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72 Appendix 2 - Welcome To NHS Highland

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									NHS HIGHLAND BALANCED SCORECARD 2008/09

TOTAL NHS HIGHLAND                                                                                                                                                                                                                                                                    2008

                                                                                                                                    Reporting Periods
Indicator    HEAT Measure & Detail                                                                                                                                                              Date of     Trajectory                                                          Comments
                                                                                                                                  Latest Reported Period
                                                                                                                                                                                                outurn      endpoint
Health Improvement                                                                          Outturn                        Trajectory 2008/09
             Health Inequalities - CHD
             Reduce mortality rate from CHD among the under 75's in deprived areas to                                                                                                                                      Target=improve rate in most deprived by 15%. Rate based
H1.KPM1      81/100,000 by 2009/11                                                          102                                                                                        90       2006       2007-2009                             on few deaths - 5 or less per annum.
             Dental Registrations                                                                                                                                                                          Jan-Mar
H2.KPM1      80% of 3-5 years olds to be registered with an NHS Dentist by 2010/11          61%                     66%                   68%                     69%                  70%      New target 2009                     % of 3-5 year olds registered with an NHS Dentist
             Health Weight of Children                                                                                                                                                                                           The number of 7-13 year olds completing the Scottish
             Achieve agreed completion rates for child healthy weight intervention                -                                                                                                                                 Government approved healthy weight intervention
H3.KPM1      programme by 2010/11                                                                                                                                                      406      New target 2008/09                                                        programmes
             Alcohol Brief Interventions
             Achieve agreed number of screenings in line with SIGN 74 guidelines by               -
H4.KPM1      2010/11                                                                                                                                                                   2988     New target 2008/09
             Suicide Prevention
             50% of key frontline staff educated & trained in using suicide                                                                                                                                                50% of key staff trained in suicide prevention relative to the
H5.KPM1      assessment/prevention programmes by 2010.                                      24%                                                                                        37%      New target 2008/09                            established baseline and learning levels.
             Smoking Cessation
             8% of smoking population successfully quitting (at one month post quit) from         -
H6.KPM1      2008/09 to 2010/11.                                                                                                                                                       1648     New target 2008
             Breast Feeding at 6-8 Weeks                                                                                                                                                                                  Number of babies recorded as being exclusively breastfed at
             New-born exclusively breastfed at 6-8 weeks to increase from 26.6% in                                                                                                                         Jan-Mar           their 6-8 week review as a % of all babies receiving a 6-8
H7.KPM1      2006/07 to 33.3% in 2010/11                                                    31%                     31%                   32%                     32%                  33%      New target 2009                                                           week review
             Immunisations - MMR                                                                                                                                                                           No
             Monitor MMR uptake rates (% at 5 years old)                                    92%                                                                                                 Jan-Mar 08 trajectory                                     Target=95% uptake nationally

             Early Teenage Pregnancy                                                                                                                                                                        No              Target is to reduce by 20% the pregnancy rate (per 1000)
             Monitor teenage pregnancy rate (per 1000 population) for 13-15 year olds       4.7                                                                                                 2006        trajectory   population in 13-15 year olds from 6.7 in 1995 to 5.1 by 2010.

Efficiency
        Community Health Index (CHI) Usage                                                                                                                                                                               Laboratory requests that include a CHI number, expressed as
E1.KPM1 Universal utilisation of CHI to maintain 97% level from April 2008.                 95%       97%    97%    97%    97%    97%     97%    97%       97%    97%    97%    97%    97%      Mar 2008    Mar 2009                               a % of all laboratory requests made
        Sickness Absence                                                                                                                                                                                                 Hours lost due to sickness absence expressed as a % of total
E2.KPM1 Achieve a sickness absence rate of 4% by 31 March 2009                              5.2%      4.8%   4.7%   4.7%   4.6%   4.6%    4.5%   4.4%      4.3%   4.2%   4.1%   4.0%   4.0%     Mar 2008    Mar 2009                                                     hours available
        KSF and Personal Development Plan
        All employees (100%) covered by A4C have an agreed KSF personal                           -                                                                                                                            % of staff covered by Agenda for Change who have an
E3.KPM1 development plan by March 2009                                                                28%    26%    33%    40%    45%     52%    60%       68%    76%    84%    92%    100% New target Mar 2009                                                          agreed day
                                                                                                                                                                                                                             Number of BADS surgical procedures performed in aPDP
        Efficiency Savings: Day Case Rates                                                                                                                                                             Jan-Mar           case or outpatient setting (same day care) expressed as a %
                                                                                                  -
E4.KPM1 Improved efficiencies by March 2011 to increase day case rate to 82.5%.                                     68%                   70%                     72%                  74% New target 2009                of the total number of BADS procedures including inpatients

             Efficiency Savings: Emergency Inpatients Average Length of Stay                                                                                                                                              Reduce the ALOS in hospital for acute inpatients discharged
                                                                                                  -
             Improved efficiencies by March 2011 to reduce non-routine inpatient average                                                                                                                   Jan-Mar               following an urgent, emergency or other non-routine
E4.KPM2      length of stay to 4.1 days.                                                                            4.4                   4.4                     4.3                  4.3      New target 2009              unplanned admission. This include emergency transfers
             Efficiency Savings: Review to New Outpatient Attendance Ratio
             Improved efficiencies by March 2011 to decrease return to new outpatient             -                                                                                                        Jan-Mar         Reduce the ratio of return to new outpatient attendance. All
E4.KPM3      attendance ratio to 2.02.                                                                              2.16                  2.15                    2.13                 2.12     New target 2009                                                              specialties
             Efficiency Savings: New Outpatient Appointment DNA rates                                                                                                                                                              A 10% reduction in all boards in the 1st outpatient
             Improved efficiencies by March 2011 to reduce 1st outpatient attendance DNA          -                                                                                                        Jan-Mar       appointment DNA rate between year ending March 2007 and
E4.KPM4      rate to 6.9%.                                                                                          7.6%                  7.5%                    7.4%                 7.3%     New target 2009                                                            March 2010
             Financial Performance
             Operate within agreed revenue resource and capital resource limits, and meet                                                                                                                                Deficit or surplus for 'End financial year' against total revenue
E5.KPM1      cash requirement.                                                              £-5.2m                                                                                     £0       Mar 2008    Mar 2009                                                         resource limit
             Cash Efficiencies
                                                                                                  -                                                                                         -
E6.KPM1      Meet cash efficiency target.                                                                                                                                                                   Mar 2009                                       Cumulative recurring savings
             Online Triage of New Outpatient Referrals
             Increase the % of new GP outpatient referrals triaged online to 10% from Mar         -                                                                                                                        % of new GP outpatient referrals into consultant led triaged
E7.KPM1      2009 to 90% by Dec 2010                                                                  0%     0%     0%     0%     0%      0%     0%        0%     0%     2%     4%     10%      New target Mar 2009                              online. Target=10% by March 2009
             Cancelled Admissions                                                           62                                                                                                             No
             Monitor IP/DC cancelled admissions.                                            2.6%                                                                                                Mar 2008   trajectory                                                  No national target
             Non clinical cancellations                                                     41                                                                                                             No
             Monitor IP/DC cancelled admissions for non-clinical reasons                    1.7%                                                                                                Mar 2008   trajectory                                                  No national target
             SMR Return Rate                                                                                                                                                                               No
             Monitor % of SMR01 returns received (3 month lag)                              99%                                                                                                 Jan-Mar 08 trajectory                                                  No national target
             Completed Complaints                                                           85%                                                                                                            No
             Monitor % of completed complaints resolved within 4 weeks                      (34)                                                                                                Mar 2008   trajectory         Target=80% of complaints responded to within 4 weeks.
Access to Services
A1.KPM1 Primary Care Team - 48 Hour Access                                                                                                                                                      Jan-Mar                        % of practices in a HB area, claiming to meet the
                                                                                               -
         Ensure that 100% of GP practices can guarantee access to a clinician within 48                          100%                 100%                 100%                 100% New target 2009                                         requirements for the DES payment
         hours.
         All Cancer Waiting Times (62 Days)                                                                                                                                                     Jan-Mar
A2.KPM1 95% of urgent referrals wait less than 62 days to treatment for all cancers.       98%                   95%                  95%                  95%                  95% Jan-Mar 08 2009                        % of patients treated within 62 days of urgent referral
         Ambulance Response Times
         Respond to 75% of Category A calls within 8 minutes from April 2009 onwards           -                                                                                -                   No
A3.KPM1 across mainland Scotland.                                                                                                                                                        New target trajectory          % of Category A ('999') calls responded to within 8 mins
         Outpatient Waiting Times Over 15 Weeks From GP Referral
         Reduce nos of patients waiting over 15 weeks for a first outpatient appointment       -                                                                                                                     Number of outpatients waiting over 15 weeks at month end
A4.KPM1 to 0 by March 2009.                                                                        208    186    166    146    125    104    84     62     42     21     0      0        New target Mar 2009                                     census, GP/GDP referrals only
         Inpatient/Day Cases Waiting Over 15 Weeks
         Reduce nos of patients waiting over 15 weeks for inpatient or day case                -                                                                                                                       Number of inpatients/day cases waiting over 15 weeks at
A5.KPM1 treatment to 0 by March 2009.                                                              78     70     63     55     47     39     33     24     16     8      0      0        New target Mar 2009                                                month end census
         Key Diagnostic Tests Waiting Over 6 Weeks
         Reduce nos of patients waiting over 6 weeks for one of the 8 key diagnostic           -                                                                                                                          Number of patients waiting over 6 weeks for 1 of 8 key
A6.KPM1 tests to 0 by March 2009.                                                                  190    173    155    138    121    104    86     69     52     35     17     0        New target Mar 2009                                                 diagnostic services
         A&E Attendances
A7.KPM1 Reduce attendance rates in A&E.                                                    2487    2487   2485   2482   2480   2478   2475   2473   2471   2468   2466   2464   2462     New target Mar 2009              Numbers of A&E attendances, per 100,000 population
         A&E Waits To Be A Maximum of 4 Hours                                                                                                                                                                       % of patients seen waiting no more than 4 hours from arrival
         Increase nos of patients waiting under 4 hours from arrival to treatment to 98%                                                                                                                                     to admission, discharge or transfer for accident and
A7.KPM2 by March 2009.                                                                     99%     98%    98%    98%    98%    98%    98%    98%    98%    98%    98%    98%    98%      Mar 2008    Mar 2009                                              emergency treatment
         Cataract Waiting Times (Outpatient)
         Reduce nos of patients waiting over 9 weeks for outpatient treatment to 0 by                                                                                                                No
         Dec 2007                                                                          0                                                                                             Mar 2008    trajectory
         Cataract Waiting Times (Inpatient/D/C)
         Reduce nos of patients waiting over 9 weeks for inpatient/day case treatment to                                                                                                             No
         0 by Dec 2007                                                                     0                                                                                             Mar 2008    trajectory
         Hip Surgery Waiting Times within 24hrs
         Monitor % of hip fracture operations performed within 24 hours of admission to                                                                                                              No
         orthopaedics.                                                                     94%                                                                                           Mar 2008    trajectory
         Maximum Cardiac Intervention Waiting Times (Angiography)                                                                                                                                    No
         Monitor number of inpatients/day cases waiting over 4 weeks                       0                                                                                             Mar 2008    trajectory

Treatment Appropriate for Patient
         Multiple Emergency Admissions (65+)                                                                                                                                                                      Number of patients (65+), admitted, for any reason, two or
         Reduce readmission rates for older people (aged 65+) to 34.5/1,000 by Mar        -                                                                                              Change in                more times in one calendar year, as an emergency to acute
T1.KPM1 2009.                                                                                                                                                                   34.5     metric      2008/09      specialties defined as a rate per 1,000 population
         Reduction In Emergency Bed-days For Patients Aged 65+
         Reduce emergency inpatient bed days for people aged 65 and over to               -                                                                                              Change in                Rate per 1,000 of population of occupied emergency bed
T1.KPM2 2949.7/1,000 by Mar 2009.                                                                                                                                               2950     metric      2008/09      days, in acute specialties, for patients aged 65+
         QIS: Improving Clinical Governance & Risk Management Standards
T2.KPM1 Improve score from 8 in Oct 2007 to 11 by Mar 2010.                            8                                                                                        9        Mar 2007    2008/09
         Prescribing of Antidepressants                                                                                                                                                                           Number of anti-depressant DDDs per capita in year ending
         Reduce the prescribing rate (DDD per capita) of anti-depressants to 26.1 by      -                                                                                              Change in   Jan-Mar      March 2010 is <= the number of anti-depressant DDDs per
T3.KPM1 Mar 2010.                                                                                                27.7                 27.5                 27.2                 27.0     metric      2009         capita in year ending December 2009
         Reduction of Psychiatric Readmissions
         Reduce the number of readmissions (within 1 year of a stay of 7 days) to 293     -                                                                                                         Jan-Mar       Reduce the number of readmissions for those with an
T4.KPM1 by Dec 2009.                                                                                             304                  302                  300                  298      Apr-Jun 06 2009          admission over 7 days by 10% by the end of December 209
         Healthcare Associated Infection                                                                                                                                                                          Number of identifications of Staphylococcus aureus
         Reduce cases of staphylococcus aureus bacteraemia (including MRSA/MSSA)          -                                                                                              Change in   Jan-Mar      bacteraemias including MRSA & MSSA) as detailed in HPS
T5.KPM1 infection to 53 by Mar 2010.                                                                             73                   70                   67                   64       metric      2009         SSHAIP surveillance protocols.
         Hospital Admission For Long term Conditions
         Reduce admission rates (for COPD, Asthma, Diabetes, CHD) to 2092/100,000         -                                                                                                                       Number of hospital episodes for specified long term
T6.KPM1 by Mar 2011.                                                                                                                                                            2135     New target 2008/09       conditions, per 100,000 population
         Healthcare Experience
                                                                                          -                                                                                          -
         Older People Cared For At healthcare experience
T7.KPM1 Improvement in the quality ofHome                                                                                                                                                New target 2008/09       To be confirmed, no trajectory set yet
         Increase the level of older people with complex care needs receiving care at
                                                                                          -                                                                                          -
T8.KPM1 home.                                                                                                                                                                            New target 2008/09       To be confirmed, no trajectory set yet
         Dementia                                                                                                                                                                                                 Number of people with a diagnosis of a dementia on the QOF
         Increase nos of patients' early diagnosis & management of dementia to 2560 by    -                                                                                                                       dementia register. Boards to achieve a 33% increase on the
T9.KPM1 Mar 2011.                                                                                                                                                               2133     New target Annual        baseline by March 2011
         Delayed Discharges                                                                                                                                                                         No                     To have no clients waiting over 6 weeks by April 2008
         To have no clients waiting over 6 weeks by April 2008                         0                                                                                                 Apr 2008   trajectory                                                    (Includes A&B)
         Cervical Screening rate                                                                                                                                                                    No             Doesn't include A&B; Uptake as per smear history within last
         Monitor % of 20-60 yr old women screened.                                     82%                                                                                               Mar 2008   trajectory                               5 yrs - not the LDP target of 5.5 yrs
NHS HIGHLAND BALANCED SCORECARD 2008/09

NHS HIGHLAND CANCER & DIAGNOSTICS                                                                                                                                                                                                                       2008

                                                                                                                    Reporting Periods
Indicator HEAT Measure & Detail                                                                                                                                        Date of   Trajectory                                                       Comments
                                                                                                                 Latest Reported Period
                                                                                                                                                                       outturn    endpoint
Access to Services                                                   Outturn                        Trajectory 2008/09
          Breast Cancer Waiting Times within 31 days                                                                                                                           Jan-Mar
          100% of patients treated within 31 days of diagnosis       51%                   100%                  100%                     100%             100%     Oct-Dec 07 2009

        All Cancer Waiting Times (62 Days)                                                                                                                                     Jan-Mar
A2.KPM1 95% of urgent patients treated within 62 days of referral.   98%                   95%                   95%                      95%              95%      Jan-Mar 08 2009           All cancer sites combined. All referrals included (not just GP).
                                                                                                                                                                               Jan-Mar
           Breast Cancer                                             96%                   95%                   95%                      95%              95%      Oct-Dec 07 2009
                                                                                                                                                                               Jan-Mar
           Urology (Prostate) Cancer                                 100%                  95%                   95%                      95%              95%      Oct-Dec 07 2009
                                                                                                                                                                               Jan-Mar
           Urology (Bladder) Cancer                                  100%                  95%                   95%                      95%              95%      Oct-Dec 07 2009
                                                                                                                                                                               Jan-Mar
           Lung Cancer Waiting                                       100%                  95%                   95%                      95%              95%      Oct-Dec 07 2009
                                                                                                                                                                               Jan-Mar
           Colorectal Cancer                                         100%                  95%                   95%                      95%              95%      Oct-Dec 07 2009
                                                                                                                                                                               Jan-Mar
           Head & Neck Cancer                                        100%                  95%                   95%                      95%              95%      Oct-Dec 07 2009
                                                                                                                                                                               Jan-Mar
           Skin Cancer                                               100%                  95%                   95%                      95%              95%      Oct-Dec 07 2009
                                                                                                                                                                               Jan-Mar
           Upper GI - OG Cancer                                      92%                   95%                   95%                      95%              95%      Oct-Dec 07 2009
                                                                                                                                                                               Jan-Mar
           Upper GI - HPB Cancer                                     100%                  95%                   95%                      95%              95%      Oct-Dec 07 2009
                                                                                                                                                                               Jan-Mar
           Gynae - Ovarian Cancer                                    100%                  95%                   95%                      95%              95%      Oct-Dec 07 2009
                                                                                                                                                                               Jan-Mar
        Haematology Lymphoma Cancer                                  100%                  95%                   95%                      95%              95%      Oct-Dec 07 2009
        8 Key Diagnostic Tests                                                                                                                                    Change to
                                                                       -
A6.KPM1 No patients waiting over 6 weeks by March 2009.                        190   173   155    138    121     104     86     69        52     35   17   0      metric       Mar 2009                           Target is no patients waiting over 6 weeks
                                                                                                                                                                  Change to
                                                                       -
           MRI Scan                                                                                                                                        0      metric       Mar 2009                           Target is no patients waiting over 6 weeks
                                                                                                                                                                  Change to
                                                                       -
           CT Scan                                                                                                                                         0      metric       Mar 2009                           Target is no patients waiting over 6 weeks
                                                                                                                                                                  Change to
                                                                       -
           Barium Studies                                                                                                                                  0      metric       Mar 2009                           Target is no patients waiting over 6 weeks
                                                                                                                                                                  Change to
                                                                       -
           Ultrasound non-obstetric                                                                                                                        0      metric       Mar 2009                           Target is no patients waiting over 6 weeks
                                                                                                                                                                  Change to
                                                                       -
           Upper GI endoscopy                                                                                                                              0      metric       Mar 2009                           Target is no patients waiting over 6 weeks
                                                                                                                                                                  Change to
                                                                       -
           Lower GI endoscopy (excluding colonoscopy)                                                                                                      0      metric       Mar 2009                           Target is no patients waiting over 6 weeks
                                                                                                                                                                  Change to
                                                                       -
           Colonoscopy                                                                                                                                     0      metric       Mar 2009                           Target is no patients waiting over 6 weeks
                                                                                                                                                                  Change to
                                                                       -
           Cystoscopy                                                                                                                                      0      metric       Mar 2009                           Target is no patients waiting over 6 weeks

								
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