Clinical Commissioning Executive: Calderdale
CKWCB/13/21A
Designate Chief Officer: Matt Walsh
22 January 2012
Subject
Summary
Actions
Quality and Safety
Quality is a key governance priority for Calderdale, recognising the role of CCGs in creating a culture which supports continuous improvement. As a subcommittee of the Cluster Board the CCE has the responsibility for scrutinising and gaining assurance in relation to the three domains of quality; safety, effectiveness and experience and the role of the Quality Group is to provide this assurance to the CCE. The group receives regular reports which collate information about quality, safety and experience from various sources. Since the last meeting CCE Quality Group has met on, 27 September, 25 October and 29 November and 20th December 2012 where information on the following key quality metrics were reported:EMSA There have been no breaches during quarter 2.
EMSA No actions required
VTE Risk Assessment VTE risk assessment at CHFT continues to be in line with the national average.
VTE No actions required
National Patient Safety alerts CHFT have one alert open past the closure date of 2 April 2012 – Safer spinal (intrathecal), epidural and regional devices (NPSA/2011/PSA001). The Royal College of Anaesthetists, Association of Anaesthetists and the Obstetric Anaesthetic Association produced a joint statement last year saying that they felt there were risks associated with individual Trusts doing their own small trials and felt that there should a national trial of the new devices and then a decision made and the device chosen to be implemented nationally. The NPSA responded by saying that they didn’t agree and urged Trusts to continue trialling and then implement their chosen device. The Clinical Director for anaesthetics is leading on this and has identified the risks to CHFT of trialling new devices with differing connectors with doctors who work across many sites. CHFT believe their risks of wrong spinal injection are extremely low as they are generally caused by wrong injection of chemotherapy agents into CSF, which they do not undertake as patients are referred to Leeds for intrathecal chemotherapy). Further advice is awaited from the College and there are other Trusts who
NPSA This alert has been reviewed by CHFT and remains open, a risk assessment has been undertaken, with mitigating actions in place.
Page 1 of 21
Clinical Commissioning Executive: Calderdale
CKWCB/13/21A
Designate Chief Officer: Matt Walsh
22 January 2012
have made the same decision on the back of the joint statement. There are no open alerts for SWYPFT or YAS. CQC Compliance The following table details the outcomes of recent inspections: Provider
CHFT – Calderdale Royal Hospital
BMI Healthcare Ltd – BMI The Huddersfield Hospital
Date of Review
November 2012
November 2012
Type of Review
Planned routine inspection
Planned routine inspection
Link to Report
Calderdale Royal Hospital – Nov 12
BMI Huddersfield Hospital Nov 12
01 – Respecting & involving people who use services
Compliant
Not assessed
02 – Consent to care & treatment
Not assessed
Compliant
04 – Care and welfare of people who use services
Not assessed
Non compliant
CQC Compliance Standing item on Clinical quality board
Outcomes
Moderate impact – compliance action required
Page 2 of 21
Clinical Commissioning Executive: Calderdale
CKWCB/13/21A
Designate Chief Officer: Matt Walsh
22 January 2012 The provider was not meeting this standard in the following areas: • Diagnostic & screening procedures • Surgical procedures • Treatment of disease, disorder or injury Evidence was not available to ensure that the emergency arrangements for the urgent provision of blood and blood products including out of hours had been tested and timed
05 – Meeting nutritional needs
Compliant
Not assessed
07 – Safeguarding people who use services from abuse
Compliant
Compliant
08 – Cleanliness & infection control
Not assessed
Not assessed
Page 3 of 21
Clinical Commissioning Executive: Calderdale
CKWCB/13/21A
Designate Chief Officer: Matt Walsh
22 January 2012
09 – Safety & suitability of premises
Not assessed
Not assessed
13 – Staffing
Compliant
Compliant
21 – Records
Non compliant
Compliant
Moderate impact – compliance action required. People were not protected from the risks of unsafe or inappropriate care and treatment One patient had an incomplete DNAR form which had not been reviewed by a doctor upon admission. Writing illegible, no written evidence in notes on how decision had been made. Patient and patient’s family had not been consulted. Assessment record of patient regarding eating and drinking instructions found in other patient’s care records. Directions very specific to the person.
Page 4 of 21
Clinical Commissioning Executive: Calderdale
CKWCB/13/21A
Designate Chief Officer: Matt Walsh
22 January 2012
Assurance has been sought from BMI that appropriate actions have been put in place. The CHFT report has been discussed at the 18th December Clinical Quality Board, where a detailed action plan was presented and assurance received on actions taken. MRSA There have been 4 cases of MRSA attributed to NHS Calderdale to date. Case 1 & 2 relate to the same patient. Initially this was following acute abdominal surgery in CHFT and the second episode was 2 weeks following discharge home and it was possibly associated with the hip prosthesis. Both episodes count towards the NHSC objective as the blood cultures were more than 14 days apart. Cases 3 & 4 both occurred at LTHT (one at LGI paediatric oncology and the other at St James). A summary of the root cause analysis has been received by the Quality Group in November 2012. There have been no new cases of MRSA since July 2012 Risk included on Calderdale risk register The risk that avoidable Health Care Acquired Infections are not prevented and future reductions in rates for Methicillin-resistant Staphylococcus aureus (MRSA) are not met is scored 16 on the Corporate Risk Register (Risk No 290)
C-Difficile The year to date has demonstrated an overall increase in incidence of Clostridium difficile. NHSC has breached its objective and at the current rate. Following the increase in numbers in June, the cases have had further scrutiny. A cluster of cases at CHFT have been investigated and typed and found to be unconnected, microbiologically. A Clostridium difficile management plan has been agreed across the wider health economy to address Clostridium difficile issues, supported by NHS North of England. Clostridium difficile is a major part of the health economy work plan for 12/13 and the Clostridium difficile
MRSA Clinical Quality Board receives CHFT Infection, prevention and control action plan. HCAI Group Meeting frequency has been increased to bi-monthly to acknowledge the risk affecting all health economy partners and reports to Calderdale CCG Quality Group. A Root Cause Analysis is undertaken for all acute and community acquired bacteraemias HCAI Health Economy Group with lessons learnt being shared across the Health Economy. C-Diff Included within the HCAI Health Economy Group work. A health economy CDI management plan has been developed and agreed and is monitored by the HCAI Health Economy Group, this Page 5 of 21
Clinical Commissioning Executive: Calderdale Designate Chief Officer: Matt Walsh management plan will be monitored through this forum. The report from the review visit of CHFT by Helen Crombie NHS North of England HCAI lead in October 2012, has been considered at the December 18th Clinical Quality Board meeting Safeguarding As part of the Quality Group work plan, Quarterly updates are presented, this includes, current issues, risk and developments, including open serious Case reviews. The annual report (11/12) for Safeguarding children was presented to CCE in July 2012 and the Adults were presented in November 2012. In addition the LSAB and LSCB annual reports have been presented to the November and December CCE meetings. Calderdale currently has one serious risks on the risk register relating to safeguarding: . The risk relates to the improvement notice issued to Calderdale in relation to Children’s Social Care. The Quality Group and CCE have received updates in relation to the delivery of the single improvement plan and NHS Calderdale’s contribution to that plan.
Single Integrated Improvement Plan – NHS Calderdale Action Plan Following the Inspection the Local Authority area Judgements in January 2010 published on the OFSTED website on 26th February 2010 reflecting an inadequate judgement for Safeguarding and an adequate judgement for Looked after Children Services, the Children’s Improvement Board was established in January 2010 and continues to oversee the implementation of the improvement of Children’s Social Care Services. The Single Improvement Interagency Plan (SIIP).
CKWCB/13/21A 22 January 2012 plan has also received SHA scrutiny. Root Cause Analysis undertaken for all Care Home CDI cases, CDI outbreaks and CDI associated deaths. Outcomes are reported to the IP & C Operational Group as per MRSA reports. Antibiotic campaign planned for winter 2012 Continual work across the health economy and region on viral gastroenteritis outbreak management. The summary of the root cause analysis is to be received by the Quality Group in January 2013. SIIP the SIIP – NHS Calderdale Action Plan is being monitored by the Quality Group.
The Notice to Improve cannot be lifted until there is a further formal inspection. A Peer Review by the local Government Development and Innovation Group was commissioned upon recommendation from the Improvement Board to review progress and took place in Calderdale in September 2011. Page 6 of 21
Clinical Commissioning Executive: Calderdale
CKWCB/13/21A
Designate Chief Officer: Matt Walsh
22 January 2012
A second peer review has been undertaken in November 2012. An initial meeting was held to discuss the process that will be undertaken and all co-ordination for this was formulated by Stuart Smith Interim Director of Children’s Social Care. The first draft of the Single Integrated Improvement Plan for NHS Calderdale has been developed and received at the August Quality Group meeting. All actions have either been completed or within timescales to complete. Savile Allegations On 12 November 2012, Sir David Nicholson wrote to all Chairs and Chief executives of NHS organisations in relation to the Savile allegations. He has asked that NHS Trusts review, with their Boards, and working as necessary with local agencies, their own arrangements and practices relating to vulnerable people, particularly in relation to: safeguarding; access to patients (including that afforded volunteers or celebrities); and listening to and acting on patient concerns. The Secretary of State has appointed Kate Lampard, a barrister and Vice Chair of NHS South of England, to provide assurance that the Department and the relevant NHS organisations are following a robust process aimed at protecting the interest of patients. She will also look, as part of that work, at NHS wide procedures, in the light of the findings of the reviews, to see whether they need tightening. When this work has concluded we will share any learning relevant for the wider system across the service as a whole. Through the Clinical Quality Boards for CHFT and SWYPFT they have been asked to provide assurance that action is being taken in response to this letter. This information will be received by the Quality Group. In addition, the Quality Group have asked the safeguarding team to consider, which of our other commissioned services we should be securing responses from. Patient Experience Friends and Family Test Implementation On 25 May 2012, the Prime Minister announced the introduction of the “Friends and Family Test” to improve patient care and identify the best performing hospitals in England. To support this, from April 2013, Standard NHS Contracts will include a requirement that this
Patient Experience Standing item on Quality group and clinical quality Board with CHFT Page 7 of 21
Clinical Commissioning Executive: Calderdale
CKWCB/13/21A
Designate Chief Officer: Matt Walsh
22 January 2012
work be delivered by providers of all NHS funded acute inpatient and A & E departments. The Friends and Family Test (FFT) aims to provide a simple, headline metric, which when combined with follow-up questions, can be used to drive cultural change and continuous improvements in the quality of the health care received by NHS patients. The Question: “How likely are you to recommend our ward/A & E Department to friends and family if they needed similar care or treatment? Organisations are expected to ask follow-up questions at the same time as the FFT, to find out more details that can help drive improvements. The number and working of follow-up questions is to be determined locally. Patients to be surveyed: • Adult acute inpatients (who have stayed at least one night in hospital) • Adult patients who have attended A & E and left without being admitted to hospital or were transferred to a Medical Assessment Unit and then discharged. Next steps • Review completed state of readiness questionnaire for each of acute and independent sector provider organisations from CKW cluster at Quality Group. • Standing agenda item on Provider Quality Boards and Contract meetings. • Monthly progress reports to CCEs, through Quality and Safety paper. CQUINs The overview of the development of local CQUIN schemes including implementation, trajectories setting, improvement plans and recommending these to the relevant Contract Management Boards continues to be managed through the Clinical Quality Board arrangements.
CQUINS No actions
All providers submitted Quarter 2 returns by the specified deadline (31st October 2012). For Quarter 2, our main providers achieved the following performance in the indicators that required data submission in Q2
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Clinical Commissioning Executive: Calderdale
CKWCB/13/21A
Designate Chief Officer: Matt Walsh
22 January 2012
Provider
Q1
Q2
Calderdale and Huddersfield Foundation Trust (CHFT) - acute
100%
100%
South West Yorkshire Partnership Foundation Trust (SWYPFT)
87.5% 81.25%
Q3
Q4
Q2 comments Achieved all indicators that required data submission and reporting in Q2
Did not achieve:Improving access for people experiencing acute mental health problems – crisis referrals. Issue identified as Wakefield and MYHT Improving access for people experiencing acute mental health problems – routine referrals. Smoking cessation - there is a documentation issue relating to this indicator in Calderdale BDU Partial achievement of the patient experience indicator
Spire Elland Hospital
100%
100%
Achieved all indicators that required data submission and reporting in Q2 Page 9 of 21
Clinical Commissioning Executive: Calderdale
CKWCB/13/21A
Designate Chief Officer: Matt Walsh
22 January 2012
Yorkshire Ambulance Service (YAS)
94%
TBC
Provisional data has been submitted to NHS Bradford and Airedale and feedback has been sent back to YAS
Never Events In July 2012 CHFT reported a wrong site surgery Never Event. The patient had a left nephrectomy on 15 March 2012 because the kidney was chronically infected and nonfunctioning. The following day the patient had to return to theatre because of bleeding. During the second procedure, it transpired that the left kidney remained in situ. An incident report was completed that day, and an internal investigation has been carried out. The investigators have found that during the first operation, the tail of the pancreas was removed instead of the left kidney. Performance
Headline Indicators: Calderdale has achieved the required thresholds for the following headline indicators from the Operating Framework : • Planned Care - referral to treatment times for admitted patients • Cancer – patient receiving their first definitive treatment with 62 days • Urgent Care – ambulance response times Areas that will require continued focus: Dignity and Respect - Mixed Sex Accommodation – discussed in section on Quality and Safety Safety – minimising the incidence of C.Difficile – discussed in section on Quality and Safety Urgent Care – time spent in A&E (< 4 hours) Calderdale achieved the 4 hour A&E target during the first 5 months of 2012/13 and year to date performance currently stands 95.4%. However performance has deteriorated during Q3 (94.97% - week ending 9th Dec). Page 10 of 21
Clinical Commissioning Executive: Calderdale
CKWCB/13/21A
Designate Chief Officer: Matt Walsh
22 January 2012
While attendance to A&E has been higher in 2012/13 compared to previous years (by approximately 2-3%), it should be noted that volume of attendance reported during Q3 has not been as high as that experienced in Q1 and Q2 of this year. CHFT has suggested an increase in the complexity of patients presenting to A&E has been a contributing factor to the underperformance. In response, Calderdale and Greater Huddersfield CCG have agreed to undertake an audit of the coding of activity in A&E. On its completion, the results and actions from the audit will be shared with Finance and Performance Group. Analysis of A&E data has led to NHS Calderdale commissioning additional A&E consultant cover to provide more senior support in the department up to 10pm. The CRH site has introduced a “physician led clinical management team” based in A & E. This provides faster access to a specialty opinion and enables patients to be managed in A & E rather than be admitted onto the short stay ward. CHFT has reported that the early results from this scheme are encouraging and are looking at the opportunities to replicate a similar service on the HRI site. Regular internal meetings throughout winter have been established to discuss patient flow patient. The immediate effect of this has: • • •
Strengthened operational management in A&E with additional nursing and administrative support for known pressure points Introduced a manager of the day to support the patient flow team. Their remit will be to ensure quicker escalation of issues across the Trust so capacity can be flexed when appropriate Strengthened the team reviewing delayed discharges. A fortnightly meeting with Calderdale Social Services has been set up to monitor and escalate any delayed discharges
In partnership with the Lean Enterprise Academy, CHFT have introduced a large service improvement programme that will implement a “plan for every patient”. This will improve patient flow, reduce lengths of stay and bed occupancy throughout the hospital. This has been supported by non-recurrent investment from the PCT.
Page 11 of 21
Clinical Commissioning Executive: Calderdale
CKWCB/13/21A
Designate Chief Officer: Matt Walsh
22 January 2012
Preparation for Winter Since November the weekly Surge and Escalation teleconference has commenced. This involves key stakeholders from the local health and social care economy (including the acute trusts and community providers, CKW PCTs, YAS, Local Authorities, SWMHT, Care UK, NHSD, LCD). The teleconferences are scheduled weekly but the frequency of the calls is to be determined by the providers. The calls will enable organisations to update partners on the current situation, escalate issues and work together to enable the system to manage pressures in a coordinated fashion to aid patient flow.
Finance and QIPP
Financial position Month 8 2012/13 • We are forecasting to deliver our control total of £3.6m. The current allocation for the year is £364m. • We are currently in line with budget and have a £2.4m surplus as at month 8. • Our QIPP plans are on line to deliver our planned £5.6m target. • A spending plan has been approved and is in the process of being delivered that commits £11.1m of non- recurrent funding Risks There continue to be a number of risks for the Group to be aware of for 2012/13: • QIPP plans don’t deliver the required level of recurrent savings, this will not pose a financial risk in 2012/13 (fixed income contracts in place with CHFT and Leeds) but could impact on 2013/14 negotiations. There is currently a £1.5m shortfall in elective and non-elective schemes. • Restitution claims – A high number of claims have been received, We are continuing to monitor what level of provision is required, any increase/shortfall will need to be met from 12/13 resources. • Spending Plan – A spending plan has been agreed to utilise £11.1m, if any of the items in the spending plan cannot be delivered further areas of spend will need to be identified. QIPP Plan 2012/13 • The PCT requires £5.6m of savings to be realised from budgets this year in order to Page 12 of 21
Clinical Commissioning Executive: Calderdale
CKWCB/13/21A
Designate Chief Officer: Matt Walsh
22 January 2012
achieve our financial targets. Our current forecast is that we will deliver this target. Items escalated from F&P group • To note the risks detailed above.
Governance and Risk
Calderdale has a well-embedded system of risk management which has been adopted by the CCG. Risks are identified at all levels within the organisation and are reviewed by the Senior Management Team. Critical risks are reported to both CCE and Cluster Governance Committee. Currently there is no critical risk. As part of transition, the local Audit and Governance Group has been undertaking a detailed review of all of the risks in each directorate through a rolling programme during this 2012/13. At its meeting on15th November 2012, the Audit and Governance Group considered the High Level Risk Log (HLRL) and recommend it to the CCE as a true reflection of the current risk position. The Audit & Governance Group has been meeting bi-monthly since November 2011. The main items of discussion at the September and November 2012 meetings were:
• • • • •
Serious incident, serious case reviews and complaints Internal audit progress report Review of the effectiveness of subgroups Equality and Diversity annual report Single Integrated Improvement Plan for Children’s Safeguarding Services in Calderdale
What are our key risks? New HLRL risks this period
• •
Avoidable Health Care Acquired Infections are not prevented and future reductions in objectives (targets) for C.Difficile are not met. Electronic Staff Record Page 13 of 21
Clinical Commissioning Executive: Calderdale
CKWCB/13/21A
Designate Chief Officer: Matt Walsh
22 January 2012
Continuing HLRL risks
•
• • •
Managing the transition
Avoidable Health Care Acquired Infections – MRSA annual target exceeded (CRITICAL RISK –risk score 20) Calderdale MBC is not yet ready for re-inspection by OFSTED/CQC. NHS Calderdale may not have the appropriate systems and processes in place to ensure the system model is affordable going forward Commissioning Support (CS): 1. Not developed in timely manner 2. Fails to offer what the CCG is looking for 3. Offer is too costly 4. The requirement to develop and resource a CSS may prevent development and retention of local capacity at a key time, leading to greater insecurity for PCT staff.
The CCG has now been authorised with one condition outstanding. This condition relates to our commissioning and financial plans for 13/14 and beyond. The NHS Commissioning Board (NHSCB) through its area team will be working with us to ensure that the financial and clinical outcomes of the Strategic Review are robust and are sufficiently reflected in our planning. We will be working with our NHSCB local area director to develop and agree our plans in this area. This condition will be assessed again prior to the 31st March 2013 and will be removed if the NHSCB is assured that we have fulfilled the authorisation requirements associated with this condition. In the meantime, the CCG is continuing to prepare for taking on full statutory responsibilities from the 1st April. This includes working closely with the Calderdale, Kirklees and Wakefield District Cluster on the transfer of staff, assets, contracts and liabilities by 1st April 2013.
Page 14 of 21
Clinical Commissioning Executive: Calderdale
CKWCB/13/21A
Designate Chief Officer: Matt Walsh
22 January 2012
Governing Body Dr Matt Walsh has now been confirmed as Chief Officer, by the NHSCB. The CCG has appointed the final member to the Governing Body. The CCG welcomed Kate Smyth as lay member (PPI) at the Clinical Commissioning Executive meeting in December. The first development session for the whole Governing Body and senior management team was held on the 20th December. The Governing Body will be holding its first meeting in public on the 17th January 2013.
Transformation
Calderdale and Kirklees Health and Social Care Strategic Review The following Report went to the Executive Steering Group in December. Progress Update 1. The first draft of the Case for Change has been developed to consolidate the work so far and to articulate the challenges in the current health and social care system. This is being issued in draft at the December meeting with a timetable for comments. 2. All of the Care Streams have met in the last two weeks to consider the implications of recent changes and have continued to develop proposals for improvements to inform the development of the Business Case for the programme. 3. Members of the finance teams from the partner organisations have met to consider how a collaborative approach across the finance community can support all the partners to achieve their financial objectives. 4. Chris Green, the new Programme Director has started work, supported by a team from PA Consulting and the Programme Management Office (PMO) team and is meeting key stakeholders as soon as is practical.
Page 15 of 21
Clinical Commissioning Executive: Calderdale
CKWCB/13/21A
Designate Chief Officer: Matt Walsh
22 January 2012
Recommendations 1. All partners review the draft version of the ‘Case for Change’ and identify appropriate individuals within their organisations to support the process of finalising the ‘Case for Change’ before the January meeting of the Executive Steering Group. 2. Care Streams continue to meet regularly to feed into the Case for Change and contribute potential options for change to inform the consolidated business case needed for the consultation process and the transformation programme. 3. A Quality and Safety group is established to support the process of developing and assessing the proposed options for change. 4. A Finance group is established to support the process of developing and assessing the proposed options for change. 5. A Cross-cutting group is established from the relevant leads in the partner organisations to support the process of developing and assessing the proposed options for change. 6. A Strategic Planning session is held with senior stakeholders in January. 7. There is increased engagement with senior managers in partner organisations to socialise the vision, case for change and options to deliver change as part of building commitment to using the Strategic Review programme as vehicle to drive transformation. 8. The resources identified in the Resource Plan are made available to support the next phase of the programme. Care Streams 1. The Care Streams continue to make significant progress in identifying the clinical priorities and challenges facing the programme. 2. The Planned Care Stream is continuing to develop the strategic context, current service description and aspirational service descriptions. The Unplanned Care Stream is Page 16 of 21
Clinical Commissioning Executive: Calderdale
CKWCB/13/21A
Designate Chief Officer: Matt Walsh
22 January 2012
developing the options for a Centre of Excellence. The Childrenâ&#x20AC;&#x2122;s Care Stream has developed an integrated model for paediatric care and is developing the business case. The Long Term Care stream is gathering evidence in support of the proposed model for assistive technology and is continuing to promote self-care and self-help. 3. The Case for Change summarises and consolidates this work and the Care Streams will have a critical role in finalising this document. As yet there has been relatively little detailed analysis of current performance levels, future demand and financial and wider resource implications. This will be further developed over coming weeks. 4. It is recommended that the Care Streams continue to meet regularly to finalise the Case for Change and contribute to the development of a consolidated business case for the consultation process and the transformation programme.
Quality & Safety 1. It is critically important to ensure that the proposed transformation programme maintains patient safety and makes the best possible use of resources to provide high quality care. 2. It is recommended that a Quality and Safety group is established to support the process of developing and assessing the proposed options for change. Finance 1. There was a discussion at the last meeting to ensure effective engagement with and involvement of the appropriate members of the finance community in the development of the financial aspects of the strategic review. Finance officers of partner organisations have held an initial meeting to discuss the best approach to do this and agreed an outline approach to how to mobilise to support the strategic review, not least to ensure the appropriate level of rigour and data is applied to the identification of potential savings and any investment from their respective organisations. 2. It is recommended that a finance group is established to support the process of developing and assessing the proposed options for change. Page 17 of 21
Clinical Commissioning Executive: Calderdale
CKWCB/13/21A
Designate Chief Officer: Matt Walsh
22 January 2012
Cross-cutting Themes 1. The PMO is developing proposals to engage colleagues from across the partners to assist in developing and assessing the proposed options for change in January. The proposed groups would include IT, estates, diagnostic services, information analysis, human resources and transport. 2. It is recommended that a cross-cutting group is established from the relevant leads in the partner organisations to support the process of developing and assessing the proposed options for change. Vision 1. The partners agreed an ambitious vision for the programme. The vision is far reaching and achieving the vision will require the partner organisations to achieve significant transformation, for example: (i) More care in the local community implies a shift of resources from acute settings and a greater role for social care services (ii) Making best use of resources may require services to be decommissioned or budgets to be transferred between agencies. (iii) Remodelling care pathways may require significant shifts of resources between partner organisations. 2. The partners are encouraged to consider the implications of the vision for their own organisation and to consider how they can mobilise their organisations to make the vision a reality over the next three years. Benefits Management 1. As the programme develops it is critical that the Executive Steering Group can clearly articulate what success will look like, and can clearly state the strategic objectives and success criteria for the transformation programme. 2. There are not currently an agreed set of objectives for the programme. Analysis of the emerging business cases have identified the key themes could form the basis of a succinct set of objectives for the programme. The themes that have been identified are: Page 18 of 21
Clinical Commissioning Executive: Calderdale
CKWCB/13/21A
Designate Chief Officer: Matt Walsh
22 January 2012
(i) Reconfigure provision for unplanned health care services for children and adults (ii) Develop integrated care pathways for long term and chronic conditions including childrenâ&#x20AC;&#x2122;s long term care, muscular skeletal conditions, respiratory conditions and Ear, nose and Throat conditions (iii) Implement effective approaches to self-management of long term conditions (iv) Increase use of primary and community care to deal with unplanned care requirements 3. It is recommended that a Strategic Programme Planning session is held with senior stakeholders in January, the purpose of this session would be: (i) To agree the strategic objectives for the programme (ii) To formally agree the scope of the programme, including the financial savings that member organisations expect the programme to deliver. 4. Undertaking this Strategic Programme Planning session would respond to the recommendation of the Gateway Review team that: â&#x20AC;&#x153;The programme reviews the priorities and phasing for deliveryâ&#x20AC;?. Risk & Issue Management 1. The PMO is continuing to monitor and manage critical risks and issues. The critical risks to the programme will be reviewed and escalated as appropriate. Stakeholder Engagement 1. The Programme Management Office (PMO) will be reviewing the plans for communications and stakeholder engagement and the audit trail for past engagement activities to ensure that the appropriate engagement evidence has been retained. 2. It is recommended that there is increased engagement with senior managers in partner organisations to socialise vision and gain commitment to using Strategic Review programme as vehicle to drive transformation. Resourcing 1. The Gateway Review recommended that a resource plan was developed that details the resource requirements until the end of March. The PMO have developed Page 19 of 21
Clinical Commissioning Executive: Calderdale
CKWCB/13/21A
Designate Chief Officer: Matt Walsh
22 January 2012
proposals for resourcing of the programme. 2. It is recommended that the resources identified in the Resource Plan are made available to support the next phase of the transformation programme. Next Steps 1. The attached high level Programme Plan sets out specific milestones for the period up until the end of March. 2. Over the next few weeks the priorities for the programmer are to: (i) Finalise and approve the case for change (ii) Develop the strategic objectives for the programme (iii) Agree the financial baseline position (iv) Develop the options for transformation.
Annual Dental Report The Annual Report into Dental Services in Calderdale for 2011-12 has been produced and received by the SMT in Calderdale. The headlines from the annual report are as follows; • • • • • • •
129,500 patients treated in previous 24 months to March 2012 – a new record high. Percentage increase in number of Calderdale patients treated in previous 24 months, 2006-2012 - is in excess of National and Regional rate Percentage of total Calderdale population receiving NHS dental care in previous 24 months (total, adult, child) – is in excess of National and Regional rate Patients treated in a domiciliary environment – an increase of 31 from 750 in 2010/2011 to 781 in 2011/2012 Improved patient satisfaction ratings in terms of dentistry received and waiting times. On-going active contract management to improve accuracy, number of patients treated and ensure value for money. Reduced demand for NHS dental services. Identified by a reduction in the number of callers to the dedicated PCT Dental Helpline from 3466 in 2010/2011 to 1535 in 2011/2012 evidenced by an increase of 1169 in the number of patients treated in the 24 months prior to 31st March 2012 against 31st March 2011. At the same time an Page 20 of 21
Clinical Commissioning Executive: Calderdale
CKWCB/13/21A
Designate Chief Officer: Matt Walsh
22 January 2012
improved patient satisfaction rating The report provides significant assurance on the delivery of improvements in access to dental care over the year 2011-12. The report is available and it may be appropriate for the Cluster Board to receive the Annual report formally.
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