Integrated Performance Report - haringeyccg.nhs.uk

1 Haringey CCG Performance and Quality Report February 2018 Contents ItemPageHaringey CCG Quality and Performance Dashboards34-5 Haringey CCG Performance and QualitySummary6 7 North Middlesex University Hospital Performance and Quality Dashboards8 10 Whittington Health Quality and Performance DashboardsWhittington Health Performance and Quality Summary12 1511 Barnet, Enfield and Haringey Mental Health Trust Performance and Quality Dashboard 16 Barnet, Enfield and Haringey Mental Health Trust Performance and Quality Summary17 -19 NCL Integrated Urgent Care Service (IUC) Summary20-22 LAS Summary23-24 Glossary of Terms and Data Sources25-262 Haringey CCG Quality and Performance Dashboard RTT and Diagnostic CCG data for December 2017 is provisional (waiting). Data Source: Unify2 and Open Exeter via NELIET hemeKPI / MeasureDec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-172017-18 YTD2017-18 TargetA&EA&E All Types W eeks Referral to treatment and Diagnostics18 W eeks RTT W eeks RTT W eeks RTT Incomplete W eeks Diagnostic >52 week waits Admitted399816454142431->52 week waits Non Admitted25627119122112247->52 week waits Incomplete11101001348109360 Cancer W aits2 W eek Cancer W W eek Cancer W ait:Breast day Cancer W ait:1st definitive Day Cancer W ait: Subsequent treatment (Surgery) Day Cancer W ait: Subsequent treatment (Chemotherapy) Day Cancer W ait: Subsequent treatment (Radiotherapy) Day Cancer W ait: GP Day Cancer W ait: Screening Day Cancer W ait.

2 Consultant ThresholdQualityMRSA reported infections00000013100050C. Difficilereported infections3703656383423750 Mixed Sex Accommodation (MSA) (Number of breaches)43142213433432503 Key MessagesA&EIn December 2017 , Haringey A&E Performance overall was , against the national target of 95%. The primary contributor tothis was poor Performance at North Middlesex University Hospital. This was due to staff shortages, high number of ambulance conveyances andbunching of ambulances (which make prompt offloads difficult), and poorly implemented pathways. The Trust continue to implement the Safer, Faster Better Improvement plan and Red to Green on the wards. The middle-grade A&E rota is being reviewed following the implementation of the new consultant rota in October 2017 and the Trust are working closely with GPs in primary care to ensure a smooth transition of paper to a result of the on-going Performance pressures, Commissioner support has increased, with operational and executive leads supporting a range of initiatives including, weekly Multi-Agency Discharge Events (MADE), supporting individual patient discharges, weekend on-callrotas and daily escalation calls.

3 The NMUH A&E system received resilience funding of 606,000 on the condition that the local system will deliver at least 90% of the Performance by quarter four 2017 /2018 Whittington Health NHS Trust A&E four hour Performance dipped in December to This deterioration in Performance was causedby the influenza outbreak (which increased admissions in the over 75 s), increased ambulance conveyances and an increased number of complex discharges. The increased complexity and age profile of admitted patients has an effect on the increased complexity of discharge arrangementsasevidenced by the increased delayed discharge numbers. Daily escalation discussions between the Provider, CCG and local authorities are now being held to address issues such as delayed for winter resilience schemes was confirmed in December 2017 these are:Three extra intermediate care beds, additional mental health bed capacity and increased mental health support to A&E.

4 Progress on implementation is regularly reviewed by the local A&E Delivery Board and through weekly calls with NHS To Treatment (RTT)The 18 Weeks Referral To Treatment Incomplete Pathways standard was met by Haringey CCG in November 2017 with Performance reported at , overall. Provisional data for December 2017 indicates that Haringey CCG met the standard with a Performance of against the national target for 52 week waits has been poor since July 2017 and the number of breaches have been steadily increasing since then, with 9 breaches in December 2017 . Five of these were at the Royal Free London, two at Imperial College Healthcare NHS Trust, one at University College London Hospital and the remaining one at Kings College London Hospital. Systems are in place to receive feedback fromtrusts about clinical reviews, treatment plans and clinical harm CCGP erformance and Quality Summary4 Haringey CCGP erformance and Quality SummaryKey MessagesCancer access standards Haringey CCG failed to achieve all of the national cancer standards in November 2017 due to a dermatology backlog across the Diagnostic waitsHaringey CCG achieved the diagnostic target in November 2017 with Performance of Provisional data indicates that Haringey CCG met the standard in December 2017 with a Performance of against the 1% standard.

5 Performance in this area has been consistent since May 2017 . North Middlesex University Hospital as a non-specialist Trust are performing well because unlike specialist Trusts who deal with more complex patients, North Middlesex University Hospitalare able to manage the flow of patients requiring CT and MRI scans well .North Middlesex University Hospital Never EventsSince 1 April 2017 , five Never Events have been reported three wrong site surgery and two retained foreign objects. This is anincrease of reported Never Events from 2016/17 when three Never Events had been reported. Haringey CCG are undertaking a thematic analysis of the learning from previous Never Events of the same type and are planning an assurance visit with a focus on root causes and action plans for March Middlesex University Hospital Dermatology clinicNorth Middlesex University Hospital have served notice to commissioners on their dermatology clinic.

6 Concordia has been awardeda contract to deliver the dermatology service from 15 January 2018 for 12 months with a 6 month break clause and is offering eleven sessions per week. This exceeds the number previously offered by North Middlesex Hospital and is aimed to address the current waiting list Digital data published by NHS DigitalLocal data derived from Provider reports to NHS EnglandHaringey CCGIAPT Performance DashboardThemeKPI/MeasureSourceReporting PeriodActualStandardCurrent Month and Previous Month's Trend Blue = NHS Digital Green = Local Data Red = TargetNHS Recovery RateNHS Digital2017-18 Data2017-18 DigitalOct-17330 NHS Digital2017-18 Q21380 BME % of Numbers Entering Treatment - QUARTERLYNHS Digital2017-18 IAPT% Waited less than 6 weeks for a course of treatment (for those finishing a course of treatment)

7 75%% Waited less than 18 weeks for a course of treatment (for those finishing a course of treatment)95%Recovery Rate - entering into Treatment388 Numbers entering into Treatment - -17 Apr -17 May -17 Jun-17 Jul-17 Aug Q 32016-17 Q 42017-18 Q 12017-18 Q 2136013351520138013982016-17 Q 32016-17 Q 42017-18 Q 12017-18 Q Q 32016-17 Q 42017-18 Q 12017-18 Q 26 Haringey CCGM ental Health Performance Dashboard *Latest data is provisional and unpublishedNHS Digital data published by NHS DigitalLocal data derived from Provider reports to NHS EnglandThemeKPI/MeasureSourceReporting PeriodActualStandardCurrent Month and Previous Month's Trend Blue = Actual Red = TargetDementia Diagnosis Rate (Age 65+)NHS percentage of RTT First Episode Psychosis (FEP) periods within 2 weeks of referral.

8 *NHS of patients on CPA who were followed up within 7 days after discharge from psychiatric inpatient care*NHS Digital2017-18 of admissions to acute wards that were gate kept by the CRHT teams*NHS Digital2017-18 of Children and Young people with eating disorders (routine cases) that wait 4 weeks or less from referral to start of NICE-approved treatment *NHS Digital2017-18 of Children and Young people with eating disorders (urgent cases) that wait 1 week or less from referral to start of NICE-approved treatment *NHS Digital2017-18 CCG MENTAL 6-17 Q3201 6-17 Q4201 7-18 Q1201 7-18 Q2201 7-18 6-17 Q3201 6-17 Q4201 7-18 Q1201 7-18 Q2201 7-18 6-17 Q3201 6-17 Q4201 7-18 Q1201 7-18 Q2201 7-18 6-17 Q3201 6-17 Q4201 7-18 Q1201 7-18 Q2201 7-18 Q37 North Middlesex University Hospital Performance Dashboard Data Source: Unify2, Open Exeter and LAS via NELIE18 Weeks RTT 18 Weeks RTT 18 Weeks RTT Incomplete Pathways92% >52 week waits Admitted-0 0 >52 week waits Non Admitted-0 0 >52 week waits Incomplete00 0 6 Weeks Diagnostic Waits1% Cancelled Operations ( 2017 -18 Q2)100% 2 Week Cancer Wait93% 2 Week Cancer Wait:Breast Symptoms93% 31 day Cancer Wait:1st definitive treatment96% 31 Day Cancer Wait.

9 Subsequent treatment (Surgery)94% 31 Day Cancer Wait: Subsequent treatment (Chemotherapy)98% 31 Day Cancer Wait: Subsequent treatment (Radiotherapy)94% 62 Day Cancer Wait: GP Referral85% 62 Day Cancer Wait: Screening service90% 62 Day Cancer Wait: Consultant KPI/ThresholdNORTH MIDDLESEX UNIVERSITY HOSPITAL NHS TRUSTNov-17 YTDNov-17 YTDKPI/ThresholdNORTH MIDDLESEX UNIVERSITY HOSPITAL NHS TRUSTA&E All Types Performance95% No of waits from decision to admit to admission (Trolley waits - over 12 hours)00 2 % Ambulance Handovers within 15 mins: KPI 1100% % Ambulance Handovers within 30 mins: KPI 2100% Number of Ambulance Handover - 30 minute breaches095 1065 Number of Ambulance Handover - 60 minute breaches04 81 % Patient Records Captured Electronically: KPI 490% NORTH MIDDLESEX UNIVERSITY HOSPITAL NHS TRUSTNov-17 Nov-17 KPI/ThresholdNORTH MIDDLESEX UNIVERSITY HOSPITAL NHS TRUSTYTDYTDKPI/Threshold8 North Middlesex University Hospital Quality DashboardData Source: Unify2, NHS Digital, STEIS and local Trust Data via NELIET hemeKPI/MeasureReporting PeriodActual2017-18 YTD2016-17 YTDC urrent Month and Previous 12 Months Trend Blue = Actual Red = TargetSHMI rate - rolling 12 month average(received quarterly)July 2016 - Jun Number of acquired pressure ulcers.

10 Grades 3 & 4(Safety Thermometer) Nov-174810 Old Pressure ulcers that are present on admission 3 & 4(Safety Thermometer) Nov-1742580 The number of patients falls with severe harm (as per NPSA definition - Safety Thermometer) Nov-17000 Number of Never EventsNov-17143 Serious Incidents (SIs) Number ReportedDec-17107383 Number of MRSA BacteraemiaNov-17012 Number of Clostridium DifficileNov-1711833 ThemeKPI/MeasureReporting PeriodActual2017-18 YTD2016-17 YTDC urrent Month and Previous 12 Months Trend Blue = Actual Red = TargetMandatory training (%) fill rate - Registered nurses/midwives (Day) fill rate - Registered nurses/midwives (Night) fill rate - Care staff (Day) fill rate - Care staff (Night) SafetyPatient Middlesex University Hospital Quality DashboardData Source.