in referrals through the SPOA. Posts have been targeted to address this need. RES provides a I hour response to A&E to support prevention of admission. Since October 2011 approximately 1900 hospital admissions have been prevented through the RES service. However there has been an increase in home care workers and the community alarm service. Appointment of a further 2 telecare technicians has facilitated rapid installation requests being completed within 4 hours which enables discharge of complex patients The GP facilitator has completed training for 14 care home managers who are now introducing advanced care planning in their local care homes. 42 champions have been identified. Additional home care support is provided to extra care housing tenants to prevent admission to care home placements. The adverse performance in relation to lost bed days continues to challenge – analysis indicates that SW assessment capacity and response is the main causative factor as home care and MHO improvements are evident. A recent meeting with Acute Senior officers has resulted in further work on our improvement plan. JIT are also providing input to the local partnership. Review meeting with COO Acute 18 May 2012.

MHO The panel recommended that the MHO issue needs to be addressed more urgently than in year two.

Update from October 2011 MHO capacity has increased and all patients who fall into the category of AWI/guardianship have a recognised MHO dealing with their care. This is improving assessment times and facilitates discharge from hospital.


22

CHP Directors brief assessment of overall performance in relation to Change Fund Plan

Renfrewshire CHPs contribution to Long Term Conditions, Older People and Disability Planning Framework - OPR Template – 3 May 2012

23

RENFREWSHIRE CHP – LONG TERM CONDITIONS, OLDER PEOPLE AND DISABILITY PLANNING FRAMEWORK


Actual 2011/12


Renfrew Status

GG&C Actual

GG&C Status


CT2/CO3 LKPI Number of people in receipt of telecare 325 100 GREEN � CT2/CO3 LKPI Number of GP practices trained to deliver

the Liverpool Care Pathway April 2012 29 29 GREEN �

CT2/CO3 kpi Long Term Conditions – bed days (per 100,000 pop)

11372 9640 RED 9157.9 GREEN �

COPD (Crude Rate per 100,000 popu) 3230 N/A N/A 3585.8 N/A � Asthma (Crude Rate per 100,000 popu) 284.3 N/A N/A 350.0 N/A � Diabetes (Crude Rate per 100,000 popu) 1495.4 N/A N/A 718 N/A � CHD (Crude Rate per 100,000 popu)

Jan 11 – Dec 11

6362.4 N/A N/A 4504 N/A CT3/CO6 KPI Number of health checks for people with a

learning disability 310 (pilot phase

completed)


No 2011/12 Planned Activity Progress to Date 1 Develop clear strategies to support self management. Our local plan is monitored regularly through the RCHP Primary / Secondary

Care Interface Group. RCHP actively contributes to the NHSGGC group and we recently completed a second mapping exercise against the NHS GGC Framework. Renfrewshire was the first area to undertake the initial self assessment and our work shared with the NHSGGC Group and other partnerships. Our directory of services is well used and our work to further develop this continues on an ongoing basis. We have recently introduced reading materials for people with LTCs within our local libraries. The resource ‘Tools to Talk’ has been developed in partnership with service users to help them talk about their condition with professionals and family is currently being piloted with 20 service users (until May 2012) It is anticipated that following evaluation this will be implemented wider in 2012. A varied programme of activities continues to take place during self management week with self care/management embedded into practice within Renfrewshire.

2 Implement tiered models of service ranging from universal services through to specialist and/or intensive care for those

Community RES Service provides a tiered service model. In the period April 11 - March 12, 1,022 new patients have been care managed.


24

with complex needs; priority to maintain people at the lowest level as long as possible.

3 Develop plans to use telecare and telehealth in supporting people safely in home, where there is evidence of effectiveness.

325 telecare packages have been put in place between April 2011 – March 2012. The target has been exceeded due to active promotion of the benefits of telecare and the availability of 24/7 responder service. Partnership working with Strathclyde Fire and Rescue has also identified vulnerable people in the community. A development via the Change Fund is the appointment of the telecare technician, resulting in the speed of response to dementia telecare service installations improving. Prior to appointment of the technician the maximum wait was 4 weeks/average wait 2 weeks. Post appointment maximum wait 14 days/average wait 48 hours. Speed of response has also increased capacity and volume of installations.

4 Develop plans for personalisation of care; more flexible services designed around the needs of the person, not the professionals.

Examples in Adult Services include: o Person centred discharge planning by Inreach DN to ensure effective

discharge on EDD. o Patient centred discharge letters from Community Respiratory Nurse

Specialist to GPs outlining treatment & care plans. o Patient centred care management for patients with complex health & social

care needs by Community Nurse Specialists Intensive care Managers, GNSs, CPNs etc.

o Person centred appointments at LW@L in Tannahill, Renfrew & Erskine Libraries.

o Provision of flexible appointments for patients referred from the homelessness service.

o Introduction of Advance Care Planning for patients in EMI service & residents in ECH & care homes.

RLDS have produced and implemented ‘My Plan’, a person-centred planning tool for adults with learning disabilities that captures not only needs, but also personal preferences and individual aspirations. Over 300 ‘My Plans’ have been completed during the past year, and have been used as the basis for the redesign of day services to ensure they are increasingly personalised and provide a wider range of opportunities than the previous model.

5 Develop clear pathways of care across primary/acute; health/social care – for dementia and key long term conditions.

We continue to develop use of our local pathways. The significant increase in the number of referrals to the SPOA and feedback from local partners are positive. Over the last 12 months: • 4,122 referrals to SPOA. • 5,200 discharges facilitated • 2,837 hospital admissions prevented


25

As previously outlined we have recently completed a review and restructuring of the Renfrewshire Diabetes Service and associated pathways jointly with acute colleagues.

6 Develop a comprehensive model of anticipatory care. Local work will be informed by lessons from Keep Well – at early stages.

In October 2011, the first 8 practices in Renfrewshire implemented Keep Well. Due to IT limitations, the numbers were low. However, after a successful networking event, a further 4 practices have signed up and the numbers are rising, increasing referrals to Live Active and increasing ABI numbers.

7 Develop comprehensive community services that support a reduced inpatient bed model: • deliver community rehabilitation and enablement service

redesign; and • case and care management.

X reference to point 2 and 5 above.

8 Deliver better end of life care through Liverpool Care Pathway in all care settings.

Over the last 12 months 76 LCPs have been initiated in community services. Cross reference to cancer section.

9 Review provision of respite and determine the shape, direction and level of short break provision.

Feedback from Carers at local Carers Events & in Carers Survey undertaken by the PRT Carers Centre confirmed that Respite provision is the highest priority for local carers. Tender awarded for an additional 17,000 hours respite in 2012/13 consistent with priorities in Renfrewshire’s carer’s strategy and with feedback from carers at carers events in early 2012.

10 Review of model and approach to day services. Day Services for Adults with Learning Disabilities have been reviewed and a number of significant changes to the day services model have either been implemented or are planned to take place during 2012/13. Day services staffing has undergone considerable change with a new management structure now in place and staffing levels having improved considerably to reflect more accurately levels of identified need. The Mirren, a new day service building based entirely within the Paisley Leisure Centre, became fully operational in April 2012. A similar model based in Linwood will open next year, and a former day services building is being converted to become the base for the new community network model and the Intensive Support Service for learning disabled adults with complex and challenging behaviour.

CHP Directors brief assessment of overall performance in relation to Long Term Conditions, Older People and Disability .

Renfrewshire CHPs contribution to Primary Care Planning Framework - OPR Template – 3 May 2012

26

RENFREWSHIRE CHP – PRIMARY CARE PLANNING FRAMEWORK


Actual 2011/12


Renfrew Status

GG&C Actual

GG&C Status


CT1/CO1 KPI Primary care phased budget allocation £’000)

Feb 12 24,129 N/A N/A 177,813 N/A -

KPI Primary care expenditure (£’000) Feb 12 24,810 N/A N/A 181,571 N/A - KPI Primary care variance from budget (£ excl

short supply) Feb 12 593 N/A N/A 2502 N/A -

KPI Cost per weighted patient (£ annualised) Dec 11 172.38 N/A N/A 168.55 N/A - CT5/CO10 HS 48 hour access to appropriate GP

practice team 2010-11 94.9% 90% GREEN 94.8% GREEN �

CT5/CO10 KPI Advance booking to an appropriate member of GP Practice teams

2010-11 84.0% 90% AMBER 87.2% AMBER �

CT7/CO12 KPI SCI Gateway referrals Feb 12 89% 95% AMBER 93% AMBER - CT6/CO4 HT Number of patients registered with dementia Feb 12 1,449 1258 GREEN 7850 � CT5/CO12 LKPI Number of hits to directory of services Mar 12 5,308


No 2011/12 Planned Activity Progress to Date 1 Agree robust systems to test and measure the access available for

patients across primary care, including variation and gaps in access, particularly in relation to specific groups who may experience difficulties in accessing services due to disability, race or gender.

RCGP Access toolkit was circulated to all practices. Short life Working Group has been established to look at access to Primary Care Services within Renfrewshire. Access questionnaire is being piloted in 2 local practices with further discussions to take place at GP Forum on rolling this out to all practices. Routine monitoring of practices takes place which operate an ‘open but full’ list or seek to apply to close their list. Practices in Paisley have been encouraged to participate in ‘Patient Opinion’ – A moderated web based tool for patients to feedback to their individual practices. 5 practices have signed up to date. Funding has now been sought to extend this initiative to those practices in the West Renfrewshire Locality.

2 Review use of Renfrewshire Directory of Services by referrers and patients.

Renfrewshire Directory of Service for Health & Social Care was launched in November 2010. Mental Health/Palliative Care and Health


27

Improvement directories containing locality level information also available. Hits facility within A/Z web-based Directory of Service is available to monitor usage (5,308 hits received). Ongoing work with ALISS (Access to Local Information to Support Self Management) continues

3 Develop a 3 year trajectory to ensure disaggregated patient data is available at practice level to ensure that we understand: - the diversity and different characteristics of our population; - their diverse needs; - their access and utilisation of services; and - ensure that this information is communicated to Acute via SCI

to enable planning for effective service delivery and to test potential discrimination at each part of the patient journey.

Requires some national changes – Director of IM&T liaising at national level. Needs further work on local data collection. One care group identified e.g. Diabetes and journey tested from an equalities perspective. All Renfrewshire practices now use SCI to make referrals to acute services. Not fully within local control requires changes at a national level . Director of IM&T leading on this. Further work required locally which will be picked up as part of PC Framework implementation. In Diabetes we are undertaking work to better understand patient access to and experience of services in both acute and community settings.

4 Develop further models of community service provision which are based around the practice structure. To achieve this we will need to:

- explore opportunities for working with groups or ‘clusters’ of practices; and

- consider the implications for small or single handed practices to ensure they benefit from changing arrangements.

Two locality groups have now been established within Paisley and West Renfrewshire. These groups are critical to reinvigorating interface with contractors and frontline staff and in doing so will contribute to the on-going ‘cultural shift’ programme. Both groups have effective and clear leadership to ensure that they deliver on their prime purpose and to ensure an inclusive approach is taken to ways of working.

5 Develop effective information flows and relationships between secondary and primary care.

Work is continuing to improve the primary/secondary care interfaces with an agreement reached over a standardised template for discharge letters within medical specialities at the RAH. The EDIS system is being used in the Medical Assessment Unit to generate letters. To date there has been a positive response on this work. In addition, the Clinical Director participated in the induction sessions for doctors new to working at the RAH to discuss the importance of effective discharge communication with GPs. Clinicians from the acute services division participated in the GP QOF


28

external review meetings where a number of interface issues were highlighted for further discussion. Discussions have taken place with the Director for ECMS around the responsiveness of gastro-enterology services locally as raised by GPs as part of the QOF/QIP feedback. Initial meeting has taken place with representatives from the RAH about having a GP based within A&E as a senior clinician resource with respect to the need to admit or otherwise. Further discussions diarised with A&E and acute medicine consultants.

6 Ensure short term delivery of specific improvements to the acute/primary care interface, specifically: - discharge information; - medicines management and hospital prescribing; - access to investigations; - CH(C)Ps to develop stronger response within primary care on

issues placing significant demand on secondary care, e.g., alcohol;

Communicate change effectively through regular reporting on progress with actions on interface and redesign.

Update from October 2011 LEAN programme has been developed with ATOS, looking at the emergency flows and the primary/secondary care interface in relation to admissions and discharges. All GP practices within Renfrewshire are participating in the medicines management local enhanced service to improve cost-effective prescribing by GPs and medicines utilisation by patients. Also working with the Scottish Ambulance Service to improve access to information from Ambulance crews to prevent avoidable admissions


PROGRESS UPDATE

Primary Care Access Whilst the panel noted the range of positive work around GP access, it was difficult to gauge its cumulative effect in addressing the gap in access. The CHP agreed to be more explicit about measures that would be put in place to assess GP access at the next OPR.

See 1 above.

CHP Directors brief assessment of overall performance in relation to Primary Care

Renfrewshire CHPs contribution to Sexual Health Planning Framework - OPR Template – 3 May 2012

29

RENFREWSHIRE CHP – SEXUAL HEALTH PLANNING FRAMEWORK


Actual 2011/12


Renfrew Status

GG&C Actual

GG&C Status


CT6/CO11 KPI Reduction in teenage pregnancy rates per 1,000 girls aged 15-17 years

June 10 38.8 N/A N/A 40.0 N/A �

CT6/CO2 KPI Numbers attending sexual health care at Sandyford

2011 6,567


No 2011/12 Planned Activity Progress to Date 1 Ensure improvement programmes are delivered optimally in

Primary Care to increase the provision of LARC and HIV testing. LARC data routinely shared with GPs.

2 Demonstrate that specific population subgroups at increased risk of poor sexual health are identified and their needs defined and quantified.

Attendances at Sandyford by young people have reduced in the last six months. The multi-agency planning group are reviewing this and will ensure that young people are targeted in publicising services.

3 In partnership with Local Authorities, provide support for the delivery of high quality consistent sexual health and relationships education in schools.

See below.

4 Review teenage pregnancy guidance and develop a local action plan.

See below.

5 Review service capacity, demand and utilisation to ensure optimal use of resources relative to need.

In response to the local training needs analysis of staff who work in residential units we have developed draft good practice guidelines. We will now undertake a period of consultation with key stakeholder to review them before progressing to getting the document ratified. We are in the final stages of agreeing a training plan to support this particular group of staff.


PROGRESS UPDATE

Teenage Pregnancy Pathway The CHP agreed to confirm when the pathway is likely to be in place outwith the OPR cycle.

The mapping exercise of current services and support for teenage mums is now complete for health, social work and voluntary services. The information for community learning and education services is being collected to provide a full picture. This is now being presented as a pathway. Early analysis shows good support for more vulnerable mothers, working with SNIPs and Barnardos, but we need to ensure those who do not accept a Barnardo’s referral and are not picked up by SNIPs, are offered support throughout their pregnancy.

Renfrewshire CHPs contribution to Sexual Health Planning Framework - OPR Template – 3 May 2012

30

Sex Education in Schools CPD for teachers is expected to be completed by March 2012.

Training has now been delivered to over 30 teachers with further opportunities being offered to more, to ensure coverage in all schools. Teachers who have been trained are delivering sexual health talks in P6, P7 and S3, supported by health improvement and school nursing staff.

CHP Directors brief assessment of overall performance in relation to Sexual Health

Renfrewshire CHPs contribution to Unplanned Care Planning Framework - OPR Template – 3 May 2012

31

RENFREWSHIRE CHP – UNPLANNED CARE PLANNING FRAMEWORK


Actual 2011/12


Renfrew Status

GG&C Actual

GG&C Status


CT2/CO3 LKPI Number of referrals to Single Point of Access

April-Jan 2012

4,122

CT2/CO3 LKPI Number of self assessments issued to carers

2011/12 233

CT2/CO3 LKPI Number of people in the rehabilitation and enablement service that are care managed

2011/12 1,022

CT2/CO3 LKPI Number of referrals to re-ablement services CHP to complete CT2/CO3 LKPI Number of people care managed 2011 1,022


No 2011/12 Planned Activity Progress to Date 1 Ensure engagement and joint working between primary and

secondary care, independent contractures (including SW services, SAS, NHS24, and Voluntary org.) which will allow for a shared decision process for the OPJPPIG on service delivery and use of resources.

The OPJPPIG provides the over view of this, and is supported by the CF sub group which is comprised of the 4 key partners with service user and carer input. The OPJPPIG is accountable to the Joint Management Group.

2 Continue to develop service provision within OOH facilitating the development of joint working and co-location with Renfrewshire 24 staff and OOH nursing staff.

The pilot demonstrated that there were no additional benefits to further development / restructuring of OOH nursing and Ren 24 rapid response service due to the different functions and priorities of each service. The services continue to work collaboratively – this will be kept under review.

3 Identify gaps in relationship between GP OOH services, pharmacy and out of hours arrangements in other services in line with the national target to reduce A&E attendances.

We have worked closely with the GP OOH service to increase awareness of nursing and RES functions which has resulted in improved interface between the services.

4 Development of an electronic directory of services that includes respite, care provider and voluntary sector services to reduce the reliance on secondary care.

Achieved. Detail provided in previous sections.

5 Develop patient pathways across health and social care continuum that improves interface exchanges between primary

As outlined in RES, Diabetes, Carers in previous sections.


32

care, secondary care, local authorities and the voluntary sector. ROAR have developed a shopping service through year 1 change fund resource. To date 27 volunteers have been interviewed. Five are currently supporting the shopping service. 20 home visits have been made and 10 people have received the service with 8 people being maintained on this service. ROAR have held a promotional event at the Piazza shopping centre in Paisley. Evaluation of the shopping pilot and recommendations for future delivery model is being submitted to the ROAR Board for approval. An initial meeting with SAS was held at their headquarters in December 2011. This was attended by the RES service manager and SW colleagues from the co0mmunity alarm service. The focus of this meeting was to explore the use Renfrewshire community alarm services to assist people who have fallen, but cannot get up without assistance, but are reporting no injury from fall - suggestion that community alarm box be put into ambulance headquarters to allow fast access to responders, who would then offer a community alarm to the person and referral to falls service where required. Further to this a meeting has taken place with met with NHS 24 Nurse Consultant to determine Clinical Decision Making. There has been communication with SAS Head of Control Services to discuss development with the out of hours services. This is ongoing with further work to be completed over next 3 - 6 months with developing RES out of hours services further.

6 Develop shared services for rapid response over the 24 hour period through the RES model.

As described in previous sections - further development in the OOH period is planned through year 2 Change Fund and in emerging Joint Commissioning Strategy. SWIFT is being developed to record the number of conditions that clients have. The table below shows the number of people recorded on SWIFT who have 1 or more disciplines involved in their care package.

Discipline

Clients

1 2 3 4 5 6

1122 180 43 10 1 1

TOTAL 1357


33


PROGRESS UPDATE

Homecare Vacancies The CHP agreed to follow-up the freeze on homecare vacancies with Renfrew Council and if necessary escalate to the CHP Committee.

Release on all home care vacancies from October 2011. All vacancies in mainstream services and additional posts from year 1 CF plan have been addressed. However this is a service with a significant turnover. This is kept under review with Senior SW officers and Joint Management Group. Social work have now completed the roll out of the reablement approach As of 1st April 2012, it is expected that all home care packages will be in place within 48 hours.

CHP Directors brief assessment of overall performance in relation to Unplanned Care .

Renfrewshire CHPs contribution to Employability, Financial Inclusion and Responding to the Recession Policy Framework - OPR Template – 3 May 2012

34

RENFREWSHIRE CHP – EMPLOYABILITY, FINANCIAL INCLUSION AND RESPONDING TO THE RECESSION


Actual 2011/12


Renfrew Status

GG&C Actual

GG&C Status


CT3/CO5 EKPI Number of staff attending Employability Awareness training/session

2011/12 197

CT3/CO5 EKPI Number of patients referred to employability advice

CT3/CO5 EKPI Numbers of work placement tasters offered

CT3/CO5 EKPI Numbers into NHS jobs CT3/CO5 EKPI Number of local employers working

towards HWLA

CT3/CO5 EKPI Number of patients referred for financial inclusion advice and outcomes

CT3/CO5 EKPI Number of referrals resulting in a positive outcome


No 2011/12 Planned Activity Progress to Date 1 Entities have a plan in place to assess employability

aspirations of patients and ensure the majority of NHS staff know where and how to refer patients for employability advice.

Employability Awareness training of CHP 197 frontline staff. A third of referrals to the Employability Service from health staff. Preliminary discussions with Job Centre Plus to provide work experience placements for 16-24 year olds.

2 Consolidate silver Healthy Working Lives award work and progress towards gold level by December 2012.

On site Gold HWL Award assessment planned for May 2012. Examples of HWL staff promotions: - Stress Awareness Day - Wear Trainers to Work Day - Staff walking groups.

3 Explore extending the requirements for contractors to engage in the Healthy Working Lives award scheme.

Currently preparing tender for Community Led Health. This will be the first opportunity to explore the potential to stipulate that service provider engages with HWL.

4 Partnerships and acute have engaged with financial inclusion advice providers to build clear pathways to support.

Clear pathways have been established with local provider – referral from GPs and Children’s Services

5 Each entity takes a proactive approach to supporting staff with financial issues to increase staff retention.

Local promotion of money week for both local community and staff. Staff have had an opportunity to receive information on the welfare reform at team

Renfrewshire CHPs contribution to Employability, Financial Inclusion and Responding to the Recession Policy Framework - OPR Template – 3 May 2012

35

meetings. 6 A clear child poverty agenda has been established with each

Local Authority served by GGCNHS Board as part of community planning and children’s services planning.

See below.


PROGRESS UPDATE

Employability The CHP agreed to maintain activity in relation to employability via an alternative set of CHP schemes which would be made explicit for the next OPR.

In our review of the Health Improvement team, we have identified a Lead with responsibility for employability. The CHP is part of Renfrewshire’s Employability Partnership and we are discussing how funding from that source can be used to support the health needs of people who are not in employment. Under previous arrangements, we had 3 posts to carry a health/employability caseload but we aim now to improve access to existing services. In addition to this work, we are reviewing the pathway into employment and meaningful day activity for people with mental health problems, using funding previously used to support a small number of people through Key Enterprise and reviewing a range of staff and resources who currently work in this area.

Child Poverty The CHP agreed to share the child poverty programme of work carried out in Glasgow with Renfrewshire’s Anti-Poverty Alliance with a view to setting up an equivalent programme.

As part of an exercise to review Renfrewshire’s Community Plan we have organised five strategic needs assessment days and the one focussed on children and young people, identified child poverty as a priority for the CP partnership. We will build on the Glasgow work to develop a programme of work for Renfrewshire when the new CP arrangements are set up in the summer. In the meantime, we are developing the learning from Healthier Wealthier Children, building capacity and confidence among our own staff around financial inclusion and improving pathways into financial support services.

CHP Directors brief assessment of overall performance in relation to Employability, Financial Inclusion and Responding to The Recession

Renfrewshire CHPs contribution to Health Improvement Policy Framework - OPR Template – 3 May 2012

36

RENFREWSHIRE CHP – HEALTH IMPROVEMENT POLICY FRAMEWORK


Actual 2011/12


Renfrew Status

GG&C Actual

GG&C Status


CT6/CO11 H6 Smoking Cessation (SIMD) Apr - Dec 11 369 279 GREEN 3485 GREEN - CT6/CO11 H6 Smoking Cessation: Quit Rate at 4 weeks Apr - Dec 11 859 555 GREEN 6455 GREEN - KPI Quit Rate in Acute Apr - Dec 11 40% N/A N/A 37% N/A - KPI Quit Rate in Community Apr - Dec 11 60% N/A N/A 55% N/A - KPI Quit Rate in Maternity Apr - Dec 11 30% N/A N/A 36% N/A - KPI Quit Rate in Pharmacy Apr - Dec 11 28% N/A N/A 29% N/A - CT6/CO4 LKPI Number of schools participating in smoke

free school programme

March 2012 All sec. schools

have signed up

CT6/CO4 LKPI Number of organisations signed up to the Tobacco Alliance

2011/12 Increased by 7 from 14 to 21.


No 2011/12 Planned Activity Progress to Date 1 Support development of the strategic Framework for obesity

across all Renfrewshire CHP and with local partner organisations. See below.

2 Support introduction of Fluoride Varnishing programme in specific pre 5 establishments.

The Renfrewshire OHAT has been proactively supporting this HEAT target. Support provided to issue consent paperwork, collect from nursery on regular basis and return to Clutha House. OHAT have been a visible presence at nurseries to answer parental concerns, questions, and aid with the consent process. Consents re-issued when required and followed up. Seven pre-5 establishments have been identified to take part in National Fluoride Varnish Programme. Round 1: May 2011 69% consents were returned and 52% of pre-school roll had fluoride applications carried out. Disparity between consent and application is due to: Parental refusal =16 Child refusal =14 Absent on day of visit =30 Not prescribed (for medical reasons) =4


37

Round 2: Nov 2011 81% consents returned and 64% of pre-school roll had fluoride applications carried out. Disparity between consent and application is due to: Parental refusal = 13 Child refusal = 7 Absent on day of visit =40 Not prescribed (for medical reasons) = 7

3 Develop local pilot to produce Bowel Cancer Screening Resources for L&D Nurses to use with their clients to encourage and support the uptake of screening.

Official Launch of Bowel Screening Made Easy programme being held on 25th April. Booklet is now available in print and for download from the Scottish Consortium for Learning Disabilities website.

4 Awareness raising and dissemination of falls prevention checklist to the following staff groups: - EMI - Mental Health - RES Team

700 Falls Prevention Checklists have been distributed to RES Team since December 2011.

5 Promote Breastfeeding Welcome Award with Community Planning Partners.

Breastfeeding Welcome award achieved by Renfrewshire Leisure on 23rd May 2011. Review of award due May 2012 via established monitoring process. Renfrewshire Council are working towards the award and are near completion with around 70% of customer facing staff trained. Evaluations and Attitude scales have been positive. Plans are underway to deliver mop up sessions. The award will be launched during breastfeeding awareness week at the end of June 2012.

6 Implement Key recommendations of the “No Health Without Mental Health” framework locally.

Stakeholder Event took place in April 2012 with main theme on No Health Without Mental Health and in particular reviewing the contents of “Keeping health in Mind” and “Mental Health in Focus” in relation to Renfrewshire CHP. Review of meaningful day and employability services within Renfrewshire Mental Health and Addictions services due to be complete by April 2012. Review outcome focuses on providing services jointly between local authority, voluntary and health to support people at all stages of the work pathway – meaningful day activity, accessing supported employment, maintaining employment. Maintaining HEAT standard for frontline staff training in suicide prevention across Renfrewshire


38

Renfrewshire continues to be a main contributor in tackling stigma and raising awareness of good mental health as part of the national Scottish Mental Health Arts and Film Festival. In Renfrewshire our programme featured 47 events and involved participating partners from community art groups, service users, Renfrewshire Council and the CHP.


PROGRESS UPDATE

Health Weight Strategy The CHP will explore the development of a joint Healthy Weight Strategy with the local authority to provide coherent approach to the individual strands of work currently taking place. Linda de Caestecker agreed to share Glasgow Plan.

We now have a Physical Activity and Nutrition Group in Renfrewshire with representatives from Education, Renfrewshire Leisure and CHP dieticians and school nurses. This is allowing us to bring together the work on Live Active, Vitality, Shape Up, Eat Up, ACES and Active Choices. This area has also been identified as a Community Planning priority at our Strategic Needs Assessment day.

Smoking Cessation Linda de Caestecker highlighted that GPs had been sent letters advising them of appropriate smoking cessation prescribing and referral routes and the CHP agreed to follow this up.

Smoking cessation quit rates remain high in the CHP and year end targets will be achieved. Discussed at both medicines management group and GP Forum with all prescribers being reminded to refer patients to local smoking cessation service rather than prescribe themselves. Renfrewshire CHP has drawn up a local plan to engage with GPs and a Health Improvement Practitioner has been identified as a GP link. To date, the service has met with 5 practices who where identified as not referring to the service. An update of relevant prescribing information and referral routes are included in the GP visits. The practitioner also attended the practice managers’ forum and electronic copies of the group programme are now sent to the managers. The process in Renfrewshire is that Smokefree Services issue GPs with business cards with the Smokefree Services local contact details and clients then self refer. This may indicate that GPs are indirectly signposting to our service but not directly referring. It would appear that this is effective in Renfrewshire and the option direct referral via sci gateway or referral form remains. Graph is attached which shows a decrease in NRT prescribing in general practices across the CHP [Susan Love]


39

CHP Directors brief assessment of overall performance in relation to Health Improvement

Renfrewshire CHPs contribution to Quality Policy Framework - OPR Template – 3 May 2012

40

RENFREWSHIRE CHP – QUALITY POLICY FRAMEWORK


Actual 2011/12


Renfrew Status

GG&C Actual

GG&C Status


CT4/CO8 KPI % of complaints received and responded to within 20 working days

Oct – Dec 11 100%

70% GREEN 75% GREEN �

CT3/CO6 ELKPI Number of staff completing e-learning Equality & Diversity training

Apr – Sept 2011

28


No 2011/12 Planned Activity Progress to Date 1 Each part of the organisation ensures that the 4 strands of activity

are part of an overall programme which improves patient outcomes.

The actions in the development plan update 2011/12 have been mapped against the 4 strands of activity as a first step in the work with the CIT on measuring the impact of equalities work.

2 Review PPF and other patient fora arrangements to support involvement of equalities groups, or ensure that additional engagement is in place.

Equality profile of PPF database has been undertaken and shared with the Executive Group. This influenced the filling of three vacancies in the Executive Group and highlighted some vulnerable groups who we will have to engage with differently.

3 Gather and analyse patient experience and outcomes to inform plans. This should ensure that the differential experiences of equality groups can be taken into account and develop greater consistency in services measuring and reporting outcomes, enabling bench marking and transparency.

4 Development of RCHP Person centred improvement resource to include : � Measurement for improvement � How to use patient stories for service improvement � How to collect and use a Patient Experience � How to share Patient Stories across the system � Templates of tried and tested methodologies. � This resource will be available to services web based or paper

format. �

Some examples are noted below: 1. R&E patient experience project has provided positive feedback from patients and carers. The service is now a pilot site for the CARE Approach, supported by funding from NES. 2. Podiatry Patient Experience project has resulted in improved and increased patient information being made available in waiting rooms aimed at promoting patient self care and independence. Podiatry services also participated in the NHSGGC Podiatry Validated Outcomes Measures to test whether podiatry intervention had reduced pain for patients – 66.3% responded that the podiatry treatment made it easier for them to carry out their daily activities.75% responded that they could look after their feet better following podiatry treatment. 3. RCHP Physio Service conducted an audit of Client Experience with walking aids in local care homes resulting in a major replacement programme to improve suitability & client safety & to reduce the risk of client falls in the care homes.

Renfrewshire CHPs contribution to Quality Policy Framework - OPR Template – 3 May 2012

41

4. DN patients are given a ‘Just to say’ card and a SAE on discharge to allow them to return their comments on their experience of the service ( anonymously if they wish) to the Clinical Governance Unit where they are recorded and analysed. First full report is awaited.

5 Improve physical access including removal of services from the Russell Institute as building unable to comply with DDA requirements.

Achieved.


PROGRESS UPDATE

Complaints The panel noted the improved performance in relation to complaints responded to on time.

CHP Directors brief assessment of overall performance in relation to Quality

Renfrewshire CHPs contribution to Sustainability Policy Framework - OPR Template – 3 May 2012

42

RENFREWSHIRE CHP – SUSTAINABILITY POLICY FRAMEWORK


Actual 2011/12


Renfrew Status

GG&C Actual

GG&C Status


CT1/CO1 HT CRES Energy Reduction (Cumulative):

TO FOLLOW

Electricity Gas Water Total kWh CT1/CO1 HT CO2 Tonnes (Cumulative)


No 2011/12 Planned Activity Progress to Date 1 Arrangements for joint planning with Local Authority partners

across the range of sustainability issues including: - transport and travel; - use of green space; and - community engagement and cohesion.

CHP is a key contributor to the Community Planning Conferences which are community engagement events across Renfrewshire. Joint work on sustainability is progressed through Healthier Renfrewshire and Active Renfrewshire groups.

2 Reducing energy use requires actions beyond the Facilities Directorate and needs support from all parts of the organisation to: - awareness raising and support for behaviour change amongst staff.

Energy survey undertaken with Renfrew Health and Social Work Centre. CHP working with the Board’s Energy Manager to implement improvements highlighted from the survey results which will reduce energy consumption. This work requires co-operation of local facilities staff.

3 Support staff and workplace health through: - Healthy Working Lives initiatives; and - flexible working practices.

Planned activities for staff around fuel efficient driving and energy saving initiatives.

4 Work with Community Planning Partnerships to support effective community engagement, community development and specific joint initiatives.

The CHP supports the annual Community Planning Conferences, linking the PPF into them.

5 Ensure appropriate segregation of waste.

Domestic and clinical waste procedures followed in all CHP premises. Recycling facilities available in health centres and clinics.

Renfrewshire CHPs contribution to Sustainability Policy Framework - OPR Template – 3 May 2012

43

6 Progress on carrying out a travel plan for at least one major site in the area.

Achieved. Travel Plan complete for Renfrew Health & Social Work centre.


PROGRESS UPDATE

Energy Efficiency It was agreed that performance in relation to the CRES energy reduction targets needs to improve.

See 2 above.

CHP Directors brief assessment of overall performance in relation to Sustainability

Renfrewshire CHPs contribution to Tackling Inequalities Policy Framework - OPR Template – 3 May 2012

44

RENFREWSHIRE CHP – TACKLING INEQUALITIES POLICY FRAMEWORK


Actual 2011/12


Renfrew Status

GG&C Actual

GG&C Status


EKPI Number of quality assured EQIAs Aug 2011 6 6 Green LEKPI Number of leaflets requested in

accessible formats. Aug 2011 1

LEKPI Number of staff trained in GBV 2011/12 217 -


No 2011/12 Planned Activity Progress to Date 1 Implement Sensitive Routine Enquiry in the areas of health

visiting and district nursing. Sensitive Routine Enquiry implemented in Health Visiting mop us session for 10 existing and new staff planned for May. Interim data collection system showing 10% disclosure rate Domestic Abuse Training for District nursing staff underway 22 (20%) trained to date. Training delivery reviewed and a shortened locality based programme will be delivered up to end of Dec 2012 (10 sessions) 12 RES staff also trained.

2 Raise awareness of employability for health and wellbeing at community level using a social marketing approach.

Although not a ‘funding‘ partner of Phase 2, RCHP will be a working partner and currently awaiting for the details and the partnership expectation to be finalised before any marketing materials are issued.

3 Take action to reduce stigma and increase access to health services for marginalised groups in Renfrewshire.

Positive Mental Attitude training provided to CHP and partner agencies specifically targeted at staff who deal with vulnerable groups – community wardens and local voluntary sector agency To ensure equal access to health services for homeless persons, Renfrewshire CHP is currently reviewing existing; and developing new; referral pathways into primary and secondary mental health; addiction; podiatry; physiotherapy; dentistry; optometry and sexual health services; and also taking steps to ensure that GP registration (temporary or permanent) for this sometimes transient group is robust. (Full details within Health and Homelessness Action Plan). We are undertaking a joint imitative with the Corporate Inequalities Team on the development of Inequalities Sensitive Practice within our Community R&E Service. This includes review of current practice, identifying barriers, describing best practice for this population and supporting staff and managers to implement best practice and sustain

Renfrewshire CHPs contribution to Tackling Inequalities Policy Framework - OPR Template – 3 May 2012

45

improvements. It is also envisaged that there will be shared learning from this process.

GOALS 2011/12 Planned Activity Progress to Date 1 Show evidence of the use of available data on race, gender,

disability, age, sexual orientation, social class, faith to meet the needs of inequality groups.

Bowel cancer screening resources appropriate for those with learning disabilities developed including a DVD. Local launch of Bowel Screening made Easy. PPF database analysed to ensure inequalities groups are represented. Integrated alcohol team and alcohol problems clinic welcome pack will include information on faith and spiritual support needs.

2 Audit PPF activity and develop plans to increase equality group engagement.

The Council has created an Inequalities Network – DEAR (Diversity in Renfrewshire). The PPF and CHP can use this mechanism to engage and consult with a number of minority groups not currently represented on the PPF.

4 A plan for ensuring routine assessment of communication and language support needs of all patients in place.

Staff provided with information on Accessible Information policy and details of Interpreting Services. EQIAs undertaken in many service areas and resulting action plans have increased the awareness of communication and language requirements. Examples include:

- Under 16 sexual health protocol (for professionals) - Bowel Screening Made Easy booklet for LD clients.

5 Mental Health, Addictions, Children’s Services will implement training and plans on GBV across selected services.

6 Training sessions held for Health Visitors and School Nurses with 57 trained. 3 Training sessions held for Addictions Staff with 36 trained. 2 Training sessions held for Mental Health staff with 26 trained.


PROGRESS UPDATE

Joint Plan The CHP agreed to continue to work with CIT on the joint plan.

During 2012/13, we will build on the early work done with the CIT to review the cumulative impact of our equalities work. This work has identified three key areas of work which will be progressed during 2012/13: 1) A review of all EQIAs carried out to identify common themes. 2) An audit of the podiatry appointment system to assess whether a recent

change to improve DNA rates had disadvantaged any group. A review of alcohol related hospital admissions by locality over time.

CHP Directors brief assessment of overall performance in relation to Tackling Inequalities

Renfrewshire CHPs contribution to Unpaid Care Policy Framework - OPR Template – 3 May 2012

46

RENFREWSHIRE CHP – UNPAID CARE POLICY FRAMEWORK


Actual 2011/12


Renfrew Status

GG&C Actual

GG&C Status


CT2/CO3 KPI Number of carers known to CHCP 2010/11 24,089 CT2/CO3 KPI Number of carers’ self assessments issued 2011/12 233 CT2/CO3 KPI Number of staff trained in carer

assessments Aug 2011

75

CT2/CO3 KPI Number of short breaks for carers 2010/11 3,710 weeks of respite care. Data for 2011/12 being collated.


No 2011/12 Planned Activity Progress to Date 1 Develop a Renfrewshire Carers’ profile. Carers’ profile developed and distributed.

2 Carers’ issues are more systematically considered across all our

programmes and work plans in relation to: - Contribution of carers to the desired outcomes; - Impact on carers of our plans Involvement of carers; - Minimum standard Information Pack for carers; AND - Explore options to promote future sustainability of services which rely heavily on unpaid care.

£200k Change Fund allocated to new services to support carers. Feedback from carers included in the Diabetes Patient Experience project confirmed that carers feel more confident in their caring role following inclusion in diabetes education programmes e.g. Desmond and conversation maps. Feedback from a carers’ event held in February 2012 informed 2012/13 Change Fund proposals.

3 Develop clear plan for responding to the changing age profile and expected rise in demand for care which has clear plans for reshaping care with unpaid care fully integrated into planning.

Change Fund respite contract awarded following tender process. Older People’s Commissioning Plan under development with input from all partners. Renfrewshire Carers’ Strategy 2012/15 being developed. All partners ensure that the Strategy is informed by the views of and priorities identified by local unpaid carers.


47

4 Clear plan in place for how support and training for carers will be continued beyond the end of dedicated Carers Information Strategy funding, particularly in relation to the National Carers’ Strategy priority of training for carers on person-centred moving and handling and on the safe use of equipment, linked to assessment at the point of hospital discharge planning.

Carer Information Strategy funding plans in place for 2012/13. Carers support initiatives funded via the Change Fund. The Carers’ Centre relies on the Carer Information Strategy funding to sustain the current arrangements.

5 Work in partnership with Renfrewshire Council to provide respite and short breaks in line with national targets.

Increase in range and volume of respite options funded by the Change Fund.

6 Renfrewshire CHP has a clear local understanding of the services available for carers and access arrangements, including financial inclusion and benefits advice, employability, support to access work and education.

Information leaflets outlining services for carers and access arrangements regularly issued to GPs and frontline staff. Carers’ website updated regularly. Carers’ Support Groups available via Carers’ Centre; M H Services; EMI Services; LD Services etc. Carers’ training programme widely distributed. Benefits Agency has strong links with GP Practices. Young Carers’ worker supports Secondary Schools to address issues identified via the Young People’s Health and Wellbeing Survey.

CHP Directors brief assessment of overall performance in relation to Unpaid Care .


1

RENFREWSHIRE CHP – EFFECTIVE ORGANISATION


Actual 2011/12


Renfrew Status

GG&C Actual

GG&C Status


CT7/CO13 HS Sickness absence (rolling yr aver): Jan 12 6.7% 4% RED 4.62% RED � Short term Jan 12 34.8% N/A N/A 39.5% N/A - Long term Jan 12 65.2% N/A N/A 60.5% N/A - CT7/CO13 KPI Staff with an e-KSF Mar 12

24.04.12. 76.91% 77.5%

N/A N/A 70.05% N/A


No 2011/12 Planned Activity Progress to Date 1 Progress on working towards Healthy Working Lives Gold Award. Portfolio submitted and CHP will be assessed on 8th May 2012. 2 Support the redesign of the District Nursing service a development

programme is in the final stages of preparation and this will be aimed at the staff in Band 6 and Band 3 (a development programme is in place for staff in Band 5).

Achieved.

3 Locality Model Progress on the implementation of agreed activities to support making the Locality model work Implementation Plan

• Readiness for change; • Describing the vision; • Developing support; • Managing development of localities and groups; and • Sustaining momentum. •

Achieved.


PROGRESS UPDATE

Finance Report The CHP confirmed the following: • an expected breakeven position for 2011-12 • to resolve the EMI budget and redistribute the • money by the year end • look in more detail at the long term sustainability of the savings plan

• Draft year-end position an underspend of £0.1m. • The overall Partnerships’ Savings Plan for 12/13 incorporates £0.5m

additional funding being allocated to RCHP EMI, this being from 1 April 2012.


2

at the six monthly financial review.

• The CHP savings plan for 11/12 was for £822k, including £146k of

non-recurring savings. The CHP’s savings plan for 12/13 includes recurring savings to cover this shortfall. Incremental drift remains an issue within District Nursing, although additional RAM monies will be allocated to the CHP over the next two years which will address this. AfC reviews within Learning Disabilities Services have also created unfunded pressures. System-wide service redesign in this area will help bring about a more appropriate and cost-effective skill mix.

Sickness Absence The panel noted that performance had not improved and further action is required to address this.

Work continues to address sickness absence. This includes: - identifying “hot spots” to focus on - return to work interviews carried out within 3 days - use of the capability/disciplinary policy when appropriate - staff reaching a trigger point are given an attendance monitoring

period - >4 week absences are reviewed by managers - All staff in ongoing absences related to a specific condition are

referred to OHS - Staff encouraged to access appropriate types of leave.

CHP Directors brief assessment of overall performance in relation to Effective Organisation

Documents

(Paper No 12/111) Date: t 4h May 2012 Fiona MacKay, Head ...library.nhsggc.org.uk/mediaAssets/CHP Renfrewshire... · draft form and a few minor changes will be made before it is submitted