Mid Highland CHP Governance Committee
OUT OF HOURS
DATE March 2010
MANAGEMENT REPORT
1.0 OVERVIEW
Work is ongoing to provide electronic prescription printing for OOH Clinicians in NHS Highland North. This is already in place in Argyll & Bute. RaigmoreHospital will be the first pilot site in Highland North.
Admin and clerical staffing levels for Hub staff working public holidays remains problematic.
Un-triaged assistance was requested by NHS24 on the weekend of 20th March due to increased call levels. Highland was unable to assist due to Out of Hours clinical staffing capacity.
Age Bracket 17-45 continues to remain the highest user of the service.
2.0 ACTIVITY
Activity data provided by NHS24 and the Highland Hub covering the period 01.01.10 to 28.02.10is shown below.
2.1 Overall Activity
January 2010
Total OOHActivity / Number from NHS 24
(x% of total)
Highland / 5330 / 76%
SkyeHospital Daytime
Included in OOH Totals
NHS24 self Care / 1726
/ Split by CHP
(Patient consultations) / Activity
/ Activity as %
of total Highland
Activity
North Highland / 560 / 11%
Mid Highland / 1972 / 37%
South East Highland / 1882 / 35%
Argyll & Bute / 629 / 12%
Dental / 239 / 5%
February 2010
Total OOHActivity / Number from NHS 24
(x% of total)
Highland / 3732 / 65%
SkyeHospital Daytime
Included in OOH Totals
NHS24 self Care / 1299
/ Split by CHP / Activity
/ Activity as %
of total Highland
Activity
North Highland / 374 / 10%
Mid Highland / 1092 / 29%
South East Highland / 1325 / 36%
Argyll & Bute / 298 / 8%
Dental / 167 / 5%
An overall decrease in activity from the Festive period.
DENTAL OOH ACTIVITY
January 2010
February 2010
Age Profile of patients January 2010
Age<5 / Age
6-16 / Age
17-45 / Age
46-60 / Age
61-75 / Age
>75
10% / 5% / 24% / 11% / 11% / 14%
Age Profile of patients February 2010
Age<5 / Age
6-16 / Age
17-45 / Age
46-60 / Age
61-75 / Age
>75
15% / 8% / 31% / 15% / 13% / 18%
Age Profile Jan 2010 – Dec 2010
The chartsbelow illustrate overall OOH activity across NHS Highland by month.
January 2010
February 2010
The charts below illustrate OOH activity by hour of the day clearly showing the peak periods for OOH activity during the early morning (weekends, public holidays) and early evenings:
January 2010
February 2010
OOH Activity by Case Type
The charts below illustrate overall OOH activity by outcome type with the majority of patients being seen via case type at OOH centres:
January 2010
February 2010
2.2 NHS24 Satellite Report:
The table below shows the volume of NHS24 calls answered by the Highland NHS24 Satellite and the distribution of Highland calls to other centres. Text in italics provides additional explanation of the content of each section.
Calls / Jan-10 / Feb-10Local calls answered via the telephony applications
Calls to NHS24 which are Highlands & Islands calls (all calls, not just OOH) / 2,604 / 1,861
Local calls answered by local site
Highlands calls handled by Inverness centre / 588 / 377
Local calls networked to other sites
Highlands calls handled in another centre / 2,016 / 1,484
Overflow calls answered by local site
National calls handled by Inverness local centre / 1,326 / 1,089
Local & regional outbound calls handled by local site
Call-backs to patients (Highland & national) handled by Inverness local centre / 814 / 848
Number of Pre-Prioritised Calls Sent to Partners / 118 / 24
OOH Outcomes - includes all skillsets and untriaged
Overall OOH calls passed to local partners
Number of patients calling NHS24 who are subsequently seen by Highland OOH services / 5,736 / 4,193
Local OOH calls handled via local centre
Highlands calls handled by Inverness centre (OOH calls only) / 953 / 758
Overall % local Patients handled locally
Percentage of total Highland OOH patients handled by Inverness NHS24 local centre / 16.6% / 18.1%
Opening hours OOH calls passed to local partners / 4,263 / 3,444
% local Patients handled locally during opening hours / 22.4% / 22.0%
Local & regional OOH calls handled by local site
OOH calls for patients in other Board areas handled by Inverness HS24 local centre / 2,465 / 2,021
OOH Response time for NHS 24 - Target = 90%
% GP Priority commenced within 20 minutes / 100.0% / 100.0%
% GP Routine commenced within 60 minutes / 100.0% / 100.0%
2.3 Call Outcomes
NHSH OOH:
January 2010
February 2010
% of appointments returning to normal levels following the festive period.
3.0 PERFORMANCE
Table to be developed to show:
Utilisation %
Response time % for 1, 2 & 4 hours
Special Notes Usage
Information for January and February not available at time of writing report.
All Special Notes Held on Adastra (provided by GP Practices and other clinical team)
Anticipatory Care Plans used in Clinical Consultations during the period
Anticipatory Care Plans input into Adastra during the period
GP Provision January – February 2010
Total hours booked through Highland Hub 9584 hrs
Total Cancelled shifts 925.5 hrs 10%
Of which sick leave70 hrs 7%
WTD Breach 0 hrs0%
Compassionate Leave 89.5 hrs 9%
Child Care 0 hrs 0%
Study leave39.5 hrs 4%
Adverse Weather 27 hrs 3%
Total hours covered by salaried GP’s 1108 hrs12%
Total hours covered by Agency GP’s 1328 hrs14%
4.0 FINANCE
OOH budget devolved to CHP/locality level. Locality level reports available in CHPs as part of overall financial management.
5.0 CLINICAL GOVERNANCE
5.1Summary
Information not available at the time of writing the report.
5.2 Complaints
Complaints received by NHS Highland Complaints Team for Out of Hours complaints are not yet identified separately in the new report.
5.3Significant Adverse Events (SAE)
Information not available at the time of writing the report.
5.4 Partner Feedback (NHS24)
No information available for reporting period .
5.5 Incidents (IR1)
Information not available at the time of writing the report
Lorraine Beigley
Acting OOH Operational Manager