Richmond Clinical Commissioning Group Report Summary
Meeting Title:
Report Title:
Agenda Item:
Date:
Governing Body in Public
Quality, Finance and Performance Committee
Attachment:
12a
Purpose:
(please delete Y/N as
appropriate)
Approval/
Ratification
Author:
Julie Sobrattee, Chief
Nurse
Presented by:
Julie Sobrattee, Chief
Nurse
Executive Summary:
The purpose of this Quality, Finance Performance Report is to provide
Governing Body members with a strategic assurance and overview of
the CCG’s performance across a range of metrics.
N
Discussion/
Comment
Y
For
Information
Executive Leads
(Clinical and
Officer) (job title):
Further
Information
contact (email
address):
10 March 2015
Hi
Other
Y
Julie Sobrattee, Chief
Nurse
Julie.sobrattee@richmo
nd.gov.uk
The report deals with the matters considered at the QFP meeting on
Tuesday 3 February 2015 in accordance with the committee’s annual
work plan.
The report gives updates on:
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•
•
•
•
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PALS & MP Letters
Amber Warning Cards
HRCH
RRRT
Acute Trusts
Performance Indicator Overview Dashboard ( Attached )
PALS, complaints & MP letters
During the period 1 October and 31 December 2014 a total of 44 Patient Advice & Liaison
Service (PALS) concerns were received by Richmond CCG. Of these, 61% were requests
for further information in relation to healthcare services within the borough. Other concerns
raised often relate to a patient’s treatment or access to services. However, as the number for
these is quite small it is difficult to identify themes or trends.
A total of five complaints were received. Three related to the Richmond Clinical Assessment
Service and two related to the commissioning of mental health services within the borough.
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During the third quarter, the CCG only received one letter from a local MP.
NHS England has reported on the number of primary care PALS and complaints reported by
patients between August and October 2014. This is the first time NHS England has provided
this information.
It is understood that reporting will be more regular after Q1 2015/16.
Complaints and MP letters, again small in number, are usually very specific to an individual
and therefore we are unable to identify themes and trends.
The aim is to resolve the majority of PALS enquiries within 24 hours. More complex
enquiries may take approximately 48 hours. Patients are advised when to expect a response
when they make contact with the service.
Statutorily, complaints should be acknowledged within three working days. However,
nationally there are no timelines in place for complaints to be responded to. Richmond CCG
endeavours to respond to each complaint and MP letter within 25 working days.
Amber Warning Cards
During Q3 a total of 34 amber warning cards were reported by 13 different GP practices.
The amber warning cards related to 12 different providers, with 38% concerning Kingston
Hospital Trust.
Feedback from GP representatives at provider clinical quality review group meetings is
inconsistent which in turn limits the feedback to clinical networks in terms of actions being
taken by providers to prevent issues being report recurring.
A template for GP leads has been developed to facilitate and improve the capture of
information/actions by providers. The information from these templates will be compiled by
the quality team for onward reporting to clinical networks.
HRCH has commenced providing more detailed feedback to the CCG on the amber warning
cards being raised which in turn is being fed back to the individual GPs who raised the
concern initially.
HRCH
HRCH/RCCG contract negotiations for 2015/16 have commended. This work is being
supported by Mary Burkett and Monique Ferdinand from South East CSU and Bhakti
Esslemont from PWC.
The 15/16 contract will need to meet some of the requirements of the Outcome Based
Commissioning (OBC) work and meet the CCGs Commissioning Intentions and BCF plans.
Through service development and contact negotiate meetings we have confirmed :
Updated community nursing specification and data set that:
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will allow localities to see activity in each area by type of activity rather than number
count
includes an IV service (to start as soon as protocols can be established between the
CCG/GPs and the two secondary care hospitals)
includes visits to housebound patients for flu vaccine and phlebotomy
TMH
Agreed a revised description of sub acute care that, once bed capacity has been released,
will be actively shared and monitored to enable a more formal review of bed usage in Q1
Quality Schedule
A quality schedule has been developed against which HRCH will be monitored as part of the
contract
Partnership working
Agreement that the GP connect email will be used as the mechanism for GP comments to
be captured and for these to be formally reviewed at contract meetings. This will give
greater transparency to GP concerns and enable RCCG to
RCCG dissemination of information from contract meetings to networks has been discussed
in order that there is better ongoing awareness of the contract
RRRT
RRRT has been reviewed as part of the work in preparing 2015/16 HRCH community
service block contract.
This has included:
• reviewing and updating the service specification
• reviewing and updating the Key Performance Indicators (in conjunction with the Local
Authority)
• reviewing governance and formal meeting arrangements (in conjunction with Local
Authority)
Updated service specification for RRRT agreed jointly with LBRuT that:
covers all aspects of RRRT delivery whether funded through the NHS or LA
has reviewed and updated the Key Performance Indicators (in conjunction with the
Local Authority)
reviewed governance and formal meeting arrangements (in conjunction with Local
Authority) to agree one joint contract meeting in order that there is better oversight
between RCCG and LBRuT on the impact of commissioning decisions made by both
will support increased referals from the community (LAS and GPs)
Acute Performance
A&E 4 Hour Waits
London-wide pressures have continued to impact performance at all of Richmond’s main
providers during January, most notably at Kingston, following improvements made at West
Middlesex who achieved 94% against the 95% target. Kingston Hospital failed in January
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with performance of 90.4%. The Trust has reported a number of issues that have contributed
to the deterioration in performance. The most significant issue that the trust has faced over
this period relates to flow and bed pressures. When completing exception reports it is often
indicated that approximately half of all A&E breaches relate to ‘bed management’; with the
trust unable to admit patients from A&E in a timely way.
The performance has led to the Trust being escalated to the Tripartite and a recovery plan
has been agreed. The plan has been agreed between the SRG and the Trust and includes
actions to improve the ED department pathway, improve flow, implement the Patient Flow
Bundle, increase out of hospital support, reduce delayed transfer of care.
Cancer Waiting Times
Richmond CCG has met 7 of the 9 Cancer Wait Time standards for December (M9). The
CCG failed to meet the 31 Day Subsequent Surgery Standard and 62 Day Consultant
Upgrade Standard:
31 Day Subsequent Surgery Standard: Richmond CCG failed to meet the 31 Day
Subsequent Surgery standard in December (M9) with Performance of 92.3% against the
94% threshold. This is a result of 1 breach from 13 patient pathways. This was a West
Middlesex breach which was attributed to capacity issues as Patients Surgery was
cancelled.
62 Day Consultant Upgrade Standard: Richmond CCG failed to meet the 62 Day
Consultant Upgrade standard in December (M9) with Performance of 75% against the 85%
threshold (Guide). This is a shared breach between West Middlesex and Imperial and was
attributed to late inter Trust Referral (There was no ITR received for treatment) Resolution is
being sought from the Trust.
Diagnostics
Richmond CCG failed the target in December with performance of 98.6%. Kingston hospital
encountered problems in Endoscopy that impacted on achieving the overall diagnostic
target. Unexpected long-term sickness and departure of the admin team leader in the
Endoscopy service in November resulted in a depleted administrative support. This resulted
in administrative element of the service being less functional than usual, which has
generated a backlog of patients waiting to be booked for diagnostic testing.
Kingston Hospital has provided a recovery plan and indicated that the service was still
affected in January. However, normal service has resumed in February and the trust
anticipates meeting the target in the same month.
Healthcare Acquired Infection.
HCAI – MRSA – 1 new case in December bringing the total to 2 cases for the CCG this
year
HCAI – CDIFF – 3 new CCG cases this month bringing the YTD total to 29, above the
annual target for the year.
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