NHS TAYSIDE WRITTEN SUBMISSION NHS Tayside - Local Delivery Plan Performance Update Scottish Target/standard March ‘19 Current Shift Average Treatment Times Guarantee (TTG) Proportion of patients that were seen within 12 week TTG 59.4% 62.3% 76.4% Standard: 100% 12 weeks First Outpatient Appointment Percentage of patients waiting no more than 12 weeks 62.7% 59.3% 73.5% from referral to first outpatient appointment Standard: ≥95% Cancer Treatment Percentage of patients beginning treatment within 31 days 92.1% 97% 94.4% Standard: ≥95% Cancer Treatment Percentage of patients beginning treatment within 62 days 89.4% 96.1% 82.1% Standard: ≥95% Child and Adolescent Mental Health Services (CAMHS) Percentage of patients seen within 18 weeks 57.9% 61.3% 69.6% Standard: ≥90% Psychological Therapy Percentage of patients to start treatment within 18 weeks 72% 72.5% 78.8% of referral Standard: ≥90% 4-hour A&E Percentage of all attendances seen within 4 hours 96.2% 95.8% 88.9% Standard: ≥95% Drug and Alcohol Treatment Percentage of patients seen within 3 weeks 98.1% 90.6% 95.1% Standard: ≥90% Clostridium Difficile Bacteraemia (SABs)* Rate of infection in patients aged 15 and over, per 1,000 0.2 0.13 0.27 total occupied bed days (Mar 18) (Dec 18 latest Standard: ≤0.32 figure) Staphylococcus Aureus Bacteraemia (SABs)* 0.35 0.41 Rate of SABs per 1,000 total occupied bed days (Dec 18 latest 0.33 (Mar 18) Standard: 0.24 figure) 18 weeks Referral to Treatment Percentage of patients seen and treated within 18 weeks 71.3% 73.4% 79.2% from initial referral Standard: 90% IVF Waiting Times All eligible patients will commence IVF treatment within 12 100% 100% 100% months Standard: ≥90% Sickness Absence Rate Maximum sickness absence rate every 12-month period 5.15% 5% 5.2% Standard: ≤4% Notes: *This LDP standard is under review; therefore data is not available after December 2018 Source: NSS Discovery, LDP Summary Dashboard as at 30/10/2019 Page 1 of 326 Item 9.11 Please note any items relating to Board/Committee business are embargoed and should not be made public until after the meeting BOARD59/2019 Tayside NHS Board 27 June 2019 Ministerial Strategic Group (MSG) for Health and Community Care- Self–Evaluation for the Review of Progress with Integration of Health and Social Care 1. SITUATION AND BACKGROUND On 4 February 2019, the Ministerial Strategic Group (MSG) for Health and Community Care’s report on the review of progress with integration was published. The Leadership Group, chaired by Malcolm Wright, Director General, Scottish Government, Health and Social Care Directorates and Chief Executive, NHS Scotland, and Sally Loudon, Chief Executive COSLA was reconvened to take on a revised role of driving forward and supporting implementation of the review. Within the review report, there is an expectation that Health Boards, Local Authorities and Integration Joint Boards (IJBs) would evaluate their current position in relation to the review report’s findings and the Audit Scotland report on integration which was published in November 2018, with a view to increasing the pace of integration. A key element of the process was the establishment of a self-evaluation template which would serve to support local discussions, share good practice and enable the Leadership Group to gain an overall insight into progress. The self-evaluation exercise would also form the basis of future local and national plans to increase the pace of integration. The self-evaluation template was received on 25 March 2019 and is based on the 25 proposals made in the MSG report, covering a wide range of issues. The self-evaluations were required to be submitted by 15 May 2019. The overall process associated with integration was divided into six key features: 1. Collaborative leadership and building relationships 2. Integrated finances and financial planning 3. Effective strategic planning for improvement 4. Agreed governance and accountability arrangements 5. Ability & willingness to share information 6. Meaningful and sustained engagement Within these key features, the 25 proposals from the review report were outlined and a rating of Not yet Established, Partly Established, Established or Exemplary was applied to each item. A fuller description of each category was outlined to support the evaluation criteria. In addition, within each proposal, there was a section for the provision of Evidence/Notes to support the evaluation and a section for proposed improvement actions. Page 2 of 326 2. ASSESSMENT Within NHS Tayside, there are three Health and Social Care Partnerships (HSCPs) and their associated IJBs covering Angus, Dundee and Perth and Kinross therefore, three separate self- assessment evaluations were undertaken by each local partnership. In addition, within each Local Authority, Council colleagues indicated their view and the Corporate Directors within NHS Tayside undertook their own review of the template, which was made available to the Chief Officer of each HSCP. The self assessments for each partnership have now been submitted for consideration by the Scottish Government / Ministerial Steering Group for consideration and comment. It is proposed that a further discussion should take place between the Chief Officer of each IJB, the Local Authority Chief Executive and the NHS Chief Executive to agree a final assessment and action plan for each partnership. Within the 25 proposals, three were outlined as being for national action which related to the improved strategic inspection of health and social care to better reflect integration. The national improvement bodies were asked to work more collaboratively to deliver the appropriate support that Partnerships require to make integration work and the establishment of a framework for community based health and social care integrated services. The remaining 22 proposals were for local evaluation. The assessments for each partnership under the six key features and 22 proposals is summarised in Appendix 1. KEY FEATURE 1: Collaborative leadership and building relationships There are 3 proposals outlined in this section relating to leadership development focussing on shared and collaborative process; the improvement of relationships and collaborative working and an improvement in relationships and partnership working with the third and independent sector. Within this area, the partners generally considered that leadership development focussed on shared and collaborative practice was Established or Partly Established. With regard to relationships and collaborative working, IJBs have scored this issue as either Partly Established or Established. Working relationships and partnerships with the third sector was in all cases considered to be Established. In Angus, the aim is to review and strengthen the workforce plan to incorporate integrated leadership development, succession planning and growing the care workforce through opportunities within the Tay Cities Deal. There is a need to develop greater consistency across work planning and partnership working and including stronger strategic links with integrated children’s services planning. There is a concern to improve the engagement of council elected members and to further strengthen the relationships with, and involvement of, the third sector. In Dundee, the aim is to enhance the visible and collaborative leadership of partners and to enhance leadership, learning and organisational development across the partnership. The partnership will seek a more formal statement of the expected level of support from the statutory partners; aim to align transformation programmes, develop a shared understanding of the needs of a truly integrated workforce and to redesign the core, meetings structure to create opportunities for engaging the statutory partners in strategic planning and delivery. The Page 3 of 326 partnership will also build a wider broader-based partnership with the third sector and develop an appropriate and workable model of partnership with the independent sector. In Perth and Kinross, the aim is to restructure the partnership to achieve a more integrated structure to improve opportunities for collaboration towards a more values-based, learning organisation opening up greater joint learning and development opportunities for senior leaders. This will respond positively and purposefully to the anticipated Joint Inspection outcomes and will align with the “Perth and Kinross Offer” (PKC Strategy) and the ambitions of Transforming Tayside. The partnership intends to build on established relationships with the third and independent sectors through strategic planning, commissioning and contracting activity. KEY FEATURE 2: Integrated finances and financial planning Within this section, there are six areas of self-evaluation – the need to have a joint understanding between Local Authorities, Health Boards and IJBs of their respective financial positions; the timely delegation of budgets to IJBs; the full implementation of delegated hospital budgets and set aside requirements; the development of a transparent and prudent reserves policy; appropriate support from statutory partners to IJB s95 Officers and the empowerment of IJBs to use the totality of their resources to meet the needs of their local population. Across these aspects, the broad assessment is that integrated finances and financial planning is broadly Partly Established to Established. In Angus, There was felt to be a need for statutory partners to develop financial planning and reporting that reflects their partnership role