NHS GRAMPIAN

PERFORMANCE REPORT –december 2009

This Performance Report is to provide Board members with assurance on key performance topics as discussed at the Performance Governance Committee (PGC) meeting on 19th November 2009.

The first part of the meeting, termed Healthstat, reviewed the documentation and outcomes from the cross system performance reviewheld on 15th October 2009 and sought assurance from the Chief Executive and Associate Medical Director about performance improvement.

HealthStat / Discussion/Assurance
Emergency Access Support Team Visit and Report/ 4 hour A&E Compliance / NHS Grampian has made steady progress in delivering against the national HEAT target of 98% against a maximum 4 hour wait within A&E prior to discharge, transfer or admission. Recent performance has been marginally below this target at around 97%,nevertheless support has been received from the Health Directorate’s Emergency Access Support Team (EAST) to help deliver this target on a sustained basis. The EAST team has helped to diagnose the root causes of emergency breaches and assisted in their resolution based on three visits in May and August 2009. Their recommendations related both to ARI and Dr Grays and included issues around leadership, patient flow and performance management. PGC members were advised by Dr Pauline Strachan, Executive lead for Unscheduled care, that the support from the EAST team had been very helpful and that this was continuing on a fortnightly basis to ensure delivery of the target. She assured PGC that the aim was to meet the target on a sustained basis by April 2010.

The second part of the meeting considered progress against the Strategic Themes and Objectives aligned to the Balanced Performance Framework and an update on the new HEAT Targets for 2010/11. The overall performance position according to the Corporate Scorecard was presented followed by more in depth consideration of key topics as follows:-

2010/11 Local Delivery Plan and HEAT Targets

The Committee was updated on the changes to the 2010/11 Local Delivery Plan and HEAT Targets for NHS Scotland. For 2010/11 the number of targets has been reduced from 29 to 24 and will include the introduction of new targets around reducing energy- based carbon emissions, waiting times for appropriate drug treatment, access to psychological therapies, an enhanced target for the reduction of staphylococcus aureus bacteraemia (including MRSA) and a 9 weeks target from being placed on a waiting list to admission for an inpatient or day case treatment by 31 March 2011. NHS Boards are required to submit draft LDPs by 18th February 2010 with final submissions by 19th March 2010. These new targets will be incorporated into the Balanced Performance Framework for 2010/11.

Strategic Theme

/

Topic

/

Discussion

/ Performance Rating /

Risk Rating

Delivering Safe, Effective and Timely care in the Right Place / Delivery of QIS clinical governance and risk management standards
Healthcare Acquired Infection / The outcome of the July 2009 review visit by Quality Improvement Scotland (QIS) to assess NHSG against the Clinical Governance & Risk Management Standards was to be published on Monday 23 November 2009. The Committee was delighted to hear that the results showed a significant improvement across all standards compared to the previous review in 2006/7 and that the Board’s HEAT target had been exceeded. PGC noted that the highest assessment category rating of “reviewing” had been achieved in Risk Management, Clinical Effectiveness & Quality Improvement, Clinical Governance & Quality Assurance and Performance Management.(Further information is contained in Agenda item 7.2.2)
Dr Roelf Dijkhuizen, Medical Director updated the Committee on the recent announced and follow up unannounced inspections by the Healthcare Environment Inspectorate (HEI) to ARI. These visits are to be carried out every three years by the HEI to each acute hospital with a focus to reduce the healthcare associated infection (HAI) risk to patients through a rigorous inspection framework. The outcome from the visits would be made public on Monday 23 November 2009 together with an action plan to address the issues raised in the Inspection Report. The action plan would be overseen by the HAI Executive Group chaired by the Chief Executive. The report focuses on three key areas: Governance/Compliance, Communication/Public Involvement and Education & Development. Dr Dijkhuizen also gave a general update on progress with the incidence of Clostridium difficile (Cdiff) and highlighted the difficulties in validating new cases. A full report would be made available under Agenda 8.2 / Green
Red / Low
High
Improving Efficiency, Productivity and Sustainability / September/ October 2009 Financial Report / Mr Bill Boyes Assistant Finance Director presented the latest financial position to October 2009. A small overspend of £45k was recorded against budget for the second month running with a year to date overspend of £3.25m which must be eliminated if we are to achieve our financial targets for the year. He highlighted the main overspend areas being Acute, Moray and Combined Child Health and the positive signs on staff numbers where the gap between funded establishment and actual staff had reduced from 342 WTE in September to 161 WTE in October. Agency nursing usage was also 40% below the level of last year. The two main risks to achieve financial balance remained around waiting times access funding and financial exposure around making good slippage on earmarked funding. In respect of the Capital Programme which currently stood at £54.4m, after seven months £16.6m (31%) had been spent. This was a significant improvement on last year and PGC was assured that we would deliver the full programme for the year. / Red / High

Directorate of Performance Improvement

November 2009

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