Integrated Performance Report 22 February 2018 Caroline Shaw Chief Operating Officer and Deputy Chief Executive

Strong performance

Standards not consistently achieving

Areas requiring improvement

Cancer 62 day standard Dec performance 81.6% adjusted (82.1% unadjusted) - negative adjustment in Dec due to surgery waits in Head & Neck and Urology Focus remains to reduce time to diagnosis in Lung and surgical wait times in Urology £98k non-recurrent funds from Cancer Alliance to increase capacity in Lung pathway Extra equipment and staff have enabled parallel Lung Endobronchial Ultrasound lists in January that has reduced wait times

Emergency access within 4 hours (1/6)

Emergency access within 4 hours (2/6) 80.1% Jan performance (with UCC) Extreme pressure on our services with significantly higher emergency admissions than planned Black escalation declared three times since last Trust Board meeting Delayed treatment to elective patients to cope with emergency demand (in line with national guidance). This has and will continue to impact on elective care standards The number of patients in hospital that required a supported discharge and were medically safe for more than 24 hours increased by 35% from Nov to Jan Zero 12 hour trolley waits in 2017/18 to date Friends and family recommends for A&E remain strong and we continue to receive positive comments about our Emergency Department on the Care Opinion website

Emergency access within 4 hours (3/6)

Emergency access within 4 hours (4/6) Emergency admissions increased by 10% in Jan-18 compared with previous year (up 12% in Feb-18) Emergency discharges increased by 11% in Jan-18 & Feb-18 compared with 2017 Jan-18 discharges were in balance with admissions. In Feb-18 they are running on average two discharges a day short Respiratory admissions have been >30% higher in Dec-17 & Jan-18 than previous year

Emergency access within 4 hours (5/6) The number of patients in hospital that required a supported discharge and were medically safe for more than 24 hours peaked in Jan-18 Backlog of supported patients waited longer post medically safe to leave hospital

Emergency access within 4 hours (6/6)

Key messages Exceptional pressure this winter has adversely impacted on patient experience, our financial position and our staff Strong performance in friends and family, diagnostic waits, referral to treatment and key patient safety and experience indicators We continue to focus considerable effort on sustainable delivery of the Cancer 62 day standard and recovery of the emergency access standard