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Trust Board28 April 2016

AGENDA ITEMNUMBER

5.4

TITLE OF PAPER Safer Staffing Nursing Establishment Framework – 6 month review

Confidential No

Suitable for publicaccess

Yes

PLEASE DETAIL BELOW THE OTHER SUB-COMMITTEE(S), MEETINGS THIS PAPER HAS BEENVIEWED

STRATEGIC OBJECTIVE(S):

Best outcomes √ Ensuring appropriate nursing establishments positively impacts on patient outcomes. Safer staffing for adult in patients in acute hospitals (NICE,2014)

Excellent experience √ Ensuring appropriate nursing establishments positively impacts on patient experience

Skilled & motivatedteams

√ Ensuring appropriate nursing establishments positively impacts on staff morale

Top productivity √ Investment in staffing is based on evidence-based methodology and supported by professional judgement

EXECUTIVE SUMMARY

This paper presents the results of the 6 month review that was conducted inFebruary 2016 including the output of the acuity and dependency review andthe application of professional judgement as well as senior executivechallenge.

Compliant with Expectation 7 of the Hard Truths requirements

The acuity and dependency review was calculated using the ShelfordGroup Safer Nursing Care tool (SNCT)

All adult in patient wards were included in the review and this includedCherry Ward who had not been part of previous reviews as it is a newward

Proposed whole time equivalent (WTE) has included activity such aspatient escorts and specials for vulnerable patients requiring closerobservation, which have not previously been calculated as part of the

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acuity and dependency review

Results demonstrate that, from the July 2015 review, 7 wards haveincreased acuity and dependency for patients with acuity level 1b andabove, whilst 8 wards have decreased acuity for level 1b and above

The review calculates that there is a deficit of -11.28 WTE across theareas when the additional activity such as close supervision of patientsis taken into account

Compared to last year, there has been a reduction of 38.3% in harmson the wards.

The business planning cycle will address this in relation to theinvestment required for additional staff. The investment in Paediatricshas a financial cost-pressure of £250,719.

RECOMMENDATION: The Board is asked to:

1. Review and discuss the paper seeking assurance as appropriate; and

2. Approve the proposed changes to the staffing establishment for the

adult inpatient areas, the emergency department and the paediatric

settings.

There should be no additional investment in staffing this year, apart from theinvestment in Paediatrics which, in order to comply with CQC complianceaction plan, has a financial cost-pressure of £250,719.

The business planning cycle will indicate any investment required from internalrestructure.

SPECIFIC ISSUES CHECKLIST:

Quality and safety The failure to comply with regular staffing reviews would have implications forthe Trust CQC rating and may impact on patient safety and experience.

Patient impact The rigour applied to the setting of nursing establishments builds confidence inthe public and patients

Employee Establishments correctly adjusted for acuity and dependency will reduce theburden to nursing and midwifery staff delivering care. This will be affected byvacancy rate

Other stakeholder Owing to multidisciplinary of working, safe staffing levels on wards wouldensure a higher quality of care delivered. This will positively impact doctors,therapists, pharmacists and other disciplines working in inpatient settings.

Equality & diversity Consideration has been given to equality of access.

Finance Will be included in the business planning cycle.

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Legal None

Link to Board AssuranceFramework PrincipleRisk

The failure to comply with regular staffing reviews could result in enforcementor legal action should the Trust fail to meet fundamental standards of care

AUTHOR NAME/ROLE Sue Harris, Lead Nurse Tissue ViabilityRussell Wernham, Deputy Chief Nurse/Associate Director of Quality

PRESENTED BYDIRECTORNAME/ROLE

Heather Caudle, Chief Nurse

DATE 25 April 2016

BOARD ACTION Assurance

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1. Background and scope

In June 2014 it became a national requirement for all hospitals to publish information relating

to staffing levels on their wards. This request followed the publication of reviews and reports

including the Francis report on Mid Staffordshire (Francis 2013)1 and the Cavendish review:

an independent inquiry into healthcare assistants and support workers in the NHS and social

care setting (Cavendish 2013)2. In February 2016 the Trust undertook the planned 6 monthly

review of the Safer Staffing Establishment using acuity and dependency data recorded by

the wards using the Shelford Group Safer Nursing Care Tool.

Although Paediatrics, Critical Care and Accident and Emergency are not included in the 6-

monthly review using the Shelford Model they have been included in this paper.

2. Strategic issues and options

This review will form part of the business priorities and resources as part of the business

planning cycle.

The proposed changes to staffing levels result in cost-neutral changes within the divisionsand therefore in adult arenas, there should be no additional investment in staffing this year.

The investment in Paediatrics which, in order to comply with CQC compliance action plan,has a financial cost-pressure of £250,719.

The business planning cycle will indicate any investment required from internal restructure.

3. Assumptions, (risks/mitigations and dependencies)

Trust Board can be assured that the review was undertaken supported by the Shelford

Group Safer Nursing Care tool (SNCT) an established methodology for data collection on

acuity and dependency.

4. Recommendations

The Board is asked to:

3. Review and discuss the paper seeking assurance as appropriate; and

4. Approve the proposed changes to the staffing establishment for the adult inpatient

areas, the emergency department and the paediatric settings.

5. Impact measures and follow up

To repeat the acuity and dependency review on a six monthly continual cycle to include redflags monitoring.

1http://www.kingsfund.org.uk/projects/francis-inquiry-report?gclid=CNr7md7W0csCFdYV0wodXEsCYw

2https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/236212/Cavendish_Review.pdf

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Appendix 1

Acuity and Dependency Review Process February 2016

Ashford and St Peter’s hospitals used SNCT methodology for data collection on acuity anddependency. To enable consistency data was collected on every patient in participatingwards from Tuesday 2nd February to Monday 29th February at 15.00hrs daily, for 20 days.The level of patient acuity is based on the patient who has retrospectively occupied the bedfor the longest period of time over the preceding 24 hours. AMU was not originally includedand therefore their data collection had a two week time lag.

The SNCT agreed multipliers for each level of patient are in order to calculate theacuity/dependency then map the level to a nurse per bed allocation:

Level 0 0.99WTE nurse per bed Level 1a 1.39 WTE nurse per bed Level 1b 1.72 WTE nurse per bed Level 2 1.97 WTE nurse per bed Level 3 5.96 WTE nurse per bed

Results

The results of the acuity and dependency data have been presented in charts 1-4 below. Itshould be noted that the tool calculates the WTE but this does not take into account the levelof activity. AMU has been included in this data capture. AMU is a new unit which is anamalgamation of MSSU and MAU. In previous reports MAU did not meet the criterion forinclusion in the Shelford Model.

Chart 1 shows the current WTE each ward is budgeted for in blue. The red column showsthe WTE calculated by the SNCT multiplier based on the data entered.

Chart 1

In addition to the SNCT, the staffing review took into account other important factors for eachward area: ward activity; escorts; deaths; quality and safety performance including falls,hospital acquired pressure ulcers and medication errors.

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Ward Activity

The activity of the ward placed a major demand on nursing time and focus. Chart 2 presentsthe activity in and out of the wards and any ward attenders. Activity in includes admissionsand transfers from other wards. Activity out includes discharges and transfers to otherwards. Ward attenders are patients who present to the ward for an episode of treatment orinvestigation but are not admitted.

Surgical Assessment Unit (SAU) had 220 ward attenders. This is an increase of 28%from the data collected in July 2015 and a second successive increase. These canbe patients who have been assessed in SAU and discharged as they do not requireadmission but return the next day for review. Patients discharged from surgical wardsthat require further wound dressings or stoma checks can also be booked in to bereviewed as a ward attender on SAU. While SAU try to allocate a nurse to managethis daily it often falls to the nurse in charge.

Birch and Coronary Care (BACU) ward had 57 ward attenders these are usually forcardiac investigations e.g. echocardiogram. In the past it indicated only 51 this isonly an increase of 7 attendees from the data collected in July 2015.

Cedar ward’s attenders totalled 70 these are patients attending Trans IschaemicAttack (TIA) clinic. This is an increase of 11 attendees from the data collected in July2015 and a 2nd successive increase.

Chart 2

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Escorts

Chart 3 demonstrates the number of hours used by an area for escorts. Escorts areregistered nurses or health care assistants who accompany a patient to theatre, x- ray, otherwards or for investigations. Data was collected on escorts both within and outside the Trustthese included staff accompanying patient going for clinical diagnostics or treatments. TheWard equates to 0.22 WTE. This is not represented in the calculation for WTE.

Chart 3

Deaths

Chart 4 shows the number of deaths in each ward during the 20 day period. Performing lastoffices requires 2 nurses and usually takes approximately 45 minutes. This includespreparing the deceased, paperwork and property recording. Holly Ward had 9 deaths whichequates to 0.15 WTE.

Chart 4

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Close Observation staffing (Specials)

Patients requiring close observation and/or are at risk of wandering. This includes patients;at risk of self-harm; likely to abscond from the ward; confused, agitated or aggressive toothers; those with a history of falls or assessed as being at high risk of falls. Chart 5 showsthe hours per ward required for close observation of patients.

Chart 5

Chart 5 shows that Kingfisher required the most at 264 hours of close observation whichequates to 1.76 WTE. Compared to last year 1/3 less was required.

Additional Data

The collection of the additional data for ward attenders, deaths, escorts and closeobservation has allowed more in depth analysis of the staffing levels within the adult in-patient wards that is not included in the acuity and dependency data calculation. Thisadditional data has been converted into hours and then, as the data collection was over 20days, this figure has been divided by 150 to give the equivalent WTEs required. This furtheranalysis and results are provided in Annex 1. Using this data gives a variance of – 21.78WTE across the Trust when compared against the budgeted WTE.

Quality and Safety Performance

The SNCT tool, while providing a quantitative assessment to assist in the determining ofoptimal staffing level, does not encapsulate more qualitative data relating to care given. Thenursing workload and provision of care is influenced by other variables and nurse sensitiveindicators that need to be considered in the presentation of results. Acuity and dependencyshould be triangulated and presented with data from the quality, safety and patientexperience.

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Other nurse sensitive indicators have been used to support ward staffing levels includestaffing levels, development of pressure ulcers, falls and medication errors. Please seeAnnex 2.

The data collected on nurse sensitive indicators has been benched against the data from theprevious review period and has shown that the subsequent investment in staffing hasresulted in a marked decrease in the number of harms recorded by ward. In 2015 thecollection period showed 94 recorded harms; the collection period in 2016 showed 58. Thisis a reduction of 38.3% year on year.

Annex 2 presents the ward by name and number of beds. The percentage of shifts ratedamber/red has been calculated by taking the number of shifts highlighted as red/amberrecorded on the Trusts daily staffing tool divided by the number of shifts in the 20 day period(60).

Taking the total adverse variance from the total positive variance figures, gives -21 WTEwhen taking into consideration the additional activity such as ward attenders, closeobservation of patients.

Annex 3 shows variance by ward shown by the tool.

Safer Staffing and Investments

AMES

MedicineThe tool identifies investment is required in both Aspen and Cherry Ward however AspenWard has recently undergone a review of skill mix and investment is not required at thepresent time. Cherry Ward requires review of its working model in relation to patient flow andtherefore staffing investment is not indicated at present.

TASCC

The financial implication of the proposed changes to staffing is awaiting confirmation fromfinance and will be agreed during the Business planning process.

SDUA change in skill mix is required from one band 5 to a band 7 in order to provide robustleadership. This will not result in a change in actual staffing numbers

KingfisherA change in skill mix on the night shift from 4 RN and 1 HCA to 3 RN and 2 HCA

This will require no additional investment.

ITUAn increase in establishment to 1 x HCA on a night shift

HDUA change in skill mix will be affected by the ICU and HDU co-location from 2 RN and 1 HCAto 3 RN on each shift.

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T & O

The results show Dickens ward as not requiring 6.51wte of its current staff and proposes thatthe 24 patients on the ward can be cared for by 18.96wte over 24hrs per day 7 days perweek.

The current audit also shows Swan ward as needing 5.41wte.

The proposed staff changes will have a cost-neutral financial impact on the division.

Recommendations and next steps

1. Improve Acuity and Dependency Review methodologyTo ensure a complete and accurate data set it is recommended that an audit team approach,in the form of a data collection team is adopted for the next data capture.

The data collection team should comprise of Senior Nurses who will visit an adopted ward at3pm each day to ensure that the data collection tool is fully completed in conjunction with thenurse in charge. In addition to this scores can be clarified and challenged at this time toensure accuracy.

Develop a tool to score the activity data to be considered alongside the WTE. This couldtake the form of a RAG rating for the data collection period.

The acuity and dependency tools multipliers allow for normal levels of activity however tobetter capture other factors such as ward activity, layout and transfers, the multiplies will befactored into the staffing levels equation identified by the Shelford Group to calculate WTE.

Future calculations of acuity and dependency may also be affected by any changes in thesafer staffing calculation methodology, the current thinking is to move towards a care hoursper patient day model.

2. Agree in-patient areas investmentThe Divisional Chief Nurses/ Midwife as per the Framework will apply professionaljudgement in order to sensibly reach a level of investment in consideration of need, risks toquality and financial context for each of the remaining wards.

Emergency DepartmentThe staffing model for an ED is primarily predicated on the geographical areas that need tobe covered. This assumes that there is good flow from the department and good internalflow dynamics within it. On that basis the recommended qualified nurse staffing contingentfor St Peter’s ED would be as follows:

Resuscitation: 4 spaces at a ratio of 1 nurse to 2 patients = 2 nursesPit Stop: 7 spaces at a ratio of 1 nurse to 3 patients = 3 nursesMajors: 20 spaces at a ratio of 1 nurse to 4 patients = 5 nursesCDU: 6 spaces at a ratio of 1 nurse to 6 patients = 1 nurse1 nurse-in-charge (ED and UCC)1 nurse in a coordinating role1 nurse as circulating cover

This would equate to 14 qualified nurses on a long day and 14 qualified nurses on a longnight. It assumes 85% occupancy of the department and would therefore allow additional

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nurses to move to resus and cover breaks and fulfil escort duties to wards and diagnosticareas without this impinging on the overall care ratios within the ED.

Delivering this would require an establishment uplift of 1.61wte on the current qualifiedestablishment.

3. Skill MixWhile the acuity and dependency tool calculates the number of WTE staff required it doesnot identify skill mix in relation to trained /untrained staff ratios. There is, as yet, no definitiveratio for skill mix however the following tools provide guidance on how to use acuity anddependency data with other methods of calculating staff requirements e.g. bed occupancy

Safe staffing for nursing in adult inpatient wards in acute hospitals | Guidance and guidelines| NICE

http://www.rcn.org.uk/__data/assets/pdf_file/0005/353237/003860.pdf

NHS England » New staffing guidance published to support providers and commissioners tomake the right decisions about nursing, midwifery and care staffing capacity and capability.

Paediatric Nursing Establishment Proposed Changes at 31 March 2016

The department’s nursing establishment has been reviewed by the Associate Director of

Nursing for Paediatrics in November 2015 based upon requirements including the BAPM3

Standards, the PANDA4 acuity staffing tool and RCN Staffing Levels for Children and Young

People’s Services (2013)5. The staffing requirements were refreshed in March 2016 and

these reviews gave rise to 6 proposed changes to the paediatric nursing establishment.

Costs below are based upon annual costs therefore the timing of recruitment could give rise

to phased costs in year 1.

Table 1 Changes to establishment

Area WTE change Cost Rationale

NICU Re-band 6.0 posts from

Band 5 to Band 6

£46,396 BAPM 1:1 requirement for ITU cots.

Increases efficient use of existing cot base to

operate at highest acuity. To meet BAPM

standards.

PAED

A&E

↑ Band 7 by 0.5 wte £19,700 To provide Clinical Practice Educator.

PAED Re-band 2.0 posts from £15,465 Nurse in-charge and specialist emergency skills

3BAPM is the British Association of Perinatal Medicine Service Standards for Hospitals Providing

Neonatal Care4

PANDA is the Paediatric Acuity and Dependency Assessment tool.5

Royal College of Nursing (RCN) Defining staffing levels for children and young people’s services:RCN standards for clinical professionals and service managers 2013 revision.

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A&E Band 5 to Band 6 due to junior workforce.

ASH ↑Band 6 by 1.7 wte £79,271 Each shift has HDU nurse per PANDA tool.

ASH ↑Band 5 by 2.0 wte £59,925 PANDA acuity staffing tool requirements.

OAK ↑Band 5 by 1.0 wte £29,962 To meet RCN 2013 guidance given the

increased level of surgical activity.

TOTAL ↓Band 5 by 5.0 wte

↑Band 6 by 9.7 wte

↑ Band 7 by 0.5 wte

↑ Establishment net 5.2

£250,719 Establishment increase of 5.2 wte overall in

order to bring service in line with BAPM

requirements, RCN guidance and the PANDA

acuity tool.

Of the above 0.99 wte is currently unfunded.

1. Re-banding 6.0 NICU posts from Band 5 to Band 6 to meet the BAPM 1:1 acuity

requirement for ITU cots costs £46,396. Having suitably qualified Band 6 nurses

to supervise the area will increase efficient use of the existing cot base so the current

cots can be used at the highest acuity of Paediatric Neonatal ITU care.

2. Increasing Paediatric A&E Band 7 by 0.5wte costing £19,700 for a Clinical

Practice Educator..

3. Re-banding 2.0 Paediatric A&E Band 6 posts from Band 5 to Band 6 to meet the

in-charge nurse requirement costs £15,465 and would bring provision of care

within the Paediatric A&E unit in line with in-charge nurse levels per the guidelines.

4. Increasing Ash Ward Band 6 establishment by 1.7 wte costs £79,271 for HDU

nurse provision per the PANDA acuity staffing tool requirements which would

enable each shift to have an HDU nurse.

5. Increasing Ash Ward Band 5 posts by 2.0 wte costing £59,925 to meet PANDA

acuity staffing tool requirements would bring provision of care on the ward in line

with best practice per RCN guidelines for safe staffing levels in services for children

and young people.

6. Increasing Oak Ward Band 5 posts by 1.0 wte costing £29,962 to meet RCN

2013 guidance would bring provision of care on the ward in line with best practice

guidelines in services for children and young people given the increased surgical

activity.

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7.

Table 2 – Paediatric nursing ward establishment after all changes in Table 1 above

are incorporated

Nursing and

HCA

establishment

(wte)

1 2 3 4 5 6 7 8A Total

wte

ASH & OAK 1.00 12.41 2.72 27.62 13.42 7.52 64.69

NICU 2.15 0.69 12.54 28.59 26.59 7.04 77.60

PAED A&E 8.59 7.37 0.5 1.0 17.46

Total wte 3.15 12.41 0.69 15.26 64.80 47.38 15.06 1.0 159.75

Finance budget as at 20 April 2016 indicates a net funded deficit of 0.99 wte across

the above establishment of 159.75.

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Annex 1 Comparison Table February 2016

Ward Beds % of patientacuity level 1band above

Actual WTE

1

BudgetedWTE

2

CalculatedWTE fromtool3

Total WTE(calculated&additional*)4

Total WTE(calculated&additional*)5

Variance WTE(includingadditional)

(3-5)**

Variance WTE

(2-3)

July2015

Feb2016

July2015

Feb2016

July2015

Feb2016

July2015

Feb2016

July 2015 Feb 2016 July2015**

Feb2016

Feb 2016

AMU*** 38 37% 14.54% 52.77 42.30 60.62 66.49 53.5 42,30 54.9 -1.76 +17.02Aspen 27 20% 53.1% 34.26 38.19 40.48 40.23 31.5 44.38 31.85 44.5 +8.38 -4.27 -4.15BACU 21 83% 85.2% 32.25 34.12 41.06 41.26 35.3 35.69 38.55 38.15 +2.71 +3.11 +5.57Cedar 23 78% 74.5% 36.34 31.90 39.6 32.25 32.2 32.92 34.76 36.10 -2.51 -3.85 -0.67Chaucer 14 62.3% 75.3% 17.20 18.20 17.55 17.55 16.1 21.21 16.56 21.24 -0.99 -3.69 -14.26Cherry 29 52.7% 21.60 28.70 42.96 43.23 -14.53 -3.66Dickens 24 22.4% 00.62% 24.8 25.06 23.6 18.55 24.4 18.96 +0.66 +6.1 +6.51Falcon 22 35% 27.50% 22.0 27.30 29.7 29.54 28 30.08 29.3 31.32 -0.57 -1.38 -0.54Heron 12 59% 15.4% 18.63 17.83 22.24 22.04 17.07 14.25 18.15 16.18 +3.9 +5.86 +7.79Holly 30 61% 52.4% 33.03 28.53 36.24 41.46 44 44.38 45.49 44.67 -6.62 -3.21 -2.92Kingfisher 33 10.3% 33.9% 21.97 25.30 36.14 35.94 38.2 40.93 40.64 42.95 -4.5 -7.01 -4.99Maple 29 88% 95.1% 29.08 28.54 34.77 45.30 48.4 48.90 49.71 49.29 -9.43 -3.99 -3.60May 22 29% 64.1% 25.0 18.50 28.86 27.63 29.5 32.13 31.03 32.38 -3.4 -4.75 -4.50SAU 15 2.5% 02.3% 28.0 26.00 32.1 31.90 15.02 15.61 23.24 24.70 +8.86 +7.2 +16.29Swan 31 71% 62.4% 36.52 41.66 47.4 47.07 48 47.16 -7.52 -5.5 -5.41Swift 26 81% 38.2% 28.7 26.60 36.24 38.87 41 38.28 42.67 38.63 -3.8 +0.24 +0.59SDU &Wren

7 14% 52.7% 15.2 13.20 15.36 18.46 8.6 10.33 8.64 10.57 +6.82 +7.89 +8.13

TotalsOverallWTE

-9.77 -21.78 +17.02

*Additional activity taken into account is escorts, close supervision of patients, deaths and these activities have been converted to WTE**July 2015 calculation took into account budgeted and calculated WTE from agreed staffing following March 2015***Previously MSSU**** New ward not previously included

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Annex 2: triangulation of results including quality and patient safety data.

*This data is collated from Datix for the 20 days of data collection with hospital acquired pressure ulcers including stages 1-4.** This data is collated from the 2015 Acuity and dependency report with 25 days of data collection with hospital acquired pressure soresincluding stage 1-4.

Ward Beds % ofshiftsratedred/amber

%patientacuity1b andabove.

Fallsincidence*

Pressureulcerincidence*

Medicationerrors*

TotalHarms2015**

TotalHarms2016

QEWs** ActualWTE

Budgeted WTE

CalculatedWTE

Variance

AMU 38 76% 14.54% 4 2 3 15 9 1 42.30 66.49 49.47 +17.02Aspen 27 1.6% 53.1% 2 2 2 16 6 2 38.19 40.23 44.38 -4.5

BACU 21 38.3% 85.2% 0 1 1 1 2 1 34.12 41.26 35.69 +5.57Cedar 23 5% 74.5% 2 2 1 7 5 1 31.90 32.25 32.92 -0.67Chaucer 14 5% 75.3% 2 0 0 1 2 2 18.20 17.55 21.21 -3.66Cherry 29 18.3% 52.7% 2 2 3 xx 7 1 21.60 28.70 42.96 -14.26Dickens 24 45% 00.62% 2 0 0 0 2 2 25.06 18.55 +6.51Falcon 22 11.6% 27.50% 0 1 0 10 1 1 27.30 29.54 30.08 -0.54Heron 12 23.3% 15.4% 2 2 1 1 5 1 17.83 22.04 14.25 +7.79Holly 30 66.6% 52.4% 0 0 0 3 0 2 28.53 41.46 44.38 -2.92Kingfisher 33 41.6% 33.9% 0 0 1 3 1 1 25.30 35.94 40.93 -4.99Maple 29 98.3% 95.1% 1 0 0 1 1 2 28.54 45.30 48.90 -3.60May 22 25% 64.1% 0 2 2 5 4 1 18.50 27.63 32.13 -4.50SAU 15 66.6% 02.3% 0 1 0 3 1 2 26.00 31.90 15.61 +16.29Swan 31 48.3% 62.4% 1 4 0 23 5 1 41.66 47.07 -5.41Swift 26 48.3% 38.2% 1 2 2 3 5 2 26.60 38.87 38.28 +0.59SDU & ***Wren

7 6.6% 52.7% 0 2 02 2

1 13.20 18.46 10.33 +8.13

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Annex 3 Staff variances by ward

Ward Beds Total WTE(calculated &additional)

Variance WTE(includingadditional)

VarianceWTE

AMU*** 38

Aspen 27 44.5 -4.27 -4.15

BACU 21 38.15 +3.11 +5.57

Cedar 23 36.10 -3.85 -0.67

Chaucer 14 21.24 -3.69 -14.26

Cherry 29 43.23 -14.53 -3.66

Dickens 24 18.96 +6.1 +6.51

Falcon 22 31.32 -1.38 -0.54

Heron 12 16.18 +5.86 +7.79

Holly 30 44.67 -3.21 -2.92

Kingfisher 33 42.95 -7.01 -4.99

Maple 29 49.29 -3.99 -3.60

May 22 32.38 -4.75 -4.50

SAU 15 24.70 +7.2 +16.29

Swan 31 47.16 -5.5 -5.41

Swift 26 38.63 +0.24 +0.59

SDU &

Wren

7 10.57 +7.89 +8.13