Board Meeting
02 08 11
Open Session
Item 6.2.1
NHS GRAMPIAN
PERFORMANCE REPORT – AUGUST 2011
This Performance Report is to provide Board members with assurance on key performance topics as discussed at the Performance
Governance Committee (PGC) meeting on 19th July 2011.
The first part of the meeting, termed Healthstat, reviewed the documentation and outcomes from the cross system performance
review held on 16th June 2011 and sought assurance from the Chief Operating Officer and Deputy Chief Executive about
performance improvement.
HealthStat
Updates on previous actions
 New Outpatient Did Not
Attends (DNAs) at Royal
Aberdeen Children’s
Hospital (RACH)
 Pre-operative Length of
Stay
 Emergency admissions
for abdominal problems
Discussion/Assurance
RACH DNAs: Consistent with elsewhere DNA rates for children were higher than those for adults. An
audit to establish reasons for DNA had been presented previously to PGC and was to have been re-run
after the roll out of patient focused booking. This had however been delayed because of
implementation of the new Patient Management System. Reminder letters to parents had been reintroduced and a range of improvement activity was underway in relation to the outpatient service. PGC
was assured that the audit would be re-run later in the year.
Pre-operative length of stay: An audit of pre-operative admissions had been presented to the
December 2010 performance review meeting and reported to the January 2010 PGC. This had
identified a high level of admission the night before surgery for patients from predominantly the Island
Boards and Highland. PGC was advised that action was ongoing to develop local pre-assessment
within these Boards to reduce the need for early admission. The audit was due to be re-run later in the
year. An evaluation of the use and capacity of the existing patient hotel accommodation was also
underway.
Emergency admissions for abdominal problems: PGC recalled that the April performance review had
highlighted abdominal problems as one of the top 10 reasons for emergency hospital admission, and
that it had been agreed to look in more detail at the data. This had now been completed and showed
that these admissions were predominantly in younger age groups and admission was often for less than
a day. Further work was now underway to determine what action could be taken to minimise the need
for admission for these conditions.
A further update would be provided in December to PGC.
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Long Term Conditions and
emergency admissions by GP
practice
The analysis presented to the performance review meeting demonstrated the good progress that had
been made in reducing emergency hospital admissions and admissions associated with long term
conditions. The data was available by GP practice and showed considerable variation between
practices. Some of the variation could be explained due to the practice demographic and deprivation
but others could not. The data was now being shared with practices who were required to consider their
data in association with peers in another CHP. Practices would begin to feedback on this by the end of
March. PGC was assured that reduction in variation was a key objective and would be addressed as
part of the Health and Care Framework. In the meantime work was ongoing across a number of
streams including unscheduled care, productive community and long term conditions to ensure the right
care in the right place.
The second part of the meeting considered Assurance Reports submitted to PGC by other Board Governance Committees and the
Community Health Partnership Committees. These reports consist of a template which documents the business discussed at the
committees relating to performance issues which might impact on delivery of one or more of NHS Grampian Strategic Objectives or
Themes and the actions put in place to mitigate these risks. At the July meeting 6 reports were presented covering a wide range of
topics including: The need to ensure greater 3rd sector and community planning input to the Change Fund initiatives (Aberdeenshire CHP)
 A wish to ensure local solutions to direction set by emerging Health and Care Framework (Aberdeenshire CHP)
 Presentation of People Strategy measurement tool (Staff Governance Committee)
 Consideration of draft Workforce Plan which was more robust and detailed than previous plans (Staff Governance
Committee)
 Progress on reshaping care for older people – the change plan (Aberdeen City CHP)
 Consideration of revised CHP structure and membership (Aberdeen City CHP)
 Noted delivery of key improvement targets relating to Healthcare Associated Infection (Clinical Governance Committee)
 Progress with arrangements for transfer of prison health services to NHS Scotland (Clinical Governance Committee)
 Presentation on Moray Tobacco Initiative (Moray CHSP)
 Progress with the Forres pathfinder project as part of the Health and Care Framework(Moray CHSP)
 Update on implementation of new patient management system (eHealth Committee)
 Consideration of the draft national eHealth Strategy (eHealth Committee)
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The third part of the meeting considered progress against the Strategic Themes and Objectives aligned to the Balanced Performance
Framework. The overall performance position was presented followed by more in depth consideration of key topics. These
included:-
Strategic
Theme
Topic
Improving the
Public’s
Health and
Reducing
Inequalities
Civil
Contingencies
Delivering
Safe, Effective
and Timely
care in the
Right Place
Continuous
Service
Improvement
Progress
Improving
Efficiency,
Productivity
and
Sustainability
Financial
Position
Discussion
Ms Diane Donald presented the Civil Contingencies Unit 2010/11 Annual
Report. This set out the achievements delivered and the challenges that
had been faced. PGC noted the considerable progress made over the last
year in improving the Civil Contingencies arrangements including the
development of an overarching strategy, the review of major incident plan
hierarchy and work to improve business continuity arrangements. The
positive feedback received following participation in the NHS Scotland
Resilience audit was noted.
An update was provided on the service improvement work being taken
forward through Continuous Service Improvement (CSI) activity. It was
noted that a number of initiatives were at a critical point of delivery. It was
vital that improvements continued to be implemented and supported across
the system in an integrated way with optimum application of staff skills and
capacity. The CSI Leadership Group would be considering the next steps.
Mr Alan Gall presented the Financial Performance Report for the first
quarter of 2011/12. Whilst there was an overspend of £778k, which
confirmed work was still required to bring expenditure in line with budget,
the performance at this point in the year was better than that for the same
period for the last two years. Mr Gall advised that full year projections
indicated that up to £1.5 million of non-recurring funding could be made
available to support a further voluntary severance round if the organisation
wished to take such action.
Anne Ross
Head of Performance and Quality Improvement
July 2011
3
Performance
Rating
Risk
Rating
Green
Low
Green
Medium
Green
Medium