Wirral Primary Care Trust � Commissioning and Performance

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					                                                                                                                           Agenda Item: 7
                                                                                                                          Ref: W08-09/043
                                                         Wirral Primary Care Trust

                                             EXECUTIVE PERFORMANCE DASHBOARD
Key Target 1 - 18 Week Referral to Treatment Time (Cathy Gritzner – Executive Lead)


Key Metrics               Current Performance           Trend           Forecast                               Commentary
                                (Target)                          Performance (Target)
                                                                                         WUTH achieved the March 18 week RTT milestones for
Inpatient RTT less than                                                                  both inpatients (85%) and outpatients (90%). The next
                                85% (85%)                     +        85% (85%)         challenge for WUTH is to consolidate this position and
       18 weeks
                                                                                         move to the December 2008 milestones (90% for inpatients
                                                                                         and 95% for outpatients). In order to facilitate this process
                                                                                         the DoH Intensive Support Team visited WUTH on
                                                                                         28/04/08. The feedback from the visit was extremely
                                                              +                          positive and highlighted a number of issues that needed
  Outpatient RTT less
                                90% (90%)                              90% (90%)         further attention to ensure achievement of December’s
    than 18 weeks                                                                        targets. These include the implementation of a full RTT
                                                                                         PTL; reducing unknown clock starts; and the
                                                                                         implementation of the Inter Provider Transfer DSCN. All
                                                                                         these issues will be addressed through the 18 week Board.



Key Target 2 – MRSA/Clostridium Difficile (Katy Kidd – Executive Lead)


Key Metrics               Current Performance           Trend           Forecast                               Commentary
                                (Target)                          Performance (Target)
                                                                                         The PCT has agreed to fund a plan to screen all
                                                                                         admissions to WUTH for MRSA. Furthermore, following the
        MRSA                      26 (15)                 -               26 (15)        upward trend in C-DIFF an improvement plan has been put
                                                                                         in place across the health economy approved by the PCT
                                                                                         Medical Director with responsibility for Infection Prevention
                                                                                         and Control, WUTHs Director of Infection Prevention and
                                                                                         Control and Consultant Microbiologist. The plan will invest
        C-DIFF                   516 (367)                -              516 (367)       in nursing staff, training and equipment (e.g. non-porous
                                                                                         chairs) to reduce C-DIFF levels and has been signed off by
                                                                                         the SHA. Also the WUTH are now subject to weekly SHA
                                                                                         performance monitoring.



Executive Performance Dashboard: Board Meeting 10 June 2008                                                                                        1/6
Wirral PCT                                                                                                                         Agenda Item: 7
                                                                                                                                   Ref: W08-09/043



Key Target 3 – Community Matrons (Tina Long/John South – Executive Leads)


Key Metrics                Current Performance          Trend         Forecast                               Commentary
                                 (Target)                       Performance (Target)
                                                                                       The PCT has achieved both HCC targets - case managers
                                                                                       and VHIUs. This is the result of the project team that has
                                                                                       been established (led by Tina long and Abhi Mantgani) and
Number of Community                                                                    implemented an agreed action plan. The key elements of
                                  35 (35)                 +            35 (35)
     Matrons                                                                           the plan included:
                                                                                       - recruitment of the full provision of case managers (35
                                                                                         W.T.E.)
                                                                                       - an agreed specification of case management and VHIUs
                                                                                       - identification and recording of all VHIUs case managed
                                                                                         across the health economy
                                                                                       - the introduction of Health Dialog to facilitate the
                                                          +                              identification of VHIUs and possible management in the
  Number Of Very High                                                                    community
                               2,838 (2,810)                        2,966 (2,810)
Intensity Users (VHIU’S)                                                               - weekly performance management at CDG of both targets
                                                                                         against the agreed recovery plan




Key Target 4 – Achieving Financial Balance (Russell Favager – Executive Lead)


Key Metric                 Current Performance          Trend        Forecast                                Commentary
                                                                   Performance

                                                                                       The PCT delivered a surplus of £9.7 million at the end of
                                                                                       the year. This is within the £10 million control total set by
                                                                                       the SHA. The surplus will be available to the PCT in future
   Financial Balance          £9.7m (surplus)                      £9.7m (surplus)     years as part of long term financial planning strategy.




Executive Performance Dashboard: Board Meeting 10 June 2008                                                                                      2/6
Wirral PCT                                                                                                                        Agenda Item: 7
                                                                                                                                  Ref: W08-09/043



Key Target 5 – Integrated Unplanned Care Services (Cathy Gritzner – Executive Lead)


Key Metrics               Current Performance           Trend         Forecast                               Commentary
                                (Target)                        Performance (Target)
                                                                                       Following two successful urgent care away days (whole
 A & E % Less Than 4                                                                   system events led by Shyamal Mukherjee) to discuss the
                                98.24 (98%)                            98% (98%)
        Hours                                                                          findings of the Utilisation Review of Emergency Admissions
                                                                                       at WUTH, key priorities for in hospital and out of hospital
                                                          +                            work streams were identified. These priorities have been
                                                                                       incorporated into an Urgent Care Development plan which
     A & E Activity           88,021 (86,944)                        88,021 (86,944)   was presented and agreed at the Wirral Urgent Care
                                                                                       Network (26/10/07) an the PEC (13/11/07). Timescales and
                                                                                       leads have been agreed for each element of the plan and
                                                                                       KPIs are under development to support the performance
                                                                                       management of this plan.
 Non Elective Activity        47,823 (46,435)                        47,823 (46,435)

                                                          +



Key Target 6 – Continuing Health Care (Tina Long - Executive Lead)


Key Metric                Current Performance           Trend         Forecast                               Commentary
                                (Target)                        Performance (Target)
                                                         +
                                                                                       The under spend against plan is due to a contingency of
                                                                                       750K to meet the implications of the new National
                                                                                       Framework and the introduction of a single band for
Continuing Health Care         £5.7m (£6.8m)                         £5.7m (£6.8m)     nursing, which relates to 600K to year end (and £1.2 million
                                                                                       next year). In addition there is the possibility of further
                                                                                       restitution claims in light of DoH guidance and a cohort of
                                                          +                            high band patients that may become eligible for CHC.




Executive Performance Dashboard: Board Meeting 10 June 2008                                                                                     3/6
Wirral PCT                                                                                                                          Agenda Item: 7
                                                                                                                                    Ref: W08-09/043



Key Target 7 – Medicines Management (John South – Executive Lead)

Key Metric                Current Performance           Trend         Forecast                                Commentary
                                (Target)                        Performance (Target)

                                                                                       The Prescribing (%) of low cost statins is improving
                                                                                       (increase of 0.8% between Q1 & Q2) but there is still a
                                                                                       significant productivity opportunity of £1.06million (as at Q2
                                                                                       07/08). This compares with a productivity opportunity of
                                                                                       £350K in Q1. This increase in the productivity opportunity
                                                                                       between Q1 and Q2 is the result of the upper quartile
                                                                                       percentage increasing from 69% to 77%. The Medicine
Percentage of Low Cost                                                                 Management Team anticipate further improvements during
                                65.3% (77%)                            77% (77%)
  Statins Prescribed                                                                   quarters 3 and 4. This will be achieved through targeting
                                                                                       practices with the greatest potential contribution, further
                                                          +                            patient reviews and the impact of Scriptswitch
                                                                                       (automatically recommends approved statins) in 58
                                                                                       practices since August 2007. Still awaiting publication of Q3
                                                                                       information by the NHS Institute for Innovation &
                                                                                       Improvement. This is due to SUS data quality issues, which
                                                                                       have delayed publication of all indicators.

Key Target 8 – Electronic Staff Record (Jo Harvey – Executive Lead)

Key Metric                Current Performance           Trend           Forecast                              Commentary
                                                                      Performance
                                                                                       Implementation of the ESR has been fully achieved. A
                                                                                       project plan was established and appropriate resources
                                                                                       assigned. There have been 4 readiness assessments
                                                                                       undertaken throughout the year, which have been
                                                          +                            submitted to the SHA. All have been completed
                                                                                       successfully. Executive sponsors signed off the final
Electronic Staff Record                                                                assessment on 25 January and the system went live on 4
                               100% (100%)                            100% (100%)
         (ESR)                                                                         February. All key data has been successfully transferred
                                                                                       and the system is now being used by HR. The first payroll
                                                                                       run will be for February salaries. The project will now move
                                                                                       into a second phase – benefits realisation. Still awaiting
                                                                                       publication of Q3 information by the NHS Institute for
                                                                                       Innovation & Improvement. This is due to SUS data quality
                                                                                       issues, which have delayed publication of all indicators.


Executive Performance Dashboard: Board Meeting 10 June 2008                                                                                       4/6
Wirral PCT                                                                                                                        Agenda Item: 7
                                                                                                                                  Ref: W08-09/043



Key Target 9 – Practice Based Commissioning (John South – Executive Lead)


Key Metrics               Current Performance           Trend        Forecast                               Commentary
                                                                   Performance

                                                                                       The PBC schemes demonstrated a significant under
                                                                                       performance against budget for 2007-08. The budget
                                                                                       encompasses all WUTH PBR activity and prescribing
      PBC Budget              £2.3m (Saving)                       £2.3m (Saving)
                                                                                       budget.


                                                          +


Key Target 10 – Mental Health (Tina Long – Executive Lead)


Key Metric                Current Performance           Trend         Forecast                              Commentary
                                (Target)                        Performance (Target)
                                                                                       As a consequence of sustained effort and increased
                                                                                       capacity (7% increase achieved through productivity gains)
                                                                                       there are currently only 16 patients waiting longer than 18
                                                                                       weeks for psychological therapies in Wirral at the end of
 Improving Access to
                                                                                       March. However, a significant increase in the number of
Psychological Therapies        98.1% (100%)                         98.1% (100%)
                                                                                       new referrals (16.6%) between February and March has
   (IAPT) – 18 weeks
                                                          +                            resulted in the 100% target not being achieved.




Executive Performance Dashboard: Board Meeting 10 June 2008                                                                                    5/6
Wirral PCT                                                                                                                 Agenda Item: 7
                                                                                                                           Ref: W08-09/043

Key Target 11 – Life Expectancy (Jane Harvey – Executive Lead)


Key Metric                Current Performance           Trend      Forecast                          Commentary
                                                                 Performance
                                                                               The Public Sector Agreement (PSA) target for improving
                                                                               the health of the population and reducing inequalities aims
                                                                               to “reduce by at least 10% the gap in life expectancy
                                                                               between the fifth of areas with the worst health and
                                                                               deprivation indicators and the population as a whole by
                                                                               2010”. The All Age All Cause Mortality (AAACM) rate per
                                                                               100,000 will be used on an annual basis to evaluate
                                                                               progress against this target. The specific target for this
  All Age All Cause
                                                                               indicator is currently under negotiation as part of the Vital
Mortality (AAACM) Rate              641                             TBC
                                                                               Signs process and will be monitored on a quarterly basis by
      per 100,000
                                                                               the SHA/DoH. As a proxy performance indicator for the
                                                                               PCT AAACM will be monitored on a monthly basis using a
                                                                               36 month rolling average of Wirral deaths. However, it is
                                                                               important to recognise that monthly variations in the
                                                                               AAACM rate are not statistically significant and need to be
                                                                               viewed over a longer time period (e.g. yearly). The ACCM
                                                                               rate per 100,000 is currently 641 and is consistent with rate
                                                                               for the previous 3 calendar years.




Executive Performance Dashboard: Board Meeting 10 June 2008                                                                              6/6

				
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