Southport & Formby Clinical Commissioning Group Integrated Performance Report October 2018 1 Contents 1. Executive Summary ..................................................................................................... 12 2. Financial Position ......................................................................................................... 15 2.1 Summary .................................................................................................................... 15 2.2 Financial Forecast....................................................................................................... 18 2.3 CCG Reserves Budget ............................................................................................... 19 2.4 Provider Expenditure Analysis – Acting as One .......................................................... 19 2.5 QIPP ........................................................................................................................... 21 2.6 Risk ............................................................................................................................ 22 2.7 Risk Adjusted Position ................................................................................................ 23 2.8 Statement of Financial Position ................................................................................... 24 2.9 Recommendations ...................................................................................................... 25 3. Planned Care ............................................................................................................... 26 3.1 Referrals by Source .................................................................................................... 26 3.1.1 E-Referral Utilisation Rates ......................................................................................... 27 3.2 Diagnostic Test Waiting Times .................................................................................... 28 3.3 Referral to Treatment Performance ............................................................................. 29 3.3.1 Incomplete Pathway Waiting Times ............................................................................ 31 3.3.2 Long Waiters analysis: Top 5 Providers ...................................................................... 31 3.3.3 Long waiters analysis: Top 2 Providers split by Specialty ............................................ 32 3.3.4 Provider assurance for long waiters ............................................................................ 33 3.4 Cancelled Operations ................................................................................................. 33 3.4.1 All patients who have cancelled operations on or day after the day of admission for non-clinical reasons to be offered another binding date within 28 days.................................. 33 3.4.2 No urgent operation to be cancelled for a 2nd time ..................................................... 34 3.5 Cancer Indicators Performance................................................................................... 34 3.5.1 - Two Week Waiting Time Performance ...................................................................... 34 3.5.2 - 31 Day Cancer Waiting Time Performance ............................................................... 35 3.5.3 - 62 Day Cancer Waiting Time Performance ............................................................... 36 3.6 Patient Experience of Planned Care ........................................................................... 37 3.7 Planned Care Activity & Finance, All Providers ........................................................... 38 3.7.1 Planned Care Southport and Ormskirk NHS Trust ...................................................... 39 3.7.2 Southport & Ormskirk Hospital Key Issues .................................................................. 40 3.7.3 Aintree University Hospital NHS Foundation Trust ...................................................... 40 3.7.4 Renacres Hospital....................................................................................................... 41 3.7.5 Wrightington, Wigan and Leigh NHS Foundation Trust ............................................... 42 3.7.6 iSIGHT Southport........................................................................................................ 42 3.8 Personal Health Budgets ............................................................................................ 43 3.9 Continuing Health Care (CHC) .................................................................................... 44 2 3.10 Smoking at Time of Delivery (SATOD) ........................................................................ 47 4. Unplanned Care ........................................................................................................... 47 4.1 Accident & Emergency Performance .......................................................................... 47 4.2 Occupied Bed Days .................................................................................................... 49 4.3 Ambulance Service Performance ................................................................................ 49 4.4 Unplanned Care Quality Indicators ............................................................................. 51 4.4.1 Stroke and TIA Performance ....................................................................................... 51 4.4.2 Mixed Sex Accommodation ......................................................................................... 52 4.4.3 Healthcare associated infections (HCAI) ..................................................................... 53 4.4.4 Mortality ...................................................................................................................... 54 4.5 CCG Serious Incident Management ............................................................................ 54 4.6 Delayed Transfers of Care .......................................................................................... 56 4.7 Patient Experience of Unplanned Care ....................................................................... 57 4.8 Unplanned Care Activity & Finance, All Providers ....................................................... 57 4.8.1 All Providers................................................................................................................ 57 4.8.2 Southport and Ormskirk Hospital NHS Trust ............................................................... 58 4.8.3 Southport & Ormskirk Hospital NHS Trust Key Issues ................................................ 59 4.9 Aintree and University Hospital NHS Foundation Trust ............................................... 59 4.10 Aintree University Hospital NHS Trust Key Issues ...................................................... 59 5. Mental Health ............................................................................................................... 60 5.1 Mersey Care NHS Trust Contract ............................................................................... 60 5.1.1 Key Mental Health Performance Indicators ................................................................. 61 5.2 Out of Area Placements (OAP‟s) ................................................................................. 61 5.2.1 Mental Health Contract Quality Overview .................................................................... 61 5.3 Patient Experience of Mental Health Services ............................................................. 64 5.4 Improving Access to Psychological Therapies ............................................................ 65 5.5 Dementia .................................................................................................................... 66 5.6 Improve Access to Children & Young People‟s Mental Health Services (CYPMH) ...... 66 5.7 Waiting times for Urgent and Routine Referrals to Children and Young People‟s Eating Disorder Services ....................................................................................................... 66 5.8 Child and Adolescent Mental Health Services (CAMHS) ............................................. 67 5.9 Learning Disability Health Checks ............................................................................... 69 6. Community Health ....................................................................................................... 69 6.1 Lancashire Care Trust Community Services ............................................................... 69 6.1.2 Quality ........................................................................................................................ 69 6.2 Patient Experience of Community Services................................................................. 70 6.3 Any Qualified Provider – Audiology ............................................................................. 70 6.4 Percentage of children waiting less than 18 weeks for a wheelchair ........................... 70 7. Third Sector Contracts ................................................................................................. 71 8. Primary Care ................................................................................................................ 74 3 8.1 Extended Access (evening and weekends) at GP services ......................................... 74 8.2 CQC Inspections ........................................................................................................