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APPENDIX 2 – Current Format for Cluster Board Performance Report NHS Calderdale, Kirklees and Wakefield District (NHS CKW) 8th May 2012 Performance Report against Key Performance Indicators for 2011/12 1.

Purpose To inform NHS CKW Cluster Board of NHS Calderdale (NHSC), NHS Kirklees (NHSK) and NHS Wakefield District (NHSWD) PCTs performance against the 2011/12 NHS Operating Framework headline outcomes/measures, together with other identified national supporting outcomes/measures. These outcomes/measures contribute towards the Primary Care Trusts 2011/12 Single Assurance Assessment Process with the Strategic Health Authority and the national annual PCTs National Benchmarking Dataset.

2.

Performance Summary Appendix A sets out a summary position of Commissioner performance against the key 2011/12 NHS Operating Framework headline outcomes/measures (highlighted in „blue‟) and supporting outcomes/measures, details the actual activity against plan, year-to-date position and forecast outturn (end-year position forecast based on year-to-date activity). The summary incorporates the existing risk management “traffic light” system (RAG) to performance monitor/manage progress being made to achieve delivery of the outcomes/measures: Green  Amber  Red

- target being achieved/no risk to delivery; - below/above target, situation needs reviewing, remedial action needs Investigation; and - serious deviation from target, corrective action plan required.

Appendix B sets out a summary position of Provider performance against the key 2011/12 NHS Operating Framework headline and identified supporting outcomes/measures. Appendix B1 details the new A & E Clinical Quality Indicators at site level for Calderdale & Huddersfield Foundation Trust (CHFT) and Mid Yorkshire Hospital Trust (MYHT). To judge compliance against the thresholds, the 5 new indicators are divided into 2 Groups, Timeliness & Patient Impact. Trusts will be assessed as achieving compliance if the minimum threshold has been achieved for at least one indicator in each of the 2 Groups. A point to note in relation to the new Clinical Quality Indicators data source is that it is recognised that not all A & E sites and organisations currently submit A & E Commissioning Data Set (CDS) information to the Secondary Uses Service (SUS) which underpins A & E Hospital Episodes Statistics (HES) and where data is sourced by the Commissioner.


3. National Priorities - Performance Issues Highlighted Issues highlighted within the performance report:Reference No. HQU02

Outcome/Measure

Calderdale RAG*

Kirklees RAG*

Wakefield RAG*

Clostridium Difficile

HQU08

Eliminate Mixed Sex Accommodation

HQU05a

18 Week RTT Admitted

HQU05b

18 Week RTT Admitted – 95th Percentile

HQU09

A&E 4 Hour Wait

HQU15_01

Cancer 62 Days

HQU15_03

Cancer 62 Days – Consultant Upgrade

SQU06_01

Stroke: (Q3 Data)

SQU06_02

Stroke: TIA within 24 hours (Q3 Data)

HRS06

Non Elective FFCEs

SRS11

GP written referrals to hospital

SRS12

Other referrals for a first outpatient appointment

SRS13

First outpatient attendance following GP referral

SRS14

All first outpatient attendances

SRS15

Elective FCEs

* *RAG status based on Periodic Review thresholds (previously known as Annual Health Check) where known, if not known, then actual versus plan is used.

3.1

Clostridium Difficile The over-performance highlighted is with NHS Kirklees and is predominantly at MYHT. Refer to Quality Report for reasons and actions being taken to address.

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3.2

Mixed Sex Accommodation The over-performance highlighted is across the CKW Cluster - the issues are predominantly at Mid Yorkshire Hospitals Trust (MYHT). Refer to Quality Report for reasons and actions being taken to address.

3.3

HQU05a/b - 18 Week RTT - Admitted, 95th Percentile The under-performance highlighted is with NHS Kirklees and NHS Wakefield District – the issues are predominantly at MYHT. 3.3.1

Mid Yorkshire Hospital Trust

The following information summarises the current performance of NHS Calderdale (NHSC), NHS Kirklees (NHSK), NHS Wakefield District (NHSWD) and Mid Yorkshire Hospitals NHS Trust (MYHT) against national 18 Weeks Referral to Treatment (RTT) waiting time targets. Latest published waiting time performance data, which is for February 2012, is summarised in Table 1. Table 1 Completed Admitted Pathways

Completed Non Admitted Pathways 95th 18 Median Percentile Weeks

Indicator

Median

95th Percentile

18 Weeks

Threshold

<11.1

<23.0

≥90%

<6.6

<18.3

MYHT

10.8

27.1

81.3%

3.6

NHSWD

8.6

25.5

85.1%

NHSK

9.9

22.9

NHSC

8.8

20.8

Incomplete Pathways Median

95th Percentile

≥95%

<7.2

<28.0

19.6

93.07%

5.1

22.1

3.3

17.8

95.2%

4.9

20.1

87.7%

3.3

15.9

96.9%

4.8

21.6

91.4%

2.4

12.6

98.7%

5.0

21.4

NHSK and NHSWD performed within all RTT performance thresholds and targets for completed non-admitted and incomplete pathways. However, with the exception of the median waiting time threshold, NHSWD did not perform within the waiting time thresholds for completed admitted pathways. Areas of underperformance against national waiting time standards relate predominantly to issues at MYHT. MYHT achieved the median waiting time thresholds across all metrics, however, failed to meet the 95th percentile and 18 weeks RTT thresholds for completed admitted and non-admitted pathways. Underperformance against the 95 th percentile threshold is reflective of a significant number of patients waiting longer than 18 weeks, and performance below the 90% admitted and 95% non-admitted 18 weeks performance Page 3 of 20


targets is symptomatic of efforts to treat this cohort of patients to reduce over the 18 weeks backlog. Latest un-validated data, which is for week ending 15th April 2012, reports an over 18 week backlog on incomplete admitted pathways of 925 at MYHT. As risks to NHSK and NHSWD performance predominantly remain with performance at MYHT, the 18 Weeks Recovery Board continues to work closely with the local acute provider to: Meet performance targets; Find sustainable approaches to reduce the over 18 week backlog. Actions in place to address these issues include:  Weekly meetings with MYHT operational managers continue to take place, and action plans and performance discussed at ECB  Specialty level service improvement and redesign work-streams continue to be developed and implemented. 3.4

A & E 4 Hour Wait – 95% Waiting Time Standard The under-performance highlighted is with NHS Kirklees and NHS Wakefield District – the issues are predominantly at MYHT. Refer to Appendix B1 for site specific data for the additional Clinical Quality indicators. 3.4.1

Mid Yorkshire Hospitals Trust

During Quarter 4 MYHT was still pushing to achieve the 95% target at all three sites; however the unvalidated position for Quarter 4 is 92.75%. The overall A&E position for the Trust as a whole, YTD is 93.64%, however including the walking centre activity the position alters to 94.98%. The breakdown by site shows: DDH = 95.7% PGH = 90.4% PGI = 97.2% The Emergency Care Recovery Board continues to meet regularly to actively manage A&E pressures. A full detailed report is to be provided to the board by the Head of Unplanned Care.

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3.5

HQU15_01/03 – Cancer 62 Days Standard and Consultant Upgrade The underperformance highlighted is with NHS Wakefield District – the issues are predominantly at MYHT and Leeds Teaching Hospitals Trust (LTHT). 3.5.1

Mid Yorkshire Hospitals NHS Trust

The overall YTD position for MYHT for 62 Days for all patients shows achievement of the target at 87.34%. However, the YTD position for Wakefield PCT patients (including the shared breaches with Leeds) seen by MYHT is red at 82.50%. Current performance of MYHT (as at February 2012) is also red at 81.43% against a target of 85%. RAG rating across the Cluster remains green at 86.88% YTD. The factors leading to these performance figures are largely as set out previously – the main influences being the performance of the Trust in transferring patients by Day 38 to Tertiary Care and once received the performance of LTHT in treating the patient within the 62 day timescale. Commissioners are working closely with MYHT and LTHT to confirm progress being made against specific actions set out in their 62 Day Recovery Action Plan and confirm and challenge is taking place at the YCN Board meetings, Cancer Locality Group meetings and the issues have recently been raised at Quality and Performance meetings of the PCT and Executive Contract Board where necessary. 62 Day performance delivered by LTHT remains a significant concern. Again, the performance of LTHT is being closely monitored as an ongoing piece of work by YCN Board and Lead Managers on a monthly basis. The next Lead Managers meeting is scheduled for 19 April 2012 and Maggie Boyle Chief Executive of LTHT will be in attendance. HQU15_03 - Consultant Upgrade The underperformance highlighted is with NHS Wakefield District. 3.5.2

Mid Yorkshire Hospitals NHS Trust

There is no national target applicable to Consultant upgrades and performance achieved by MYHT is a year-to-date average of around 75%. It should be noted this category affects relatively low numbers of patients 3.6

SQU06_01 Stroke: Transient Ischaemic Attack (TIA) The underperformance highlighted is across the CKW Cluster The lead has informed the performance team that as Quarter 4 data is not yet available there is no further update. The update given in the last cluster report remains the ongoing current work.

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NHS Calderdale Significant changes have been made to the TIA service provided in Calderdale over the last 12 months which has increased the levels of patient access. However despite good performance in the initial 6 months of 2011/12, the service has performed below the required thresholds during Quarter 3 and 4. Breach analysis is routinely undertaken to support improvements and the PCT is in discussion with the provider to understand the causes of the delays. This issue has been escalated through contract discussions. Actions The PCT continues to work with the acute trust to resolve issues that are causing breaches: Undertake further awareness session on the stroke/ TIA pathway across both primary and secondary care; The lead consultant from the local acute trust will contact practices when an inappropriate referral form has been sent or they have not been sent in the appropriate timescales; Clinics will be held 7 days a week from June when the additional Consultant starts; Best Practice Tariff incentivises trusts to investigate and treat patients within 24 hours; CHFT are currently undergoing an accreditation process for stroke and are required to demonstrate that they meet the 60% of High risk TIA being treated & Investigated; and Access to outpatient clinics has been extended and is now available 7 days a week for two weeks of the month and 5 days a week for the other 2 weeks of the month. To ensure consistency in service delivery, the local acute hospital has employed an additional consultant (start date â&#x20AC;&#x201C; June 2012) that will enable the clinic to be provided 7 days a week every week. In addition, the hospital has employed stroke nurses to support the delivery of stroke and TIA services (especially now that thrombolysis is being delivered locally). This increased capacity will improve patient flow through the service so patients who need prompt access to care can receive their investigations and treatment they need within the expected timescales. NHS Kirklees In respect of TIA at Calderdale & Huddersfield Foundation Trust, the trust will not meet the national standard for 2011/12 due to a lack of Consultants to provide TIA clinics 7 days a week.

The Trust will not be compliant with this target at least until June 2012 when it is expected that they will have enough doctors to run clinics 7 days a week. In relation to March activity, 4 of the breaches were due to referrals being sent on Saturday/Sunday, 2 were due Carotid Dopplers not being completed at the weekend, one was requested on a Friday and completed on the Monday, 6 breaches are due to bloods results not being reported on within the time limits and these processes are being looked at. Page 6 of 20


Action being taken Also, In addition to the actions being taken in association with NHS Calderdale (refer to NHS Calderdale action points), the NHS Kirklees Lead Manager for Stroke, Hayley Haycock, is intending to launch an awareness raising and education exercise in Primary Care around the stroke an TIA pathways in the New Year and planning will closely involve GPs and other Primary Care professionals to ensure greater spread and success NHS Wakefield District This indicator is slow to improve but the factors required to ensure delivery are now in place, or have robust plans. These are: 3.7

24/7 coverage of Stroke Assessment Nurses (SANs); Prescribing of first dose of aspirin by SANs under a Patient Group Directive; Consultant clinics on 6 days. Sunday is currently not covered but patients triaged by the SANs will receive first dose of aspirin and then be seen on Monday. This is in line with good practice around initiating treatment; Sunday cover by the on call neurologist is planned as part of the neurology service dependent on filling the additional consultant sessions with the Hyperacute Stroke and TIA business case; 4 week follow-up clinic with Stroke Nurse Consultant.

HRS06 â&#x20AC;&#x201C; Non Elective FFCEs The underperformance highlighted is with NHS Kirklees The trajectory figures are indicative figures advised to the SHA before contracts for 2011/12 were finalised. Figures have since been refreshed but these are not yet reflected in the SHA returns on which this data is based. NHS Kirklees is closely performance monitoring this measure, which has consistently been above reporting trajectories throughout the year and is currently projecting a 6% full-year variance. Any associated impact is factored in to financial plans.

3.8

SRS11 â&#x20AC;&#x201C; GP Written Referrals The underperformance highlighted is with NHS Calderdale and NHS Kirklees. NHS Calderdale and NHS Kirklees The PCTs are activity working with their Primary Care contractors to understand current referral patterns and are closely performance monitoring this 18 Week RTT supporting measure and although actual activity is showing above planned trajectory, there is confidence at this stage that the year-end plan figures will be achieved.

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3.9

SRS12 – Other Referrals for a First Outpatient Appointment The underperformance highlighted is with NHS Kirklees and NHS Wakefield District. NHS Kirklees The trajectory figures for this group of indicators (Referrals for 1st Outpatient appointment - GP and Other - and First Outpatient attendances – GP and Total) are indicative figures advised to the SHA before contracts for 2011/12 were finalised. Figures have since been refreshed but these are not yet reflected in the SHA returns on which this data is based. NHS Kirklees is closely performance monitoring these measures, which have consistently been above reporting trajectories throughout the year and are currently projecting full-year variance between 4% and 10% for the various measures. Any associated impact is factored in to financial plans.

3.10

SRS13 - First Outpatient Attendance Following GP Referral The underperformance highlighted is with NHS Calderdale and NHS Kirklees. NHS Calderdale Forecast out turn for all first outpatient attendances is higher than plan for 2011/12 – the assumptions in the profile developed for this year have been refreshed to ensure a more accurate plan is developed for 2012/13. Triangulation with contracting data indicates NHS Calderdale is not overtrading with the volume and expenditure on outpatient appointments (both 1st and follow up). NHS Kirklees The trajectory figures for this group of indicators (Referrals for 1st Outpatient appointment - GP and Other - and First Outpatient attendances – GP and Total) are indicative figures advised to the SHA before contracts for 2011/12 were finalised. Figures have since been refreshed but these are not yet reflected in the SHA returns on which this data is based. NHS Kirklees is closely performance monitoring these measures, which have consistently been above reporting trajectories throughout the year and are currently projecting full-year variance between 4% and 10% for the various measures. Any associated impact is factored in to financial plans.

3.11

SRS14 – All First Outpatient Attendances The underperformance highlighted is NHS Calderdale and NHS Kirklees. NHS Calderdale FOT is higher than plan for 2011/12 – the assumptions in the profile developed for this year need to refreshed to ensure a more accurate plan is developed for 2012/13. Page 8 of 20


Triangulation with contracting data indicates NHS Calderdale is not overtrading with the volume and expenditure on outpatient appointments, both 1 st and follow up. All other activity levels for NHS Calderdale remain broadly in accord with the plans established for 2011/12. It should also be noted that the rate of growth in GP referrals is also decreasing which will impact on demand for outpatient attendances. NHS Kirklees The trajectory figures for this group of indicators (Referrals for 1st Outpatient appointment - GP and Other - and First Outpatient attendances – GP and Total) are indicative figures advised to the SHA before contracts for 2011/12 were finalised. Figures have since been refreshed but these are not yet reflected in the SHA returns on which this data is based. NHS Kirklees is closely performance monitoring these measures, which have consistently been above reporting trajectories throughout the year and are currently projecting full-year variance between 4% and 10% for the various measures. Any associated impact is factored in to financial plans. 3.12

SRS15 – Elective FFCEs The underperformance highlighted is with NHS Kirklees. NHS Kirklees The trajectory figures are indicative figures advised to the SHA before contracts for 2011/12 were finalised. Figures have since been refreshed but these are not yet reflected in the SHA returns on which this data is based. NHS Calderdale and NHS Kirklees is closely performance monitoring this measure, which has consistently been above reporting trajectories throughout the year and is currently projecting a 10% fullyear variance. Any associated impact is factored in to financial plans.

4.

Seasonal Influenza Vaccination Programme Report 4.1

Introduction The Chief Medical Officer‟s Gateway letter advised all practices of the national targets for influenza immunisation uptake for the 2011/12 programme. They were; 75% uptake for those aged 65 and over; 60% uptake for those aged from 6 months to 65 years in clinical risk groups; and 60% uptake for pregnant women. There was no national campaign to promote the vaccination or support the achievement of these targets. Therefore, plans were agreed locally across the Calderdale, Kirklees & Wakefield District (CKW) Cluster Partnership to provide support to General Practices in the delivery of the seasonal influenza vaccination programme. This part of the performance report will provide detail of those plans, will give details of each Primary Care Trust‟s (PCT) uptake, it will provide narrative where necessary to explain any

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variation in performance and programme delivery and will identify actions required for the 2012/13 programme. 4.2 Support for achieving targets All PCTs within the CKW Cluster Partnership were provided with the following support to general practices; The delivery of training or workshop events aimed at sharing evidence based good practice on increasing uptake and meeting targets; Detailed data relating to the targets and the number of vaccinations each practice were to administer, in each patient group, to meet the targets; On a monthly basis practice uptake data was shared with individual practices and Clinical Commissioning Groups advising practices to use robust and proactive call and recall system; The role of midwives were to advocate and promote the vaccine to pregnant women in any trimester and signpost them to their GP to receive it. Evidence based guidance was developed in the form of Questions & Answers for both clinical staff in GP practices and midwives across CKW; and Patient information leaflets were developed in collaboration with NHS North of England. A generic leaflet was developed and one specifically for pregnant women. NHS Wakefield District rolled out the Community Pharmacy Vaccination Scheme where vaccinations were made available to certain eligible patients and healthcare workers. A total of 14 pharmacies signed up to the Local Enhanced Service and 288 vaccinations were given to eligible patients. 4.2.1

65 and over 6 months to under 65 years in clinical risk groups Pregnant Women* Healthcare Workers**

Performance NHS Calderdale 2011/12 2010/11 72.9% 70.7% 51% 50%

NHS Kirklees 2011/12 2010/11 72% 70.4% 48.3% 48.6%

NHS Wakefield District 2011/12 2010/11 74% 72.6% 49.6% 50.6%

England 2011/12 2010/11 74% 72.4% 51.6% 50.3%

27.1%

43.5%

20.7%

36%

20.3%

33.1%

27.4%

37.7%

56.8%

15.4%

62.1%

35.2%

49.1%

37.1%

44.7%

34.7%

Table1: Seasonal Flu Vaccination Uptake 2011/12 with 2010/11 comparison *Please see section 3.13.4 below for an explanation into the variance in uptake over the two years. ** As a result of Transforming Community Services the number of frontline healthcare workers in PCTs has substantially changed between the two years and therefore direct comparisons are not possible. For benchmarking purposes the highest performing PCTs within Yorkshire & Humber for each patient group were; Page 10 of 20


65 and over – NHS Leeds with 78.3% Under 65 in clinical risk groups – NHS Barnsley with 53.7% Pregnant Women – NHS Leeds with 41.2% 4.2.2

Practice Variations The following table highlights the variation in uptake between each PCTs practices. NHS Calderdale

NHS Wakefield District 65 and over 64.3% - 86.4% (14 45.8% - 88.9% (27 48% - 86.2% (19 practices achieved the practices achieved the practices achieved the target) target) target) 6 months to under 31.2% - 76.7% (6 18.5% - 71.7% (10 31.5% – 65.8% (4 65 years in clinical practices achieved the practices achieved the practices achieved the risk groups target) target) target) Pregnant Women 8.6% - 57.7% (No 0% - 68.8% (2 practices 3.6% - 54.5% (No practices achieved the achieved the target) practices achieved the target) target) Table 2: Practice Variations and number of practices achieving targets 4.2.3

NHS Kirklees

Pregnant Women The table below shows that the number of pregnant women in each PCT more than doubled in 2011/12 compared to 2010/11. These are not additional pregnancies but reflect national changes in the way in which this data is gathered. Therefore direct comparison of percentage uptake between the two years is not possible. However each PCT administered more vaccines to this group in 2011/12 than in the previous flu season.

No. Of women Vaccinated No. Of women eligible

NHS Calderdale 2011/12 2010/11 589 453

NHS Kirklees 2011/12 2010/11 1083 813

NHS Wakefield District 2011/12 2010/11 674 576

2176

5238

3328

1048

2405

1690

Table 3: Pregnant women data variations from 2010/11 to 2011/12 4.2.4

Healthcare Workers All PCTs within the CKW cluster report the uptake for frontline healthcare workers in GP practices. In addition NHS Kirklees reports the uptake for Locala and NHS Wakefield District reports the uptake for Spectrum. Encouraging practices to provide this data within the national deadlines is difficult and some practices decline as they are not contracted to do so.

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4.2.5

Planning for the 2012/13 Programme The national targets for 2012/13 programme are expected to be; 75% over 65; 70% under 65 in clinical risk groups; and 70% pregnant women. These targets are a significant increase from the 2012/13 programme for those under 65 in clinical risk groups and pregnant women. All practices within the CKW cluster have been provided with their individual performance data for the 2011/12 programme and have been informed of the additional number of vaccines needed to be administered to achieve the targets. The CKW Cluster Partnership Flu Leads have identified the following actions for improving performance in the 2012/13 programme; There is a need to explore how practices are identifying eligible patients and how this correlates to the data collection searches via the Immform system to ensure that practices are identifying all eligible patients for call and recall purposes; To identify high performing PCTs and learn from them with regards to their uptake in those aged under 65 in clinical risk groups and pregnant women; To increase the uptake and protection of pregnant women there is a need promote vaccination as part of the overall package of care by exploring the possibilities of commissioning flu vaccination service via acute trust antenatal services; To encourage Clinical Commissioning Groups to support the PCT in obtaining data from general practices; and To provide advice to independent contractors on the calculation to the healthcare worker denominator.

5.

Workforce Metrics â&#x20AC;&#x201C; CKW Cluster This section of the report is from the Human Resource and Organisational Development (HR&OD) Shared Service and provides the Cluster Executive Team with the latest key workforce metrics from NHS CKWDâ&#x20AC;&#x;s constituent PCTs. Workforce metrics can be a good barometer for an organisation. Significant peaks, troughs or deviation from plans can represent an area requiring further investigation or assurance. The metrics presented here focus on the latest figures for staff in post, sickness absence and turnover, with trend information dating back to April 2010. Unless otherwise stated, all information derives from the NHS Electronic Staff Record (ESR).

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5.1 Staff in post The table below shows the quantity of staff in post across the CKW Cluster at 31 st March 2012: PCT NHS Calderdale NHS Kirklees NHS Wakefield District CKW Cluster Total

Headcount 149 243 260 652

FTE 134.6 213.5 233.4 581.6

The graph on the following page shows the change in number of full time equivalent (FTE) staff employed in the CKW cluster since April 2010. Please note that these figures have been adjusted to remove all Provider directorate staff from the outset; but they do contain any Commissioner staff who latterly TUPE transferred to other organisations with Provider directorates. This factor largely accounts for the significant drop in FTE numbers between March 2011 and April 2011. The dotted purple line indicates the expected trajectory of the workforce during 2012/13. The trajectory is based on assumptions about the rate of turnover and rate of recruitment. It assumes a similar level of attrition to that in 2011-12 but does not take into account leavers through Voluntary Redundancy Schemes. The trajectory also assumes the proportion of vacant posts that are backfilled remains low. The dotted green line indicates the 2011-12 expected trajectory which was set at the start of 2011-12 and did not take into account any of the departures from the recent Voluntary Redundancy / Early Retirement Schemes or TUPE.

CKW FTE 850.0 800.0 750.0 700.0 650.0 593.3

600.0

581.6 541.8

550.0 500.0

Apr May Jun

Jul

Aug Sep Oct Nov Dec Jan Feb Mar

2010-11

2011-12

Trajectory - 2011-12

Trajectory - 2012-13

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FTE numbers peaked in June 2010 at 807.3 FTE and have since dropped to 581.6 FTE. This represents a decrease of almost 28%. The reduction in the workforce during 2011/12 followed the expected trajectory; however the impact of autumn 2011â&#x20AC;&#x;s voluntary schemes resulted in a sharper drop in numbers during at the end of 2011-12. The 2011-12 trajectory predicted an FTE of 593.3 at March 2012, this is 11.7 FTE higher than the actual position. 5.2

Turnover In this context, turnover refers to the quantity of staff leaving the organisation. The table below shows the number of leavers and the 12 month rolling turnover for each PCT up to March 2012.

PCT NHS Calderdale NHS Kirklees NHS Wakefield District CKW Cluster Total

Number of leavers in the 12 months to 31 March 2012 27 49 32 108

12 month rolling turnover rate 17.8% 18.6% 11.9% 15.7%

The graph on the following page shows the 12 month rolling turnover in NHS Calderdale, Kirklees and Wakefield Cluster dating back to 1 April 2010. The dotted green line shows the expected trajectory of turnover during 2011-12, the dotted purple line indicates the expected trajectory of turnover during 2012-13.

CKW 12 month rolling turnover 25.0% 20.0%

15.0% 10.0% 5.0% 0.0%

Apr

May

Jun

Jul

Aug

Sep

2010-11 Trajectory - 2011-12

Oct

Nov

Dec

Jan

Feb

Mar

2011-12 Trajectory - 2012-13

The rolling 12 month turnover rate has been high for all PCTs. This is due mainly to the introduction of Voluntary Schemes in each PCT during the 2011/12 financial year, and to a number of TUPE transfers out of the organisations during the course of the year.

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The rate of turnover dropped during the summer but as expected it increased over the last three months of the financial year as the 2011/12 Cluster Voluntary Scheme departures took effect. 5.3

Sickness absence The expectation of the Yorkshire & Humber SHA in 2011/12 was that Commissioner organisations should achieve a sickness absence rate of 2.5% or less. It is now understood that the SHA will not be setting a sickness target specifically for Commissioning organisations in 2012-13. Instead a health economy sickness target is expected, covering both Provider and Commissioning organisations; which we are led to believe will be 3.4%. As the PCTs are going through a period of significant organisational change and the impact that small organisations‟ sickness absence rates will have on the overall rate for the health economy is small, the HR&OD Shared Service has recommended to each PCT‟s Senior Management Team that the sickness target for 2012-13 should remain at 2.5% . The table below shows the rate and cost of sickness across the Cluster for the full 2011/12 year, from 1 April 2011 to 31 March 2012. It can be seen that the CKW Cluster has remained within target, with an overall sickness absence rate for 2011/12 of 2.5%: PCT NHS Calderdale NHS Kirklees NHS Wakefield District CKW Cluster Total

Short term Long term Sickness Cost of sickness sickness rate sickness rate rate 1.0% 0.7% 1.7% £90,021 1.5% 1.0% 2.5% £262,667 1.4% 1.4% 2.8% £307,753 1.3% 1.1% 2.5% £660,441

The graph below shows the sickness absence rate across the Cluster dating back to April 2010. The 2.5% expected rate is marked on the graph in green. The graph clearly shows that up until January 2012, sickness absence rates were markedly lower during 2011/12 than in the previous financial year. Until that point the peaks and troughs of sickness absence during 2011/12 followed a similar pattern to 2010/11. However in February 2012 there was a sharp increase in sickness absence in NHS Wakefield District (from 2.6% to 4.7%) and in March 2012 there was a sharp increase in NHS Kirklees (from 2.9% to 4.5%). These increases, unusual compared with Quarter 4 sickness absence trends in previous years, have caused an overall increase in Cluster sickness absence to 3.8% in March 2012 – the highest level of sickness absence all year. The increases are primarily due to an increase in long term sickness absence rates in both NHS Wakefield District and NHS Kirklees. With the PCTs now relatively small, one or two individuals requiring lengthy sickness absence can have a significant Page 15 of 20


impact on the overall sickness figures. The HR&OD Shared Service is working closely with managers to manage all sickness absence cases accordingly. NHS Calderdale continued to show the expected sickness absence trend on Quarter 4, with sickness absence levels dropping consistently in February and March, to a very low March 2012 sickness absence level of 1.4%.

5.4

Provider workforce metrics Except where stated otherwise, the information below is taken from the NHS I-View system, which lifts data from Providers‟ own Electronic Staff Record (ESR). The data is gathered regularly by I-View, but is two months behind the data that we are able to report for Cluster organisations. This means that the data below is correct at January 2012.

5.4.1

Calderdale & Huddersfield NHS Foundation Trust

The graph on the following page shows the change in number of full time equivalent (FTE) staff employed by CHFT since April 2010. The green line represents CHFT‟s own anticipated trajectory for their workforce during 2011/12. The purple line indicates CHFT‟s anticipated trajectory for 2012/13 that they provided in their operating plan.

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CHFT FTE 5400 5300 5200 5162.3

5160.0

5110.3 5100 5000

4956.2 4900 4800 4700 Apr

May

Jun

Jul

Aug

Sep

Oct

Nov

Dec

Jan

2010-11 FTE from i-view

2011-12 - FTE from iview

Revised 2011-12 Schedule 3 figures (includes TCS)

Operating Plan - 2012-13

Feb

Mar

The significant jump in workforce numbers between March 2011 and April 2011 is likely to be as a result of the TUPE transfer of several hundred employees to CHFT from the Provider directorate of NHS Calderdale. The graphs below show CHFTâ&#x20AC;&#x;s sickness and turnover dating back to April 2010. The straight green line on the sickness graph represents the SHAâ&#x20AC;&#x;s expected level of sickness absence in Provider organisations, which is 4%.

CHFT Sickness

7.0%

Between April and September 2011, CHFT remained within the 4% expected sickness level. Since October 2011 sickness rates have been above target. It was expected that sickness levels would rise during Quarter 3 and it is anticipated they will have fallen in Quarter 4. The 2011-12 average rate may still remain at or below 4%.

6.0%

5.0% 4.0% 3.0% 2.0% 1.0%

0.0% Apr

May

Jun

Jul

2010-11

Aug

Sep

Oct

2011-12

Nov

Dec

Jan

Feb

Mar

Target (4%)

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CHFT 12 month rolling turnover

Turnover at CHFT throughout 2010/11 and during 2011/12 to date is at levels commensurate with a stable organisation and gives no cause for concern.

25.0% 20.0%

15.0% 10.0% 5.0% 0.0%

Apr May

Jun

Jul

Aug

Sep

Oct

2010-11

5.4.2

Nov Dec

Jan

Feb

Mar

2011-12

Mid Yorkshire Please note that with effect from June 2012 this report will use FTE figures accessed directly from Mid Yorkshire, which should provide a more coherent picture than those accessed via iView. The graph below shows the change in number of full time equivalent (FTE) staff employed by Mid Yorkshire since April 2011, as taken from iView. The red line represents Mid Yorkshire‟s own anticipated trajectory for their workforce during 2011/12. The purple line indicates Mid Yorkshire‟s own anticipated trajectory for 201213 that they provided in their operating plan. Please note that iView includes all staff on Mid Yorkshire‟s Electronic Staff Record and so includes 200+ Balfour Beatty staff hosted by the Trust. These staff are omitted from workforce returns and trajectories produced by Mid Yorkshire. In January 2012, the FTE of Balfour Beatty staff equated to 246.

Mid Yorkshire FTE 7400 7200 7000 6800

7130.0 6889

6872

6600 6400 6200 6000 5800

5600 Apr

May

Jun

Jul

Aug

Sep

Oct

Nov

Dec

Jan

2011-12 - FTE from iview

Schedule 3

Operating Plan - Mar 2012 Baseline

Operating Plan - 2012-13

Feb

Mar

Page 18 of 20


It should be noted that the sharp rise in Mid Yorkshire‟s actual FTE (the blue line) is likely to be linked to the c 750 FTE Provider staff it received from NHS Wakefield District at the start of the 2011/12 financial year but which didn‟t appear on Mid Yorkshire‟s Electronic Staff Record until November 2011. At January 2012, Mid Yorkshire employed 7130 FTE against a projected workforce size of 6837 FTE. The 293 difference is partly explained by the 246 Balfour Beatty staff that were not included in the projected workforce figures. The graphs below show Mid Yorkshire‟s sickness and turnover dating back to April 2010. The straight green line on the sickness graph represents the SHA‟s expected level of sickness absence in Provider organisations, which is 4%. Between April and December 2011, Mid Yorkshire‟s sickness absence levels have been consistently higher than during the same period in 2010/11, and are significantly above the 4% expected sickness level.

Mid Yorkshire Sickness

7.0% 6.0%

5.0% 4.0% 3.0% 2.0% 1.0%

0.0% Apr

May

Jun

Jul

Aug

2010-11

Sep

Oct

Nov

Dec

2011-12

Jan

Feb

Mar

Target (4%)

Mid Yorkshire has provided CKW with assurance in relation to its sickness absence management plans, and reductions of 0.5% year on year are expected to be seen in sickness absence figures from 2012/13 onwards.

Mid Yorkshire 12 month rolling turnover 25.0% 20.0%

15.0% 10.0% 5.0% 0.0%

Apr

May

Jun

Jul

Aug 2010-11

Sep

Oct

Nov

Dec

Jan

Feb

Mar

Turnover at Mid Yorkshire throughout 2010/11 and during 2011/12 to date is at levels commensurate with a stable organisation.

2011-12

The HR&OD Shared Service continues to meet on a bi-monthly basis with Mid Yorkshire‟s Director of Human Resources and Workforce Lead. An agreed set of workforce metrics will be provided directly to CKW by Mid Yorkshire with effect from May 2012, giving access to more detailed, up-to-date information than is available via iView. A further range of assurances related to workforce planning and risks is monitored at the bi-monthly meetings. Page 19 of 20


5.5 Conclusion This report is designed to give the Cluster Board a snapshot of workforce metrics from its own workforce and those of its main acute providers. The report can be adjusted as needed to meet the Boardâ&#x20AC;&#x;s ongoing requirements. HRODSS will continue to work closely with Board members and the CKW workforce to deliver expected outputs in internal workforce metrics; and to work with Providers in ongoing efforts to obtain assurances about their own workforces and workforce plans. 6. Recommendations The CKW Cluster Board is asked to: -

NOTE NHS Calderdale, NHS Kirklees and NHS Wakefield District PCTs performance against the key headline and supporting outcomes/measures; APPROVE the action being taken to address areas of under/over performance; and AGREE additional actions required to address areas of over/under performance.

Report Owner: Peter Flynn, Director of Performance & Commissioning Intelligence Report Author: Natalie Ackroyd, Business Planning and Performance Reporting Manager

Page 20 of 20

CKWCB.12.114d_Performance_Report_Appendix_2_May_2012_v3  

http://www.kirklees.nhs.uk/fileadmin/documents/meetings/8_May_2012/CKWCB.12.114d_Performance_Report_Appendix_2_May_2012_v3.pdf

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