NHS Information Environment Policy 02 Performance Management Linda Blenkinsopp October 2008.

NHS Information Environment

Policy 02 Performance Management

Linda BlenkinsoppOctober 2008

Format of the session

• Recap of Key Reforms• Feedback on Patient Choice• Performance Management• The Annual Healthcheck• Scores on the Doors• Group work• Linking Performance and Choice• Choice Indicators• Recap/Next session

Key Reforms

Performance Management

• What is it ?

• Why bother?

• Pulling these together - A working definition

Performance Management Defined

“ Performance management is an organisations systems, processes and culture, aimed at establishing, measuring, monitoring and reporting indicators of service quality and resource usage to ensure effective patient care”

Group WorkIn care sector groups you have 10 minutes to:

• Identify 3 strengths in your organisations performance system

• Identify 3 opportunities for improvement

• Identify 3 benefits of effective performance management

• Appoint spokesperson (different to last week) to feed back

Annual Healthcheck

• Annual Declaration

• New Targets

• Existing Targets

• Improvement Reviews

• Use of Resources

Annual Healthcheck Framework

Core Standards

Existing Targets

New Targets

Use ofResources

Improvement Reviews

Quality Rating

Use of Resources Rating

Assessment ReviewAssessment Review

Annual Declaration• Self Assessment• Core standards - 7 domains, • First Domain - Safety • Second Domain – Clinical and Cost Effectiveness • Third Domain – Governance • Fourth Domain - Patient Focus • Fifth Domain - Accessible and Responsive Care • Sixth Domain - Care Environment and Amenities • Seventh Domain - Public Health

• 24 standards, 400+ prompts• Evidence portfolio• Met, unmet, insufficient assurance• Subject to scrutiny

Existing Targets

• Familiar areas

• Split by care sector

• Composite indicators

• Score 0,2,3

• weak, fair, good, excellent

• 49/54 to be “excellent”

Existing targets - AcuteAll cancers: one month diagnosis (decision to treat) to treatment

All cancers: two month GP urgent referral to treatment

All cancers: two week wait

Cancelled operations and those not admitted within 28 days

Convenience and choice - provider information on nhs.uk and availability of

slots

Delayed transfers of care comparative indicator

Number of inpatients waiting longer than the standard

Number of outpatients waiting longer than the standard

Patients waiting longer than three months for revascularisation

Thrombolysis - 60 minute call to needle time

Total time in A&E: four hours or less

Waiting times for rapid access chest pain clinic

Existing targets – Mental HealthCrisis resolution team implementation

Existing targets – Ambulance

Category A calls meeting 19 minute target

Category A calls meeting eight minute target

Category B calls meeting national 19 minute target

Thrombolysis - 60 minute call to needle time

Existing targets – Primary CareAccess to a GPAccess to a primary care professionalAll cancers: one month diagnosis (decision to treat) to treatmentAll cancers: two month GP urgent referral to treatmentAll cancers: two week waitCategory A calls meeting 19 minute targetCategory A calls meeting eight minute targetCategory B calls meeting national 19 minute targetCommissioning a comprehensive child and adolescent mental health serviceCommissioning of crisis resolution/home treatment servicesConvenience and choice - PCT bookingConvenience and choice - PCT facilities in place to support choiceDelayed transfers of careDiabetic retinopathy screeningNumber of inpatients waiting longer than the standardNumber of outpatients waiting longer than the standardPatients waiting longer than three months for revascularisationPractice based registers - patients called for reviewThrombolysis - 60 minute call to needle timeTotal time in A&E: four hours or less

New Targets• Developmental in nature

• 11 targets

• Composite indicators

• Score 0,2,3 (last year 34 to be “Excellent”)

4 main areas: – Improve health of the population– Support people with long illnesses– Improved access– Improved user experience

Improvement Reviews• Comprehensive review of service

pathways-multiagency/Multidisciplinary

• 4 in 2006/07 - 11 in 2007/08

• Major burden and not included in overall ratings

08/09 include:– Health care in prisons, Managing medicines, IG in

organisations, LD (services and commissioning)

Use of ResourcesNon Foundation trusts• Financial stability, Finance process, Deliver break even,

Value for Money• Risk Management

Foundation Trusts• Monitor determine a risk rating - three components:

finance, governance and mandatory services.• The finance component looks at four criteria:

achievement of plan, underlying performance, financial efficiency, and liquidity.

Overall Rating CalculationOverall

Score

Core

Standards

Existing

Targets

New

Targets

Improvement

Reviews

WEAK Not Met Not met

GOODAt least

Almost Met

At Least

Almost Met

At Least

Good

EXCELLENT Fully Met Fully Met ExcellentNo weak,

2 good or

1 excellent

Fair Any other combination not covered above

Scores on the Doors

• How did your trusts do?

Linking Performance and Choice

Teams of 4 or 5 you have 10 minutes to:

• Identify your top 5 current indicators to support Choice

• Identify 5 New Indicators you would put in place

• Now decide the top 4

• Important considerations about Indicators

• Spokesperson to feed back

Choice Indicators

• Agreeing the top 5

• Which is important

• What does this tell us

• Top 5 for each patient group

Recap/Next Week

• Importance of Performance Management• Annual Healthcheck• Further research www.healthcarecommission.org.uk• Next week PBR – Dr Helen Byworth