Measure / Target / Performance
Percentage of patients will wait no longer than 12 weeks to first appointment offered (MSK Physiotherapy) / 95% / 87% (Oct)
The MSK Physiotherapy service’s performance against its 12 weekreferral to first appointment KPI hascontinued to decline since theadditional funding ceased in March 2016. The service continuesdiscussions with OCCG in relation to the gap in funded capacity.The service is, in part, endeavouring to manage activity and waits by way of areduced first to follow up appointment ratio, however this falls below the national benchmark. Patient outcomes and satisfaction remain positive.
Measure / Target / PerformanceThe snapshot number of delays for Oxford Health’s community hospitals is below the threshold for that month / M7: 18
M8: 17
M9: 15
Q4: 15 / 30 (Oct)
The snapshot position for October was 30, an increase of 3 on last month’s position. This is 15 above the Q4 target of 15, and is 12 above October’s planned trajectory of 18. 53% of delays at the last snapshot were attributable to Social Services (28%) and HART (25%). 25% of this month’s delays were patient choice delays.
Over the past 8 weeks, the number of patients delayed has increased with an increasing number attributable to the NHS and Social Services. The last two weeks have seen a decrease in the number of delays attributable to HART.
Measure / Target / PerformancePercentage of unfilled shifts (OOH) / <2% / 14% (Oct)
OOH urgent triage (walk in) - time to triage / ≥ 95% within 20 minutes / 69% (Oct)
OOH non-urgent triage (walk in) - time to triage / ≥ 95% within 60 minutes / 88% (Oct)
OOH urgent F/F base visit / ≥ 95% within 2 hours of triage / 85% (Oct)
The Out of Hours Service is required to perform against 10 National Quality Requirements (NQRs) each month. In October, the service did not achieve 4.
Clinical risk is mitigated in the following ways:
- Advice is given to the patient during telephone consultation about steps they can take to self-manage and what to do if the condition deteriorates (e.g. ringing back into 111 or 999 as appropriate)
- When there is a delay in the GP phoning patients to book base/home visits, and where appropriate, a receptionist/driver will ring the patient to offer an appointment.
- Walk-in patients are initially triaged by a clinician to assess the urgency of medical need and whether it is safe for them to wait longer for an appointment.
Measure:
(Oxfordshire CAMHS) / Target / Performance Month 7 / YTD
Percentage of emergency referrals seen within 24 hours / 95% / 100% / 100%
Percentage of urgent referrals seen within 2 weeks / 95% / 100% / 100%
Percentage of routine referrals assessed within 12 weeks / 75% / 39% (Oct) / 35%
Oxfordshire CAMHS service’s performance against its 12 week referral to first appointment KPI for routine referrals continues to remain below target, risk mitigation plans have been put in place and all YP waiting longer than 26 weeks have been contacted to assess for any change in presentation, and only 1 YP has had to be seen sooner. October performance has declined to 39% due to the service concentrating on seeing the longest waiters; the number waiting has decreased from 1200 referrals to 800 referrals over the last 4 months.
Actions in place to address the under performance with CAMHS waiting times
Workforce-The Oxon CAMHS have a number of vacancies across various professions. The national CAMHS transformation plan has increased the competition within CAMHS services for successful candidates with a depleted workforce, therefore a recruitment strategy including creation of 2 x B7 Nurse Prescribers, Creation of 3 x B7 SPA roles. 1x role offered Oct 16, 2 x roles out for advert.Linking with TVSCN/HEE/NHS E to push the recruitment agenda and seek advice and guidance on recruitment strategies. Discussions with NHS E with regards to training post for evidence based interventions and
recruiting to trainee posts rather than seeking backfill. We have agreement and funding to support agency/locum staff to provide capacity to assist with the waiting lists and to support gaps in workforce.
Increasing Demand V Capacity-The continual increase in referral rates are adding pressure to the capacity of the services within existing resource, 30 ASD referrals subcontracted out August 2016 to private clinic, families have welcomed this approach. This has reduced our overall numbers for ASD waiters, considering further procurement in private sector.
Measure / Target / Performance Month 7 / YTDPercentage of mothers who receive an antenatal contact with a health visitor (CQUIN Indicator-Oxfordshire Health Visiting Service) / Q1-55%
Q2-60%
Q3-62%
Q4 65% / 71.8% (Q2) / 68%
Oxfordshire Health Visiting service have achieved Q1 & Q2 CQUIN Targets for the % of mothers who receive an antenatal contact with a health visitor, this indicator is a new KPI for the Health Visiting Contract for 17/18 with a challenging target of 95%, during 16/17 the service will be working towards achieving this new target which will be applied next financial year. The performance for this indicator has continued to improve and has increased by 40% in the last 2 FY’s.
The Health Visiting Service are meeting 7/8 contractual KPIs YTD, the indicator which remains a challenge to achieve is the New Birth Visit (NBV) within 14 days, target of 95%, achieved 94.1%, exceptions are reported for all breaches, these are mainly attributed to patient choice.
Measure / Target / Performance Month 7 / YTDOxfordshire Adult Eating Disorder Community Activity against contractual target. / 961 Contacts Month 7 / 2233 Contacts / 135% Over
performance
Oxfordshire Adult Eating Disorder Community Service continues to over perform against contracted activity levels by 135%; this over performance is consistent with the last three financial years.
Discussions with commissioners to review this service have commenced, despite the over performance patients are still waiting 12 months for CBTE Therapy, on average 30 sessions are provided per patient, however the contracted activity target is only based on 55 patients receiving 30 sessions each, the service has approx. 380 patients on their caseload with over 50% requiring CBTE therapy, all patients are seen every 2-3 months for a review of their presentation.
Measure / Target / PerformanceEIS 2 week referral to treatment / 50% / 89%
This indicator was introduced in December 2015 by NHS England and for thelast eight months the service has continually exceeded to target, with an average of 72% since March 2016.
The graph below shows there has been a gradual increase in recorded activity over the period and teams are continuously improving on the referral to treatment timeframe
Measure: Referral timeframes / Target / Performance / ActualsEmergency referrals (within 4 hours) / 95% / 95% / 18/19
Urgent referrals (within 7 days) / 95% / 95% / 169/178
Routine referrals (within 28 days) / 95% / 84% / 400/451
There has been inconsistency in the performance for Adults against the referral timescales over the last four months and this is partly due to the change in definition of what counts as a breach. The inability to discount patient cancellations as a valid breach means that the 95% target is challenging as some people will delay their appointments through choice, particularly for routine appointments.
7 day follow-ups / Target / Performance / Actuals7 day follow-ups / 95% / 95% / 60 out of 61
This measure relates to the percentage of Service Users under adult mental illness specialties on CPA who were followed up within 7 days of discharge from psychiatric in-patient care. Since April the target has only been missed twice, in May16 and in August16.
Caring, Safe and Excellent