10.1
NHS Board Agenda Item 10.1
Date of Meeting
25 June 2009
Paper Number
OHB20.09/10
Title
Performance Management Strategy and Reporting Framework
Purpose of Report
This paper sets out a proposed strategy for consideration by the
Board in respect of the development of performance management
and reporting in order to assist the organisation deliver it’s corporate
objectives.
Options
N/A
Recommendations
The Board is asked to approve a new performance management
strategy and reporting framework which is to be implemented over the
next six months as set out in the attached paper.
Attachments
Appendix 1 – Corporate Objectives 2009/10
Appendix 2 – HEAT Targets 2009/10
Appendix 3 – Single Outcome Agreement Targets 2009/10
Appendix 4 – Performance Report to 31 May 2009
Author
Jayne Scott, Management Consultant
Mark Clouston, Performance Manager
Contact Details
01856 888181
Jayne.scott2@nhs.net, Mark.clouston@nhs.net
NHS Orkney Board
Paper No:
OHB20.09/10
Title: Performance Management Strategy and Reporting Framework
1. Purpose of Report
1.1
The purpose of this report is to present a performance management strategy
and reporting framework to the Board for consideration.
2. Recommendations
2.1
The Board is asked to approve the performance management strategy and
implementation of the proposed new system over the next 6 months and note
the arrangements to evaluate and review the system later in the year.
3. Introduction and Background
3.1
NHS Orkney requires sound and effective performance arrangements to be in
place throughout the system; this is one of the keys to the success of our
organisation in its pursuit of delivering significant improvements in health, in
reducing health inequalities, in delivering high quality health services and in
optimising the efficient use of resources.
3.2.
This document sets out proposed
management across NHS Orkney.
arrangements
for
performance
4. What is performance management?
4.1
In a public sector context, performance management has been defined as
“taking action in response to actual performance to make outcomes for users
and the public better than they would otherwise be 1”. Performance
management is integral to NHS Orkney’s overall operation in that it helps the
Board to plan, monitor and manage delivery of health improvement and health
care services.
4.2
In summary performance management should help the Board achieve its
corporate objective.
A manager’s guide to performance management ISBN 0748892966
5. Effective performance management requires:
5.1
Systematically deciding and communicating what needs to be done (aims,
objectives, priorities and targets).
5.2
A plan for ensuring that it happens (improvement, action and service plans).
5.3
Some means of assessing if this has been achieved (performance measure).
5.4
Information reaching the right people at the right time (performance reporting)
so decisions are made and actions taken.
5.5
Effective performance management arrangements can help to integrate
planning, review, financial management and improvement systems to enable
NHS Orkney to make informed decisions and improve services.
5.6
This document sets out proposed arrangements for performance
management across NHS Orkney which will be developed in 2009.
6. Proposed Reporting Arrangements
6.1
We intend to translate the organisations aims and objectives into measurable
targets. Each department throughout the organisation monitors its own targets
which, in turn, will be integrated with those of other departments to create a
performance framework for the whole organisation.
6.2
The framework is then used to track performance and ensure action is taken t
o address areas of under-performance as necessary.
6.3
This will sit within the context of an integrated approach to performance
management at a corporate, department and individual basis to ensure the
personal objectives of staff are aligned to the organisation’s vision and
corporate objectives. This ensures that staff understand how they contribute
towards delivery of the organisation’s goals and priorities.
6.4
This is shown in the diagram below;
Board Vision and values
Strategic Themes
Vision & Values
Corporate Strategy
P
E
R
F
Strategic Objectives
O
R
Allocation & Alignment of Resource
M
A
Service, Department & Program
Objectives
N
Personal Objectives
E
Supporting Development Plans
M
C
A
N
A
7. Reporting Framework
7.1
The main elements of the reporting framework are proposed as follows. This
ensures performance management arrangements are connected from
operational level through to Board level.







Personal objectives are set for individual members of staff linked to the
performance framework.
Operational performance management arrangements at department level led
by service managers.
Monthly performance reviews with service managers by CMT facilitated by the
Performance Management Team.
Monthly review of corporate targets and follow up action by CMT.
Bi-monthly review of performance against corporate targets at the Finance
and Performance Committee.
Bi-monthly reporting to the Board on Key Performance Indicators (KPIs)
Annual assurance reporting to the Board on overall performance of the
system by the Finance and Performance Committee.
8. Performance Management System
8.1
In order to facilitate this proposed corporate-wide performance management
arrangements an information system requires to be put in place. At present no
such system exists within NHS Orkney. In order to develop such a system the
first phase of the project was to identify the objectives and targets to be
included in such a system.
8.2
Initially it is proposed that we develop a performance management system
which incorporates the following targets;



8.3
NHS Orkney corporate objectives
LDP/HEAT targets
Single Outcome Agreement Targets
However, it is proposed to develop a system which can be expanded in due
course to cover all performance targets on which the organisation reports.
NHS Orkney Corporate Objectives
8.4
In April the Board approved the vision and values for the organisation
following discussion at a board work-shop in March. In addition, a number of
high-level corporate objectives were agreed for 2009/10. These objectives
have been reviewed by CMT and have been turned into detailed targets.
8.5
The objectives and targets are shown in Appendix 1.
LDP/HEAT Targets
8.6
Our main corporate objectives are determined by Scottish Government and
set out in the health improvement, efficiency and governance improvements,
access to services and treatment appropriate to individuals (HEAT) targets
issued annually by the Scottish Government Health Directorates (SGHD).
These targets are wide ranging and cover a range of objectives from health
improvement targets such as reducing suicide rates through to waiting time
targets and finance targets. As a result the supporting information sources to
measure delivery against these targets are also very wide-ranging.
Timescales for receipt of this data also varies from monthly to quarterly and
annually. In addition some of the data is produced locally, some of the data is
prepared through ISD returns, some is produced via the Board’s finance
systems and some is produced manually.
8.7
In addition, a Board the size of Orkney has to ensure that very small numbers
of patients do not skew the results reported nor render trend analysis
statistically invalid.
8.8
Appendix 2 sets out all of the 2009/10 HEAT targets and shows the
supporting data source required to measure delivery of each target.
Single Outcome Agreement Targets
8.9
A current major initiative from Scottish Government is the development of
Single Outcome Agreements between local authorities, health boards and
other partner organisations. The Single Outcome Agreement for Orkney has
now been finalised and the Board’s 2009/10 Local Delivery Plan (LDP)
requires to be updated to include the single outcome agreement targets
relevant for the Board.
8.10
These are listed at Appendix 3.
8.11
In order to be able to introduce an effective performance management system
all corporate targets will re reviewed by the Performance Management team
to ensure they meet the SMART objectives (Specific, Measurable,
Achievable, Relevant and Time bound).
9. Information Systems
9.1
In order to develop a corporate reporting framework there needs to be a
mechanism to pull all of the data to support the range of targets identified
above into one reporting system. We have reviewed the approaches which
have been developed by a number of other Boards all of whom are struggling
to manage the wide range of data required to support such a system. In
addition, NHS Orkney is the smallest territorial Health Board and as such has
the smallest team available to support such a system. However, NHS Orkney
still has the same number and range of HEAT targets to deliver and
performance manage. As a result the system which is to be developed will
require to be proportionate to the needs of this organisation.
9.2
In order to manage this process we have developed a local data-base system
with input from IT colleagues. The benefits of developing a data-base system
are as follows;

To allow the manipulation of targets for reporting purposes at departmental
and corporate levels.

To ensure an owner is identified for each target.

To allow exception reporting to be developed.

To minimise data input requirements.
9.3
A range of alternatives to developing a local data-base system were explored
initially but discounted for the following reasons;

Manual reporting – volume of data makes this impractical.

Development of local spread-sheet system – spread-sheets are not so easy to
manipulate for reporting purposes.

Buying-in a system from another Board – all Boards are currently developing
their systems and none were identified which meet the needs of a small
Board.
9.4
In addition, the development of a system solely for NHS Orkney allows it to be
focused on the needs of the organisation at the out-set.
9.5
The key features of the new data-base system which is being developed are
as follows;

Each individual target is identified along with details of the owner, source of
supporting data, reporting frequency and linked to trajectories where relevant.

The system will be web-based and linked to the NHS Orkney blog for ease of
access.

Links will be made to capture centrally available data (eg from ISD) through
the use of web links.

Owners will be able to input data directly where this is collected locally.

Owners will be able to input commentary as appropriate.

Quality controls will be built into the system from the start.
10. Corporate Reporting Framework
10.1
To develop the corporate reporting framework three key features are being
developed:
a) A system to rank targets as key or standard. The key targets will be the focus
of most attention. Other targets will be reported to CMT and the Finance and
Performance Committee on an exception basis. From this a small number of
high level Key Performance Indicators (KPIs) will be agreed with the Board.
b) A RAGs traffic light system will be used. This is based on the simple Red,
Amber, Green (RAGs) approach where green is on target, amber is where the
target will be met but not within the agreed timescales, red is where targets
are unlikely to be met.
c) At all reporting stages the focus will be on ensuring adequate follow-up action
and all reports will include adequate narrative to ensure targets are being
properly reviewed.
11. Reporting Arrangements
11.1
A hierarchal reporting framework is being developed using information from
the new system. This is based on a reducing level of detail through the review
process from departmental level to CMT and the Finance and Performance
Committee through effective use of exception reporting.
11.2
Each month target owners will be asked to review their targets and update the
supporting data where necessary and add narrative comments.
11.3
A departmental report will be prepared for every service lead showing all the
targets under their control. This will also include departmental finance reports
produced by the finance team. This will also be submitted to the relevant
CMT/ Executive Director for review.
11.4
A monthly review meeting will be arranged where necessary by the
Performance Management team with the CMT lead and service lead to
identify areas of concern and agree follow-up action required. The Director of
Finance or another member of the finance team will also attend where
appropriate.
11.5
A monthly report will be prepared for consideration by CMT showing delivery
against the key targets as well as by exception those targets which are
identified as red or amber. The report will also include details of follow up
action agreed with the CMT and service lead.
11.6
A bi-monthly report will be prepared for the Finance and Performance
Committee showing the key targets and by exception those targets which are
identified as red or amber along with details of follow-up action agreed.
Individual members of CMT and service leads may also be invited to attend
the Finance and Performance Committee to discuss areas of concern where
necessary.
11.7
A report will also be prepared for each Board meeting which will focus on the
KPIs which are to be based on the Board’s corporate objectives. The Finance
and Performance Committee will also routinely report to the Board after each
Committee meeting.
11.8
This hierarchal reporting framework is shown diagrammatically below:
NHS
Orkney
Board
Finance and
Performance
Committee
Corporate Management
Team
Service manager level
Team and individual level
12. Quality Assurance and Control
12.1
The Finance and Performance Committee will have overall responsibility for
ensuring the quality of the performance management system and that
reporting arrangements are operating effectively. An annual report will be
provided to the Board from the Finance and Performance Committee to
provide assurance on the overall operation of the performance management
system.
12.2
The Performance Management team, reporting to the Director of Nursing,
Allied Health Professions, Planning and Performance will ensure the reporting
data included within the data base system has been validated to source data
where-ever possible. This will also be facilitated through the use of web links
directly to externally held data (eg ISD data) where possible.
12.3
Controls built into the system will ensure only appropriate levels of access to
review, input and change data are permitted by system users.
12.4
It is proposed that an internal audit review of the system is undertaken after
the end of the first year of its operation.
13. Implementation Arrangements
13.1
It is proposed to roll out the new system over the next 6 months and the
following key actions have been agreed with the Performance Management
team and CMT;

Individual 1/1 training on the new system will be provided for all service leads
and to ensure performance management responsibilities are understood.

The Board will be asked to approve the relevant KPIs for 2009/10 based on
the key targets identified in the new system following review a detailed review
by the Finance and Performance Committee of the 2009/10 targets and
classification of key targets. This is scheduled for August 2009.

Further testing of the data-base system will be carried out and functional
suitability reviewed with users.

A programme of monthly review meetings will be set up with CMT and service
leads by the Performance Management team. These meetings will commence
in August and September.

A review of roles and responsibilities within the Performance Management
team and reporting arrangements will be carried out by the Executive Lead
and CMT to ensure the new arrangements are sustainable.

A schedule of reporting dates will be agreed with CMT and the Finance and
Performance Committee in August 2009.

The first full performance report will be presented to the Finance and
Performance Committee in October.
14. NHS Quality Improvement Scotland Assurance and Accountability
Standards
14.1
The proposals set out in this paper have been designed to ensure that
following implementation the Board can fully implement the NHS QIS
Standard 3 for Assurance and Accountability. At the present time the Board’s
self assessment position is that for Standard 3 the Board meets level 2 –
implementation. Following full introduction of the new system over the next 6
months the Board should be able to move to Level 3 (monitoring) followed in
due course by level 4 (reviewing).
15. Initial Performance Report to the Board
15.1
Appendix 4 provides an example of the reports to be produced from the new
system, based on performance data available to the end of May. Although this
initial report is not complete it is presented as an example of the style of
reports which will be produced for CMT and the Finance and Performance
Committee in due course.
15.2
In future performance reports to the Finance and Performance Committee and
the Board will also include waiting times reports routinely produced at present.
16. Evaluation and Review
16.1
It is proposed that the effectiveness of the new system should be reviewed
towards the end of the 2009/10 financial year. The aim of the review will be to
identify how well the system is operating based on its ability to deliver the
corporate targets. In addition, the review will also consider how easy the
system is for managers to use and the quality of reports produced for CMT,
the Finance and Performance Committee and the Board.
17. Impact on Health Inequalities
17.1
This strategy and new reporting system should have a positive impact on
reducing health inequalities as it should facilitate delivery of the Board’s
corporate objectives in this area.
18. Resource Implications
18.1
There are no direct resource implications arising from these proposals as the
system is being developed in-house and reporting arrangements are being
introduced within existing staffing. However, CMT has agreed that there will
require to be a review of existing roles and responsibilities to support the
Performance Team.
19. Risk Assessment
19.1
There are serious risks to the organisation’s ability to deliver its corporate
objectives, HEAT targets and SOA targets if there continues to be no formal
performance management reporting system in place.
19.2
There is an operational risk during the implementation phase that other
operational work-streams will be effected given the time required to roll out
the new system. However, this will be limited as far as possible and kept
under review by CMT.
20. Recommendation
20.1
The Board is asked to approve the performance management strategy and
implementation of the proposed new system over the next 6 months and note
the arrangements to evaluate and review the system later in the year.
Jayne Scott
Management Consultant
25 June 2009
NHS Orkney Draft Corporate Objectives 2009 / 2010
The Board of NHS Orkney has set out 6 Strategic Aims. These are key areas of action that need to be addressed in order to deliver the Board’s vision. They
provide the framework against which strategy is developed and they under pin the development of annual Corporate Objectives which, along with HEAT
and locally set performance targets, set out the priority actions for a business year. This document sets out the Corporate Objectives for NHS Orkney in
2009 / 2010, against each of the Strategic Aims as agreed by the Board in April. In addition, proposed targets have been identified by CMT which are shown
below the objectives.
Governance
Committee
A
Delivering Safe And Effective Care
Target Date
A1
Develop a Clinical Strategy that sets out a framework for the delivery of sustainable
clinical services for the Orkney population
End June 2009
Medical Director,
Director of Nursing
and Planning &
Chief Operating
Officer
Board
End June 2009
Chief Operating
Officer
Board
Approval of Clinical Strategy by the professional advisory committees and Area
Partnership Forum and the Board
A2
Develop and deliver a service redesign plan and operational delivery plan which
ensure that the Clinical Strategy becomes a reality
Approval of Clinical Strategy by the professional advisory committees and Area
Partnership Forum and the Board.
A3
Deliver the following key services changes arising from the Service Redesign
Programme during 2009/10
End March 2010
Establishing an effective shadow Community Health and Social Care Partnership,
End March 2010
13
Finance and
Performance
Chief Operating
Board
evaluating its success and setting out a clear proposal for long term joint working
arrangements.
Officer
Shadow CHSCP established and success evaluated
A4
Develop and deliver systems and processes to reduce the amount of, and impact on
patients from, Healthcare Acquired Infection
Throughout year
Director of Nursing
and Planning and
Medical Director
Clinical
Governance
Throughout year
Medical Director
Clinical
Governance
End March 2010
Medical Director
Clinical
Governance
End June 2009
Director of Finance
Board
Ensure all HAI targets set out in NHS QIS recommendations are met.
Deliver HAI HEAT targets (T11)
A5
Continue the delivery of the Scottish Patient Safety Programme which will lead to a
15% reduction in healthcare related mortality and a 30% reduction in patient harm,
across NHS Scotland, by 2011.
Deliver Scottish Patient Safety Targets
A6
Deliver a step change in standards of clinical governance processes and delivery
against the national Quality Improvement Service (QIS) framework and standards
Deliver QIS standards and follow up recommendations from all QIS reviews
Increase overall NHS QIS rating from level 1
B
Creating Sustainable Financial Balance And Demonstrating Best Value
B1
Develop a sustainable 5 year financial strategy
Approval of Financial Strategy by the Board
14
B2
Develop a Financial Recovery Plan which closes the gap between current spending and
future funding levels
End August 2009
Director of Finance
Board
End March 2010
Director of Finance
Finance and
Performance
Financial Recovery Plan approved by SGHD and the Board
B
Creating Sustainable Financial Balance And Demonstrating Best Value (Cont)
B3
Deliver a 2009 / 2010 financial plan which is acceptable to stakeholders within the
overall context of the 5 year Financial Plan and the Financial Recovery Plan
2009/10 financial plan signed off by SGHD and agreed financial targets delivered
including HEAT Targets E5 and E6.
B4
Deliver a step change in standards of financial governance with particular emphasis on
financial reporting, strengthening the overall controls and assurance framework and
promoting and demonstrating best value
Implement Controls and Assurance framework, business cycle and Board assurance
process for Audit Committee
Implement Controls and Assurance framework, business cycle and Board assurance
process for Finance & Performance Committee
Director of Finance
End August 2009
Audit
End August 2009
Deliver the following changes in financial governance during 2009/10
end March 2010
Finance and
Performance
Finance and
Perfromance
C
Improving Health And Reducing Health Inequalities
15
C1
C2
Develop a Health Improvement Strategy
Director of Public
Health
Health Improvement Strategy approved by the board
End Oct 2009
Board
Agree and deliver key actions for 2009/10
End March 2010
Deliver HEAT Targets (H2 – H8)
End March 2010
All strategic and operational plans identify opportunities and actions to sustain and
improve the population’s health
Throughout year
Director of Public
Health
Clinical
Governance
End September
2009
Chief Executive
Clinical
Governance
End September
2009
Director of Public
Health
Clinical
Governance
Director of HR
Staff Governance
Finance and
performance
All plans reviewed to ensure opportunities and actions identified
C3
Develop and implement robust Emergency Planning processes and capability
Revised emergency planning processes approved
C4
Staff have appropriate knowledge, skills and confidence to act to support health
improvement
Programme of staff training designed and completed
D
Developing Our Workforce To Deliver Our Service
D1
Develop an HR Strategy that interprets ‘A Force for Improvement’ in an Orkney
context and an updated Workforce Plan which sets out the workforce actions required
16
End September
2009
to support the 5 year plan
HR Strategy approved by Board and workforce plan agreed
Key actions for 2009/10 to be identified and delivered once strategy approved
D2
Recruiting permanent Medical and Financial Directors
End March 2010
June 2009
Director of HR
Medical and Finance Directors appointed
D3
D4
Remuneration
Committee
Delivering a step change in leadership and management capability
Director of HR
Staff Governance
Pilot Leadership Programme delivered to plan.
End March 2009
Establish leadership standards for middle management
End Aug 2009
6 weekly extended leadership team engagement sessions established
End July 2009
Deliver 2009/10 Board development programme
End March 2010
Using the 2008 Staff Survey results to drive higher levels of staff engagement
End Aug 2009
Director of HR
Staff Governance
End March 2010
Director of HR
Staff Governance
Staff diagnostics sessions completed
Staff engagement delivery plan approved by the Board
Identify and deliver key actions once delivery plan approved by Board
D5
Strengthening the Boards partnership working between managers and staff to deliver
service changes
Evidence of strengthened partnership working by identification and delivery of key
actions from Partnership Forum development session
17
E
Working Mutually Involving Patients, Partners And The Wider Community
Target Date
Governance
Committee
E1
Improving our engagement with the community, particularly with young people and
hard to reach groups
Throughout year
Director of Nursing
and Planning
Mutuality
Committee
End march 2010
Chief Executive
Finance and
Performance
End March 2010
Director of Nursing
and Planning
Mutuality
End march 2010
Director of Nursing
and Planning
Mutuality
Establishment of PFPA forum
Satisfactory delivery of Scottish Health Council annual review recommendations
E2
Further develop partnership arrangement between NHS Orkney, Orkney Island
Council, NHS Grampian and the North of Scotland Planning Groups so that they
deliver tangible benefits for Orkney in the form of improved clinical and support
services.
Establish SPV with OIC
Delivery of Partnership agreement with NHS Grampian
Establish joint AM&T and procurement services with OIC
E3
Using the national Better Together patient experience programme and survey to really
understand what matters to our patients
Outcomes of Better Together patient experience programme delivered [DN Rhoda to
identify key deliverables]
E4
Set out and implement an equality and diversity strategy and implementation plan
which achieves both statutory compliance and genuine benefits for patients, service
18
users and staff.
Equality and Diversity Strategy approved
Key actions identified and delivered once strategy approved
F
Creating A Culture Of Excellence And Continuous Improvement
F1
Meet or exceed the HEAT targets and standards, joint Single Outcome Agreement
targets and locally agreed targets.
Throughout year
Chief Executive
Finance and
Performance
End July 2009
Director of Nursing
and Planning
Finance and
Performance
End March 2010
HR Director
Board
March 2010
Chief Operating
Officer
Staff Governance
Evidence of delivery of HEAT Targets, SOA targets and Board objectives/targets
F2
Design and deliver dynamic organisational performance management arrangements
which drive improved performance
Revised organisational performance management arrangements approved by Board
F3
Completing the implementation of the strengthened corporate governance
arrangements
Revised corporate governance arrangements fully implemented
F4
Roll out a set of improvement skills and tools so that every member of staff can
improve services and processes
Improvement skills and tools identified and rolled out to every member of staff
19
Local Delivery Plan HEAT Targets 2009/2010
Target
Number
Target Description
H
Health Improvement – 7 targets
H2:
80% of all three to five year old children to be registered with an NHS dentist by 2010/11
H3:
Achieve agreed completion rates for child healthy weight intervention programme by 2010/11.
H4:
Achieve agreed number of screenings using the setting-appropriate screening tool and appropriate alcohol brief intervention, in line
with SIGN 74 guidelines by 2010/11.
H5:
Reduce suicide rate between 2002 and 2013 by 20%, supported by 50% of key frontline staff in mental health and substance misuse
services, primary care, and accident and emergency being educated and trained in using suicide assessment tools/ suicide
prevention training programmes by 2010.
H6:
Through smoking cessation services, support 8% of your Board’s smoking population in successfully quitting (at one month post quit)
over the period 2008/9 – 2010/11
H7:
Increase the proportion of new-born children exclusively breastfed at 6-8 weeks from 26.6% in 2006/07 to 33.3% in 2010/11.
H8
Achieve agreed number of inequalities targeted cardiovascular Health Checks during 2009/10.
20
E
Efficiency and Governance – 7 targets
E4:
NHS Boards to deliver agreed improved efficiencies for 1st outpatient attendance DNA, non-routine inpatient average length of stay,
review to new outpatient attendance ratio and day case rate by March 2011.
E5:
NHS Boards to operate within their agreed revenue resource limit; operate within their capital resource limit; meet their cash
requirement.
E6:
NHS Boards to meet their cash efficiency target.
E7:
To increase the percentage of new GP outpatient referrals into consultant led secondary care services that are managed
electronically to 90% from December 2010.
E8:
NHS Scotland to reduce emissions over the period to 2011.
E9:
Achieve universal utilisation of CHI (radiology requests).
E10:
NHS Boards to ensure at least 80 per cent of staff covered by Agenda for Change to have their annual Knowledge Skills Framework
development reviews completed and recorded on e-KSF by March 2011.
21
A
Access to Services – 5 targets
A8:
Provide 48 hour access or advance booking to an appropriate member of the GP Practice Team by 2010/11.
A9:
The maximum wait from urgent referral with a suspicion of cancer to treatment is 62 days; and the maximum wait from decision to
treat to first treatment for all patients diagnosed with cancer will be 31 days from December 2011.
A10:
Deliver 18 weeks referral to treatment from 31 December 2011. No patient will wait longer than 12 weeks from referral to a first
outpatient appointment from 31 March 2010. No patient will wait longer than 12 weeks from being placed on a waiting list to
admission for an inpatient or day case treatment from 31 March 2010.
A11:
To offer drug misusers faster access to appropriate treatment to support their recovery.
A12:
NHS Boards to deliver faster access to Child and Adolescent Mental Health Services.
T
Treatment - 10 targets
T2:
QIS clinical governance and risk management standards improving.
T3:
Reduce the annual rate of increase of defined daily dose per capita of anti-depressants to zero by 2009/10, and put in place the
required support framework to achieve a 10% reduction in future years.
T4:
Reduce the number of readmissions (within one year for those that have had a psychiatric hospital admission of over 7 days by 10%
by the end of December 2009).
T6:
To achieve agreed reductions in the rates of hospital admissions and bed days of patients with primary diagnosis of COPD, Asthma,
Diabetes or CHD, from 2006/7 to 2010/11.
T7:
Improvement in the quality of healthcare experience.
22
T8:
Increase the level of older people with complex care needs receiving care at home.
T9:
Each NHS Board will achieve agreed improvements in the early diagnosis and management of patients with a dementia by March
2011.
T10:
To support shifting the balance of care, NHS Boards will achieve agreed reductions in the rates of attendance at A&E, between
2007/08 and 2010/11.
T11:
To reduce all staphylococcus aureus bacteraemia (including MRSA) by 30% by 2010; to introduce and comply with local antimicrobial
policies by 2010; and to reduce the rate of C.diff infection in hospitals by at least 30% by 2011
T12:
By 2010/11, NHS Boards will reduce the emergency inpatient bed days for people aged 65 and over, by 10% compared with
2004/05.
23
Single Outcome Agreement Targets for NHS Orkney 2009/10 – Appendix 3
Local Outcomes
Indicators
Baseline
Progress targets
End targets
Awareness of wider
influences on health and
wellbeing is raised
Proportion of woman still breast feeding at 6
weeks or more
2006/07 – 60%
2009/10 – 63%
2010/11 – 65%
% 3-5 year olds registered with a dentist
2007/08 – 55.1%
2009/10 – 76%
2010/11 – 80%
Number of Healthy Weight Interventions
New target 2008/09 –
2
2009/10 – 40
2010/11 – 81
Reduce inequalities in rate of smoking during
pregnancy
2006 – 17.1%
2009/10 – 15%
2010/11 – 14%
Number of inequalities targeted cardiovascular
Health Checks (NHSO LDP Annex 2 H8)
New target
2009/10 – 116
2010/11 – 120
Healthier lifestyle choices are
easier choices
Mortality from CHD among under 75s
2007 – 233.5
2009/10 – 200
2010/11 – 175
A shift in the balance of care
and raised awareness of
wider influences on health
and wellbeing
Percentage of delayed discharges outwith the
six week delayed discharge planning period
(Information Services Division Scottish Health
Statistics Delayed discharge)
2007/08 – 0
2009/10 – 0
2010/11 – 0
A community which
challenges discrimination,
promotes diversity, and
Staff trained in suicide prevention (NHSO LDP
Annex 2 H5)
2007/08 – 27%
2009/10 – 37%
2010/11 – 50%
Promotion of health equality
24
(national target 50%)
Local Outcomes
Indicators
Baseline
Progress targets
End targets
General Acute Inpatient Discharges with an
alcohol related diagnosis. (age standardised
rate per 100,000 population)
2007/08 – 1003
2009/10 – 988
2011/12 – 953
Number of screenings and alcohol brief
intervention in line with sign 74
New target
2009/10 – 305
2010/11 – 577
% of population successfully quitting smoking
(at one month)
2008/09 – 17
2009/10 – 92
2010/11 – 200
2002 – 22% aged 13,
39% aged 15
2009 – decrease to
9% aged 13
2010 –
Decrease to 7%
aged 13
prioritises safety and support
for the most venerable
The harmful effects of drugs,
alcohol and smoking are
minimised through positive
action
Crime, other antisocial
Level and frequency of alcohol consumption
behaviour and the effect it has among children and young people: percentage
on our community is reduced
of 13 and 15 year olds drinking once a week
(SALSUS report – DASAT)
27% aged 15
20% aged 15
2006 – 12% aged 13,
34% aged 15
NHS Orkney operating within their agreed
revenue resource limit; operate within their
capital resource limit; meet their cash
requirement (NHSO Annual report)
25
2007/08 – Amber
(performance is
equal to nationally
acceptable
standards)
2007/08 – Amber
(performance is
equal to nationally
acceptable
standards)
2007/08 –
Amber
(performance is
equal to
nationally
acceptable
standards)
26