UNIVERSITY HOSPITALS OF MORECAMBE BAY NHS TRUST
TRUST BOARD
To be held on 26 May 2010 Agenda No 10a
Report of: / Director of Service and Commercial DevelopmentPaper Prepared by: / Patrick McGahon
Date of Paper: / 17 May 2010
Subject: / Business Plan 2009/10 – Quarter 2 Performance
Care Quality Commission Standards: / Outcome 15
Assurance Framework Link: / Strategic Objective - All
Auditors Local Evaluation (ALE) Link:
Background Papers: / Previous Business Plan Quarterly Update reports to FPSC
Items Considered at Earlier Committees (pls detail mtgs): / Business Plan 2009/10 (Board, 18 March 2009)
Patient & Public Involvement
In case of query, please contact: / Patrick McGahon Ext 46697
Purpose of Paper:
To update the Board with progress against the Business Plan 2009/10 for period ending 31 March 2010.
The report highlights good levels of progress against the Trust’s strategic objectives during 2009/10.
The Finance and Performance Scrutiny Committee is asked to:
NOTE quarter 4 performance and actions being taken to further improve performance moving into 2010/11.
AGENDA ITEM NO 10a
TRUST BOARD: 26 MAY 2010
BUSINESS PLAN 2009/10 – QUARTER 2 PERFORMANCE
Executive Summary
1. Background
1.1 In line with good practice the Board approved a Business Plan 2009/10 on 18 March 2009.
1.2 The Board agreed that all key targets should be monitored by the Finance
and Performance Scrutiny Committee (FPSC) or Board but utilising a revised format to focus upon key deliverables as detailed in our Summary Business Plan 2009/10. This report is structured as follows:-
( i) Key deliverables (Section 2)
( ii) Summary Progress against six Strategic Objections (Appendix 1)
(iii) Full Business Plan progress by action (posted on secure intranet site)
2. Key Deliverables
Outcome Measures for / Q1 / Q2 / Q3 / Q4 / Financial and Investment Implications / Governing Forum / Executive Lead / Responsible Manager / Q3 rating / Q4 rating / CommentFoundation Trust / Achievement of Foundation Trust status / As Per Agreed Financial Plan / Trust Board / Patrick McGahon / Jo Borthwick / Amber / Amber / Trust assessment process has been restarted
Secure 6,000 public Foundation Trust members / As Per Agreed Financial Plan / Trust Board / Jackie Holt / Emma Wright / Amber/Red / Red / Membership at 15.4.10 is 5,639. Full Time FT Membership Services Officer commences in post 26.4.10. Priority will be membership recruitment to achieve the target
Establish a Council of Governors / As Per Agreed Financial Plan / Trust Board / Jackie Holt / Emma Wright / Green / Green / Following the sad death of a Shadow Governor, an individual has agreed to take up the vacant post in the Lancaster, Craven & Wyre constituency. These arrangements are in line with the Trust’s Constitution
National Standards / Targets / Achievement of good rating for patient services in Care Quality Commission rating / As Per Agreed Financial Plan / Trust Board / Steve Vaughan / Karen Quigley / Amber / Green / In the 2008-9 Health-check scores Quality of services were rated as Fair. Year to date estimates are: National Priorities”Excellent/Good” (DoH are yet to publish all thresholds for scoring) and Existing Commitments “Almost Met”
Achievement of highest score in PEAT (cleanliness inspections) / As Per Agreed Financial Plan / PEAT / Steve Vaughan / Dave Passant / Green / Green / Working towards National Standards. Current average 94%
Delivery of healthcare acquired infection targets
(MRSA and Clostridium Difficile) / As Per Agreed Financial Plan / Clinical Quality & Safely Committee / Jackie Holt / Kim Wilson / Amber / Green / Achieved
There were 12 MRSA bacteraemia cases and 83 CDiff cases
Delivery of 18 weeks referral to treatment targets / As Per Agreed Financial Plan / Trust Board/FPSC / Steve Vaughan / Karen Quigley / Green / Amber / Continued to achieve overall compliance monthly. Failed in one Specialty in Q4, which is outside of the Operating Framework tolerance, but the CQC has not yet published the performance indicator threshold for this national priority
Delivery of 4 hour A&E standards / As Per Agreed Financial Plan / Trust Board/FPSC / Steve Vaughan / Steve Vaughan / Amber / Green / The Trust exceeded the A&E 4 hour wait standard in both Q4 and the year 2009-10
Delivery of national cancer targets / As Per Agreed Financial Plan / Trust Board/FPSC / Steve Vaughan / Alison Scott / Green / Green / The Trust has provisionally met the standards for all indicators in Q4 and the year
Patient Experience / New Trust website / As Per Agreed Financial Plan / HMT / Patrick McGahon / Phil Woodford / Amber / Amber / A-Z Directory to ‘go live’ in May2010 and process to populate has been agreed
Improving national patient satisfaction survey
scores / As Per Agreed Financial Plan / Trust Board/FPSC / Jackie Holt / Helen Jarram / Amber / Amber / Inpatient and outpatient survey results have been analysed to identify trends and themes plus cross referenced with other sources of patient feedback currently underway. Picker due to present findings at HMT in June and action plan for targeting areas for improvement and dissemination within Divisions due to be drawn up after this meeting
Piloting new approach to customer service / As Per Agreed Financial Plan / Marketing Group / Patrick McGahon / Phil Woodford / Amber / Amber / Meeting arranged with Director of Nursing and Modernisation to seek agreement on the submitted paper
Financial / Delivery of financial planned surplus / As Per Agreed Financial Plan / Trust Board / Tim Bennett / Janet Higgs / Amber / Green
Secure an overall Auditors Local Assessment (ALE)
score of at least three / As Per Agreed Financial Plan / Trust Board / Tim Bennett / Janet Higgs / Green / Green
Informatics / Delivery of electronic transfer of clinical correspondence to primary care / As Per Agreed Financial Plan / Health informatics Steering Group / Patrick McGahon / Steve Fairclough / Amber / Amber / Current position has stalled as NLPCT or GP practices will not fund document management systems within practices
Rollout of Electronic Patient Record System / As Per Agreed Financial Plan / Health informatics Steering Group / Patrick McGahon / Steve Fairclough / Amber / Amber / Full stage final testing nearing completion but final rollout date to be confirmed
Service Developments / Expansion of urology services / As Per Agreed Financial Plan / HMT / Steve Vaughan / John Bannisater / Amber / Amber / Partially implemented due to changes in Commissioner requirements
Full implementation of pre-operative assessment / As Per Agreed Financial Plan / HMT / Steve Vaughan / John Bannisater / Green / Green
Introduction of a Cumbria-wide Diabetes service / As Per Agreed Financial Plan / Trust Board / Patrick McGahon / Jo Borthwick / Amber / Red / Cumbria PCT have decided not to progress with a UHMBT-led service. Negotiations on-going around finance, operational and TUPE issues as new service to be run by PCT Provider Arm
Introduction of Mohs Surgery service / As Per Agreed Financial Plan / Trust Board/FPSC / Patrick McGahon / John Gorman / Amber / Amber / Discussions ongoing with Specialist Commissioners in relation to proposed pathway and tariff as well as in relation to cross cover with Wirral to overcome potential risks associated with single handed provider
Introduction of GP-led beds and Primary Care Assessment Services (PCAS) at Furness General Hospital (Barrow) / As Per Agreed Financial Plan / Trust Board/FPSC / Steve Vaughan / Steve Vaughan / Amber / Green / Both in place
Develop a business case for a Cancer Centre at Westmorland General Hospital (Kendal) / As Per Agreed Financial Plan / Trust Board/FPSC / Patrick McGahon / Jo Borthwick / Amber / Amber / Site visit to Aintree satellite centre run by Clatterbridge Oncology Centre took place on 29 April 2010
3. Conclusion
3.1 Performance against most key national targets was delivered excluding thrombolysis call-to-needle.
The Foundation Trust application has re-started and actions are on-going relating to Monitor requests.
Financial performance delivered a surplus of £1.9m for 2009/10.
4. Risks
4.1 The Board completed a review of the Top risks (November 2009) with an updated list of risks for on-going monitoring reported to the Board on a regular basis.
5. Recommendations
5.1 The Committee is asked to NOTE progress for quarter 4 and the year in full.
Appendix 1
Business Plan 2009/10 – Quarter 2 Performance Against Strategic
Objectives
This section looks at performance across the six strategic objectives of the Business Plan 2009/10.
Strategic Objective 1 – Patient Safety and Patient Experience
Change in Key IndicatorsRating / Quarter 3 / Quarter 4 / Change
Green / 14 / 17 / +3
Amber / 13 / 10 / -3
Red / 0 / 0 / 0
Overall Rating: Amber (Quarter 4 = Amber)
Comments on progress:
· Improved performance in terms of compliance with Standards for Better Health, Breast Screening expansion and MRSA
Next steps:
· Further work required to implement the Stroke Strategy
· Further actions need with NWAS on Thrombolysis “call to needle” performance
Strategic Objective 2 – Top Performing Healthcare Provider
Change in Key IndicatorsRating / Quarter 3 / Quarter 4 / Change
Green / 11 / 11 / 0
Amber / 5 / 6 / -1
Red / 1 / 0 / +1
Overall Rating: Amber (Quarter 4 = Amber)
Comments on progress:
· Continued strong performance against key national targets but concerns relating to 18 week failure in one speciality in Quarter 4 even though overall compliance delivered
Next steps:
· No specific actions identified
Strategic Objective 3 Public, Patients, Families and Carer Involvement
Change in Key IndicatorsRating / Quarter 3 / Quarter 4 / Change
Green / 5 / 6 / +1
Amber / 6 / 3 / -3
Red / 0 / 2 / +2
Overall Rating: Green (Quarter 4 = Amber)
Comments on progress:
· Further work required on recruitment to deliver target of 6,000 public members plus representative membership
Next Steps:
· Increased membership recruitment drive targeting Lancaster, Craven and Wyre constituencies
Strategic Objective 4 – Workforce Development
Change in Key IndicatorsRating / Quarter 3 / Quarter 4 / Change
Green / 5 / 6 / +1
Amber / 2 / 1 / -1
Red / 0 / 0 / 0
Overall rating: Amber (Quarter 4 = Green)
Comments on progress:
· Appraisal process is well established
· Staff survey results have improved in 2009 compared to 2008
· Current absence level shows the Trust as the best performing Acute in the North West
Next Steps:
· Implementation of key elements of People Strategy Phase 3
Strategic Objective 5: To provide excellent value for money for tax payers and provide sustained long term financial viability.
Change in Key IndicatorsRating / Quarter 3 / Quarter 4 / Change
Green / 5 / 6 / +1
Amber / 1 / 0 / -1
Red / 0 / 0 / 0
Overall rating: Amber (Quarter 4 = Green)
Comments on progress:
· Financial performance delivered surplus for 2009/10
Next Steps:
· Focus on financial performance in 2010/11
Strategic Objective 6: To ensure that the appropriate infrastructure exists to support the long-term delivery of the Integrated Business Plan
Change in Key IndicatorsRating / Quarter 3 / Quarter 4 / Change
Green / 2 / 3 / +1
Amber / 2 / 1 / -1
Red / 0 / 0 / 0
Overall Rating: Green (Quarter 4 = Green)
Comments on progress:
· Lorenzo Release 1.9 on track with full testing and awaiting final rollout date
· Good progress on Board Development Plan and working arrangements
Next Steps:
· Lorenzo Release 1.9 rollout