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					Trust Board Integrated
 Performance Report
        6th May 2010




                         |   0
          NUH at a Glance
                                                                               Current                 YTD      Forecast                                                                                                     Last        YTD    Forecast
                                                                                data      Month       (April-     next   Data                                                                                     Month     Period      (April-   next    Data
CLINICAL OUTCOMES                                                   Standard   month      Actual      March)     month Quality   PATIENT EXPERIENCE                                            Standard           Actual    Actual      March) month     Quality
            A&E 4 hour wait target                                   98%       March      99.0%       97%                                        Patients recommend NUH (%)                        N/A                     to come
Access                                                                                                                           Overall
            Access to'GUM' within 48 hours                           98%       March      100.0%       N/A                                       Complaint resp. times (Dec, %)                   90%             Dec 09     89%                  A
            2 week referral to appointment RACP                      96%       March      100.0%     99.8%                                       Patient complaints                              0.06%            March     0.1%                  G
                                                                                                                                                                                                                                                  A
            Succesful Choose and Book                                96%       March       91%        91%                                        Same sex compliance                           Complete                    Complete
            18 weeks referral to treatment - admitted                90%       March      92.8%        N/A                       STAFF EXPERIENCE

            18 weeks referral to treatment - non-admitted            95%       March      98.4%        N/A                                       Appraisal rate                                   70%             March      89%         N/A
                                                                                                                                 Workforce
            # clinical specialties not achieving 18 week target        0       March        3          N/A                                       Sickness rate                                     3%             March     4.09%        N/A
            % spending >90% of their stay on a stroke unit           60%       Q4          70%        77%                                        WTE (actual versus plan)                          tbc            March
            Delayed transfers as a % of admissions                   3.5%      March       1.1%       0.9%                                       Vacancy rate                                      na             March     4.81%        N/A
            Primary Angioplasty within 150 mins                      75%       March       63%         N/A                                       Attendance at compulsory training                75%
            Thrombolysis within 60 mins                              68%       March       71%         N/A                       VALUE FOR MONEY
                                                                                                                                 VALUE FOR MONEY

Cancelled   28 days readmission breaches                              5%       March       9.4%       7.8%                                     Monitor Risk Rating
                                                                                                                                                Monitor Risk Rating                             4 4                3         3
                                                                                                                                 Finance
                                                                                                                                 Finance
Ops
            Last minute non-clinical cancelled ops(elective)        0.80%      March       1.5%      1.60%                                     EBITDA margin
                                                                                                                                                EBITDA margin                                  5%5%              5.2%      6.5%
                                                                                                                  G                            EBITDA achieved                            85% of plan 84.2%                86.5%
Cancer      2 week GP referral to 1st outpatient appointment         93%       Feb        97.3%      94.6%                                       EBITDA achieved                            85% of plan
targets                                                                                                           G                            Return on Assets (%)                             5%             5.0%         5.0%
            31 day diagnosis to treatment                            96%       Feb        98.5%      98.0%                                       Return on Assets (%)                               5%
                                                                                                                  G
                                                                                                                                               I&E Surplus margin                               1%             1.3%         1.0%
            31 day second or subsequent treatment (drug)             98%       Feb        100.0%     98.3%                                       I&E Surplus margin                                 1%
                                                                                                                  G
                                                                                                                                               Liquidity ratio (days)                      15 days               1            1
            31 day second or subsequent treatment (surgery)          94%       Feb        100.0%     96.4%                                       Liquidity ratio (days)                         15 days
                                                                                                                                                                                           within 0.5% of
                                                                                                                                               Total income (actual versus plan)                within 0.5% of 6.2%
                                                                                                                                                                                                plan                        1.8%
            62 days urgent referral to treatment                     85%       Feb        86.7%      80.5%        G                              Total income (actual versus plan)                   plan
                                                                                                                                               Pay Expenditure (actual versus plan)       At or below plan     2.7%         0.1%
            62 day referral to treatment from screening              85%       Feb        93.5%      94.1%        G                              Pay Expenditure (actual versus plan)         At or below plan
                                                                                                                                               Non pay Expenditure (actual versus plan)   At or below plan   17.80%        9.10%
            62 day referral to treatment from hospital specialist    85%       Feb        100.0%     86.2%        G                             Non pay versus plan)
                                                                                                                                               CIP (actual Expenditure (actual versus plan)above plan 16.3%
                                                                                                                                                                                           At or below plan
                                                                                                                                                                                       At or                                0.0%
                                                                                                                                                                                           within 0.5% of
            Urgent referals for breast symptoms                      93%       Feb         99.2%     97.9%        G                             CIP (actual versus plan)
                                                                                                                                               Capex(actual versus plan)                      At or above plan
                                                                                                                                                                                                plan            37.1%      (6.7%)
                                                                                                                                                                                               within 0.5% of
Patient     Hospital standardised mortality ratio (all diagnoses)     100      Jan         97.1       91.7        G              Efficiency     Capex (actual versus plan)                      plan
                                                                                                                                               Theatre usage (%)                            80.0%                March     72.0%        71.0%
Safety                                                                                                                           and
                                                                                                                                 Efficiency
            HSMR - basket of 56 diagnosis groups                      tbc      Jan         98.2       92.0        G              Utilisation    Theatre usage
                                                                                                                                               Bed occupancy (%)                               80%
                                                                                                                                                                                             tbc                  March
                                                                                                                                                                                                                 March       72%
                                                                                                                                                                                                                           90.1%         71%
                                                                                                                                 and
            Number of patient slips, trips, falls and incidents       tbc      Jan        0.65%        N/A                       Utilisation    Bed occupancy
                                                                                                                                               ALOS (Elective)                                   tbc
                                                                                                                                                                                               tbc                March
                                                                                                                                                                                                                 March      90.1%
                                                                                                                                                                                                                            3.46
            Clostridium difficile (NUH acquired)                      tbc      March        24         191                                     ALOS (Non elective)
                                                                                                                                                ALOS (Elective)                                tbc
                                                                                                                                                                                                 tbc             March
                                                                                                                                                                                                                  March     4.74
                                                                                                                                                                                                                             3.46
            MRSA (Number of cases NUH acquired)                        1       March        2          21                                      ALOS (Elective pre op bed nights)
                                                                                                                                                ALOS (Non elective)                            tbc
                                                                                                                                                                                                 tbc              March    to 4.74
                                                                                                                                                                                                                              come

            Screening all elective in-patients for MRSA              90%       Feb        94.0%        N/A                                     Agency spend (% of pay) bed nights)
                                                                                                                                                ALOS (Elective pre op                          1%tbc             3.6%      3.4%
                                                                                                                                                                                                                           to come

            Number of SUI's                                           0        March        1                                                    Agency spend (% of pay)                           1%
            Number of emergency readmissions within 28 days           tbc                 to come

            Diagnostic waiters, 6 weeks and over-QDIAG                 0       March        2          422                                       NHS Performance Framework                                        March    Performing
Other                                                                                                                            Perspectives
            Diagnostic waiters, 6 weeks and over-DM01                 0        March        0          53                                        CQC Indicators                               Under Development
            % coding completeness within 5 days                      90%       March      95.0%        N/A                                       CQUIN                                        Under Development
            Ethnic coding of inpatients                              85%       March      92.0%        N/A


Legend / key                                                                   Data Quality indicator                                                                         Not sufficient
 Forecasts                                                                                          Judgment of Executive Director
                                                                                                                                                                              Sufficient
 R A G Shows whether next month’s                                                        Granularity                                       Timeliness
                 position will meet the standard                                                                                                                              Exemplary
                                                                                    Completeness                                           Audit                              Not yet                                                                              1
                                                                                                                                                                              assessed
                                                                                                                                                                                                                                                               |
                                                                                       Validation                                           Source
       Escalation pages (1/4)
Successful Choose and Book appointments                                              Indicator level      1   Standard March     YTD    Forecast
% of successful Choose and Book referrals to appointments booked via the Telephone Appointment Line,          96%
over number of TAL slots
                                                                                                                       91%    91%      A
What is driving the reported
underperformance?                        What actions have we taken to improve performance?
▪ General reduction across services ▪ Ophthalmology - A referral refinement pathway for NHS
   of slots availability over the Easter   Nottingham City went live on 4th Jan and NHS Notts County
   bank holiday period.                    referral pathway will live by 30th April 2010. A triage service
▪ Ophthalmology – impact of                went live from March for Nottingham City PCT – limited
   significant increase in referrals       success made date.
   following the change in Royal         ▪ ENT: Shortage of specialised staff. New staff due to
   College referral guidance.              commence in post over period of the next 2 months.
                                         ▪ Work continues with PCTs to redirect appropriate referrals
                                           into the appropriate community based service. Referral
                                                                                                           Expected date
                                           criteria are agreed and the pathways for the Nottingham Back
                                                                                                           to meet standard September 2010
                                           Care Team, Pain Management and Spinal Service have now
                                           also been agreed.                                               Lead Director    Michelle Rhodes
Breaches of the 28 day readmissions guarantee                                        Indicator level      1   Standard March     YTD    Forecast
% patients whose operation was cancelled, by the hospital, for non-clinical reasons, on the day of or after
admission, treated within 28 days
                                                                                                                5%       9.4%    7.8%        A
What is driving the reported
underperformance?                      What actions have we taken to improve performance?
•   Bed and theatre capacity              ▪   Weekly reviews of reasons for cancelled operations is
                                              highlighting any emerging trends. This is enabling
                                              appropriate actions to be taken, for example reviews of
                                              theatre scheduling




                                                                                                              Expected date
                                                                                                              to meet standard   July 2010
                                                                                                              Lead Director      Michelle Rhodes

                                                                                                                                                   |   2
      Escalation pages (2/4)
Screening all day case patients for MRSA                                                Indicator level         2   Standard   March   YTD     Forecast
Screening of all day case patients for MRSA; exclusions currently includes Children, Radiology, ophthalmic,           90%
Routine Obstetrics, Termination of Pregnancies, Pain management, Endoscopy, Minor Dermatology
                                                                                                                                75%      N/A

What is driving the reported
underperformance?                          What actions have we taken to improve performance?
▪ Certain areas continue to develop        ▪ Underperforming areas identified and being performance
  systems and practices to allow             managed via the Infection Control Operational Group
  screening of all day cases               ▪ Clinical Leads have developed Action plans to ensure greater
▪ Due to screening and clinical coding       compliance in future months
  data there is a two month gap which
  may not reflect improvement made
  until later data is released


                                                                                                                    Expected date
                                                                                                                                       June 2010
                                                                                                                    to meet standard
                                                                                                                    Lead Director      Stephen Fowlie

Screening all emergency patients for MRSA                                               Indicator level         2   Standard   March   YTD     Forecast
Screening of all relevant emergency admissions for MRSA 'Relevant emergency admissions' is currently defined           90%
as excluding all children
                                                                                                                                58%      N/A       A
What is driving the reported
underperformance?                          What actions have we taken to improve performance?
▪   This does not become a reportable      ▪   Work is being undertaken to ensure that the lab capacity is in
    national target until 31st December        place. Once completed clinical areas will be asked to
    2010                                       commence screening all emergency admissions
▪   Currently NUH screens all emergency
    patients admitted to surgical wards.
    At present there is not the lab
    capacity to process the increased
    swabs to extend to other clinical
    inpatient areas
                                                                                                                    Expected date
                                                                                                                                       December 2010
                                                                                                                    to meet standard
                                                                                                                                                   |    3
                                                                                                                    Lead Director      Stephen Fowlie
      Escalation pages (3/4)
Diagnostic waiters (number waiting 6 weeks and over) - as reported in QDIAG             Indicator level        1   Standard   March    YTD     Forecast
# patients waiting over 6 weeks for diagnostic procedures in endoscopy, imaging, pathology and physiological
                                                                                                                       0           2     N/A
measurement
What is driving the reported
underperformance?                          What actions have we taken to improve performance?
▪ Visual electo diagnostic - Ophthalmic    ▪ Admin and process procedures reviewed and amended to avoid
  Science - Delayed referral due to          any recurrence
  Admin error
▪ Nerve conduction test -                  ▪   Issue has been taken forward with Kings Mill for them to ensure
  Neurophysiology. Delayed referral            systems are reviewed and revised
  received from Kings Mill



                                                                                                                   Expected date
                                                                                                                                       April 2010
                                                                                                                   to meet standard
                                                                                                                   Lead Director       Michelle Rhodes
Primary Angioplasty within 150 mins                                                     Indicator level        1   Standard   March    YTD     Forecast
Patients receiving Primary Angioplasty within 150 mins                                                                75%      63%       N/A        A
What is driving the reported
underperformance?                          What actions have we taken to improve performance?
▪ This is a jointly owned target with      ▪ We will be operating a 24 hour service in September before
  EMAS and the long delays for March         which we are planning to work with colleagues at a 'productive
  have been experienced in the call to       cath lab‘
  door times not door to perfusion         ▪ A project manager has been appointed to start in May.
                                           ▪ We will instigate regular performance meetings with our
                                             colleagues from EMAS as we plan to move towards full
                                             operational 24/7.
                                           ▪ We also need to ensure that the data capture is accurate and in
                                             line with MINAP guidelines, we have put in an audit officer for       Expected date
                                             PPCI within the business case to ensure the accuracy of data                              September 2010
                                                                                                                   to meet standard
                                             being used for this indicator
                                                                                                                   Lead Director       Michelle Rhodes

                                                                                                                                                    |    4
      Escalation pages (4/4)
Patient complaints responded to within agreed time                                 Indicator level      1   Standard   March   YTD       Forecast

% patient complaints responded to within agreed timescale                                                     90%       89%

What is driving the reported
underperformance?                      What actions have we taken to improve performance?
▪ Matrons and Clinical Leads have been ▪ During this period the Complaints Lead has provided addition
  supporting the increased operational   support by reviewing and editing response letters for those
  activity during the winter months,     directorates where timelines have been more difficult to achieve
  which has led to challenges in
  delivering timely responses




                                                                                                            Expected date
                                                                                                                               June 2010
                                                                                                            to meet standard
                                                                                                            Lead Director      Jenny Leggott
% theatre usage over past month                                                    Indicator level      1   Standard   March   YTD       Forecast

Specialty Usage of Session Time                                                                               80%       72%      71%         A
What is driving the reported
underperformance?                         What actions have we taken to improve performance?
▪ Session utilisation (due to cancelled   ▪    Productive elective specialty (Better for you)
  list)                                   ▪    Performance management framework
▪ In session utilisation                  ▪    Cancellation fees
▪ Theatre closure




                                                                                                            Expected date      Incremental as Better
                                                                                                            to meet standard    for You rolls out

                                                                                                            Lead Director
                                                                                                                                             |
                                                                                                                               Michelle Rhodes
                                                                                                                                                   5
      The In-Depth Review: Cancelled ops
  Cancelled ops
  % of last minute elective cancellations for non-clinical reasons. Last minute means on the day the patient was due to arrive, or after the patient has
  arrived in hospital, or on the day of operation
  Cancellations by Directorate % per directorate in Mar 10                         Cancellations Trend                                       Number of cancellations
                                         Cancer and                                Number per month                                          Number of 28 Day breaches
     Thoracic and 12%              14% associated specialities
     digestive                                     Diabetic, infection,               200                                                                174
     diseases                                      renal and
                                              6%
                                                                                      150                                                    141                    128
                                                   cardiovascular                                             124 119                  122
                                                      1% Diagnostics and                           102 94                     98
                                 38                                                                                                                            121
                                                  6%      clinical support            100                                                          102
                                                          Family health               50                                 65
                                                                                                       12     14 10                                            18
      Musculo-
                                                                                                   8                     4        4     7     9     5    5            12
                                                  10% Head and neck
      skeletal                                                                           0
      and neuro-                                                                             Mar       May        Jul         Sep            Nov         Jan          Mar
      sciences   51%
                                                                                                                 2009                                          2010
  Reasons for Cancellations Number                                        Mar 10                                              Agreed corrective actions (planned
  Complications Previous Patient                      1
                                                      1                   Feb 10 Issues causing underperformance              and commenced)
                                                      2
  Emergencies/Trauma                                  3                           ▪ Cancellations in March were due           ▪       Revised processes and procedures
  Surgeon Unavailable                                 2                              largely due to lack of ward beds                 to be followed have been finalised
                                                          10
  Other                                                3                             available due to D&V virus City                  with directorates
                                                       4
  Equipment Failure/Unavailable                        3
                                                        6
                                                                                     Campus (Lister ward) and at              ▪       Weekly PLT meeting set up to look
                                                       5                             QMC (D8), in addition to                         at reasons for cancellations
  Medical/Anaesthetist/Theatre staff unavailable       3
  Replaced By Urgent Case                               7
                                                                                     Operating list over runs.                ▪       Directorate level trajectories have
                                                       4                             Scheduling of Operating lists                    been set up
  Theatre Time Unavailable                                11                         being reviewed to ensure
                                                        7
                                                          12                                                                  ▪       Performance management
  No ICU/HDU Beds                                         10                         effective utilisation of lists by
                                                                                                                                      framework in place
  List Overrun                                              18                       Directorates
                                                           14
  Ward Bed Unavailable                                                   63
                                                                        59

 Indicator                                    Latest                                         Signed off by:           Expected date to             Plan for next Board
              Red       Amber Green                              YTD          Forecast
 level                                        performance                                                             meet standard:               report:
                        0.8% -                                                               Michelle Rhodes          0.8% in month for Dec        July 2010
  1           >1.5%                   <0.8%   1.53%              1.6%         Amber
                        1.5%                                                                                          10 – Mar 11                                      |    6
SOURCE: ORMIS, PAS, HISS, Information team
               The In-Depth Review: 18 week
Number of treatment functions which are failing the 18 week admitted or non-admitted targets
The number specialties with <85% of eligible admitted patients whose adjusted RTT clock stopped in 18 weeks or less (<127 days) or <90% of eligible non-
admitted patients whose RTT clock stopped in 18 weeks or less (<127 days)
                                                                                                                         Month
                                                                                                             Standard Actual # Treated Breaches
    Trauma and Ortho                                          Capacity
Non admitted




                                                                                  Patient choice                  Admitted: Spines           90%        74.9%      203      51
                        Spines                                                    Hospital cancellation
                                                                                                                  Admitted: Trauma and       90%        84.0%      463      74
                                                                                  Diagnostic delay                Ortho
                  Maxillo Facial
                                                                                  Complex case                    Admitted: Neurosurgery     90%        79.2%      48       10
                  Neurosurgery                                                    Non in patients best interest
                                                                                  Medically unfit                 Admitted Maxillo Facial    90%        81.0%      84       16
                  Maxillo Facial
                                                                                  Process delays                  Non admitted:              95%        82.6%      69       12
Admitted




                  Neurosurgery                                                    late tertiary referral          Neurosurgery
                                                                                  Patient non cooperation         Non admitted: Spines
               Trauma and Ortho                                                                                                              95%        91%        267      24
                                                                                  Admin error
                                                                                  Other                           Non admitted: Trauma and   95%        94.1%      236      14
                        Spines
                                                                                                                  Ortho
                                   0         20        40       60           80                                   Non admitted: Maxillo      95%        92.6%      444      33
                                                                                                                  Facial
                            Issues causing underperformance      Agreed corrective actions (planned and commenced)
       Spines               Bed and theatre capacity                 Funding approved to open 6 beds
                                                                     Additional spinal theatre capacity

        Trauma and Ward closure due to D&V virus                     Patients moved out to the private sector
        Ortho      Consultant sickness leave                         Beds opened on a temporary basis to allow more electives admissions
                                                                     Review of administration services within the specialty


        Neuro-              Bed and theatre capacity             Imminent appointment of locum neurosurgeon.
        surgery                                                  Use of private sector
                                                                 Additional capacity


        Maxillo             Reduction in day case procedures         All daycase beds now open
        Facial              Cancer surgery has been extremely        Additional consultant capacity
                            active in the first quarter

Indicator                                               Latest                                                Signed off by:         Expected date to       Plan for next
                        Red            Amber Green                         YTD              Forecast
level                                                   performance                                                                  meet standard:         Board report:
                                                                                                                                                                            |    7
1                       1              N/A        0     3                  N/A              Red               Michelle Rhodes        September 2010         July 2010
       The In-Depth Review: Sickness Rate
Sickness Rate



    Sickness Rate %                                                            Sickness Rate per Directorate % Mar-10




Issues causing underperformance                 Agreed corrective actions (planned and commenced)
•The Trust has made significant progress with   •Robust sickness management policy in place
reducing sickness absence, with an underlying
downward trend.                                 •Closer scrutiny on 2 areas reporting highest sickness

•Directorates continue to work towards the      •Ongoing monitoring of all sickness absence Trust-wide
challenging Trust target of 3% sickness by
March 2011                                      •Further escalation methods being considered


Indicator                              Latest                                Signed off by:          Expected date to   Plan for next Board
             Red      Amber Green                    YTD        Forecast
level                                  performance                                                   meet standard:     report:
1            3.5%     3-3.5%   3.0%    4.09%         N/A        Red          Danny Mortimer          March 2011         Monthly
                                                                                                                                        |     8
Projected Improvement Trackers
62 days urgent referral to treatment of all cancers                 Actions taken and lessons learnt
% of patients receiving first definitive treatment within 62-days
following referral from an NHS Cancer Screening Service during
                                                                    ▪   Specialties produce a Root Cause Analysis report to understand the cause of
a given period                                                          their breaches. This is presented at the weekly Cancer PTL meeting.
                                                                    ▪   There is Directorate Management representation at the Cancer PTL, with
Standard            85%                                                 Directorates feeding back on patients. This has improved the lines of
                                                                        communication and accountability.
Month escalated May 09                                              ▪    A red alert system for cancer diagnostic referral requests has been
Performance                                                             implemented both at NUH and Treatment Centre with a maximum 5 days
                    77.9%                                               turnaround time for tests.
when escalated
                                                                    ▪   The majority of Patient Navigators are now working within the specialty areas,
Latest period       86.7%                                               which has improved clinical engagement as well as identifying where potential
                                                                        problems exist with the patient’s pathway.
YTD                 80.5%                                           ▪   Patient pathways for each tumour site have been reviewed and bottle necks
                                                                        identified. The new pathway are currently being agreed and signed off by the
Lead Director       Michelle Rhodes                                     Clinical Leads.
                                                                    ▪   A daily PTL has been developed with all 62 day patients from day 1 of entering
                                                                        the pathway. Specialties have received training on how to use and access this
                                                                        report.


A&E 4 hour wait target                                              Actions taken and lessons learnt

% of patients spending four hours or less in all types of A&E       ▪   Implemented actions from national emergency care intensive support review
department, until discharge/ admission/ transfer
                                                                    ▪   Additional senior mangers support to patient flow process
Standard            98%
                                                                    ▪   Additional clinical start in ED and admission wards
Month escalated Aug 09
Performance
                                                                    ▪   Development programme for advance nurse practitioners
                    97%
when escalated
                                                                    ▪   Additional winter beds
Latest period       99%

YTD                 97%

Lead Director       Michelle Rhodes                                                                                                                      9
                                                                                                                                                 |
      Appendix 1: NHS Performance Framework
      Indicators 2009/2010
        YTD - Year to Date, MA - Monthly Actual                                                                                                     Standards & Targets                         Thresholds
                                                                                                                             CURRENT
                                                                                                                                                                      Weighted
        Weight                                                      Indicator                                                  DATA  Perform ance         Score
                                                                                                                                                                       score
                                                                                                                              MONTH                                                      Achieve           Fail
          1.00    A&E Type 1 & 2 (Trust) waiting time (% within 4 hours from arrival to discharge/ admission/ transfer)      Mar YTD         97%            2             2.0             98%              97%
          1.00    Breaches of 28 days readmission guarantee as % of cancelled ops                                            Mar YTD        7.8%            2             2.0              5%              15%
          1.00    MRSA (Number of cases)                                                                                     Mar YTD         21             3             3.0             45.0             46.0
          1.00    Clostridium difficile (number of cases - NUH Acquired)                                                     Mar YTD         191            3             3.0             240.0           241.0
          1.00    18 weeks referral to treatment time - admitted                                                              Mar MA        92.8%           3             3.0             90%              85%
          1.00    18 weeks referral to treatment time - non-admitted                                                          Mar MA        98.4%           3             3.0             95%              90%
          0.50    18 weeks RTT - Number of specialties not achieving 18 week standards (excluding Orthopaedics/               Mar MA          2
                                                                                                                                              3             3             1.5               5                9
                  including DA Audiology)*
          0.50    Non-achievement of 18 week referral to treatment standards in Orthopaedics                                  Mar MA          2             0             0.0               0                1
          1.00    Breaches of 3 month wait target for revascularisation (as % of admissions for revascularisation)           Mar YTD         0%             3             3.0            0.10%            0.20%
          1.00    % of patients meeting 2 week target (referral to appointment): Rapid Access Chest Pain Clinic (RACP)       Mar YTD        99.8%           3             3.0             98%              95%
          1.00    Access to Genito-urinary medicine clinic 'GUM' (48 hour referral to appointment)                            Mar MA        100%            3             3.0             98%              95%
          1.00    Delayed transfers as % of admissions                                                                        Mar MA        0.9%            3             3.0             3.5%             5.0%
          1.00    2 week GP referral to 1st outpatient, cancer                                                               Feb YTD         95%            3             3.0             93%              88%
          0.33    31 day diagnosis to treatment for all cancers                                                              Feb YTD         98%            3             1.0             96%              91%
          0.33    31 day second or subsequent treatment (drug)                                                               Feb YTD        98.3%           3             1.0             98%              93%
          0.33    31 day second or subsequent treatment (surgery)                                                            Feb YTD        96.4%           3             1.0             94%              89%
          0.33    62 days urgent referral to treatment of all cancers                                                        Feb YTD         81%            2             0.7             85%              80%
          0.33    62 day referral to treatment from screening                                                                Feb YTD        94.1%           3             1.0             90%              85%
          0.33    62 day referral to treatment from hospital specialist                                                      Feb YTD        86.2%           3             1.0             85%              80%
          1.00    Patients that have spent more than 90% of their stay in hospital on a stroke unit                          Quarter 4
                                                                                                                                             70%            3             3.0             60%              30%
                                                                                                                             (2009-10)
          0.50    Outpatient breaches as % of first outpatient attendances                                                   Mar YTD         0%             3             1.5            0.03%            0.15%
          0.50    Inpatient breaches as % of elective admissions                                                             Mar YTD         0%             3             1.5            0.03%            0.15%
                                                                                                                                                                                44.1
        * awaiting full confirmation of calculation from Strategic Health Authority but expect full achievement currently.
                                                                                                                                         Current performance total:                    Upper            Lower
                                                                                                                                                         2.76                                    2.40             2.10
                  Current performance rating:                                                                                                         Performing
Standards and targets:                                                                                                                                                                                                   | 10
SOURCE: NHS Performance Framework Implementation Guidance (Annex 1: Operation Standards and targets indicators acute trusts - June 2009)

				
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