Mid Highland Chp Heat Target

Mid Highland CHP Governance Committee 23 April 2010

MID HIGHLAND CHP DAY CASE SURGERY RATES HEAT TARGET E4.4 KPM1 A5 T7

1 CURRENT POSITION

Improved efficiencies by March 2011 to increase day case rate to 81%. The number of BADS surgical procedures performed in a day case or outpatient setting.

BELFORD HOSPITAL MTHLY QUARTERLY ROLLING YR END JUNE 09 42.5% 48.5% 48.83% (38 Procedures in total) AUG 09 46.5% - 48.65% (36 In total) SEP 09 56.8% 47.8% 49.9% (37 In total) NOV 09 46.5% - 48.6% (43 In total)

MACKINNON MEMORIAL MTHLY QUARTERLY ROLLING YR END HOSPITAL JUNE 09 92.9% 78.8% 80.2% (14 Procedures in total) AUG 09 71.4% - 78.2% (7 in total) SEP 09 77.8% 66.7% 78.9% (9 in total) NOV 09 100% - 79.2% (3 in total)

COMBINED MTHLY QUARTERLY ROLLING YR END MID CHP JUNE 09 55.6% 55.9% 56.8% (54 procedures in total) AUG 09 50% - 55.9% (50 in total) SEP 09 60.9% 50.3% 55.6% (46 in total) NOV 09 50% - 53.6% (46 in total)

OVERALL NHSH POSITION MTHLY OUT-TURN JUNE 09 74.1% - AUG 09 74.9% - SEP 09 75.2% - NOV 09 76.2% 69.8%

This report encompasses data from last year to the most up-to-date available in Nov 2009 and indicates that the December 09 target of 77% was unmet. On examination it appears that Day Case procedures performed in the Belford OPD had previously been captured on NSOP (non-scheduled outpatient) forms which do not contribute to the data above. Mid Highland CHP Governance Committee 23 April 2010

2 ACTION PLANS TO ADDRESS

 Implementation of the Pre-op Assessment Service & 10 bedded Surgical Day Case Unit as part of the Belford Service Redesign.  All scheduled day case patients via OPD will now be booked onto a dedicated OPLA clinic template to go live on Feb 18th 2010.  All NSOP forms will cease to be in use for this cohort of patients from the above date.  All BADS coding will be undertaken by the specialist coding staff as per any Day Case procedure.  Robust and consistent approach to data collection in place to ensure that BADS procedures are recorded.  Exploration of day case beds in Mackinnon Memorial Hospital (over 90% of patients attending Theatre are Day Cases).  Development of Day Case Services in Community Hospitals.  1yr data of all BADS procedures performed in the Belford has been made available to Lochaber LGM for analysis.

3 EXPECTED IMPACT OF ACTIONS ON PERFORMANCE

 Belford Service Redesign will support an improved clinical outcome, an increase in the use of Day Case facilities, improved Theatre & efficient bed utilisation.  Accurate data collection of activity will increase Day Case rates and this is expected to be evidenced by 15th April 2010 at the earliest.  Validation & accreditation of Clinician work, an increase in overall Day Case rates linking cost to activity.

4 FORECAST OF RETURN TO PLANNED PERFORMANCE (ie Trajectory)

Improved efficiencies by March 2011 to increase Mid-Highland CHP Day Case rate to 82.4% and an overall NHSH Day Case rate to 81%. Mid Highland CHP Governance Committee 23 April 2010