Performance Framework (Trust Summary) November 2012 ORBIT Reporting
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ORBIT Reporting Performance Framework (Trust Summary) November 2012 This report outlines the number of indicators that have achieved, under-achieved or failed a target for the latest period. The number of indicators without a target are also presented alongside for information. Integrated Performance Framework Access Finance Quality Workforce 18 weeks, A/E and cancelled operations Balance Sheet Outcomes Head count/Pay costs Activity Capital Patient Experience Staff Experience Cancer Waits Cash & Liquidity Safety Narrative Page 13 I&E Narrative Page 18 Statutory and Mandatory Competence Compliance Narrative Page 19 Narrative Page 16 Colour Description Green Target Achieved Amber Target Under-achieved Red Target Failed Grey No Target Page 10 of 20 ORBIT Reporting Performance Framework Access 18 weeks, A/E and cancelled operations Indicator Information In Period Included in (Framework) Year To Date Latest Actual Period Plan Variance Actual Forecast Outturn Plan Variance From Plan Variance Data Quality Evidence /RAG A&E Q067 % of patients who spent 4 hours or less in A&E from arrival, transfer or discharge - AESitrep4 Operating Framework, Monitor Framework & Outcomes Framework Q3 96.63% Activity Q069 Number of attendances at A/E depts in a Operating Framework month - AEAttend Nov 10199 Cancellations A033 None Last minute elective cancellations for treatment/surgery as a percentage of all elective admissions - CancelRate Nov 1.44% 0.8% 0.64% A 11.16% 0.8% 10.36% R 0.5% G 3 A036 % patients not rebooked within 28 days - None CancelFail Nov 45.38% 5% 40.38% R 34.07% 5% 29.07% R 5% G 3 Elective Access Q064 % Diagnostic waits waiting 6 weeks or more - DiagWaits2 Operating Framework Nov 6.57% 1% 5.57% R 3.64% 1% 2.64% A 1% G 3 RTT - Admitted Q050 RTT - admitted % within 18 weeks 18Adm Operating Framework & Monitor Framework Nov 92.9% 90% 2.9% G 91.33% 90% 1.33% G 90% G 3 Q051 admitted - median wait - RTTAdmM None Nov 7.04 11.1 -4.06 G 7.38 11.1 -3.72 G Q052 95th percentile for admitted waiting no None longer - RTTAdm95 Nov 21.17 23 -1.83 G 22.84 23 -0.16 G Q051a RTT - # specialties not delivering the admitted standard - RTTNodelAdm Operating Framework Nov 1 0 1 A Q056 RTT - incomplete % within 18 weeks 18Incomp Operating Framework Nov 94.93% 92% 2.93% G Q058 Numbers waiting on incomplete referral Operating Framework & Monitor Framework to treatment pathway - InCompPath Nov 35009 Q053 RTT - non-admitted % within 18 weeks - Operating Framework & Monitor Framework 18NonAdm None non-admitted - median wait RTTNonAdmM None 95th percentile for non-admitted no longer than - RTTNonAdm95 RTT - # specialties not delivering the non- Operating Framework admitted standard - RTTNodelNonAdm Nov 97.74% 95% 2.74% G 97.49% 95% 2.49% G Nov 4.87 6.6 -1.73 G 4.15 6.6 -2.45 G Nov 16.12 18.3 -2.18 G 16.03 18.3 -2.27 G Nov 0 0 0 A RTT Incompletes RTT - Nonadmitted Q055 Q054 Q0553a 95% 1.63% G 93.87% 95% -1.13% R 95% G 2 84139 2 2 23 G 3 3 95.4% 92% 3.4% G 92% G 2 2 95% G 2 2 18.3 G 3 2 Page 11 of 20 Activity In Period Indicator Information Activity Delayed Discharges Elective Access Theatre Utilisation Included in (Framework) Year To Date Latest Actual Period Plan Variance Actual Forecast Outturn Plan Variance From Plan Variance Data Quality Evidence /RAG A001 No of GP written referrals - GPRefWrit Operating Framework Nov 12343 97880 94103 3 A002 Other referrals for a first outpatient appointment - FAOther Operating Framework Nov 8192 65604 64447 3 A003 First outpatient attendances following GP referral - FAGP Operating Framework Nov 9426 72163 89962 2 A004 Total number of first outpatient attendances - FA Operating Framework Nov 15650 120878 151903 2 A016 Non-elective FFCEs - FFCENE Operating Framework Nov 5581 46205 51703 2 A017 Number of Elective FFCEs - admissions - Operating Framework FFCEAdm Nov 1923 1904 19 A 14118 15234 -1116 G 22850 G 3 A018 Number of Elective FFCEs - daycases FFCEDC Operating Framework Nov 5737 5396 341 R 38420 43165 -4745 G 64747 G 3 A023 Total number of delayed discharges DelPat None Nov 64 39 25 R 723 312 411 R 432 G 2 A052 Delayed Transfers of Care as a Percentage of Occupied beds - DTC Operating Framework Q3 7.04% 3.5% 3.54% R 8.54% 3.5% 5.04% R Q060 Total on Inpatient Waiting List EALTotal None Nov 11438 3 Q061 Total on Inpatient Waiting List dates less None than 18 weeks - EAL17 Nov 9115 3 Q062a Total on Inpatient Waiting List waiting between 18 and 34 weeks - EAL1734 None Nov 1683 3 Q062 Total on Inpatient Waiting List waiting 35 weeks and over - EAL35 None Nov 640 3 Q063 % of Planned Inpatient Waiting List patients with a TCI date - EALTCI None Nov 19.35% 3 A029 Theatre Utilisation - Total - TURate None Nov 75.03% 80% -4.97% A 74.97% 80% -5.03% R 80% G A030 Theatre Utilisation - Elective - TUEL None Nov 78.88% 80% -1.12% A 79.4% 80% -0.6% A 80% G A031 Theatre Utilisation - Emergency - TUEM None Nov 62.83% 80% -17.17% R 62.46% 80% -17.54% R 80% G 2 Page 12 of 20 Cancer Waits In Period Indicator Information Cancer 2 week waits Cancer 31 day waits Cancer 62 day waits Included in (Framework) Year To Date Latest Actual Period Plan Variance Actual Forecast Outturn Plan Variance From Plan Variance Data Quality Evidence /RAG Q072 Percentage of patients seen within two weeks of an urgent GP referral for suspected cancer - CancerUrgFirst0 Operating Framework, Monitor Framework & Outcomes Framework Oct 96.47% 93% 3.47% G 95.23% 93% 2.23% G 93% G 2 Q073 Percentage of patients seen within two weeks of an urgent referral for breast symptoms where cancer is not initially suspected - CancerBreast0 Operating Framework, Monitor Framework & Outcomes Framework Oct 93.75% 93% 0.75% G 97.1% 93% 4.1% G 94% G 2 Q004 Percentage of patients receiving first definitive treatment within one month of a cancer diagnosis - CancerAll0 Operating Framework, Monitor Framework & Outcomes Framework Oct 96.89% 96% 0.89% G 96.82% 96% 0.82% G 96% G 5 Q005 Operating Framework, Percentage of patients receiving subsequent treatment for cancer within Monitor Framework & Outcomes Framework 31-days where that treatment is Surgery - CancerSurgery0 Oct 96.77% 94% 2.77% G 95.35% 94% 1.35% G 94% G 5 Q006 Operating Framework, Percentage of patients receiving subsequent treatment for cancer within Monitor Framework & Outcomes Framework 31-days where that treatment is an AntiCancer Drug Regime - Canceranti0 Oct 100% 98% 2% G 99.64% 98% 1.64% G 98% G 5 Q007 Percentage of patients receiving subsequent treatment for cancer within 31-days where that treatment is a Radiotherapy Treatment Course CancerRadio0 Percentage of patients receiving first Operating Framework, Monitor Framework & Outcomes Framework Oct 94.88% 94% 0.88% G 96.72% 94% 2.72% G 94% G 5 Operating Framework, Monitor Framework & Outcomes Framework Oct 88.6% 85% 3.6% G 85.84% 85% 0.84% G 85% G 5 Operating Framework, Monitor Framework & Outcomes Framework Oct 100% 90% 10% G 95.98% 90% 5.98% G 90% G 5 Operating Framework & Outcomes Framework NA Q001 definitive treatment for cancer within 62-days of an urgent GP referral for suspected cancer - CancerUrgTreat0 Q002 Q003 Percentage of patients receiving first definitive treatment for cancer within 62-days of referral from an NHS Cancer Screening Service - CancerNatScr0 Percentage of patients receiving first definitive treatment for cancer within 62-days of a consultant decision to upgrade their priority status CancerCons0 5 Page 13 of 20 Issue Last minute cancellations and readmissions with 28 days Unvalidated data. Action Plan Technical reporting issues of last minute cancellations have now been resolved, and validation work work plan has been agreed on an ongoing basis. The figure presented for November data (1.44%) is considered to be of much better data quality than the much higher percentage reported in previous months. Validation effort needs to switch to the last minute cancellation breaches of the 28 day standard. The figure of 45.38% is still unvalidated. % of patients waiting for diagnostic tests over 6 weeks The Trust is now reporting a full return to the Department of Health for the first time since EPR go-live (from November 2012). However, there are still waiting times problems in MRI, Non-obstetric ultrasound and echocardiography with large numbers still waiting over 6 weeks. Recovery plans have been revised to ensure performance has imporved by end of December 2012. Number of daycase FFCEs Day case activity is still tracking above plan, but since the endoscopy backlog clearance work finished part of the way through November this is less pronounced than it was for October. Delayed transfers of care performing at 7.82% for Quarter 3 to date, Performance has shown a slight improvement on September's performance, down to 7.04% compared with October's performance of 7.82%. against a target of 3.5%. Emergency theatre utilisation is well below (62%) the planned target There are significant vacancies within theatre staffing but the Trust is actively recruiting. Newton Europe, an external company have been engaged to work with of 80%. staff to improve sessional productivity. Timescale on-going. Page 14 of 20 Finance Balance Sheet In Period Indicator Information Balance Sheet Included in (Framework) Latest Actual Period Plan Variance Actual Forecast Outturn Plan Variance From Plan Variance Data Quality Evidence /RAG F075 Debtor Days - DebtDays None Nov 20 5 F076 Creditor Days - CredDays None Nov 55 5 F077 Debtors > 90 Days as % of Total NHS Debt90NHS None Nov 0% 5% -5% G 0.2% 5% -4.8% G 5 F078 Debtors > 90 Days as % of Total NonNHS - Debt90NonNHS None Nov 41% 5% 36% R 37% 5% 32% R 5 F082 BPPC by value (%) All - BPPCAllVal None Nov 85.69% 95% -9.31% A 85.3% 95% -9.7% A 5 Capital In Period Indicator Information Capital Year To Date F069 Included in (Framework) Capital Programme as % of Plan CapProg None Cash & Liquidity Year To Date Latest Actual Period Nov 1089 Plan Variance 924 17.86% Actual G In Period Indicator Information Cash & Liquidity F072 F101 Included in (Framework) Forecast Outturn Plan 9664 8181 Variance 18.13% Year To Date Latest Actual Period Plan Variance Actual Plan Variance From Plan Data Quality Evidence /RAG G 5 Forecast Outturn Variance From Plan Variance Data Quality Evidence /RAG Cash Held at Month End cf. Plan (Displayed in £000s) - CashHeld None Nov 61199.9 36394 24806 G 5 Liquidity Ratio (Score) - LiquidRSc Monitor Framework Nov 3 2 1 G 5 Page 15 of 20 I&E In Period Indicator Information I&E Included in (Framework) Year To Date Latest Actual Period Plan Variance Actual F030 Net Income as % of Plan (Displayed in £000s) - NetInc None Nov 465.1 267 74.17% G F031 Commissioning Income as % of Plan (Displayed in £000s) - CommInc None Nov 58741.4 54589 7.61% G 448581.7 F032 None Private Patients Overseas and RTA Income as % of Plan (Displayed in £000s) - PPOInc Other Income as % of Plan (Displayed in None £000s) - Oinc Nov 1310.7 1111 18% G Nov 9906.6 11055 -10.39% R F033 3237.1 Forecast Outturn Plan Variance From Plan Variance Data Quality Evidence /RAG 1622 99.57% G 5 434213 3.31% G 5 8814 8778 0.41% G 5 81398.7 83869 -2.94% R 5 F034 Pay as % of Plan (Displayed in £000s) Pay None Nov -36955.6 -36775 -0.49% A -292215.6 -289434 -0.96% A 5 F035 Non-Pay as % of Plan (Displayed in £000s) - NonPay None Nov -27060.6 -24400 -10.91% R -200001.9 -193290 -3.47% R 5 F060 CIP Performance as % of Plan - CIPPerf None Nov 4507 5053 -10.8% R 27822.3 30841 -9.79% R 5 F063 EBITDA as % of Plan - EBITDA None Nov 5942.4 5581 6.47% G 46576.7 44135 5.53% G 5 F066 Break Even Surplus as % of Plan BrEven None Nov 616.2 438 40.69% G 3180.2 2983 6.61% G 5 F097 EBITDA Margin (Score) - EBITDAMarSc Monitor Framework Nov 3 3 0 G 5 F098 EBITDA Achieved (Score) - EBITDAAchSc Monitor Framework Nov 5 5 0 G 5 F099 NRaF net return after financing RetAssSc Monitor Framework Nov 3 3 0 G 5 F100 I&E Surplus Margin (Score) - IESurplusSc Monitor Framework Nov 2 2 0 G 5 Page 16 of 20 Issue Action Plan F078: Debtors > 90 Days as % of Total Non-NHS - Debt90NonNHS The amount of debt owed as recorded on the Accounts Receivable system (A/R) has reduced every month since July. £0.8m of the amount owed by non-NHS organisations and over 90 days old is owed by the University of Oxford. A meeting was held with University representatives on 13 December with the aim of resolving these debts. The Trust continues to manage payments due to the University and will do so until the disputes over the aged debt are resolved. F082: BPPC by value (%) All - BPPCAllVal Performance in November was above the average for the year-to-date and there has been a steady upwards trend over the past few months. F033: Other Income as % of Plan (Displayed in £000s) - Oinc Other income is only below plan because spend on R&D is behind plan and therefore £3.9m income has been deferred. "Other" income for non-R&D activities is ahead of plan year-to-date. F034: Pay as % of Plan (Displayed in £000s) - Pay The Trust’s level of activity for elective, non-elective and out-patient work is in aggregate £11.3m, or 4.2%, higher than plan for the year-to-date with nonelective activity in particular over-performing. The Trust has spent £10.75m on agency staff in the first eight months of the year. If it is assumed that the cost of using an agency member of staff is only 20% higher than employing them on the payroll then this means the use of agency staff has resulted in £2.2m additional expenditure year-to-date. In practice, the relative cost of agency staff is likely to be greater than this. The Trust’s pay-related savings schemes are approximately £3.8m behind plan after the first eight months of the year. F035: Non-Pay as % of Plan (Displayed in £000s) - NonPay The Trust’s level of activity over-performance as described above. Non-pay costs represent approximately one third of cost and are variable to a significant degree; the over-performance on elective, non-elective and out-patient activities would result in £4.8m additional non-pay spend on a proportionate basis. Expenditure on “pass through” drugs and devices was £2.4m greater than plan after the first eight months of the year (October = £1.2m). This increases the level of income recovered concomitantly. The Trust’s non-pay savings schemes were approximately £3.3m behind plan at the end of November. F060: CIP Performance as % of Plan - CIPPerf As previously reported the high level of bed occupancy within the Trust means that the full level of planned savings from ward closures will not be realised in the current year. Other than this only £0.2m of the original savings plan is currently categorised as being high risk and which is considered possibly still to be deliverable in 2012/13. Page 17 of 20 Quality Outcomes In Period Indicator Information Included in (Framework) Year To Date Latest Actual Period Plan Variance Actual Forecast Outturn Plan Variance From Plan Variance Data Quality Evidence /RAG ANTT Q135 ANTT Injectables - ANTT None Nov 98% 90% 8% G 96.59% 90% 6.59% G HSMR Q133 Hospital Standardised Mortality ratio HSMR Operating Framework & Outcomes Framework Aug 88.5 100 -11.5 G 93.48 100 -6.52 G 4 Maternity Q137 Proportion of Assisted deliveries AssistedDel None Nov 15.68% 15% 0.68% A 14.69% 20.88% -6.19% G 2 Q138 Proportion of Assisted deliveries CsectionDel None Nov 23.52% 23% 0.52% A 21.41% 23% -1.59% G 2 Q109 Proportion of normal deliveries NormalDel None Nov 60.8% 62% -1.2% A 63.9% 62% 1.9% G 2 Q139 Total # of deliveries - TotalDels None Nov 727 Q134 Summary Hospital-level Mortality Indicator - SHIMI Operating Framework & Outcomes Framework Aug 0.98 SHIMI Patient Experience Included in (Framework) 1.13 -0.15 G 2 0.99 1.13 -0.14 G Year To Date Latest Actual Period G 5787 In Period Indicator Information 90% Plan Variance Actual 4 Forecast Outturn Plan Variance From Plan Variance Data Quality Evidence /RAG Q132 Monthly numbers received - CompNo None Nov 57 Same sex Q075 accommodation breaches Stroke Indicator Q085 Same sex accommodation breaches AccBreach Operating Framework & Outcomes Framework Q3 8 0 8 R 8 0 8 R 0 G 2 Number of patients who spend at least 90% of their time on a stroke unit StrokeOnUnitM Operating Framework & Outcomes Framework Nov 87.14% 80% 7.14% G 87.48% 80% 7.48% G 80% G 5 Complaints 570 2 Page 18 of 20 Safety In Period Indicator Information Included in (Framework) Year To Date Latest Actual Period Plan Variance Actual Forecast Outturn Plan Variance From Plan Variance Data Quality Evidence /RAG Q095 Number of Patient Falls with Harm Falls None Nov 0 Q096 Patient Falls per 1000 bed days Fall1000 None Nov 5.5 Q076 MRSA bacteraemia - MRSAInc Operating Framework, Monitor Framework & Outcomes Framework Nov 0 1 -1 G 2 4 -2 G 7 G 5 Q077 CDI - CDiff Operating Framework, Monitor Framework & Outcomes Framework Nov 10 7 3 R 57 60 -3 G 88 G 5 Incidents Q097 Incidents per 100 admissions - Inci100 Operating Framework & Outcomes Framework Oct 8.2 47 2 Never Events Q131 Never Events - Never None Nov 0 1 2 Number SIRIs Q094 Number SIRIs - SIRI None Nov 9 32 2 Pressure Ulcers Q101 Operating Framework Number of newly acquired, avoidable Grade 3 or 4 pressure Ulcers - PU3and4 & Outcomes Nov 3 22 3 VTE risk assessment Q078 Q3 93.23% Falls HCAI % of all adult inpatients who have had a VTE risk assessment - VTE Framework Operating Framework & Outcomes Framework 0 9 9 2 13.4 90% 3.23% G 92.02% 3 90% 2.02% G 90% G 5 Issue Action Plan Same sex accommodation breaches Same sex accommodation breaches, using October data a total of eight at the Horton in EAU due to significant increase in ED activity and capacity pressures. No bre CDI - C Diff There was an increased incidence in the number of cases identified in November. Out of the ten cases, six had active disease, seven were treated empirically and one was admitted with it but the sample was not sent until four days after admission. Two patients died with active disease and both of these cases were investigated as SIRI’s. Page 19 of 20 Workforce Head count/Pay costs In Period Indicator Information Included in (Framework) Year To Date Latest Actual Period Plan Variance Actual Forecast Outturn Plan Variance From Plan Variance Data Quality Evidence /RAG Agency usage W003 Agency usage (Displayed in 000s) AgencyUs None Nov £ -556 £ -9683 5 Bank usage W002 Bank usage (Displayed in 000s) - BankUs None Nov £ -595 £ -4412 5 Contracted WTE W001 against Plan Contracted WTE against Plan - WTE None Nov 8898.7 9429 -530 Total pay costs Total costs of staff (to include cost of staff within provider contracts) (Displayed in 000s) - PayCost Operating Framework Nov £ -36956 £ -36775 £ -181 W011 Staff Experience G R £ -292216 In Period Indicator Information Included in (Framework) £ -289434 £ -2782 R Year To Date Latest Actual Period Plan Variance Actual 8870 G £ -428051 G Forecast Outturn Plan 4 Variance From Plan Variance Data Quality Evidence /RAG Sickness absence W006 Sickness absence - SickAbs None Nov 3.32% 3.2% 0.12% R Turnover rate W007 Turnover rate - TurnORate None Nov 10.98% 11% -0.02% G 2 Vacancy rate W005 Vacancy rate - VacRate None Nov 5.62% 5% 0.62% R 2 Statutory and Mandatory Competence Compliance Indicator Information Statutory and Mandatory Comptence Compliance W058 In Period Included in (Framework) Overall Statutory and Madatory competence Compliance - StatMan None 3.2% -0.17% Year To Date Latest Actual Period Q2 3.03% Plan 51% 55% Variance -4% Actual Plan G 2 Forecast Outturn Variance From Plan Variance A Issue Action Plan WO11 Total Costs of Staff Reconciliation of pay costs against income. WOO6 Sickness absence On-going monitoring and control of absence management. WOO5 Vacancy Vacancy continues to stablise, noted that this is reported as against pay budget rather than actuals. Data Quality Evidence /RAG 4 Page 20 of 20
