Council of Governors Meeting Elaine Hobson Chief Operating Officer January 2010, Item 7 Relates to Domain 1 (C4a) and Domain 5 (C18, C19)

Key Targets 1 Hospital Acquired Infections Performance Indicators Risk Rating Target Current Position Nov 2009 Year to Date Position Incidence of Clostridium difficile MON01, CQC16 Low 183 (112) 1366 Incidence of MRSA MON02, CQC15 Med 18 (9) 04

Key Targets 1 Hospital Acquired Infections C. Difficile InfectionsMRSA Bacteraemias

Key Targets 2 Cancer Waiting Times Performance Indicators Risk Rating Target Current Position Nov 2009 Year to Date Position Cancer: 14 day wait from urgent GP referral MON09, CQC18 Low93% 98.5% (8 of 547) 98.5% (72 of 4870) Cancer: 31 days from diagnosis to treatment for all cancers MON10, CQC19.I Low96% 95.7% (68 of 1576) 95.9% (8 of 195) Cancer: 31 days for subsequent cancer treatments - Surgery MON03.I, CQC19.II Low94% 96.7% (1 of 30) 95.1% (10 of 203) Cancer: 31 days for subsequent cancer treatments – Anti-Cancer Drugs MON03.II, CQC19.III Low98% 99.7% (1 of 288) 96.7% (1 of 30) Cancer: 62 days referral to treatment - GP Urgent Referral MON04.I, CQC20.I Low85% 86.4% (12 of 88.5) 84.7% (112 of 734) Cancer: 62 days referral to treatment – Consultant Screening Service MON04.II, CQC20.II Low90% 93.3% (1 of 15) 97.6% (2 of 85) Cancer: 62 days referral to treatment – Consultant Upgrade CQC20.III Low90% 66.7% (3 of 9) 86.7% (3 of 22.5)

Key Targets 2 Cancer Waiting Times Cancer 31 Day Wait For First Treatment Cancer 62 Day Wait For First Treatment

Key Targets 3 Emergency Department Performance Indicators Risk Rating Target Current Position Nov 2009 Year to Date Position Maximum waiting time of 4 hours in A&E from arrival to admission, transfer or discharge (bracketed figure is RD&E activity only) MON07, CQC04 Very Low 98% 97.7% (95.6%) 98.8% (97.5%)

Key Targets 3 Emergency Department

Key Targets 4 Referral to Treatment Waiting Times Performance Indicators Risk Rating Target Current Position Nov 2009 Year to Date Position 18-week maximum wait Admitted patients. MON05, CQC17.III Low90%92.3%n/a 18-week maximum wait Non-admitted patients. MON06,CQC17.IV Low95%97.1%n/a 18-week maximum wait by 2010 Admitted orthopaedic patients. LOC3 Low90%70.6%n/a 18-week maximum wait by 2010 Non-admitted orthopaedic patients. LOC4 Low95%90.1%n/a 13-week maximum wait by 2010 Admitted patients (excl orthopaedics). LOC1 Low90%90.0%n/a 13-week maximum wait by 2010 Non-admitted patients (excl orthopaedics). LOC2 Low95%94.7%n/a Cancelled operations. CQC09 Med0.80%1.21%2.57%

Key Targets 4 Referral to Treatment Waiting Times Referral to Treatment for Admitted Pathways Referral to Treatment for Non-Admitted Pathways

Current Capacity Pressures 11 wards affected by Norovirus – 25 – 50 beds empty and blocked Increase in trauma admissions due to adverse weather conditions Increased number of medical outliers significantly reducing surgical and orthopaedic bed capacity Short term difficulty due to weather conditions in transferring patients home and to community beds Reduction in elective surgery impacting adversely on 18 week target Increase in A&E 4 hour breaches due to lack of bed availability for admissions

Actions underway Additional cleaning staff provided to ensure wards can be opened as quickly as possible Additional medical and nursing staff provided at weekends and evenings for Emergency Department, Trauma and Medical Wards Devon Health and Social Care Complex Care Teams pulling patients out of RDE to home

Actions underway Additional bed and day case areas being opened as an exception Extra elective capacity being provided - Vanguard mobile theatre and beds, Nuffield, Plymouth Independent Sector Treatment Centre Daily Eastern Devon multi-agency conference call Board rounds are being rolled out across the wards Joint consultant/GP work to agree admission criteria for community hospitals

Council of Governors Meeting Suzanne Tracey Director of Finance and Business Development January 2010, Item 7

Finance Report – Month 8 Year to Date £5.0m surplus approx £400k below budget Clinical income broadly on plan but overspends on expenditure budgets Significant overspend on non pay budgets – action taken on authorisation levels Year end forecast still to achieve planned surplus of £7m Financial Risk Rating Year to date 4

Capital Expenditure Annual planned expenditure £23.5m YTD plan £14.7m, expenditure £10m Forecast expenditure £18.6m Annual slippage £4.8m –Pain Management –Replacement of CT scanner –Integrated minimal access theatre –Order Communications and E Prescribing

Understanding slippage Savings on schemes Maintaining operational capacity Ensuring the scheme meets requirements Ensuring procurement meets regulations Further action – improvements to capital planning process