The latest edition of Trust Brief - East and North Herts NHS Trust

TrustBriefThis month’snews from theBoardJuly 2013Contents:Page1. Trust’s performance to June 2013 2- operational, clinical and financial performance2. In brief… 4

Trust Brief – July 2013Trust performanceAt its July meeting, which was held onWednesday, 24 July 2013, at the QEII the Boarddiscussed the Trust’s performance againstnational and local standards to the end of June2013 – which represents the first quarter of the2013/14 NHS year.Below is a table setting out the Trust’sperformance against Monitor’s nationalcompliance framework, which mirrors that usedby the Trust Development Authority.Over the next couple of pages, an account of theTrust’s operational, clinical and financialperformance, with tables to illustrate year-to-dateachievement, is provided.Operational performanceHighlights for June’s performance are set outbelow:The Trust delivered all MCF standards inmonth,with the exception of Clostridiumdifficile infections that are ahead of theTrust’s trajectory ceiling for this point in theyear;The four-hour A&E waiting time standardcontinued to be met in June, building on theimproved performance achieved in May;Most of the key contract requirements andlocal priorities agreed with the Trust’scommissioners were met in June 2013. Twoexceptions were percentage admissions to astroke bed on arrival at hospital (76.3%against 90% standard); percentage of strokepatients spending 90% of stay in a specialistunit (73.8% against standard of 80%);The level of delayed transfers of care, i.e.patients waiting to be discharged with thesupport of community/social care services,remains above target – average daily rate of27 patients during June. Work continueswith partners to reduce these levels goingforward, although progress remains slow.Remaining surgical specialties yet to meet18-week referral to treatment times – oralsurgery, trauma and orthopaedics andrestorative dentistry – all have a trajectory toachieve the standard by the Autumn.Clinical performance – patientexperiencePatient experience continues to be an area ofmajor focus for the Trust Board. Some of the keyindicators being monitored include the followingyear-to-date positions:Net promoter for month of June 2013 was76.32 (continues to place the Trust in topquartile of performance for the region);Operational performance standard June 2013 2013/14 ytd18 weeks standard, admitted (≥90.0%)* 92.0% 92.74%18 weeks standard, non-admitted (≥95.0%)* 96.9% 96.71%18 weeks standard – open pathways (≥92.0%)* 95.9% 95.73%A&E four-hour wait (≥95.0%) 96.7% 95.65%Two-week maximum cancer wait, referral to outpatient appointment (≥93%)** 98.2% 98.2%31-day diagnosis to treatment (≥96%)** 97.5% 97.2%31-day second or subsequent treatment (≥94%)** 100% 98.3%62-day urgent GP referral to treatment (≥85%)** 86.5% 86.4%*18-weeks performance are provisional and may change slightly**All cancer-related figures are not yet finalised as the position remains open until six weeks after month-end2

Trust Brief – July 2013Performance on preventing C. difficile andMRSA blood stream infections has beenmixed thus far – still only one avoidableMRSA blood infections against a full-yeartarget of none and seven C. difficile infectionsagainst a year-end target of 14.The Trust continues to perform well inreducing harmful falls and pressure ulcers, aswell as in relation to prescribing errors, neverevents and ensuring that surgical teams usethe WHO check list.More work is needed still to improve MRSAemergency screening, as well as VTE riskassessments.Although mortality indicators are abovelocally agreed rates, they are all showing aconsistent downward trend over the last 12months. It is anticipated that this willcontinue to be the case broadly goingforward.Financial performanceThe Trust delivered a £1.130 million deficit forJune 2013, which was £4,000 better thanplanned for the month. The cumulative year-todateposition was a deficit £2.674 million againsta plan of a £2.375 million deficitWith income ahead of plan in June, the principaldrivers behind the month’s improvedperformance was better management of Trust’spay expenditure and in particular use of agencynursing staff. This was offset, however, bydeterioration in the Trust’s non-pay position.The Trust’s cost improvement programme (CIP)performance in June dipped, with 79% of themonth’s CIPs delivered. This leaves thecumulative year-end position at 86% delivery(£1.959 million) – work is underway to ensurethat CIP performance improves going forward.The Trust continues to forecast that its year-endoutturn position will be a surplus of a £2.1 million.Healthcare quality indicator June 2013 2013/14 ytdVenous thromboembolism (VTE) risk assessment (≥98.0%) 96.61% 97.69%Hospital standardised mortality ration (HSMR) – rolling 12 months average* (≤94) TBC 92.6Summary hospital-level morality indicator (SHMI) – rolling 12 months average** (≤100) TBC 111.39SHMI adjusted for palliative care – rolling 12 months average** (≤95) TBC 102.04National Patient Safety Agency (NPSA) patient safety alerts still to be implemented 0 0MRSA blood infections (0 post 48-hours – deemed as hospital-acquired) 0 1Clostridium difficile hospital-acquired infections (≤14) 4 7MRSA emergency screening (≥95%) 90.45% 91.9%Delayed transfer of care (≤3.5%) 3.01% 3.41%Falls resulting in serious harm (≤24) 1 3Pressure ulcers – grade 2 to 4 (≤8 in month and ≤96 for the year) 6 15‘Never events’ (0) 0 0Serious dispensing drug errors (≤3) 0 0Administering drug errors (≤145) 6 21WHO surgery check list (100%) 100% 100%*Data provided three months in arrears.**Data provided six months in arrears.3

Trust Brief – July 2013In brief… The Board approved the full business casefor the creation of the new £3.0 million ListerMacmillan Cancer Centre, which is beingfunded jointly by the Trust and Macmillan.Work starts on building the new unit in August2013, with the service opening May 2014. Plans were received by the Board as to howthe Trust’s children’s services will cope withadditional patients coming to the Listerfollowing changes being made to paediatricservices at Bedford hospital from 1 August2013. Monday, 22 July 2013 saw many existing andformer staff gather at the QEII to mark thehospital’s 50 th anniversary to the day of itsofficial opening by Her Majesty The Queen.The Vice Lieutenant and former Trustchairman, Richard Beazley, read out a letterof congratulations from Her Majesty; he alsopresented several long serving members ofstaff with awards. The East and North Hertfordshire ClinicalCommissioning Group held a groundbreaking event to mark the official start to thecreation of the New QEII Hospital on Friday,26 July. The guest of honour was WelwynHatfield MP, Grant Shapps.Peter GibsonAssociate director, public affairsEast and North Hertfordshire NHS TrustHospital extension: 5362 (Lister)Direct line: 01438 781522E-mail: peter.gibson@nhs.netCopies of relevant papers discussed by the Board, both current and historic, are available onthe Trust’s website at:https://www.enherts-tr.nhs.uk/about-the-trust/board-meetings/july-2013/4