FINANCE, CONTRACTING, QIPP & PERFORMANCE REPORT - JANUARY 2018.
FINANCE , CONTRACTING & QIPP
Finance
The key points regarding the full year forecast financial position of each CCG based on the
information available on current year activity are:
Airedale, Wharfedale & Craven CCG
i) On the basis that any further financial risk can be appropriately managed, the
CCG is forecasting to meet its financial targets for 2017/18.
ii) The full year forecast overspend has decreased by £255k to £6,368k mainly due
to the confirmation of premises cost charges for void space and the re-
assessment of non-pay administration commitments. Forecast prescribing spend
has also reduced again.
Whilst there has been on overall reduction in the budget overspend, acute
contract spend has increased by a further £353k related to non-contracted
activity.
iii) The forecast overspend is funded by using all uncommitted reserves and there is
a reduced residual financial risk of £683k (last month £939k) that needs to be
managed to ensure delivery of 2017/18 financial targets.
iv) Identification of £3.3m of additional savings to address the underlying recurrent
deficit position that will be taken into 2018/19 remains a priority for the Airedale
Accountable Care Board and Clinical Executive.
v) A significant part of the reserves used to support the financial position in 2017/18
are non-recurrent and as a result, we are currently forecasting that we will take
an underlying deficit of £3.3m into 2018/19.
vi) All new expenditure commitments will continue to require prior approval by the
Clinical Executive.
Bradford Districts CCG
i) The CCG is forecasting to meet its financial targets for 2017/18. This is based on
forecast budget performance which includes a savings programme shortfall of
£5.5m (last month £4.9m).
ii) The forecast net budget overspend has decreased by £0.2m to £7.5m due to the
confirmation of premises cost void space charges and an underspend on the
Virtual Ward budget. These expenditure reductions have more than offset
increases in forecast continuing care and primary care spend.
iii) Potential in year financial risk has been assessed at £7.7m (last month, £7.9m),
with reserves of £9.3m (last month, £9.3m) available to manage this risk. This
leaves a margin of £1.6m for managing any further in year financial risk.
iv) The priority remains to address the savings scheme shortfall of £5.5m, both to
manage in year financial performance and to provide a strong financial base for
2018/19. Programme Boards will need to continue to identify additional savings
schemes and prioritise the implementation of current schemes.
v) New expenditure commitments will continue to require prior approval by the
Clinical Board.
Bradford City CCG
i) The CCG is forecasting to meet its financial targets for 2017/18. This is based on
forecast budget performance which includes an over-performance on the savings
programme of £0.04m (last month £0.4m).
ii) The forecast net budget overspend has decreased by £0.1m to £0.3m with small
increases in forecast continuing care and primary care spend being offset by
reductions in forecast acute and community contract spend. Reserves are still
forecast to fully spend to maintain the forecast break-even position.
iii) Potential in year financial risk has been assessed at £0.3m (last month, £0.4m),
with reserves of £3.3m (last month, £3.8m) available to manage this risk. This
leaves a margin of £3m for managing any further in year financial risk.
iv) Uncommitted reserves are being retained until the financial position on the
Bradford Hospital contract for 2017/18 has been finalised.
Contracting
i) Across acute contracts there is an overall full year forecast over-trade for
Airedale, Wharfedale & Craven CCG of £3.8m. The full year forecast has
increased from the £2.5m previously reported due to increased activity at
Airedale Hospital and the Yorkshire Clinic.
For Bradford Districts CCG, the acute contract position shows a full year forecast
overtrade of £1.6m, which is the same as previously reported. The main contract
overtrades are with Airedale Hospital and the Yorkshire Clinic.
For Bradford City CCG, the acute contract position shows a full year forecast
overtrade of £0.8m, which is £0.2m less than previously reported. The main
overtrades are with Bradford Hospitals and the Yorkshire Clinic.
ii) Following the issue of a Contract Performance notice to Bradford Teaching
Hospitals Foundation Trust on the 6th December 2017 and the subsequent
receipt of a ‘Reporting Action Plan’ from the Trust on the 16th February 2018, the
CCGs are now assured that the Trust will be able to meet the requirements of
the contract regarding quality performance monitoring, except for diagnostic
waiting times and CQUIN Sepsis recording. Plans are in place to address both of
these issues.
Contract activity data submissions (SUS and SLAM) remain an issue.
Submissions can be made by the Trust, but there are significant data quality
issues. The Trust has indicated that August 2018 is the earliest date by which full
activity reporting will resume. The Contract Management Board sub-groups will
continue to monitor the implementation of the activity reporting plan and will
update the Governing Body on progress.
In light of the data quality issues, forecast performance on the Bradford Hospitals
contract is based on the CCGs’ assessment of September activity data, which
has now been re-run to correct the allocation of specialised services activity to
the correct Commissioner. A full year contract position for 2017/18 is now being
finalised with the Trust.
iii) Significant contract activity queries being addressed with our two main acute
Providers include:
- Increased number of orthopaedic outpatient procedures at Airedale Hospital
which AWC CCG views as a coding and counting change and therefore not
chargeable in 2017/18. Discussions are continuing with the Trust on this as
part of agreeing a full year position for 2017/18; and
- A national activity coding issue relating to Sepsis interventions which is
leading to increased activity costs. Guidance on how to calculate the value of
the impact to be neutralised has been issued by NHS Improvement and the
CCGs are working with Bradford Hospitals and Airedale Hospital Trusts to
agree a position for 2017/18.
Following further analysis of activity trends, the previously reported issue
concerning Maternity Pathway activity and the increase in reported birth
complexities at Bradford Hospitals has now been resolved.
iv) Yorkshire Clinic activity continues to be significantly above plan for Airedale,
Wharfedale and Craven CCG due to shift in orthopaedic and general surgery
referrals from Airedale Hospital, and also due to the impact of the EPR
implementation at Bradford Hospitals. To help manage patient activity, the CCGs
have agreed with the Yorkshire Clinic to monitor adherence to agreed clinical
referral pathways and have put in place a clinical working group to address the
levels of follow-up outpatient activity across all specialities.
v) Contract negotiations are well underway with all Providers for 2018/19. At this
stage, we have not highlighted a need to use the national mediation process and
expect all contracts and/or contract variations to be signed by the 23rd March
2018.
CCG PERFORMANCE
Dashboards are included for each CCG (Appendix G) which show performance against the key operational plan performance indicators. Issues to draw to the attention of the Governing Body relate to NHS Constitution targets and these are described below.
a) A&E Waiting times.
- Both Airedale Hospital and Bradford Hospitals failed to achieve the 4 hour target in January, achieving 90.9% and 83% respectively (target, 95%). A number of measures have been put in place to help manage non-elective activity which include: - weekly surge and escalation calls; - Implementation of the 9 point urgent and emergency care plan (monitored by
the A&E Delivery Board); and - progressing the transformation work of the urgent care programme.
- An escalation meeting with NHS England has taken place to discuss BTHFT’s current challenges and actions being taken to address under performance. Following this meeting a further number of actions have been agreed that should translate into better headline performance.
b) Referral to Treatment (RTT) Waiting Times. - Airedale - AHFT continue to deliver the RTT target overall (92.1% in January),
but pressures remain in General Surgery and Trauma & Orthopaedics where options for securing additional capacity are being explored for 2018/19.
- Bradford - Reporting issues continue following the implementation of the new EPR system and therefore the latest CCG scorecard position is not a true reflection of performance. The Trust has made a formal 18 week RTT return for January which shows performance at 79.26% (a deterioration since September). Also, there has been a significant increase in the size of the waiting list for patients waiting both under and over 18 weeks. The Trust is continuing to validate 18 week waiters and reviews the position of patients who have waited over 39 weeks on a weekly basis.
c) Cancer 62 Day Standard. - Airedale Hospital – achieved the 62 day target in December.
- Bradford Hospitals – Has now re-commenced national cancer performance
submissions. The return submitted for December 2017 shows the Trust reporting failures against the 2 week wait (69.8%) and 62 day first treatment (78.3%) targets. For the 2 week wait target, the sites of concern continue to be Skin (8.3%), Lower GI (81%) and Gynaecology (80.2%).
We are continuing to work with the Trust on an action plan to address performance in this area.
d) Diagnostic Waiting Times.
- Airedale - AFT did not achieve the target in January due to the previously
reported demand and service pressures in Ultrasound. Additional evening and weekend sessions are being run to meet the demand pressures.
- Bradford - BTHFT did not achieve the target in January with most of the
breaches relating to Non-Obstetric Ultrasound for a specialised Rheumatology led test.
Reported waiting times performance continues to exclude endoscopy and neurophysiology.
e) Mixed Sex Accommodation.
There was one breach in December for AWC CCG which was at Wrightington Hospital and early indication is that following the considerable operational pressures at AHFT, there were two breaches of the Mixed Sex Accommodation standard in January. This standard is exempt from contractual penalties during the winter period, as notified by NHS England and NHS Improvement.
f) Improving Access to psychological therapies (IAPT).
IAPT waiting times continue to be delivered across the three CCG areas and access continues to be near to the new 2017/18 target of 16.8% (although the contractual performance level is 15%). Recovery rates in Bradford City CCG (41%) and Bradford Districts CCG (47.7%) are below the target rate of 50%, but through work carried out by the Community Mental Health Team and the My Wellbeing College at Bradford District Care Trust to improve triage and assessment processes, local data is now indicating recovery rates above 50% for all CCGs.
g) Better Care Fund.
The national BCF data for Q2 has been published as part of the NHS-Social Care Interface Dashboard (see Appendix 3). Key points to note are:
At the time of initial publication, Bradford was ranked 2nd nationally for performance against the new BCF composite measure. This position has slipped to 5th at Q2;
Delayed discharges remain low with Bradford ranked 9th out of 150 local authorities nationally (previously 7th);
Bradford is ranked 4th nationally and 1 of 16 compared with statistical neighbours for the new non-elective admissions - weekend discharges;
Bradford is also ranked 4th nationally and 1 of 16 compared with statistical neighbours for the non-elective admissions - length of stay;
However, emergency admissions continue to be a challenge across the district, with a ranking at Q2 of 99 out of 150 local authorities. The district wide Urgent Care Programme, overseen by the A&E Delivery Board, continues to work on system wide solutions including: A&E GP streaming and ambulatory care pathways. Work also continues across the CCGs on pathways and new models of care in the community setting, to see improved outcomes for patients and reduced non-elective demand on acute services. In addition, plans for extended weekday opening and training and development of the primary care workforce are in place.
SYSTEM PERFORMANCE
The Accountable Care Dashboards are presented as Appendix J. Issues to draw to the
attention of the Governing Body are:
There is still some work required to map all the KPIs across the accountable care
programmes;
Work is also underway to further develop the dashboards to reflect accountable care
communities;
As the current KPIs become sustainable, it is envisaged that they will evolve and
change to reflect KPIs which better reflect outcomes associated with new models of
care and accountable care systems.
RECOMMENDATIONS The Governing Body is asked to: Airedale, Wharfedale & Craven CCG
a) Note the year to date and full year forecast financial position as at Month 10;
b) Note that there is a residual financial risk of £683k that needs to be managed to
ensure achievement of 2017/18 financial targets;
c) Note the level of non-recurrent savings supporting the financial position in 2017/18
and the impact on the CCG’s underlying recurrent financial position;
d) Note the continued need to identify further savings of £3.3m to address the non-
recurrent savings used to support the 2017/18 financial position and to establish a
sound financial baseline for 2018/19;
e) Note the issues in relation to acute contract performance and the action being taken
to manage them;
f) Note the performance against waiting times targets and the action being taken to
improve performance where required; and
g) Note the good performance against the Better Care Fund metrics, whilst
acknowledging the work that is being done to manage non-elective activity.
Bradford Districts CCG
a) Note the year to date and full year forecast financial position as at Month 10;
b) Note the assessment of financial risk and the actions being taken to manage this
risk;
c) Note that the CCG is now assured that Bradford Hospitals will now be able to meet
the contract requirements for quality performance monitoring, except for diagnostic
waiting times and CQUIN Sepsis recording issues (plans in place to resolve these
issues).
d) Note that contract activity data submissions for Bradford Hospitals are not expected
to be resolved in full until August 2018 and that progress with this will continue to be
overseen by the Contract Management Board;
e) Note the performance against waiting times targets and the action being taken to
improve performance; and
f) Note the good performance against the Better Care Fund metrics, whilst
acknowledging the work that is being done to manage non-elective activity.
Bradford City CCG
a) Note the year to date and full year forecast financial position as at Month 10;
b) Note the continued retention of all uncommitted reserves to manage financial risk;
c) Note that the CCG is now assured that Bradford Hospitals will now be able to meet
the contract requirements for quality performance monitoring, except for diagnostic
waiting times and CQUIN Sepsis recording issues (plans in place to resolve these
issues).
d) Note that contract activity data submissions for Bradford Hospitals are not expected
to be resolved in full until August 2018 and that progress with this will continue to be
overseen by the Contract Management Board;
e) Note the performance against waiting times targets and the action being taken to
improve performance; and
f) Note the good performance against the Better Care Fund metrics, whilst
acknowledging the work that is being done to manage non-elective activity.
APPENDICES
Summarised Financial Performance:
Appendix A Airedale, Wharfedale & Craven CCG
Appendix B Bradford Districts CCG
Appendix C Bradford City CCG
Savings Scheme (QIPP) Dashboard
Appendix D Airedale, Wharfedale & Craven CCG
Appendix E Bradford Districts CCG
Appendix F Bradford City CCG
Performance Dashboard
Appendix G Airedale, Wharfedale & Craven CCG
Appendix H Bradford Districts CCG
Appendix I Bradford City CCG
Appendix J ACO Bradford draft system dashboard
Appendix A
Summary Financial Performance for the period to 31st January2018
Full Year
Forecast
AWC CCGAnnual
Budget
YTD
Budget
(Under) /
Over
(Under) /
Over
(Under) /
OverMvt
£'000 £'000 £'000 £'000 £'000 £'000
Acute Care 112,241 93,533 3,271 3,801 3,448 353
Urgent Care 7,457 6,213 -23 -6 -3 -3
Community Services 16,042 13,371 111 146 196 -50
Continuing Healthcare 9,192 7,620 693 1,113 963 4
Mental Health Services 18,072 15,059 24 76 97 -21
Prescribing 27,277 22,854 651 370 550 -180
Primary Medical Care 20,399 16,998 49 167 56 111
Other Primary Care 553 461 0 0 0 0
Non-Recurrent Programme 1,083 880 -10 -24 -24 0
Other Commissioning 6,366 5,095 447 -13 391 -152
QIPP Savings Balance -1,102 0 0 1,102 1,102 0
Residual Financial Risk to Manage 0 0 -450 -683 -939 402
Total Operating Costs 217,580 182,084 4,763 6,049 5,837 464
Contingency Reserves 1,145 1,145 -1,145 -1,145 -1,145 0
Non-Recurrent Reserve (1%) 1,266 857 0 -130 -130 0
Other Reserves 4,591 3,515 -3,499 -4,410 -4,409 -278
Total Reserves 7,002 5,517 -4,644 -5,685 -5,684 -278
Total Healthcare Expenditure 224,582 187,601 119 364 153 186
CCG Running Costs 3,415 2,848 -185 -364 -153 -186
Target In Year Surplus 1,857 1,548 -1,548 -1,857 -1,857 0
Total Expenditure 229,854 191,997 -1,614 -1,857 -1,857 0
Last Month Full Year
ForecastYear to Date
OPERATING WITHIN: IN YEAR ALLOCATION
RUNNING COST ALLOCATION
CASH LIMIT
ACHIEVING : PLANNED SURPLUS
QIPP 90.86%
UNDERLYING POSITIONRECURRENT SURPLUS -1.44%
Y
Y
Y
N
N
Y
Appendix B
Summary Financial Performance for the period to 31st January 2018
Full Year
Forecast
Bradford Districts CCGAnnual
Budget
YTD
Budget
(Under) /
Over
(Under) /
Over
(Under) /
OverMvt
£'000 £'000 £'000 £'000 £'000 £'000
Acute Care 230,819 192,420 615 1,612 1,630 -18
Urgent Care 17,294 14,342 -268 -280 -278 -2
Community Services 37,520 31,273 -266 -277 53 -330
Continuing Healthcare 25,041 20,727 1,388 814 596 218
Mental Health Services 45,595 37,996 261 256 264 -8
Prescribing 52,968 44,378 1,849 1,807 1,901 -94
Primary Medical Care 49,031 40,857 -775 -593 -723 130
Other Primary Care 1,168 971 0 0 0 0
Non-Recurrent Programme 1,022 806 6 13 3 10
Other Commissioning 16,236 13,223 207 -114 85 -199
QIPP Savings Balance -4,291 0 0 4,291 4,291 0
Residual Financial Risk to Manage 0 0 0 0 0 0
Total Operating Costs 472,403 396,993 3,017 7,529 7,822 -293
Contingency Reserves 2,490 943 -943 -639 -862 223
Non-Recurrent Reserve (1%) 4,041 3,367 -1,322 -1,586 -1,586 0
Other Reserves 6,449 1,735 -681 -5,248 -5,248 0
Total Reserves 12,980 6,045 -2,946 -7,473 -7,696 223
Total Healthcare Expenditure 485,383 403,038 71 56 126 -70
CCG Running Costs 6,586 5,487 -295 -56 -126 70
Target In Year Surplus 3 0 0 -3 -3 0
Total Expenditure 491,972 408,525 -224 -3 -3 0
Last Month Full Year
ForecastYear to Date
FINANCIAL PERFORMANCE TARGETS - FULL YEAR FORECAST
OPERATING WITHIN: IN YEAR ALLOCATION
RUNNING COST ALLOCATION
CASH LIMIT
ACHIEVING: PLANNED SURPLUS
QIPP 58.73%
UNDERLYING POSITION RECURRENT SURPLUS 0.13%
Y
Y
N
Y
Y
Y
Appendix C
Summary Financial Performance for the period to 31st January 2018
Full Year
Forecast
Bradford City CCGAnnual
Budget
YTD
Budget
(Under) /
Over
(Under) /
Over
(Under) /
OverMvt
£'000 £'000 £'000 £'000 £'000 £'000
Acute Care 66,277 55,198 1,283 781 882 -101
Urgent Care 5,893 4,889 -92 -94 -97 3
Community Services 11,414 9,515 -56 -60 62 -122
Continuing Healthcare 7,623 6,308 420 252 184 68
Mental Health Services 13,413 11,183 169 150 139 11
Prescribing 18,675 15,647 22 -48 11 -59
Primary Medical Care 20,844 17,368 -661 -659 -759 100
Other Primary Care 425 358 0 0 0 0
Non-Recurrent Programme 1,233 596 -24 -23 -33 10
Other Commissioning 5,297 4,316 -489 -254 -182 -72
QIPP Savings Balance -230 0 0 230 230 0
Residual Financial Risk to Manage 0 0 0 0 0 0
Total Operating Costs 150,864 125,378 572 275 437 -162
Contingency Reserves 1,578 800 -800 0 0 0
Non-Recurrent Reserve (1%) 1,208 634 0 0 0 0
Other Reserves 1,444 53 1 -224 -370 146
Total Reserves 4,230 1,487 -799 -224 -370 146
Total Healthcare Expenditure 155,094 126,865 -227 51 67 -16
CCG Running Costs 2,404 2,003 -139 -51 -67 16
Target In Year Surplus 0 0 0 0 0 0
Total Expenditure 157,498 128,868 -366 0 0 0
Last Month Full Year
ForecastYear to Date
FINANCIAL PERFORMANCE TARGETS - FULL YEAR FORECAST
OPERATING WITHIN: IN YEAR ALLOCATION
RUNNING COST ALLOCATION
CASH LIMIT
ACHIEVING: PLANNED SURPLUS
QIPP 101.22%
UNDERLYING POSITION RECURRENT SURPLUS 0.68%
Y
Y
Y
Y
Y
Y
Appendix D - Airedale Wharfedale & Craven CCG
Appendix E – Bradford Districts CCG
Bradford District CCG - QIPP Dashboard Financial Year 2017/1812 RAG Rating Key
Reporting Month -January 18 FOT savings achieve or exceed plan
QIPP Target £13,392 FOT savings but less than plan
QIPP Forecast Achievement £7,681 No savings achieved
QIPP shortfall -5,711 4
Previous Month -4,913
Improvement/decline -£798
Revised
plan value -
£000
Forecast
Achivement
full year -
£000
Full year
variance to
plan - £000
Year to date
Plan - £000
Previous
YTD Savings
In month
savings
Year to date
acheivement -
£000
YTD variance -
£000
Movement
on previous
month
Scheme Name/Programme Programme Board Scheme lead
Cash Releasing Schemes
Out of Hospital Out of Hospital Walter O'Neill 113 - 113- 66 - - - 66- -
Urgent care & Emergency Urgent Care Louise Atherton 578 246 332- 337 381 -265 116 221- 337-
Diabetes Kath Helliwell - - - - - - - -
Bradford Healthy Hearts Kath Helliwell 64 - 64- 37 - - - 37- -
Self care and Prevention Self Care Collette Connelly - - - - - - - - -
Planned Care Planned Care Ian Wallace 2,107 383 1,724- 868 212 -147 65 803- 452-
Planned Care - Tariff Impact on Follow Ups Planned Care Ian Wallace 1,126 2,983 1,857 500 1,393 407 1,801 1,301 190
Cancer Ian Wallace - - - - - - - - -
Bradford breathing better Kath Helliwell 337 - 337- 196 - - - 196- -
Primary Care (OOH) Out of Hospital Vicki Wallace 542 - 542- 127 - - - 127- -
Prescribing prescribing Tracey Gaston 3,974 3,179 795- 2,318 2,772 -46 2,726 408 199-
Children Ruth Hayward - - - - - - - - -
Mental Health Mental Health Sasha Bhat 33 - 33- 19 - - - 19- -
Learning Disabilities mental Health Mairead O'Donnell - - - - - - - - -
Estates and Facilities Other Robert Madden - - - - - - - - -
IT Other Simon Wilson - - - - - - - - -
Continuining Health Other - - - - - - - - -
Commissioning Support Savings Other Julie Lawreniuk 259 259 - 151 194 22 216 65 -
Primary Care Other Diane Lawlor - 307 307 - 281 9 290 290 -
Out of Area schemes Mental Health Kris Farnell - 323 323 - 203 40 243 243 -
Unidentified QIPP 4,259 - 4,259- 2,484 - - - 2,484- -
Non Cash Releasing Schemes
Total Expected QIPP 13,392 7,681 5,711- 7,103 5,436 20 5,456 1,647-
RAG
Rating
Appendix F – Bradford City CCG
Bradford City CCG - QIPP Dashboard Financial Year 2017/1812 RAG Rating Key 3
Reporting Month -January 18 FOT savings achieve or exceed plan
QIPP Target £3,519 FOT savings but less than plan
QIPP Forecast Achievement £3,512 No savings achieved
QIPP shortfall -7
Movement from previous Month 410
Improvement/decline -£417
Revised
plan value -
£000
Forecast
Achivement
full year -
£000
Full year
variance to
plan - £000
Year to date
Plan - £000
Previous
YTD Savings
In month
savings
Year to date
acheivement -
£000
YTD variance -
£000
Movement
on previous
month
Scheme Name/Programme Programme Board Scheme lead
Cash Releasing Schemes
Out of Hospital Out of Hospital Walter O'Neill 23 - 23- 13 - - - 13- -
Urgent care & Emergency Urgent Care Louise Atherton 214 222 8 125 255 -151 104 21- 234-
Diabetes Kath Helliwell - - - - - - - - -
Bradford Healthy Hearts Kath Helliwell 21 - 21- - - - - - -
Self care and Prevention Self Care Collette Connelly - - - - - - - - -
Planned Care Planned Care Ian Wallace 587 324 263- 178 157 -51 106 72- 129-
Planned Care - Tariff Impact on Follow Ups Planned Care Ian Wallace 320 662 342 - 24 348 372 372 4
Cancer Ian Wallace - - - - - - - -
Bradford Breathing Better Kath Helliwell 77 - 77- 45 - - - 45- -
Primary Care (OOH) Out of Hospital Vicki Wallace 341 - 341- 199 - - - 199- -
Prescribing prescribing Tracey Gaston 1,468 1,987 519 856 1,392 313 1,705 849 57-
Children Ruth Hayward - - - - - - - -
Mental Health Mental Health Sasha Bhat 17 - 17- 10 - - - 10- -
Learning Disabilities mental Health Mairead O'Donnell - - - - - - - -
Estates and Facilities Other Robert Madden - - - - - - - -
IT Other Simon Wilson - - - - - - - - -
Continuining Health Other - - - - - - - -
Commissioning Support Savings Other Julie Lawreniuk 218 218 - 127 164 18 182 55 -
Out of Area schemes Mental Health Kris Farnell 100 100 - 63 12 75 75 -
-
Unidentified QIPP 233 - 233- 117 - - 117- -
-
Non Cash Releasing Schemes
Total Expected QIPP 3,519 3,512 7- 1,670 2,055 489 2,544 874
RAG
Rating
Appendix G
NHS Airedale, Wharfedale And Craven CCG Number of Providers w ithin DCO 31
Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17
<87% 91.7% 92.0% 91.6% 91.9% 91.7% 92.0% 92.3% 92.0% 91.4% 92.1% 93.0% 92.9% 92.6%
87% to 92% 92.5% 92.8% 92.2% 92.7% #N/A #N/A #N/A
>=92% Rank 9/23 9/23 8/23 8/23 7/23 7/23 7/23 61/207 44/207 35/207
>10
1 to 10
0 Rank 1/23 1/23 1/23 1/23 1/23 1/23 15/23 20/207 53/207
Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17
<6% 0.3% 0.5% 0.3% 1.0% 2.0% 2.9% 3.9% 4.4% 1.4% 0.7% 0.9% 1.0% 4.8%
1% to 6% 0.2% 0.3% 0.3% 0.2% 0.0% 0.2% #N/A
>=1% Rank 5/23 6/23 4/23 10/23 10/23 16/23 19/23 59/207 113/207 193/207
Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17
<88% 98.0% 96.7% 97.8% 97.7% 97.1% 95.2% 95.0% 92.3% 89.2% 96.4% 95.6% 79.1% 75.0%
88% to 93% 97.7% 96.7% 97.8% 96.9% #N/A #N/A #N/A
>=93% Rank 4/23 6/23 3/23 3/23 13/23 9/23 54/207 203/207 207/207
<88% 100.0% 98.8% 98.1% 93.5% 100.0% 100.0% 100.0% 97.9% 93.3% 100.0% 96.3% 95.2% 96.4%
88% to 93% 97.8% 95.1% 98.3% 98.8% #N/A #N/A #N/A
>=93% Rank #N/A 9/23 18/23 #N/A #N/A 1/23 5/207 134/207 96/207
<91% 100.0% 100.0% 100.0% 98.9% 98.4% 100.0% 98.8% 100.0% 100.0% 98.5% 100.0% 96.8% 96.9%
91% to 96% 100.0% 97.6% 100.0% 100.0% #N/A #N/A #N/A
>=96% Rank 1/23 1/23 7/23 9/23 1/23 9/23 74/207 148/207 156/207
<89% 100.0% 100.0% 100.0% 94.3% 100.0% 100.0% 93.8% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0%
89% to 94% 100.0% 100.0% 100.0% 96.9% #N/A #N/A #N/A
>=94% Rank 1/23 1/23 15/23 1/23 1/23 18/23 18/207 23/207 26/207
<93% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0%
93% to 98% 100.0% 100.0% 100.0% 100.0% #N/A #N/A #N/A
>=98% Rank 1/23 1/23 1/23 1/23 1/23 1/23 29/207 32/207 34/207
<89% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0%
89% to 94% 100.0% 100.0% 100.0% 100.0% #N/A #N/A #N/A
>=94% Rank 1/23 1/23 1/23 1/23 1/23 1/23 22/207 28/207 #31/207
<80% 93.9% 80.9% 83.3% 89.7% 90.9% 83.3% 88.5% 77.8% 94.1% 85.7% 86.7% 83.0% 75.6%
80% to 85% 93.0% 87.8% 89.2% 92.3% #N/A #N/A #N/A
>=85% Rank 1/23 9/23 4/23 2/23 9/23 3/23 63/207 99/207 185/207
<85% 92.3% 100.0% 0.0% 75.0% #N/A 100.0% 100.0% 100.0% 88.9% 75.0% 100.0% 100.0% 100.0%
85% to 90% 100.0% 100.0% 100.0% 100.0% #N/A #N/A #N/A
>=90% Rank #N/A #N/A 19/23 1/23 1/23 165/207 17/207 20/207
NA 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 66.7% 100.0% 80.0% 100.0% 100.0% 80.0% 66.7%
66.7% 66.7% 66.7% 66.7% #N/A #N/A #N/A
Rank #N/A #N/A #N/A #N/A #N/A #N/A 10/207 146/207 176/207
Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17
>10
1 to 10
0 Rank 1/23 1/23 1/23 1/23 1/23 1/23 1/23 14/207 83/207
14-15 Q3 14-15 Q4 15-16 Q1 15-16 Q2 15-16 Q3 15-16 Q4 16-17 Q1 16-17 Q2 16-17 Q3 16-17 Q4 17-18 Q1 17-18 Q2 17-18 Q3
<90%
90% to 95%
>=95% Rank 11/23 23/23 19/23 12/23 7/23 8/23 1/23 10/23 1/23 1/23 1/23 6/207 81/207
Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17 Jan-18
<62% 73.4% 73.5% 73.7% 78.7% 78.5% 78.2% 78.2% 78.0% 78.4% 77.5% 78.6% 78.2% 77.5%
62% to 67% 75.0% 75.0% 75.0%
>=67% Rank 11/23 11/23 11/23 7/23 7/23 7/23 - - - 30/207 28/207
98.2% 96.1% 96.8% 96.4% 98.0% 98.1% 100.0%
Mental Health
Mixed Sex Accommodation
Breaches of Mixed-Sex Accommodation
Maximum 62-day wait from referral from an NHS screening service
to first definitive treatment for all cancers
0 0 0
RTT
Patients on incomplete non-emergency pathways (yet to start
treatment) waiting no more than 18 weeks from referral
0 0 0
Maximum 62-day wait from urgent GP referral to first definitive
treatment for cancer
Commissioner data with CCG plans in grey. CCGs are ranked out of 23 Yorkshire & Humber CCGs until Jun 17 and then out of 207 CCGs nationally
100 0
Number of patients waiting more that 52 weeks on incomplete
pathways
1 0 10 1 1 1 10 0
Diagnostic
Maximum two-week wait for first outpatient appointment for
patients referred urgently with breast symptoms (where cancer was
not initially suspected)
Maximum 31-day wait from diagnosis to first definitive treatment
for all cancers
Maximum 31-day wait for subsequent treatment where that
treatment is surgery
Maximum 31-day wait for subsequent treatment where the
treatment is an anti-cancer drug regimen
Maximum 31-day wait for subsequent treatment where the
treatment is a course of radiotherapy
Percentage of patients waiting 6 weeks or more for a diagnostic
test (15 key tests)
Cancer Monthly
Maximum two-week wait for first outpatient appointment for
patients referred urgently with suspected cancer by a GP
Dementia
Dementia diagnosis rate
Care Programme Approach (CPA): Percentage of people under
adult mental illness specialities on CPA who were followed up
within 7 days of discharge from psychiatric inpatient care during
the period
Maximum 62-day wait for first definitive treatment following a
consultants decision to upgrade the priority of the patients (all
cancers)
0 0 0 0 0 0
97.9% 100.0% 100.0% 100.0% 100.0% 97.6%
Oct-16 Nov-16 Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17
<70%
70% to 75%
>=75% Rank 9/23 1/23 1/23 7/23 7/23 5/22 8/23
<90%
90% to 95%
>=95% Rank 1/23 1/23 1/23 1/23 20/23 1/22 1/23
Oct-16 Nov-16 Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17
<3.75% 4.3% 4.4% 4.7% 4.8% 4.4% 4.2% 4.0% 4.6% 4.6% 4.6% 4.1% 3.8% 3.8%
3.8% 3.8% 3.8% 3.8% 3.8% 3.8% 4.2% 4.2% 4.2%
>=4.20% Rank 6/23 6/23 4/23 3/23 2/23 8/23 11/23
<45%
45% to 50%
>=50% Rank 2/23 3/23 3/23 2/23 1/23 1/23 2/23
Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17 Jan-18
<45%
45% to 50%
>=50% Rank 20/23 17/23 21/23 13/23 18/23 15/23 144/207 133/207
Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17
>0 0 0 0 0 0 0 0 0 0 0 0 0 0
Rank 1/23 1/23 1/23 1/23 1/23 1/23 1/23 19/207 34/207 30/207
>Ceiling 5 4 3 1 7 2 1 2 0 2 2 0 3
<=Ceiling Rank 13/23 11/23 5/23 1/23 15/23 6/23 1/23
Ceiling 3 3 3 3 3 3 3 22/207 202/207 122/207
Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17
<70%
70% to 75%
>=75%
NA 77.6% 66.0% 83.9% 78.6% 81.1% 78.0% 80.7% 67.6%
NA NA NA NA NA NA NA NA
NA 65.1% 64.9% 69.0% 70.3% 68.5% 70.8% 68.3% 67.6%
NA NA NA NA NA NA NA NA
69.2%
100.0% 100.0% 100.0% 100.0%
97.1% 100.0% 100.0% 96.8% 96.4% 96.7%
55.6% 54.6% 55.1% 56.5% 61.4% 61.2%
70.6%
IAPT Monthly
IAPT 6 Weeks First Treatment
IAPT 18 Weeks First Treatment100.0% 100.0% 100.0% 100.0% 96.4% 100.0% 100.0% 100.0% 100.0%
95.5% 100.0% 100.0% 96.6% 91.7% 100.0% 96.6%
IAPT (Rolling 3 month)
IAPT Access (rolling 3 months)
IAPT Recovery rate (rolling 3 months)
Safe Environment and Protecting from Avoidable Harm
Early Intervention Psychosis - 2 Week Waits (rolling quarter )
Early intervention in psychosis - 2 week wait (Rolling quarter)61.1% 71.4% 57.9% 75.0% 63.2% 70.6% 66.7% 63.6% 65.0% 55.6% 66.7%
66.4% 61.2% 67.6% 59.8% 60.0% 70.3% 67.7% 60.2%
60.0% 58.7% 59.4% 59.7% 59.7% 54.4% 50.0%
** YAS have been participating in a pilot which has involved new call categories. The initial pilot ran from 21st April 2016 until 19th October 2016 and the second phase began on 20th October 2016. Due to the changes in categories direct comparison between the different phases cannot
be done because they don't necessarily represent the same activity. Currently no performance target has been set for the 2R and 2T categories.
Ambulance Calls (Pilot Phase 2.2) **
Category 1 - Response within 8mins
Category 2R - Response within 19mins by a resource.
Category 2T - Response within 19mins by DCA unless RRV arrives
and DCA is not required
Incidence of healthcare associated infection (HCAI) ii) C.difficile
Incidence of healthcare associated infection (HCAI) i) MRSA -
Cases which have been assigned to the CCG following a Post
Infection Review
Appendix H
NHS Bradford Districts CCG Number of Providers w ithin DCO 31
Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17
<87% 90.0% 89.4% 89.7% 90.0% 89.3% 90.2% 89.7% 89.5% 87.3% 92.8% 93.0% 93.2% 92.8%
87% to 92% 94.1% 94.1% 94.1% 94.1% #N/A #N/A #N/A
>=92% Rank 16/23 16/23 15/23 15/23 16/23 15/23 15/23 38/207 38/207 28/207
>10
1 to 10
0 Rank 1/23 1/23 1/23 1/23 1/23 13/23 1/23 1/23 23/207 24/207
Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17
<6% 0.5% 1.2% 0.6% 1.4% 2.4% 3.1% 3.5% 3.3% 4.0% 1.3% 1.1% 1.3% 2.3%
1% to 6% 0.4% 0.4% 0.4% 0.4% 0.4% 0.4% #N/A
>=1% Rank 9/23 12/23 9/23 13/23 13/23 18/23 17/23 121/207 131/207 163/207
Jan-17 Feb-17 Dec-16 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17
<88% 96.8% 96.8% 96.8% 96.4% 93.8% 94.8% 94.2% 94.2% 91.8% 98.5% 97.3% 71.6% 76.0%
88% to 93% 95.6% 95.6% 95.6% 95.6% #N/A #N/A #N/A
>=93% Rank 2/23 11/23 12/23 12/23 14/23 14/23 8/207 206/207 206/207
<88% 94.7% 94.7% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 91.7% 92.3% 91.7%
88% to 93% 96.6% 96.6% 96.6% 96.6% #N/A #N/A #N/A
>=93% Rank #N/A 1/23 1/23 #N/A #N/A 1/23 7/207 177/207 170/207
<91% 99.1% 99.1% 96.6% 98.4% 99.1% 99.3% 99.2% 97.0% 100.0% 98.1% 90.3% 97.6% 100.0%
91% to 96% 98.5% 98.5% 98.5% 98.5% #N/A #N/A #N/A
>=96% Rank 4/23 19/23 9/23 5/23 5/23 3/23 93/207 107/207 10/207
<89% 91.7% 91.7% 94.9% 93.5% 96.4% 97.0% 100.0% 100.0% 100.0% 100.0% 100.0% 92.9% 91.3%
89% to 94% 100.0% 100.0% 100.0% 100.0% #N/A #N/A #N/A
>=94% Rank 15/23 16/23 18/23 14/23 15/23 1/23 21/207 159/207 162/207
<93% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0%
93% to 98% 100.0% 100.0% 100.0% 100.0% #N/A #N/A #N/A
>=98% Rank 1/23 1/23 1/23 1/23 1/23 1/23 32/207 35/207 37/207
<89% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0%
89% to 94% 97.4% 97.4% 100.0% 100.0% #N/A #N/A #N/A
>=94% Rank 1/23 1/23 1/23 1/23 1/23 1/23 24/207 31/207 33/207
<80% 79.4% 79.4% 78.1% 91.5% 78.9% 82.8% 77.8% 79.1% 83.3% 84.4% 41.7% 72.4% 81.3%
80% to 85% 86.1% 86.1% 85.1% 85.1% #N/A #N/A #N/A
>=85% Rank 16/23 16/23 2/23 14/23 11/23 19/23 85/207 191/207 142/207
<85% 100.0% 100.0% 71.4% 93.8% 93.3% 100.0% 100.0% 100.0% 100.0% 100.0% 81.0% 100.0%
85% to 90% 100.0% 100.0% 100.0% #N/A #N/A #N/A
>=90% Rank 1/23 #N/A 13/23 #N/A 1/23 1/23 29/207 164/207 22/207
NA #N/A 100.0% 100.0% 50.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 0.0% 75.0% 100.0%
100.0% 100.0% 100.0% 100.0% #N/A #N/A #N/A
Rank #N/A #N/A #N/A #N/A #N/A #N/A 183/207 162/207 12/207
Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17
>10
1 to 10
0 Rank 21/23 1/23 1/23 1/23 1/23 1/23 17/207 17/207
14-15 Q3 14-15 Q4 15-16 Q1 15-16 Q2 15-16 Q3 15-16 Q4 16-17 Q1 16-17 Q2 16-17 Q3 16-17 Q4 17-18 Q1 17-18 Q2 17-18 Q3
<90%
90% to 95%
>=95% Rank 9/23 1/23 14/23 4/23 6/23 21/23 20/23 8/23 14/23 10/23 1/23 105/207 95/207
Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17 Jan-18
<62% 81.4% 81.3% 81.5% 81.6% 82.0% 81.9% 82.0% 82.1% 82.4% 83.0% 83.5% 82.9% 82.3%
62% to 67% 75.0% 75.0% 75.0%
>=67% Rank 4/23 4/23 4/23 1/23 1/23 1/23 13/207 14/207
0 0 0
98.8% 100.0% 97.1% 98.0%98.3% 100.0% 98.0% 99.1% 98.9% 93.7% 96.0% 98.3% 97.0%
Dementia diagnosis rate
Mental HealthCare Programme Approach (CPA): Percentage of people under
adult mental illness specialities on CPA who were followed up
within 7 days of discharge from psychiatric inpatient care during
the period
Breaches of Mixed-Sex Accommodation0 0 0 0 0 0 2 0 0 0
Mixed Sex Accommodation
Maximum 62-day wait for first definitive treatment following a
consultants decision to upgrade the priority of the patients (all
cancers)
Diagnostic
Percentage of patients waiting 6 weeks or more for a diagnostic
test (15 key tests)
Number of patients waiting more that 52 weeks on incomplete
pathways
Dementia
Maximum 31-day wait for subsequent treatment where the
treatment is an anti-cancer drug regimen
Commissioner data with CCG plans in grey. CCGs are ranked out of 23 Yorkshire & Humber CCGs until Jun 17 and then out of 2017 CCGs nationally
Maximum 62-day wait from urgent GP referral to first definitive
treatment for cancer
Maximum 62-day wait from referral from an NHS screening service
to first definitive treatment for all cancers
Maximum 31-day wait from diagnosis to first definitive treatment
for all cancers
Maximum 31-day wait for subsequent treatment where the
treatment is a course of radiotherapy
0 0
Patients on incomplete non-emergency pathways (yet to start
treatment) waiting no more than 18 weeks from referral
0 0 0 0
Maximum 31-day wait for subsequent treatment where that
treatment is surgery
RTT
Cancer Monthly
Maximum two-week wait for first outpatient appointment for
patients referred urgently with suspected cancer by a GP
Maximum two-week wait for first outpatient appointment for
patients referred urgently with breast symptoms (where cancer was
not initially suspected)
0 1 0 0 0 00
Oct-16 Nov-16 Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17
<70%
70% to 75%
>=75% Rank 16/23 13/23 15/23 14/23 #N/A 7/22 9/23
<90%
90% to 95%
>=95% Rank 1/23 18/23 19/23 17/23 16/23
Oct-16 Nov-16 Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17
<3.75% 3.7% 3.7% 3.9% 3.8% 3.9% 3.9% 3.8% 4.1% 4.0% 3.9% 3.6% 3.5% 4.0%
3.8% 3.8% 3.8% 3.8% 3.8% 4.2% 4.2% 4.2% 4.2%
>=4.20% Rank 12/23 13/23 11/23 14/23 12/23 13/23 14/23
<45%
45% to 50%
>=50% Rank 16/23 13/23 10/23 10/23 9/23 11/23 11/23
Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17 Jan-18
<45%
45% to 50%
>=50% Rank 18/23 15/23 13/23 9/23 11/23 11/23 138/207 121/207
Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17
>0 1 0 0 1 1 1 0 0 1 0 0 0 0
Rank 22/23 1/23 1/23 22/23 21/23 18/23 19/23 199/207 33/207
>Ceiling 6 9 6 7 4 6 8 7 1 3 4 5 4
<=Ceiling Rank 16/23 19/23 18/23 18/23 10/23 19/23 19/23
Ceiling 9 9 9 11 7 14 8 105/207 91/207
Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17
<70%
70% to 75%
>=75%
NA 89.4% 82.8% 81.3% 89.7% 82.5% 86.8% 83.9% 83.9%
NA NA NA NA NA NA
NA 80.3% 77.6% 78.3% 83.4% 81.8% 79.2% 73.8% 69.4%
NA NA NA NA NA NA
70.0% 74.1% 61.4%
70.0% 71.7% 64.9% 67.6% 74.4% 70.8% 77.2% 71.0%
79.5% 80.4% 71.7%
100.0% 100.0% 100.0% 97.9%
51.6% 52.1% 56.0% 54.2% 51.1%
90.7% 92.9% 93.0% 91.1% 94.6% 93.9% 94.6%
Category 2T - Response within 19mins by DCA unless RRV arrives
and DCA is not required
** YAS have been participating in a pilot which has involved new call categories. The initial pilot ran from 21st April 2016 until 19th October 2016 and the second phase began on 20th October 2016. Due to the changes in categories direct comparison between the different phases cannot
be done because they don't necessarily represent the same activity. Currently no performance target has been set for the 2R and 2T categories.
Ambulance Calls (Pilot Phase 2.2) **
Category 1 - Response within 8mins
Category 2R - Response within 19mins by a resource.
Safe Environment and Protecting from Avoidable Harm
IAPT Recovery rate (rolling 3 months)
Incidence of healthcare associated infection (HCAI) i) MRSA -
Cases which have been assigned to the CCG following a Post
Infection Review
Early Intervention Psychosis - 2 Week Waits (rolling quarter)
Early intervention in psychosis - 2 week wait (Rolling quarter)
46.8% 46.2% 47.7%
68.8% 68.5%64.3% 73.8% 73.2% 82.9% 76.5%
45.9% 47.5% 49.7% 50.7% 51.7%
Incidence of healthcare associated infection (HCAI) ii) C.difficile
IAPT Access (rolling 3 months)
IAPT Monthly
IAPT 6 Weeks First Treatment94.4% 95.3% 95.9% 97.8% 95.8% 94.3%
100.0% 98.2% 97.7% 98.2% 98.2% 100.0%IAPT 18 Weeks First Treatment
IAPT (Rolling 3 month)
98.1% 98.0% 98.2%
Appendix I
NHS Bradford City CCG Number of Providers w ithin DCO 31
Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17
<87% 90.1% 89.7% 89.4% 89.7% 88.4% 89.0% 88.7% 87.7% 88.8% 90.5% 92.0% 91.8% 91.9%
87% to 92% 93.4% 93.4% 93.4% 93.4% #N/A #N/A #N/A
>=92% Rank 15/23 15/23 16/23 17/23 17/23 17/23 17/23 113/207 84/207 51/207
>10
1 to 10
0 Rank 1/23 1/23 1/23 1/23 1/23 1/23 1/23 26/207 26/207
Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Jan-00 Dec-17
<6% 0.3% 1.1% 0.7% 1.3% 2.3% 3.1% 4.1% 4.2% 3.6% 1.6% 1.2% 1.1% 2.1%
1% to 6% 0.3% 0.3% 0.3% 0.3% 0.3% 0.3% #N/A
>=1% Rank 6/23 11/23 13/23 12/23 11/23 17/23 21/23 137/207 120/207 152/207
Jan-17 Feb-17 Dec-16 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17
<88% 94.3% 94.9% 94.9% 96.2% 97.8% 92.9% 94.7% 96.6% 93.9% 90.5% 100.0% 68.3% 80.7%
88% to 93% 96.4% 96.4% 63.7% 96.4% 96.4% #N/A #N/A #N/A
>=93% Rank 20/23 14/23 16/23 2/23 16/23 15/23 5/23 1/207 207/207 204/207
<88% #N/A #N/A 100.0% 100.0% #N/A #N/A 100.0% 100.0% 100.0% 100.0%
88% to 93% 100.0% 100.0% 100.0% 100.0% 100.0% #N/A #N/A #N/A
>=93% Rank 1/23 1/23 1/23 8/207 6/207 -
<91% 91.7% 82.4% 82.4% 100.0% 93.8% 96.2% 100.0% 100.0% 100.0% 96.8% 100.0% 88.2% 86.7%
91% to 96% 100.0% 100.0% 100.0% 100.0% 100.0% #N/A #N/A #N/A
>=96% Rank 23/23 23/23 1/23 23/23 17/23 1/23 1/23 6/207 206/207 207/207
<89% 100.0% 60.0% 60.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 96.3% 100.0% 100.0%
89% to 94% 100.0% 100.0% 100.0% 100.0% 100.0% #N/A #N/A #N/A
>=94% Rank 1/23 23/23 1/23 1/23 1/23 1/23 1/23 - 26/207 29/207
<93% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0%
93% to 98% 100.0% 100.0% 100.0% 100.0% 100.0% #N/A #N/A #N/A
>=98% Rank 1/23 1/23 1/23 1/23 1/23 1/23 1/23 35/207 38/207 40/207
<89% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0%
89% to 94% 100.0% 100.0% 100.0% 100.0% 100.0% #N/A #N/A #N/A
>=94% Rank 1/23 1/23 1/23 1/23 1/23 1/23 1/23 27/207 34/207 36/207
<80% 85.7% 66.7% 66.7% 63.6% 62.5% 76.9% 68.8% 90.0% 72.7% 85.9% 100.0% 80.0% 71.4%
80% to 85% 100.0% 100.0% 100.0% 100.0% 100.0% #N/A #N/A #N/A
>=85% Rank 8/23 21/23 23/23 22/23 18/23 23/23 1/23 2/207 136/207 197/207
<85% 100.0% 66.7% 66.7% #N/A 100.0% 100.0% 100.0% 100.0% 66.7% 100.0% 100.0% 0.0%
85% to 90% #N/A #N/A #N/A #N/A #N/A #N/A #N/A
>=90% Rank #N/A 22/23 1/23 #N/A 1/23 1/23 - 20/207 194/207
#N/A #N/A #N/A #N/A #N/A #N/A #N/A 100.0% 100.0% 100.0%
#N/A #N/A #N/A #N/A #N/A #N/A #N/A
Rank - 12/207 -
Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17
>10
1 to 10
0 Rank NA NA NA NA NA NA NA 20/207 20/207
14-15 Q3 14-15 Q4 15-16 Q1 15-16 Q2 15-16 Q3 15-16 Q4 16-17 Q1 16-17 Q2 16-17 Q3 16-17 Q4 17-18 Q1 17-18 Q2 17-18 Q3
<90%
90% to 95%
>=95% Rank 14/23 17/23 17/23 23/23 19/23 12/23 21/23 1/23 1/23 #N/A 1/23 7/207 196/207
Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17 Jan-18
<62% 80.6% 81.8% 80.8% 81.0% 80.3% 81.4% 81.8% 82.3% 81.1% 80.9% 83.0% 82.1% 81.8%
62% to 67% 75.1% 75.1% 75.1%
>=67% Rank 1/23 1/23 1/23 2/23 2/23 2/23 20/207 16/207 16/207
0 0
Commissioner data with CCG plans in grey. CCGs are ranked out of 23 Yorkshire & Humber CCGs until Jun 17 and then out of 2017 CCGs nationally
0 0 0 0 0
Breaches of Mixed-Sex Accommodation
Maximum two-week wait for first outpatient appointment for
patients referred urgently with breast symptoms (where cancer was
not initially suspected)
RTT
Patients on incomplete non-emergency pathways (yet to start
treatment) waiting no more than 18 weeks from referral
Cancer Monthly
Number of patients waiting more that 52 weeks on incomplete
pathways
Diagnostic
Percentage of patients waiting 6 weeks or more for a diagnostic
test (15 key tests)
0 0 0 0 0 0 00
Maximum two-week wait for first outpatient appointment for
patients referred urgently with suspected cancer by a GP
100.0% 100.0% 89.6%
Maximum 31-day wait from diagnosis to first definitive treatment
for all cancers
Maximum 62-day wait from urgent GP referral to first definitive
treatment for cancer
Maximum 62-day wait from referral from an NHS screening service
to first definitive treatment for all cancers
Mixed Sex Accommodation
Maximum 62-day wait for first definitive treatment following a
consultants decision to upgrade the priority of the patients (all
cancers)
0
Maximum 31-day wait for subsequent treatment where that
treatment is surgery
00 0 0 0 1
Maximum 31-day wait for subsequent treatment where the
treatment is an anti-cancer drug regimen
Maximum 31-day wait for subsequent treatment where the
treatment is a course of radiotherapy
0 0 0 0
Dementia diagnosis rate
Dementia
Mental HealthCare Programme Approach (CPA): Percentage of people under
adult mental illness specialities on CPA who were followed up
within 7 days of discharge from psychiatric inpatient care during
the period
98.0% 97.1% 95.2% 89.7% 94.6% 97.5% 92.7% 100.0% 100.0% 96.5%
Oct-16 Nov-16 Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17
<70%
70% to 75%
>=75% Rank 1/23 11/23 1/23 1/23 1/23
<90%
90% to 95%
>=95% Rank 1/23 1/23 1/23 1/23 1/23
Oct-16 Nov-16 Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17
<3.75% 3.3% 3.3% 3.8% 4.0% 4.3% 4.4% 5.0% 5.4% 5.1% 4.7% 4.3% 4.2% 4.3%
3.8% 3.8% 3.8% 3.8% 3.8% 4.2% 4.2% 4.2% 4.2%
>=4.20% Rank 17/23 19/23 13/23 8/23 6/23
<45%
45% to 50%
>=50% Rank 13/23 20/23 16/23 15/23 13/23
Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17 Jan-18
<45%
45% to 50%
>=50% Rank 16/23 13/23 16/23 12/23 12/23 10/23 143/207 103/207
Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17
>0 0 0 0 0 0 0 0 0 1 0 0 0 0
Rank 1/23 1/23 1/23 1/23 1/23 1/23 1/23 132/207 40/207 36/207
>Ceiling 1 1 2 1 1 1 1 2 0 0 1 1 1
<=Ceiling Rank 1/23 1/23 1/23 1/23 3/23 2/23 1/23
Ceiling 2 2 2 9 1 1 0 1/207 185/207 181/207
Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17
<70%
70% to 75%
>=75%
NA 83.6% 80.5% 92.7% 91.2% 90.2% 84.5% 84.3% 87.6%
NA NA NA NA NA NA NA NA
NA 82.9% 82.0% 81.4% 86.5% 84.2% 83.3% 78.5% 78.5%
NA NA NA NA NA NA NA NA
57.1% 62.5% 67.7% 77.8% 63.0%
100.0% 100.0% 100.0% 100.0%
50.0% 48.6% 45.2% 41.9%
IAPT Monthly
IAPT 6 Weeks First Treatment
IAPT 18 Weeks First Treatment
100.0% 94.4% 100.0% 100.0% 100.0% 91.7% 100.0% 90.9% 85.7% 92.9% 92.9% 92.9% 93.3%
IAPT (Rolling 3 month)
IAPT Access (rolling 3 months)
100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0%
IAPT Recovery rate (rolling 3 months)
Early Intervention Psychosis - 2 Week Waits (rolling quarter)
Early intervention in psychosis - 2 week wait (Rolling quarter)70.4% 74.1% 71.0% 78.3% 73.9% 83.3% 75.0% 69.2%
48.9% 43.5% 46.5% 47.5% 50.0% 47.2% 45.5% 44.1% 48.3%
Safe Environment and Protecting from Avoidable Harm
Incidence of healthcare associated infection (HCAI) i) MRSA -
Cases which have been assigned to the CCG following a Post
Infection Review
Incidence of healthcare associated infection (HCAI) ii) C.difficile
73.6% 77.3% 74.3% 81.8% 79.1% 79.5% 80.5% 74.2%
** YAS have been participating in a pilot which has involved new call categories. The initial pilot ran from 21st April 2016 until 19th October 2016 and the second phase began on 20th October 2016. Due to the changes in categories direct comparison between the different phases cannot
be done because they don't necessarily represent the same activity. Currently no performance target has been set for the 2R and 2T categories.
Category 2T - Response within 19mins by DCA unless RRV arrives
and DCA is not required
Ambulance Calls (Pilot Phase 2.2) **
Category 1 - Response within 8mins
Category 2R - Response within 19mins by a resource.
21
Appendix J – ACO System Dashboards
Mapping across Programmes/Workstreams
Metric Programme
Reducing 1st:FU ratios
Reducing A&E attendances
Planned Care
Reducing DTOC
Reducing average LOS (elective)
Achieving 18 weeks RTT target
Reducing average LOS (NEL)
Reducing GP referrals
Planned care
Provider Alliance
Planned care
Urgent care
Planned care - referral efficiency, procedures of limited clinical value, pathway adherence
Planned Care - 1st:FU ratios
Note: Data is for the 2 Bradford CCGs unless otherwise indicated as: *1
Trust level, *2
DTOC at Bradford level, CCG NEL activity at BTHFT, *3
CCG referrals to BTHFT, G&A referrals to
all providers Note due to ongoing data quality issues with EPR activity is only availab le to September so only A&E & DTOC figures can be updated.
Out of Hospital - reduced practice variation
Workstream
Achieving the A&E target
Reducing NEL admissions
Out of Hospital - developing community provision through community/intermediate care beds & integrated care
team workstreams
Urgent care - primary care streaming
Urgent care - urgent care centre, ACSC pathway work, children's pathway work
Out of Hospital - extended primary care access and primary care at scale
Urgent care - ACSC pathway work, children's pathway work
Urgent care
Urgent care
Out of Hospital
Provider Alliance
Bradford Accountable Care
The Urgent Care System
The Planned Care System
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
0
2000
4000
6000
8000
10000
12000
14000
16000
A M J J A S O N D J F M A M J J A S O N D J
16/17 17/18
A&E*1
Attendances Admissions 4 hour performance Admission rate
A&E target Trend (attendances) Trend (admissions)
0%
2%
4%
6%
8%
10%
12%
14%
16%
0
1,000
2,000
3,000
4,000
5,000
6,000
7,000
A M J J A S O N D J F M A M J J A S
16/17 17/18
NEL Admissions
NEL admissions - BTHFT NEL Admissions - ALL
30 day re-admission rate - BTHFT Linear (NEL Admissions - ALL)
2.0
2.1
2.2
2.3
2.4
2.5
2.6
2.7
2.8
2.9
3.0
0
5000
10000
15000
20000
25000
30000
35000
A M J J A S O N D J F M A M J J A S
16/17 17/18
Outpatients
1st OP - all FU OP - ALL1st - CCG @ BTHFT FU - CCG @ BTHFTRatio 1st:FU - ALL Ratio 1st:FU - CCG @ BTHFTTrend (1st OP) Trend (FU OP)
0.0
0.5
1.0
1.5
2.0
2.5
3.0
3.5
4.0
0
1000
2000
3000
4000
5000
A M J J A S O N D J F M A M J J A S
16/17 17/18
Inpatients
Elective - ALL Daycase - ALLElective - BTHFT Daycase - BTHFTAverage LOS - ALL Average LOS - BTHFTLinear (Elective - BTHFT) Linear (Daycase - BTHFT)Trend (LOS)
0
20
40
60
80
100
120
140
160
180
0
1000
2000
3000
4000
5000
6000
A M J J A S O N D J F M A M J J A S O N D
16/17 17/18
Delayed Transfers*2
NEL admissions - BTHFT Rate/100,000 population
Trend (NEL admissions) Linear (Rate/100,000 populat ion)
2.0
2.2
2.4
2.6
2.8
3.0
3.2
3.4
3.6
4200
4400
4600
4800
5000
5200
5400
5600
5800
6000
A M J J A S O N D J F M A M J J A S
16/17 17/18
Average LOS
NEL admissions Average LOS - ALL
Average LOS - CCG @ BTHFT Trend (LOS)
Linear (Average LOS - ALL) Linear (Average LOS - CCG @ BTHFT)
84.0%
85.0%
86.0%
87.0%
88.0%
89.0%
90.0%
91.0%
92.0%
93.0%
A M J J A S O N D J F M A M J J A
16/17 17/18
18 week RTT*1
18 weeks RTT Target
0
2000
4000
6000
8000
10000
12000
14000
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
2016/17 2017/18
Referrals*3
All referrals - 3 CCGs GP referrals - 3 CCGsGP Referrals - District CCG GP Referrals - City CCGCity - All referrals (G&A) Districts - All referrals (G&A)
22
Mapping across Programmes/Workstreams
Metric Programme
Note: Data is for the AWC CCG unless otherwise indicated as: *1
Trust level, *2
DTOC at Trust level, *3
CCG referrals to ANHSFT, G&A referrals to all providers
Workstream
Achieving the A&E target Urgent care Urgent care - primary care streaming
Reducing A&E attendances Urgent careUrgent care - urgent care centre, ACSC pathway work, children's pathway work
Primary & Community ?
Reducing NEL admissions Urgent care Urgent care - ACSC pathway work, children's pathway work
Reducing DTOCPrimary &
Community?
Reducing average LOS (NEL) ? ?
Reducing average LOS (elective) ? ?
Achieving 18 weeks RTT target Planned care
Reducing GP referrals Planned care
Planned care - referral efficiency, procedures of limited clinical value, pathway adherence
Primary & Community ?
Reducing 1st:FU ratios Planned Care Planned Care - 1st:FU ratios
Airedale, Wharfedale & Craven Accountable Care
The Urgent Care System
The Planned Care System
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
0
1000
2000
3000
4000
5000
6000
7000
A M J J A S O N D J F M A M J J A S O N D J
16/17 17/18
A&E*1
Attendances Admissions 4 hour performance Admission rate
A&E target Trend (attendances) Trend (admissions)
0%
2%
4%
6%
8%
10%
12%
14%
16%
0
500
1,000
1,500
2,000
2,500
A M J J A S O N D J F M A M J J A S O N D
16/17 17/18
NEL Admissions
NEL admissions - ANHSFT NEL Admissions - ALL
30 day re-admission rate - ANHSFT Linear (NEL Admissions - ALL)
1.0
1.2
1.4
1.6
1.8
2.0
2.2
2.4
2.6
2.8
3.0
0
2000
4000
6000
8000
10000
12000
14000
A M J J A S O N D J F M A M J J A S O N D
16/17 17/18
Outpatients
1st OP - all FU OP - ALL1st - CCG @ ANHSFT FU - CCG @ ANHSFTRatio 1st:FU - ALL Ratio 1st:FU - CCG @ ANHSFTTrend (1st OP) Trend (FU OP)
0.0
1.0
2.0
3.0
4.0
0
500
1000
1500
2000
2500
3000
3500
A M J J A S O N D J F M A M J J A S O N D
16/17 17/18
Inpatients
Elective - ALL Daycase - ALLElective - ANHSFT Daycase - ANHSFTAverage LOS - ALL Average LOS - ANHSFTLinear (Elective - ANHSFT) Linear (Daycase - ANHSFT)Trend (LOS)
0.0%
0.5%
1.0%
1.5%
2.0%
2.5%
3.0%
3.5%
4.0%
4.5%
5.0%
0
200
400
600
800
1000
1200
1400
1600
1800
2000
A M J J A S O N D J F M A M J J A S O N D
16/17 17/18
Delayed Transfers*2
NEL admissions - ANHSFT DTOC rate
Trend (NEL admissions) Linear (DTOC rate)
2.0
2.5
3.0
3.5
4.0
4.5
5.0
0
500
1000
1500
2000
2500
A M J J A S O N D J F M A M J J A S O N D
16/17 17/18
Average LOS
NEL admissions Average LOS - ALL
Average LOS - CCG @ ANHSFT Trend (LOS)
Linear (Average LOS - ALL) Linear (Average LOS - CCG @ ANHSFT)
89.5%
90.0%
90.5%
91.0%
91.5%
92.0%
92.5%
93.0%
93.5%
94.0%
A M J J A S O N D J F M A M J J A S O N D
16/17 17/18
18 week RTT*1
18 weeks RTT Target
0
500
1000
1500
2000
2500
3000
3500
4000
4500
5000
A M J J A S O N D J F M A M J J A S O N D
16/17 17/18
Referrals*3
All referrals - 3 CCGs GP referrals - 3 CCGsGP Referrals - AWC CCG AWC - All referrals (G&A)Linear (GP Referrals - AWC CCG) Linear (AWC - All referrals (G&A))
23