Agenda and supporting papers - Plymouth Hospitals NHS Trust

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Item 3 109/13 Performance Report Finance and Efficiency A contract value of £353.2m had been agreed with commissioners. The contract would operate on a managed Payment by Results (PbR) basis which assumed that full PbR would be operated but both parties would work together to D deliver all contractual commitments within the funding envelope available. Mr Teape drew the Board’s attention to the variable elements of the contract, including cardiac activity, set out in his report. Dr Williams asked whether there was confidence that a PbR contract would enable cardiac to deliver at the required level. Mr Teape stated that focused support was being given to this team. Two additional ring fenced R beds had been provided as an immediate measure. Noting the ISTC provision, locally, of cataract surgery, Dr Williams asked whether this had been built in to budget assumptions. Mr Teape confirmed that it had; about £0.5m had been taken out of the ophthalmology budget A and the service line had been asked to produce a capacity plan with sensitively analysis. Mr Teape stated the intention to include in future reports key contract issues, including activity variations, as well as contract penalties and CQUIN achievements to raise the profile of these issues at Board level. F Operational Performance Mr Baber stated that May had seen a significant decrease in cancellations but performance remained unacceptable. The Chairman queried progress T with driving theatre efficiency. Mr Baber stated that authority had been given to surgeons/anaesthetists to get lists under way. A Service Line Director for Theatres had been appointed and would drive this. Cancelled Operations Accident & Emergency Department 4 hour target May performance had been 94.75%, with 97.74% to date in June. Year to date performance was 93.53% and the quarter may yet be recovered. Follow-up Backlog Dr Williams was concerned that the follow-up backlog remained static at 23,000 and the Board was not assured that the actions in place would deliver the required improvement. Dr Mayor stated that he had asked Assistant Medical Director Paul McArdle to undertake a full risk assessment on all patients on the follow-up list and Mr Baber explained the approach to appropriately prioritising patients and to remove those with no ongoing clinical need. Commander Spencer asked whether there was confidence that the backlog was not 9
Item 3 continuing to build. Mr Baber stated that this was being addressed as part of the waiting list policy. Referral to Treatment (exception report) The report set out actions to address under-performance. The Trust would fail this target in Quarter 1 but the planned actions facilitated the speediest resolution of long patient waits. Mr Baber expected to reach a sustainable position by October. D The Board noted performance ahead of target in April. The Trust failed the target in April and performance had further deteriorated in May. R Mr Baber stated that an options paper would be submitted to commissioners on the Trust’s overall capacity; this would include additional staffing and the outsourcing of some activity. Mrs Raikes queried whether the actions to achieve stroke and cancer performance, reported A in February and March respectively, remained relevant as performance had not reached the required targets. Mr Baber stated that the issue with stroke concerned admittance to the ASU but beds had been ring fenced, compounded by a peculiarity around the appropriateness of some of the targets when there were overriding clinical reasons not to admit to the ASU. Exception reports on cancer and stroke F would be included in next month’s report to the Board. The Board were pleased to note performance at 85% for April. Mr Dix stated that the quality of the responses had improved; the next step to improve quality would T be to survey complainants’ satisfaction with the Trust’s process. A recently published report on NHS governance of complaints handling had been circulated to Board members; this would inform an internal review of complaints due to be reported in July. Fractured Neck of Femur Diagnostics and surveillance Cancer and Stroke Complaints COO Friends and Family Test Response The Trust has failed this target in April and May. Mr Dix had reviewed performance by ward in order to focus effort where necessary. Discretionary Pay Mrs Raikes queried the high level of discretionary pay reported in April. Mr Teape acknowledged that the Senior Management Team’s focus had not yet had the required impact. The Board agreed that a seminar on understanding and mitigating discretionary pay would be incorporated in the Board development schedule. Workforce Mr Bamber stated that the scoping of a new framework for non- 10
Page 1 and 2: Trust Board Friday 5 July 2013, 9.0
Page 3 and 4: Members of Plymouth Hospitals NHS T
Page 5 and 6: Item 3 observer. The Chairman requi
Page 7 and 8: Item 3 Board oversight of contribut
Page 9 and 10: Item 3 the Board next month. • Th
Page 11: Item 3 been involved and there was
Page 15 and 16: Item 3 to Norovirus, Professor Lewi
Page 17 and 18: Item 3 • Careful communication of
Page 19 and 20: Item 3 • Approved the writing off
Page 21 and 22: Updated: prior to July Board Item 4
Page 23 and 24: Updated: prior to July Board Item 4
Page 25 and 26: Item 8 Quality Impact Assessment Pa
Page 27 and 28: Item 8 3.2 Quarterly Summary Hospit
Page 29 and 30: Item 8 4.4 Monthly Proportion of Pa
Page 31 and 32: Item 8 Inpatient falls are currentl
Page 33 and 34: Item 8 REI signage PALS were contac
Page 35 and 36: Item 8 Complaints received listed b
Page 37 and 38: Item 8 The graphs below illustrate
Page 39 and 40: Item 8 5.5 Friends and Family Test
Page 41 and 42: Item 8 1. Pressure Ulcers (EoC) 2.
Page 43 and 44: Item 8 Observations The essence of
Page 45 and 46: Item 8a SUMMARY REPORT Trust Board
Page 47 and 48: Annex 2 Item 8a Summary of Serious
Page 49 and 50: Item 9 Key Recommendations The Trus
Page 51 and 52: Item 9 Effective Care (Section B2 o
Page 53 and 54: Item 9 Description 31 days from 'de
Page 55 and 56: Item 9 4.6 Non Elective Activity is
Page 57 and 58: Item 9 Summary of performance excep
Page 59 and 60: Item 9 Ensure that all patients adm
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Item 9 Update on previous actions C
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Contents EXECUTIVE SUMMARY D FINANC
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B1 Safe care Description Hospital S
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Response Rate Recommender Score B3
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B5 Other safety & quality metrics D
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C2 Non-Elective Activity Descriptio
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C4 Referral To Treatment (RTT) Desc
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C6 Other access & activity metrics
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D2 Cost improvement programme (CIP)
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D4 Cash Management Description Revi
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E1 Staffing numbers Description Est
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E3 Sickness absence PERFORMANCE IND
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Risk Rating F2 Monitor's Financial
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Item 10 DETAILED REPORT Trust Board
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Item 10 4. Key Issues for the Board
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Item 11 SUMMARY REPORT Trust Board
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Item 11 DETAILED REPORT Trust Board
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Item 11 • Challenge in respect of
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Item 11 Over the past two years, me
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Item 11 Getting it Right Charter An
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Item 11 Outcome of review with exte
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Item 11 Learning Disabilities Natio
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Item 11 Peer Review 2.5 Peer Review
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Item 12 Next Steps 1. Conversation
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Item 12 2. Board Inclusion Developm
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Item 12 EDS Grades and E & D Object
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Item 12 Plymouth Hospitals Trust -
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Item 12 3.6 The workforce is suppor
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Item 13 Key Recommendations The Tru
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Item 13 Telephone conversations.
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Item 13 19. The Medical Director ha
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Item 15 incident investigations to
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Item 15, Annex 1 3. Review of Actio
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Item 15, Annex 1 • Top three issu
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Item 15, Annex 1 The Chair asked SS
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Item 16 COMMITTEE MINUTES Finance,
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Item 16 pay and staffing, highlight
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Item 16 • PACS contract - likely
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Item 17 Terms and Conditions of Emp
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Item 17, Annex 1 29/2013 Minutes an
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Item 17, Annex 1 31/2013 Francis Re
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Item 18 Next Steps The Audit Commit
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Item 18, Annex 1 Matters arising 4/
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Item 18, Annex 1 time to embed and
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Item 18, Annex 1 Payroll & Expenses
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Item 18, Annex 1 The Committee note
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Item 18, Annex 1 Going Concern Revi
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Item 18, Annex 1 if Internal Audit
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Agenda and supporting papers - Plymouth Hospitals NHS Trust

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