nhsggc(m)09/3 - NHS Greater Glasgow and Clyde

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EMBARGOED UNTIL 23 JUNE 2009 BOARD MEETING • At 31 January 2009, expenditure of £54m had been incurred on capital schemes leaving a balance of £68.4m to spend by 31 March 2009. ACTION BY • At 31 January 2009, the Board was reporting achievement of £40.3m against its year to date target of £41.2m of recurring savings and it was anticipated that the full £50.7m would be achieved by 31 March 2009. Mr Griffin reported that the initial draft of the NHS Board’s Annual Accounts had been prepared and that these indicated that the NHS Board’s financial outturn for the year would be breakeven. This would be confirmed when the NHS Board’s final accounts were drafted and presented to the Audit Committee and, thereafter, the NHS Board at their meetings scheduled for June 2009. Mr Calderwood commended Mr Griffin and his finance team for ensuring the Board’s financial stability for the fourth consecutive year despite increasing cost pressures. Mr Williamson agreed and noted that the NHS Board’s financial plan for 2008/09 required the NHS Board to set a cost savings target that had to meet the Scottish Government Health Directorates’ requirement to achieve a 2% recurring reduction in costs against revenue allocation as part of the Scottish Government Efficiency Savings Initiative. Mr Griffin confirmed a similar cost savings requirement for 2009/10 and that a financial plan would be presented to the NHS Board’s Performance Review Group in May 2009. For 2010/11, however, early suggestions were that increased savings would have to be found across the whole of the public sector and this would clearly impact on the NHS. Accordingly, system-wide cost savings initiatives would be required to be identified. In response to a question from Mr Lee regarding the capital expenditure balance of £68.4m to be spent by 31 March 2009, Ms Byrne confirmed that the year-end outturn on capital expenditure was closely in line with year-end plans. The NHS Board’s Capital Planning Group was due to consider this fully at its next meeting and, thereafter, it would be reported to the next Performance Review Group meeting. Mr Calderwood assured members that spending was monitored on a weekly basis by project managers and traditionally in the NHS, capital expenditure was weighted to the last financial quarter of the year. NOTED 41. WAITING TIMES AND ACCESS TARGETS A report of the Acting Chief Operating Officer (Acute Services Division) [Board Paper No. 09/21] asked the NHS Board to note progress against the national targets as at the end of February 2009. Ms Grant led the NHS Board through the report noting performance. She highlighted the following:- • Outpatient waiting times – at the end of March 2009, the Acute Services Division met the target of no patients waiting more than 12 weeks from GP referral to an outpatient appointment. • Inpatient/Day Case waiting times - at the end of March 2009, the Acute Services Division met the target of no inpatient/day case waiting more than 12 weeks from a decision to undertake treatment to the start of that treatment. 6
EMBARGOED UNTIL 23 JUNE 2009 BOARD MEETING • Diagnostic waiting times - the maximum wait for referral to MRI Scan, CT Scan, Non Obstetric Ultrasound, Barium Studies, Gastroscopy, Sigmoidoscopy, Colonoscopy and Cystoscopy, was 6 weeks by the end of March 2009. That 6 week target was achieved at the end of December 2008 for CT, MRI, Ultrasound and Barium Studies and had been maintained since that period. Similarly, it was expected that by the end of March 2009 this target would be met in respect of Upper Endoscopy, Lower Endoscopy, Colonoscopy and Cystoscopy. ACTION BY • Cataract targets – the target of maximum time from referral to completion of treatment for cataract surgery was 18 weeks and this had been maintained since December 2007. • Hip fracture – the target was that 98% of all hip fracture patients would be operated on within 24 hours of admission to an orthopaedic unit, subject to medical fitness and during safe operating hours – this target was being maintained. • Accident and Emergency 4 hour wait – the target was that 98% of accident and emergency patients should be treated and discharged, admitted or transferred within 4 hours of arrival at the department. The NHS Board currently reported 97% compliance against this target and the Emergency Care and Medical Services Directorate continued to work collaboratively with colleagues and other directorates and with key provider agencies to ensure the 98% target was met as soon as possible. • Cancer waiting times – 95% of all urgent referrals with suspected cancer should wait a maximum of 62 days from urgent referral to treatment (31 days for breast cancer). The 4 month average for the period November 2008 to February 2009 was 96%. • Chest pain – The NHS Board was only responsible for rapid access chest pain services, with a target waiting time of 2 weeks and had met this 2 week target throughout 2008 and this had continued to be met in January and February 2009. • Delayed discharge – The NHS Board was required to maintain a performance standard of no patients waiting over 6 weeks for discharge. Significant difficulties had been encountered in Glasgow City Council in recent weeks due to a combination of staff changes and some particularly complex cases. Continuing efforts were being made to return to no patients waiting over 6 weeks. • Stroke – the outpatient target of 80% of fast track referrals to stroke/TIA clinics was within 14 days and this outpatient target was now being delivered consistently across the NHS Board’s area. In respect of the target that 80% of stroke patients should have a CT or MRI scan within 48 hours of admission, the Glasgow Managed Clinical Network had reviewed and changed the CT target from 48 hours to 24 hours as more clinically pertinent to stroke management. Access to CT/MRI in Clyde met the national standard of 48 hours and work was ongoing to reduce this to 24 hours. Mr P Hamilton asked what effect the new bowel cancel screening programme was having in terms of capacity planning for colonoscopy. Ms Grant confirmed that waiting times would be maintained and this would be monitored carefully. Workforce plans were in place and there was flexibility to deal with increases/decreases in yield as need be. Ms Grant confirmed that bowel cancer screening could be undertaken in a patient’s local hospital and/or at the two new ambulatory care hospitals at Stobhill and the Victoria. 7
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