NHS Harrow Performance Board Report July 2011/12

1. NHS Harrow Performance Board Report July 2011/12 Jonathan Wise Director of Finance and Performance

2. Contents Slides 4 - 7 Performance Delivery – overall summary Slides 8 - 13 2011/12 Performance Delivery Slides 14 – 20 Performance Review – Risks and Actions/Next Steps Appendices Appendix 1: Performance dashboards Appendix 2: Performance dashboards – by Consortia

3. Executive Summary Overall framework 11/12 Operating Framework was published in December 2010 Suite of Headline measures and supporting measures to measure Quality (safety, effectiveness The NHS Outcomes Framework for 11/12 was published in Dec 2010 for consultation. The White Paper, Healthy Lives, Healthy People was published in Dec 2010 and consultation closed 31 March. This sets out the future role of Public Health England as part of a new health and social care system outlining its remit at a high level. A number of Public Health indicators have moved from the Operating Framework into the Outcomes Framework and Healthy Lives, Healthy People 11/12 PCT Plans The April Initial Budgets and Performance Board report outlined the PCTs performance approach and plans for 2011/12. Where year-end performance outturn was greater than indicated at Q3, some targets have increased to reflect this e.g. e.g. breastfeeding prevalence At the time of this report , Q1 data is not available and therefore current performance for some of the indicators is unavailable. Additionally, there are some indicators excluded from this report which will be included in future reports (A&E is the only Headline Measure all others are Supporting Measures): A&E - data collection is in development however we are performing at 100% for patients seen within 4 hrs within walk-in centres and UCC’s in the Borough. Deaths at home - no data for 2011-12 or 2010-11. Annual files from ONS to be released in order to calculate 10-11 performance Community indicators - indicator still under development Low value procedures- indicator still under development Safeguarding - indicator under development.

4. Performance Delivery – overall summary (1/4) The achievement is based on the current months performance (although this may relate to a previous month due to the availability of data) Where a table indicates progress, the progress relates to the most recent published data where available or monthly or weekly leading measures for each indicator. Currently, there are 0 underachieving headline measures. Headline Measures Supporting Measures Public Health Measures

5. Performance Delivery – overall summary (2/4) Headline Measures * Performance level based on 2010-11 data Note: The performance levels indicated have been assessed using a mix of national submissions and leading indicators dependant on data availability.

6. Performance Delivery – overall summary (3/4) Supporting Measures * Performance level based on 2010-11 data Note: The performance levels indicated have been assessed using a mix of national submissions and leading indicators dependant on data availability.

7. Performance Delivery – overall summary (4/4) Public Health Measures * Performance level based on 2010-11 data 7 Note: The performance levels indicated have been assessed using a mix of national submissions and leading indicators dependant on data availability.

8. 2011/12 Performance Delivery - Summary (1)Headline Measures (all) Patient experience 1= Access and waiting , 2= Safe, high quality, coordinated care, 3= Better information, more choice, 4= Building relationships, 5 = Clean, comfortable, friendly place to be. 8

9. 2011/12 Performance Delivery - Summary (2)Supporting Measures (underachieve & failing) Breastfeeding 1 = prevalence, 2= coverage Health Checks 1 = number invited of eligible population 2 = received

10. 2011/12 Performance Delivery - Summary (3)Supporting Measures (underachieve & failing) *11/12 target below 10/11 performance due to target being based on 09/10 outturn as determined by NHSL 10

11. 2011/12 Performance Delivery - Summary (4)Public Health Measures (underachieve & failing) Cervical screening 1 = 25-49 years 2 = 50-64years

12. 2011/12 Performance Delivery - Summary (6)GP Consortia A summary of performance by Practice is noted below however please refer to appendix 2 for the more detailed performance dashboards by GP practice • Breast Screening: • 12 out of 36 practices achieved the national coverage target (70%) for breast screening in March 2010. • Cervical Screening: • 27 out of 36 practices achieved above the PCT % (95%) of cervical screening test results received within 14 days in 2010-11. • Immunisations: • 2 out of 36 practices achieved at or above the PCT targets for all six childhood immunisation indicators in 2010-11.

13. 2011/12 Performance Delivery - Summary (7)Patient Experience and Primary Care Access • The slides in appendix 2 break down the survey into the five component parts for Access and Experience: For Patient Experience • access and waiting • safe, high quality, coordinated care • better information, more choice • building relationships • clean, comfortable, friendly place to be For Primary Care Access • Able to see a doctor fairly quickly • Able to book ahead for an appointment with a doctor • Satisfaction with opening hours • Able to see a preferred doctor • Ease of getting through on the phone • The results have been RAG rated to show results against the England and PCT average and the variances between Q4 (Apr 10 – Mar 11) and 2009/10 have also been RAG rated to highlight improvements, with Green showing a positive variance above the national average movement • For Patient Experience three practices reached or exceeded the England average in all areas (The Elmcroft Surgery, Elliot Hall Medical Centre and St Peters Medical Centre) and two practices reached or exceeded the England average in all areas for Primary Care Access (The Ridgeway and The Elmcroft Surgery) • Four practices performed worse in all areas than the PCT average (Reds) for Patient Experience (Charlton Medical Centre, Belmont Health Centre, Zain Medical Centre and Kenton Bridge Medical Centre) and three practices obtained only reds for Primary Care Access (The Northwick Surgery, The Kenton Bridge Medical Centre and The Civic Medical Centre)

14. Performance Review – Risks and Actions/Next StepsContext (1) Principles of approach for 11/12 • Sharing lesson's learned and Best Practice • A network of Directors of Public Health across the Sector focus on sharing best practice • Performance Improvement Co-ordinator liaising with performance leads in both Brent and Harrow • Monthly Cluster performance meetings (Directors of Performance/Performance Leads in each sub-cluster) meet to review performance and discuss actions to improve performance 14

15. Performance Review – Risks and Actions/Next StepsContext (2) Performance Monitoring Process NHS London Sub-cluster board 3. Performance Board Report GP Clinical Executive / Clinical Commissioning Board Cluster Performance Team Actual performance against target EMT / Borough Directors Summary of actions 1.Performance Dashboard Programme boards 2. Information and Performance Team Performance by PCT/Locality/ Practice Public Health Borough Actions Finance team link GP Incentive Scheme QIPP PMO team link Activity tracking Frequency proposed Monthly Quarterly 15

16. Performance Review – cross cutting risks and actions

17. Performance Review – Actions/Next Steps for Underachieving and Failing indicators

18. Performance Review – Actions/Next Steps for Underachieving and Failing indicators

19. Performance Review – Actions/Next Steps for Underachieving and Failing indicators

20. Performance Review – Actions/Next Steps for Underachieving and Failing indicators

21. APPENDIX 1 Performance Dashboards

22. 4 week smoking quitters

23. Access to Maternity Services • In Q1 10-11, 67.36% of booking assessments were done by 12 weeks of pregnancy. • In Q2 10-11, 68.86% of booking assessments were done by 12 weeks of pregnancy. • In Q3 10-11, 77.96% of booking assessments were done by 12 weeks of pregnancy. • In Q4 10-11, 73.03% of booking assessments were done by 12 weeks of pregnancy.

24. Breastfeeding 6-8 weeks • In Q1, Q2, Q3 and Q4 10-11 , we reported 67.2%, 66.9%, 73.6% and 70.0% of infants were being breastfed or partially breastfed at 6-8 weeks respectively. 91.5% of infants who were due for 6-8 week check in Q1 10-1, had a feeding status recorded against them. In Q2, 92.0% of infants who were due for 6-8 week check, had a feeding status recorded against them and in Q3, 97.1% had a feeding status recorded against them. In Q4, 94.1% of infants who were due for 6-8 week check, had a feeding status recorded against them

25. Childhood Immunisations

26. Access to Dental Services • There were 114,375 people accessing dental services in the last 24 months as at May 11 against a plan of 116,574.

29. APPENDIX 2 Performance Dashboards by Practice

30. Patient Experience (1)

31. Patient Experience (2)

32. Primary Care Access (1)

33. Primary Care Access (2)

34. 4 week smoking quitters

35. Breastfeeding 6-8 wks

36. Cervical Screening- test results

37. Cervical screening- Coverage

38. Breast screening- invites

39. Breast screening- Coverage

40. Childhood Immunisations (1/2)

41. Childhood Immunisations (2/2)