Glossary Of Terms And Phrases Used

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					                                      SOUTH TEES HOSPITALS NHS TRUST

Glossary Of Terms And Phrases Used

A&E - Accident and Emergency (usually refers to an ambulance or a hospital casualty department).
Access – the extent to which people are able to receive the information, services or care they need.
Active citizenship – means members of the public becoming actively involved in recognising and tackling the
problems of their communities and in improving their quality of life.
Actual run time – This is a percentage comparing the actual time a list runs with the planned time for it to run.
Acute - A condition of short duration that starts quickly and has severe symptoms.
Acute Leukaemia – Malignant disorder of white blood cells.
ADQ – Average daily quantity consumed by an average patient on a drug.
Amortisation – Process used to recognise that assets are worth less as time goes on. For example, a 30-year
lease is worth less after each year – eventually becoming worth nothing, and amortisation is the process by which
the decrease in value is calculated.
Angina - Pain resulting from the heart‟s demand for blood being greater than the coronary arteries can supply.
Anxiolytics – Drugs for the relief of anxiety.
APCIMS – Association of Private Client Investment Managers and Stockbrokers.
Assets – In general assets include land, buildings, equipment, cash and other property.
Assurance – Confidence, based on sufficient evidence, that internal controls are in place, operating effectively
and objectives are being achieved.
Assurance Committee – A board level committee with overarching responsibility for ensuring appropriate
assurance is gained on the management of all principal risks. Assurance Framework – A structure within which
boards identify the principal risks to the organisation meeting its principal objectives and map out both key controls
in place to manage them and also how they have gained sufficient assurance about their effectiveness. This
Framework is monitored by the Assurance Committee on behalf of the Trust Board.
Bacteraemia – Infection identified in a patient‟s blood.
Benign – Not harmful. Used especially to describe tumours that are not malignant.
Benzodiazepines – A group of drugs used for anxiety and insomnia that can/will increase drowsiness.
Board of Directors – The Board of Directors is the executive body responsible for the operational management
and conduct of a particular NHS Trust.
Board Assurance Action Plan – An action plan approved by the board to improve its key controls to manage its
principal risks, and gain assurances where required. Regular monitoring takes place at the Assurance Committee.
Board Assurance Reports – Key information reported to the board on the assurance framework, providing
details of positive assurances and significant gaps in internal controls and assurances relating to principal risks. In
addition to providing information leading to a board assurance action plan this will also provide evidence to
support the annual statement on internal control.
BPPC – Better Payment Practice Code. Indicator records how many invoices we pay within 30 days.
Cancer Services Collaborative (CSC) – the CSC‟s Improvement Partnership is a national programme to develop
practical approaches to deliver the targets in the NHS Cancer Plan and is part of the NHS Modernisation Agency.
Capital – expenditure on assets (equipment, buildings, etc.) non-recurring over the value of £5,000.
Capital Expenditure – Payments to acquire tangible fixed assets. Capital Costs are the purchase or major
enhancement of fixed assets, for example, computer equipment (building and plant) and are often also referred to
as „one-off‟ costs.
Capital Programme – the Trust‟s main vehicle for the replacement of equipment, financing developments and
maintaining the estate.
Cardiothoracic Surgery – Surgery on the heart, chest and lungs.
CDG- Corporate Directors Group
CD & TV CLRN – County Durham & Tees Valley Comprehensive Local Research Network
Chemo prescribing – an IT system which manages the scheduling and prescribing of chemotherapy drugs
Chemotherapy – The use of anti-cancer drugs to destroy cancer cell.
Chief Executive’s Emergency Replacement Fund – this allocation is used to fund the replacement of medical
equipment which fail in year and cannot be repaired.
Choose and Book – a national programme to facilitate the implementation of electronic booking which allows
patient choice of place, date and time for first outpatient appointments.
CIP - Cost Improvement Programme - a plan to make financial savings whilst maintaining service provision.
‘Cleanyourhands’ – a campaign by the National Patient Safety Agency to promote hand hygiene. The three
components are availability of alcohol gel or alternative hand hygiene facilities at every point of patient contact, an
eye-catching poster campaign which changes monthly and a monthly observational audit.
Clinical Audit – a quality improvement process that seeks to improve patient care and outcomes through
systematic review of care against explicit criteria and the implementation of change. Aspects of the structure,
processes, and outcomes of care are selected and systematically evaluated against specific criteria. Where



GM/DAC/Tboard/Glossary/revisedAugust2007                                                                             1
indicated, changes are implemented at an individual, team, or service level and further monitoring is used to
confirm improvement in health care delivery.
Clinical Governance – the system of steps and procedures adopted by the NHS to ensure that patients receive
the highest possible quality of care, ensuring high standards, safety and improvement in patient services
(Healthcare Commission April 2004).
Clinical Networks – connections across disciplines which provide integrated care across institutional and
professional boundaries, raising clinical quality and improving the patient experience.
Clinical Trial – Medical research involving patients to identify new and better treatments.
Clinician – professionally qualified staff providing clinical care to patients.
Clostridium difficile – A bacteria which causes diarrhea, most frequently in elderly patients who have taken
antibiotics. The Department of Health collects data on these infections in patients over 65 years who have the
toxin produced by this organism detected in their stools. Although the data is presented by Trust, the patients with
the illness may be in hospital or in the community. Most cases of Clostridium difficile-associated diarrhea are not
severe. However severe disease is becoming more common in some parts of the country and outbreaks have
occurred in some hospitals. South Tees has not experienced outbreaks of severe infection.
CLRN – Comprehensive Local NHS Research Network.
CMAT – Corporate Mandatory Awareness Training.
Commissioning – a continuous cycle of activities that underpins and delivers on the overall strategic plan for
healthcare provision and health improvement of the population. These activities include stakeholders agreeing
and specifying services to be delivered over the long term through partnership working, as well as contract
negotiation, target setting, providing incentives and monitoring.
Constitution – An NHS Foundation Trust‟s constitution describes what type of body it is and its primary purpose,
as well as defining its membership and its address. The constitution may also set out the internal governance
arrangements.
Consultant – Senior Physician or surgeon advising on the treatment of a patient.
Coronary Artery Bypass Graft (CABG) - Grafting a section of vein to allow blood to by-pass blocked coronary
arteries and therefore supply the heart muscle. Around 10,000 people annually undergo this procedure that lasts
several hours.
Coronary Intervention (PCI) – Angioplasty is a method of treating blockage or narrowing of a blood vessel by
inserting a balloon into the constriction to reopen it. A stent (small tube-like device) may be inserted to help keep
the unblocked blood vessel open.
Council of Governors – Each Foundation Trust is required to establish a Board of Governors. The Council of
Governors represents the interests of the members of the NHS Foundation Trust and partner organisations in the
local health economy, thereby ensuring that the local community is directly involved in the governance of the NHS
Foundation Trust. The Council of Governors is directly accountable to the members for ensuring the Foundation
Trust operates in a way that is compliant with its objects and terms of authorisation.
Cplnhs – Commissioning a Patient-Led NHS.
Crime and disorder reduction partnerships – partnerships between the police, Local Authorities, probation
service, health authorities, the voluntary sector, and local residents and business which work to reduce crime and
disorder in their area.
Creditor days – Average number o days it takes to pay off creditor invoices
Cross-border SHA – a special health authority performing functions in respect of both England and Wales.
CS – Clinical Supervisor
CSIM – Clinical Sciences and Investigative Medicine
CT – Computerised Tomography - This modality gives cross sectional body images using ionising radiation and
sensor plates to produce and x-ray image which is reconstructed to give detailed images. Multiple images are
produced per examination. Due to using radiation this modality is particularly suitable to images of bony structures
although contrast enhancement of body tissues greatly extends its diagnostic capability. Because of safety issues
these are usually static units in a dedicated site.
Current Ratio – Current assets divided by current liabilities – an indicator the resource available to meet short
term debts.
Cutaneous – Belonging to the skin.
CVRR – Cardiovascular, Respiratory and Renal Medicine
Daleslink – comprised of voluntary agencies, community nurses and carers from across Richmondshire
DATAC - Durham and Tees Audit Consortium - Internal Audit, provided by Durham and Tees Audit Consortium
Daycase - Patient who is admitted to hospital for an elective procedure and is discharged without an overnight
stay.
DBS (Directly Bookable Service) – where first outpatient appointments can be booked electronically at the time
of referral (in the GP Surgery) or by other means at the convenience of the patient.
Debtor Days – Average number of days it takes to receive payment of debtor invoices.
Depreciation – The loss of value over a period of time for assets with finite lives.




GM/DAC/Tboard/Glossary/revisedAugust2007                                                                           2
Deprivation - Being economically disadvantaged. Deprived areas are identified by using one of several available
indices related to lower income.
Dermatology/Dermatological – Pertaining to the skin.
Diagnostic Test – Test of procedure to determine the cause of an illness or disorder.
DDA -Disability Discrimination Act.
DDA – Disability Discrimination Act – Schemes are funded from capital to ensure the Trust fulfils its statutory
obligations.
Digital Dictation – An IT system which provides workflow management for digitally dictated correspondence and
documents.
Direct Booking – where the patient attends their GP and at the time of decision to refer, has the opportunity to
book a mutually convenient date and time for their first outpatient appointment via an electronic means.
Directorate Level Objective – How the organisation translates an overall goal into deliverables at directorate (or
equivalent) level.
DIPC – Director of Infection Prevention and Control. The DIPC is the director of nursing. She has corporate
responsibility for infection control and healthcare-associated infections on the Trust Board.
Diversity – Diversity means involving people from all walks of life regardless of, for example:
Age, Race or cultural background, Gender, Religion or belief, Sexuality, Disability
DNA – Did not attend (for a hospital appointment).
DNAR – Do not attempt resuscitation.
Drugs of limited clinical value – A group of drugs that includes many regularly prescribed, low cost drugs of
which the effectiveness is either unproven or apparent in a low proportion of patients.
e-CaMIS – the latest version of the CaMIS patient administration system
E of C – Essence of Care.
EBITDA – Earnings before Interest, Tax, Depreciation, and Amortisation.
EBITDA Margin – EBITDA expressed as a percentage of income.
EJRs – Essential Junior Rotations
EL – Elective spells (Ordinary and day case).
Elective - A planned episode of care, usually involving a day case or inpatient procedure.
Emergency - An urgent unplanned episode of care.
Encoder – An IT system which supports the coding of clinical activity, ensuring that activity is sequenced in the
correct order, and the coding is high quality.
End utilisation – This measure uses totaled individual patient anaesthetic.surgical times, divided by the full 52
week scheduled operating time.
Energy Centre – means the building on the site housing certain items of the Equipment and includes every other
erected building on the site from time to time other than the offices.
e-rostering – An IT system which supports the development and maintenance of staff rosters.
EP – Electrophysiology.
ES– Educational Supervisor
Estate Investment – an allocation earmarked for investment on the estate to ensure standards are maintained on
item such as window replacement, water mains, roads, etc. at The Friarage Hospital.
Equipment Rolling Programme – capital amount set aside each year to fund items of medical equipment such
as defibrillators, haemodialysis machines, anaesthetic machines and ventilators, which owing to the number
across the Trust, need continuous replacement.
EUETs- European Union Emission Transmissions.
Extended spectrum beta-lactamase (ESBL) producing coliforms – Coliforms are bacteria which live in the
intestines. If a patient is given a lot of antibiotics they can acquire coliforms which are resistant to powerful beta-
lactam antibiotics (e.g. all penicillin‟s and cephalosporin‟s). These bacteria are difficult to treat because they are
resistant to most commonly used antibiotics. These infections are relatively uncommon in our Trust, but some
hospitals have a major problem.
External Assurance – Assurances provided by reviewers, auditors and inspectors from outside the organisation,
such as External Audit, Healthcare Commission or Royal Colleges for example.
FCE - Finished Consultant Episode – completed episode of care with a specialist doctor.
FFCE - First Finished Consultant Episode – first completed appointment with a specialist doctor.
FHN – Friarage Hospital, Northallerton.
Financial Flows - new system of „payment by results‟ against a national tariff of prices.
FM – Facilities Management
FOI – Freedom of Information Act – an Act that requires every Public Authority to specify what information they
publish and how this is made available.
FP – Foundation Programme
Foundation Trust – a public benefit corporation established by the Health and Social Care (Community Health
and Standards) Act 2003 which is authorised to provide goods and services for the purpose of the health service.




GM/DAC/Tboard/Glossary/revisedAugust2007                                                                             3
FRAG21 – Financial Reporting and Auditing Group of the Institute of Chartered Accountants in England and
Wales
Full Booking – the patient has the opportunity to choose a mutually convenient date and time for their
appointment, within one working day of the decision to admit or refer.
Gap in Assurance – Failure to gain sufficient evidence that policies, procedures, practices or organisational
structures on which reliance is placed are operating effectively.
Gap in Control – Failure to put in place sufficient effective policies, procedures, practices or organisational
structures to manage risks and achieve objectives.
GDP – General Dental Practitioner.
Glycopeptide-resistant enterococci (GRE) – Enterococci are bacteria which live in the intestines. If a patient is
given a lot of antibiotics they can acquire Enterococci which are resistant to powerful glycopeptide antibiotics (eg
Vancomycin). These bacteria do not often cause infections but when they do they are difficult to treat because
they are resistant to most commonly used antibiotics. These infections are extremely rare in our Trust, but some
hospitals have a major problem.
GMS - General Medical Services Contract – the means by which the NHS reimburses General Practitioners (GPs)
for providing primary health care services.
Governance – Governance arrangements are the „rules‟ that govern the internal conduct of an organisation by
defining the roles and responsibilities of key offices/groups and the relationship between them, as well as the
process for due decision making and the internal accountability arrangements. Governance arrangements will be
set out in the constitutions of NHS Foundation Trusts and will be enshrined under the terms of authorisation.
GUM – Genito-urinary medicine.
GPVTS – General Practice Vocational Training
GPwSI - GP with Special Interest.
HAL – Health Action Link.
HCC-Healthcare Commission.
Headcount – Total number of individual employees on the Trust‟s payroll.
Head of Internal Audit Opinion – An annual opinion provided to inform the Board in completing their Statement
on Internal Control. This provides opinions on (a) the overall assurance framework and (b) the effectiveness of
that part of the system on internal control reviewed by Internal Audit during the year.
Healthcare – services provided for, or in connection with, the prevention, diagnosis or treatment of illness, and the
promotion and protection of public health.
Healthcare Commission – established in April 2004 as the independent body encompassing the work of the
Commission for Health Improvement (CHI). It will inspect health care provision in accordance with national
standards and other service priorities and will report directly to Parliament on the state of health care in England
and Wales.
Healthcare organisation – English NHS Bodies, cross-border SHAs and other organisations and individuals,
including the independent and voluntary sectors, which provide or commission health care for individual patients
and the public.
Healthcare professional – a person who is a member of a profession regulated by a body mentioned in section
25 (3) of the National Health Service Reform and Health Care Profession Act 200.
Health inequalities – differences in people‟s health between geographical areas and between different groups of
people.
Health promotion – includes the provision of information on healthier lifestyles for patients, and how to make the
best use of health services, with the intention of enabling people to make rational health choices and of ensuring
awareness of the factors determining the health of the community.
HES – Hospital Episode Statistics. Hospital Episode Statistics (HES) provide information on admitted patient
care delivered by NHS hospitals in England from 1989. This is used to provide wide-ranging analysis for the
NHS, Government and many other organisations and individuals who have an interest in health and healthcare
administration. The HES database is a record level database of hospital admissions and is currently populated
by taking an annual snapshot of a sub-set of the data submitted by NHS Trusts to the NHS-Wide Clearing
Service (NWCS). Quarterly information is also collected. A separate database table is held for each financial
year containing approximately 11 million admitted patient records from all NHS Trusts in England.
Hemiarthroplasty – A hip replacement operation where part of the patient‟s joint is replaced with prosthetic
material. This type of operation is usually performed on patients who have had a traumatic fracture. In contrast
a total hip replacement is usually performed on patients who are having an elective procedure.
Hemiarthroplasty was selected by our Trust for the Department of Health‟s mandatory monitoring of surgical site
infections.
HIMP – Health improvement and Modernisation Programme – the framework document that draws together
all of the local work on health improvement, the reduction of inequalities in health and service modernisation.
High Impact Interventions – Care bundles based on: prventing microbial contamination, venous cannula care,
preventing surgical site infections, care of the ventilated patient and indwelling urinary catheter care and C.
difficile. These are part of the „Saving Lives‟ delivery programme.



GM/DAC/Tboard/Glossary/revisedAugust2007                                                                           4
Hospital-acquired – This term is often used for infection or colonisation which is first identified more than 48
hours after admission. However the definition is not perfect as patients who satisfy this criteria may have had
unknown infection or colonisation prior to admission.
HRG – Healthcare Resource Groups – Codes that describe a group of procedures or treatments that are
clinically similar and use a similar amount of resources within the hospital. They summarise groups of surgical
or other diagnostic codes.
Hypnotics – Drugs that induce sleep.
Hypertension – Raised blood pressure.
IBS – (Indirectly Bookable Service) – an alternative means of booking first outpatient appointments where the
technology is currently unavailable in the GP Practice to support Direct Booking. The patient is given a unique
booking reference number (UBRN) at the time of decision to refer which is then used to book their appointment
via a referral management service.
ICAS – Independent Complaints Advocacy Service – this service offers independent support for people who
wish to complain about the NHS, whilst complementing the current arrangements for complaints handling.
ICT- Information and Communication Technology.
I&E – Income & expenditure
I&E surplus – The amount income exceeds expenditure.
I&E margin – I&E surplus expressed as a percentage of income
Income and expenditure- This shows the forecast outrun difference between income and expenditure for the
full year for NHS trusts, as forecast at the last month of the quarter in question. The number is given as an
absolute figure so there will be a tendancy for larger organisations to show larger variences. The figure given is
total forecast operating income for the year minus the total forecast net expenditure for the year.
Inf – Infant.
IOG – Improving Outcomes Guidance.
IRPs-Independent Review Panels.
Independent Assurance – Assurances provided by (a) reviewers external to the organisation and (b) internal
reviewers working to government standards, such as Internal Audit (see DATAC).
Independent Regulator – The Office of the Independent Regulator for NHS Foundation Trusts is responsible for
authorising, monitoring and regulating NHS Foundation Trusts. The Independent Regulator is independent from
the Department of Health and is accountable to Parliament.
Inpatient - Patient requiring at least one overnight stay in hospital.
Integration Engine – An IT system which provides a single interface between the patient administration system
and other Trust IT systems.
Integrated Governance Development Plan - A plan produced by the Trust, to an agreed framework, to enable
the Board to gain assurance of performance against the Core and, when issued, the Development Standards of
Standards for Better Health. This Plan will also be used by the Strategic Health Authority who will performance
manage the Trust‟s progress.
Internal Assurance – Assurances provided by reviewers, auditors and inspectors who are part of the
organisation, such as Clinical Auditor management peer review.
Internal Control – The ongoing policies, procedures, practices and organisational structures designed to provide
reasonable assurance that objectives will be achieved and that undesired events will be prevented or detected
and corrected.
Intervention (PCI) - Angioplasty is a method of treating blockage or narrowing of a blood vessel by inserting a
balloon into the constriction to reopen it. A stent (small tube-like device) may be inserted to help keep the
unblocked blood vessel open.
Joint Venture – An undertaking in which an NHS Foundation Trust is a corporate member. Joint ventures may be
commercial or non-commercial and may involve an NHS Foundation Trust becoming a member of a company
alongside one or more other public/private sector organisations.
IPC- Infection Prevention and Control.
IUCD – Intrauterine contraceptive device.
IVU – Intravenous Urogram – This is a contrast examination to demonstrate renal urinary excretion, ureters and
bladder.
JCUH – James Cook University Hospital.
KPI- Key Performance Indicator.
(KSF) Knowledge and Skills Framework - A tool which recognises the knowledge and skills that a person
requires to be effective in a particular NHS post.
LDC - Local Dental Committee - the representative group for General Dental Practitioners (GDP).
LDL Cholesterol – Low density lipid cholesterol, high levels of which increase the risk of CHD
LDP - Local Development Plan. The annual process for agreeing activity and financial targets.
Leasing Capital Equipment – equipment procured by the Trust is leased rather than outright purchase. This is
funded from a revenue stream rather than capital.
LMC - Local Medical Committee - the representative group for General Practitioners (GP).



GM/DAC/Tboard/Glossary/revisedAugust2007                                                                        5
LOC - Local Ophthalmic Committee - the representative group for Opticians.
Local Compacts – part of the process for developing the PPI agenda. These are agreements between the
voluntary and community sector and statutory agencies to improve their relationship for mutual advantage.
Local Health Economy – The NHS organisations including GP practices, and voluntary and independent sector
bodies involved in the commissioning, development and provision of health services for particular population
groups.
LS – Life Support
LSCB – Local Safeguarding Children Board
Local Strategic Partnerships – non-statutory bodies intended to bring together the public, private, voluntary and
community sectors at a local level. Their purpose is to improve the delivery of services and quality of life locally
Lower Gastro-Intestinal – Lower gastro-intestinal tract = large bowel and rectum.
LPC - Local Pharmaceutical Committee - the representative group for Pharmacists.
Malignant – A term applied in several ways to serious disorders. Tumours are called malignant when they grow
rapidly, tend to infiltrate surrounding healthy tissues, and to spread to distant parts of the body, leading eventually
to death. The term is also applied to types of diseases which are much more serious than the usual form.
Mapping of Assurance – A process, providing a clear management trail, that links (1) Principal objectives to
principal risks (2) Principal risks to key controls (3) Key controls to assurances (Key Control – A control to manage
one or more principal risks.
Maximum Time to Treatment Guarantee - This refers to the requirement that all patients referred to hospital with
suspected breast cancer, testicular cancer, acute leukemia (malignant white blood cells) or a child with cancer
should wait no more than one month before being treated either from being referred by a GP in the case of breast
cancer or from the point of clinical diagnosis by a responsible specialist in the case of the other cancers.
MDT – Multi Disciplinary Team
MDHU- Military Defence Hospital Unit.
Medical devices – all products, except medicines, used in health care for diagnosis, prevention, monitoring or
treatment. The range of products is very wide: it includes contact lenses and condoms; heart valves and hospital
beds; resuscitators and radiotherapy machines; surgical instruments and syringes; wheelchairs and walking
frames.
MHRA – Medicines and Healthcare Products Regulatory Agency.
MOD – Ministry of Defence
MRI – Magnetic Resonance Imaging – This modality gives cross sectional body images using the effect of a
magnetic field on the cellular structure which is then used to generate a detailed image by digital reconstruction.
Multiple images are produced per examination. MRI is particularly used for soft tissue structures. Because of the
physical size, cost and safety requirements involved in using MRI most units are static and within a hospital
environment.
MRSA – Methicillin-resistant Staphylococcus aureus. The Department of Health collects data on bloodstream
infections (bacteraemia) due to this infection. Although the data is presented by Trust, the patients with the illness
may be in hospital or in the community.
MSSA – Methicillin-sensitive staphylococcus aureus.is not a part of national mandatory reporting
MTAS – Medical Training Application System
National Service Frameworks (NSF)–               NSFs
                Set national standards and identify key intervations for a defined service or care group
                Put in place strategies to support implementation; and
                Establish ways to ensure progress within an agreed timescale
                    The NSFs published to date cover:
                Mental health
                Coronary heart disease
                Older people
                Diabetes
                Paediatric intensive care
                Children, Young People and Maternity Services
                Children to tackle inequalities in services for disabled children
                Long term conditions
                Arrhythmias and Sudden Cardiac Death
                Involvement of Pharmaceutical Industry
                Cancer
                Renal
NCEPOD – National Confidential Enquiry into Perioperative Deaths.
NE PCTs – North East Primary Care Trusts
NEL – Non-elective spells (emergency and non-emergency),
Newcastle CRF – Clinical Research Faculty
NHS Direct - National telephone and internet service that provides direct advice and guidance on health issues.



GM/DAC/Tboard/Glossary/revisedAugust2007                                                                             6
NHS LA – NHS Litigation Authority,




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NHS INDICATORS SCORECARD- ACUTE TRUSTS

Definitions

1.1 Income and Expenditure: This shows the forecast outturn difference between income and expenditure for
    the full tar for the NHS trusts, as forecast at the last month of the quarter in question. The number is given as
    an absolute figure so there will be a tenancy for organizations to show larger variances. The figure given is
    the total forecast net expenditure for the year.

1.2 Cash flow: This indicator shows the percentage variance between actual cash drawings from, or cash
    repayments made to, the Department of Health, compared to those in the plan, shown as a percentage
    variance from plan. This is calculated using year to date figures as follows. Cash drawings are calculated as
    Temporary PDC Received minus Temporary PDC repaid, plus Permanent Received minus Permanent PDC
    Repaid, plus Loans Received from DH minus loans repaid to DH. From this is subtracted the planned cash
    drawings, amd the remaining variance is divided by the planned figure for each of the above and expressed
    as a percentage. Since the trusts can be net drawers, or net repayers , of cash, there are footnotes applicable
    to some trusts. The data is for the quarter shown at the top of the page

1.3 Monthly run rate: This indicator shows the extent of the variance I income and expenditure in the last month
    of the quarter. The variance is expressed as a percentage of total operating income. This is calculated by
    taking the total actual operating income for the month and subtracting first the total actual net expenditure for
    the month and then any planned surplus or deficit. This is divided by the total actual operating income for the
    month to gibe the indicator. A negative figure show that the organisation has failed to achieved its financial
    plan for the month. The calculation excludes any non-recurrent impact of RAB carry forward and the reversal
    of previous years‟ financial support, in order to establish the true underlying recurrent position..

2.1 Potential Bed Day Saved: This is calculated by working out the number of bed days that would have been
    saved if there had been a 25% reduction in the amount of time being spent by patients in excess of the
    median length of stay for the patients with the same age, sex, diagnosis, method of admission and social
    deprivation. This is expressed as a percentage of all bed days in the trust. The 25% figure has been chosen
    as representing an achievable reduction in the above average bed days. In general the lower the percentage,
    the better the performance in terms of avoiding above average hospital stays. The data is for the quarter
    shown at the top of the page.

2.2 Day Case Rates: The day case rate is the percentage of all operation from the Audit Commission basket of
    25 procedures performed as a day case. Note that the indicator is expressed as a percentage of all activity so
    trust that perform well on the indicator may still have scope for significant potential improvement. In general,
    the higher the day case rate, the better. The data is for the quarter shown at the top of the page.

2.3 Pre-operative Bed Days: The pre-operative bed days indicator is the percentage of all bed days for patients
    undergoing a procedure in hospital between date if admission and date of operation where that valid data
    were available. Note the trusts that perform well on the indicator may have scope for larger improvement than
    trusts that perform lower on the percentage of pre-operative bed days, the better. The data is for the quarter
    shown at the top of the page.

3.1 Staff Turnover: The indicator show the number of full-time equivalent leavers from an individual organization
    over one quarter multiplies by four to give an annualized figure. The turn over rate is expressed as a
    percentage of the average number of staff in the post .The data is for the quarter shown at the top of the
    page.

3.2 Sickness Absence: The indicator shows the number of full-time equivalent staff days lost to sickness
    absence. It is expressed as a percentage of the staff in the post for the period. Low values in the general
    indicate good performance. The date is for the quarter shown at the top of the page.




GM/DAC/Tboard/Glossary/revisedAugust2007                                                                                                              7
3.3 Agency Costs: This indicator shows the amount spent on agency staff, expressed as a percentage of paybill
    plus agency spend. A low value in general indicates good performance. The data for this quarter shown at
    the top of the page.

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NICE - National Institute for Clinical Excellence – the National Institute of Clinical Excellence is a special health
authority for England and Wales. Its role is to provide patients, health professionals and the public with
authoritative, robust and reliable guidance on current “best practice”. The guidance covers both individual health
technologies (including medicines, medical devices, diagnostic techniques, and procedures) and the clinical
management of specific conditions

NICE guidance – terms used

The core standards refer to guidance from The National Institute of Health and Clinical Excellence (NICE). NICE
produces three kinds of guidance:

          Technology appraisals - guidance on the use of new and existing medicines and treatments within the
           NHS in England and Wales.

          Interventional procedures - guidance on whether interventional procedures used for diagnosis or
           treatment are safe enough and work well enough for routine use in England, Wales and Scotland.

          Clinical guidelines - guidance on the appropriate treatment and care of people with specific diseases
           and conditions within the NHS in England and Wales.

The NICE website describes these as follows:

1)       Technology appraisals

Technology appraisals are recommendations on the use of new and existing medicines and treatments within the
NHS in England and Wales, such as: medicines             medical devices (for example, hearing aids or inhalers)
diagnostic techniques (tests used to identify diseases) surgical procedures (for example, repairing hernias) health
promotion activities (for example, ways of helping people with diabetes manage their condition).

2)   Interventional procedures

NICE makes recommendations about whether interventional procedures used for diagnosis or treatment are safe
enough and work well enough for routine use. An interventional procedure is a procedure used for diagnosis or
treatment that involves one of the following: Making a cut or a hole to gain access to inside a patient's body - for
example, when carrying out an operation or inserting a tube into a blood vessel. Gaining access to a body cavity
(such as the digestive system, lungs, womb or bladder) without cutting into the body - for example, examining or
carrying out treatment inside the stomach using an instrument inserted via the mouth. Using electromagnetic
radiation (which includes X-rays, lasers, gamma-rays and ultraviolet light) - for example, using a laser to treat eye
problems.

3)       Clinical guidelines

Clinical guidelines are recommendations on the appropriate treatment and care of people with specific diseases
and conditions within the NHS in England and Wales. Clinical guidelines are based on best available evidence.
Guidelines help healthcare professionals in their work, but they do not replace their knowledge and skills.

See tables for standard by standard


NME – Nutrition, Metabolism Endocrinology
Non-discretionary GMS (General Medical Services) - Fees and allowances for Primary Care.



GM/DAC/Tboard/Glossary/revisedAugust2007                                                                                                    8
NPfIT – National Programme for Information Technology – a programme to establish a national care records
service for the NHS.
NPSA – National Patient Safety Agency.
NSAIDS – Non-steroidal anti-inflammatory drugs – reduce inflammation and pain.
NY&Y – North Yorkshire and York PCT.
OCCR – Order communications and results reporting – an electronic system which submits orders for pathology
tests and radiological images and receives the resulting reports.
Oncologist – A doctor who specialises in the diagnosis, treatment and rehabilitation of people with cancer. A
clinical oncologist is trained in the use of radiotherapy and chemotherapy.
ODG – Operational Delivery Group.
Orthopaedics - Branch of medical science dealing with skeletal deformity, fractures and infections of bones,
replacement of arthritic joints and the treatment of bone tumours.
OJEU – Office Journal of the European Union.
Operating Surplus – Measure of operating cashflow.
OPFA – Outpatients first attendances seen.
OPFU – Outpatients review attendances seen.
OSC - Overview and Scrutiny Committee. Set up at County Council level although they will have members from
District Councils. Has role in local consultations and has power to question Chief Executive.
Overview and Scrutiny Committees (OSC) – OSCs have the power to scrutinise health services. This
contributes to their wider role in health improvement and reducing health inequalities for their area and its
inhabitants. OSCs will have to be consulted by the NHS where there are to be major changes to the protected
services of an NHS Foundation Trust.
PAs – Programmed Activities – are part of senior medical staff clinical contract.
PALS - Patient Advice and Liaison Service - a service that each NHS Trust is required to provide, giving direct
advice to consumers of local health services, addressing any concerns and seeking immediate resolution to such
concerns.
PAS – patient administration system – the corporate system which holds all the administration data associated
with patient contacts. The system is connected to an index of patients, referred to as the patient master index
(PMI)
Partial Booking – where the patient is advised of the waiting time for a service and is able to choose and confirm
their appointment or admission approximately 4 – 6 weeks in advance.
Pathology – The study of the causes and effects of disease by examining changes on tissues and cells.
Patient – those in receipt of health care provided by or for an English NHS body or cross-border SHA.
Patient and Public Involvement Forums are bodies set up for each NHS Trust and Primary Care Trust in
England. They take part in decisions about health and health services in local communities and reflect local
people‟s views and concerns.
Patient operation hours – This calculates the actual anaesthetic and surgical time for each patient and totals this
time, which is then divided by the time from the actual start to actual finish of the session.
PCI – Percutaneous Intervention – This term encompasses any minimally invasive approach on the coronary
arteries, including balloon angioplasty, stenting, atherectomy.
PCTs - Primary Care Trusts
PDC – Public Dividend Capital
PDS - Personal Dental Services - Local funding to develop local dental services.
PEC – Professional Executive Committee.
PEAT- Patient Environment Action Team
PFI- Private Finance Initiative
Percutaneous Transluminal Coronary Angioplasty (PTCA) or Percutaneous Coronary - This phrase has now
been largely superseded by PCI
PMETB – Postgraduate Medical Education Training Board
PMS - Personal Medical Services - The new system of local contracting and funding
of General Practice.
Pooled Budgets - where revenue budgets of health and social care are combined and managed as a single
budget.
PPA - Prescription Pricing Authority -The body in Newcastle that analyses and
costs all prescriptions dispensed by Pharmacists / GPs.
PPCI – Primary Percutaneous Coronary Intervention
PPD – Personal Professional Development
PPI - Patient and Public Involvement.
PPIF – Patient & Public Involvement Forums – are independent bodies made up o local people who volunteer.
There are forums for every NHS Trust and Primary Care Trust in England. Their role is to monitor and review NHS
services from the patient perspective.            Locally, PPIF‟s are provided with administrative support from
Middlesbrough Age Concern.



GM/DAC/Tboard/Glossary/revisedAugust2007                                                                         9
PPM- Planned Preventative Maintenance
Primary Care – first-contact health services directly accessible to the public
Primary Care Trusts – a local health organisation responsible for managing local health services. PCTs work
with Local Authorities and other agencies that provide health and social care locally to make sure that the
community‟s needs are being met
Primary Targeting List (PTL) - A methodology for identifying and targeting any particular cohort of patients who
are at risk of breaching the target if not treated. The PTL provides a focus for key managers and clinicians to
ensure patients are targeted and treated in line with clinical urgency and then chronologically thus ensuring that
overall targets are achieved.
Principal Objectives – Objectives set at strategic and directorate (or equivalent) level
Principal Risks – A risk which threatens the achievement of Principal Objectives
Prioritisation of Risk – A process by which risks are graded in order based on the likelihood of their occurrence
and the impact of their consequences
--------------------------------------------------------------------------------------------------------------------------------------------------------
Productivity and Efficiency Benchmarking Definitions:
OUTPATIENTS:
Review: New Ratios: This relates specifically to consultant led clinics only. The national benchmark is
taken from the DoH QM08 national data returns (April - June 2006/07) as reported by the NHS
Information Centre (in collaboration with Dr.Foster). The benchmark target for each specialty is the
upper quartile value taken from the national average distribution .
DNAs: The national benchmark is taken from DoH QM08 national data return (April - March 2005/06)
as reported by the NHS Information Centre (in collaboration with Dr.Foster). The national benchmark
target for each specialty is the median value taken from the national average distribution.
INPATIENTS:
Same day cancellations: The benchmark for same day cancellations is an internal benchmark based
on the number of same day cancellations for the previous year (2006/07). The expectation for 2007/08
is to achieve a 20% reduction compared with the same period for the previous year and this will
monitored on a cumulative basis.
Cancellations within 7 days: The benchmarks for cancellations within 7 days is an internal
benchmarks based on the number of cancellations for the previous year (2006/07). The expectation for
2007/08 is to achieve a 10% reduction compared with the same period for the previous year (2006/07)
and this will monitored on a cumulative basis.
Cancelled operations: The benchmark for cancelled operations is based on the 2006/07 Healthcare
Commission's expectation that cancelled operations for non-clinical reasons should be reduced to a
minimum level, and should not exceed 0.8% of the total elective FFCEs. For obvious reasons, the
benchmark level is established at the lower level of 0.7% of the total elective FFCEs, with an amber
traffic light indicating a value between 0.7% and 0.8% (maximum allowable tolerance used by the
Healthcare Commission for the 2006/07 Annual Health Check).
Cancelled operations not re-admitted within 28 days: The benchmark for this is zero, in line with
national expectations that any patients with a cancelled operation for non-clinical reasons should be re-
admitted within 28 days.
INPATIENT STAY:
Pre-Operative bed days (Elective and Non-Elective): Data not yet available.                 The national
benchmark is taken from NHS wide clearing service (NWCS) data for the period 2005/06, as reported
by the NHS Information Centre (in collaboration with Dr.Foster). The benchmark target is the median
value taken from the national average distribution for each specialty.
Average length of stay: The national benchmark is taken from NHS wide clearing service (NWCS)
data for the period 2005/06, as reported by the NHS Information Centre (in collaboration with
Dr.Foster). The benchmark target is the upper quartile value taken from the national average
distribution for each specialty.
Excess bed days: Excess bed days is normally part of the Service Level Agreement between
commissioner and provider to recover costs associated with patients who stay in hospital longer than
expected. It is based on national average lengths of stay for specific HRGs and is used here as a
proxy to indicate which specialties have patients occupying beds longer than expected for their
casemix undertaken. The benchmark level is set at the same level of excess bed days for 2006/07,
the understanding being that for specialties with bed capacity issues, the expectation is not to increase
beyond the 2006/07 levels. This will be monitored on a cumulative basis.



GM/DAC/Tboard/Glossary/revisedAugust2007                                                                                                            10
Daycase rates: The national benchmark for daycase rates is taken from NHS wide clearing service
(NWCS) data for the period April - September 2005/06, as reported by the NHS Information Centre (in
collaboration with Dr.Foster). The benchmark target is the upper quartile value taken from the
national average distribution for each specialty.

Prudential Borrowing Limit – Borrowing limit for Foundation Trusts by Monitor. Made up of maximum long term
borrowing and working capital facility
PSU - Prescribing Support Unit - A part of the PPA that advises the NHS on
interpretation of prescribing issues.
Public Health – Public health is concerned with improving the health of the population, rather than treating the
diseases of individual patients. Public health functions include:
                Health surveillance, monitoring and analysis
                Investigation of disease outbreaks, epidemics and risk to health
                Establishing, designing and managing health promotion and disease prevention programmes
                Enabling and empowering communities to promote health and reduce inequalities
                Creating and sustaining cross-Government and inter-sectoral partnerships to improve health
                    and reduce inequalities
                Ensuring compliance with regulations and laws to protect and promote health
                Developing and maintaining a well educated and trained, multi-disciplinary public health
                    workforce
                Ensuring the effective performance of NHS services to meet goals in improving health,
                    preventing disease and reducing inequalities
                Research, development, evaluation and innovation
                Quality assuring the public health function
Public Service Agreement – the PSA for the Department of Health sets out the priorities for the Department‟s
spending programme and, for each priority, the target(s) it is expected to achieve
Quick ratio – Measures the ability of an organisation to use its near cash or quick assets to immediately
extinguish its current liabilities. Quick assets include those current assets that can be quickly converted to cash.
Ideally the ratio would be above 1.
Radiographer – A non-medically qualified healthcare professional.
Radiology – The use of X-rays to diagnose a disease.
Radiotherapy – The treatment of disease by radiation
Reasonable Best – A decision or course of action, agreed by the board, that is based on sufficient evidence
Regulators are organisations who are paid by the Government to set standards, and to carry out inspections of
different services, including the NHS
R&D – Research and Development
Research governance framework – defines the broad principles of good research governance and is key to
ensuring that health and social care research is conducted to high scientific and ethical standards and applies to
all research undertaken within the remit of the Secretary for Health
Revascularisation - Procedures for repairing arteries, such as CABG or PTCA.
Revenue Expenditure – Day to day running expenses of the Trust.
Risk – The possibility of suffering some form of loss or damage. The possibility that objectives will not be
achieved
Risk Assessment – The identification and analysis of relevant risks to the achievement of objectives
Risk Management – A systematic process by which potential risks are identified, assessed, managed and
monitored
RfPB – Research for Patient Benefit
RRL – Revenue Resource Limit – The amount of expenditure the PCT is allowed to incur
RTT – Referral to treatment.
Saving Lives – a delivery programme produced by the Department of Health to reduce healthcare-associated
infections including MRSA. South Tees is fully committed to this programme which it is currently implementing.
Screening – Examination of people with no symptoms to detect disease. In England there are national screening
programmes for breast and cervical cancer.
SDO Research – Service Development Organisational
Service user – an individual who uses a health care service, including those who are not in need of treatment,
such as blood donors, carers or those using screening services
SLA - Service Level Agreement - a detailed agreement that sets out the services / obligations of two or more
parties to achieve an agreed outcome
Session uptake – Sessions delivered, divided by total planned sessions according to consultant theatre
timetables for a 52 week year




GM/DAC/Tboard/Glossary/revisedAugust2007                                                                         11
Silver alloy coated catheter- This is an indwelling bladder catheter which is coated with a silver alloy which
inhibits colonisation by bacteria. These catheters have been associated with around 25% fewer urinary tract
infections compared to a standard dwelling urinary catheter
SHS- Sovereign Hospital Services
SIFT – Service Increment for Teaching
SSCS – Special Study Components
SSD- Sterile Services Department
SO / SFIs - Standing Orders and Standing Financial Instructions - these documents set out the main financial
framework that the Trust operates within.
Sources of Assurance – The various reviewers, auditors and inspectors, both internal and external, who carry
out work at NHS organisations (see Internal Assurance and External Assurance). Boards will have to determine
which sources of assurance are relevant to principal risks and to what extent they are sufficient
South Tees Hospitals NHS Trust (STHT) - includes the Friarage Hospital (FHN), The James Cook University
Hospital (JCUH), Middlesbrough.
Specialist – Someone devoted to the care of a particular part of the body, or a particular aspect of diagnosis,
treatment or care.
Spine compliance – a requirement for interfacing with the spine record in the national care record system
Stakeholders are people or organisations which are important for the work another organisation does e.g.
Patients and the public, Local authorities, NHS Trusts, Patient/Voluntary organisations concerned with health

Standards for Better Health – Department of Health‟s common set of requirements to ensure all healthcare
organisations meet core standards in relation to the safety and quality of services and that progress is made
towards the achievement of the Development Standards
STAR PU (Prescribing Unit) – Weighted PU values dependent on the most likely users of the drug type
Statement on Internal Control (SIC) – An annual statement signed by the Accountable Officer on behalf of the
board that forms part of the Annual Financial Statements for the year. The SIC provides public assurances about
the effectiveness of the organisation‟s system of internal control
Statin – Drug for reducing cholesterol
Statutory Instrument - a legal document laid before Parliament that sets up / amends arrangements within the
various NHS Acts of Parliament.
Strategic Health Authority (SHA) – responsible for:
                Developing plans for improving health services in its local area
                Making sure local health services are of a high quality and are performing well
                Increasing the capacity of local health services so they can provide more services and
                Making sure national priorities are integrated into local health service plans
Strategic Objective – An overall goal of the organisation
SUI – Serious Untoward Incident
Surgical Site Infection – This is a wound infection which occurs after a patient has had an operation. Wounds
can be classified as “superficial” or “deep”. A superficial wound is one which affects the skin and is usually
straightforward to treat. A deep wound is more serious as it may require removal of a new prosthetic joint.
System of Internal Control – A system, maintained by the board, that supports the achievement of the
organisation‟s objectives. This should be based on an ongoing risk management process that is designed to
identify the principal risks to the organisation‟s objectives, to evaluate the nature and extent of those risks, and to
manage them efficiently, effectively and economically.
Tariff – The tariffs effectively fix the prices that organisations can charge NHS commissioners in relation to
services for NHS patients.
TCI date – To come into hospital date
TCRs – Teesside Centre for Rehabilitation Services
TEWV – Tees, Esk and Wear Valley NHS Trust- Provides mental health service.
Terms of Authorisation – Establishment as an NHS Foundation Trust will be subject to applicants being granted
terms of authorisation – similar to a licence – by the Independent Regulator. Each terms of authorisation will
include a statement on the public interest purpose of the organisation and will set out the conditions under which it
will operate.
Testicular Cancer – Cancer of the Testes
Theatre efficiency measures – see Appendix 1 for diagram
3T NMR – 3 Tesla Nuclear Magnetic Resonance
UPS- Uninterrupted Power Supply
Urological – Relating to the branch of medicine which treats disorders and diseases of the kidneys, ureters,
bladder, prostate and urethra
VIP- „Voice Integrated Products’ - A system which has voice integrated into it. This can be anything from
telephones (mainly call centres and voice mail) to voice recognition but is generally thought of more as the voice
recognition or voice controlled systems.



GM/DAC/Tboard/Glossary/revisedAugust2007                                                                            12
Virement - Option to move money between one department funding stream and another. The transfer from capital
to revenue is limited by HM treasury and managed by the Strategic Health Authority.
WAFA – Ward attenders first attendance seen (plan included in the OPFA plan)
WAFU – Ward attenders review attendance seen (plan included in the OPFU plan)
Whitley - the current national terms and conditions for NHS staff will be replaced as part of Agenda for Change
Working Capital Facility – An irrevocable borrowing facility repayable in the short-term (within 24 months) that an
NHSFT may draw from on a temporary basis to smooth cash flow.
WTE – Whole Time Equivalents, number of staff expressed in terms of hours worked.
xDC – IP spells charged at local tariff (J37 and N12, plan included in EL plan for all except obstetrics which will be
in the NEL plan
Yorkshire and The Humber Strategic Health Authority. The NHS organisation to which the North Yorkshire
and City of York PCT is accountable




GM/DAC/Tboard/Glossary/revisedAugust2007                                                                           13

				
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