rotherham clinical commissioning group: governing body … body papers... · march 2019 achieving...

Rotherham Clinical Commissioning Group:

Governing Body Delivery Dashboard for 2018/19

Delivery Dashboard

Constitution and Pledges

Improvement and Assessment Framework

Health Outcomes

Better Care Fund

Quality Premium

Focus on Performance Tables

Focus on Performance - 111

March 2019

Number Achieving Nationally Please note:

Diagnostic To ensure comparison accuracy,

DTOC this table is based on the latest

RTT month's published data, instead

A&E (Rotherham FT) of provisional data published

Cancer 2 ww elsewhere in this report.

Cancer 2 ww Breast

Cancer 31 Day

Cancer 62 Day (Rotherham FT)

Cancer 62 Day (Rotherham CCG)

IAPT 6 Week Wait*

*IAPT Figures are as at November 2018

Rotherham CCG Delivery Dashboard

Meeting standard - no change from last month

Not meeting standard - no change from last month

Meeting standard - improved on last month

Not meeting standard - improved on last month

Meeting standard - deteriorated from last month

Not meeting standard - deteriorated from last month

97.06%

64 out of 196

105 out of 222

50th out of 196

68th out of 222

Performance Comparison - Rotherham CCG/FT v National December 2018

Target RCCG/Trust National Rotherham Performance

0.94%

2.15%

1.0%

3.5%

2.40%

3.50%

150 out of 196

74 out of 155

65 out of 196

174 out of 197*

51st out of 239

109th out of 196

129th out of 196

155th out of 196

145th out of 155

166th out of 196

117th out of 197

5 out of 238

143 out of 196

99 out of 196

92.0% 92.86% 84.70%

95.0%

93.0%

93.0%

84.32%

94.76%

90.43%

86.43%

93.74%

86.14%

March 2019

AchievingLast three months met and YTD met

Improving

Last MonthCurrent

Month

Next Month

Predicted

Previous

Month

72.58%

92.40%

81.04%

81.07%

89.20%

25 out of 195 14th out of 195

Performance This Month

96.0%

85.0%

85.0%

75.0%

95.87%

85.96%

Previous

Month

DTOC

Target

Cancer Waits: 31

days

Target

Last month met but previous not met or YTD not met

Next Month

PredictedLast Month

Current

Month

Cancer Waits: 62

days85%

0

Referral to

treatment92%

Previous

Month

Cancelled

Operations

Cancer Waits: 2

weeks

Mixed Sex

Accomodation

Diagnostics

Not met last two months

Previous

Month

0

96%

Next Month

Predicted

Deteriorating

3.5%

Target

Last MonthCurrent

Month

Next Month

Predicted

Not met last month but met previously or YTD met

Target

93%

1%

Current

Month

75%

Last Month

Concern

A&E 95.0%

IAPT - 6 week

wait

IAPT

The national target for patients accessing IAPT services is 75% within 6 weeks and 95% within 18 weeks. The 6 week wait position for Rotherham CCG as at end January was 89.6%. This is above

the standard of 75%. December performance was 95.3%. The IAPT position has been performing well for a number of months. Self-referral into the service is now established and contributing to this

position.

Urgent and emergency care is now a single streaming service at The Rotherham Foundation Trust (TRFT). The February position to date has seen deterioration in performance from January.

Performance in February to date (as at 17th February) is 75.7%. Performance in January was 80.6%. This represents underperformance against the 95% standard and the Sustainable Transformation

Fund (STF) trajectory.

The challenges on performance are linked to increased attendances above plan, workforce within the department, which remain challenging and flow through the hospital with an increased number of

patients delayed from discharge during this reporting period. The CCG continue to work closely with partners through the A&E delivery board to realise improvement. Local comparison to other Trusts

in South Yorkshire can be seen below. England performance in January was 84.4%.

The 18 week wait position for the service as at end January was 98.6%. Performance is consistently meeting the 95% standard for 18 weeks.

Key Performance Issues

A&E

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%

Mar-18 Apr-18 May-18 Jun-18 Jul-18 Aug-18 Sep-18 Oct-18 Nov-18 Dec-18 Jan-19 Feb-19

% Seen within 4 hours - Rotherham CCG STF Trajectory

0%

20%

40%

60%

80%

100%

21/02/201931/01/201931/12/201830/11/201831/10/201830/09/201831/08/201831/07/201830/06/201831/05/201830/04/201831/03/2018

IAPT - Total waiting less than six weeks Target

92%

93%

94%

95%

96%

97%

98%

99%

100%

21/02/201931/01/201931/12/201830/11/201831/10/201830/09/201831/08/201831/07/201830/06/201831/05/201830/04/201831/03/2018

IAPT 18 Weeks Performance Target

88.8% 88.5%

92.7%

86.6%

94.0%

97.5% 87.3%

80.0%

82.0%

84.0%

86.0%

88.0%

90.0%

92.0%

94.0%

96.0%

98.0%

100.0%

NoE England DBHFT RFT BHFT SCHFT STHFT

A&E Year to Date Benchmarks as at January 2019 YTD Target

92.00% 92.00%

92.9%

92.00%92.00%Target 92.00%

31 day

93.4%92.4%

Jul-18

94.5%

Aug-18May-18Mar-18 Apr-18

62 day

Actual

Dec-18

Eliminating Mixed Sex Accomodation

MSA

Nov-18

There were no breaches of this standard in December.

Cancer Waits

In December the 62 day GP referral to treatment target did not meet the national standard of 85%, with performance at 72.6% for Rotherham CCG. 62 day performance deteriorated at the Rotherham

Foundation Trust with performance at 86.0% in November and 77.2% for December. TRFT achieved the 62 day performance target for Q2 at 85.4%, which is in line with the agreed recovery plan

between the CCG and TRFT. Continued focus remains in areas relating to pathways associated with lower GI, urology and on earlier diagnostics. The RCCG reported position of 72.6% is also being

impacted by the number of breaches reported by Sheffield Teaching Hospitals NHS Foundation Trust.

The 31 day standard was not achieved in December, with performance at 95.9% against the standard of 96%. The two week wait cancer standard was achieved in December with performance of

94.8% against the 93% standard. The two week wait standard for breast symptoms was however not achieved with performance at 90.4% against the 93% standard.

Most of the breaches for the breast symptoms standard were at Rotherham Hospital Foundation Trust.

The 31 day wait standard for Surgery subsequent treatments was not achieved in December. This was principally due to elective capacity issues at Sheffield Teaching Hospitals NHS Foundation

Trust.

Jun-18 Oct-18

Dec-18

Oct-18

Nov-18

RTT Incomplete Pathways continue to meet the 92% national standard in January with performance at 92.4%. Further details of specialty level performance can be found in the “focus on” section of

the report. The CCG continues to see strong Referral to Treatment performance in most specialties.

There were no 52+ week waiters in January. The non-admitted 52+ week waiter noted on the report is the Ophthalmology waiter previous reported as incomplete at Doncaster and Bassetlaw NHS

Foundation Trust, that was seen in January.

Jan-19

2 week wait

Nov-18

92.00%92.00% 92.00%

93.2% 93.8%

Feb-18

94.3% 93.9%93.3%

Dec-18

Referral to Treatment

92.00%

RTT Incomplete

Oct-18

93.0%

Jan-19

92.00% 92.00%

Sep-18

92.4%

92.00%

94.4%

Dec-18

52 week wait

Nov-18

90.5%91.0%91.5%92.0%92.5%93.0%93.5%94.0%94.5%95.0%

Feb-18 Mar-18 Apr-18 May-18 Jun-18 Jul-18 Aug-18 Sep-18 Oct-18 Nov-18 Dec-18 Jan-19

% Patients on incomplete non-emergency pathways waiting no more than 18 weeks

Actual Target

Nov-18

Diagnostic Waiting Times

Provisional performance in January of 0.92% meets the <1% standard.

36 breaches occurred during January. There were 34 at Rotherham NHS Foundation Trust (31 Respiratory Physiology - sleep studies, 2 Non-obstetric Ultrasound and 1 Magnetic Resonance

Imaging), 1 at Barlborough NHS Treatment Centre (Magnetic Resonance Imaging) and 1 at Manchester University NHS Foundation Trust (Magnetic Resonance Imaging).

Capacity for sleep studies has been identified as an issue across a number of providers in the region. Work is on-going at a local and a South Yorkshire and Bassetlaw level to understand the issues

and address them.

Incidence of C.diff and MRSA

Diagnostic Waits

CCG c.diff

RFT c.diff

Performance for the CCG overall year to date (YTD), as at January was 43 cases against a plan of 54. The 4 cases in January all occurred at Rotherham FT. The year-end target for the CCG is to

achieve less than 62.

TRFT performance YTD as at January is 7 cases against the target of 21. TRFT year-end target is to achieve less than 25.

MRSA

Jan-19Dec-18

Nov-18 Dec-18 Jan-19

DTOC

Oct-18 Nov-18 Dec-18

Delayed Transfers of Care

The national standard is 3.5% of total occupied bed days taken up by delayed transfers of care. The Rotherham NHS Foundation Trust are currently meeting that standard at 2.1% in December. This

is an improvement from November when performance was 2.3%. It should be noted that whilst performance within Rotherham Foundation Trust is good, across Rotherham as a whole DTOCs are

above the position required by the Better Care Fund trajectory. Performance against the Better Care Fund trajectory is displayed in the Better Care Fund section of the report .

0.0%

0.5%

1.0%

1.5%

2.0%

2.5%

3.0%

3.5%

4.0%

4.5%

5.0%

Jan-18 Feb-18 Mar-18 Apr-18 May-18 Jun-18 Jul-18 Aug-18 Sep-18 Oct-18 Nov-18 Dec-18

% B

ed

day

de

lays

Month

Delayed days rate performance in last 12 months - THE ROTHERHAM NHS FOUNDATION TRUST

The Rotherham NHS FT (current)

North Region (current)

Target

3

2

31

Breaches by Test

Magnetic Resonance Imaging

Non-obstetric Ultrasound

Respiratory physiology - sleep studies34

1 1

Breaches by Provider

The Rotherham NHSFoundation Trust

Manchester University NHSFoundation Trust

Barlborough NHS TreatmentCentre

Current YAS Performance (Response Times)

Handovers at NGH Worse

48.10%

Change

Worse

Previous Month - December

00:07:03

00:21:03

Category 1

Current Performance - January Change

Better

46.50%

Worse

Category 3

Category 4

Current performance - January

02:15:22

03:38:33

00:06:59

00:19:49

01:58:10

03:52:38

Better

15 Min Turnaround RFT on target

Yorkshire Ambulance Service (YAS) is continuing to participate in NHS England’s Ambulance Response Programme (ARP), which has moved to phase three. Based on feedback from the pilot, there

are now four categories and the eight minute response time for category 1 incidents no longer exists.

Currently, YAS are producing information at provider level, without any individual CCG performance data. RCCGs individual performance cannot therefore be reported this month. Details of the new

standards are below. YAS as an organisation achieved a mean of 6 minutes 59 seconds for category 1 calls in January.

YAS

BetterCategory 2

Category

Description Target

1 Life-threatening illnesses/injuries

Mean target of 7 minutes and 90th percentile target of 15 minutes

2 Emergency calls Mean target of 18 minutes and 90th percentile target of 40 minutes

3 Urgent calls 90th percentile target of 2 hours

4 Less urgent calls 90th percentile target of 3 hours

NHS Constitution and Pledges

Denotes that a measure that has been updated in this report

Nov-18 Dec-18 Jan-19 Target QP

93.4% 92.9% 92.4% 92.0% Y

2 1 0 0

0 0 1 0


0.80% 0.94% 0.92% 1.0%

Dec-18 Jan-19 Feb-19 Target QP

84.3% 80.6% 75.7% 95.0% Y

Oct-18 Nov-18 Dec-18 Target QP

89.3% 92.0% 90.4% 93.0%

94.5% 93.3% 94.8% 93.0%


93.5% 95.1% 95.9% 96.0%

93.9% 100.0% 87.0% 94.0%

100.0% 100.0% 100.0% 98.0%

98.0% 92.7% 94.9% 94.0%


77.9% 81.9% 72.6% 85.0% Y

80.0% 100.0% 100.0% 90.0%

84.6% 80.9% 92.7%

% patients receiving subsequent treatment where treatment

is anti-drug regime within 31 days


is radiotherapy within 31 days

Cancer - 62 Day Waits

% patients treated within 62 days following referral from a

Consultant

% patients starting first treatment within 62 days of referral

from GP

% patients starting first treatment within 62 days after

breast, bowel and cervical screening referral

Referral to Treatment

Diagnostic Waiting Times

Cancer - 31 Day Waits


is surgery within 31 days

% of patients seen within 2 weeks of urgent referral by a GP

Total A&E: % 4 hour A&E waiting times - seen within 4 hours

(latest monthly position)

% Patients waiting for diagnostic test waiting > 6 weeks from

referral (Commissioner)

% patients referred with breast symptoms seen within 2

weeks of referral

Number of 52 week referral to treatment pathways non

admitted (Commissioner)

Number of 52 week referral to treatment pathways

incomplete (Commissioner)

% Patients on incomplete non-emergency pathways waiting

no more than 18 weeks (Commissioner)

A&E Waits

Cancer - Two Week Waits

% patients receiving first definitive treatment within 31 days

following referral

NHS Constitution and Pledges

Denotes a measure that has been updated in this report


00:07:02 00:07:03 00:06:59 00:07:00

00:20:29 00:21:03 00:19:49 00:18:00

01:58:25 02:15:22 01:58:10 02:00:00

03:44:04 03:38:33 03:52:38 03:00:00


36 29 37 0

216 288 297 0


0 0 0 0

Q1 2018/19 Q2 2018/19 Q3 2018/19 Target QP

1 0 0 0

Q4 2017/18 Q1 2018/19 Q3 2018/19 Target QP

93.9% 99.0% 100.0% 95.0%

Q4 2017/18 Q1 2018/19 Q2 2018/19 Q3 2018/19 QP

Target 92.0% 92.0% 92.0% 92.0%

Actual 21.1% 41.5% 19.3% 50.0%

The underperformance against this standard is being worked through with the new service provider.

YAS Performance

Category 1 (Mean target of 7 minutes per call)

Category 2 (Mean target of 18 minutes per call)

Category 3 (90th percentile target of 2 hours per call)

Category 4 (90th percentile target of 3 hours per call)

Wheelchairs for Children*

Percentage of equipment delivered within 18

weeks

YAS - Ambulance Calls

Mixed Sex Accommodation Breaches

Cancelled Operations

Mental Health

Proportion of people on Care Programme Approach (CPA)

who were followed up within 7 days of discharge

Crew clear delays of over 30 minutes

Cancelled operations re-booked within 28 days

Number of mixed sex accommodation breaches

(commissioner)

Ambulance handover delays of over 30 minutes


Priority Clinical Areas

Child obesity High Quality Care Provision

Diabetes Cancer

Falls Mental health

Personal Health Budgets Learning disability

Health inequalities Maternity

Anti-microbial resistance Dementia

Carers Urgent and emergency care

End of Life Care

Primary medical care

Elective access

7 Day services

NHS continuing healthcare

Sepsis

Diagnostic Tests

Probity and corporate Financial performance

governance E-Referral Service

Workforce engagement Expenditure

CCGs local relationships

Patient and public participation

Quality of leadership


Reporting

Frequency

Latest available

data

Latest Period

PerformanceTarget

Annual2014-15 to 2016-

1736.0%

Annual 2017/18 36.8%

Annual2017/18 (2016

Cohort)7.8%

Quarterly Q3 17/18 2158

Quarterly Q2 18/19 51.0


Monthly Dec-2018 1.064 1.16

Monthly Dec-2018 6.24% 10

Annual 2018 0.61

Bet

ter

Hea

lth

Health inequalities

(Indicator 106a)

Anti-microbial

resistance

(Indicators 107a &

107b)

Carers

(Indicator 108a)

People with diabetes diagnosed less than a year who

attend a structured education course

Appropriate prescribing of broad spectrum antibiotics

in primary care

The proportion of carers with a long term condition

who feel supported to manage their condition

Narrative

Good

Good

Requires Improvement

Inadequate


Appropriate prescribing of antibiotics in primary care

Child obesity

(Indicator 102a)


Mental Health

Dementia

Learning Disabilities

Cancer

Diabetes

Maternity

Percentage of children aged 10-11 classified as

overweight or obese

Diabetes patients that have achieved all the NICE

recommended treatment targets: three (HbA1c,

cholesterol and blood pressure) for adults and one

(HbA1c) for childrenDiabetes (Indicators

103a & 103b)

Personal Health

Budgets

(Indicator 105b)

Falls

(Indicator 104a)Injuries from falls in people aged 65 and over

Personal health budgets

Inequality in unplanned hospitalisation for chronic

ambulatory care sensitive and urgent care sensitive

conditions

Delivering the Five Year

Forward View



Reporting

Frequency

Latest available

data

Latest Period

PerformanceTarget

Six-monthly Q1 2018/19 60



Annual 2016 46.9% 49.2%

Monthly Dec-18 72.6% 85%

Annual 2015 70.7%

Annual 2017 8.9 8.8

Monthly Dec-18 63.0% 50.0%

Monthly Dec-18 13.00% 17.8%


Quarterly

Quarterly 2018 02 14

Annual

Quarterly

Annual

Quarterly Q2 2018/19 Compliant Compliant

Quarterly


Annual 2017/18 46.8%

Annual 2017/18 0.59%

Annual 2016 5.79

Annual 2017 78.1

Annual 2017 55.4

Quarterly Q2 2018/19 18.1%

Monthly Jan-19 85.6% 66.7%

Annual 2017/18 76.5%


Monthly Feb-19 75.7% 95.0%

Monthly Dec-18 9.7


Annual 2017 6.79%

Annual Aug-18 84.5% 74.6%

Quarterly Oct-18 100%

Bi-annual 2018 03 0.99

Quarterly Q2 2018/19

(1) The Cancer Patient Experience target is the National Average, so Rotherham's performance is being measured against the national average

Choices in maternity services

Reliance on specialist inpatient care for people with a

learning disability and/or autism

Proportion of people with a learning disability on the

GP register receiving an annual health check

Completeness of the GP learning disability register

Maternal smoking at delivery

Neonatal mortality and stillbirths

Women’s experience of maternity services

Cancer patient experience (1)

Improving Access to Psychological Therapies –

access People with first episode of psychosis starting

treatment with a NICE-recommended package of

care treated within 2 weeks of referral

Children and young people’s mental health services

transformation

Mental health out of area placements

Mental health crisis team provision

Population use of hospital beds following emergency

admission

Estimated diagnosis rate for people with dementia

Dementia care planning and post-diagnostic support

Emergency admissions for urgent care sensitive

conditions

Percentage of patients admitted, transferred or

discharged from A&E within 4 hours

Delayed transfers of care per 100,000 population

Provision of high quality care: hospitals

Provision of high quality care: primary medical

services

Provision of high quality care: adult social care

Cancers diagnosed at early stage

People with urgent GP referral having first definitive

treatment for cancer within 62 days of referral

One-year survival from all cancers

Provision of High

Quality Care

(Indicators

121a, 121b & 121c)

Cancer

(Indicators

122a, 122b, 122c &

122d)

Learning disability

(Indicators 124a,

124b & 124c)

Maternity

(Indicators 125a,

125b, 125c & 125d)

Dementia

(Indicators 126a &

126b)

Primary care access - Proportion of population

benefitting from extended access services

Percentage of deaths with three or more emergency

admissions in last three months of life

Primary care workforce

Patient experience of GP services

Delivery of the mental health investment standard

Mental health

(Indicator 123d)

Bet

ter

Car

e

Amended Indicator - Awaiting Data



Proportion of people on GP severe mental illness

register receiving physical health checks

Cardio metabolic assessment in mental health

environments

Quality of mental health data submitted to NHS Digital

(DQMI)

Count of the total investment in primary care

transformation made by CCGs compared with the £3

head commitment made in the General Practice

Forward View

Primary medical care

(Indicators 128b,

128c, 128d & 128e)

Improving Access to Psychological Therapies –

recovery


Urgent and

emergency care

(Indicators 127b,

127c, 127e and 127f)

End of Life Care

(Indicator 105c)


Mental health

(Indicators 123a,

123b & 123c)

Mental health (123f)

Mental health (123i)

Mental health

(Indicators 123e,

123g & 123h)

Mental health (123j)



Reporting

Frequency

Latest available

data

Latest Period

PerformanceTarget

Monthly Jan-19 92.4% 92%

Annual 2017 2

Quarterly Q2 2018/19 1.6% 15%

Annual 2017 +


Reporting

Frequency

Latest available

data

Latest Period

PerformanceTarget


Monthly Dec-18 115.6% 100%


Reporting

Frequency

Latest available

data

Latest Period

PerformanceTarget


Annual 2017 3.64

Annual 2017 0.13

Annual 2017/18 82.9


Annual 2017

Lea

der

ship

Percentage of NHS Continuing Healthcare full

assessments taking place in an acute hospital setting

NHS continuing

healthcare (Indicator

131a)

Patient Safety

(Indicator 132a)

Evidence that sepsis awareness raising amongst

healthcare professionals has been prioritised by the

CCG

Probity and corporate governance

7 Day services

(Indicator 130a)

Patients waiting 18 weeks or less from referral to

hospital treatment

Workforce

engagement

(Indicators 163a &

163b)

Patient and Public

Participation

(Indicator 166a)

Elective access

(Indicator 129a)

Quality of leadership

(Indicator 165a)

Effectiveness of working relationships in the local

system

Compliance with statutory guidance on patient and

public participation in commissioning health and care

Quality of CCG leadership

Staff engagement index

Progress against the Workforce Race Equality

Standard

CCGs local

relationships

(Indicator 164a)

Financial

Performance

(Indicator 141b)

E-Referral Service

(Indicator 144a)

CCG In-year financial performance

Utilisation of the NHS e-referral service to enable

choice at first routine elective referral

Probity and

corporate

governance

(Indicator 162a)

Achievement of clinical standards in the delivery of 7

day services

S

ust

ain

abili

ty

Expenditure in areas with identified scope for

improvement

Expenditure

(Indicator 145a)

Bet

ter

Car

e

Patients waiting six weeks or more for a diagnostic

test

Diagnostic Tests

(Indicator 133a)

Health Outcomes


2014 2015 2016 Target

2499.7 2378

86.5 76.8 79.5 63.7

31.2 41.3 44.0 27.6

18.9 18.0 18.7 15.8

143.5 127.3 131.4 121.4

07/13-03/14 07/14-03/15 07/15-03/16 07/16-03/17 Target

0.707 0.702 0.708 0.720 0.740

07/14-03/15 07/15-03/16 07/16-03/17 07/17-03/18 Target

65.20 66.20 62.10 59.00 67.14

2014/15 2015/16 2016/17 2017/18 Target

1162.4 1064.9 1025.1 943.4 1,074

355.9 270.1 236.7 231.6 364

Nov-18 Dec-18 Jan-19 YTD Target

85.70% 85.77% 85.64% 85.64% 66.70%

2014/15 2015/16 2016/17 2017/18 National

1573.1 1627.6 1591.9 1498.4 1,362

490.6 338.6 422.4 283.6 403.9

Target

437.3%

83.8%

68.6%

Nov-18 Dec-18 Jan-19 2018/19 YTD

0 0 0 3 Actual

0 0 0 0 Plan

0 0 0 1 Actual

0 0 0 0 Plan

1 3 4 43 Actual

4 4 4 54 Plan

0 1 0 7 Actual

2 2 2 21 Plan

Dec-18 Jan-19 Feb-19 2018/19 YTD Target

95.3% 89.6% 94.0% 91.0% 75.0%

99.7% 98.6% 98.8% 99.6% 95.0%

Latest Period Performance

Jul-17

Aug-18

Aug-18

440.8%

84.5%

66.5%Satisfaction with accessing primary care

Mental Health: Monthly Indicators

Incidence of healthcare associated infection (HCAI) - MRSA

(Commissioner)

Incidence of healthcare associated infection (HCAI) - MRSA

(Provider) - RFT

Incidence of healthcare associated infection (HCAI) - C.Diff

(Commissioner)

Incidence of healthcare associated infection (HCAI) - C.Diff

(Provider) - RFT

Proportion of people waiting 6 weeks or less from referral to entering

a course of IAPT treatment

Proportion of people waiting 18 weeks or less from referral to

entering a course of IAPT treatment

Under 75 mortality rate from cardiovascular disease (CCG)

Under 75 mortality rate from respiratory disease (CCG)

Under 75 mortality rate from liver disease (CCG)

Under 75 mortality rate from cancer (CCG)

Satisfaction with the overall care received at the surgery

Enhancing Quality of Life

Preventing Premature Mortality


Helping Recovery

Patient Experience

Protecting People From Avoidable Harm



Health-related quality of life for people with long-term conditions

Emergency admissions for children with Lower Respiratory Tract

Infections (LRTI)

Satisfaction with the quality of consultation at the GP practice

Proportion of people feeling supported to manage their condition

Unplanned hospitalisation for chronic ambulatory care sensitive

conditions

Unplanned hospitalisation for asthma, diabetes and epilepsy in

under 19s

Diagnosis rate for people with dementia, expressed as a percentage

of the estimated prevalence

Emergency admissions for acute conditions that should not usually

require hospital admission

Potential Years of Life Lost (PYLL) from causes considered

amendable to healthcare, per 100,000

Health Outcomes

Oct-18 Nov-18 Dec-18 YTD 18/19 Target

10.1% 11.9% 13.00% 13.00% 17.80%

59.80% 57.10% 63.00% 57.20% 50.0%

Q4 2017/18 Q1 2018/19 Q2 2018/19 Q3 2018/19 Target

5 5 1 2 3

7 7 3 2 3

71.4% 71.4% 33.3% 100% 95.0%Percentage of CYP with ED that start treatment within one week of

referral

Improved Access to Psychological Services-IAPT: People entering

treatment against level of need (YTD)

Improved Access to Psychological Services-IAPT: People who

complete treatment, moving to recovery

CYP Eating Disorder (ED) Services - Urgent Cases

Number of CYP with ED (urgent cases) referred with a suspected

ED that start treatment within 1 week of referral

Number of CYP with a suspected ED (urgent cases) that start

treatment

Mental Health: Monthly Indicators

Better Care Fund


Delayed Transfers of Care - Rotherham Foundation Trust


Actual 2.2% 1.9% 2.7% 2.8% 2.1% 1.6% 2.1% 3.7% 2.6% 3.4% 2.3% 2.1%

Target 3.5% 3.5% 3.5% 3.5% 3.5% 3.5% 3.5% 3.5% 3.5% 3.5% 3.5% 3.5%

Actual YTD 4.0% 3.8% 3.7% 2.8% 2.5% 2.2% 2.1% 2.5% 2.5% 2.6% 2.6% 2.5%

Target YTD 3.5% 3.5% 3.5% 3.5% 3.5% 3.5% 3.5% 3.5% 3.5% 3.5% 3.5% 3.5%

Delayed Transfers of Care - Rotherham Health & Wellbeing Board

Apr-18 May-18 Jun-18 Jul-18 Aug-18 Sep-18 Oct-18 Nov-18 Dec-18 Jan-19 Feb-19 Mar-19

Actual 14.9 14.1 15.3 19.6 27.9 18.8 25.3 21.6 21.0 0.0 0.0 0.0

Target 16.0 16.0 16.0 16.0 16.0 16.0 16.0 16.0 16.0 16.0 16.0 16.0

Delayed transfers of care are monitored in two different ways. At a Hospital Trust level and a Health and Wellbeing Board (HWB) level.

The Hospital Trust indicator considers delays as a % of patients in hospital. The HWB level indicator considers the average delayed days in a month.


Actual 59 105 168 206 238 262 309 347 392 436 0 0

Target 23 73 122 171 221 270 320 369 419 468 518 562

Actual YTD 59 105 168 206 238 262 309 347 392 436 0 0

Target YTD 23 73 122 171 221 270 320 369 419 468 518 562

Both the target and actual figures are cumulative. The target for the year is 562

The final position for 2017/18 was 614 versus a target of 589

Actual

Target

Delayed transfers of

care from hospital

(delays days rate)*

Long-term support

needs of older people

(65 and over) met by

admission to residential

and nursing care

homes, per 100,000

population

90.0% 91.0%

2015/16 2016/17

Proportion of older

people (65 and over)

still at home 91 days

after discharge from

hospital into reable-

ment / rehabilitation

services

89.6% 87.5%

Delayed transfers of

care. Average delayed

days a month for

Rotherham Health and

Wellbeing Board.

2017/18

82.8%

88.0%

2018/19

89.0%

Quality Premium


Preventing Premature Mortality Target

Proportion of cancers diagnosed at stages 1 and 2 49.2%

Increase in proportion of GP referrals by e-referral Target

Proportion of GP referrals made by e-referrals 100.0%

Overall Experience of Making a GP Appointment Target

% of respondents who said they had a good experience of

making an appointment68.6%

Continuing Health Care Target

NHS CHC eligibility decision is made by the CCG within 28

days from receipt of the Checklist (or other notification of

potential eligibility)

Full NHS CHC assessments take place in an acute hospital

setting to be less than Quality Premium target

Antimicrobial Resistance (AMR) Improving Antibiotic

Prescribing in Primary Care Target

Reducing gram negative bloodstream infections: Reduction of

Ecoli BSI reported at CCG level4

Reducing inappropriate antibiotic prescribing for UTI in primary

Care:

A 10% or greater reduction in the number of Trimethoprim

items prescribed to to patients aged 70 year or over

2894

Appropriate prescribing of broad spectrum antibiotics in

primary care1.161 Dec-18 1.064


Jan-19 3

Nov-18 3219


Please see quality report for performance against CHC indicators

Dec-18 115.6%


2016 46.9%


Please see quality report for performance against CHC indicators

Latest Period Peformance

Aug-18 66.5%

0.950

1.000

1.050

1.100

1.150

1.200

1.250

1.300


Appropriate Prescribing of Antibiotics in Primary Care

This chart shows the improvement in appropriate prescribing since April 2017

AppropriatePrescribing Rate2017-18

AppropriatePrescribing Rate2018-19

Target

Focus on Performance

Focus on - A&E Waits


Actual 83.1% 83.5% 89.8% 92.1% 86.2% 87.5% 84.7% 88.7% 88.8% 84.3% 80.6% 75.7%

Target 95.0% 95.0% 95.0% 95.0% 95.0% 95.0% 95.0% 95.0% 95.0% 95.0% 95.0% 95.0%

F:\Data\Bu

siness tbc


% Seen within 4 hours - RFT 83.1% 83.5% 89.8% 92.1% 86.2% 87.5% 84.7% 88.7% 88.8% 84.3% 80.6% 75.7%

% Seen within 4 hours - Barnsley FT 91.1% 90.3% 93.0% 95.4% 92.1% 90.3% 98.6% 95.4% 97.4% 96.7% 91.1%

% Seen within 4 hours - Doncaster & Bassetlaw FT 93.3% 92.3% 94.6% 94.9% 92.2% 92.7% 93.7% 92.2% 92.9% 91.3% 90.2%

% Seen within 4 hours - England 84.6% 88.5% 90.4% 90.7% 89.3% 89.7% 88.9% 89.1% 87.6% 86.4% 84.4% 0.0%

% Seen within 4 hours - North 84.5% 88.3% 90.7% 91.0% 89.1% 90.1% 89.2% 89.2% 88.3% 86.6% 84.6% 0.0%

% Seen within 4 hours - Target 95.00% 95.00% 95.00% 95.00% 95.00% 95.00% 95.00% 95.00% 95.00% 95.00% 95.00% 95.00%


% Seen within 4 hours - Rotherham CCG 83.1% 83.5% 89.8% 92.1% 86.2% 87.5% 84.7% 88.7% 88.8% 84.3% 80.6% 75.7%

STF Trajectory 95.0% 80.0% 80.7% 83.1% 85.7% 88.2% 90.1% 90.6% 90.8% 91.1% 91.5% 93.1%

Variance - Actual v STF Trajectory -11.9% 3.5% 9.1% 9.0% 0.5% -0.7% -5.4% -1.9% -2.0% -6.8% -10.9% -17.4%

% 4 Hour A&E waiting times - seen

within 4 hours latest monthly position

Focus on - STF Trajectory

65.0%

70.0%

75.0%

80.0%

85.0%

90.0%

95.0%

100.0%


% 4 Hour A&E waiting times -seen within 4 hours latestmonthly position

Target

65.0%

70.0%

75.0%

80.0%

85.0%

90.0%

95.0%

100.0%


% Seen within 4 hours - RFT

% Seen within 4 hours - Barnsley FT

% Seen within 4 hours - Doncaster & Bassetlaw FT

% Seen within 4 hours - England

% Seen within 4 hours - North

% Seen within 4 hours - Target

Supporting Narrative The A&E position for Rotherham Hospital Foundation Trust in February to date (as at 17th February) is 75.7%. Performance during this period last year (February 18 full month) was 87.7%.

-20.0%

-15.0%

-10.0%

-5.0%

0.0%

5.0%

10.0%

15.0%

75.0%

80.0%

85.0%

90.0%

95.0%

100.0%


Variance - Actual v STF Trajectory

% Seen within 4 hours - Rotherham CCG

STF Trajectory

Supporting Narrative The STF trajectory is the trajectory for A&E improvement agreed between RFT, RCCG and NHS England. Performance for February to date (as at 17th February) of 75.7% does not meet the STF trajectory of 93.1%.

Focus on - Refer to Treatment: Incomplete Pathways by Speciality - RCCG Patients

% Over

13 Weeks Oct-18 Nov-18 Dec-18 Jan-19 Target

All specialities - total incomplete 21.0% 92.4% 93.4% 92.9% 92.4% 92.00%

Cardiology 20.4% 95.6% 95.8% 96.6% 95.6% 92.00%

Cardiothoracic Surgery 11.4% 95.5% 97.8% 86.4% 95.5% 92.00%

Dermatology 25.6% 93.2% 96.2% 94.7% 93.2% 92.00%

ENT 18.5% 94.0% 92.5% 93.8% 94.0% 92.00%

Gastroenterology 22.1% 92.9% 95.7% 94.0% 92.9% 92.00%

General Medicine 21.1% 89.1% 93.1% 90.6% 89.1% 92.00%

General Surgery 21.4% 92.9% 92.8% 93.1% 92.9% 92.00%

Geriatric Medicine 12.1% 96.7% 97.6% 98.2% 96.7% 92.00%

Gynaecology 24.3% 89.2% 91.6% 90.5% 89.2% 92.00%

Neurosurgery 9.1% 84.7% 89.9% 89.7% 84.8% 92.00%

Neurology 35.4% 97.7% 95.7% 96.9% 97.7% 92.00%

Ophthalmology 13.6% 95.4% 97.1% 96.1% 95.4% 92.00%

Oral Surgery - 100.00% 100.00% 100.00% 100.0% 92.00%

Other 18.9% 91.9% 90.7% 90.3% 91.9% 92.00%

Plastic Surgery 25.3% 89.3% 93.8% 90.8% 89.3% 92.00%

Rheumatology 18.9% 94.1% 94.2% 94.7% 94.1% 92.00%

Thoracic Medicine 37.9% 80.0% 90.5% 84.5% 80.0% 92.00%

Trauma & Orthopaedics 25.2% 91.7% 92.6% 91.7% 91.7% 92.00%

Urology 10.9% 96.4% 95.9% 96.1% 96.4% 92.00%

Supporting Narrative Latest provisional data for January shows seven specialties under the 92% standard, General Medicine, Gynaecology, Thoracic Medicine, Neurosurgery, Plastic Surgery, Trauma and Orthopaedics and Other. Issues identified in Gynaecology matching consultant time with theatre slots is being addressed through additional sessions. This has significantly improved performance and Gynaecology is now close to meeting the standard. Thoracic Medicine is experiencing some temporary capacity issues at The Rotherham Hospital Foundation Trust. Trauma and Orthopaedics is expected to be a short blip as performance is only slightly below the standard. Neurosurgery, Other, Plastic Surgery and General Medicine are relatively small numbers. The CCG will continue to monitor these specialties closely. The longer waits in these specialties are generally being seen outside Rotherham FT. Rotherham CCG benchmarks favourably against other CCG's in South Yorkshire for RTT Incomplete waits in December (92.9%): Barnsley CCG – 94.2% Bassetlaw CCG – 87.4% Doncaster CCG – 86.5%/ Sheffield CCG – 93.8% National – 86.6%

Focus on - IAPT Waiting Times

31/03/2018 30/04/2018 31/05/2018 30/06/2018 31/07/2018 31/08/2018 30/09/2018 31/10/2018 30/11/2018 31/12/2018 31/01/2019 21/02/2019

Actual 94.4% 85.4% 81.1% 78.3% 83.4% 89.4% 88.1% 92.2% 92.4% 95.3% 89.6% 94.0%

Target 75% 75% 75% 75% 75% 75% 75% 75% 75% 75% 75% 75%

Focus on - IAPT 6 Week Wait Waiting List

31/03/2018 30/04/2018 31/05/2018 30/06/2018 31/07/2018 31/08/2018 30/09/2018 31/10/2018 30/11/2018 31/12/2018 31/01/2019 15/01/2019

IAPT incomplete - total waitingActual 417 577 483 405 451 410 424 430 520 499

IAPT incomplete - total waiting 0-6

weeksActual 384 498 398 330 381 353 364 337 440 436

IAPT incomplete - total waiting

over 6 weeksActual 33 79 85 75 70 57 60 93 80 63

Proportion of people waiting six

weeks or less from referral to

entering a course of IAPT

treatment

0.0%

20.0%

40.0%

60.0%

80.0%

100.0%

120.0%

Actual

Target

0

100

200

300

400

500

600

700

IAPT incomplete - totalwaiting

IAPT incomplete - totalwaiting 0-6 weeks

IAPT incomplete - totalwaiting over 6 weeks

Supporting Narrative Local comparison (published data November 18) shows the following benchmark position. Barnsley – 97% Bassetlaw – 99% Doncaster – 87% Sheffield – 93% National – 89.2%


Actual 71.21% 79.59% 82.54% 81.08% 79.45% 82.26% 80.77% 78.08% 82.61% 77.92% 81.94% 72.58%

Target 85.00% 85.00% 85.00% 85.00% 85.00% 85.00% 85.00% 85.00% 85.00% 85.00% 85.00% 85.00%


47 39 52 60 58 51 63 57 57 59 58 45

66 49 63 74 73 62 78 73 69 68 67 62Total cancer patients waiting to be seen

within 62 days of referral from GP

Cancer patients seen within 62 days of

referral from GP

Cancer - % patients seen within

62 days of referral from GP

Focus on - Cancer (62 Days)

0.00%10.00%20.00%30.00%40.00%50.00%60.00%70.00%80.00%90.00%

100.00%


Actual

Target

Supporting Narrative In December the 62 day GP referral to treatment target did not meet the national standard of 85%, with performance at 72.6% for Rotherham CCG. National performance in December was 81.1%. Breach details for December can be seen below. TUMOUR TYPE FIRST SEEN FIRST TREATMENT WAIT DAYS DELAY REASON COMMENT

Head and Neck Rotherham FT Sheffield Teaching FT 109Complex diagnostic pathway (many, or complex,

diagnostic tests required)

Sarcoma Rotherham FT Sheffield Teaching FT 77Complex diagnostic pathway (many, or complex,


Urological (Excluding

Testicular)Rotherham FT Sheffield Teaching FT 69

Complex diagnostic pathway (many, or complex,



Testicular)Rotherham FT Rotherham FT 80

Health Care Provider initiated delay to diagnostic test or

treatment planning

Skin Rotherham FT Sheffield Teaching FT 140 Administrative delay


Testicular)Rotherham FT Leeds Teaching FT 160

Health Care Provider initiated delay to diagnostic test or

treatment planning


Testicular)Rotherham FT Sheffield Teaching FT 111 Other reason (not listed)

Upper Gastrointestinal Rotherham FT Sheffield Teaching FT 87Complex diagnostic pathway (many, or complex,



Testicular)Rotherham FT Rotherham FT 70 Other reason (not listed)


Testicular)

Doncaster and

Bassetlaw FTDoncaster and Bassetlaw FT 93 Other reason (not listed)



Lower Gastrointestinal Rotherham FT Sheffield Teaching FT 78Health Care Provider initiated delay to diagnostic test or

treatment planning





Lower Gastrointestinal Rotherham FT Rotherham FT 68

Diagnosis delayed for medical reasons (PATIENT unfit for

diagnostic episode, excluding planned recovery period

following diagnostic test)





Focus on - Delayed Transfer of Care (Rotherham NHS Foundation Trust)


Actual 2.2% 1.9% 2.7% 2.8% 2.1% 1.6% 2.1% 3.7% 2.6% 3.4% 2.3% 2.1%

Target 3.5% 3.5% 3.5% 3.5% 3.5% 3.5% 3.5% 3.5% 3.5% 3.5% 3.5% 3.5%

Actual YTD 4.0% 3.8% 3.7% 2.8% 2.5% 2.2% 2.1% 2.5% 2.5% 2.6% 2.6% 2.5%

Target YTD 3.5% 3.5% 3.5% 3.5% 3.5% 3.5% 3.5% 3.5% 3.5% 3.5% 3.5% 3.5%


Actual 14.9 14.1 15.3 19.6 27.9 18.8 25.3 21.6 21.0

Target 16.0 16.0 16.0 16.0 16.0 16.0 16.0 16.0 16.0 16.0 16.0 16.0

Delayed transfers of care.

Average delayed days a month for

Rotherham Health and Wellbeing

Board.

Delayed transfers of care from

hospital (delays days rate)*

0.0%

0.5%

1.0%

1.5%

2.0%

2.5%

3.0%

3.5%

4.0%

4.5%

0.0%

0.5%

1.0%

1.5%

2.0%

2.5%

3.0%

3.5%

4.0%


Actual

Target

Actual YTD

Supporting Narrative Delayed transfers of care are monitored in two different ways. At a Hospital Trust level and a Health and Wellbeing Board (HWB) level. The Hospital Trust indicator considers delays as a % of patients in hospital. The HWB level indicator considers the average delayed days in a month for all of Rotherham. Rotherham FT is meeting the less than 3.5% national standard for Hospital Trusts. TRFT are currently at 2.1% in December 18, with performance in November 18 at 2.3%. This compares to provisional figures of 3.3% for Yorkshire and the Humber and 3.5% nationally. Rotherham as a whole is not meeting the required HWB target of 16 average delays a day. Performance currently stands at 21 average delays a day in December 18.

0.0%

0.5%

1.0%

1.5%

2.0%

2.5%

3.0%

3.5%

4.0%

4.5%


DTOC Benchmarking

ENGLAND

YORKSHIRE AND THE HUMBER

THE ROTHERHAM NHS FT

TARGET

0

5

10

15

20

25

30


Delayed Transfer ofCare Rate

Delayed Transfer ofCare Target

Focus on Performance - 111

Total Number of Calls

Call Backs Within 10 Minutes

Dispositions

0

1000

2000

3000

4000

5000

6000

7000

Jan 18 Feb 18 Mar 18 Apr 18 May 18 Jun 18 Jul 18 Aug 18 Sep 18 Oct 18 Nov 18 Dec 18

NHS ROTHERHAM CCG TOTAL NUMBER OF CALLS

Jan 18 - Dec 18

Jan 18 - Dec 18

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Jan 18 Feb 18 Mar 18 Apr 18 May 18 Jun 18 Jul 18 Aug 18 Sep 18 Oct 18 Nov 18 Dec 18

NHS ROTHERHAM CCG PERCENTAGE OF CALL BACKS WITHIN 10 MINUTES

Jan 18 - Dec 18

Jan 18 - Dec 18

Target

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

AmbulanceDispatches

Dispositions

Primary andCommunity

CareDispositions

Recommendedto Attend

Dental Service

Recommendedto Attend A&E

Recommendedto Attend Other

Service

Recommendedto Self CareDisposition

No Disposition

DISPOSITIONS PERCENTAGE DECEMBER 2018

NHS Rotherham CCG

Y&H Aggregate (including OOA and Unknown)

Number of Dispositions

Y&H Rotherham % of Total

17036 851 5.0%

57103 2,625 4.6%

18133 878 4.8%

75236 3,503 4.7%

Recomended to Attend Dental Service 15798 663 4.2%

11334 495 4.4%

5494 271 4.9%

19443 742 3.8%

111 Top Six Symptoms - Rotherham CCG

Recommended to Self Care

Ambulance Dispatches

Primary and Community Care -

Outside GP Hours

Within GP Hours

Total

Recommended to Attend A&E

Recommended to Attend Other Service

Supporting Narrative This focus on section has been added at the request of governing body. It displays key information relating to the 111 service on calls, dispositions and symptoms.

0

100

200

300

400

500

600

700

Toothache Without DentalInjury

Chest And Upper Back Pain Health And SocialInformation

Breathing Problems,Breathlessness Or Wheeze

Sore Throat Non-Trauma Emergency

NHS ROTHERHAM CCG TOP SIX SYMPTOMS DECEMBER 2018

Total

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