Appendix 2

2013/14 Business plan

List of Detailed Targets / KPIs

EQUALITIES
Project name / Purpose / Project Lead / Success measure / Qtr
Mental Health Serious mental illness / To improve the physical health of people known to have mental health problems especially people with severe mental illness (SMI) / DOR / Reducing the numbers who smoke and narrow the gap between people with SMI (44.2% known to be smokers according to GP records) and thegeneral adult population of Lambeth (23% smokers)
Improving diabetic control fromthe beyond the Lambeth average (66% achieving good control as measured byHbA1C) towards that of the highest performing practices in Lambeth of80% or above for people with SMI and diabetes
Increase access to talking therapy services to those people over 55 and who have long term conditions. Target needed.
Increase access to the memory service for peoplefrom ethnic minority communities. Target needed.
Cardio Vascular Disease / To improve control of high blood pressure (defined as less than 150/90) in Lambeth. / Reduce the between practice variation by achieving measurable change in the poorest performing practices towards the Lambeth average of blood pressure controlled in at least 75% of people known to have hypertension
Diabetes / To improve the detection and control of diabetes in Lambeth (as defined by achieving HbA1c of less than 8). / Reduce the between practice variation in control achieving measurable change in the poorest performing practices towards the Lambeth average of 66% of people known to have diabetes achieving good control and between different population groups focusing on some ethnic minority populations andpeople with mental health.
HIV / To ensure the revised HIV treatment and support services are informed both by detailed evidence on which populations are experiencing the highest prevalence, the highest transmission rates and the highest social needs profile,and by a diverse Service User Reference Group (SURG) indicative of the different communities affected inLambeth. / Target = improve late detection rate to 14% by Mar 14
Smoking / To enable all smokers to have equal opportunity to quit through the Lambeth stop smoking service focusing particularly on particularly on lower socio economic groups who are more likely to smoke / Target?
Childhood Obesity / To reduce any inequality experienced by different population groups in their ability to benefit from the Childhood Obesity Programme and to promote equality and equity as a key element to successful delivery of the Programme overall / Target?
Alcohol / To promote equity of access to information on alcohol and safe drinking, and to alcohol misuse services for population groups at higher risk of alcohol related / Target = staff trained

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PLANNED CARE PROGRAMME
Project name / Purpose / Project Lead / Success measure / Qtr
Respiratory / to reduce the number of first and follow up outpatient appointments in respiratory medicine / SS / FOP appt >= -36; FUP appt >= -105 / Qtr1
FOP appt >= -83; FUP appt >= -210 / Qtr2
FOP appt >= -143; FUP appt >= -315 / Qtr3
FOP appt >= -203; FUP appt >= -421 / Qtr4
CVD/Cardiology / to reduce the number of first and follow up outpatient appointments in CVD/Cardiology / SS / FOP appt >= -15; FUP appt >= -24 / Qtr1
FOP appt >= -54; FUP appt >= -81 / Qtr2
FOP appt >= -108; FUP appt >= -162 / Qtr3
FOP appt >= -162; FUP appt >= -243 / Qtr4
MSK / to reduce the number of follow up outpatient appointments in MSK / SS / FUP appt >= -279 / Qtr1
FUP appt >= -558 / Qtr2
FUP appt >= -837 / Qtr3
FUP appt >= -1113 / Qtr4
Opthamology / to reduce the number of first and follow up outpatient appointments in acute opthamology / SS / FOP appt >= -294; FUP appt >= -138 / Qtr1
FOP appt >= -588; FUP appt >= -276 / Qtr2
FOP appt >= -882; FUP appt >= -414 / Qtr3
FOP appt >= -1176; FUP appt >= -582 / Qtr4
Diabetes / to reduce the number of first outpatient appointments in acute diabetic medicine / SS / FOP appt >= -125 / Qtr1
FOP appt >= -250 / Qtr2
FOP appt >= -375 / Qtr3
FOP appt >= -500 / Qtr4
Non face to face / to reduce the number of first and follow up outpatient appointments / SS / FUP appt >= -1352 / Qtr1
FUP appt >= -2704 / Qtr2
FUP appt >= -4056 / Qtr3
FUP appt >= -5408 / Qtr4
Gynaecology / to reduce the number of first and follow up outpatient appointments in gynaecology / SS
FOP appt >= -252; FUP appt >= -207 / Qtr2
FOP appt >= -1134; FUP appt >= -930 / Qtr3
FOP appt >= -203; FUP appt >= -421 / Qtr4

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MENTAL HEALTH IMPROVEMENT PROGRAMME
Project name / Purpose / Project Lead / Success measure / QRT
Equalities / DOR / Reducing smoking rates in clients of SLaM (via contract 2013/14)
Review access/take up of new integrated talking therapy service
Review of first year of memory service in progress to set baseline for access by ethnicity & other parameters / Qrtly
Qrtly
Qrtly
MHIP - Transforming community and primary care mental health services / Whole system transformation to support better outcomes for people with serious mental illness / DOR
SF/KC
DOR/SF
DOR / Support (min) 250 to move on from secondary care and reduction (by 10%) of people case managed by CMHT (Recovery & Support teams) / Qtr 4
MHIP - Primary care mental health / To improve access to talking therapy and improved physical health for people with mental health conditions. / SF/BW
SF/JS
DOR/SF
BW/JS / % Reduction in number of people with smi (managed by secondary care) smoking (baseline to be agreed qtr 1) / Qtr 4
MHIP - Payment by results / PbyR for secondary care MH services goes live April 2014 / DOR
DOR
DOR
DOR
MHIP - Criminal justice pathways / To improve the quality and access to appropriate community based care and support for people with mental health conditions in contact with the criminal justice system / DOR
EC/DOR
DOR
SF/ML / Reduce by (min) 10% % of people in residential care (inc forensic) / Qtr 4

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Older people including dementia
Project name / Purpose / PM / Success measure / Qtr
Mental Health Oder Adults - Continuing Care / Achieve QIPP £400k / LC/JB
LC/JB
LC/JB
LC/JB
Improved recognition of dementia in primary care / 5% increase in registered diagnosis of dementia / PJ/JB
PJ/JB
PJ/JB
PJ/JB
MEDICINES OPTIMISATION PROGRAMME
Project name / Purpose / Project Manager / Success measure / Qtr
Medicines Optimisation Plan: QIPP Elements Primary Care Prescribing / Delivery of Medicines QIPP; Promoting evidence based prescribing, better outcomes from medicines / VB / prescribing spend on budget / Qtr1
prescribing spend on budget / Qtr2
prescribing spend on budget / Qtr3
prescribing spend on budget / Qtr4
Medicines Optimisation Plan: CVD Optimisation elements / Better outcomes from medicines / VB / Proportion of patients meeting BP target / Qtr1
Proportion of patients meeting BP target / Qtr2
Proportion of patients meeting BP target / Qtr3
Proportion of patients meeting BP target / Qtr4
Medicines Optimisation Plan: implementation of London Respiratory Team key prescribing messages / Promoting evidence based prescribing, delivery of medicines QIPP, encouraging stop smoking and pulmonary rehabilitation / VB / reduce amount of high dose inhaled steroid prescribed to reduce side effects / Qtr1
reduce amount of high dose inhaled steroid prescribed to reduce side effects / Qtr2
reduce amount of high dose inhaled steroid prescribed to reduce side effects / Qtr3
reduce amount of high dose inhaled steroid prescribed to reduce side effects / Qtr4
Managed Entry of New Drugs - via Area Prescribing Committee and Acute Trust KPIs / Management of acute prescribing spend, managing growth on primary care prescribing / VB / acute prescribing meets performance framework standards and is within budget / Qtr1
acute prescribing meets performance framework standards and is within budget / Qtr2
acute prescribing meets performance framework standards and is within budget / Qtr3
acute prescribing meets performance framework standards and is within budget / Qtr4
Governance relating to medicines / Support for Controlled Drug Accountable Officer (NHSCB), Management of Medicines Individual Funding Requests, investigation of errors via Datix for medicines, support for community pharmacy local services. / VB
Acute prescribing budget / to reduce the overall cost of prescribing drugs in an acute setting / VB
reduction in spend on high cost drugs and individual funding requests for drugs cf LY / Qtr4
URGENT CARE
Project name / Purpose / Project Lead / Success measure / Qtr
Winter Pressures / Robust pressure surge management / TF
Achieve annual A&E Wait target =/< 95% / Qtr4
A&E Diversion Scheme / Redirect patients back to primary care so they are seen by the most appropriate clinician for their needs / TF
111 Programme / Single point of access so patients are signposted to the most appropriate service for their needs / TF
Re-commission UCC provision at GSTT / Reduce inappropriate activity going through the Emergency Department so it can be freed up to see more complex patients that need to be there / TF
Achieve annual A&E Wait target =/< 95% / Qtr1/2/3/4
Access Initiative / Increase urgent care access in primary care / TF / Have access to primary care service/ advice 24hrs, 7 days a week for urgent care needs through a combination of appointments and walk in services, telephone appointments, 111/NHS Direct or same day urgent care etc. / Qtr4
Choose Well Campaign (Patient Behaviour) / Understand why patients routinely access the emergency department at the acute trust for their primary care provision / TF
Develop Alcohol Recovery Centre / Reduce the impact and distruption on the emergency department / TF
Achieve annual A&E Wait target =/< 95% / Qtr1/2/3/4

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