New by decree

VIEWS: 22 PAGES: 10

									                                                                                                                                         APPENDIX A
OPERATING FRAMEWORK 2008/09 - VITAL SIGNS

Vital Signs - Tier 1 & Tier 2 Indicators (National requirement and national priority for local delivery)

                                                                                                                       VS
Priorities      Commitment                     Key Performance Indicator                        2007/08 2008/09                             Comments
                                                                                                                  Trajectory
Cleanliness     Reduce levels of MRSA          Incidence of MRSA. Proportion of                  yes      yes     not required MRSA levels to be sustained,
and                                            admissions screened for MRSA                                                    locally determined stretch targets
associated                                                                                                                     taking us beyond national target to
healthcare                                                                                                                     be agreed
infections      Reduce levels of Clostridium   number of C. difficile infections for patients    yes      yes          yes     The national target is to deliver a
                Difficile                      aged 2 or more                                                                  maximum 30% reduction nationally
                                                                                                                               in 2010/11 compared with 2007/08
                                                                                                                               baseline. In addition to the
                                                                                                                               maximum rate, PCTs and Acute
                                                                                                                               Trusts mush achieve a minimum
                                                                                                                               10% improvement.
                Infection control              Infection control - 6 questions relating to       yes      no           no      Dropped from national assessment
                                               NICE Guidance G2                                                                by the Healthcare Commission,
                                                                                                                               reason being, all organisations
                                                                                                                               comply with the code of practice for
                                                                                                                               the prevention and control of
                                                                                                                               healthcare associated infections
                                                                                                                               and implement best practice from
                                                                                                                               'Saving Lives'.
Access to       By December 2008, no-one       % of admitted patients within 18 weeks            yes      yes         yes      Rates of hospital admissions for
personalised    waiting longer than 18 weeks                                                                                   ambulatory care sensitive
                                               % of non-admitted patients within 18              yes      yes         yes
and effective   from GP referral to hospital                                                                                   conditions is one of the 2 Vital
                                               weeks
care            treatment                      Total number of tests for the 15 key              yes      yes         yes      Signs Local Action Indicators
                                               diagnostic tests in the month                                                   chosen as a local priority - the other
                                                                                                                               being, Emergency Bed Days that
                                               number of patients waiting longer for the         yes      no          no
                                                                                                                               can be found under Long Term
                                               14 non-audiology diagnostic tests
                                                                                                                               Conditions.
                                               Number of patients waiting >13 weeks or           yes      no          no
                                               more, for 15 key diagnostic tests
                                               number of patients waiting >6 weeks for 15        yes      yes         yes
                                               key diagnostic tests
                                               number of patients waiting >6 weeks for all        no     new          yes
                                               other diagnostic tests
                                               % of patients seen within 18 weeks for             no     new          yes
                                               direct access to audiology treatment
                                               patient reported experience of 18 week             no     new          yes
                                               pathway
                                               supporting activity levels, ie numbers of         yes      yes         yes
                                               elective, non-elective, GP written referrals,
                                               other referrals
                                               Rates of hospital admissions for                   no      new         yes
                                               ambulatory care sensitive conditions                     (local)     (local)
                                               Number of nightingale wards                       yes       no         no
                                               decomissioned
                                               G&A elective day case FFCEs carried out           yes      no          no
                                               by UK IS and overseas providers
                                               G&A elective ordinary FFCEs carried out           yes      no          no
                                               by UK IS and overseas providers
                                               G&A 1st OP attendances (consultant led)           yes      no          no
                                               carried out by UK IS and overseas
                                               providers
                                                                                                 yes      no          no
                                               G&A elective FFCEs com'd locally
                                               G&A elective FFCEs com'd locally and              yes      no          no
                                               spot purchased
                Access to Primary Care         Patient reported measure of GP access             yes     yes          yes      Surveys run Jan-Mar each year,
                                               By December 2008, 50% of practices                no      new          yes      though potential for quarterly
                                               number of practices offering extended                                           surveys for 2008.09 is being
                                               opening hours                                                                   explored by the DoH. There is
                                                                                                                    no plan    around a 2-3 month time lag
                                               Increase capacity in primary care                  no     new
                                                                                                                   required    between fieldwork and results being
                                               Number of GPs with special interests              yes      no          no       available.
                                               Number of primary care one stop centres           yes      no          no
                                               Number of primary care one stop centres
                                                                                                 yes      no          no
                                               or mobile service units in a rural area

                                                                               1
                                                                                                       though potential for quarterly
                                                                                                       surveys for 2008.09 is being
                                                                                                       explored by the DoH. There is
                                                                                                       around a 2-3 month time lag
                                                                                                       between fieldwork and results being
                                                                                                                 APPENDIX A
Vital Signs - Tier 1 & Tier 2 Indicators (National requirement and national priority for local delivery)
                                                                                                       available.

                                                                                                                    VS
Priorities     Commitment                        Key Performance Indicator                    2007/08 2008/09                            Comments
                                                                                                                Trajectory
Cleanliness                                      patient experience of access to Out-of-        no     new         yes
and                                              Hours service indicator being developed
associated                                       for 2008/09
healthcare     Implementation of the Cancer      Proportion of patients with breast             no     new         yes       not currently covered by 2-week
infections     Strategy                          symptoms referred to a specialist who are                                   waits for suspected breast cancer.
                                                 seen within 2 weeks of referral                                             100% of patients by December
                                                                                                                             2009
                                                 % of patients waiting no more than 31 days     no     new         yes       All patients by December 2008
                                                 for second or subsequent cancer treatment
                                                 (chemotherapy and surgery)
                                                 % of patients waiting no more than 31 days     no     new         yes       All patients by December 2010
                                                 for second or subsequent cancer treatment
                                                 (radiotherapy)
                                                 % of patients with suspected cancer            no     new         yes       All patients by 2009.
                                                 detected through national screening
                                                 programmes or by hospital specialists who
                                                 wait less than 62 days from referral to
                                                 treatment
               Access to NHS Dentistry           Year-on-year improvement in the numbers        no     new         yes
                                                 of patients accessing NHS dental services.
                                                 Number of patients receiving NHS primary
                                                 dental services located within the PCT
                                                 area within a 24 month period
Improving      Implementation of the Stroke      Number of patients who spend at least          no     new         yes
Health and     Strategy                          90% of their time on a stroke unit
Reducing                                         % of higher risk Trans Ischemic Attack         no     new         yes
Health                                           (TIA) cases who are treated within 24
Inequalities                                     hours
               All-Age all-Cause Mortality       All-age all-cause mortality rate              yes      yes        yes
               Rates - substantial reduction
               by 2010
               Cancer Mortality Rates -          Breast cancer screening for women aged        yes      no         no
               substantial reduction by at       50-70 years; % of eligible women aged 53-
               least 20% in people under 75,     64 screened for breast cancer in last 3
               with a reduction in the           years
               inequalities gap of at least 6%   Breast cancer screening for women aged        yes      no         no
               between the fifth of areas with   50-70 years; % of eligible women aged 65-
               the worst health and              70 screened in last 3 years
               deprivation indicators and the    NHS Breast Screening Programme will be         no     new       deferred    plans deferred for 2007/08
               population as a whole             extended to all women aged 47-73 by
                                                 2010; % of women aged 50 years old with
                                                 a breast screening test result
                                                 NHS Breast Screening Programme will be         no     new       deferred    plans deferred for 2007/08
                                                 extended to all women aged 47-73 by
                                                 2010; % of 50 - 73 year-old women
                                                 screened for breast cancer
                                                 % of 60-74 year old adult population           no     new       deferred    plans deferred for 2008/09. NHS
                                                 screened for bowel cancer in the previous                                   Bowel Screen Programme will be
                                                 2 years                                                                     extended from 2010 to invite men
                                                                                                                             and women aged 70-75 to take part
                                                                                                                             and extended to those aged 60-75
                                                                                                                             by 2012.
                                              % of women receiving cervical cancer              no     new         no        plans deferred for 2008/09. 100%
                                              screening test results within 2 weeks                                          of women to be seen by 2010.
                                              Number of designated specialist multi-           yes      no         no
                                              disciplinary teams (MDTs) in 5 named
                                              cancer sites
               Heart Disease and Stroke       <75 cardiovascular disease mortality rate        yes      yes        yes
               Mortality Rates - substantial  Blood pressure, number of patients on            yes      no         no
               reduction by at least 40% in   hypertension registers
               people under 75, with a 40%    Cholesterol levels, number of patients on        yes      no         no
               reduction in the inequalities  practice CHD registers
               gap between the fifth of areas Practice based registers - % of GP               yes      no         no
               with the worst health and      practices with PCT validated registers of
               deprivation and the population patients with symptoms of CVD and an
               as a whole                     absolute risk of CVD events greater than
                                              20% in the next 10 years
                                              Number of patients waiting longer than 2         yes   moved to   moved to     refer to existing commitments
                                              weeks for access to Rapid Access Chest                 existing   existing
                                              Pain Clinic
                                                                              2
Vital Signs - Tier 1 & Tier 2 Indicators (National requirement and national priority for local delivery)                          APPENDIX A

                                                                                                                VS
Priorities    Commitment                      Key Performance Indicator                     2007/08 2008/09                        Comments
                                                                                                            Trajectory
Cleanliness   Suicide and Undetermined        Number of patients accessing Early             yes   moved to moved to refer to existing commitments
and           Injury Mortality Rates -        Intervention service                                 existing  existing
associated    substantial reduction by 2010
healthcare    by at least 20%                 Number of Early Intervention Teams             yes   moved to   moved to   refer to existing commitments
infections                                                                                         existing   existing

                                              Number of Assertive Outreach Teams             yes      no        no
                                              Number of patients accessing Assertive         yes      no        no
                                              Outreach service
                                              Number of Crisis Resolution Teams              yes   moved to   moved to   refer to existing commitments
                                                                                                   existing   existing

                                              Number of patients accessing Crisis            yes   moved to   moved to   refer to existing commitments
                                              Resolution service                                   existing   existing

                                              Number of Community Development                yes      no        no
                                              Workers
                                              Number of people on CPA                        yes      no        no
                                              Suicide Audit in PCT localities                yes      no        no
              *Sexual Health - reduce the     *Under-18 conception rates (females aged       yes      yes       yes
              under 18 conception rates by    15-17)
              50% by 2010 as part of the      Chlamydia screening - % of 15-24 year          yes   moved to   moved to   refer to existing commitments
              broader strategy to improve     olds screened or tested                              existing   existing
              sexual health
                                            Access to reproductive health;                   yes      no        no
                                            questionnaire - 7 questions
                                            Access to GUM Clinics - % of patients            yes   moved to   moved to   refer to existing commitments
                                            attending a GUM service who were offered               existing   existing
                                            an appointment to be seen within 48 hours
                                            of contacting a service
              *Substance Misuse - increase Number of drug users in treatment                  no      no        no
              participation of problem drug Number of drug users retained in treatment        no      no        no
              users in drug treatment       for 12-weeks or more
              programmes by 100% by 2008
              and increase year-on-year the *The number of drug users using crack             no     new        yes
              proportion of users           and/or opiates recorded as being in
              successfully sustaining or    structured drug treatment in a financial
              completing treatment          year who were discharged from treatment
              programmes                    after 12 weeks or more, or who were
                                            discharged from treatment in a care
                                            planned way.

              *Smoking - reduce adult         Number of quitters                             yes      no        no
              smoking rates to 21^% or less
                                              Number of 4-week smoking quitters who          yes      yes       yes
              by 2010 with a reduction
                                              attended NHS Stop Smoking Services
              among routine and manual
              groups to 26% or less           Smoking status among the population            yes      yes       yes
                                              aged 16 and over; proportion of the GP list
                                              who have their smoking status recorded

                                              *Smoking prevalence among people aged           no     new        yes
                                              16 and over in manual and routine groups
              *Infant Mortality Rates -       Data quality on ethnic group, % of care        yes      no        no
              reduce by 10% by 2010 as        spells for PCT on MHMDS
              measured by infant mortality    Data quality on ethnic group, % of FCEs        yes      no        no
              and life expectancy at birth    for PCT on HES
                                              Number of maternities                          yes      no        no
                                              Number of mothers known to be                  yes      no        no
                                              breastfeeding
                                              Number of mothers known not to be              yes      no        no
                                              breastfeeding
                                              Numbers no known                               yes      no        no
                                              *Number of mothers known to be smoking         yes      no        no
                                              at the time of delivery
                                              Number of mothers not known to be              yes      no        no
                                              smoking at the time of delivery
                                              Numbers not known                              yes      no        no
                                              number of maternities at 12 completed          no      new        yes
                                              weeks


                                                                            3
Vital Signs - Tier 1 & Tier 2 Indicators (National requirement and national priority for local delivery)                                 APPENDIX A

                                                                                                                       VS
Priorities      Commitment                         Key Performance Indicator                     2007/08 2008/09                            Comments
                                                                                                                   Trajectory
Cleanliness                                        *% of women who have seen a midwife or          no     new         yes
and                                                a maternity healthcare professional for
associated                                         assessment of health and social care
healthcare                                         needs, risks and choices, by 12 completed
infections                                         weeks of pregnancy
                                                   *% of infants breastfed at 6-8 weeks            no     new         yes
                                                   % of children recorded as receiving both        no     new         yes
                                                   breast milk and infant formula
                                                   Proportion of children who complete             no     new         yes
                                                   immunization by recommended ages
                Long Term Conditions - to          Number of Community Matrons                    yes      no          no
                improve health outcomes for        Number of Case Managers                        yes      no          no
                people with long term              Number of VHIUs                                yes      no          no
                conditions by offering a           Number of emergency bed days                   yes      yes         yes
                personalized care plan for                                                               (local)     (local)
                Older People - improve the         Community equipment - % of items               yes      no          no
                quality of life and                delivered within 7 days
                independence of vulnerable         Older people mental health assessment of       yes      no          no
                older people by supporting         needs and services - 2 part questionnaire
                them to live in their own homes    containing 9 questions
                where possible by; increasing      Total Intermediate Care Expenditure            yes      no          no
                the proportion of older people     Number of "places" in non-residential          yes      no          no
                being supported to live in their   intermediate care schemes.
                own homes by 1% annually by        Number of Intermediate Care beds.              yes      no          no
                2008 and; by 2008 increasing       Total number of episodes of people using       yes      no          no
                the proportion of those            Intermediate Care
                supported intensively to live at   Number of people receiving continuing          yes      no          no
                home to 34% of the total of        care
                those being supported at home      Number of people newly meeting eligibility     yes      no          no
                or in residential care             criteria for continuing care.
                                                   Number of people receiving NHS funded          yes      no          no
                                                   (free) nursing care
                                                   Number of people eligible for NHS funded       yes      no          no
                                                   (free) nursing care
                                                                                                  yes      no          no
                                                   Number of health and social care systems

                                                   Number of health and social care systems       yes      no          no
                                                   with integrated falls services
                *Obesity - tackle the              *National Child Measurement Programme          yes      yes        yes
                underlying determinants of ill     (NCMP) - % of primary school age children
                health and health inequalities     in year 6 with height and weight recorded
                by halting year-on-year rise in    in past school year
                obesity among children under       National Child Measurement Programme           yes      yes        yes
                11 by 2010 in the context of       (NCMP) - % of primary school age children
                the broader strategy to tackle     in year R with height and weight recorded
                obesity as a whole in the          in past school year
                population                         GP recording of BMI - total number of          yes      no          no
                                                   people aged 16 and over on GP list
                                                   Compliance with NICE Guidance 43               yes      no         no
Reputation,     Secure sustained                   Public confidence in local NHS                 no      new         no        plans deferred for 2007/08
satisfaction    improvement in the patient,        NHS staff survey score-based measure of        yes     yes         yes
and             public, user and staff             job satisfaction
confidence in   experience of the NHS as           Self-reported experience of patients and       yes      yes        yes       NB. Carers are missing as a target
the NHS         measured by independent            users                                                                        audience.
Finance         Achieve financial balance           all organisations will contain expenditure    yes      yes
                                                   within Resource Limits & Cash Limits.
                                                   Efficiency Savings = 2.7% 2005-2008 and
                                                   3% over next 3 year period (2008-2011) -
                                                   mixture of cost, efficiency and quality
                                                   improvements, including savings achieved
                                                   through adult social care which should
                                                   generate around 10% of the total savings.

                                                   recurrent baseline allocation                  yes      yes
                                                   Increase over previous years recurrent         yes      yes
                                                   baseline allocation


                                                                                 4
Vital Signs - Tier 1 & Tier 2 Indicators (National requirement and national priority for local delivery)           APPENDIX A

                                                                                                          VS
Priorities    Commitment               Key Performance Indicator                    2007/08 2008/09                 Comments
                                                                                                      Trajectory
Cleanliness                            unavoidable pressures covered by Tariff       yes      yes
and                                    Uplift (which will include an uplift for
associated                             additonal local IM&T spend from 2006/07
healthcare                             onwards)
infections                             pay awards                                    yes      yes
                                       pay drift                                     yes      yes
                                       agenda for change                             yes      yes
                                       consultant contract                           yes      yes
                                       capital charges                               yes      yes
                                       non-pay inflation                             yes      yes
                                       clinical negligence payments                  yes      yes
                                       HCHC drugs (including NICE)                   yes      yes
                                       unavoidable pressured not covered by          yes      yes
                                       tariff uplife
                                       GMS/PMS Contract                              yes      yes
                                       FHS drugs (including NICE)                    yes      yes
                                       total other financial pressures (deficit      yes      yes
                                       funding, trusts deficits, local brokerage,
                                       national brokerage)




                                                                     5
OPERATING FRAMEWORK 2008/09 - VITAL SIGNS                                                                                  APPENDIX B

Vital Signs - Tier 3 - Local Action - Indicators for PCTs to choose, in consultation with local partners, which of these to
prioritise locally

                                                                                                       VS
Priorities      Commitment                  Key Performance Indicator            2007/08 2008/09                        Comments
                                                                                                   Trajectory
Cleanliness    Infection control            Achievement of CNST risk                                   no     Dropped from national
and associated                              management standards                                              assessment by the
healthcare                                                                                                    Healthcare Commission,
infections                                                                                                    reason being, all
                                                                                                              organisations comply with the
                                                                                                              code of practice for the
                                                                                                              prevention and control of
                                                                                                              healthcare associated
                                                                                                              infections and implement
                                                                                                              best practice from 'Saving
                                                                                                              Lives'.
Access to       Mental Health               Proportion of people with                                  no
personalised                                depression and/or anxiety
and effective                               disorders who ore offered
care                                        psychological therapies
                                            Proportion of adults in contact                           no
                                            with secondary mental health
                                            services in settled
                                            accommodation
                                            Proportion of adults in contact                           no
                                            with secondary mental health
                                            services in employment

                Social Care - Adults        Proportion of adults (18 and                              no
                                            over) supported directly
                                            through social care to live
                                            independently at home
                Social Care - Adults        Number of adults and older                                no
                and Older People            people receiving direct
                                            payments and/or individual
                                            budgets (aged 18 and over)
                Health & Social Care        Patient-reported unmet care                               no
                                            needs
                Carers                      Proportion of carers receiving                            no
                                            a 'carer's break' or a specific
                                            service for carers as a % of
                                            clients receiving community
                                            based services
                Children, Substance         Proportion of people                                      no
                Misuse, Crime &             achieving independence 3
                Disorder                    months after entering
                                            care/rehabilitation

                Learning                    Proportion of adults with                                 no
                Disabilities/Difficulties   learning disabilities in settled
                                            accommodation

                                            Proportion of adults in contact                           no
                                            with learning difficulties in
                                            employment

                                            Learning disabilities/difficulties                        no
                                            indicator to be developed




                                                                       6
Vital Signs - Tier 3 - Local Action - Indicators for PCTs to choose, in consultation with local partners, which of these to
prioritise locally

                                                                                                VS
Priorities     Commitment              Key Performance Indicator          2007/08 2008/09                         Comments
                                                                                            Trajectory
               Secondary Care          Number of delayed transfer of                            no
                                       care
                                       Ambulance conveyance rate                               no
                                       to A & E (indicator to be
                                       developed)
                                       Number of emergency bed             yes      yes        yes       Indicator dropped from
                                       days                                                              national performance
                                                                                                         assessment indicator list
                                                                                                         used by the Healthcare
                                                                                                         Commission, however, Is
                                                                                                         considered by the DoH to be
                                                                                                         a priority for use as a local
                                                                                                         measure
                                    Rates of hospital admissions                               yes
                                    for ambulatory care sensitive
                                    conditions
               Long-Term Conditions Proportion of people with long-                            no
                                    term conditions supported to
                                    be independent and in control
                                    of their condition

               Social Care -           Timeliness of social care                               no
               Assessments             assessments
               Social Care -           Timeliness of social care                               no
               Packages                packages
               Mortality Rates         Proportion of deaths that                               no
                                       occur at home
               Choose & Book           Patient-reported measure of                             no        In 2007/08, captured within
                                       choice                                                            'existing' commitments.
               Prescribing             Prescribing Indicators to be                            no
                                       developed
Improving      CHD                     Vascular risk score                                     no
Health and
Reducing                               % of patients admitted with         yes                 no
Health                                 heart attack who, upon
Inequalities                           discharge, are prescribed an
                                       anti-platelet, a statin, a beta-
                                       blocker
               Older People            Healthy life expectancy at age                          no
                                       65
               Substance Misuse -      Rate of hospital admissions         yes                 no
               Alcohol                 per 100,000 for alcohol-
                                       related harm
               Diabetes                Patients with diabetes in           yes                 no
                                       whom the last HbA1c is 7.5 or
                                       less from Quality Outcomes
                                       Framework (QOF)

               Physical Activity       Proportion of people where                              no
                                       health affects the amount/type
                                       of work they can do

               Accidents & Injuries    Hospital admissions caused          yes                 no
                                       by unintended and deliberate
                                       injuries




                                                                 7
Vital Signs - Tier 3 - Local Action - Indicators for PCTs to choose, in consultation with local partners, which of these to
prioritise locally

                                                                                             VS
Priorities     Commitment              Key Performance Indicator      2007/08 2008/09                         Comments
                                                                                         Trajectory
               Mortality Rates       Mortality rate from causes                              no
                                     considered amenable to
                                     healthcare
Reputation,    Reputation,           Self-reported measure of           yes                  no
satisfaction   satisfaction and      people's overall health
and confidence confidence in the NHS Patient and user reported                               no
in the NHS                           measure of respect and
                                     dignity in their treatment
                                     Patients' experience of                                 no
                                     services for disabled children
Finance        Financial Balance     NHS estates energy/carbon                               no
                                     efficiency




                                                               8
OPERATING FRAMEWORK 2008/09 - VITAL SIGNS
                                                                                                                                          APPENDIX C
Existing Commitments for Maintaining During 2008/09 onwards (National Requirement)

  Priorities                          Key performance Indicator                                 2007/08 2008/09   Comments
  4-hour A & E Waits                  4-hour maximum wait in A&E from arrival to                  yes     yes
                                      admission, transfer or discharge;
  Access to Primary Care              guaranteed access to a primary care professional            yes     yes     Patient Survey will be captured as an element of
                                      within 24 hours                                                             the measures reported by patients in the new
                                      guaranteed access to a GP within 48 hours                   yes     yes     targets
                                      Primary Care Access Patient Survey                          yes     no
  Outpatient Waiting Time Standards   a maximum wait of 13 weeks for an outpatient                yes     yes
                                      appointment;
  Inpatient Waiting Time Standards    a maximum wait of 26 weeks for in-patients                  yes     yes
                                      appointments;
  Revascularisation                   three month maximum wait for revascularisation;             yes     yes
  Rapid Access Chest Pain Clinics     a maximum two-week wait standard for Rapid Access           yes     new     an existing target for Acute Trusts - data
                                      Chest Pain Clinics                                                          historically provided by Provider but contributing
                                                                                                                  to Commissioner LDP process, however not
                                                                                                                  showing on the PA system
  Thrombolysis                        thrombolysis “call to needle” of at least 68 percent        yes     yes     target has changed from 10% year on year
                                      within 60 minutes, where thrombolysis is the preferred                      improvement to at least 60% or people receiving
                                      local treatment for heart attack;                                           within 60 minutes
  Access to GUM                       guaranteed access to a GUM clinic within 48 hours of        yes     yes     changed from new target in 2007/08 to existing
                                      contacting a service;                                                       in 2008/09
  Cancelled Operations                all patients who have operations cancelled for non-         yes     new     an existing target for Acute Trusts - data
                                      clinical reasons to be offered another binding date                         historically provided by Provider but contributing
                                      within 28 days, or the patient’s treatment is funded at                     to Commissioner LDP process, however, not
                                      the time and hospital of the patient’s choice;                              showing on the PA system
  Delayed Discharges                  delayed transfers of care to be maintained at a             yes     yes
                                      minimal level;
  Ambulance Response Times            all ambulance trusts to respond to 75 percent of            yes     yes     Cat A within 19 mins - indicator dropped from
                                      Category A calls within 8 minutes;                                          national assessment - not detailed in operating
                                      all ambulance trusts to respond to 95 percent of            yes     no      framework 2008/09 technical guidance
                                      Category A calls within 19 minutes;
                                      all ambulance trusts to respond to 95 percent of            yes     yes
                                      Category B calls within 19 minutes;
  Choose & Book                       convenience and choice, PCT booking, % of referrals         yes     no      Enabling Strategy for 2008/09 onwards, also,
                                      received by Providers for first consultant outpatient                       choice will be captured as an element of the
                                      appointments that are made through choose and book                          measures reported by patients in the new targets

                                      convenience and choice, PCT facilities in place to          yes     no      Enabling Strategy for 2008/09 onwards, also,
                                      support choice, % of eligible patients who answered                         choice will be captured as an element of the
                                      positively "before you visited your GP, did you know                        measures reported by patients in the new targets
                                      that you now have a choice of hospitals that you can
                                      go to for your first hospital appointment"?

                                      convenience and choice, PCT facilities in place to          yes     no      Enabling Strategy for 2008/09 onwards, also,
                                      support choice, % of eligible patients who answered                         choice will be captured as an element of the
                                      positively "were you offered a choice of hospital for                       measures reported by patients in the new targets
                                      your first appointment"?
  Cancer Waiting Time Standard        a two-week maximum wait from urgent GP referral to          yes     yes
                                      first outpatient appointment for all urgent suspected
                                      cancer referrals;
                                      a maximum waiting time of one month from diagnosis          yes     yes
                                      to treatment for all cancers;
                                      a maximum waiting time of two months from urgent            yes     yes
                                      referral to treatment for all cancers;
  Diabetic Retinopathy Screening      100 percent of people with diabetes to be offered           yes     yes
                                      screening for the early detection (and treatment if
                                      needed) of diabetic retinopathy;
  Early Intervention                  deliver 7,500 new cases of psychosis served by early        yes     yes     changed from new target in 2007/08 to existing
                                      intervention teams per year;                                                for 2008/09 onwards
  Crisis Resolution                   all patients who need them, to have access to crisis        yes     yes     changed from new target in 2007/08 to existing
                                      services with delivery of 100,000 new crisis resolution                     for 2008/09 onwards
                                      home treatment episodes each year;
  CAMHS                               all patients who need them, to have access to a             yes     yes
                                      comprehensive child and adolescent mental health
                                      service, including 24-hour cover/appropriate services
                                      for 16- and 17-year-olds and appropriate services for
                                      children and young people with learning disabilities;

  Chlamydia Screening                 Chlamydia Screening Programme rolled out nationally;        yes     yes     changed from new target in 2007/08 to existing
                                      number/% of 15-24 year olds being screened or                               in 2008/09
                                      tested.
  Primary Care - Practice Based       ensure practice based registers and systematic              yes     no      dropped from 'national' performance monitoring
  Registers                           treatment regimes, including appropriate advice on                          by Healthcare Commission, however, DoH
                                      diet, physical activity and smoking, also cover the                         guidance states 'to be determined if relevant for
                                      majority of patients at high risk of CHD, particularly                      local action'
                                      those with hypertension, diabetes and a BMI greater
                                      than 30
                                                                                 Page 1 of 1
                                                                                                                            APPENDIX D

Vital Signs - Performance Indicators selected and detailed in the Local Area Agreement 2008/09

                   NI                                                                                                                  VS
Area                                      Sub-area                                    Performance Indicator
                   Number                                                                                                          Trajectory
Children & Young NI117      Improving the life chances of            16-18 year olds who are not in education, training or            no
People                      vulnerable children & young people       employment (NEET)
                 NI 111     Improving the life chances of            First time entrants to Youth Justice System aged 10-17           no
                            vulnerable children & young people
                   NI 56    Healthy minds and bodies                 Obesity among primary school age children in Year 6              yes

                   NI 50    Healthy minds and bodies                 Emotional health of children                                     no
                   NI 57    Healthy minds and bodies                 Children and young people's participation in high quality        no
                                                                     PE and sport
                   NI 69    Healthy minds and bodies                                                                                  no
                   NI 112   Healthy minds and bodies                 Under 18 conception rate                                         yes
                   NI 115   Healthy minds and bodies                 Substance Misuse by young people (Survey)                        no
Stronger and Safer NI 1     Cohesive communities                     % of people who believe people from different                    no
Communities                                                          backgrounds get on well together in their local area
                   NI 5     Resident satisfaction with their local   Overall/general satisfaction with local area                     no
                            area
                   NI 6     Strong community & vibrant voluntary     Participation in regular volunteering                            no
                            sector
                   NI16     Crime, anti-social behaviour & fear of   Serious acquisitive crime rate                                   no
                            crime
                   NI 17    Crime, anti-social behaviour & fear of   Perceptions of anti-social behaviour
                            crime
                   NI 20    Crime, anti-social behaviour & fear of   Assault with injury crime rate                                   no
                            crime
                   NI 40    Substance misuse including drugs &       Number of Drug Users in Effective Treatment                      yes
                            alcohol
                   NI 32    Crime, anti-social behaviour & fear of   Repeat Incidents of domestic Violence                            no
                            crime
Healthier          NI 8     Healthy Lifestyles                       Adult participation in sport and active recreation               no
Communities and    NI 123   Healthy Lifestyles                       16+ smoking rate prevalence                                      yes
Older People       NI 53    Maternal Health                          Breastfeeding at 6-8 weeks                                       yes
                   NI 126   Maternal Health                          Access to Maternity Services                                     yes
                   Local    Maternal Health                          % of Women Smoking at time of Delivery in Dewsbury &             no
                                                                     Batley
                   NI 124   Living Independently                     People with long-term condition supported to be                  no
                                                                     independent and in control of their condition
                   NI 139   Living Independently                     People over 65 who say that they receive the                     no
                                                                     information, assistance and support needed to exercise
                                                                     choice and control to live independently
                   NI150    Mental Well-being                        Adults in contact with secondary mental health services          no
                                                                     in employment
                   NI 173   Mental Well-being                        People falling out of work and on to incapacity benefits         no

                   NI 153   Reduce worklessness                      Working age people claiming out of work benefits in the          no
                                                                     worst performing neighbourhoods
                   NI 163   Increase skill levels of working age     Working age population qualified to at least Level 2 or          no
                            population                               higher
Economic           NI 171   Grow local businesses                    VAT registration rate                                            no
Development and    NI 186   Combating climate change                 Per capita CO2 emissions in the LA area                          no
the Environment    NI 187   Combating climate change                 Tackling fuel poverty - people receiving income based            no
                                                                     benefits living in homes with a low energy efficiency
                                                                     rating
                   NI 188   Combating climate change                 Adapting to climate change                                       no
                   NI 193   Reduce waste and increase recycling      Municipal waste land filled                                      no

                   NI 155   Affordable homes                         Number of affordable homes delivered (gross)                     no
                   NI 167   Local transport                          Congestion - average journey time per mile during the            no
                                                                     morning peak (this is an indicator for West Yorkshire.
                                                                     The targets set are a jointly agreed set of indicators with
                                                                     all Authorities within West Yorkshire boundary)

                   NI 168   Local transport                 Page 1 ofPrincipal roads where maintenance should be
                                                                      1                                                               no
                                                                     considered

								
To top