Royal National Orthopaedic Hospital Trust
Trust Board Meeting - Executive Summary
Report/Paper:
2008/09 Healthcare Commission Annual Health Check Action Plan
Date:
17th March 2009
Purpose of Paper:
To provide the Trust Board with an update on the 2008/09 Healthcare Commission
Annual Health check Action Plan
Summary of Paper:
Key issues
Use of Resources
1. Improvement in the use of resources rating is dependent on delivery of
£0.5m planned surplus. The plan has been reduced from a £1m surplus
target with agreement of NHS London further to NHS London confirming
that they would not be able t provide £0.5m redevelopment project funding
assumed in the plan.
Quality
2.
The overall proportion of cancelled operations (for non-clinical reasons)
has continued at 1.7% (107 Apr-September) (153 April – February) since
the ratings were published. Based on last year’s benchmark the Trust
would need to get within 1.5% to avoid a “fail” on this indicator. There has
been a significant underlying reduction in January and February down to 3
from a previous monthly average of 16 per month. However, the impact of
adverse weather conditions in early February caused 15 cancellations in
one day. Based on last year’s benchmark the Trust would need to get
within 1.5% to avoid a “fail” on this indicator. It is currently unlikely this will
be achieved in 2008/9. However, the Trust will achieve a monthly run rate of less
than 12 per month from January which, if sustained over the whole year would bring
in % cancelled operations within 1.5% next year.
3. There have been no breaches of the cancelled operation 28 day
guarantee target since the implementation of the new policy to seek
private treatment for patients who cannot be brought back within 28 days
onto NHS lists.
4. There has been 1 spinal surgery breaches this year of the 26 weeks
inpatient stage of treatment target. There was 1 non-spinal surgery
breach earlier this year. The total of 2 breaches remains within the forecast
overall tolerance applied last year of 0.03%.
5. 18 weeks
o Data completeness targets now achieved on monthly returns
o February 18 week performance
 Non admitted: 85% (aggregated clinical units except
spinal surgery was 89%). Impact of breach sharing is
likely to move this to 88%.
 Admitted: 87% (aggregated clinical units except spinal
surgery was 92%). Impact of breach sharing is likely to
move this to 88%.
o Improvement above this will be determined by progress on spinal
surgery capacity increases or patient transfers to alternative
capacity
6. Ethnic Coding – April to February performance was 87% compared to an
internal target of 90%. A figure below 80% would have under achieved
against this target last year but we are confident we can maintain levels
over the 85% Healthcare Commission target. We are internally targeting a
continued increase to 90% by March to ensure that improvements
continue.
Other 2008/09 issues that need to continue be monitored:- Cancer waiting times (low volumes mean that if breaches occur these are
likely to exceed tolerance levels).
- Delayed transfers of care (not a major issue historically but spinal cord
injury unit delayed transfers are being kept under review to minimise
Action Required by
the Board:
occurrence).
To note the progress made against the 2008/09Healthcare Commission Annual
Health Check Action Plan.
Recommendation
from Legal Advisors
(if applicable):
N/A
Author and position
of Report/Paper
Rob Hurd, Chief Executive
Lead Director
Ahmet Koray, Finance Director (Use of Resources action plan)
Sheila Puckett, Director of Operations & Service Development
(Access elements of the quality action plan)
Links to Assurance Framework, Local Performance Targets and Corporate Strategic risk register:
This paper/report links to the following principal objectives, local performance targets and the corporate
strategic risks: - (please tick as appropriate)
Principal Objectives
Tick as
appropriate
Principal Objective One- Re-development and capital investment
To redevelop the RNOH Stanmore campus to provide a modern healthcare building.
To effectively use capital investment to improve the working environment and health and safety. To improve and
sustain business activity.
(Linked to performance target 5 and corporate strategic risks: 463, 467, 470, 472))
Principal Objective Two - Finance
√
To achieve financial balance and maintain liquidity.
(Linked to performance target 6a, 6b and corporate strategic risk: 468)
Principal Objective Three - Leadership and workforce
To ensure that the workforce is fit for purpose and supports the Trusts service and financial plans.
(Linked to performance target 7a, 7b and corporate strategic risk: 465)
Principal Objective Four – Governance
√
To implement, embed and monitor effective arrangements that reflect current Trust business
(Linked to corporate strategic risks: 464, 466)
Principal Objective Five - Achievement of access / activity targets
√
To achieve access targets and to deliver the activity targets.
(Linked to performance target 2a, 2b, 2c 3, 8a, 8b, 8c, 8d and corporate strategic risk: 463)
Principal Objective Six - IM&T
Develop and implement a cohesive and integrated IM&T strategy.
(Linked to corporate strategic risk: 471)
Principal Objective Seven - Maintaining clinical excellence
To be an effective, efficient and safe provider of orthopaedic and musculoskeletal services, providing the
highest standards of care.
(Linked to performance target 1a, 1b, 1c, 1d, 8a, 8b, 8c, 8d and corporate strategic risk: 463)
Principal Objective Eight - Foundation Trust
To achieve Foundation Trust status.
(Linked to performance target 4 and corporate strategic risks: 463, 467, 469, 472)
√