Integrated Business Report

Transcription

1 Integrated Business Report 9.% 8.% 7.% 6.% 5.% 4.% 3.% 2.% 1.%.% -1.% -2.% Surplus Cat A Performance 75.6% 77.6% 76.6% 75.1% 76.5% 77.3% 75.1% 76.7% 67.6% 76.6% 77.3%.% PTS Activity vs Contract -2% -8% -6% 3% -12% -2% -1% % % % % % Vacancies 7.5% 7.38% 7.% 7.71% 5.47% 4% Call Handling Cat A calls = patient presents with life-threatening illness or injury. Cat B calls = patient presents with serious but not lifethreatening illness or injury. Alternatively patients may be referred to alternative providers of healthcare or self care for non life threatening or non serious illness or injury. Average Call length is time from call hitting switch to close of call. Volume of calls is the total number of emergency (999) calls (excluding duplicate calls). Answered within five seconds is the total number of emergency (999) calls answered within 5 seconds from hitting the switch. Percentage of calls answered within 5 seconds of connection to the control room <5 Apr-8 May-8 Jun-8 Jul-8 Aug-8 Sep-8 Oct-8 Nov-8 Dec-8 Jan-9 Feb-9 Mar-9 96.% 92.9% 96.6% 97.4% 98.2% 97.8% 98.% 98.7% 97.5% 97.9% 97.5% Number of Calls Calls Apr-8 May-8 Jun-8 Jul-8 Aug-8 Sep-8 Oct-8 Nov-8 Dec-8 Jan-9 Feb-9 Mar Call Allocation / Process Time Reported Separately for Category A & B Calls Percentage of Calls Processed Within Target of 45 Seconds A B 5.% 4.% 3.%

2 3.% 2.% 1.%.% A 43.2% 43.6% 43.8% 42% 43% 44% 43% 45% 38% 44% 45% B 43.5% 42.% 41.8% 42% 44% 44% 42% 44% 37% 43% 44% Call categorisation (A, B, referred to alternative provider or self care) A B C Referred Self Care Apr-8 May-8 Jun-8 Jul-8 Aug-8 Sep-8 Oct-8 Nov-8 Dec-8 Jan-9 Feb-9 Mar-9 29.% 29.% 3.% 29.% 29.% 29.% 29.% 31.2% 34.% 34.% 33.7% 58.% 59.% 59.% 6.% 59.% 59.% 58.7% 55.7% 51.% 5.5% 5.6% 5.% 5.% 5.% 5.% 5.% 5.% 5.% 5.% 5.4% 5.% 5.6% 2.% 2.% 2.% 2.% 2.% 2.% 2.2% 2.8% 3.6% 4.% 3.7%.8%.8%.7%.1%.1%.1%.1%.1%.2%.2%.2% Response The mobilisation performance for category A and B is below the standard we have set for the year however the performance being achieved has been reasonably consistent throughout the year. We will continue to review mobilisation times and minimise delays where possible. Category A and B performance standards have been achieved in February returning to average levels following a difficult December and January. The activity level for February this year is consistent with the activity last year and is one of the quietest months in the year so far. Percentage of Vehicles Mobilised in less than 45 seconds. split by category. Target 75% A B Target 8.% 7.% 6.% 5.% 4.% 3.% 2.% 1.%.% 58% 6% 61% 62% 63% 63% 65% 63% 64% 61% 62% 55% 57% 58% 59% 59% 6% 61% 59% 62% 58% 59% Category A and B Performance - Service Wide Service Service 1% 95% 9% 85% 8% 75% 7% 96.5% 96.2% 96.2% 96.% 96.3% 95.9% 95.8% 95.9% 95.3% 95.3% 91.5% 77.6% 75.6% 76.6% 75.1% 76.5% 77.3% 75.1% 76.7% 76.6% 77.3%

3 7% 65% 6% 55% 5% 75.6% 77.6% 76.6% 75.1% 76.5% 77.3% 75.1% 76.7% 76.6% 77.3% 67.6% Emergency and Urgent Activity 28/9 27/ Patients conveyed to hospital Conveyance Rate is the calls where a crew is activated and the patient is transported to hospital. Percentage of patients transported to hospital 8% 7% 6% 5% 4% 3% 2% 1% % 7% 69% 7% 7% 7% 7% 71% 71% 69% 7% 71% Outcomes Clinical KPIs are now reported each month following an audit cycle. Each of the five audits are carried out once every cycle. Cycle 1 covers the period May-September 28, Cycle 2 covers the period November 28-March 29 and Cycle 3 covers the period May-September 29. The Percentage of Shocked Patients experiencing a ROSC: January 21 to December 28

4 The Percentage of Shocked Patients experiencing a ROSC: January 21 to December 28 6 The Percentage of Shocked Patients experiencing a ROSC from Jan 21 Avg % ROSC upper control Lower control Linear (% ROSC) % shocked % shocked patients patients experiencing experiencing a ROSC a ROSC Jan 1 Feb 1 Mar 1 Apr 1 May 1 Jun 1 Jul 1 Aug 1 Sep 1 Oct 1 Nov 1 Dec 1 Jan 2 Feb 2 Mar 2 Apr 2 May 2 Jun 2 Jul 2 Aug 2 Sep 2 Oct 2 Nov 2 Dec 2 Jan 3 Feb 3 Mar 3 Apr 3 May 3 Jun 3 Jul 3 Aug 3 Sep 3 Oct 3 Nov 3 Dec 3 Jan 4 Feb 4 Mar 4 Apr 4 May 4 Jun 4 Jul 4 Aug 4 Sep 4 Oct 4 Nov 4 Dec 4 Jan 5 Feb 5 Mar 5 Apr 5 May 5 Jun 5 Jul 5 Aug 5 Sep 5 Oct 5 Nov 5 Dec 5 Jan 6 Feb 6 Mar 6 Apr 6 May 6 Jun 6 Jul 6 Aug 6 Sep 6 Oct 6 Nov 6 Dec 6 Jan 7 Feb 7 Mar 7 Apr 7 May 7 Jun 7 Jul 7 Sep 7 Nov 7 Dec 7 Jan 8 Feb 8 Mar 8 Apr 8 May 8 Jun 8 Jul 8 Aug 8 Sep 8 Oct 8 Nov 8 Dec 8 Jan 1 Mar 1 May 1 Jul 1 Sep 1 Nov 1 Jan 2 Mar 2 May 2 Jul 2 Sep 2 Nov 2 Jan 3 Mar 3 May 3 Jul 3 Sep 3 Nov 3 Jan 4 Mar 4 May 4 Jul 4 Sep 4 Nov 4 Jan 5 Month Mar 5 May 5 Jul 5 Sep 5 Nov 5 Jan 6 Mar 6 May 6 Jul 6 Sep 6 Nov 6 Jan 7 Mar 7 May 7 Jul 7 Sep 7 Nov 7 Jan 8 Mar 8 May 8 Jul 8 Sep 8 Nov 8 Mean % ROSC Upper Control Lower Control ROSC Apr-8 May-8 Jun-8 Jul-8 Aug-8 Sep-8 Oct-8 Nov-8 Dec-8 Jan-9 Feb-9 Mar-9 6% 9% 6% 5% 6% 5% 1% 6% 3% 7% 8% Patient Safety and Satisfaction Complaints and Appreciations Formal Complaints are those complaints received from patients / carers in relation to the service provided by the Trust which are investigated and responded to in line with current NHS Complaints Regulations. The appreciations reported are 'thank you's' received from patients / carers for the care provided, students attending training courses and for staff attending events (i.e. school fates). February - formal complaints registered compares to 14 received for the year 7-8, appreciations received compares to 25 for the year 7-8. Apr-8 May-8 Jun-8 Jul-8 Aug-8 Sep-8 Oct-8 Nov-8 Dec-8 Jan-9 Feb-9 Mar-9 Complaints Appreciations Infection Control

5 Reducing Healthcare Associated Infection (HCAI) Registration with the Care Quality Commission in relation to the Health and Social Care Act 28 was completed at the end of January 29. Declared overall compliance with the Act but partially met to criteria 1, 2, 5, 8 and 9, fully met to criteria 3 and 4, criteria 6 and 7 where not applicable to Ambulance Trusts. Further work is on-going in order to meet those standards. The Infection Prevention and Control Action Plan continue to be reviewed and updated by the Infection Prevention and Control Committee on a bi-monthly basis. Discussions have taken place with regard to the HCAI bid currently under discussion with the Commission Forum, this bid covered aspects of the cleanliness agenda extra cleaning staff to increase vehicle cleaning, cleaning equipment for stations and cannulation packs to include IV dressing, skin preparation solution. The National Patient Safety Agency (NPSA) published cleanliness specifications for Ambulance Services this was briefly discussed at the IPC Committee and will be an agenda item for the next meeting in April to discuss how these can be imple The CleanyourHands campaign was launched in January, posters are now on display throughout the service at stations, Head Quarters and training venues. These are changed on a monthly basis and reminders are posted on the intranet and in the Pulse publications. Alcohol hand rub is being placed on new vehicles and staff have access to personal issue, the new sanitising wipe available for staff can also be used for hand cleansing as well as equipment/surface cleaning. The Infection Prevention and Control Policy/Strategy has been reviewed and updated in line with the requirements of The Health and Social Care Act 28. Fleet infection control The Fleet department monitor the effectiveness of the planned cleaning processes by measuring readings from 4 random swab samples taken by the Team Leader from 2 selected locations in the vehicle every 6 months. Swabbing results dropped slightly checking with cleaning staff to see if there is a reason for this. New osprey deep clean steam cleaner ordered for March this should raise the standards in places currently difficult to clean. Swabs Apr-8 May-8 Jun-8 Jul-8 Aug-8 Sep-8 Oct-8 Nov-8 Dec-8 Jan-9 Feb-9 Mar-9 92% 83% 81% 97% 1% 95% 95% 99% 96% 93% Training Statutory & Mandatory trianing programmes must be completed by ALL Trust staff (both clinical and non clinical) in order for the Trust to protect the staff and stakeholders. All staff will receive a full Statutory & Mandatory programme which will provide them will annual updates and training for all elements of training that must be completed for the Trust to amintain NHSLA standards and also ensure that staff have the knowledge required to protect them against injury/infection. Provision of this programme for all staff will ensure the Trust is compliant with national legislation and DOH requirements for Statutory training. The programme covers the following areas: H&S, Infection Control, Manual Handling, Spinal Awareness, Fire safety, COSSH. The Programme comenced in July 28 and it is anticipated that 1% of Trust staff will have accessed the training by July 29. The programme is also further supported via Train for Health's online learning packages that are available to all staff. As of end of August 28 the programme is on target to meet the 1% standard by July 29. Training Apr-8 May-8 Jun-8 Jul-8 Aug-8 Sep-8 Oct-8 Nov-8 Dec-8 Jan-9 Feb-9 Mar-9 25% 3% 3% 48% 48% 48% 48% 54% 6% Serious Untoward Incidents

6 A serious untoward incident (SUI) is an accident or incident (or series of incidents) when a patient, member of staff (including those working those working in the community), or member of the public suffers serious injury, major permanent harm or unexpected death (or the risk of death or serious injury) on either premises where care is provided, or whilst in receipt of health care, or where actions of health service staff are likely to cause significant public concern. A serious untoward incident is an event which is likely to produce significant legal, media or other interest and which, if not properly managed, may result in loss of the Trust's reputation or assets. There were no SUIs reported this month. Workforce Since April 28 the Absence rates have averaged 7.2%, which is continuing the downward trend which began in 27. HR Advisors continue to work pro-actively with Operations Managers in each Division in order to target long term absence. Support has been given to managers in order to ensure Occupational Health referrals are made at the earliest possible stage resulting in a reduction in the length of absences. We have also adopted a policy of seeking medical redeployment for those staff who are no longer able to carry out their original duties, but are fit enough to work in a job with lighter duties. A number of staff with long term absences have been managed out of employment either by early retirement where appropriate or dismissal, where no other option was available. It should be noted that absence does peak during winter months, and the increase in November and December s absence rate is already decreasing, down over 2% from its peak in December. A revised Attendance Management Policy has been agreed at Policy Review Group, and will be submitted to ET and JCC in March for ratification. It is anticipated that the measures contained in the revised policy will further reduce absence rates. Gender Breakdown of the Trust Male Female 1% 9% 8% 7% 6% 5% 4% 3% 2% 1% % 33.8% 33.8% 34.2% 34.2% 34.7% 35.% 35.% 35.% 34.% 35.3% 35.2% 66.2% 66.2% 65.9% 65.9% 65.3% 65.% 65.% 65.% 66.% 64.7% 64.8% Workforce turnover rate Turnover is at 7.83% for the year to 28 Feb 29. This includes the staff who have been managed out of the organisation due to attendance levels, as well as age retirements and resignations. Voluntary resignations account for 1.6% of our turnover. Monthly Annual Sickness Apr-8 May-8 Jun-8 Jul-8 Aug-8 Sep-8 Oct-8 Nov-8 Dec-8 Jan-9 Feb-9 Mar-9 1.1% 1.%.71%.44%.66%.4%.63%.61%.57%.27%.43% 6.58% 6.36% 6.89% 6.9% 7.1% 4.4% 7.26% 7.36% 6.81% 7.% 7.83% Apr-8 May-8 Jun-8 Jul-8 Aug-8 Sep-8 Oct-8 Nov-8 Dec-8 Jan-9 Feb-9 Mar-9

7 Monthly 7.5% 8.6% 7.% 7.71% 5.5% 6.9% 7.55% 7.62% 9.87% 8.6% 7.24% Workforce Analysis February 9 A&E Team Leader (inc TL relief) Paramedic University Student Paramedics Training Complete awaiting registration Advanced Tech IHCD Trainees UCA ECSW Operational Trainee - ECSWs in training Sub-total Establishment 28-9 Mar 9 SIP Variance PTS Control A&E PTS Support Services Non Exec Directors CEO & Directors Senior Managers A&C (incl Emergency Plan.) Support/Mtce Nursing Staff Sub-total TOTAL Establishment 1) The Paramedic Establishment numbers include increased provision numbers for AVP And Skills Mix in Tees Division. Increased provision for Durham Dales and HART will be added to the 29/1 establishment 2) The Technician establishment has been reduced 15 since 27/8, with an increase in the ECSW establishment to refl the gradual phasing out of this role 3) The ECSW establishment has been increased by 15 to reflect that as Technicians leave or are promoted we replace the with ECSWs Staff In Post

8 1) Team Leaders - although we have 9.47 staff, together with Protected Time for TLs we have 11.4 in post 2) Paramedics - in addition to the staff in post there are 4 staff who are awaiting HPC registration from the Universit course, plus 1 awaiting registration from IHCD courses 3) Student paramedics - 48 will qualify in 29/1 4) Advanced Technicians - the SIP figure of does not include those on IHCD Paramedic training courses. They are listed separately and will be qualified by the end of the year. 14 staff started the Feb 9 course - they are counted in IHCD trainees figures, along with those trainees from last year who have yet to register wit hthe HPC. 5) ECSW - The ECSW does not include the 17 trainees currently in training. 6) PTS - A PTS course will commence on 23 March with 9 candidates. A further course is planned for April to meet the dem for the Durham OOH contract. Percentage of Trust Employees Declaring themselves as Disabled and/or BME (of those employees providing the information) BME Employees Disabled Employees 1.%.9%.8%.7%.6%.5%.4%.3%.2%.1%.%.72%.72%.67%.67%.65%.65%.68%.7%.65%.59%.59%.55%.55%.48%.48%.48%.48%.48%.5%.52%.52%.52% Finance Income and Expenditure Income and Expenditure Surplus Position 28-9 Plan ( K) Actual ( K) Apr May Jun Jul Aug Sept Oct Nov Dec Jan Feb Mar The reason for the better than expected performance against the planned I&E position is primarily the agreement reached with Commissioners on additional funding to reflect the consistently increased activity undertaken by the Accident and Emergency services with a net increase of 1,93,.

9 EBITDA Operating Surplus I&E Surplus YTD Plan ' 6,317 1, YTD Actual 8,72 3,213 1,899 YTD Variance 2,43 1,73 1,749 EBITDA (Earnings Before Interest, Taxation, Dividends and Amortisation) shows the net surplus generated by revenue resources for the period. At present the Trust is generating earnings in excess of its planned position at the end of November. Once depreciation has been taken into account, the operating surplus generated by the Trust is 1,73, more than planned to date. The Trusts retained surplus includes additional interest earned on cash balances over and above plans and totals 1,899, for the year to date. Forecasted outturn for the year is 1,92,. Margins EBITDA Margin Operating Margin Plan % 8..2 Actual % Variance % The variation in EBITDA margin to date reflects additional income invoiced accrued to for the period in respect of over activity on A&E services and the under spend on pay budgets due to vacancies identified in the finance report. Balance Sheet Capital Programme Plan Spend ' Actual ' Apr May Jun Jul Aug Sept Oct Nov Dec Jan Feb Mar Plan Spend ' Actual ' Capital expenditure during January, related primarily to vehicle replacement schemes continuing being brought into account. this includes front line and PTS vehicles. In addition to this there was further activity on estates. Liquidity Cash Debtors Days Current Ratio (Liquidity) Prudential Borrowing Limit ms

10 BPPC Financial Risk Rating Weighting Actual Score Overall Rating Underlying Performance Margin 25.% 1.6% 4 Achievement of Plan EBITDa Achieved 1.% 132.5% 5 Financial Efficiency Return on assets excluding dividend 2.% 8.4% 5 I&E surplus margin net of dividend 2.% Liquidity Liquidity ration (days) 25% DEFINITIONS: EBITDA Margin - 'Earning Before Interest, Taxation, Dividends and Amortisation'. Effectively Operating Surplus plus depreciation as shown on the Trusts I&E statement expressed as a proportion of Turnover. A good Foundation Trust would be expected to achieve a risk rating of 4 - which equates to an EBITDA Margin of at least 9% EBITDA Achieved - EBITDA achieved to date as a proportion of original plan to date. To achieve a score of 4 under the Monitor rating scheme, a FT would be expected to achieve at least 85% of its EBITDA compared to Plan. Return on Assets - Takes the total if the surplus achieved to date on the I&E statement plus any PDC Dividends paid, and expresses this figure as a proportion of the average 'Total net assets employed' shown on the Balance Sheet. Effectively this return shows the level of financial return the Trust is generating from the operational use of its assets. A Monitor rating of 4 is achieved by making a ROA of 5%. I&E Surplus Margin - takes the bottom line I&E surplus achieved to date, and expresses this as a proportion of Trust turnover to date. A risk rating of 4 is achieved by generating an I&E surplus margin of 2%, whilst a margin of 1% gets a rating of 3. Liquidity Ratio Liquidity Ratio - Shows the number of days liquidity the Trust has to continue its operations and to meet its costs should cash stop flowing into the organisation. Takes the current value of liquid assets (cash, debtors and shortterm creditors on the balance sheet) plus an assumed ability to borrow equivalent to one month's operating expenses (termed the Working Capital Facility = 6.7m for NEAS) and expresses this total as a proportion of our operating costs. Multiplying the resultant calculation by the days in the year to date gives allows us to express our liquidity in terms of days. A Monitor rating of 4 would be achieved by having a liquidity ration equivalent to 25 days. Foundation Trust Status All work streams for the FT project are on schedule, except for a slight delay regarding the agreement of the new organisational structure. The public consultation has been delayed and so a new schedule for the project will be agreed in the next few weeks.