Finance Performance Report

Transcription

1 Finance Finance Performance Report October 217 For the period April to October Southend University Hospital Foundation Trust Board 7 INDEX Page Finance Summary 1 Income 2 Activity 3 Pay 4 Pay analysis 5 Non Pay 6 Financial summary trend forecast 7 CIPs - performance 8 Capital 9 SOFP (Balance Sheet) 1 Cash Flow 11 Risks, Mitigations & Actions 12 Internal Trust Reporting Reporting Conventions Run Rate 12 Adverse Variances = (Negative) Borrowings 13 Favourable Variance = Positive Forecast Summary 14 Directorate Positions - YTD 15 Income = Positive Directorate Positions - In Month 16 Expenditure = (Negative) Directorate Performance Rating 17 Directorate Performance Rating Trend 18 Site DoF Reporting CIPS - governance dashboard 19 Pay WTE's 2 Non Operating Expenditure 21 Risks and Opportunities 22 Metrics 23 Integrated Quality and Performance Board Report Page 21

2 Finance Monthly Financial Summary - Page 1 Description In Month Year to Date Full Year Last Year Budget Actual Variance Budget Actual Variance Budget Forecast Variance Actuals m m m m m m m m m m Income Pay (16.411) (16.5) (.9) ( ) ( ) ( ) ( ) (186.9) Non Pay (9.163) (1.21) (.858) (63.433) (65.678) (2.246) (11.47) ( ) (3.665) (112.4) EBITDA (.185) (.21) (.17) (7.365) (6.636).729 (8.4) Financing (1.314) (1.326) (.12) (9.21) (9.171).3 (15.773) (15.85) (.32) (15.5) S&T Funding (.23) (.23) (.69) 12.8 Surplus / (Deficit) (Control Total).78 (.156) (.234) (5.515) (5.732) (.217) (15.49) (15.42).7 (11.1) Fixed Asset Income / Impairments Surplus / (Deficit).78 (.156) (.234) (5.515) (5.289).226 (15.49) (14.632).417 (1.8) Key Headlines - Commentary and Actions The position for October was a deficit of 156k which was 234k adverse against the plan. The S&T funding relating to A&E performance has not been assumed in the October position as the percentage of patients seen within 4 hours in October was less than the 9% target (89.39%). There is a possibility that this could be achieved for the quarter if performance improves in November and December. Clinical Income (excluding pass through) was ahead of plan by 658k in October due largely to non-elective actvity. Other Income (excluding STF) was higher than budget by 91k in October, bringing the YTD adverse variance to 63k. Pay budgets were overspent in the month by 9k, but remain underspent by 1,295k YTD. Non-Pay budgets (excluding pass through) were over spent by 65k in the month. This overspend relates primarily to clinical supplies and premises costs. The YTD non-pay over spend increased to 2,85k USE of RESOURCES Area Weighting Metric Definition Score Actual SCORCE Weighted Financial Sustainability 2% Capital service capacity (times) 2% Liquidity Ratio(days) Degree to which the provider's generated income covers its financial obligations Days of operating costs held in cash or cashequivalent forms, including wholly committed >2.5x x x < 1.25x > (7)- (14)-(7) <(14) (11.8) 3.8 Financial Efficiency 2% I&E margin I&E surplus or deficit / total revenue >1% 1-% -(1)% <=(1)% (3.2%) 4.8 Financial Controls 2% Distance from financial plan 2% Agency spend Year-to-date actual I&E surplus/deficit in comparison to Year-to-date plan I&E surplus Distance from provider's cap >=% (1)-% (2)-(1)% <=(2)% 1.7% 1.2 <=% %-25% 25-5% >5% 48.8% 3.2 Scoring a '4' on any metric will mean that the overall rating is at least a 3 KEY 1 (Best) to 4 (Worst) Concern OVERALL SCORE 3 Integrated Quality and Performance Board Report Page 22

3 Finance ' Income - Page 2 In Month Year to Date Commentary Contracted Clinical Income Budget Actual Fav/(Adv) Budget Actual Fav/(Adv) The year-to-date clinical income performance was 998k ' ' ' ' ' ' favourable to plan, with an under-achievement in pass-through Elective 4,267 4, ,177 28, income ( 561k) offset by overperformance in acute activity Non Elective 5,926 6, ,886 44,613 3,727 1,558k. Outpatients 3,845 3, ,732 24,743 (989) Critical Care ,53 5,69 (813) Accident & Emergency 1,174 1,131 (42) 8,96 7,712 (384) Maternity Pathway 1,552 1,426 (127) 1,585 1,61 16 CQUIN ,362 3,362 Fines (2) (2) Other 1,799 1, ,163 13, Direct Access 1,341 1,36 (36) 8,94 8,574 (331) Subtotal 21,327 21, ,49 146,967 1,558 High Cost Drugs & Devices 2,746 2, ,341 17,781 (561) Grand Total 24,73 24, ,75 164, Other Income Budget In Month Actual Variance Fav/(Adv) Budget Year to Date Actual Variance Fav/(Adv) Private Patients (41) Injury Cost recovery (RTA) (46) Training & Education (43) 4,435 4, Research & Development , (33) Other Income 1,1 1, ,36 7,3 (7) S&T Funding (23) 3,871 3,641 (23) Total 2,893 2,754 (139) 16,941 16,648 (293) There is no provision made for fines and challenges, in accordance with the agreed contract. There are no reductions made in the plan for Commissioner QIPP schemes. Whilst the Trust is committed to working with the CCG to deliver QIPP, any activity reductions in the short term are unlikely, particularly given the size of the backlog. The Trust has agreed the payment of full CQUIN, no fines and minimal challenges as part of the acute contract. As a result, no adjustments for these items have been made. 7.7m of Sustainability and Transformation Fund (STF) funding has been added to the annual Clinical Income budget, and 3.6m has been included in the Month7 position. This is adverse to plan as the Trust believes A&E performance targets have not been met (subject to confirmation from NHSI) for October. 35, Income Budget v. Actual (including Pass through) 3, 25, 2, 15, 1, 5, Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar CLINICAL INCOME OTHER INCOME BUDGET Last Year Integrated Quality and Performance Board Report Page 23

4 Finance Units of Activity Units of Activity Units of Activity Units of Activity Units of Activity Units of Activity Activity - Page 3 SLA clinical activity by Point of Delivery (POD) Budget Actual Fav/(Adv) Budget Actual Fav/(Adv) Currency Units Units Units Units Units Units Elective spell (5) 4,747 4,57 (177) Day Case spell 3,368 3,289 (79) 22,498 21,897 (61) Regular Day Patients spell Non Elective spell 3,323 3, ,921 23, Outpatients attendance 32,9 32,784 (116) 219,787 21,43 (9,744) Critical Care day 1,198 1,28 1 8,264 7,463 (81) Accident & Emergency attendance 9,28 8,792 (236) 62,282 59,848 (2,434) Maternity Pathway epidsode 1,22 93 (92) 6,94 6,787 (117) Note: Activity in Elective & Non Elective excludes Excess Bed Days and Non Chargeable In Month Year to Date Commentary and Actions The main year-to-date activity variances are: Elective Inpatients 177 (3.7%) adverse to plan, largely in Medicine, across a range of specialties, and MSK. Day cases - 61 (2.7%) adverse largely in Surgery, mainly due to staff vacancies in Ophthalmology, offset by General surgery and Medicine Non-Elective (3.9%) ahead of plan mainly in Medical specialties, reflecting continued pressures on the Trust Outpatients - 9,744 (4.4%) adverse on Firsts and Follow-ups, against all Points of Delivery, but mainly in Surgery (Ophthalmology), largely due to Consultant vacancies Elective: Budget v. Actual Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar ACTUAL - DC ACTUAL - Elective BUDGET 4, 3,5 3, 2,5 2, 1,5 1, 5 Non Elective: Budget v. Actual Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar ACTUAL BUDGET 45, 4, 35, 3, 25, 2, 15, 1, 5, Outpatients: Budget v. Actual Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar ACTUAL BUDGET 1,6 1,4 1,2 1, Critical Care: Budget v. Actual Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar 1, 9, 8, 7, 6, 5, 4, 3, 2, 1, A&E: Budget v. Actual Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar 1,2 1,1 1, Maternity: Budget v. Actual Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar ACTUAL BUDGET ACTUAL BUDGET ACTUAL BUDGET Integrated Quality and Performance Board Report Page 24

5 Finance ' Pay Expenditure - Page 4 Pay Expenditure In Month Year to Date Budget Actual Fav/(Adv) Budget Actual Fav/(Adv) Last Yrs YTD Actuals ' ' ' % ' ' ' % ' Medical and Dental 4,923 5,37 (446) (9.1%) 34,584 35,494 (91) (2.6%) 33,188 Nurses and Midwives (inc. HCAs') 5,963 6,9 (45) (.8%) 41,534 4, % 4,571 Scientific, Therapeutic & Tech 2,238 2, % 15,517 15, % 14,678 Other Pay 3,286 2, % 21,937 2,794 1, % 2,328 Total 16,411 16,5 (9) (.5%) 113, ,278 1, % 18,766 19, 18, 17, 16, 15, 14, 13, 12, 11, 1, 9, 8, 7, 6, 5, 4, 3, 2, 1, Pay: Budget v. Actual o Apr May Jun o Jul Aug Sep o Oct Nov o Dec Jan Feb Mar Note: those months marked with "o" indicate a 5 week bank pay bill month Last Year ACTUAL OTHER ACTUAL STT ACTUAL NURSING ACTUAL M&D BUDGET Commentary and Actions Total pay expenditure in October was 16.5m, which is the highest level seen this year. Substantive staff costs were 12.9m which was 159k higher than the average seen this year, but there was no corresponding reduction in agency spend. Medical staff pay costs overspent by 446k in the month ( 91k YTD). This YTD overspend is offset by underspends on all other staff categories, although nursing staff were overspent in the month for the first time this year. Agency In overall terms, agency expenditure was consistent with the previous two months. Medical vacancies were 11 WTE in October, which is 1 (or 9%) less than September. The average cost of covering each vacancy with agency is rising (from previous average 5.6k to 7k in Oct) which indicates more vacant shifts are being filled. Trained nursing and midwifery vacancies decreased significantly (by 17%) in October to 148 (September 179, August 173, July 175). However, the costs of agency nursing to cover vacancies remained consistent with September at 331k indicating that the roles being filled were not previously being backfilled with agency. HCA agency costs remained high in October at 148k. Vacancies have reduced to 63 WTE (from 73 in September). The agency costs related to sickness cover were as follows: Oct 83k Sep 97k Aug 121k Jul 78k Jun 46k Integrated Quality and Performance Board Report Page 25

6 Finance ' Pay Analysis - Page 5 TOTAL PAY Spend Additional Month Pay Bill Overtime Bank Agency Total on BANK Medical Nursing STT Other Total Sessions Month Spend ' ' ' ' ' ' ' ' ' ' ' Apr 12, ,74 1,186 15,63 o Apr ,74 May 12, ,113 1,36 15,82 1% May , % Jun 13, ,156 1,415 16,26 2% Jun , % Jul 12, ,278 1,41 15,966-1% o Jul , % Aug 12, ,24 1,651 16,268 2% Aug , % Sep 12, ,156 1,652 15,915-2% Sep , % Oct 13, ,98 1,669 16,5 4% o Oct ,98-24.% Nov Nov Dec o Dec Jan Jan Feb Feb Mar Mar Total 89,983 1,292 2,68 8,116 1, ,278 Total 2,736 3, ,257 8, % 1.2% 2.3% 7.2% 9.2% o indicates 5 week mth 34% 48% 3% 15% Agency Cap Target (annual) 11,4 ' Medical Agency Reduction Target (annual) ' YTD Actual 1,279 YTD Actual - Medical agency - 1,199 YTD Agency Plan 6, ADV YTD Medical Agency Target (pro rata)* ADV 1,8 1,6 1,4 1,2 1, Agency by staff group Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Medical Nursing STT Other Agency Ceiling Medical agency cap NHSI target is to reduce medical agency spend by 755k over previous year AGENCY Spend Medical Nursing STT Other Total ' ' ' ' ' Apr ,186 May ,36 1% Jun ,415 8% Jul ,41-1% Aug ,651 18% Sep ,652 % Oct ,669 1% Nov Dec Jan Feb Mar Total 5,674 2, ,279 55% 29% 8% 8% Aver Week on Week Month on Month Integrated Quality and Performance Board Report Page 26

7 Finance ' Non Pay Expenditure (including Pass through) - Page 6 In Month Year to Date Commentary & Actions Non Pay Budget Actual Fav/(Adv) Budget Actual Fav/(Adv) ' ' ' ' ' ' Drugs (69) 3,931 4,762 (831) Supplies & Services Clinical 1,846 2,199 (353) 13,365 14,863 (1,497) Supplies & Services General ,31 2,17 14 Establishment (54) 1,651 1,864 (213) Premises (55) 6,318 6,378 (6) Outsourcing (76) 2,739 2,989 (249) CNST ,233 6,233 Pathology Contract ,462 6,651 (189) Other (51) 2,36 2, Subtotal 6,418 7,68 (65) 45,91 47,896 (2,85) High Cost Drugs & devices (Passthrough) 2,746 2,954 (28) 18,341 17, Grand Total 9,163 1,21 (858) 63,433 65,678 (2,246) Non Pay: Budget v. Actual Non-Pay budgets were over spent by 858k in the month. Excluding pass through costs, this is an overspend of 65k in the month and 2,85k YTD. 353k of the overspend in the month relates to Clinical Supplies. This is predominantly in the following directorates: MSK ( 15k), Theatres ( 89k), Surgery ( 45k) and Medicine ( 35k). 11% of the current month overspend relates to drugs (3% YTD). This comprises high activity levels, price increases (due to shortages) on certain drugs and a shortfall on the drugs CIP schemes. Establishment costs were overspent in the month by 55k due to general servicing and repair costs (eg pipework, valves, doors) and air conditioning servicing and repairs. 11, 1, 9, 8, 7, Premises costs were overspent by 55k in October. 24k of this relates to print services ( 55k YTD). The procurement team are looking at ways in which the ordering of these items can be improved to ensure better control. A futher 28k relates to recruitment fees, which reflects the decrease in vacancies seen this month. 6, 5, The adverse variance on other non-pay in the month relates to a shortfall oncentral procurement CIPs. 4, 3, 2, 1, Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar LAST YEAR ACTUAL BUDGET Integrated Quality and Performance Board Report Page 27

8 Finance Financial summary trend forecast - Page 7 Income & Expenditure (rolling 12 months) Actual Actual Actual Actual Actual Actual Actual Forecast Forecast Forecast Forecast Forecast Apr-17 May-17 Jun-17 Jul-17 Nov-17 Dec-17 Jan-18 Feb-18 Mar-18 Total ' ' ' ' ' ' ' ' ' ' ' ' ' Income 23,5 24,721 25,85 25,95 25,966 24,669 27,143 25,864 24,83 25,939 23,429 25,779 32,848 Income (S&T Funds) ,399 Pay (15,63) (15,82) (16,26) (15,966) (16,268) (15,915) (16,51) (16,521) (16,467) (16,437) (16,361) (16,381) (194,455) Non Pay (8,711) (9,129) (9,825) (9,182) (9,735) (9,73) (1,11) (9,518) (9,136) (9,393) (8,95) (9,19) (111,81) Non Operating (1,3) (1,272) (1,278) (1,279) (1,324) (949) (1,326) (1,295) (1,276) (1,334) (1,337) (1,425) (15,395) TOTAL DEFICIT (SURPLUS) (2,114) (745) (72) (43) (926) (63) (156) (933) (2,259) (33) (2,279) (322) (11,412) o indicates a 5 week pay month for Bank o o o o Developments & cost pressures yet to be incurred GP Streaming Medical HDU (5) (5) (5) (124) (124) (398) CQUIN costs (2) (12) (12) (12) (12) (5) Junior Doctors new contract (41) (41) (41) (41) (41) (25) Urology Business Case (37) (37) (37) (37) (37) (185) Increase in Utilities costs (4) (4) (4) (4) (4) (2) Winter Pressures (178) (178) (179) (178) (178) (891) Ward Pharmacists (21) (21) (21) (21) (22) (16) Month 12 pay increase (1) (1) Outsourcing - Income ,185 Outsourcing - Cost (242) (242) (242) (242) (242) (1,21) Other small non pay items < 1k (67) (67) (67) (67) (67) (335) Other small pay items < 1k (55) (55) (55) (55) (55) (275) Income 23,5 24,721 25,85 25,95 25,966 24,669 27,143 26,11 24,32 26,176 23,666 26,16 34,33 Income (S&T Funds) ,399 Pay (15,63) (15,82) (16,26) (15,966) (16,268) (15,915) (16,5) (16,885) (16,841) (16,812) (16,799) (16,92) (196,535) Non Pay (8,711) (9,129) (9,825) (9,182) (9,735) (9,73) (1,21) (9,977) (9,595) (9,852) (9,374) (9,659) (114,135) Non Operating (1,3) (1,272) (1,278) (1,279) (1,324) (949) (1,326) (1,295) (1,276) (1,334) (1,337) (1,425) (15,395) FORECAST DEFICIT (SURPLUS) (2,114) (745) (72) (43) (926) (63) (156) (1,519) (2,855) (927) (2,949) (1,93) (14,632) PLANNED DEFICIT (2,19) (79) (738) (12) (865) (1,7) 78 (1,832) (2,334) (1,17) (2,997) (1,354) (15,49) Commentary The overall forecast is a deficit of 14.6m, which is better than the planned deficit due to charitable income. The charitable income does not count towards the control total, so the forecast is not an improvement to the control total, rather it shows that the Trust will meet the control total inoverall terms. Integrated Quality and Performance Board Report Page 28

9 Finance ' Cost Improvement Plans (CIPs) - Page 8 Delivered Profile by Month Actual Non Variance Budget Recurrent Delivery recurrent Fav/(Adv) 's 's 's 's 's Apr (32) May (145) Jun (129) Jul (11) Aug Sep Oct (176) Nov 762 Dec 7 Jan 665 Feb 697 Mar 729 Total 8,8 4,95 3,665 1,286 (298) 7, 6, 5, 4, 3, 2, 1, - CIPs Rating 8 2,783-2,215 2, L L1 L2 L3 L4 Green Amber Red Workstream by workstream Annual Budget Delivered YTD Delivered In Month YTD Variance Forecast Variance 's 's 's 's 's Income () () Workforce - Agency 1, (248) (46) Workforce - Other Procurement 1, (12) (194) Other Non-Pay Savings 4,232 2, (129) (218) ESR schemes (5) (9) Total 8,8 4, (298) (71) CIP pipeline L Ideas L1 Scoping L2 QIA L3 Implementation L4 Complete TOTAL Income Workforce - Agency , ,746 Workforce - Other Procurement - 3-1, ,696 Other Non-Pay Savings ,686 1,337 4,232 ESR schemes ,798 2,33 8,8 Commentary The cost improvement programme has achieved 4,95k of savings YTD which is behind plan by 298k (or 6%). The main reasons for the YTD shortfall is Agency CIPs which are 248k behind plan, and forecast to be 46k behind plan by the end of the year. Other Non-Pay savings are behind plan by 129k YTD, and a 218k shortfall is forecast by the end of the year. The largest schemes within here (not delivering to plan) are Drugs (forecast 7k shortfall) and Clincial Waste (forecast 72k shortfall). Other non-pay savings are also behind plan The CIP pipeline table shows that the majority of the efficiency schemes are currently in the implementation stage ( 5,798k) with a large proportion already being fully implemented ( 2,33k). Integrated Quality and Performance Board Report Page 29

10 Finance ' Capital - Page 9 Strategic Budget Actual Fav/(Adv) Budget Actual Fav/(Adv) Budget Committed Forecast Fav/(Adv) ' ' ' ' ' ' ' ' ' ' MRI replacement 1, ,453 2, ,984 5,184 3,954 3,954 1,23 Laparoscopic Theatre (23) (1) GP Streaming (29) (16) 1, 1, 1, Medical HDU 1 (1) 32 (32) 32 1, (1,) Linacc replacement Electronic Patient Record E-Rostering PACS Replacement (29) Teletracking Contingency (18) (156) 1, ,389 (187) Routine Capital work stream In Month Year to Date Full Year Back Log Maintenance ,756 1, ,968 1,588 3,198 (23) IM&T , ,58 23 Equipment Purchases Equipment Leases (4) ,5 (7) Donated Total 3, ,688 8,54 4,795 3,79 15,32 9,315 15,114 (82) (Adv) means scheme is ahead of budget.. Fav is behind budget 15, 14, 13, 12, 11, 1, 9, 8, 7, 6, 5, 4, 3, 2, 1, Cumulative Capex Budget v. Actual Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Actual Actual / Forecast Internal Budget Commentary on Trend/Forecast The Trust's original plan for was 12m. We have received external funding for the GP Streaming Scheme and use of the STF Incentive Bonus to fund the Teletracking project and increase the contingency bringing the revised plan to it's currrent level. Within the programme 4.3m is planned to be funded by the use of leasing, this includes 2.6m for the replacement MRIs. Year to date 4,795k has been spent on the programme which is 3,79k behind the planned profileof spend, this is largely due toslippage on the MRI replacement. The programme continues to be carefully monitored and governed by the Investment Approval Committeewherepotential issues can be raised and addressed. Integrated Quality and Performance Board Report Page 3

11 Finance Statement of Financial Position (Balance Sheet) - Page 1 Last Year SOFP (Statement of Financial Position) Plan Actual Variance Plan Forecast Mar-217 m m m m m NON CURRENT ASSETS Year to Date Year End 3.1 Intangible Assets (.7) Property, Plant and Equipment (2.) Trade & Other Receivables (.8) CURRENT ASSETS 6.3 Inventories (.) Trade and Other Receivables (.4) Other Current Assets Assets held for sale Cash and cash equivalents (2.9) (3.3) CURRENT LIABILITIES (29.1) Trade and Other Payables (3.5) (28.) (2.5) (27.4) (18.2) (.9) Borrowings (1.4) (2.6) 1.2 (1.9) (1.9) (.5) Provisions..... (2.5) Other Liabilities (3.6) (.5) (3.2) (3.6) (3.6) (33.) (35.5) (31.1) (4.4) (32.9) (23.7) TOTAL ASSETS less CURRENT LIABILITIES (8.5) NON-CURRENT LIABILITIES Commentary The Trust's closing cash position is above the 1.5m plan. The Trust drew down 3.2m in loans in October. The Trust s performance against the PSPP (Public Sector Payment Policy) was 86% compliant year to date in respect of the value of all invoices paid within 3 days of receipt by the Trust. The NHS target is 95% of all invoices paid within 3 days.. Trade and Other Payables..... (5.6) Borrowings (PFI/Leases) (11.5) (4.1) (7.4) (12.2) (12.2) (34.2) Borrowings (Loans) (34.6) (42.) 7.4 (33.9) (43.5) (1.5) Provisions (1.5) (2.).5 (1.5) (1.5) (1.1) Other Liabilities (1.2) (1.1) (.1) (1.2) (1.2) (42.4) (48.7) (49.2).5 (48.7) (58.3) TOTAL NET ASSETS EMPLOYED (8.) FINANCED BY 13. Public Dividend Capital (.6) Revaluation Reserve (13.6) Retained Earnings (26.5) (18.9) (7.6) (32.6) (32.6) TOTAL TAXPAYERS' EQUITY (8.) Integrated Quality and Performance Board Report Page 31

12 Finance Statement of Cash Flow - Page 11 millions YTD Actual Actual Actual Actual Actual Actual Actual Plan Plan Plan Plan Plan CASH FLOWS FROM OPERATING ACTIVITIES Plan Actual Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Operating surplus/(deficit) (6.4) (2.3) (1.7) (2.) (.5) (.2).3 (.3) (1.6).2 (2.) (.3) Add back Non Cash Items Movements in Working Capital (1.4) (3.7) 1.5 (1.6) (1.4) 2.5 (1.5) (1.9) (1.3) (1.5) (1.) (2.1). (1.4) Net Cash Surplus/(Deficit) (1.6) (.2).7 (1.9) (1.1) (1.6) (.) (.9) (1.7) (1.) (1.1) (.7) Capital Purchases (5.3) (4.4) (.7) (.3) (1.3).8 (.8) (.6) (1.5) (.4) (.6) (.2) (.2) (.5) Capital Receipts Movement in Borrowings Public Dividend Capital received Loans Repaid - (3.) (1.5) (1.5) (7.) New Loans Revenue Loans Working Capital Loans Capital Loans Net Movement in Borrowings (1.5) (5.7) Check (.7) (3.4) (1.6) 1.7 (.). (.).. Cash Movement in Period (3.4) (1.6) 1.8 (.). (.).. Cumulative Cash Position Loan Type Status Loan Period Drawdown date Repayment date Borrowing / repayments Cumulative Borrowing / repayments Rate Interest payable in year Interest payable over loan duration (see key) ' ' % ' Prior Years Uncommitted revenue support loan Actual 3 years 14-Mar Feb-19 7, 7, 1.5% Uncommitted revenue support loan Actual 3 years 3-Jan-17 2-Jan-2 21,551 28, % Uncommitted revenue support loan Actual 3 years 13-Feb Feb-2 1,189 29,74 1.5% 3 65 Uncommitted revenue support loan Actual 3 years 13-Mar Mar-2 2,311 32,51 1.5% Current Year May Uncommitted revenue support loan Actual 3 years 15-May May-2 1,5 33, % 2 68 Jun Uncommitted revenue support loan Actual 3 years 12-Jun Jun-2 2, 35, % Jul Uncommitted revenue support loan Actual 3 years 17-Jul Jul-2 1,7 37, % Oct Uncommitted revenue support loan Actual 3 years 16-Oct Oct-2 3,195 4, % 145 Total Borrowings 4,446 1,82 Net Total Borrowings , Commentary The cash balance at the end of October was 4.4m which is above the planned month end cash position. 3.2m of borrowings were drawn within the month. The planned support required for 217/18, before any potential land sale receipt, is 15.3m Within the loan agreements, the Trust has been set a minimum month end closing cash balance of 1.5m and a maximum of 7.641m. Integrated Quality and Performance Board Report Page 32

13 Finance Integrated Quality and Performance Board Report Page 33

14 Finance Integrated Quality and Performance Board Report Page 34

15 Appendix: A - Domain Scorecards Safe Target Apr-17 May-17 Jun-17 Jul-17 Nov-17 Dec-17 Jan-18 Feb-18 Mar-18 No. Falls (Moderate) No. Falls (High/ Extreme) Falls per 1 OBD HNQI 9.% 95.5% 96.2% 97.% 96.2% 96.7% 94.6% 95.1%.%.%.%.%.% Incidents of C-Diff C Diff YTD (Cumulative) C-Diff Per 1 OBD YTD Direct lapse in care resulting in C Diff infection Incidents of MRSA Maternity - Total LSCS 25.% 34.1% 3.3% 31.2% 3.7% 31.8% 27.7% 3.4%.%.%.%.%.% Maternity - Emergency LSCS 15.% 18.3% 15.72% 16.51% 15.22% 17.5% 17.4% 16.61%.%.%.%.%.% Maternity -Normal births 6.% 6.% 64.1% 64.9% 64.2% 61.9% 67.6% 61.7%.%.%.%.%.% Med Errors - Extreme Med Errors - High Pressure Ulcers (avoidable) Cumulative.1%.11%.5%.7%.7%.9%.9%.%.%.%.%.%.% Pressure Ulcers (Grade 2+) Safety Thermometer 92.% 93.9% 94.1% 95.4% 92.3% 93.1% 92.3% 92.5%.%.%.%.%.% Serious Incidents Never Events 1 VTE risk assessment testing 95.% 98.8% 98.8% 98.7% 98.7% 98.5% 98.1%.%.%.%.%.%.% MRSA Screening 95.% 89.4% 85.8% C-Diff per OBD HPA Note: the indicators 'C-Diff per OBD HPA' and 'C Diff YTD (Cumulative)' are RAG-rated on the most recent period only as the target changes every period. MSB Maternity Dashboard Red Flag Apr-17 May-17 Jun-17 Jul-17 Nov-17 Dec-17 Jan-18 Feb-18 Mar-18 Workforce Ratio midwives to births 1:3 >1:32 1:29 1:29 1:29 1:29 1:29 1:29 1:32 Births Total maternities 42 (>35) C. Section Total LSCS 25% >26% 34.1% 3.3% 31.2% 3.7% 31.8% 27.7% 3.4% Activity Initiation of breast 74.8% 79.5% 73.7% 79.% 75.5% 76.2% 76.% Feeding feeding at delivery >7% <7% Breastfeeding at 1 days >75% <7% 73.8% 75.1% 74.6% 73.8% 78.2% 69.6% 72.3% Clinical Indicators Maternal Deaths Integrated Quality and Performance Board Report Page 35

16 Appendix: A - Domain Scorecards Caring Target Apr-17 May-17 Jun-17 Jul-17 Nov-17 Dec-17 Jan-18 Feb-18 Mar-18 Complaints YTD compliance % -1.% % % -6.19% -3.79% -1.77% -2.49% -.42%.%.%.%.%.% Monthly Complaints Compliance IP F&F Response Rate 29.3% 25.6% 27.7% 25.3% 25.4% 29.5% 25.4% 26.8%.%.%.%.%.% IP F&F Recommended 95.% 92.1% 92.3% 91.9% 92.8% 93.% 92.3% 93.%.%.%.%.%.% A&E F&F Response Rate 12.4% 17.2% 19.2% 18.1% 16.7% 16.9% 15.3% 15.6%.%.%.%.%.% A&E F&F Recommended 85.% 87.9% 86.7% 87.2% 86.9% 87.4% 85.1% 83.1%.%.%.%.%.% Mat F&F Response Rate 23.7% 4.% 9.6% 13.9% 19.9% 9.8% 12.8% 12.5%.%.%.%.%.% Mat F&F Recommended 95.% 95.8% 1.% 93.3% 95.2% 95.4% 98.1% 92.2%.%.%.%.%.% OP F&F Response Rate 9.3% 14.4% 19.6% 17.7% 16.9% 17.6% 16.3% 18.4%.%.%.%.%.% OP F&F Recommended 95.% 92.7% 93.2% 93.4% 92.5% 93.1% 93.2% 92.6%.%.%.%.%.% Maternity - Initiation of breast feeding at delivery 7.% 74.8% 79.5% 73.7% 79.% 75.5% 76.2% 76.%.%.%.%.%.% Mixed Sex Accomodation Note: F&F response rates are RAG-rated on the most recent month only as the target changes every month. Integrated Quality and Performance Board Report Page 36

17 Appendix: A - Domain Scorecards Responsive Target Apr-17 May-17 Jun-17 Jul-17 Nov-17 Dec-17 Jan-18 Feb-18 Mar-18 RTT - Admitted 9.% 46.5% 58.3% 48.4% 49.8% 51.2% 49.8% 52.2%.%.%.%.%.% RTT - Non Admitted 95.% 92.% 91.3% 89.9% 89.6% 89.1% 88.6% 88.3%.%.%.%.%.% RTT - Incomplete 92.% 86.% 86.3% 85.4% 83.6% 82.7% 82.6% 84.2%.%.%.%.%.% RTT - Admitted Backlog 18 1,849 1,788 1,821 1,85 1,86 1,643 1,411 RTT - 52 Week Breaches RTT - Admitted 95th% RTT - Non Admitted 95th% A&E - Unplanned Re-attend 5.% 6.3% 7.4% 7.1% 6.9% 6.8% 7.% 7.3%.%.%.%.%.% A&E - Time Spent in A&E 4: 4: 5:21 5:26 5:1 5:36 6:3 5:36 : : : : : A&E - Left Without Being Seen 5.% 1.%.9% 1.7% 2.% 1.9% 1.9% 1.8%.%.%.%.%.% A&E - Time to Assessment :15 :44 :51 :54 :55 1:5 1:2 1:1 : : : : : A&E - Time to Treatment 1: :49 :58 1:1 1:7 1:6 :57 :47 : : : : : A&E - Max 4 hr Wait 95.% 95.3% 91.7% 9.7% 91.7% 91.1% 87.5% 89.4%.%.%.%.%.% A&E - Trolley Waits +12 hr 1 Ambulance Handover > 3 mins Ambulance Handover > 6 mins Ambulance Turnover - Arrival to Handover 85.% 57.1% 44.% 41.% 43.4% 38.2% 37.7% 43.7%.%.%.%.%.% ALOSpell - Elective ALOSpell - Non Elective Cancellations - Short Notice.8%.54%.72% 1.57%.62% 1.%.58%.39%.%.%.%.%.% Cancellations - Rebooked >28 days Cancellations - Short Notice Clinic 1.%.16%.23%.39%.16%.22%.25%.16%.%.%.%.%.% Cancellations - Urgent 2nd Time Cancer - 2wk Diag to Treat 93.% 95.3% 97.1% 94.2% 95.2% 94.2% 96.4% 96.9%.%.%.%.%.% Cancer - 2wk Symp Breast 93.% 95.7% 97.7% 96.1% 95.3% 94.1% 94.% 1.%.%.%.%.%.% Cancer - 31d Diag to 1st Treat 96.% 96.7% 93.8% 91.4% 98.3% 96.2% 96.1% 98.7%.%.%.%.%.% Cancer - 31d 2nd Treat Drug 98.% 99.% 1.% 1.% 99.2% 1.% 1.% 99.2%.%.%.%.%.% Cancer - 31d 2nd Treat Surg 94.% 88.9% 92.3% 85.% 86.7% 83.3% 1.% 9.%.%.%.%.%.% Cancer - 31d 2nd Treat Radio 94.% 99.1% 97.8% 1.% 99.2% 99.2% 1.% 97.8%.%.%.%.%.% Cancer - 62d GP Ref to Treat 85.% 71.9% 65.5% 63.5% 76.6% 7.7% 79.5% 78.3%.%.%.%.%.% Cancer - 62d GP (Southend only) 85.% 78.6% 79.1% 72.7% 82.8% 79.3% 85.3% 84.8%.%.%.%.%.% Cancer - 62d Screen to Treat 9.% 1.% 97.7% 1.% 92.3% 96.8% 89.3% 96.8%.%.%.%.%.% Cancer - 62d Cons Upgrade 85.% 1.% 75.% 66.7% 66.7% 66.7% 8.% 75.%.%.%.%.%.% DTOC Compliance 3.5% 4.73% 3.29% 2.46% 2.65% 2.5% 3.11% 3.49%.%.%.%.%.% Diagnostic Breaches - Compliance 99.% 98.1% 98.6% 98.7% 99.% 99.2% 99.% 99.1%.%.%.%.%.% Diagnostic (DM1) 99.% 88.5% 89.2% 92.8% 97.6% 98.2% 97.2% 98.4%.%.%.%.%.% Maternity - Bk before % 94.1% 95.2% 92.5% 77.8% 92.4% 91.8%.%.%.%.%.%.% Integrated Quality and Performance Board Report Page 37

18 Appendix: A - Domain Scorecards Effective Target Apr-17 May-17 Jun-17 Jul-17 Nov-17 Dec-17 Jan-18 Feb-18 Mar-18 Pre Op Bed Days - Elective 7.45% 9.3% 4.3% 6.3% 5.6% 7.7% 9.3% 1.8%.%.%.%.%.% Readmissions 3d - Elective 3.47% 3.8% 2.5% 2.9% 2.3% 4.% 2.6%.%.%.%.%.%.% Readmissions 3d - Non Elective 9.69% 13.3% 11.8% 12.4% 12.2% 12.8% 12.7%.%.%.%.%.%.% SHMI Crude Mortality Rate 2.% 2.75% 2.93% 2.22% 2.8% 2.42% 2.38% 3.2%.%.%.%.%.% Integrated Quality and Performance Board Report Page 38

19 Appendix: A - Domain Scorecards Workforce Target Apr-17 May-17 Jun-17 Jul-17 Nov-17 Dec-17 Jan-18 Feb-18 Mar-18 Appraisals 8.% 65.78% 7.2% 72.4% 73.82% 76.94% 76.57% 76.76%.%.%.%.%.% Induction 99.% 99.53% 99.65% 99.41% 99.8% 99.76% 99.76% 99.42%.%.%.%.%.% Average Agency Ceiling (as a percentage) 6.% 9.31% 9.12% 8.99% 8.87% 8.92% 8.94% 9.3%.%.%.%.%.% Bank Spend as % of Pay Bill % 6.65% 6.85% 6.99% 7.4% 7.16% 7.17%.%.%.%.%.% All Temp Spend as % of Pay Bill 11.5% 17.27% 17.1% 17.17% 17.19% 17.28% 17.42% 17.51%.%.%.%.%.% Headcount (perm, temp & locum) Establishment (FTE) 4, % Staff in Post against Establishment 93.% 87.28% 87.79% 87.41% 87.86% 87.37% 88.47% 89.5%.%.%.%.%.% FTE (perm, temp, locum staff & bank) Bank Staff Rate % % 12.37% 12.22% 12.7% 11.98% 11.93% 11.92%.%.%.%.%.% Sickness Absence Rate 3.5% 4.% 3.96% 3.88% 3.84% 3.8% 3.78% 3.78%.%.%.%.%.% Turnover FTE % - All Leavers (ex jr drs) 9.5% 13.97% 14.24% 14.56% 14.95% 14.72% 14.48% 14.52%.%.%.%.%.% Turnover FTE % - Voluntary (ex jr drs) 9.5% 12.55% 12.78% 13.7% 13.49% 13.24% 13.1% 13.%.%.%.%.%.% % of Leavers Left Within 2 Years % 41.67% 42.36% 42.49% 43.41% 45.44% 44.21%.%.%.%.%.% Statutory Mandatory Training 85.% 85.36% 84.22% 85.3% 85.19% 82.93% 84.67% 85.24%.%.%.%.%.% Employment Tribunals Grievances Raised Vacancy Rate based on Establishment 7.% 12.72% 12.21% 12.59% 12.14% 12.63% 11.53% 1.95%.%.%.%.%.% Vacancy Rate based on Requisitions % 12.7% 14.21% 13.77% 11.86% 9.86% 11.6%.%.%.%.%.% Annual Leave Entitlement 7.%.%.%.%.%.%.% 76.57%.%.%.%.%.% Note: 'Appraisals' and 'Annual Leave Entitlement' are RAG-rated on the most recent month only as their targets change every month. Note: Several indicators are only RAG rated from Aug/Sept onwards due to their targets having been changed mid-year. Integrated Quality and Performance Board Report Page 39

20 Appendix: A - Domain Scorecards Estates Target Apr-17 May-17 Jun-17 Jul-17 Nov-17 Dec-17 Jan-18 Feb-18 Mar-18 EFM Referrals each month EFM Jobs remaining open EFM Reactive Priority one 95.% 1.% 1.% 1.% 1.% 97.3% 98.4% 96.6%.%.%.%.%.% EFM Reactive Priority Two 75.% 93.% 92.% 89.8% 93.2% 91.4% 8.9% 79.8%.%.%.%.%.% EFM Reactive Priority Three 65.% 53.7% 72.3% 59.% 57.8% 54.4% 52.6% 49.%.%.%.%.%.% EFM Reactive Priority Four 8.% 67.7% 66.5% 67.4% 64.3% 49.2% 46.9% 53.5%.%.%.%.%.% EFM Reactive Priority Five 9.% 63.% 89.2% 6.9% 56.3% 63.2% 5.% 48.3%.%.%.%.%.% EFM (PPM) 75.% 96.1% 84.7% 84.4% 99.3% 78.2% 94.7% 73.8%.%.%.%.%.% Statutory PPM 1.% 99.2% 93.1% 94.9% 99.8% 91.4% 96.5% *.%.%.%.%.% EFM Catering Very High Risk 99.% 99.% 99.% 99.% 99.% 99.% 99.% 99.%.%.%.%.%.% EFM Catering High Risk 98.% 98.% 98.% 98.% 98.% 98.% 98.% 98.%.%.%.%.%.% EFM Catering Significant Risk 98.% 98.% 98.% 98.% 98.% 98.% 98.% 98.%.%.%.%.%.% EFM Catering Low Risk 97.% 98.% 98.% 98.% 98.% 98.% 98.% 98.%.%.%.%.%.% EFM Domestics Very High Risk 98.% 99.% 99.1% 99.1% 99.3% 98.8% 99.6% 99.1%.%.%.%.%.% EFM Domestics High Risk 95.% 98.% 98.1% 98.1% 96.% 97.6% 97.8% 97.8%.%.%.%.%.% EFM Domestics Significant Risk 85.% 94.9% 97.% 96.5% 94.8% 95.7% 96.% 93.8%.%.%.%.%.% EFM Domestics Low Risk 75.% 95.2%.%.% 86.1%.% 89.1%.%.%.%.%.%.% Nurse Clean Very High Risk 98.% 95.3% 92.4% 94.3% 95.5% 94.8% 97.9% 95.3%.%.%.%.%.% Nurse Clean High Risk 95.% 93.6% 93.2% 94.5% 94.7% 91.8% 95.% 93.4%.%.%.%.%.% Nurse Clean Significant Risk 85.% 91.8% 83.6% 89.5% 93.1% 95.2% 97.4% 94.8%.%.%.%.%.% Nurse Clean Low Risk 75.% 95.2%.%.%.%.%.%.%.%.%.%.%.% EFM Telephony Priority 1 95.% 74.5% 84.3% 85.6% 87.2% 86.1% 89.2% 93.8%.%.%.%.%.% EFM Telephony Priority 2 95.% 94.9% 9.1% 92.% 93.2% 9.6% 88.% 89.4%.%.%.%.%.% EFM Telephony Priority 3 95.% 94.7% 92.1% 92.5% 93.1% 9.3% 87.% 89.1%.%.%.%.%.% EFM Telephony Priority 4 85.% 9.4% 85.6% 88.7% 89.5% 87.9% 83.4% 86.2%.%.%.%.%.% Helpdesk calls answered in time 95.% 86.% 85.5% 81.2% 91.5% 88.7% 87.5% 95.9%.%.%.%.%.% MEMS Total Activity MEMS Turnaround Critical 85.% 1.% 88.% 87.% 92.% 91.% 88.% 1.%.%.%.%.%.% MEMS Turnaround High 85.% 59.% 82.% 87.% 82.% 85.% 84.% 91.%.%.%.%.%.% MEMS Turnaround Medium 85.% 89.% 88.% 85.% 88.% 87.% 91.% 92.%.%.%.%.%.% MEMS PPM Compliance 78.% 72.% 81.5% 8.9% 79.4% 79.1% 79.2% 78.5%.%.%.%.%.% MEMS Helpdesk Telephone 95.% 91.5% 95.9% 89.9% 89.4% 83.8% 94.5% 92.8%.%.%.%.%.% MEMS Medical Equipment Loans - 94.% 91.% 94.8% 96.% 99.% 81.% 88.%.%.%.%.%.% * Due to data cleansing this figure is not available for month. Integrated Quality and Performance Board Report Page 4

21 Appendix B: Additional Charts for Safe Domain Safety Thermometer Maternity - Total LSCS 1% 98.% 96.% 8% 94.% 6% 92.% 4% 9.% 2% 88.% 4.% 3.% 2.% 1.%.% Safety Thermometer 93.1% 92.3% 92.5% Maternity - Total LSCS 31.8% 27.7% 3.4% Maternity -Normal births 7% 65% 6% 55% 5% 1% 8% 6% 4% 2% % Med Errors - Extreme Maternity -Normal births 61.9% 67.6% 61.7% Med Errors - Extreme Integrated Quality and Performance Board Report Page 41

22 Appendix B: Additional Charts for Safe Domain Med Errors - High HNQI 1 1.% 95.% 9.% 85.% Med Errors - High HNQI 96.7% 94.6% 95.1% MRSA Screening C-Diff Per 1 OBD YTD 1% 95% 9% 85% 8% Jun-17 Sep-17 Dec-17 Mar Mar-17 Jun-17 Sep-17 MRSA Screening 88.1% 89.4% 85.8% C-Diff Per 1 OBD YTD Integrated Quality and Performance Board Report Page 42

23 Appendix B: Additional Charts for Safe Domain 3. C-Diff per OBD HPA Jun-17 Sep-17 Dec-17 Mar-18 Dec-16 Mar-17 Jun-17 C-Diff per OBD HPA Integrated Quality and Performance Board Report Page 43

24 Appendix C: Additional Charts for Caring Domain IP F&F Response Rate A&E F&F Response Rate 4.% 3.% 2.% 1.%.% 25.% 2.% 15.% 1.% 5.%.% IP F&F Response Rate 29.5% 25.4% 26.8% A&E F&F Response Rate 16.9% 15.3% 15.6% Mat F&F Response Rate 4.% 3.% 2.% 1.%.% 25.% 2.% 15.% 1.% 5.%.% OP F&F Response Rate Mat F&F Response Rate 9.8% 12.8% 12.5% OP F&F Response Rate 17.6% 16.3% 18.4% Integrated Quality and Performance Board Report Page 44

25 Appendix C: Additional Charts for Caring Domain 1% 8% 6% 4% 2% % Maternity - Initiation of breast feeding at delivery Maternity - Initiation of breast feeding at delive 75.5% 76.2% 76.% Integrated Quality and Performance Board Report Page 45

26 Appendix D: Additional Charts for Responsive Domain RTT - Admitted RTT - Non Admitted 1% 8% 6% 4% 2% % 1% 8% RTT - Admitted 51.2% 49.8% 52.2% RTT - Non Admitted 89.1% 88.6% 88.3% RTT - Admitted Backlog RTT - 52 Week Breaches RTT - Admitted Backlog RTT - 52 Week Breaches Integrated Quality and Performance Board Report Page 46

27 Appendix D: Additional Charts for Responsive Domain RTT - Admitted 95th% RTT - Non Admitted 95th% RTT - Admitted 95th% RTT - Non Admitted 95th% A&E - Unplanned Re-attend 8.% 6.% 4.% 2.%.% 1: 8: 6: 4: 2: : A&E - Time Spent in A&E A&E - Unplanned Re-attend 6.8% 7.% 7.3% A&E - Time Spent in A&E 5:36 6:3 5:36 Integrated Quality and Performance Board Report Page 47

28 Appendix D: Additional Charts for Responsive Domain A&E - Left Without Being Seen A&E - Time to Assessment 6.% 4.% 2.%.% 2: 1: : A&E - Left Without Being Seen 1.9% 1.9% 1.8% A&E - Time to Assessment 1:5 1:2 1:1 A&E - Time to Treatment 2: 1: : A&E - Trolley Waits +12 hr A&E - Time to Treatment 1:6 :57 :47 A&E - Trolley Waits +12 hr Integrated Quality and Performance Board Report Page 48

29 Appendix D: Additional Charts for Responsive Domain Ambulance Handover > 3 mins Ambulance Handover > 6 mins Ambulance Handover > 3 mins Ambulance Handover > 6 mins Ambulance Turnover - Arrival to Handover ALOSpell - Elective Previous Year Rate 1.% 8.% 6.% 4.% 2.%.% Ambulance Turnover - Arrival to Handover 38.2% 37.7% 43.7% ALOSpell - Elective Integrated Quality and Performance Board Report Page 49

30 Appendix D: Additional Charts for Responsive Domain ALOSpell - Non Elective Cancellations - Short Notice Previous Year Rate % 1.%.% ALOSpell - Non Elective Cancellations - Short Notice 1.%.6%.4% Cancellations - Rebooked >28 days Cancellations - Short Notice Clinic 2.%.% Cancellations - Rebooked >28 days Cancellations - Short Notice Clinic.2%.2%.2% Integrated Quality and Performance Board Report Page 5

31 Appendix D: Additional Charts for Responsive Domain Cancellations - Urgent 2nd Time Cancer - 2wk Diag to Treat 5 1.% 9.% 8.% 7.% Cancellations - Urgent 2nd Time Cancer - 2wk Diag to Treat 94.2% 96.4% 96.9% 1.% 8.% 6.% 4.% 2.%.% Cancer - 2wk Symp Breast Cancer - 31d Diag to 1st Treat 1.% 9.% 8.% Cancer - 2wk Symp Breast 94.1% 94.% 1.% Cancer - 31d Diag to 1st Treat 96.2% 96.1% 98.7% Integrated Quality and Performance Board Report Page 51

32 Appendix D: Additional Charts for Responsive Domain Cancer - 31d 2nd Treat Drug Cancer - 31d 2nd Treat Surg 1.% 9.% 1.% 8.% 6.% 4.% 2.%.% Cancer - 31d 2nd Treat Drug 1.% 1.% 99.2% Cancer - 31d 2nd Treat Surg 83.3% 1.% 9.% Cancer - 31d 2nd Treat Radio 1.% 9.% 1.% 8.% 6.% 4.% 2.%.% Cancer - 62d GP (Southend only) Cancer - 31d 2nd Treat Radio 99.2% 1.% 97.8% Cancer - 62d GP (Southend only) 79.3% 85.3% 84.8% Integrated Quality and Performance Board Report Page 52

33 Appendix D: Additional Charts for Responsive Domain Cancer - 62d Screen to Treat Cancer - 62d Cons Upgrade 1.% 8.% 6.% 4.% 2.%.% 1.% 8.% 6.% 4.% 2.%.% Cancer - 62d Screen to Treat 96.8% 89.3% 96.8% Cancer - 62d Cons Upgrade 66.7% 8.% 75.% DTOC Compliance 8.% 6.% 4.% 2.%.% Diagnostic Breaches - Compliance 1.% 95.% DTOC Compliance 2.5% 3.1% 3.5% Diagnostic Breaches - Compliance 99.2% 99.% 99.1% Integrated Quality and Performance Board Report Page 53

34 Appendix D: Additional Charts for Responsive Domain Maternity - Bk before % 1.% 8% 8.% 6% 6.% 4% 4.% 2% 2.% %.% Jul-17 Aug-17 Sep-17 Maternity - Bk before % 92.4% 91.8% Integrated Quality and Performance Board Report Page 54

35 Appendix E: Additional Charts for Effective Domain Pre Op Bed Days - Elective Readmissions 3d - Elective 15.% 1.% 5.%.% 5% 4% 3% 2% 1% % Pre Op Bed Days - Elective 7.7% 9.3% 1.8% Jul-17 Aug-17 Sep-17 Readmissions 3d - Elective 2.3% 4.% 2.6% Readmissions 3d - Non Elective 2% 15% 1% 5% % Jul-17 Aug-17 Sep-17 Readmissions 3d - Non Elective 12.2% 12.8% 12.7% Integrated Quality and Performance Board Report Page 55