Board Report - Performance

September 2008

Produced by Business Intelligence (Performance)

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RWSx 1 0 1 2WASH 5 2 3 2QV 1 0 0 0YTD MRSA Infections 7 9 13 17Cumulative Trajectory 2 4 6 8 10 13 15 17 20 22 24 27

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RWSx WASH QVCumulative trajectory YTD Actual MRSA Infections

Performance Traffic Light

West Sussex PCT

Cleanliness and HCAI - MRSA infections 2008-09

Whilst the total numbers of infections is of concern in our acute trusts, the number of preventable hospital acquired infections is within the trajectory. All cases are now being assiduously investigated by the clinicians concerned, and signed off by the PCT and trust directors of infection prevention and control.. The trusts are carefully monitoring adherence to behaviours which can increase the risks of infection (line, wound and catheter care, hand washing and general cleanliness – and in general standards are high. The focus on community acquired infections continues to grow with the ongoing recruitment of primary care infection control nurses.

Cleanliness and HCAI

The Clostridium difficile infection rate per 10,000 population is currently at 11.5% for Q1 against a target of 8.5% target for 2011. The PCT remains just over trajectory but further seasonal improvement has been seen in July.

Cleanliness and HCAI

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RWSx 28 12 18 18WASH 34 29 28 20QV 0 0 1 1BSUH 11 9 10 9SASH 8 16 14 5Other 1 0 1 0YTD C.difficile infections 82 148 220 273Cumulative Trajectory 70 139 207 270 333 401 469 543 617 691 764 834

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RWSx WASH QVBSUH SASH Cumulative trajectoryYTD Actual C difficile Infections

Performance Traffic Light

West Sussex PCT

Cleanliness and HCAI - Commissioner Clostridium difficile infections 2008-09

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No. direct access audiology pathways who waited <= 18 weeks 71 162 225 400Total direct access audiology pathways 402 520 491 606Trajectory 85.0% 87.5% 90.0% 92.5% 95.0% 97.5% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0%% treated <= 18 weeks 17.7% 31.2% 45.8% 66.0%

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Performance Traffic Light

West Sussex PCT

% seen < 18 weekspatients seen < 18 weekspatients seen > 18 weeks

18 weeks - Audiology Pathway

Overall achievement for admitted and non-admitted patients remains on target, although both Brighton University Hospitals and Surrey and Sussex Healthcare have signalled that for admitted patients they may not meet the local stretch target of end of September. The impact of this on the overall PCT position is being evaluated. Direct Access Audiology (above) remains below plan although further significant improvements have been seen in July. All audiology providers have given assurance that the 95% threshold for achievement will be reached by October.

18 Weeks

There were 2 breaches for Patients waiting >26 weeks for IP appointment in July, these were both Orthopaedic patients at BSUH and the Royal National Orthopaedic Hospital, and were due to short term staffing and equipment constraints. The majority of breaches are against the 6 week diagnostic target (table above) and relate to audiology assessments at Action for Deafness. Clearance of the backlog is going according to plan.

18 Weeks

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Patients waiting > 6 weeks for 15 key diagnostic tests (monthly data) 21 7 125 46Patients Waiting 6+ Weeks for all other diagnostic tests on Quarterly Census 0 0 2

Total 21 7 127 46Target 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0

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Non-obstetric ultrasound Audiology - Audiology Assessments

Cardiology - echocardiography Colonoscopy

Other all other diagnostic tests - patients seen > 6 weeks (Census Data)

Performance Traffic Light

West Sussex PCT 18 weeks - diagnostic tests

West Sussex PCTGP Referrals - All Specialties

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2008/09 Plan

Demand

Actual referrals for July YTD is 13.4% higher compared to last year and 10.6% up against plan. This is consistent with national increases. Movement by Trust:

• Brighton and Sussex University Hospital NHS Trust 31% increase in referrals against Plan and 21% from July YTD.

• Royal West Sussex NHS Trust 2% up from plan and 30% increase against 07/08

• Queen Victoria Hospital NHS Trust up by 36% against plan and last year.

• Worthing and Southlands Hospitals NHS Trust 16% increase against Plan and 10% from 07/08.

• Surrey and Sussex Healthcare NHS Trust figures are estimated, as general and acute data has not been submitted. This is being followed up through the contractual route.

An action plan to manage referral rates has been submitted to the Strategic Commissioning Board and progress will be monitored monthly

West Sussex PCTOther Referrals - All Specialties

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2008/09 Plan

Demand

Actual referrals for Q1 is 17% lower compared to last year and 19% lower than plan.

The increase in GPO referrals continues to be partially offset by a reduction in other (including consultant-to consultant) referrals, suggesting that referral patterns are changing due to the implementation of 18 week pathways and increased contractual rigourPlease note the totals in MAR 2008/09 include an estimate for SASH, as they have not submitted any data.

99.9% of patients contacting G.U Medicine services are now being offered appointments within 48 hours, but the number seen within that time is below the target of 95%. Patient choice of appointment is a factor but there is considerable variation between providers as shown above. West Sussex Health remains the best performer at over 98%. Variation elsewhere is being taken up via contract discussions.

Sexual Health

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West Sussex Health 99.6% 98.7% 98.3% 98.8%RWSx 96.9% 94.3% 87.8% 92.1%WASH 85.1% 91.1% 86.0% 81.6%BSUH 68.4% 73.9% 75.2% 82.6%Surrey PCT - East Surrey Hospital 55.0% 88.6% 85.0% 61.1%Surrey PCT - Farnham Road Hosp 94.1% 85.0% 84.6% 71.4%Portsmouth Hospitals 100% 92.3% 93.8% 94.1%C&WH - Victoria Clinic South Westminster Centre 60.0% 50.0% 66.7% 66.7%C&WH - Victoria Clinic South Westminster Centre 75.0% 75.0% 50.0% 50.0%West Sussex PCT Commissioner 89.0% 91.9% 89.1% 88.9%

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Performance Traffic Light

West Sussex PCT

% patients seen < 2 daysPatients seen < 2 daysPatients seen > 2 days

Sexual Health - seen by genito-urinary medicine clinic < 2 days - commissioner

95 %

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Performance Traffic Light

West Sussex PCT Sexual Health - seen by genito-urinary medicine clinic < 2 days - provider

95 %

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No. 15 - 24 year old persons screened or tested for Chlamydia 282 284 252 201target 1,270 1,270 1,270 1,270 1,270 1,270 1,270 1,270 1,270 1,270 1,270 1,270Annualised Screening or testing 3,384 3,396 3,272 3,057 The population aged 15 - 24 years 89,663 89,663 89,663 89,663 89,663 89,663 89,663 89,663 89,663 89,663 89,663 89,663Actual % population aged 15 - 24 screened or tested for chlamydia 4% 4% 4% 3% 0% 0% 0% 0% 0% 0% 0% 0%Target % population aged 15 - 24 screened or tested for chlamydia 17% 17% 17% 17% 17% 17% 17% 17% 17% 17% 17% 17%

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West Sussex PCT

% of population 15-24 screenedTarget

Number of pateints screenedTarget number of patients screened

Sexual Health - Screening for Chlamydia

There are now 140 screening sites (Community Contraceptive Services, Young People’s Information Shops, GPs, Youth Provision, some Secondary schools, Further Education Colleges, the University, Foyers (housing schemes for vulnerable young people) and HMP Ford, within the target Chlamydia area). If all sites screened 6 young people per month then the target would be reached. The ‘Target Chlamydia’ programme is auditing the generic sites to find out if this could be achievable for them and what support they would need to be able to reach this goal.

Sexual Health – Chlamydia Screening

Health Improvement – Smoking Cessation

75% of the plan for Quarter 1 was achieved. The PCT will be developing a strategic action plan for smoking cessation and reducing prevalence to support the achievement of this target as one if its key outcome measures for World Class Commissioning and progress on implementation will be reported to future board meetings

 

Quarterly - No. of 4-week smoking quitters who attended NHS Stop Smoking Services

Target no. of 4-week smoking quitters who attended NHS Stop Smoking Services

Quarterly - No. of 4-week smoking quitters per 100,000 population aged 16 and over

Target no. smoking quitters per 100,000 population aged 16

and over.

June 747 989 118 167

September   1935   334

December   2813   500

March   4237   667