CHCP Performance Management Report
2006/7 Quarter 1
1.
2.
Introduction
1.1
The Performance Management Report for the first quarter (April –
June) was issued at the beginning of September.
1.2
The report, which provides an overview of citywide performance and,
where information is provided, a comparison of the performance the
CHCPs, is attached as Appendix 1.
CHCP Performance Assessment Framework
2.1
The CHCP Performance Assessment Framework has been developed
jointly by NHS Greater Glasgow and Clyde and Social Work Services,
Glasgow City Council. It focuses on the key health and social work
targets that the Scottish Executive has set for health boards and local
authorities, to which CHCPs will contribute.
2.2
Previously information has been gathered at a citywide or health board
area level to measure progress on these targets – but increasingly this
information will be analysed at a CHCP level to help provide more
meaningful feedback on local activity. For this first report, however,
there are only a limited number of indicators that can be reported upon
at CHCP level. The report for Quarter 2 will include more CHCP
specific information.
2.3
The results are grouped together under the following 7 strategic
objectives:
1.
Improve services
2.
Improve health status
3.
Reduce health inequalities
4.
Improve the engagement and involvement of patients,
carers and communities
5.
Human resources
6.
Finance
7.
Improve systems and processes.
2.4
In the main, the report concentrates on quantitative information that is
collected routinely to meet the information requirements of the Scottish
Executive. As the Committee has previously identified there are
limitations in measuring local progress against city-wide or health
board area targets, and we therefore need to develop more local
performance indicators to track progress in a more meaningful way.
CHCP Heads of Service already collect a suite of more detailed
information, from which other key indicators could be extracted to be
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reported regularly to Committee. In some instances we need to develop
new indicators or milestones to help track progress against the strategic
priorities set out in the CHCP development plan. . There are other
measures of progress (e.g. client satisfaction) that are not included in
this performance framework, but which might be usefully gathered to
complement the quantitative results.
There are some instances where it is considered that difficulties with
reporting procedures may currently result in incomplete or inaccurate
results. This will be addressed as CHCPs become more performance
oriented and over time the performance management system is refined
to become more effective as a driver for change.
3.
A Summary of the Results
3.1
The report that was prepared for Glasgow City CHCP Executive Group
is attached as Appendix 2.
The report highlights improvements in performance across Glasgow
City in relation to:
 Increasing the number of children in foster care
 Supporting more older people at home
 Increases in the number of new or enhanced care packages for
people with learning disability
 Increased levels of physical activity among the population
 Reduced rates of teenage pregnancy.
3.2
The report however also highlights the following areas of
underperformance in relation to targets set regarding:
 Percentage of children hearing reports delivered on time
 Percentage of young people leaving care with SCQF levels 3 in
English and Maths
 Percentage of young people leaving care with a pathway plan
or completed care plan
 Percentage of children subject to supervision requirements seen
within 15 days
 Average waiting rime between first contact and first service
start
 Number of shared assessments for older people
 Delayed discharges
 Rates of smoking
 Alcohol consumption
 Overweight adults
 Child oral health
 Breastfeeding
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4.
North Glasgow CHCP results
4.1
This is the first set of results since the inception of the CHCP – and
much of the practices and activity on which the results are based have
been ‘inherited’. It is therefore difficult at this stage to draw many
conclusions from these results.
4.2
However the following are drawn to the Committee’s attention as areas
that are considered notable.
4.3
Deliver services which protect and support the most vulnerable
children and families and contribute to shifting the balance of care
for children to community based responses
North CHCP is amongst the best in relation to the following indicators:
% children on Child Protection Register North has lowest % (7.9%) – East
is highest with 20.1%
who have previously been on the register
North has lowest % (1.9%) – East
% children in residential schools
and West are highest with 3.9%
North with 58% exceeds target of
% children at home with family/friends
56%
North CHCP performance is the worst in relation to
73% against a target of 100%
% LAAC with completed care plan
4.4
4.3.1
The apparent ‘success’ in North Glasgow may however be a
feature of different practice to cope with a high workload, rather
than real achievement. With the highest proportion of children as
social work clients, (10%) there is the possibility that a different
(and higher) threshold is applied to decisions regarding when
children should receive residential care. Similarly we need to
investigate what lies beneath the figures regarding placing
children on the Child Protection Register.
4.3.2
Work is currently under way to review the caseloads of qualified
and unqualified staff and a task force has been established to
clear the backlog of unallocated cases. (From our own review we
know that there are 2164 open cases of which 30% are
unallocated.)
Older people
% shared assessments
% older people with delayed discharge
All CHCPs are below target – but
North at 21% is best in city
North with 11 is amongst the best
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4.4.1
4.4.2
4.5
4.6
While welcoming the apparent success in the North, we are
conscious that this is a figure we have inherited and may reflect
coding issues. We need to continue to reinvigorate single shared
assessment.
The delayed discharge situation is one that is not within the gift
of the CHCP – and requires close collaboration with Acute
Services Division. A programme of work is being agreed on a
number of areas of common concern between the CHCPs and the
Acute Division.
Addictions
4.5.1
There is no CHCP data – although this is expected to be included
in the Quarter 2 report.
4.5.2
It is considered that the issues regarding the wait time between
first contact and first service is likely to represent problems with
data collection rather than actual delivery. This is a particular
problem in North Glasgow where shortage of administrative staff
resource is compounded by the lack of shared accommodation,
making the collection of data difficult and time consuming.
Learning Disability
North is improving but amongst worst 3 results
New care packages
% service users with named Amongst lowest (82% against target of 100%)
worker
Only SW (with 80%) is ‘green’ with other
% people reviewed annually
CHCPs ‘red’ – however North with 62% is best
of the rest.
4.7
4.6.1
Resources for new care packages are allocated centrally. North
was not considered a priority for the quarter this report refers to –
it is anticipated that these results will improve next quarter, but
they are a feature of central decision-making not local activity.
4.6.2
The poor performance re named workers is a result of severe staff
vacancies.
Primary Care
North CHCP records the best performance regarding participation the
Primary Care Collaborative. This reflects the previous Primary Care
Division’s priority for support to practices in areas of high deprivation.
2010/Keep well is another example of GP practices being supported to
work in new ways to meet the health challenges provided by
deprivation
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4.8
Health Improvement
Many of the indicators cannot be provided at a CHCP level. Much of
the information has been gathered through the Health and Well-being
Survey, which takes place every three years and for which information
has been provided on a Glasgow City level only (expect for East
CHCP, which is being used as a pilot by Glasgow Centre for
Population Health). Consideration will be given to appropriate proxy
measures – (e.g. numbers of people accessing smoking cessation
services as a measure of our success in reducing smoking rates).
4.8.1
Of the measures that can be reported at CHCP level, North is
generally at the bottom– which is as expected given the
deprivation in the area. The notable exception is breastfeeding
rates among women living in deprivation, where North CHCP
is second highest.
North is ‘red’ (24.7% compared to
target of 20%) but better than East and
SW.
Adults admitted as emergency with 3.1% - better than Glasgow average,
alcohol-related reason
but overall worse trend
Mental health
Highest suicide rate (3.1%)
Childhood vaccination
At 86.4% the lowest in city – but
marked improvement over time
Cervical screening
Amongst worse at 77.1%
Children with dmft
North Glasgow at 38.1% is lagging
behind SE, West and SW – all above
42%, but ahead of East (27.2%)
% women in lowest depcat still North at 32.4% is much better than
breastfeeding at 6 weeks
East, (15.5%) SW ( 20.5%) and West (
18.8%)
Rates of smoking in pregnant women
5.
4.8.2
It is proposed to include childhood vaccination and cervical
screening within the CHCP development plan as priority areas
for action.
4.8.3
Childsmile, the West of Scotland pilot oral health initiative, is
operating in North and East Glasgow CHCPs and will
encourage more prevention activity by dentists.
Conclusion and Recommendations
5.1
This first report provides a baseline from which future performance
can be compared. It is however of limited value as many of the
indicators are not yet available on a CHCP basis. There is also further
work required to understand what lies beneath the figures presented in
the report.
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5.2
Over time, however, as more information (and more accurate
information) is provided through these reports we will gain a better
understanding of our progress in improving our service delivery
(addressing areas of under performance) with the outcome of
improving the health and social circumstances of our population.
5.3
The Committee is asked to
(a) Consider the results for the first quarter 2006/7
(b) Consider what type of information they would find helpful in
measuring the performance of the CHCP
(c) Instruct the Head of Planning and Health Improvement, in
conjunction with Heads of Service, to report to a future meeting on
locally agreed performance measures to complement the centrally
compiled report.
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