Board Report - Performance November 2008 Produced by Business Intelligence (Performance)

1. Board Report - Performance November 2008 Produced by Business Intelligence (Performance)

2. Cleanliness and HCAI C. Diff - September year to date sees the first time our infection rate is lower than plan. For RWSx: Compliance with the High impact Intervention bundle has improved greatly. WASH: All gastrointestinal inpatients are now to have routine stool sampling to ensure early detection. Matrons are reviewing the care plans of patients experiencing a relapse of symptoms to ensure that the level of care received was not a cause of the relapse. Wards at Worthing Hospital which do not have single rooms are now receiving daily rounds from the infection control team to heighten awareness of their high risk patients. MRSA - The PCT will take steps to improve urinary catheter care and the management of wounds in the community. Standardise data collection for RCA audits will assist with the investigation process, in line with DH recommended best practice. The PCT will continue to seek improvements in the recording of HCAI risk status in GP information systems and to improve the quality of information on transfer of patients between institutions.

3. Emergency Care The above charts relate to West Sussex PCT. For the Annual health check we are measured against SECAmb performance, based on our score for March 09 YTD. For Category A - % within 8 minutes September month performance is above the 75% target required, at 78.6%. This gives a year to date performance of 72.8%. To achieve the target set, performance will need to be above 77.7% every month till March 09 (except for December 08 where its 75%). Both Category A 19 and B 19, performance are both above target for the month and year to date. See Appendix A - SECAmb Cat A (8 min) Performance MIS Package - September 08 for details of local performance.

4. Emergency Care - Focused Wards: Cat A (8 min) Calls Wards with >100 calls (Jan-Sep) and <50% Performance The above table is an addition to the SECAmb Cat A (8 min) Performance MIS Package, which will be produced monthly this will help to identify those Wards with high calls and low performance. This information will be shared with Contract Managers and taken into account when developing specific schemes to improve performance. See Appendix A - SECAmb Cat A (8 min) Performance MIS Package - September 08 for details of local performance.

5. Emergency Care - Focused Wards: Cat A (8 min) Calls Wards with >100 calls (Jan-Sep) and <50% Performance See Appendix A - SECAmb Cat A (8 min) Performance MIS Package - September 08 for further details.

6. 18 Weeks • Breach reports for non-obstetric ultrasound scans at Park Surgery are currently being validated, but it is clear a proportion of the breaches are genuine. Work is continuing to ensure the surgery complies with reporting and waiting time standards. All other diagnostic waits including audiology assessments now at 6 weeks. • The diagnostic return for October will include numbers of patients breaching the 6 week target, which have not previously been visible via this statutory return. This is due to numbers being included in the West Sussex Health 18 week RTT Provider return and were included with other paediatric services rather than being reported separately under the audiology and / or diagnostic pathways. • Numbers attributable to the West Sussex Health Paediatric Audiology Services are as follows: • 115 patients were treated in October, of which 86 waited 6 weeks or longer (69 from Crawley and 17 from Haywards Heath) • 166 patients were still waiting at the end of October, of which 57 had already waited  6 weeks or longer (43 from Crawley and 14 from Haywards Heath). There is an Action Plan to address the backlog of patients waiting 6 weeks or longer; Haywards Heath by end of November and Crawley by December.

7. Demand There has been an increase of all referrals of 0.8% against last year. This can be broken down into General & Acute (G&A) and Non G&A. G&A referrals as at September YTD have increased by 1.6% from 2007/08, this is made up of GP (11.8% growth) and Other (12.2% reduction). For Non G&A referrals there has been a reduction of 50% since last year.

8. Primary Care Dental services – The Oral health needs assessment is now complete and informing to the commissioning plan. New services will be tendered in areas of greatest need to improve access for patients. Primary care Access – In 2007 08 the PCT under achieved this indicator despite year on year improvements in the PC Access survey score. This indicator was made up of two parts – Access to a GP (under achieved) and Access to a primary care professional (Achieved). The former was based on the GP patient survey and the latter on actual recorded data. Its important to point out that targets have to be met for both sub indicators to achieve the required score, and that the difference between the two scores was also taken into account. In 2008/09 the PCT has made good progress in offering extended hours in Primary Care.

9. Sexual Health A meeting has been arranged for the DH in December to review the Chlamydia screening programme to seek improvements. From October screening will be offered by GPs at the same time as HPV vaccine and postal kits are to be sent out daily.

10. Health Improvement – Obesity amongst school age children The criteria for measurement for the Annual Health Check is based on performance in 2007 08, those numbers have been collected and we have achieved this target. The above numbers will be published on the National Child Measurement Programme website in December.

11. Health Improvement • Actions planned include: • Working with GP practices to improve data collection • Pfizer mail shot project in Burgess Hill to be rolled out if successful • Poster and publicity campaign in LNIA areas • Pharmacy Enhanced Service to launched on 10th November • New communications plan being developed with Public Health • Letter to dentists and acute medical directors to encourage referral to smoking cessation services

12. Health Improvement There has been an improvement in performance in Q2, but still below target. Plans are in place to improve data collection through health visitors from January 2009 onwards.

13. Health Improvement – Child Immunisation rates There are plans in place to carry out a benchmarking exercise between GPs on a 6 monthly basis and provide GPs with performance reports, to identify areas of under performance. Currently there is a possibility that some vaccinations are not been counted. A data cleansing exercise will take place over the coming months to ensure GP records are in line with the Child Health System. To improve awareness of this service, health visitors will be encouraged to promote the availability of this service to children. Other reasons for the drop in performance relate to; staffing issues at the Child Health Bureau, which have been resolved, the low availability of vaccinations which resulted in a backlog which they are currently resolving.

14. Health Improvement WASH national re-visit is now taking place in November. Q2 performance worsened as predicted. The cumulative achievement for both providers (BSUH and WASH) against 100% target for quarter 4 is estimated to be 83%. Whilst BSUH expects to maintain the 100% target, WASH will not be in a position to meet it by the end of the 4th quarter. Throughout January to March 09 WASH will have in place sufficient screening appointments and staffing capacity to meet and sustain a screening level of 2000 patients per month which will enable that service to achieve the 100% target throughout 2009/10. The English National Screening Programme for Diabetic Retinopathy (ENSPDR) Quality Assurance visit to the WASH Diabetic Retinopathy service takes place on December 2nd.

15. Stroke An Acute Stroke Data Group has been set up and meet on a monthly basis, the aim is to ensure robust data can be collected, to meet the required targets which have been set. At present all acute trusts are reviewing the data and will collect a sample set for review in quarter 4.

16. Appendix A • SECAmb Cat A (8 min) Performance MIS Package - September 08