Council of Governors Meeting

Elaine HobsonChief Operating Officer

January 2010, Item 7

Relates to Domain 1 (C4a) and Domain 5 (C18, C19)

Key Targets 1

Hospital Acquired Infections

Performance Indicators Risk Rating

Target 2009-10

Current Position Nov 2009

Year to DatePosition

Incidence of Clostridium difficileMON01, CQC16 Low

183 (112)

13 66

Incidence of MRSAMON02, CQC15 Med

18(9)

0 4

Key Targets 1

Hospital Acquired Infections

C. Difficile Infections MRSA Bacteraemias

0

5

10

15

20

25

30

0

1

2

3

4

5

6

Key Targets 2

Cancer Waiting Times

Performance Indicators Risk Rating

Target 2009-10

Current Position Nov 2009

Year to DatePosition

Cancer: 14 day wait from urgent GP referral MON09, CQC18 Low 93%

98.5% (8 of 547)

98.5% (72 of 4870)

Cancer: 31 days from diagnosis to treatment for all cancers MON10, CQC19.I Low 96%

95.7% (68 of 1576)

95.9% (8 of 195)

Cancer: 31 days for subsequent cancer treatments - Surgery MON03.I, CQC19.II Low 94%

96.7% (1 of 30)

95.1% (10 of 203)

Cancer: 31 days for subsequent cancer treatments – Anti-Cancer Drugs MON03.II, CQC19.III Low 98%

99.7% (1 of 288)

96.7% (1 of 30)

Cancer: 62 days referral to treatment - GP Urgent Referral MON04.I, CQC20.I Low 85%

86.4% (12 of 88.5)

84.7% (112 of 734)

Cancer: 62 days referral to treatment – Consultant Screening Service MON04.II, CQC20.II Low 90%

93.3% (1 of 15)

97.6% (2 of 85)

Cancer: 62 days referral to treatment – Consultant Upgrade CQC20.III Low 90%

66.7% (3 of 9)

86.7% (3 of 22.5)

Key Targets 2

Cancer Waiting Times

Cancer 31 Day Wait For First Treatment

Cancer 62 Day Wait For First Treatment

90.0%

91.0%

92.0%

93.0%

94.0%

95.0%

96.0%

97.0%

98.0%

99.0%

100.0%

70.0%

75.0%

80.0%

85.0%

90.0%

95.0%

100.0%

Key Targets 3

Emergency Department

Performance Indicators Risk Rating

Target 2008-09

Current Position Nov

2009

Year to DatePosition

Maximum waiting time of 4 hours in A&E from arrival to admission, transfer or discharge (bracketed figure is RD&E activity only) MON07, CQC04

Very Low 98%

97.7%(95.6%)

98.8%(97.5%)

Key Targets 3

Emergency Department

96.50%

97.00%

97.50%

98.00%

98.50%

99.00%

99.50%

100.00%

Key Targets 4

Referral to Treatment Waiting Times

Performance Indicators Risk Rating

Target 2009-10

Current Position Nov 2009

Year to DatePosition

18-week maximum wait Admitted patients. MON05, CQC17.III Low 90% 92.3% n/a

18-week maximum wait Non-admitted patients. MON06,CQC17.IV Low 95% 97.1% n/a

18-week maximum wait by 2010 Admitted orthopaedic patients. LOC3 Low 90% 70.6% n/a

18-week maximum wait by 2010 Non-admitted orthopaedic patients. LOC4 Low 95% 90.1% n/a

13-week maximum wait by 2010 Admitted patients (excl orthopaedics). LOC1 Low 90% 90.0% n/a

13-week maximum wait by 2010 Non-admitted patients (excl orthopaedics). LOC2 Low 95% 94.7% n/a

Cancelled operations. CQC09 Med 0.80% 1.21% 2.57%

Key Targets 4

Referral to Treatment Waiting Times

Referral to Treatment for Admitted Pathways

Referral to Treatment for Non-Admitted Pathways

80.00%

82.00%

84.00%

86.00%

88.00%

90.00%

92.00%

94.00%

96.00%

98.00%

100.00%

90.00%

91.00%

92.00%

93.00%

94.00%

95.00%

96.00%

97.00%

98.00%

99.00%

100.00%

Current Capacity Pressures

11 wards affected by Norovirus – 25 – 50 beds empty and blocked

Increase in trauma admissions due to adverse weather conditions

Increased number of medical outliers significantly reducing surgical and orthopaedic bed capacity

Short term difficulty due to weather conditions in transferring patients home and to community beds

Reduction in elective surgery impacting adversely on 18 week target

Increase in A&E 4 hour breaches due to lack of bed availability for admissions

Actions underway

Additional cleaning staff provided to ensure wards can be opened as quickly as possible

Additional medical and nursing staff provided at weekends and evenings for Emergency Department, Trauma and Medical Wards

Devon Health and Social Care Complex Care Teams pulling patients out of RDE to home

Actions underway

Additional bed and day case areas being opened as an exception

Extra elective capacity being provided - Vanguard mobile theatre and beds, Nuffield, Plymouth Independent Sector Treatment Centre

Daily Eastern Devon multi-agency conference callBoard rounds are being rolled out across the

wardsJoint consultant/GP work to agree admission

criteria for community hospitals

Council of Governors Meeting

Suzanne Tracey

Director of Finance and Business Development

January 2010, Item 7

Finance Report – Month 8

Year to Date £5.0m surplus approx £400k below budget

Clinical income broadly on plan but overspends on expenditure budgets

Significant overspend on non pay budgets – action taken on authorisation levels

Year end forecast still to achieve planned surplus of £7m

Financial Risk Rating Year to date 4

Capital Expenditure

Annual planned expenditure £23.5m

YTD plan £14.7m, expenditure £10m

Forecast expenditure £18.6m

Annual slippage £4.8m

– Pain Management

– Replacement of CT scanner

– Integrated minimal access theatre

– Order Communications and E Prescribing

Understanding slippage

Savings on schemes

Maintaining operational capacity

Ensuring the scheme meets requirements

Ensuring procurement meets regulations

Further action – improvements to capital planning process