Rotherham Clinical Commissioning Group: Governing Body … Body Papers... · The new Urgent and Emergency Care Centre has been live since the 06th July. The WIC also closed on this

Rotherham Clinical Commissioning Group:

Governing Body Delivery Dashboard for 2017/18

Summary

Constitution and Pledges

Improvement and Assessment Framework

Health Outcomes

Better Care Fund

Quality Premium

Focus on Performance Tables

Focus on Performance - 111

November 2017

Diagnostics 1%

Last MonthCurrent

Month

Next Month

Predicted

Cancelled

Operations0

95%

Mixed Sex

Accomodation

Referral to

treatment

Last MonthCurrent

Month

Next Month

Predicted

Previous

MonthTarget

Current

Month

Next Month

PredictedTarget

Previous

Month

Deteriorating

3.5%

TargetPrevious

Month

Cancer Waits: 2

weeks

Last MonthCurrent

Month

Next Month

Predicted

Not met last month but met previously or YTD met

Last Month

Concern

Not met last two months

0

75%IAPT - 6 week

wait

A&E 95.0%

93%

DTOC

Cancer Waits: 31

days96%

Meeting standard - deteriorated from last month

Not meeting standard - deteriorated from last month

Meeting standard - no change from last month

Not meeting standard - no change from last month

Meeting standard - improved on last month

Not meeting standard - improved on last month

AchievingLast three months met and YTD met

Improving

Last month met but previous not met or YTD not met

TargetPrevious

Month

Cancer Waits: 62

days85%

November 2017

Rotherham CCG

Delivery Dashboard

The new Urgent and Emergency Care Centre has been live since the 06th July. The WIC also closed on this date. Urgent and emergency care is now a single streaming service at TRFT. The position

remains challenged with performance in October to date (as at 22nd October) at 86.0% .This is a notable improvement in performance from September however, which was 81.8%. This remains an

underperformance against the STF trajectory of 94.8%.

Bedding in of the new model of care within the department and workforce challenges continue to present as the main factors in delivering sustainable performance, with additional challenges arising

during the weekend period. TRFT continue to receive support from the National A&E improvement team. Three new A&E consultants are due to commence in the department throughout October and

November and will significantly improve the current A&E Dr workforce capacity. It is expected this additional capacity will improve current performance.

GP streaming has been implemented within the department, which has had a positive impact, streaming on average 30-35% of patients routinely. The CCG continue to work closely with partners

through the A&E delivery board to realise improvement. Local comparison to other Trust's in South Yorkshire can be seen below.

The national target for patients accessing IAPT services is 75% within 6 weeks and 95% within 18 weeks. The 6 week wait position for Rotherham CCG as at w/c 9th October 2017 was 98.4%. This is

above the standard of 75%. September performance was 96.8%. The IAPT position has seen steady improvement over the last few months, and is now performing well. Self-referral into the service is

now established and contributing to this improvement.

The 18 week wait position for the service as at w/c 9th October 2017 was 100%. Performance is consistently meeting the 95% standard for 18 weeks.

Key Performance Issues

A&E

IAPT

70.0%

75.0%

80.0%

85.0%

90.0%

95.0%

100.0%

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

% Seen within 4 hours - Rotherham CCG STF Trajectory

0%

20%

40%

60%

80%

100%

120%

17/07/2017 24/07/2017 31/07/2017 07/08/2017 14/08/2017 21/08/2017 28/08/2017 04/09/2017 11/09/2017 18/09/2017 25/09/2017 02/10/2017 09/10/2017

IAPT - Total waiting less than six weeks Target

92%

93%

94%

95%

96%

97%

98%

99%

100%

17/07/2017 24/07/2017 31/07/2017 07/08/2017 14/08/2017 21/08/2017 28/08/2017 04/09/2017 11/09/2017 18/09/2017 25/09/2017 02/10/2017 09/10/2017

IAPT 18 Weeks Performance Target

90% 90% 92%

85%

92%

98% 91%

75%

80%

85%

90%

95%

100%

NoE England DBHFT RFT BHFT SCHFT STHFT

A&E Year to Date Benchmarks as at September 2017 YTD Target

Eliminating Mixed Sex Accomodation

MSA

Jul-17 Aug-17

92.00%

Jun-17

There were no breaches of this standard in September.

Apr-17

Target

Referral to Treatment

RTT Incomplete Pathways continue to meet the 92% national standard in September with performance at 95.0%. Further details of specialty level performance can be found in the “focus on” section

of the report. The CCG continues to see strong Referral to Treatment performance in most specialties.

There were no 52+ week waiters in September.

Sep-17

In August the 62 day GP referral to treatment target failed the national standard of 85%, with performance at 81.8%. Breaches of the standard were due to a number of reasons but most related to

some form of pathway delay. 10 of the 14 breaches were patients transferred from Rotherham FT to Sheffield Teaching FT.

The 31 day standard was met in August, with performance at 96.1% against the standard of 96%. Performance against this standard has been falling from 98.5% in June to 96.1% in August.

Performance against the two week wait standard has also been falling. The standard was met in August with performance of 93.2% against the 93% standard. This standard has been met throughout

the financial year but August has seen the lowest monthly performance to date.

The two week wait for breast symptoms standard was not met in August however with performance of 92.6% against the 93% standard. All other cancer standards were met in August.

Jun-17

Jul-17 Aug-17

RTT Incomplete

Sep-17

95.0%

92.00%

94.8%

Diagnostic Waiting Times

Jan-17 Feb-17

92.00% 92.00%

95.1%

Mar-17

94.9%

Sep-17

Nov-16 Dec-16

94.8%

Sep-17Aug-17Jul-17

95.5%Actual

92.00%

94.8%

Aug-17

95.4%

Jul-17

92.00%92.00% 92.00%

May-17

92.00% 92.00%92.00% 92.00%

95.1% 94.5%

Oct-16

94.0% 94.5%

2 week wait

31 day

62 day

Cancer Waits

Diagnostic Waits

Jul-17 Aug-17

Performance in September of 0.9% met the <1% standard. Only 1 breach for RCCG occurred at RFT. The Sheffield Teaching Hospitals Echocardiography service is reporting high numbers of

breaches for RCCG patients. 19 breaches were reported in September, an increase from the 17 in August.

It should be noted however that September is an under reported position. The Care UK diagnostics contract novated from Care UK to Rotherham FT from the 1st October. Care UK should have

reported their final September position, unfortunately the opportunity for reporting was missed during the handover process. The positions for Echocardiography, DEXA and Non Obstetric Ultrasound

are therefore under reported.

52 week wait

90.0%

91.0%

92.0%

93.0%

94.0%

95.0%

96.0%

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

% Patients on incomplete non-emergency pathways waiting no more than 18 weeks

Actual Target

1

5

19

1

2

1 2

Breaches by Test

Neurophysiology - peripheral

DEXA Scan

Cardiology-echocardiography

Respiratory physiology

Gastroscopy

Urodynamics

Audiology - assessments

25

1

2

3

Breaches by Provider

Sheffield TeachingHospital

Rotherham FoundationTrust

Sheffield Children'sHospital

Doncaster andBassetlaw

Aug-17

Delayed Transfers of Care

The national standard is 3.5% of total occupied bed days taken up by delayed transfers of care. Rotherham FT is currently above that standard at 5.0% (August). For the previous two months

performance has been at 4.9% (Jul-17) and 5.7% (Jun-17).

TRFT and RMBC commissioned an external review of DTOC pathways via the Local Government Association, the findings of this work have been reported to A&E delivery board with proposed

actions for improvement. Partners have agreed an improvement action plan and agreed specific identified funding through the improved Better Care Fund, to support the plan delivery.

YAS

Yorkshire Ambulance Service (YAS) is continuing to participate in NHS England’s Ambulance Response Programme (ARP), which from 1st September has moved to phase three. Based on feedback

from the pilot, there are now four categories and the eight minute response time for category 1 incidents no longer exists.

Currently, YAS are producing information at provider level, without any individual CCG performance data. RCCGs individual performance cannot therefore be reported this month. Details of the new

standards are below. YAS as an organisation achieved a mean of 7 minutes 14 seconds for category 1 calls.

Worse

Performance for the CCG overall YTD as at September was 32 cases against a plan of 39. The year-end target for the CCG is 63. The 5 cases in September occurred at Rotherham FT (4) and

Barnsley FT (1).

Worse

68.90%15 Min Turnaround RFT on target

Jul-17 Aug-17 Sep-17

53.40%Handovers at NGH

DTOC

Jun-17 Jul-17

Current performance - September 2017 Change

MRSA

CCG c.diff

RFT c.diff

Incidence of C.diff and MRSA

0.0%

1.0%

2.0%

3.0%

4.0%

5.0%

6.0%

7.0%

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

% B

ed

day

de

lays

Month

Delayed days rate performance in last 12 months - THE ROTHERHAM NHS FOUNDATION TRUST

The Rotherham NHS FT (current)

North Region (current)

Target

NHS Constitution and Pledges

Denotes that a measure that has been updated in this report

Jul-17 Aug-17 Sep-17 Target QP

95.4% 94.8% 95.0% 92.0% Y

0 0 0 0

0 0 0 0


0.6% 1.2% 0.9% 1.0%

Aug-17 Sep-17 Oct-17 Target QP

82.4% 81.8% 86.0% 95.0% Y

Jun-17 Jul-17 Aug-17 Target QP

89.9% 93.2% 92.6% 93.0%

94.5% 93.4% 93.2% 93.0%


98.5% 99.2% 96.1% 96.0%

100.0% 100.0% 94.7% 94.0%

100.0% 97.3% 100.0% 98.0%

98.1% 87.2% 94.7% 94.0%


86.6% 78.9% 81.8% 85.0% Y

100.0% 88.9% 90.9% 90.0%

92.0% 92.1% 87.8%

Referral to Treatment

Diagnostic Waiting Times

Cancer - 31 Day Waits

Cancer - % patients seen within 31 days for subsequent

surgery treatment

Cancer - % patients referred within 2 weeks of referred

urgently by a GP

Total A&E: % 4 hour A&E waiting times - seen within 4 hours

(latest monthly position)

% Patients waiting for diagnostic test waiting > 6 weeks from

referral (Commissioner)

Cancer - % patients referred with breast symptoms seen

within 2 weeks of referral

Number of 52 week referral to treatment pathways non

admitted (Commissioner)

Number of 52 week referral to treatment pathways

incomplete (Commissioner)

% Patients on incomplete non-emergency pathways waiting

no more than 18 weeks (Commissioner)

A&E Waits

Cancer - 2 Week Waits

Cancer - % patients seen within 31 days from referral to

treatment

Cancer - % patients seen within 31 days for subsequent drug

treatment

Cancer - % patients seen within 31 days for subsequent

radiotherapy treatment

Cancer - 62 Day Waits

Cancer - % patients seen within 62 days (referral Consultant)

Cancer - % patients seen within 62 days of referral from GP

Cancer - % patients seen from referral within 62 days

(screening service - breast, bowel and Cervical)

NHS Constitution and Pledges

Denotes a measure that has been updated in this report


63.8% 62.3% 55.7% 75%

71.1% 71.5% 71.5%

58.6% 64.0% 57.3%

70.4% 73.7% 71.5%

45.4% 49.4% 53.1%

90.9% 95.0% 83.3%

54.8% 66.7% 58.8%


16 30 37 0

25 154 152 0


0 0 0 0

Q3 2016/17 Q4 2016/17 Q1 2017/18 Target QP

0 0 1 0

Q3 2016/17 Q4 2016/17 Q1 2017/18 Target QP

100.0% 100.0% 94.3% 95.0%

Mixed Sex Accommodation Breaches

Cancelled Operations

Mental Health

Proportion of people on Care Programme Approach (CPA)

who were followed up within 7 days of discharge

Crew clear delays of over 30 minutes

Cancelled operations re-booked within 28 days

Number of mixed sex accommodation breaches

(commissioner)

Ambulance handover delays of over 30 minutes

YAS - Ambulance Calls

YAS Performance (from 20th October 2016)

GreenT Under 90 minutes

GreenH Under 90 minutes

Category 1 Under 8 minutes

Category 2R Under 19 minutes

Category 2T Under 19 minutes

Category 3R Under 40 minutes

Category 3T Under 40 minutes


Priority Clinical Areas

Mental Health

Dementia

Learning Disabilities

Cancer

Diabetes

Maternity

Smoking Care ratings

Child obesity Cancer

Diabetes Mental health

Falls Learning disability

Personalisation and choice Maternity

Health inequalities Dementia

Anti-microbial resistance Urgent and emergency care

Carers Primary medical care

Elective access

7 Day services

NHS continuing healthcare

Sustainability and Financial sustainability

transformation plan Allocative efficiency

Probity and corporate governance New models of care

Workforce engagement Paper free at the point of care

CCGs local relationships Estates strategy

Quality of leadership


Reporting

Frequency Latest available data

Latest Period

Performance Target

01. Smoking Quarterly Q1 2017/18 20.0%

02. Child obesity Annual 2015/16 35.8%

Annual 2015/16 37.9%

Annual 2014 6.2%

04. Falls Annual 2016/17 12322

Monthly Aug-17 85.9% 80.00%

2nd half of each

year

January 2017 -

March 201762.1%

Annual 2016/17 Q1 - 2016/17 Q4 47.32

Quarterly Q4 16/17 43.0


Quarterly Q3 16/17 2237.18

Monthly Sep-2017 1 1

08. Carers Annual 2016/17 0.77

Inequality in emergency admissions for urgent care

sensitive conditions

Reducing gram negative bloodstream infections:

Reduction of Ecoli BSI reported at CCG level

Health related Quality of Life for Carers (GP Survey)

07. Anti-microbial

resistance

Bet

ter

Hea

lth

Narrative

03. Diabetes

05. Personalisation

and choice

06. Health

inequalities

Injuries due to falls in people aged 65 and over

(Actual - true figure is based on standardised

measure that is currently not available)

Diabetes patients that have achieved all the NICE

recommended treatment targets. Three (HbA1c,

cholesterol and blood pressure) for adults and one

(HbA1c) for children

People with diabetes diagnosed less than a year who

attend a structured education course

% GP Referrals to First OP Appointments Booked Using

Choose and Book

A greater proportion of people aged 18 and over

suffering from a long-term condition feeling supported to

manage their condition (GP Survey)

Percentage of deaths which take place in hospital

Personal Health Budget

Inequality in unplanned hospitalisation for chronic

ambulatory care sensitive conditions

Maternal smoking at delivery

Year 6: Prevalence of overweight (including obese) -

Children aged 10-11 classified as overweight or obese

Needs Improvement

Performing Well

Needs Improvement

Needs Improvement

Needs Improvement

Needs Improvement

Delivering the Five Year

Forward View



Reporting

FrequencyLatest available data

Latest Period

PerformanceTarget

Quarterly Q4 2016/17 62



Monthly Aug-17 81.8% 85.0%

Annual 2016 8.7 8.7

Annual 2014 68.4%

Annual 2015 47.6% 60.0%

Monthly Aug-17 52.3% 50.0%

Monthly Aug-17 100.0% 50.0%

Quarterly Q4 2016/17 70%




Annual 2016/17 69.0%

Annual 2015 62.80

Annual 2015 4.6

Annual 2015 80

Annual 2015/16 77.2%

Monthly Sep-17 79.87% 66.7%

Monthly Aug-17 55.7% 75.0%

Monthly Oct-17 86.0% 95.0%

Monthly Aug-17 5.0% 3.5%


Quarterly Q3 2016/17 463.20

Monthly Jan-17 4

Bi-annual Jan-Mar 16 to Jul-Sep 16 85.7% 74.6%

Monthly Jun-17 90

Annual 2015/16 997 1074

Monthly Sep-17 95.0% 92%

Quarterly Q1 2017/18 32.92

(1) The Cancer Patient Experience target is the National Average for 2016, so Rotherham's performance is being measured against the national average(2) The delayed transfer of care target is is the target for the month.

07. Urgent and

emergency care

Use of High Quality Providers-Hospitals

Use of High Quality Providers-Primary Medical Services

Achievement of milestones in the delivery of an

integrated urgent care service

population use of hospital beds following emergency

admission

Emergency admissions for urgent care sensitive

conditions

Delayed transfers of care from hospital (delays days rate)

% of patients admitted, transferred or discharged from

A&E within 4 hours (TRFT)

Ambulance waits (Category 1 Under 8 Minutes)

Estimated diagnosis rate for people with dementia.

Dementia care planning and post-diagnostic support

Women's experience of maternity services (National

Maternity Services Survey)

Neonatal mortality and stillbirths (Rate per 1,000 )

Choices in maternity services

Proportion (%) of eligible adults with a learning disability

having a GP health check

Reliance on specialist inpatient care for people with a

learning disability and/or autism

Out of area placements for acute mental health inpatient

care - transformation

Crisis care and liaison mental health service

transformation

Children and young peoples mental health services

transformation

Not currently in publication.

Not currently in publication.

People with first episode of psychosis starting treatment

with a NICE recommended package of care treated

within 2 weeks of referral

% of people who are moving to recovery

Cancers diagnosed at early stage

One year survival from all cancers

Cancer patient experience (National Cancer Patient

Experience Survey)(1)

Percentage of patients receiving first definitive treatment

for cancer within two months (62 days) of an urgent GP

referral for suspected cancer.

Use of High Quality Providers- Adult Social Care

01. Care ratings

02. Cancer

03. Mental health

04. Learning

disability

05. Maternity

06. Dementia

08. Primary medical

care

Primary Care Access

Patient experience of Primary Care - GP services

Primary care workforce (FTE per 1,000 patients)

Unplanned hospitalisation for chronic ambulatory care

sensitive (ACS) conditions (rate per 100,000 )

09. Elective accessPatients waiting 18 weeks or less from referral to hospital

treatment

10. 7 Day servicesAchievement of clinical standards in the delivery of 7 day

services

11. NHS continuing

healthcare

People eligible for standard NHS continuing healthcare

(Rate per 50,000 population)

Bet

ter

Car

e



Reporting


Latest Period

PerformanceTarget

Annual 2016

Quarterly Q4 2016/17


Quarterly Q4 2016/17 In Place In Place

Quarterly Q4 2016/17 55.6%

Quarterly Q4 2016/17 In Place In Place

Reporting


Latest Period

PerformanceTarget

Annual 2016/17




Quarterly Q3 2016/17 81.67%


03. Workforce

engagement

04. CCGs local

relationships

05. Quality of

leadership

Sustainability and transformation plan

Probity and corporate governance

Not currently in publication

Not currently in publication

Staff engagement index

Progress against workforce race equality standard

Effectiveness of working relationships in the local system

Quality of CCG leadership

02. Probity and

corporate

governance

Lea

der

ship

01. Sustainability and

transformation plan

01. Financial

sustainability

Financial plan

In year financial performance

Outcomes in areas with identified scope for

improvement

Expenditure in areas with identified scope for

improvement

Adoption of new models of care

Local digital roadmap in place

Digital interactions between primary and secondary care

Local Strategic Estates Plan (SEP) in Place

02. Allocative

efficiency

03. New models of

care

04. Paper free at the

point of care

05. Estates strategy

Su

stai

nab

ility

Health Outcomes


2013 2014 2015 2016 Target

2490.2 2499.7 2378

70.8 86.5 76.8 63.7

39.1 31.2 41.3 27.6

14.9 18.9 18 15.8

141.6 143.5 127.3 121.4

07/13-03/14 07/14-03/15 07/15-03/16 07/16-03/17 Target

0.707 0.702 0.708 0.720 0.740

64.40 65.20 66.20 62.10 67.14

2013/14 2014/15 2015/16 2016/17 Target

937.3 1074.1 996.7 1,074

305.8 364.0 272.0 364

Jul-17 Aug-17 Sep-17 YTD Target

77.52% 77.75% 79.87% 79.87% 66.70%

2013/14 2014/15 2015/16 2016/17 Target

1496.6 1542.3 1581.3 0.0 1,581

480.8 541.8 372.3 0.0 372.3

Target

437.3%

86.2%

74.6%

Jul-17 Aug-17 Sep-17 2017/18 YTD

0 0 0 0 Actual

0 0 0 0 Plan

0 0 1 1 Actual

0 0 0 0 Plan

11 5 5 32 Actual

7 7 6 39 Plan

2 0 2 4 Actual

2 1 4 14 Plan

Jul-17 Aug-17 Sep-17 2017/18 YTD Target

90.0% 91.0% 96.8% 87.1% 75.0%

99.7% 100.0% 100.0% 99.9% 95.0%

Preventing Premature Mortality

Enhancing Quality of Life

Helping Recovery

Patient Experience

Protecting People From Avoidable Harm



Health-related quality of life for people with long-term conditions

Emergency admissions for children with Lower Respiratory Tract

Infections (LRTI)

Satisfaction with the quality of consultation at the GP practice

Proportion of people feeling supported to manage their condition

Unplanned hospitalisation for chronic ambulatory care sensitive

conditions

Unplanned hospitalisation for asthma, diabetes and epilepsy in

under 19s

Diagnosis rate for people with dementia, expressed as a percentage

of the estimated prevalence

Emergency admissions for acute conditions that should not usually

require hospital admission

Potential Years of Life Lost (PYLL) from causes considered

amendable to healthcare, per 100,000

Under 75 mortality rate from cardiovascular disease (CCG)

Under 75 mortality rate from respiratory disease (CCG)

Under 75 mortality rate from liver disease (CCG)

Under 75 mortality rate from cancer (CCG)

Satisfaction with the overall care received at the surgery

Satisfaction with accessing primary care

Mental Health: Monthly Indicators

Incidence of healthcare associated infection (HCAI) - MRSA

(Commissioner)

Incidence of healthcare associated infection (HCAI) - MRSA

(Provider) - RFT

Incidence of healthcare associated infection (HCAI) - C.Diff

(Commissioner)

Incidence of healthcare associated infection (HCAI) - C.Diff

(Provider) - RFT

Proportion of people waiting 6 weeks or less from referral to entering

a course of IAPT treatment

Proportion of people waiting 18 weeks or less from referral to

entering a course of IAPT treatment

Latest Period Performance

Jan-Mar 17

Jan-Mar 17

Jan-Mar 17

440.8%

85.7%

71.1%

Health Outcomes

Jun-17 Jul-17 Aug-17 YTD Target

4.1% 5.4% 6.9% 6.9% 3.50%

57.60% 51.10% 52.30% 54.10% 50.0%

Q1 2017/18 Q2 2017/18 Q3 2017/18 Q4 2017/18 Target

6 0 0 0 3

7 0 0 0 3

85.7% #DIV/0! #DIV/0! #DIV/0! 95.0%

The number of routine cases were low for the quarter, so the data on routine cases has been suppressed. Therefore there is nothing to report on

for routine cases in Q1.

Mental Health: Monthly Indicators

Improved Access to Psychological Services-IAPT: People entering

treatment against level of need (YTD)

Improved Access to Psychological Services-IAPT: People who

complete treatment, moving to recovery

CYP Eating Disorder (ED) Services - Urgent Cases

Number of CYP with ED (urgent cases) referred with a suspected

ED that start treatment within 1 week of referral

Number of CYP with a suspected ED (urgent cases) that start

treatment

Percentage of CYP with ED that start treatment within one week of

referral

Better Care Fund


Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17 Jan-18 Feb-18 Mar-18

Actual 5.3% 6.1% 5.7% 4.9% 5.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0%

Target 3.5% 3.5% 3.5% 3.5% 3.5% 3.5% 3.5% 3.5% 3.5% 3.5% 3.5% 3.5%

Actual YTD 5.3% 5.7% 5.7% 5.5% 5.4% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0%

Target YTD 3.5% 3.5% 3.5% 3.5% 3.5% 3.5% 3.5% 3.5% 3.5% 3.5% 3.5% 3.5%

*BCF DTOC measure has now been confirmed as rate per 100,000 population. This will be reflected in this part of the report once the trajectory is confirmed.


Actual - - 89 0 0 0 0 0 0 0 0 0

Target 50 100 149 198 248 297 347 396 446 495 545 589

Actual YTD - - 89 0 0 0 0 0 0 0 0 0

Target YTD 50 100 149 198 248 297 347 396 446 495 545 589

Both the target and actual figures are cumulative. The target for the year is 589

Actual

Target

Delayed transfers of

care from hospital

(delays days rate)*

Long-term support

needs of older people

(65 and over) met by

admission to residential

and nursing care

homes, per 100,000

population

90.0% 91.0%

2015/16 2016/17

Proportion of older

people (65 and over)

still at home 91 days

after discharge from

hospital into reable-

ment / rehabilitation

services

89.6% 87.5%

Quality Premium


Preventing Premature Mortality Target

Proportion of cancers diagnosed at stages 1 and 2 60.0%

Increase in proportion of GP referrals by e-referral Target

Proportion of GP referrals made by e-referrals 80.0%

Overall Experience of Making a GP Appointment Target

% of respondents who said they had a good experience of

making an appointment74.6%

Continuing Health Care Target

NHS CHC eligibility decision is made by the CCG within 28

days from receipt of the Checklist (or other notification of

potential eligibility) - 13 out of 60 this Quarter

80%

Full NHS CHC assessments take place in an acute hospital

setting to be less than Quality Premium target - 16 out of 54

this Quarter

Less than

15%

Antimicrobial Resistance (AMR) Improving Antibiotic

Prescribing in Primary Care Target

Reducing gram negative bloodstream infections: Reduction of

Ecoli BSI reported at CCG level1

Reducing inappropriate antibiotic prescribing for UTI in primary

Care:

A 10% or greater reduction in the Trimethoprim: Nitrofurantioin

prescribing ratio

0.559

Reducing inappropriate antibiotic prescribing for UTI in primary

Care:

A 10% or greater reduction in the number of Trimethoprim

items prescribed to to patients aged 70 year or over

3721

Sustained reduction of inappropriate prescribing in primary

care1.16


Q1 2017/18 22.0%

Q1 2017/18 30.0%

Latest Period Peformance

Jan-Mar 17 71.1%

Aug-17 85.9%


2015 47.6%


Jul-17 1.246


Sep-17 1

Jul-17 0.502

Jul-17 3357

Focus on Performance

Focus on - A&E Waits

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

Actual 85.2% 79.2% 82.2% 85.1% 90.1% 87.2% 88.1% 87.2% 81.2% 82.4% 81.8% 86.0%

Target 95.0% 95.0% 95.0% 95.0% 95.0% 95.0% 95.0% 95.0% 95.0% 95.0% 95.0% 95.0%

F:\Data\Bu

siness tbc


% Seen within 4 hours - RFT 85.2% 79.2% 82.2% 85.1% 90.1% 87.2% 88.1% 87.2% 81.2% 82.4% 81.8% 86.0%

% Seen within 4 hours - Barnsley FT 93.2% 83.5% 87.1% 85.0% 92.5% 89.0% 91.1% 91.8% 95.2% 92.5% 94.6%

% Seen within 4 hours - Doncaster & Bassetlaw FT 92.8% 86.6% 85.1% 88.7% 92.6% 90.4% 91.4% 92.5% 93.2% 93.6% 93.7%

% Seen within 4 hours - England 89.0% 86.2% 85.1% 87.6% 90.0% 89.1% 90.5% 89.7% 90.7% 90.3% 90.3%

% Seen within 4 hours - North 89.2% 85.7% 85.0% 87.1% 90.7% 89.4% 91.0% 89.9% 90.9% 90.3% 90.6%

% Seen within 4 hours - Target 95.00% 95.00% 95.00% 95.00% 95.00% 95.00% 95.00% 95.00% 95.00% 95.00% 95.00% 95.00%


% Seen within 4 hours - Rotherham CCG 85.2% 79.2% 82.2% 85.1% 90.1% 87.2% 88.1% 87.2% 81.2% 82.4% 81.8% 86.0%

STF Trajectory 92.5% 91.0% 91.0% 89.0% 92.0% 87.3% 89.7% 93.0% 93.0% 85.5% 89.8% 94.8%

Variance - Actual v STF Trajectory -7.3% -11.8% -8.8% -3.9% -1.9% -0.1% -1.6% -5.8% -11.8% -3.1% -8.0% -8.8%

% 4 Hour A&E waiting times - seen

within 4 hours latest monthly position

Focus on - STF Trajectory

65.0%

70.0%

75.0%

80.0%

85.0%

90.0%

95.0%

100.0%


% 4 Hour A&E waiting times - seen within 4 hours latestmonthly position

Target

65.0%

70.0%

75.0%

80.0%

85.0%

90.0%

95.0%

100.0%


% Seen within 4 hours - RFT

% Seen within 4 hours - Barnsley FT

% Seen within 4 hours - Doncaster & Bassetlaw FT

% Seen within 4 hours - England

% Seen within 4 hours - North

% Seen within 4 hours - Target

Supporting Narrative Rotherham CCG data is used to monitor for the Quality Premium and is now published via NHS England on a monthly basis; however it runs 1 month in arrears. To monitor A&E in a timely manner it has been agreed to use RFT's daily data as a proxy for the CCG measure. The A&E position for RFT, October to date (as at 22nd October) is 86.0%. Performance during this period last year for RFT only without the WIC patients (October 2016) was 84.6%.

-15.0%

-10.0%

-5.0%

0.0%

75.0%

80.0%

85.0%

90.0%

95.0%

100.0%


Variance - Actual v STF Trajectory

% Seen within 4 hours - Rotherham CCG

STF Trajectory

Supporting Narrative The STF trajectory is the trajectory for A&E improvement agreed between RFT, RCCG and NHS England. December onwards has been updated to show the Rotherham system wide position. The trajectory from Apr 17 onwards is provisional.

Focus on - Refer to Treatment: Incomplete Pathways by Speciality - RCCG Patients

% Over

13 Weeks Jun-17 Jul-17 Aug-17 Sep-17 Target

All specialities - total incomplete 14.8% 95.1% 95.4% 94.8% 95.0% 92.00%

Cardiology 24.1% 93.7% 94.9% 93.7% 92.2% 92.00%

Cardiothoracic Surgery 13.6% 84.1% 89.3% 90.9% 90.9% 92.00%

Dermatology 10.9% 96.5% 98.1% 97.1% 98.0% 92.00%

ENT 17.9% 94.0% 93.5% 92.3% 93.2% 92.00%

Gastroenterology 9.2% 97.2% 97.4% 99.2% 99.5% 92.00%

General Medicine 15.1% 87.6% 95.7% 97.7% 98.8% 92.00%

General Surgery 14.5% 93.8% 93.7% 93.4% 93.0% 92.00%

Geriatric Medicine 10.2% 98.5% 100.0% 97.5% 98.8% 92.00%

Gynaecology 21.3% 92.6% 92.6% 91.4% 90.1% 92.00%

Neurosurgery 3.2% 99.0% 100.0% 98.9% 99.0% 92.00%

Neurology 10.6% 98.8% 97.6% 98.9% 98.9% 92.00%

Ophthalmology 9.6% 98.3% 97.4% 97.7% 97.8% 92.00%

Oral Surgery - 100.0% 100.0% 100.0% 100.0% 92.00%

Other 14.3% 95.8% 95.7% 95.0% 95.4% 92.00%

Plastic Surgery 11.6% 88.0% 93.7% 94.4% 93.0% 92.00%

Rheumatology 10.8% 98.4% 99.5% 99.4% 97.5% 92.00%

Thoracic Medicine 19.8% 96.7% 95.8% 91.9% 97.0% 92.00%

Trauma & Orthopaedics 17.2% 92.6% 93.7% 92.7% 92.9% 92.00%

Urology 8.7% 98.0% 98.1% 98.5% 98.3% 92.00%

Supporting Narrative Latest provisional data for September shows two specialties under the 92% standard, Cardiothoracic Surgery and Gynaecology. Gynaecology is part of on-going discussions with RFT in the context of their theatre refurbishment work. Cardiothoracic surgery is small numbers, 6 pathways over 18 weeks. Rotherham CCG benchmarks favourably against other CCG's in South Yorkshire for RTT Incomplete waits in August (94.8%): Barnsley CCG – 92.3% / Bassetlaw CCG – 90.1% / Doncaster CCG – 90.7% / Sheffield CCG – 95.5% / National – 89.4%

Focus on - IAPT Waiting Times

17/07/2017 24/07/2017 31/07/2017 07/08/2017 14/08/2017 21/08/2017 28/08/2017 04/09/2017 11/09/2017 18/09/2017 25/09/2017 09/10/2017

Actual 90.7% 89.8% 90.0% 89.9% 89.6% 90.2% 90.8% 98.5% 97.1% 96.9% 96.9% 98.4%

Target 75% 75% 75% 75% 75% 75% 75% 75% 75% 75% 75% 75%

Focus on - IAPT 6 Week Wait Waiting List

26/06/2017 03/07/2017 10/07/2017 17/07/2017 24/07/2017 31/07/2017 07/08/2017 14/08/2017 21/08/2017 28/08/2017 25/09/2017 09/10/2017

IAP incomplete - total waitingActual 356 353 336 347 322 318 262 276 258 248 258 306

IAPT incomplete - total waiting 0-6

weeksActual 299 303 283 295 269 273 232 250 235 220 239 284

IAPT incomplete - total waiting

over 6 weeksActual 57 50 53 52 53 45 30 26 23 28 19 22

Proportion of people waiting six

weeks or less from referral to

entering a course of IAPT

treatment

0.0%

20.0%

40.0%

60.0%

80.0%

100.0%

120.0%

Actual

Target

0

50

100

150

200

250

300

350

400

IAP incomplete - total waiting

IAPT incomplete - total waiting 0-6 weeks

IAPT incomplete - total waiting over 6 weeks

Supporting Narrative Local comparison (published data June 17) shows the following benchmark position. Please note these benchmarks have not been updated since the previous report as further data is still to be published. Barnsley – 58% Bassetlaw – 99% Doncaster – 85% Sheffield – 92% National – 88.8%


Actual 78.87% 83.64% 76.56% 79.31% 79.17% 85.71% 78.18% 78.95% 86.76% 86.57% 78.95% 81.82%

Target 85.00% 85.00% 85.00% 85.00% 85.00% 85.00% 85.00% 85.00% 85.00% 85.00% 85.00% 85.00%


56 46 49 46 38 42 43 45 59 59 58 63

71 55 64 58 48 49 55 57 68 68 67 77Total cancer patients waiting to be seen

within 62 days of referral from GP

Cancer patients seen within 62 days of

referral from GP

Cancer - % patients seen within

62 days of referral from GP

Focus on - Cancer (62 Days)

0.00%10.00%20.00%30.00%40.00%50.00%60.00%70.00%80.00%90.00%

100.00%


Actual

Target

Supporting Narrative In August the 62 day GP referral to treatment target failed the national standard of 85%, with performance at 81.8%. TRFT saw a slight decrease in performance July 86.7%, to August 86.2%, which is still above the national standard. National performance in July was 82.4%. There were 14 breaches in August for RCCG patients: FIRST SEEN FIRST TREATMENT REASON

Rotherham FT Rotherham FT Health Care Provider initiated delay to diagnostic test

Rotherham FT Sheffield FT IPT late in pathway (RFR day 53)

Rotherham FT Rotherham FT Diagnosis and treatment delayed for medical reasons

Rotherham FT Sheffield FT Outpatient patient capacity inadequate (OPA RHQ) compounded

by patient choice and adherence to clinical trial

Rotherham FT Sheffield FT Treatment delayed for medical reasons (RHQ) (IPT day 37 RFR)

(No breach report received from RFR)

Sheffield FT Sheffield FT Complex diagnostic pathway compounded by treatment delayed

due to medical reasons

Rotherham FT Sheffield FT IPT after breach date (RFR day 71)



Rotherham FT Sheffield FT Outpatient capacity inadequate (treatment planning) (RHQ)


Rotherham FT Rotherham FT Patient choice compounded by health care provider initiated

delay to diagnosis (RHQ)

Rotherham FT Sheffield FT IPT after breach date (RFR day 160) Breach reason not agreed

between trusts (RHQ and RFR)

Rotherham FT Sheffield FT Comment to be added


Actual 5.3% 6.1% 5.7% 4.9% 5.0%

Target 3.5% 3.5% 3.5% 3.5% 3.5% 3.5% 3.5% 3.5% 3.5% 3.5% 3.5% 3.5%

Actual YTD 5.3% 5.7% 5.7% 5.5% 5.4%

Target YTD 3.5% 3.5% 3.5% 3.5% 3.5% 3.5% 3.5% 3.5% 3.5% 3.5% 3.5% 3.5%

Focus on - Delayed Transfer of Care

Delayed transfers of care from

hospital (delays days rate)*

5.1%

5.2%

5.3%

5.4%

5.5%

5.6%

5.7%

5.8%

0.0%

1.0%

2.0%

3.0%

4.0%

5.0%

6.0%

7.0%


Actual

Target

Actual YTD

Supporting Narrative Rotherham FT is not currently meeting the 3.5% national standard. The national standard relates to total occupied bed days taken up by delayed transfers of care. Rotherham FT’s performance in August 17 is 5.0%. This compares to a Yorkshire and Humber performance of 3.9%, a North of England performance of 4.1% and an England performance of 4.9%. Sheffield Teaching FT’s performance for August 17 is 5.7% and Barnsley FT’s is 0.5%. Doncaster and Bassetlaw’s performance is 2.7%.

0.0%

1.0%

2.0%

3.0%

4.0%

5.0%

6.0%

7.0%DTOC Benchmarking

ENGLAND

YORKSHIRE AND THE HUMBER

THE ROTHERHAM NHS FT

TARGET

Focus on Performance - 111

Total Number of Calls

Call Backs Within 10 Minutes

Dispositions

0

1000

2000

3000

4000

5000

6000

7000

Apr 17 May 17 Jun 17 Jul 17 Aug 17 Sep 17 Oct 17 Nov 17 Dec 17 Jan 18 Feb 18 Mar 18

NHS ROTHERHAM CCG TOTAL NUMBER OF CALLS

2017/18

2016/17

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Apr 17 May 17 Jun 17 Jul 17 Aug 17 Sep 17 Oct 17 Nov 17 Dec 17 Jan 18 Feb 18 Mar 18

NHS ROTHERHAM CCG PERCENTAGE OF CALL BACKS WITHIN 10 MINUTES

2017/18

2016/17

Target

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

35.0%

40.0%

45.0%

50.0%

AmbulanceDispatches

Dispositions

Primary andCommunity

CareDispositions

Recommendedto Attend

Dental Service

Recommendedto Attend A&E

Recommendedto Attend Other

Service

Recommendedto Self CareDisposition

No Disposition

DISPOSITIONS PERCENTAGE AUGUST 2017

NHS Rotherham CCG

Y&H Aggregate (including OOA and Unknown)

Number of Dispositions

Y&H Rotherham % of Total

11101 548 4.9%

38679 1,543 4.0%

12761 531 4.2%

51440 2,074 4.0%

Recomended to Attend Dental Service 16279 689 4.2%

9081 299 3.3%

3834 149 3.9%

18742 626 3.3%

111 Top Six Symptoms - Rotherham CCG

Recommended to Self Care

Ambulance Dispatches

Primary and Community Care -

Outside GP Hours

Within GP Hours

Total

Recommended to Attend A&E

Recommended to Attend Other Service

Supporting Narrative This focus on section has been added at the request of governing body. It displays key information relating to the 111 service on calls, dispositions and symptoms.

0

100

200

300

400

500

600

700

Toothache Without DentalInjury

Chest And Upper Back Pain Health And SocialInformation

Repeat Prescription Breathing Problems,Breathlessness Or Wheeze

Pain And/Or FrequencyPassing Urine

NHS ROTHERHAM CCG TOP SIX SYMPTOMS AUGUST 2017

Total

Documents

Rotherham Clinical Commissioning Group: Governing Body … Body Papers... · The new Urgent and Emergency Care Centre has been live since the 06th July. The WIC also closed on this