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Content Page Existing Commitments

Page Number

EC01

Guaranteed access to a GUM clinic within 48 hours of contacting a service

3

EC02

All ambulance trusts to respond to 75 percent of Category A calls within 8 minutes

4

EC03

All ambulance trusts to respond to 95 percent of Category A calls within 19 minutes

6

EC04

All ambulance trusts to respond to 95 percent of Category B calls within 19 minutes

7

EC05

Access to Crisis Resolution Services

8

EC06

Access to Early Intervention in Psychosis Services

9

EC07

Data quality on ethnic group

10

EC08

Delayed Transfers of Care

11

EC09

Diabetic Retinopathy Screening

12

EC13

Thrombolysis 'call to needle'

13

EC14

A 4-hour maximum wait in A&E from arrival to admission, transfer or discharge

14

National Priorities NPI01

Percentage of patients seen within 18 weeks for admitted and non-admitted pathways (Monthly Validated Data)

15

NPI02

Access to Primary Care "GP Patient Survey".

17

NPI03

Access to NHS Dental Services

18

NPI05a

All cancers: two week wait

19

NPI05b

Proportion of patients with breast symptoms referred to a specialist who are seen within two weeks of referral

20

NPI06a

The proportion of patients receiving their first definitive treatment within one month (31 days) of a decision to treat (as a proxy for diagnosis) for cancer

21

NPI06b

Proportion of patients waiting no more than 31 days for second or subsequent cancer treatment (surgery)

22

NPI06b

Proportion of patients waiting no more than 31 days for second or subsequent cancer treatment (drug treatments)

22

NPI06c

Proportion of patients waiting no more than 31 days for second or subsequent cancer treatment (radiotherapy

24

NPI07a

The proportion of patients receiving their first definitive treatment for cancer within two months (62 days) of GP or dentist urgent referral for suspected cancer

25

Page 1 of 46


NPI07b

Proportion of patients with suspected cancer detected through national screening programmes or by hospital specialists who wait less than 62 days from referral to treatment (from an NHS Cancer Screening Service during a given period)

26

NPI07b

Proportion of patients with suspected cancer detected through national screening programmes or by hospital specialists who wait less than 62 days from referral to treatment (Percentage of patients receiving first definitive treatment for cancer within 62-days of a consultant decision to upgrade their priority status )

26

NPI09 (LAA)

Obesity among primary school age children (National Child Measurement Programme (NCMP))

28

NPI10

Prevalence of Chlamydia

29

NPI11

Effectiveness of Children and Adult Mental Health Service (CAMHS)

30

NPI13 (LAA)

Smoking prevalence

31

NPI14

Rates of Clostridium Difficile - Kirklees

33

NP15

NHS staff survey scores based measures of job satisfaction

35

NP17 (LAA) Prevalence of infants breastfed at 6-8 weeks

36

NPI18

38

Proportion of children who complete immunisation by recommended ages

NP23 (LAA) Percentage of women who have seen a midwife or a maternity healthcare professional, for assessment of health and social care needs, risks and choices by 12 completed weeks of pregnancy.

39

Other Performance Measures OPI01

MRSA number of infections

40

OPI02

Supporting measures: Extended opening hours for GP practices, Increased capacity in primary care, Patient reported access to out-of-hours care

42

OP103

Convenience and Choice - GP Referrals (GP Booking)

43

OPI06 (LAA)

Emergency Bed Days

44

OPI07

Hospital admissions for ambulatory care sensitive conditions

45

End of Report

Page 2 of 46

46


Performance Report 2010/11 Accountability EC01: Guaranteed access to a GUM clinic within 48 hours of contacting a service.

Period 31 Aug 2010

Owner

Rachel Spencer

Sponsor

Judith Hooper

Key Achievements Since Last Report:

Both clinics continue to offer a selection of drop in and booked appointments.

Submitted (1) 4 Oct 2010

The PCT is meeting its trajectory for this indicator with 100% offered and 98% seen for August. First appointments 993, offered 993 seen 976.

Current Concerns PI

Due Date

Planned

Latest YTD

Variance

(8) (9)

Comments

Percentage: first attendances at a GUM service who were offered an appointment to be seen within 48 hours of contacting a service Aug-10

31 Aug 2010

98%

100%

Page 3 of 46

(4)


Accountability EC02 : All ambulance trusts to respond to 75 percent of Category A calls within 8 minutes

Period 31 Aug 2010

Submitted (1) 4 Oct 2010

(4)

Owner Sponsor

Rachel carter Carol McKenna

Key Achievements Since Last Report:

August performance for YAS was 78.8% compared with a target of 75%. The cumulative annual performance for YAS (CQC measure) at the end of August was 76.6% (i.e. above target). Performance for Kirklees was 76.4% in August (10th of 12 PCTs) and 73.9% year-to-date (10th of 12 PCTs).

Current Concerns

NHS Kirklees has been identified as one of 4 PCTs with underperforming YAS performance, with a target identified of 70% by September 2010 (which was achieved). There has been significant improvement in NHS Kirklees performance in 2010/11, but this masks significant variation across the different Kirklees localities. In August, performance ranged from: Cat A8: 25.0% in Denby Dale and Kirkburton, to 89.4% in Huddersfield North. Cat A19: 95.3% in Denby Dale and Kirkburton, to 100% in Birstall, Batley and Birkenshaw, Dewsbury and Mirfield, and Spen (NB all localities above 95% target). Cat B19: 83.6% in Denby Dale and Kirkburton, to 99.0% in Birstall, Batley and Birkenshaw. Overall activity for Kirklees is up 5.4% against plan for August and 3.2% for YtD. At £192.28 marginal rate, this translate to £122k current pressure and a projected full-year overspend of £296k.

Reasons for Variance and Actions Taken

The Operational Improvement Plan is currently going through the 6 month review process and an updated plan will be circulated mid-October. 1 Patient Self Handover This initiative, already in place in Bradford, is to be rolled out across Bradford/Calderdale/Kirklees (BCK) and Rotherham shortly. The PPI forum had some concerns but these are being addressed prior to roll out. 2 Front Loaded Model (FLM) Following resolution of the staff grievance in BCK, the FLM is to be implemented in BCK, York, Harrogate and the coast w/c 4th October. 3 Conveyance Rate Reduction working group The BCK YAS Assistant Director is leading a working group to address conveyance rate reduction regionally. 4 Training To help ensure maximum staff availability, the YAS training requirement is being re-profiled –YAS will be monitoring this to ensure that an unmanageable training backlog is not created. 5 System efficiencies These are currently running somewhat under plan, particularly around abstraction and overtime (O/T) management. Action has been taken to tighten up the management of these parameters, especially around appropriate targeting of O/T. This is intended to redress the performance fluctuations (mainly weekends) that YAS are currently experiencing. 6 Rota changes The review of rotas / resource requirement has been completed. The new rotas to reflect the review results are now being prepared and staff will be consulted about them from mid – October. The statutory 90 days notice of change will be issued in December to facilitate operation of the new rota patterns from April 2011.

Page 4 of 46


PI

Due Date

Planned

Latest YTD

Variance

(8) (9)

Comments

Percentage of category A calls resulting in an emergency response arriving at the scene of the incident within 8 minutes Aug-10

31 Aug 2010

75%

Page 5 of 46

76.6%

This is the CQC measure.


Accountability EC03 : All ambulance trusts to respond to 95 per cent of Category A calls within 19 minutes Owner

Rachel carter

Sponsor

Carol McKenna

Period 31 Aug 2010

Submitted (1) 4 Oct 2010

(4)

August performance for YAS was 98.2% compared with a target of 95%. The cumulative annual performance for YAS (CQC measure) at the end of August was 97.8% (i.e. above target). Performance for Kirklees was 99.0% in August (7th of 12 PCTs) and 98.5% year-to-date (9th of 12 PCTs).

Key Achievements Since Last Report:

PI

Due Date

Planned

Latest YTD

Variance

(8) (9)

Comments

Percentage of category A calls requiring transport resulting in an emergency response arriving at the scene of the incident within 19 minutes Aug-10

31 Aug 2010

95%

Page 6 of 46

97.8%

This is the CQC measure.


Accountability EC04 : All ambulance trusts to respond to 95 percent of Category B calls within 19 minutes Owner

Rachel carter

Sponsor

Carol McKenna

Period 31 Aug 2010

Submitted (1) 4 Oct 2010

(4)

June performance for YAS was 93.9%. Cumulative annual performance (the CQC measure) at the end of June was 94.0%. At 27th June, in-month performance was achieving the target at 95.09%. Performance for Kirklees was 93.0% in June (8th of 12 PCTs) and 92.7% Year-to-date. April performance for YAS was 94.3%, compared with a target of 95.0% (i.e. under-achieving). Performance for Kirklees patients was the 10th poorest of the PCTs commissioning from YAS, at 92.1%. May performance for YAS was 93.8%. Performance for Kirklees was 92.9%.

Key Achievements Since Last Report:

PI

Due Date

Planned

Latest YTD

Variance

(8) (9)

Comments

Percentage of category B calls resulting in an ambulance vehicle able to transport the patient arriving at the scene of the incident within 19 minutes Aug-10

31 Aug 2010

95%

Page 7 of 46

94.7%

This is the CQC measure.


Accountability EC05 : All patients who need them to have access to crisis services, with delivery of 100,000 new crisis resolution home treatment episodes each year Owner

Vicky Dutchburn

Sponsor

Carol Mckenna

Key Achievements Since Last Report:

Current Concerns PI

Period 30 Jun 2010

Submitted (1) 9 Aug 2010

Performance targets were fully achieved at the end of quarter 4 09/10. A new mental health contract was agreed for April 2010. Performance indicators were agreed with providers and financial penalty clauses were agreed as part of the process. Maintenance of the year end position is expected. Current quarter 1 data is been checked for accuracy & rigor. this should be confirmed by the 21/7 as per contract requirements Due Date

Planned

Latest YTD

Variance

(8) (9)

Comments

Number of separate episodes of home treatment provided by crisis resolution teams Quarter 1 June 10

30 Jun 2010

213.

389

Percentage of separate episodes of home treatment provided by crisis resolution teams of locally agreed share of the national target Quarter 1 June 10

(4)

30 Jun 2010

100.

182.6%

Page 8 of 46


Accountability EC06 : Deliver 7,500 new cases of psychosis served by early intervention teams per year Owner

Vicky Dutchburn

Sponsor

Carol Mckenna

Key Achievements Since Last Report:

Current Concerns PI

Period 30 Jun 2010

Submitted (1) 9 Aug 2010

Performance targets were fully achieved at the end of quarter 4 09/10. A new mental health contract was agreed for April 2010. Performance indicators were agreed with providers and financial penalty clauses were agreed as part of the process. Maintenance of the year end position is expected. Current quarter 1 data is been checked for accuracy & rigor. this should be confirmed by the 21/7 as per contract requirements Due Date

Planned

Latest YTD

Variance

(8) (9)

Comments

Number of people with newly diagnosed cases of first episode psychosis receiving early intervention in psychosis services Quarter 1 June 10

(4)

30 Jun 2010

48.

Page 9 of 46

42


Accountability EC07: Ethnic coding data quality

Period 31 Aug 2010

Submitted (1) 4 Oct 2010

Owner

Helen Bridges

Sponsor

Peter Flynn

Key Achievements Since Last Report:

Both acute and mental health providers continue to maintain high levels of ethnicity coding completeness.

(4)

No major concerns, however, Mid Yorkshire Hospitals Trust had aimed for 90% completeness by March 2010, which has not been achieved. A detailed coding improvement plan had been developed to identify actions for improvement - there will be ongoing discussions at the regular SLA meetings to monitor progress in this area.

Current Concerns

PI

Due Date

Planned

Latest YTD

Variance

(8) (9)

Comments

Percentage of care spells for inpatients (bed days greater than 0) recorded for the PCT (commissioner basis) on Mental Health Minimum Data Set (MHMDS) with valid 2001 census coding for ethnic category (excluding 'not stated' and 'not known'). Aug-10

31 Aug 2010

85.

89.38%

Percentage of Finished Consultant Episodes (FCEs) for the PCT (commissioner basis) on Hospital Episode Statistics (HES) data with valid 2001 census coding for ethnic category (excluding 'not stated' and 'not known'). Aug-10

31 Aug 2010

85.

97.21%

Page 10 of 46


Accountability EC08 : Delayed transfers of care to be maintained at a minimal level [NI131]

Period 30 Jun 2010

Submitted (1) 30 Jul 2010

(4)

Owner

Paul Howatson

Sponsor

Sheila Dilks

Key Achievements Since Last Report:

5 delayed discharges in Q1. CHFT 1 Acute delayed 75+ and MYHT 4 Acute delayed, 2 of which 75+ and 3 Non Acute delayed in Q1

PI

Due Date

Planned

Latest YTD

Variance

(8) (9)

Comments

The number of patients (acute and non-acute, aged 18 and over) whose transfer of care was delayed, averaged across quarter one to quarter four. (numerator) Quarter 1 June 10

30 Jun 2010

0

Page 11 of 46

8


Accountability EC09: 100 percent of people with diabetes to be offered screening for the early detection (and treatment if needed) of diabetic retinopathy Owner

Gaynor Schofield

Sponsor

Judith Hooper

Period 30 Jun 2010

Submitted (1) 11 Aug 2010

(4)

NHS Kirklees is the lead commissioner for the Calderdale and South Kirklees Diabetic Retinopathy Screening Programme, however, the lead commissioning manager left the organisation in June 2010 and has not been replaced. In the interim, Gaynor Scholefield, Senior Public Health Manager for NHS Calderdale, is managing the Programme on behalf of NHS Kirklees with NHS Kirklees input from Philip Hargreaves, Public Health Improvement Practitioner Specialist and Gillian Longbottom, Diabetes Project Co-ordinator.

Current Concerns

At the beginning of July 2010 the service had a software upgrade to Optimize Vs2 which necessitated the Programme having one week’s down time to facilitate the upgrade, user training etc. The reporting function of the upgrade has not been successful and we have been unable to provide 2010/11 Q1 data for the Vital Signs Monitoring Returns for South Kirklees area and NHS Calderdale. It has been identified that this issue is not specific to our Programme and in this instance, this matter has been reported to the English National Screening Programme for their attention. Digital Healthcare are addressing this as a matter or urgency. Due to the shut down of the Programme 28th November 2009 to 15th February 2010, as a result of the External Quality Assurance (EQA) visit, the re-call of patients for screening is running 2 months behind and a meeting is arranged for September to look at 'catch up' options.

PI

Due Date

Planned

Latest YTD

Variance

(8) (9)

The percentage of patients with diabetes identified by practices in the PCT who were offered screening. Qtr 1 10/11

31/06/2010

100.

83.09%

Page 12 of 46

Comments


Accountability EC13 : Thrombolysis call to needle of at least 68 percent within 60 minutes, where thrombolysis is the preferred local treatment for heart attack

Period 31 Mar 2010

Submitted (1) 7 Jul 2010

(4)

Owner

Alison Bragg

Sponsor

Sheila Dilks

Key Achievements Since Last Report:

This target has been achieved. However thrombolysis is not the preferred local treatment for heart attack and the numbers receiving thrombolysis are low, NHS Kirklees and the other WY PCTs are ruled out on the low numbers rule against this target.

Current Concerns

No current concerns

PI

Due Date

Planned

Latest YTD

Variance

(8) (9)

Comments

Percentage of eligible patients with acute myocardial infarction who received primary PCI within 150 minutes of calling for professional help. Qtr 1 10/11

31/06/2010

Percentage of eligible patients with acute myocardial infarction who received thrombolysis treatment either by injection or by infusion within 60 minutes of calling for professional help Qtr 1 10/11

31/06/2010

68%

100%

Page 13 of 46


Accountability EC14 : A 4-hour maximum wait in A&E from arrival to admission, transfer or discharge

W/E

Period 26/09/2010

Submitted (1) 4 Oct 2010

(4)

Owner

Tony Cooke

Sponsor

Carol Mckenna

Key Achievements Since Last Report:

A&E targets green for both MYHT and CHFT. Relaxation of the target has made sustained performance easier to achieve for both trusts.

Current Concerns

Increase in overall number of attendances at A&E is concerning and is being investigated via both GPs and commissioners. Variance across practices is being looked at, plus use of A&E by other UC services such as OOH and WIC.

PI

Due Date

Planned

Latest YTD

Percentage of patients spending four hours or less in all types of A&E department Weekly

26 Sep 2010

95%

97.73%

Page 14 of 46

Variance

(8) (9)

Comments


Accountability NPI01: Percentage of patients seen within 18 weeks for admitted and non-admitted pathways Owner

Jim Barwick

Sponsor

Carol Mckenna

Key Achievements Since Last Report:

18 Standard has been maintained at CHFT.

Period 31 Aug 2010

Submitted (1) 4 Oct 2010

(4)

18 week standard not being met at MYHT. Action plan developed and agree; MYHT progressing. Specific issues relate to: Current Concerns

* Size of the backlog continue to increase despite validation and activity; * The PAS system does not accurately record the back log and diagnostics. This is being resolved; * Not meeting 18 weeks in the sub-specialisations.

Reasons for Variance and Actions Taken

Further work with MYHT through contract mechanism to address scale of back log including identifying additional capacity to treat patients.

PI

Due Date

Planned

Latest YTD

Variance

(8) (9)

Comments

Percentage of eligible (*) admitted patients whose adjusted RTT clock stopped during the month who waited 18 weeks or less (<127 days) (monthly validated data) Aug-10

31 Aug 2010

90%

87.9%

Percentage of eligible (*) non-admitted patients whose RTT clock stopped during the month who waited 18 weeks or less (<127 days) (monthly validated data) Aug-10

31 Aug 2010

95%

97.9%

18 week RTT - Direct Access to Audiology (monthly validated data) Aug-10

31 Aug 2010

95%

100%

Page 15 of 46


Page 16 of 46


Accountability NPI02: Access to Primary Care "GP Patient Survey".

Period 31 Aug 2010

Owner

Mark Jenkins

Sponsor

Carol Mckenna

Key Achievements Since Last Report:

England average 24/48 hr target is 80%. Kirklees 83%

PI

Due Date

Planned

Latest YTD

Variance

Percentage of respondants who were able to get an appointment same day or in next working day. Year End 2009/10

31 Mar 2010

89%

82.52%

Page 17 of 46

(8) (9)

Submitted (1) 4 Aug 2010

Comments

(4)


Accountability NP103: Primary dental services, based on assessments of local needs and with the objective of ensuring year-on-year improvements in the numbers of patients accessing NHS dental services (VSB18) Owner

Clare Priestley

Sponsor

Carol Mckenna

Period 31 Aug 2010

Submitted (1) 4 Oct 2010

(4)

Removal of waiting list and provision of list of dentists providing NHS dentistry supplied to patients on request. End of year contract management undertaken and carry forward of a number of UDAs from practices who achieved within the 4% tolerance. Practices noted as outliers for clinical data have been addressed and continue to be monitored for compliance.

Key Achievements Since Last Report:

DH is reluctant to sign off the trajectory submission for NHS Kirklees as they feel we are not investing appropriately to increase access (for reasons stated below). The team had significant concerns about the demand estimate of 63% made by Kirklees for the following reasons: • the demand estimate is 7% below the lower end of the GP survey based forecast of demand which ranged from 70% to 76% • the access level has not improved since March 2006 and there is no plan to improve access, yet..... • the success rate for people getting NHS dentistry over a 6 month period measured by the GP survey was 93% - this compares with a national average of 95% and an expected success threshold for the new indicator from April 2011 in the region of 97-98% • the success rate for people getting NHS dentistry over a 24 month period measured by the GP survey was 89% - this compares with a national average of 92% • the PCT is only aiming to achieve minimal productivity gains through contract management Information taken to PCCG and agreed at Director level as correct for what NHS Kirklees has submitted to DH.

Current Concerns

Removal of a further number of underachieved UDAs from the dental budget to support the PCR shortfall is a cause for concern with the LDC. Reduction in the number of practices accepting NHS patients on a monthly basis has been noted. Due Date Planned Latest YTD Variance (8) (9) Comments

PI

Number of patient receiving NHS primary dental services located within the PCT area within a 24 month period Aug-10

30 Aug 2010

272,564

256,403

Page 18 of 46


Accountability NPI05a : A two-week maximum wait from urgent GP referral to first outpatient appointment for all urgent suspected cancer referrals Owner

Janet Cawtheray

Sponsor

Carol Mckenna

Period 31 Aug 2010

Submitted (1) 11 Oct 2010

(4)

We have achieved 96.55% performance in August which gives us a year to date position of 96.07% as we continue to sustain this target.

Key Achievements Since Last Report:

Current Concerns

MYHT have capacity problems in Radiology due to two radiologists leaving. The main impact of this has been on the 2 week breast symptomatic target but it may also begin to impact on the sustainability of this target so we will be closely monitoring over the next couple of months.

Reasons for Variance and Actions Taken:

MYHT have capacity problems in Radiology due to two radiologists leaving. The main impact of this has been on the 2 week breast symptomatic target but it may also begin to impact on the sustainability of this target so we will be closely monitoring over the next couple of months.

PI

Due Date

Planned

Latest YTD

Variance

(8) (9)

Comments

Percentage of patients first seen by a specialist within two weeks (14 days) when urgently referred by their GP or dentist with suspected cancer Aug-10

30 Aug 2010

93%

96.07%

Page 19 of 46


Accountability NP105b: Proportion of patients with breast symptoms referred to a specialist who are seen within two weeks of referral (VSA08) Owner

Janet Cawtheray

Sponsor

Carol Mckenna

Period 31 Aug 2010

Submitted (1) 11 Oct 2010

(4)

August Performance is 97.55% giving a Year to Date position of 90.81%. Key Achievements Since Last Report:

The 2 week waiting time for Breast Symptomatic at Mid Yorkshire has been sustained again this month after the dip in performance in May and June.

Current Concerns

There were 4 breaches of this target in August, 3 of which were due to patient choice.

PI

Due Date

Planned

Latest YTD

Variance

(8) (9)

Comments

Percentage of Patients referred for evaluation/investigation of "breast symptoms" by a primary care professional during a period (excluding those referred urgently for suspected breast cancer) who are FIRST SEEN within 14 calendar days Aug-10

30 Aug 2010

100.

90.81%

Page 20 of 46


Accountability NPI06a : A maximum wait of one month from diagnosis to treatment for all cancers Owner

Janet Cawtheray

Sponsor

Carol Mckenna

Period 31 Aug 2010

Submitted (1) 11 Oct 2010

(4)

National operational standard (96%) being maintained withAugust performance at 99.28% giving a year to date position of 98.58%.

Key Achievements Since Last Report: PI

Due Date

Planned

Latest YTD

Variance

(8) (9)

Comments

Percentage of patients receiving their first definitive treatment within one month (31 days) of a decision to treat (as a proxy for diagnosis) for cancer Aug-10

30 Aug 2010

96%

98.58%

Page 21 of 46


Accountability NP106b: Proportion of patients waiting no more than 31 days for second or subsequent cancer treatment (surgery and drug treatments) (VSA11) Owner

Janet Cawtheray

Sponsor

Carol Mckenna

Period 31 Aug 2010

Submitted (1) 11 Oct 2010

(4)

100% achievement in drug treatment in August against an operational standard of 98%, YTD 100% Key Achievements Since Last Report:

Surgery achieved 90.63% inAugust giving a year to date position of 95.14% against an operational standard of 94%

Current Concerns

The 31 day subsequent surgery target has dipped in August to 90.63% against the 94% standard. There have only been 3 patients seen over the 31 days but because the numbers are small it has a bigger impact on the target.

Reasons for Variance and Actions Taken:

The 3 breaches for subsequent surgery were at Leeds. The longest wait was 57 days. We do not have a breakdown of what surgery they were waiting for but the reasons for the longer waits were due to inadequate capacity. We will monitor this more closely over the next couple of months and if the problem continues we will escalate our concern through contracting via the lead commissioner NHS Leeds.

PI

Due Date

Planned

Latest YTD

Variance

(8) (9)

Percentage of patients receiving subsequent drug treatment within one month (31 days) of a decision to treat Aug-10

30 Aug 2010

98%

100%

Percentage of patients receiving subsequent surgery treatment within one month (31 days) of a decision to treat Aug-10

30 Aug 2010

94%

95.14%

Page 22 of 46

Comments


Page 23 of 46


Accountability NP106c: Proportion of patients waiting no more than 31 days for second or subsequent cancer treatment (radiotherapy treatments) (VSA12) Owner

Janet Cawtheray

Sponsor

Carol Mckenna

Period 31 Aug 2010

Submitted (1) 11 Oct 2010

(4)

100% was achieved inAugust against an operational standard of 94% giving a year to date position of 96.70%. Key Achievements Since Last Report:

This is still a shadow indicator until December 2010.

PI

Due Date

Planned

Latest YTD

Variance

(8) (9)

Comments

Percentage of patients receiving subsequent/adjuvant radiotherapy treatment within a maximum waiting time of 31-days during a given period, including patients with recurrent cancer Aug-10

1 Aug 2010

93%

96.70%

Page 24 of 46


Accountability NPI07a : A maximum wait of two months from urgent referral to treatment for all cancers Owner

Janet Cawtheray

Sponsor

Carol Mckenna

Key Achievements Since Last Report: PI

Period 31 Aug 2010

Submitted (1) 11 Oct 2010

(4)

Performance in August of 84.48% again the national operating standard of 85%, however, year to date position is 87.46%. Due Date

Planned

Latest YTD

Variance

(8) (9)

Comments

Percentage of patients receiving their first definitive treatment for cancer within two months (62 days) of GP or dentist urgent referral for suspected cancer Aug-10 1 Aug 2010 85. 87.46%

Page 25 of 46


Accountability NP107b: Proportion of patients with suspected cancer detected through national screening programmes or by hospital specialists who wait less than 62 days from referral to treatment (VSA13) Owner

Janet Cawtheray

Sponsor

Carol Mckenna

Period 31 Aug 2010

Submitted (1) 11 Oct 2010

(4)

100% achievement inAugust against an operational standard of 90% for screening giving a year to date position of 97.78% and 66.67% achievement for upgrade giving a year to date position of 88.57% - there is no operational standard yet for upgrade.

Key Achievements Since Last Report:

PI

Due Date

Planned

Latest YTD

Variance

(8) (9)

Comments

Percentage of patients receiving first definitive treatment for cancer within 62-days of a consultant decision to upgrade their priority status Aug-10

30 Aug 2010

88.57%

Percentage of patients receiving first definitive treatment within 62-days following referral from an NHS Cancer Screening Service during a given period Aug-10

30 Aug 2010

90%

97.78%

Page 26 of 46


Page 27 of 46


Accountability NPI09 VSB09 NI55 : NI56 Obesity among primary school age children Owner

Liz Messenger

Sponsor

Judith Hooper

Period 30 Sep 2009

Submitted (1) 5 Jul 2010

(4)

Weighing and measuring of year 6 pupils commenced at the beginning of June and is now nearing completion. The data from the 2009/10 programme will not be available until December 2010. Key Achievements Since Last Report:

The routine feedback pilot project is currently being implemented in Spen and Huddersfield South. Parents will receive a letter within six weeks of their child being weighed and measured to inform them of the result. Supporting materials have been developed to ensure parents with overweight and obese children are sign posted to appropriate programmes and services. Capacity within the School Nursing Team to complete the weighing and measuring has been reduced this year. This could impact on the coverage of the programme, as potentially not all schools will be visited before the end of the academic year; this raises concerns about meeting the participation targets. Steps have been taken by the School Nursing Teams to free up capacity in order to meet the requirements of the programme.

Current Concerns

PI

PCTâ&#x20AC;&#x2122;s have experienced negative media interest following the implementation of routine feedback to parents. The Obesity Programme is working closely with the Communications Team to proactively work with the local press around the National Child Measurement Programme and provide information about local initiatives and services for overweight and obese children, young people and their families.

Due Date

Planned

Latest YTD

Variance

(8) (9)

Comments

Percentage of children in Reception with height and weight recorded who are obese. School Year Sept 2009

31 Mar 2010

10%

9.3%

Data from the 2009/10 NCMP will not be available until December 2010.

95%

Data from the 2009/10 NCMP will not be available until December 2010.

Percentage of children in Reception with height and weight recorded. School Year Sept 2009

31 Mar 2010

92%

Percentage of children in Year 6 with height and weight recorded who are obese. School Year Sept 2009

31 Mar 2010

17%

16.4%

Data from the 2009/10 NCMP will not be available until December 2010.

92%

Data from the 2009/10 NCMP will not be available until December 2010.

Percentage of children in Year 6 with height and weight recorded. School Year Sept 2009

31 Mar 2010

88%

Page 28 of 46


Accountability NPI10: Prevalence of Chlamydia (VSB13) [NI113] Owner

Rachel Spencer

Sponsor

Judith Hooper

Period 31 Jul 2010

Submitted (1) 4 Oct 2010

(4)

Screens in North Kirklees have seen considerable improvement this month as a result of increased outreach screening i.e. party in the park. Sexual Health Youth workers have increased screening for a third month with over 70 screens, agreements made at the SLA performance meeting that Sexual health Youth Workers will now focus on increasing capacity for screening with in all youth centres.

Key Achievements Since Last Report:

GPs and Pharmacies: small numbers of screen still being received from pharmacies and GPs and further training is being offered via CSOs. F.E. SLA has been agreed to continue the Sexual health Nurse led clinic at Kirklees College. The PCT is not currently meeting the August trajectory of ????? Screens. The total number of screens performed to date is ????? (inclusive of those screens obtained direct from the lab) Current Concerns

Core services continue not to meet required screening levels per month in order to meet trajectory. Screens carried out in North Kirklees via Brunswick outreach have been decreasing. The following actions are taking place to obtain the additional screens needed to meet the trajectory of 14024 screens by March 2011. Sexual health youth workers will increase screening capacity in all youth clubs.

Reasons for Variance and Actions Taken

Evidence is being gathered to identify areas of high risk in order to target screening where prevalence and positivity may be higher. A more targeted approach to Chlamydia screening is being considered.

PI

Due Date

Planned

Latest YTD

Number of people aged 15 - 24 screened or tested for chlamydia Jul-10

31 Jul 2010

4,675

4,538

Page 29 of 46

Variance

(8) (9)

Comments


Accountability NPI11: Effectiveness of Children and Adult Mental Health Service (CAMHS) (percentage of PCTs and Local Authorities who areDebi providing a comprehensive CAMHS) (VSB12) Owner Hemingway Sponsor

Key Achievements Since Last Report:

Period

Submitted

(1)

(4)

Carol Mckenna Considerable progress as been made over the past 3 months towards developing a full range of early intervention support services delivered in universal settings and through targeted services for children and young people experiencing mental health problems. Through the Targeted Mental Health in Schools (TaMHS) grant we have started a pilot project which aims to work closely with schools to find the best ways to support children at risk of or experiencing mental health problems. This will promote strategic integration across childrenâ&#x20AC;&#x2122;s services and foster stronger links between schools and CAMHS. Targeted support will be based upon the existing evidence base relating to effective interventions to guide the support offered to children. Fourteen schools are involved in the TaMHS project and will focus on developing an emotional wellbeing pathway for schools to include early intervention and targeted support. Work is progressing well and the rating for this indicator has progressed from a 2 to a 3 The lack of a CAMHS/LD service is still an ongoing concern and risk to performance

Current Concerns PI

Due Date

Planned

Latest YTD

Variance

(8) (9)

Comments

Are arrangements in place for the council area to ensure that 24 hour cover is available to meet urgent mental health needs of children and young people and for a specialist mental health assessment to be undertaken within 24 hours or the next working day where indicated? (rate 1-4) Qtr 1 10/11

30 Jun 2010

4.

4

Do 16 and 17 year olds from the council area who require mental health services have access to services and accommodation appropriate to their age and level of maturity? (rate 1-4) Qtr 1 10/11

30 Jun 2010

4.

4

Has a full range of CAMH services for children and young people with learning disabilities been commissioned for the council area? (rate 14) Qtr 1 10/11

30 Jun 2010

4.

2

Is a full range of early intervention support services delivered in universal settings and through targeted services for children experiencing mental health problems commissioned by the Local Authority and PCT in partnership? (Indicator in Development (rate 1-4) Qtr 1 10/11

30 Jun 2010

4.

Page 30 of 46

2


Accountability NPI13: Smoking prevalence among people aged 16 or over and, aged 16 or over in routine and manual groups (quit rates locally 2008) (VSB05) [NI123] Owner

Rachel Spencer

Sponsor

Judith Hooper

Key Achievements Since Last Report:

Period Jun-10

Submitted (1) 04/10/2010

(4)

The Tobacco Programme has been presented at WHIB to help identify interdependencies and partnership working opportunities to improve outcomes. Aspects of Tobacco Control have also been discussed at LPSB and KPE and actions agreed. A pilot smoke free homes project in North Kirklees ran for twelve months from June 2009, parents’ awareness of the dangers to children of second hand smoke were raised and they were encouraged to make their home smoke free. The project funding has come to an end and a business case is being prepared to enable further work on this agenda. An enhanced service specification has been agreed with the Stop Smoking Service 2010-11 building in quality measures and development work to support the target populations, a reduced target has been set in recognition of work with more difficult to engage clients. Specialist advisors from the Stop smoking Service have been given a development role with an allocated target population focus. They will provide peer support and inform the training for frontline workers (Brief interventions) and are key members of the Tobacco Control Alliance cessation subgroups. Smoking cessation pilot groups targeting R&M workers began in January 2010 following social marketing insight work. Designated R&M advisors from the specialist service, outside speakers and ex-service users are involved in programme delivery. This work is being evaluated to inform future service provision. GPs and pharmacists provide an intermediate stop smoking service via a locally enhanced service, both schemes are under review to increase activity in areas of highest smoking prevalence and improve access to treatments. Systems are being reviewed to improve quality of maternity data and monitoring forms are being amended, alongside training on their completion, to capture occupation status more accurately. Brief interventions training is being recommended for all front-line workers in contact with target populations, an audit of training needs of identified staff is underway. An e-learning package is being developed with colleagues from Calderdale and Wakefield which will support front line workers who are unable to attend face to face training. A project focused on raising awareness of dangers of “niche tobacco products” in BME communities has been awarded funding and will be led by WYJS in Kirklees and Bradford.

Current Concerns

Smoking prevalence in Yorkshire and Humber region has increased from 22% in 2007 to 25% in 2008 making it the region with the highest smoking rate in England. Reduce smoking in 'routine and manual' groups where 32% people smoke and to stop smoking during pregnancy are the biggest challenges regionally as well as in Kirklees. Development of the Tobacco control Alliance is crucial to a whole systems approach to tobacco control and reduced smoking prevalence; this has been slow to progress due to capacity in the Tobacco programme. Currently R&M make up only 26% of 4 week quits through the specialist service; development work is required to ensure services meet the needs of this population and target group is engaged. Momentum and stakeholder commitment around smoke-free homes may be lost whist funding is sought. From 2011 measurement will move to prevalence rather than 4 week quits. Kirklees GP recording of smoking status remains below the 70% required by DH to calculate smoking prevalence, risk taken to Primary Care Quality Group for follow-up action. More work is required to establish method for calculating prevalence. There is a lack of public concern re cheap & illicit tobacco especially among populations targeted in the Tobacco programme plan. Withdrawal of regional funding has postponed the planned awareness raising social marketing campaign. Kirklees Tobacco Alliance has “Tackling Cheap and Illicit Tobacco” as a work stream and partnerships are being developed to take work forward at a local level.

Page 31 of 46


Reasons for Variance and Actions Taken

PI

Total quit numbers are below target for June 2010 (565 against target of 573), the specialist service is on target however reduced targets for the specialist service require good quit rates from intermediate advisors (via LES schemes) in order to meet target. The specialist service have been asked to increased peer support to practices, particularly in areas of high prevalence, to strengthen commitment to smoking cessation prior to the new LES scheme being launched. Due Date

Planned

Latest YTD

Number of 4-week smoking quitters who attended NHS Stop Smoking Services Jun-10

30 Jun 2010

573.

Page 32 of 46

565

Variance

(8) (9)

Comments


Accountability NPI14 : Rates of Clostridium Difficile (Commissioner) VSA03a Owner

Jane O'Donnell

Sponsor

Judith Hooper

PI

Due Date

Period 31 Aug 2010

Planned

Latest YTD

62.

52

31 Aug 2010

45.

36

31 Aug 2010

70.

58

Number of C. Difficile infections - Kirklees Aug-10 31 Aug 2010 Number of C. Difficile infections - CHFT Aug-10 Number of C. Difficile infections - MYHT Aug-10

Page 33 of 46

Variance

(8) (9)

Submitted (1) 4 Oct 2010

Comments

(4)


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Accountability NPI15: NHS staff survey scores based measures of job satisfaction (VSB17) Owner

Carolyn Dixon

Sponsor

Sue Ellis

Key Achievements Since Last Report:

Period 31 Dec 2010

Submitted (1) 13 Jul 2010

(4)

The 2009/10 NHS Survey ran from October-December 2009. Our response rate stands at 69%, exceeding our 2008 response of 66%. We have seen significant improvement overall. Areas identified for continued improvement are being taken forward through individual directorate and organisational action plans for implementation during 2010/11. It is anticipated that the 2010/11 NHS Survey will run between OctoberDecember 2010.

At this point in time the CQC has not confirmed which questions will be used for the assessment of staff satisfaction as part of the 2009/10 Periodic Review. The latest CQC guidance states "selected questions from the NHS Staff Survey will be used to calculate a job satisfaction key score, which will be used to score this indicator overall". The staff survey currently consists of 40 key findings, all relating to staff satisfaction. At this point in time, based on a best guesstimate of the specific questions under the Job Satisfaction Additional Theme, for 2009/10 the PCT is above better than national average for the 4 questions asked. This would give an overall weighted achievement of "green". Current Concerns Also, overall staff engagement is a new focus within the staff survey for 2009/10, and it could be that the questions asked in this area are the ones used by the CQC for the Periodic Review. If this is the case, the overall staff engagement score for the PCT is in the best 20% nationally, which would result in a "green" rating. However, until the CQC specify which questions they will assess for overall rating, there remains uncertainty. Until clarity has been received, the indicator used in this instance is the staff response rate for the questionnaire, which was the measurement in 2008/9 Annual Assessment process. PI

Due Date

Planned

Latest YTD

National NHS staff survey: Job Satisfaction 2010

31 Dec 2010

3.49

Page 35 of 46

Variance

(8) (9)

Comments


Accountability NPI17: Percentage of infants breastfed at 6-8 weeks (VSB11) [NI53]

Period

Submitted

(1)

(4)

Owner

Keith Henshall

Sponsor

Judith Hooper

Key Achievements Since Last Report:

Q1 figures show a continued steady improvement in prevalence rates across Kirklees, as coverage rates have improved significantly over the quarter. GP practices have been continuously supported with data collection. Work continues to increase prevalence (ie maintenance) of breastfeeding at 6-8 weeks through the development of peer support projects and by increasing initiation on delivery suites. Kirklees Partnership Executive are sponsoring work to develop workplace breastfeeding policies to support women returning to work early after having their baby. This will include appropriate provision for expressing and storing breast milk.

Current Concerns

Reasons for Variance and Actions Taken PI

The difference in prevalence between north and south Kirklees continues to cause concern. Initiation and maintenance of breastfeeding, along with many other health related outcomes, are linked to cultural and socioeconomic factors. These deprivation linked factors are intractable and difficult to address in the short term.

Continue to develop local community based solutions to support women to initiate and continue breastfeeding beyond discharge from maternity services. Ensure links to wider programmes are developed to address inherent cultural and socio-economic factors in areas with low prevalence. Due Date

Planned

Latest YTD

Variance

(8) (9)

Comments

Coverage: The number of children with a breastfeeding status recorded as a percentage of all infants due for a 6-8 week check. Qtr 1 10/11

30 Jun 2010

95.

90.83%

Prevalence; The number of infants recorded as being totally breastfed at 6-8 weeks plus the number of children recorded as being partially breastfed (receiving both breast milk and infant formula) at 6-8 weeks as percentage of the number of infants due for a 6-8 week check. Qtr 1 10/11

30 Jun 2010

48.3

40%

The number of children being recorded as not at all breastfed at 6-8 weeks during quarter 4. Qtr 1 10/11

30 Jun 2010

655.

638

The number of children recorded as being partially breastfed (receiving both breast milk and infant formula) at 6-8 weeks during quarter 4. Qtr 1 10/11

30 Jun 2010

358.

184

The number of infants due for a 6-8 week check during quarter 4. Qtr 1 10/11

30 Jun 2010

1440.

1255

The number of infants recorded as being totally breastfed at 6-8 weeks during quarter 4. Qtr 1 10/11

30 Jun 2010

338.

Page 36 of 46

318


Page 37 of 46


Accountability NPI18 : Proportion of children who complete immunisation by recommended ages (VSB10) Owner

Jane O'Donnell

Sponsor

Judith Hooper

PI

Due Date

Planned

Latest YTD

Period 30 Jun 2010

Variance

(8) (9)

Submitted (1) 23 Jul 2010

(4)

Comments

Immunisation rate for children aged 1 who have completed immunisation for diphtheria, tetanus, polio, pertussis, Haemophilus influenzae type b (Hib) - (i.e. all 3 doses of DTaP/IPV/Hib) Q1 2010/11

30 Jun 2010

95.

96.13

1.13

Immunisation rate for children aged 2 who have completed immunisation for Haemophilus influenzae type b (Hib), meningitis C (MenC) - (i.e. received Hib/MenC booster) Q1 2010/11

30 Jun 2010

95.

93.33

-1.67

Immunisation rate for children aged 2 who have completed immunisation for measles, mumps and rubella (MMR) - (i.e. 1 dose of MMR) Q1 2010/11

30 Jun 2010

95.

91.65

-3.35

Immunisation rate for children aged 2 who have completed immunisation for pneumococcal infection (i.e. received Pneumococal booster) (PCV) Q1 2010/11

30 Jun 2010

95.

92.63

-2.37

Immunisation rate for children aged 5 who have completed immunisation for diphtheria, tetanus, polio, pertussis (DTaP/IPV) (i.e. all 4 doses) Q1 2010/11

30 Jun 2010

95.

93.93

-1.07

Immunisation rate for children aged 5 who have completed immunisation for measles, mumps and rubella (MMR) (i.e. 2 doses) Q1 2010/11

30 Jun 2010

95.

89.32

Page 38 of 46

-5.68


Accountability NPI23: Percentage of women who have seen a midwife or a maternity healthcare professional, for assessment of healthKeith and Henshall social care needs, risks and choices by 12 Owner Sponsor Key Achievements Since Last Report:

Current Concerns

Reasons for Variance and Actions Taken PI

Period

Submitted

(1)

(4)

Carol Mckenna Out of 1338 pregnancies in Q1 2010/11, 1196 were under 13 weeks when they had their assessment. This is a ratio of 89.4% against a target of 90%.

In order to focus on the more vulnerable women and families, pregnancy care still needs to increase community midwifery capacity and skill mixing with Maternity Support Workers. Investment in staffing still seems to be an issue. This may be due to providers investing income from maternity services into other priorities. The shortfall in investment from tariff into maternity services and the accuracy of activity coding is being analysed by commissioners. This will be addressed through the contracting process.

Due Date

Planned

Latest YTD

Variance

(8) (9)

Comments

Data quality return for women who have seen a midwife or maternity healthcare professional, for assessment of health and social care need, risks and choices, by 12 weeks and 6 days of pregnancy Qtr 1 10/11

30 Jun 2010

The percentage of women in the relevant PCT population who have seen a midwife or a maternity healthcare professional, for health and social care assessment of needs, risks and choices by 12 weeks and six days of pregnancy. Qtr 1 10/11

30 Jun 2010

85.

89.38%

Page 39 of 46


Accountability OPI01: MRSA number of infections (VSA01) Owner

Jane O'Donnell

Sponsor

Judith Hooper

Period 31 Aug 2010

Submitted (1) 4 Oct 2010

(4)

As the health economy of Kirklees and Wakefield is over trajectory, contact has been made with the SHA and the Department of Health HCAI improvement team to discuss the assistance and support they can offer to ensure that the health economy team has reviewed all the necessary actions.

Current Concerns PI

Due Date

Planned

Latest YTD

31 Aug 2010

5.

11

31 Aug 2010

1.

2

31 Aug 2010

4.

6

Number of MRSA bacteraemia - Kirklees Aug-10 Number of MRSA bacteraemia - CHFT Aug-10 Number of MRSA bacteraemia - MYHT Aug-10

Page 40 of 46

Variance

(8) (9)

Comments


Page 41 of 46


Accountability OPI02 : Supporting measures: Extended opening hours for GP practices, Increased capacity Owner in primary care, Patient reported Markaccess Jenkinsto out-of-hours care (indicator to be

Period 31 Jul 2010

Sponsor

Carol Mckenna

Key Achievements Since Last Report:

July 10 - 64 practices out of 72 practices provide extended hrs (88.9%)

PI

Due Date

Planned

Latest YTD

Variance

Submitted (1) 2 Aug 2010

(8) (9)

Percentage of GP practices in the PCT offering extended opening in compliance with Department of Health guidelines Aug 10

31 Aug 2010

85.1

88.9%

Page 42 of 46

Comments

(4)


Accountability OPI03 : Convenience & Choice – GP referrals (PCT booking) Owner

Rachel Carter

Sponsor

Carol Mckenna

Key Achievements Since Last Report:

Period 31 Aug 2010

Submitted (1) 4 Oct 2010

(4)

Choose and Book usage for NHS Kirklees in August was 51%, representing a sustained drop in performance (April – 59%, May 60%, June 55%, July 52%). This reflects continued drops in both National and Regional performance but in August the Kirklees performance was below both National (August 52%, July 55%, June 57%, May - 61%; April – 60%) and Regional (August 58%, July 60%, June 62%, May - 66%; April – 64%) performance. Kirklees performance was 10th of 14 PCTs in Y&TH; Y&TH performance was 4th of 10 SHAs. The Kirklees performance reflects performance for referrals to our main providers of 60% for CHFT (July 62%, June 63%, May 66%, April 65%) and 42% for MYHT (July 45%, June 45%, May 51%, April 49%). The proportion of C&B bookings made to Directly Bookable services was 96% for Kirklees (96% in April, May and June, 97% in July) compared with National performance of 87% (87% April, May, June and July) and Regional performance of 90% (91% in April, May, June and July). This reflects rates of 100% at CHFT (100% in April, May, June and July) and 85% at MYHT (89% in July, 88 % in June, 87% in May, 88% April).

Current Concerns:

PI

MYHT is a national outlier in slot availability issues (i.e. no slot available for patient to book into when accessing C&B). Progress in this area is being monitored at operational and Executive contract management groups. We are receiving soft feedback from HP referrers that the lack of available slots is affecting their willingness to use C&B. The PCT does not have a Local Enhanced Service for C&B in 2010/11 and this may be affecting C&B usage. There are recognised concerns with the accuracy of figures used nationally for C&B performance reporting and it is anticipated that a revised system will be implemented in the next few months. Due Date

Planned

Latest YTD

90%

51.0%

Convenience & Choice – GP referrals (PCT booking) Aug 10

31 Aug 2010

Page 43 of 46

Variance

(8) (9)

Comments


Accountability OP106: Number of emergency bed days per head of weighted population (VSC20) [NI134] Owner Pat Andrewartha Sponsor

Period 31 Aug 2010

Submitted (1) 4 Oct 2010

(4)

Carol Mckenna The predictive risk tool is being used in most practices. Work continues which is looking at the variation in use, by practice population, in the urgent care services (A&E, OOHs, WiC), this will enable specific, targeted work to be undertaken with particular groups and practices. It will also support planning and developments around primary care / A&E integration.There is a reduction in EBD's of -837 / -24.9% on the same period last year, for trauma and orthopedics for CHFT.

Key Achievements Since Last Report:

Winter planning is underway; however there remain concerns that winter activity will impact further upon emergency bed usage.

Current Concerns Reasons for Variance and Actions Taken: PI

See above; work is continuing to understand the use of urgent care services and through it to provide clarity and understanding for patients on the best alternative for their needs. Due Date

Planned

Latest YTD

Number of emergency bed days per head of weighted population Aug-10

31 Aug 2010

71,445

83,347

Page 44 of 46

Variance

(8) (9)

Comments


Accountability OP107: Rates of hospital admissions for ambulatory care sensitive conditions per 100,000 population (VSC21) Owner

Joanne Crewe

Sponsor

Sheila Dilks

Period 01 Jun 2010

Submitted (1) 4 Oct 2010

(4)

People with Long term Conditions being supported by Community Matrons or Specialist Nurses are being identified as suitable for telehealth monitoring â&#x20AC;&#x201C; and significantly reducing reliance on secondary care. The Kirklees Predictive risk model is now available to all practices who have consented to share their data - 69 practices data now available in the Kirklees Tool. All these practices are using the predictive risk tool in their practice unit MDT meetings

Key Achievements Since Last Report:

Generic workers are available 24 hours per day 7 days per week via a single point of access and can support people with health or social needs at home to prevent hospital admission or facilitate early discharge. There is a significant reduction in activity and bed days for people who are managed by the LTC services Availability of community therapy services to respond in a timely manner to hospital discharges still requiring a rehabilitation programme - potentially will increase Length of stay or readmission to hospital Current Concerns

Under utilization of generic worker service Under utilization of Early supported discharge service Early identification of those at risk of admission STILL not being identified early enough and therefore opportunities to proactively manage to prevent admission not being realised. The predictive risk tool will enable clinicians and the PCT to identify current and future resource/service utilization.

Reasons for Variance and Actions Taken:

Need to review care pathways for those areas where there is significant or increased activity.

PI

Areas identified as priorities for development/ redesign are COPD, heart failure and epilepsy admission avoidance service Due Date Planned Latest YTD Variance (8) (9) Comments

Rate of hospital admissions for ACS conditions per 100,000 population Jun-10

1 Jun 2010

1323

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1575


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