4 December 2012 Mike Potts Chief Executive NHS Calderdale, Kirklees and Wakefield
Blenheim House West One Duncombe Street Leeds LS1 4PL Tel: 0113 295 2000 www.yorksandhumber.nhs.uk
Dear Mike As you are aware, this is the time of year that we would normally engage in face to face discussions regarding mid-year performance. In view of transition pressures we have agreed to undertake the exercise in an exchange of correspondence. Overall the North of England is performing strongly across a range of measures but there are still pockets of delivery shortfall which means that some of our patients are not receiving the standards of care and treatment that they deserve. I know that you will share my concern in this respect and that every effort will be made, despite the onset of winter, to improve delivery where needed over the second half of the year. Performance: Mid Yorkshire NHS Trust - Overall performance at Mid Yorks has significantly improved over the last 2 quarters and the Trust should be congratulated on the improvements they have made across all aspects of performance. Calderdale and Huddersfield Foundation Trust - There are concerns regarding A&E performance at CHFT. The Trust is currently failing Q3 to date and is required to deliver weekly performance of 96% in order to deliver the 95% standard for Q3. This presents a particular challenge given that demand on A&E during the winter months is heightened. Measures need to be put in place across both primary care and secondary care to ensure that patients are seen in the most appropriate care setting and that the default is not always to front line A&E services. Yorkshire Ambulance Service - As you will be aware next year there will be penalties for both handover and turnaround. Over the coming months commissioners need to work with both acute trusts and the ambulance service so improvements are made on delays for patients and ensuring crews and back on the road in an efficient way and that data capture continues to be refined.
Chair: Kathryn Riddle
Chief Executive: Ian Dalton
From 3 October 2011 NHS North East, NHS North West and NHS Yorkshire and the Humber - the three strategic health authorities in the North of England - will be placed under a single management framework and work together as NHS North of England.
Summary Care Records (SCR) - SCR uploads continue to improve month on month across the CKW patch with one of the highest rates across the North of England. With 70% SCRs created as at November 1st it is reassuring to see that progress towards the 100% national framework target by March 2013 is being made. Emergency Preparedness Resilience and Response and Winter: At the end of August all PCT Clusters provided a statement of readiness for both EPRR and winter (please see attached) and have since provided a progress report on implementing the new EPPR system. I ask that you review information sent to us in advance of our confirm and challenge meetings set up with all PCT Clusters/LATs on 7 th and 20th December 2012. Finance: With the exception of Mid Yorkshire Hospitals, all organisations in the cluster area delivered their agreed 2011/12 control totals without giving rise to any serious concerns around the financial position and at month 7 are in line to deliver their 2012/13 plan: Mid Yorkshire Hospitals NHS Trust ended 2011/12 in deficit and are currently forecasting a ÂŁ26m deficit in 2012/13. There is a high level of confidence that the Trust will deliver no worse than the forecast deficit of ÂŁ26m. There is a continuing favourable variance on year to date position (c.ÂŁ1m at m7) which indicates strong potential for an improved year end position, which will be firmed up over the next couple of months. In year delivery of QIPP: The cluster continues to progress well with their QIPP plans linked to Planned Care, Elective, Mental Health, Continuing Care, Support for people with Learning Disabilities and for Elderly People with Dementia. Other initiatives relating to responsive urgent care and long term conditions including end of life care and developing alternative community services have some significant delays. You have highlighted the key risk to overall QIPP delivery for cluster is the rise in nonelective activity against planned assumptions. The cluster are about to receive an external utilisation report to explain this adverse trend. There remains an acknowledgement that the reconfiguration of MYHT will affect QIPP for CCGs in Wakefield and North Kirklees, although the CCGs will retain accountability for the overall transformation and savings as originally set out. The SHA agree with the Cluster on the overall RAG rated AMBER position at the end of October. (Please see attached for the most recent QIPP on a page summary)
FT Pipeline: No formal decision has yet been taken with regard to the FT journey for Mid Yorkshire Hospitals NHS Trust, this will be informed by the continued progress of the Clinical Services Strategy and the maintained in-year improvement on both finance and performance. Quality and Safety: Never events - There have been 2 never events since April 2012: 1 retained foreign object post-operation and 1 wrong site surgery. Friends and family test - In Mid Yorkshire the Trust is aware of implications on implementing FFT and working on procuring a company to collect the data. There are issues regarding receiving monthly „state of readiness‟ reports via commissioners. Public Health Health Outcomes - The progress on delivering public health outcomes continues to be generally positive and there is a more detailed dashboard published at SHA level. Health Checks - Current performance in Kirklees indicates that they are not meeting expected levels. Confirmation that there are plans to achieve targets by the end of 2012/13 would be helpful. Smoking Cessation - This continues to be a priority for NHS delivery in 2012/13 and progress is generally good. However Calderdale and Kirklees are rated as more than 10% „off-track‟ (as at Quarter 1 of the year) and it would be helpful to confirm action to correct trajectories. Transition Public Health - Significant progress has been made on the transition of public health function to local government. There are a number of risks that will need ongoing focus and management to conclude this process successfully. In summary these are:
Agreeing transfer schemes for public health assets with local government colleagues. Concluding information governance arrangements - including those that secure the public health team's access to NHS information resources in the future. Working together with the Area Teams on the development of new arrangements for public health services e.g. immunisation and screening services - including a system test.
Further details can be found in the Yorkshire and Humber Public Health Transition Risk Register.
CCGs and Commissioning Board Good progress has been made in CKW in preparation for authorisation and your support in setting up the Area Team is much appreciated. A key task for colleagues in the PCT cluster/area team will be working with CCGs on the patch to address the support issues identified for each of them in their conditions letters from the NHSCB ahead of the “10 day evidence window� and the proposed Mach review meetings. Summary Whilst overall performance is the patch is mostly okay and I appreciate your great efforts and the work of your team. However, progress needs to be maintained and in some areas improved upon over the rest of the year. A key deliverable will be working in partnership to agree the future direction of Mid Yorkshire Hospitals. The complexity and uncertainty of the environment in which we are working provides a potential distraction from the challenging agenda that we are all currently facing. I would urge you to retain the vital focus that is required to ensure that patient safety and quality of care remain our priority. Yours sincerely
PROFESSOR STEPHEN SINGLETON OBE Interim Chief Executive NHS North of England GMC 2502535