CCG Planning Template 2015-16
Third (24th May) Submission
As part of the CCG Planning Round, Kingston CCG is expected to return planning information on the following areas:
1. CCG Constitutional Indicators:
a. RTT, Diagnostics and Cancer are collected in regard to activity and performance for the CCG. These indicators have been collected throughout 2014-15.
b. A&E Waiting times - Total time in the A&E department (also a constitutional indicator, but collected as host commissioner for the entirety of Kingston Hospital.
c. Ambulance times – Kingston CCG is not required to submit a plan – these will be submitted by the lead commissioner of the London Ambulance Service.
2. Other Commitments:
a. HCAI (C-Difficile infection rates) – the objective has been given as 30.
b. Estimated Dementia diagnosis rate – the objective is to maintain the 66.7% diagnosis rate throughout 2015-16, against an expected prevalence of 1,553
c. IAPT access and recovery rates to be maintained at the 2015-16 plans that were submitted through the 2014-15 planning round.
d. The proportion of people that wait 6 and 18 weeks or less from referral to entering a course of IAPT treatment against the number of people who finish a
course of treatment in the reporting period.
3. Primary Care:
a. The aggregated percentage of patients who gave positive answers to five selected questions in the GP survey about the quality of appointments at the GP
practice. These questions for the GP and nurse in the practice are:
i. Giving you enough time
ii. Listening to you
iii. Explaining tests and treatments
iv. Involving you in decisions about your care
v. Treating you with care and concern
b. Satisfaction with the overall care received at the surgery
c. Satisfaction with accessing Primary Care
4. Activity Planning, based on the 2014-15 forecasted outturn, incorporating any known recurrent and non-recurrent changes
5. The Quality Premium measures. These incorporate selected measures covering:
a. Urgent and Emergency Care
b. Mental Health
c. Two locally defined priorities
All metrics have been agreed through the CCG by lead managers and clinicians, although changes in guidance/ new metrics may need to be resubmitted in subsequent returns.
1. Constitutional Indictors - 18 weeks and Diagnostics
E.B.1
Completed pathways < 18 weeks
Total Completed Pathways
2013-14
%
Completed pathways < 18 weeks
Total Completed Pathways
2014-15
%
Completed pathways < 18 weeks
2015/16 Plan Total Completed Pathways
%
APRIL
618
655
94.4%
569
641
88.8%
590
655
90.1%
MAY
707
752
94.0%
584
644
90.7%
563
625
90.1%
JUNE
592
634
93.4%
603
665
90.7%
590
655
90.1%
JULY
589
630
93.5%
706
777
90.9%
617
685
90.1%
AUGUST
586
625
93.8%
518
574
90.2%
563
625
90.1%
SEPTEMBER OCTOBER NOVEMBER DECEMBER
581
619
606
496
635
671
646
539
91.5%
92.3%
93.8%
92.0%
646
687
668
585
723
760
731
625
89.3%
90.4%
91.4%
93.6%
590
590
563
617
655
655
625
685
90.1%
90.1%
90.1%
90.1%
JANUARY
588
642
91.6%
600
663
90.5%
563
625
90.1%
FEBRUARY
613
676
90.7%
563
625
90.1%
MARCH
635
695
91.4%
617
685
90.1%
Completed pathways < 18 weeks
Total Completed Pathways
2013-14
%
Completed pathways < 18 weeks
Total Completed Pathways
2014-15
%
Completed pathways < 18 weeks
2015/16 Plan Total Completed Pathways
%
APRIL
2194
2258
97.2%
2302
2389
96.4%
2532
2665
95.0%
MAY
2161
2212
97.7%
2498
2586
96.6%
2417
2544
95.0%
JUNE
1982
2049
96.7%
2688
2789
96.4%
2532
2665
95.0%
JULY
2406
2494
96.5%
2884
2976
96.9%
2647
2786
95.0%
AUGUST
1932
1974
97.9%
2190
2253
97.2%
2417
2544
95.0%
SEPTEMBER OCTOBER NOVEMBER DECEMBER
2405
2771
2655
2390
2458
2837
2744
2465
97.8%
97.7%
96.8%
97.0%
2611
2776
2339
2304
2695
2865
2440
2374
96.9%
96.9%
95.9%
97.1%
2532
2532
2417
2647
2665
2665
2544
2786
95.0%
95.0%
95.0%
95.0%
JANUARY
2933
3016
97.2%
2872
2964
96.9%
2417
2544
95.0%
FEBRUARY
4256
4438
95.9%
2417
2544
95.0%
MARCH
2700
2798
96.5%
2647
2786
95.0%
Incomplete Pathways < 18 weeks
Total Incomplete Pathways
2013-14
RTT - The percentage of
%
Incomplete Pathways < 18 weeks
incomplete pathways within 18
Total Incomplete Pathways
2014-15
weeks for patients on
%
incomplete pathways at the
Incomplete Pathways < 18 weeks
end of the period.
2015/16 Plan Total Incomplete Pathways
%
APRIL
7461
7861
94.9%
8372
8963
93.4%
7986
8680
92.0%
MAY
7678
8086
95.0%
8400
8970
93.6%
7623
8285
92.0%
JUNE
7812
8287
94.3%
8490
9008
94.2%
7986
8680
92.0%
JULY
7800
8249
94.6%
8403
8954
93.8%
8349
9074
92.0%
AUGUST
7717
8141
94.8%
8403
8929
94.1%
7623
8285
92.0%
SEPTEMBER OCTOBER NOVEMBER DECEMBER
7947
8241
8567
8218
8402
8720
9047
8798
94.6%
94.5%
94.7%
93.4%
8642
8523
8386
8716
9145
9066
8887
9258
94.5%
94.0%
94.4%
94.1%
7986
7986
7623
8349
8680
8680
8285
9074
92.0%
92.0%
92.0%
92.0%
JANUARY
7810
8374
93.3%
8117
8698
93.3%
7623
8285
92.0%
FEBRUARY
8038
8671
92.7%
7623
8285
92.0%
MARCH
7839
8440
92.9%
8349
9074
92.0%
E.B.4
APRIL
MAY
JUNE
JULY
AUGUST
SEPTEMBER OCTOBER NOVEMBER DECEMBER
JANUARY
FEBRUARY
MARCH
3
9
10
100
164
473
144
66
RTT - The percentage of
admitted pathways within 18
weeks for admitted patients
whose clocks stopped during
the period, on an adjusted
basis
E.B.2
RTT - The percentage of nonadmitted pathways within 18
weeks for non-admitted
patients whose clocks stopped
during the period.
E.B.3
Number waiting > 6 weeks
2013-14
Diagnostics Test Waiting Times
203
182
463
Total Number waiting
2014
2076
2061
2302
2198
2459
2662
2434
2692
2836
2780
2536
%
0.1%
0.4%
0.5%
4.3%
7.5%
7.5%
7.6%
7.5%
17.2%
16.7%
5.2%
2.6%
67
21
15
136
12
3
11
3
44
32
-
-
2321
2172
2852
2511
1557
2048
2485
2537
2231
2251
-
-
2.9%
24
2439
1.0%
1.0%
23
2329
1.0%
0.5%
24
2439
1.0%
5.4%
25
2550
1.0%
0.8%
23
2329
1.0%
0.1%
24
2439
1.0%
0.4%
24
2439
1.0%
0.1%
23
2329
1.0%
2.0%
25
2550
1.0%
1.4%
23
2329
1.0%
23
2329
1.0%
25
2550
1.0%
Number waiting > 6 weeks
2014-15
184
Total Number waiting
%
Number waiting > 6 weeks
2015/16 Plan Total Number waiting
%
1. Constitutional Indictors - Cancer Waits
E.B.6
2WW
Number waiting < 2 weeks
2013-14 Total number waiting
%
Number waiting < 2 weeks
Cancer- All Cancer
2014-15 Total number waiting
two week wait
%
Number waiting < 2 weeks
2015/16
Total number waiting
Plan
%
E.B.7
2WW-BR
Number waiting < 2 weeks
2013-14 Total number waiting
Cancer - Two week
%
wait for breast
Number waiting < 2 weeks
symptoms (where 2014-15 Total number waiting
cancer not initially
%
suspected)
Number waiting < 2 weeks
2015/16
Total number waiting
Plan
%
E.B.12
62-GP
Number waiting < 62 days
2013-14 Total number waiting
%
Cancer - All cancer
Number waiting < 62 days
62 day urgent
2014-15 Total number waiting
referral to first
%
treatment wait
Number waiting < 62 days
2015/16
Total number waiting
Plan
%
E.B.13
Cancer - 62 day
wait for first
treatment
following referral
from an NHS
cancer screening
service
E.B.14
62-SCR
Number waiting < 62 days
2013-14 Total number waiting
%
Number waiting < 62 days
2014-15 Total number waiting
%
Number waiting < 62 days
2015/16
Total number waiting
Plan
%
62-UP
Number waiting < 62 days
Cancer - 62 day
2013-14 Total number waiting
wait for first
%
treatmnet for
Number waiting < 62 days
cancer following a
2014-15 Total number waiting
consultant's
%
decision to
Number waiting < 62 days
upgrade the
2015/16
Total number waiting
patients priority
Plan
%
Quarter 1
818
845
96.8%
980
1045
93.8%
997
1072
93.0%
Quarter 2
873
903
96.7%
1032
1106
93.3%
997
1072
93.0%
Quarter 3
949
975
97.3%
1047
1085
96.5%
997
1072
93.0%
Quarter 4
1022
1077
94.9%
997
1072
93.0%
E.B.8
Quarter 1
129
133
97.0%
102
115
88.7%
107
115
93.0%
Quarter 2
107
117
91.5%
118
130
90.8%
107
115
93.0%
Quarter 3
94
96
97.9%
79
82
96.3%
107
115
93.0%
Quarter 4
90
95
94.7%
107
115
93.0%
E.B.9
Quarter 1
67
73
91.8%
39
55
70.9%
57
67
85.1%
Quarter 2
56
70
80.0%
63
75
84.0%
57
67
85.1%
Quarter 3
53
66
80.3%
72
86
83.7%
57
67
85.1%
Quarter 4
70
84
83.3%
57
67
85.1%
E.B.10
Quarter 1
3
4
75.0%
20
23
87.0%
13
14
92.9%
Quarter 2
10
11
90.9%
16
17
94.1%
13
14
92.9%
Quarter 3
14
14
100.0%
15
17
88.2%
13
14
92.9%
Quarter 4
16
19
84.2%
13
14
92.9%
E.B.11
Quarter 1
2
2
100.0%
4
5
80.0%
3
4
75.0%
Quarter 2
2
2
100.0%
4
4
100.0%
3
4
75.0%
Quarter 3
5
5
100.0%
7
7
100.0%
3
4
75.0%
Quarter 4
2
2
100.0%
3
4
75.0%
31-1ST
Number waiting < 31 days
Cancer 2013-14 Total number waiting
Percentage of
%
patients receiving
Number waiting < 31 days
first definitive
2014-15 Total number waiting
treatment within
%
31 days of a cancer
Number waiting < 31 days
2015/16
diagnosis.
Total number waiting
Plan
%
31-SURG
Number waiting < 31 days
2013-14 Total number waiting
Cancer - 31 Day
%
standard for
Number waiting < 31 days
subsequent cancer 2014-15 Total number waiting
treatments %
surgery
Number waiting < 31 days
2015/16
Total number waiting
Plan
%
31-DRUG
Number waiting < 31 days
2013-14 Total number waiting
Cancer - 31 Day
%
standard for
Number waiting < 31 days
subsequent cancer
2014-15 Total number waiting
treatments -anti
%
cancer drug
Number waiting < 31 days
regimens
2015/16
Total number waiting
Plan
%
31-RT
Number waiting < 31 days
2013-14 Total number waiting
Cancer - 31 Day
%
standard for
Number waiting < 31 days
subsequent cancer 2014-15 Total number waiting
treatments %
radiotherapy
Number waiting < 31 days
2015/16
Total number waiting
Plan
%
Quarter 1
145
146
99.3%
154
159
96.9%
147
153
96.1%
Quarter 2
153
155
98.7%
164
168
97.6%
147
153
96.1%
Quarter 3
146
146
100.0%
176
181
97.2%
147
153
96.1%
Quarter 4
176
179
98.3%
147
153
96.1%
Quarter 1
28
29
96.6%
18
21
85.7%
24
25
96.0%
Quarter 2
27
30
90.0%
28
28
100.0%
24
25
96.0%
Quarter 3
14
14
100.0%
22
22
100.0%
24
25
96.0%
Quarter 4
32
32
100.0%
24
25
96.0%
Quarter 1
52
52
100.0%
51
51
100.0%
49
50
98.0%
Quarter 2
36
37
97.3%
61
61
100.0%
49
50
98.0%
Quarter 3
46
46
100.0%
55
55
100.0%
49
50
98.0%
Quarter 4
51
51
100.0%
49
50
98.0%
Quarter 1
51
52
98.1%
66
67
98.5%
63
67
94.0%
Quarter 2
46
46
100.0%
72
75
96.0%
63
67
94.0%
Quarter 3
61
61
100.0%
73
73
100.0%
63
67
94.0%
Quarter 4
85
86
98.8%
63
67
94.0%
1. Constitutional Indictors – Accident and Emergency (plans submitted by Lead Commissioners of Type 1 Trusts) - Kingston Hospital
2013-14
2014-15
Quarter 1
Quarter 2
Quarter 3
Quarter 4
Number waiting > 4 hours
1136
1024
1241
1297
Total Attendances
28401
27413
27244
27275
% < 4 hours
96.0%
96.3%
95.4%
95.2%
Number waiting > 4 hours
1298
1151
1461
-
Total Attendances
28547
27237
28221
-
95.5%
1452
29055
95.0%
95.8%
1386
27722
95.0%
94.8%
1431
28621
95.0%
1415
28311
95.0%
% < 4 hours
Number waiting > 4 hours
2015/16 Plan Total Attendances
% < 4 hours
2. Other Commitments – C-Difficile and Dementia Diagnosis Rates
E.A.S.5
HCAI measure
(C.Difficile
infections)
APRIL
MAY
JUNE
JULY
AUGUST
SEPTEMBER
OCTOBER
NOVEMBER
DECEMBER
JANUARY
FEBRUARY
MARCH
Total
2013-14
1
3
4
3
5
4
1
4
2
3
0
3
33
2014-15
2
9
1
2
4
3
-
-
-
-
-
-
21
2015-16 Objective
2015-16 Plan
2
3
2
3
2
2
3
2
3
3
2
3
30
30
1,036
1,036
1,036
1,036
1,036
1,036
1,036
1,036
1,036
1,036
1,036
1,036
E.A.S.1
Dementia Estimated
diagnosis rate
Number of People
diagnosed (65+)
2015-16
Estimated dementia
Plan
prevalence (65+ Only
(CFAS II))
%
1,553
1,553
1,553
1,553
1,553
1,553
1,553
1,553
1,553
1,553
1,553
1,553
66.71%
66.71%
66.71%
66.71%
66.71%
66.71%
66.71%
66.71%
66.71%
66.71%
66.71%
66.71%
2. Other Commitments – Improving Access to Psychological Therapies
E.A.3
IAPT Access Roll Out
Quarter 1
5
19,044
0.03%
495
19,044
2.60%
The number of people who receive psychological therapies
2013-14
The number of people who have depression and/or anxiety disorders (local estimate based on Adult Psychiatric Morbidity Survey 2000).
% per quarter (e.g. 3.75%)
The number of people who receive psychological therapies
2014-15
The number of people who have depression and/or anxiety disorders (local estimate based on Adult Psychiatric Morbidity Survey 2000).
% per quarter (e.g. 3.75%)
2015-16 Previous plan The number of people who receive psychological therapies
(from year 2 of 14/15 to The number of people who have depression and/or anxiety disorders (local estimate based on Adult Psychiatric Morbidity Survey 2000).
18/19 planning round) % annual
The number of people who receive psychological therapies
2015-16 Plan
The number of people who have depression and/or anxiety disorders (local estimate based on Adult Psychiatric Morbidity Survey 2000).
% per quarter (e.g. 3.75%)
The proportion of people that w ait 6
w eeks or less from referral to entering a
course of IAPT treatm ent against the
num ber of people w ho finish a course of
treatm ent in the reporting period.
The number of ended referrals that finish a course of treatment in the reporting
period w ho received their first treatment appointment w ithin 6 w eeks of referral
2015-16 Plan The number of ended referrals that finish a course of treatment in the reporting
period.
%
E.H.2 - A2
The proportion of people that w ait 18
w eeks or less from referral to entering a
course of IAPT treatm ent against the
num ber of people w ho finish a course of
treatm ent in the reporting period.
The number of ended referrals that finish a course of treatment in the reporting
period w ho received their first treatment appointment w ithin 18 w eeks of referral
2015-16 Plan The number of ended referrals w ho finish a course of treatment in the reporting
period.
%
Quarter 4
680
19,044
3.57%
-
719
19,044
3.78%
719
19,044
3.78%
719
19,044
3.78%
719
19,044
3.78%
Quarter 1
Quarter 2
Quarter 3
Quarter 4
-
41
87
115
-
125
228
325
The number of people who have completed treatement having attended at least two treatment contacts and are moving to recovery
(those who at initial assessment achieved 'caseness' and at final session did not)
2013-14
The number of people who finish treatement having attended at least two treatment contacts and coded as discharged) minus (The
number of people who finish treatment not at clinical caseness at initial assessment)
%
The number of people who have completed treatement having attended at least two treatment contacts and are moving to recovery
(those who at initial assessment achieved 'caseness' and at final session did not)
2014-15
The number of people who finish treatement having attended at least two treatment contacts and coded as discharged) minus (The
number of people who finish treatment not at clinical caseness at initial assessment)
%
The number of people who finish treatement having attended at least two treatment contacts and are moving to recovery (those who at
2015-16 Previous plan initial assessment achieved 'caseness' and at final session did not)
(from year 2 of 14/15 to The number of people who finish treatement having attended at least two treatment contacts and coded as discharged) minus (The
18/19 planning round) number of people who finish treatment not at clinical caseness at initial assessment)
%
The number of people who finish treatement having attended at least two treatment contacts and are moving to recovery (those who at
initial assessment achieved 'caseness' and at final session did not)
2015-16 Plan
The number of people who finish treatement having attended at least two treatment contacts and coded as discharged) minus (The
number of people who finish treatment not at clinical caseness at initial assessment)
%
E.H.1 - A1
Quarter 3
745
19,044
3.91%
-
2,875
19,044
15.10%
E.A.S.2
IAPT
Recovery
Rate
Quarter 2
449
19,044
2.36%
530
19,044
2.78%
32.8%
38.2%
35.4%
115
90
-
-
335
315
-
-
34.3%
28.6%
-
-
502
984
51.0%
171
166
166
171
335
325
325
335
51.0%
51.1%
51.1%
51.0%
Quarter 1
Quarter 2
Quarter 3
Quarter 4
270
270
270
270
360
360
360
360
75.0%
75.0%
75.0%
75.0%
Quarter 1
Quarter 2
Quarter 3
Quarter 4
342
342
342
342
360
360
360
360
95.0%
95.0%
95.0%
95.0%
3. Primary Care
Satisfaction w ith the quality of
consultation at GP practices
(This is a score out of 500)
E.D.1
The aggregated percentage of patients w ho
gave positive answ ers to five selected
questions in the GP survey about the quality of
appointm ents at the GP practice
2015/16
Satisfaction w ith the overall care
received at the surgery
E.D.2
The percentage of patients w ho gave
positive answ ers to the GP survey
question ‘Overall, how w ould you
describe your experience of your GP
surgery?’
Numerator - The number of patients w ho answ ered ‘very good’ or ‘fairly good’ to the
question, ‘Overall, how w ould you describe your experience of your GP surgery?’
2015/16 Denominator - The number of patients responding to the question ‘Overall, how w ould you
describe your experience of your GP surgery?’
%
2514
2940
85.5%
Satisifcation w ith access to
prim ary care
E.D.3
The percentage of patients w ho gave
positive answ ers to the GP survey
question ‘Overall, how w ould you
describe your experience of m aking
an appointm ent?’
440
Numerator - The number of patients answ ering ‘’Very good’ or ‘Fairly Good’ to the question
‘Overall, how w ould you describe your experience of making an appointment?’
2015/16
Denominator - The number of patients responding to the question ‘Overall, how w ould you
describe your experience of making an appointment?
%
2109
2850
74.0%
4. Activity Planning
Kingston CCG
All Trusts
Non-elective
spells - all
specialities
(E.C.23)
2013-14 Out-Turn
M10 SUS FOT
Seasonality
Other (POD REMAPPING)
Remove non-recurrent activity
Restated FOT
Pop Growth
Non-demographic growth
Service developments (Pathway design)
Other
Other (Reversals Metrics & Challenges)
Less QIPP
Less BCF
RTT 15/16
Net
Revised year on year growth (%)
2015/16
Growth in 2014/15 (%)
Growth in 2015/16 (%)
18,839
18,869
0
0
0
18,869
263
0
0
0
0
0
(423)
0
(160)
NHS England Letter agreed percentages:
-0.8%
18,709
0.2%
-0.8%
ACTIVITY TYPE (e.c denotes technical guidance code - SUS data to be used unless specified otherwise)
All First
All subsequent
Daycase
Ordinary
A&E
GP Written Referrals
Total - all spec
Outpatient
outpatient
Elective Spells - Elective Spells attendances all for a first outpatient
elective spells Attendances attendances all specialities all specialities
types
appointment - G&A
(E.C.22)
all specialities all specialities
(E.C.32)
(E.C.21)
(E.C.8)
(E.C.9) (MAR DATA)
(E.C.24)
(E.C.6)
11,351
3,259
14,610
78,504
127,922
61,703
38,617
11,777
3,350
15,127
81,281
136,129
60,841
40,904
0
0
0
0
0
0
0
0
0
0
0
0
0
0
(164)
(32)
(196)
(217)
(238)
0
0
11,613
3,318
14,931
81,064
135,891
60,841
40,904
163
46
209
1,135
1,902
852
573
163
46
209
2,270
3,805
0
1,145
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
(1,140)
(1,140)
0
(1,140)
0
0
0
0
0
(423)
0
0
0
0
0
0
0
0
326
92
418
2,265
4,567
429
578
11,939
2.3%
2.8%
3,410
1.8%
2.8%
15,349
2.2%
2.8%
2.8%
83,329
3.3%
2.8%
140,458
6.2%
3.4%
61,270
-1.4%
0.7%
41,482
5.9%
1.4%
5. Selected Quality Premium Metrics
Urgent and Emergency Care (select measure below, where applicable)
Measure 1 Delayed transfers of care which are an NHS responsibility
Measure 2 Increase in the number of patients admitted for non-elective reasons, who are discharged at weekends or bank holidays.
SUM (30%)
15%
15%
30%
Mental Health (select measure below, where applicable)
Measure 1 Reduction in the number of people with severe mental illness who are currently smokers
15%
Reduction in the number of patients attending an A&E department for a mental health-related needs who wait more than
Measure 2 four hours to be treated and discharged, or admitted, together with a defined improvement in the coding of patients
attending A&E.
15%
SUM (30%)
30%
Local Priorities (select 2 local priorities)
C2.13 Estimated diagnosis rate for people with dementia (NHS OF 2.6i)
Increased diagnosis rate of those people with dementia against the 2014-2015 dementia diagnosis rate.
LOCAL PRIORITY 1 MEASURE
10%
Enhanced Kingston at Home Rapid response Service - 25% increase in people seen by the service to avoid A&E attendances and emergency
admissions (links with BCF)
Baseline: 1,100 people (275 per quarter). Q1: 289 (5% increase) Q2: 303 (10% increase) Q3: 385 (40% increase) Q4: 399 (45% increase).
2015-16 will show an total increase of 25%, or 275 additional people seen by the service.
Building on the success of the Kingston at Home Rapid Response Service, which treated 1,100 patients in their own homes, avoiding attendances
at A&E and avoid potential emergency admissions. In 2015-16, Kingston CCG is increasing the capacity of the rapid response service so that the
service is available throughout the week. It is expected that this will ensure that an additional 10% of people with urgent care needs will have
increased access to the care and support in 2015-16 compared to 2014-15.
LOCAL PRIORITY 2 MEASURE
10%