NHS Information Environment Policy 02 Performance Management Linda Blenkinsopp October 2008

Format of the session Recap of Key Reforms Feedback on Patient Choice Performance Management The Annual Healthcheck Scores on the Doors Group work Linking Performance and Choice Choice Indicators Recap/Next session

Key Reforms

Performance Management What is it ? Why bother? Pulling these together - A working definition

Performance Management Defined “ Performance management is an organisations systems, processes and culture, aimed at establishing, measuring, monitoring and reporting indicators of service quality and resource usage to ensure effective patient care”

Group Work In care sector groups you have 10 minutes to: Identify 3 strengths in your organisations performance system Identify 3 opportunities for improvement Identify 3 benefits of effective performance management Appoint spokesperson (different to last week) to feed back

Annual Healthcheck Annual Declaration New Targets Existing Targets Improvement Reviews Use of Resources

Annual Healthcheck Framework Core Standards Existing Targets New Targets Use of Resources Improvement Reviews Quality Rating Use of Resources Rating Assessment Review Assessment Review

Annual Declaration Self Assessment Core standards - 7 domains, First Domain - Safety Second Domain – Clinical and Cost Effectiveness Third Domain – Governance Fourth Domain - Patient Focus Fifth Domain - Accessible and Responsive Care Sixth Domain - Care Environment and Amenities Seventh Domain - Public Health 24 standards, 400+ prompts Evidence portfolio Met, unmet, insufficient assurance Subject to scrutiny

Existing Targets Familiar areas Split by care sector Composite indicators Score 0,2,3 weak, fair, good, excellent 49/54 to be “excellent”

Existing targets - Acute All cancers: one month diagnosis (decision to treat) to treatment All cancers: two month GP urgent referral to treatment All cancers: two week wait Cancelled operations and those not admitted within 28 days Convenience and choice - provider information on nhs.uk and availability of slots Delayed transfers of care comparative indicator Number of inpatients waiting longer than the standard Number of outpatients waiting longer than the standard Patients waiting longer than three months for revascularisation Thrombolysis - 60 minute call to needle time Total time in A&E: four hours or less Waiting times for rapid access chest pain clinic

Existing targets – Mental Health Crisis resolution team implementation Existing targets – Ambulance Category A calls meeting 19 minute target Category A calls meeting eight minute target Category B calls meeting national 19 minute target Thrombolysis - 60 minute call to needle time

Existing targets – Primary Care Access to a GP Access to a primary care professional All cancers: one month diagnosis (decision to treat) to treatment All cancers: two month GP urgent referral to treatment All cancers: two week wait Category A calls meeting 19 minute target Category A calls meeting eight minute target Category B calls meeting national 19 minute target Commissioning a comprehensive child and adolescent mental health service Commissioning of crisis resolution/home treatment services Convenience and choice - PCT booking Convenience and choice - PCT facilities in place to support choice Delayed transfers of care Diabetic retinopathy screening Number of inpatients waiting longer than the standard Number of outpatients waiting longer than the standard Patients waiting longer than three months for revascularisation Practice based registers - patients called for review Thrombolysis - 60 minute call to needle time Total time in A&E: four hours or less

New Targets Developmental in nature 11 targets Composite indicators Score 0,2,3 (last year 34 to be “Excellent”) 4 main areas: –Improve health of the population –Support people with long illnesses –Improved access –Improved user experience

Improvement Reviews Comprehensive review of service pathways-multiagency/Multidisciplinary 4 in 2006/ in 2007/08 Major burden and not included in overall ratings 08/09 include: –Health care in prisons, Managing medicines, IG in organisations, LD (services and commissioning)

Use of Resources Non Foundation trusts Financial stability, Finance process, Deliver break even, Value for Money Risk Management Foundation Trusts Monitor determine a risk rating - three components: finance, governance and mandatory services. The finance component looks at four criteria: achievement of plan, underlying performance, financial efficiency, and liquidity.

Overall Rating Calculation Overall Score Core Standards Existing Targets New Targets Improvement Reviews WEAKNot MetNot met GOOD At least Almost Met At Least Almost Met At Least Good EXCELLENTFully Met Excellent No weak, 2 good or 1 excellent FairAny other combination not covered above

Scores on the Doors How did your trusts do?

Linking Performance and Choice Teams of 4 or 5 you have 10 minutes to: Identify your top 5 current indicators to support Choice Identify 5 New Indicators you would put in place Now decide the top 4 Important considerations about Indicators Spokesperson to feed back

Choice Indicators Agreeing the top 5 Which is important What does this tell us Top 5 for each patient group

Recap/Next Week Importance of Performance Management Annual Healthcheck Further research Next week PBR – Dr Helen Byworth