NHS CHC Turnaround Project North Norfolk CCG Governing Body

Transcription

1 Agenda Item: 6.2(i) NHS CHC Turnaround Project North Norfolk CCG Governing Body Date 18 th March 2014 CHC Turnaround Project 18/02/2014

2 Project Update Work streams: - Contracting: The AQP procurement is progressing for the 14/15 contracts with care homes, for 1 st April 2014 start - PHB, North Norfolk patients on a Personal Health Budgets is 16 as of week 60 - Commissioning: Market Management, The negotiations between the CSU and CCGs for the KPIs in the SLA continues Main Stream Contracts, NCHC and NSFT have agreed to carry out checklist on patients known to them and to be actively involved in the process for decision on eligibility within the 14/15 contract, this has the potential to release resources with in the CHC team. - Operations: The eligibility and assessment backlog has decreased to 241 cases (North Norfolk CCG is 70) as at week 60, however a long term solution to clearing the whole backlog is still awaited. CHC Turnaround Project 18/02/2014 2

3 Data commentary - The number of active CHC patients has increased in the last four weeks. The main reasons are: conversions from the existing backlog, increasing FTs, and a small number of patients who become CHC eligible while in hospital and stay in the backlog for a very short period. The overall increase against benchmark position in week 21 is 87 (8.8%) patients. - The total CHC cost is raising consistently with the patients increase observed. The average cost per patient has increased slightly in the last week and is currently 1,050 per patient. - Fast tracks remained very low from week 42 to week 55 but have recently increased reaching 45 patients, higher if compared with the benchmarking position (39 FT). - The backlog peaked during week 39 (382 people on the waiting list) and has decreased since then reaching 241,of which 98 have been waiting over 6 months. All patients post June 2013 have now a booked appointment for a MDT. CHC Turnaround Project 11/03/2014 3

4 CHC Key KPI Dash Board Graph 1 shows the weekly trend of all NHS CHC active patients including FT from week 21 (agreed benchmarking position) plus an additional estimate on how the backlog converts to a yes eligibility decision. The number of active patients on the case load has increased in the last weeks. The reasons are varied and linked to the backlog conversion, increasing FTs, and in a small measure patients who become CHC active while being in hospital. See table below for comparison against w21. Graph 1 The number of Fast Track patients remained low for many weeks and have reached 45, higher than on week 21. Wk 21 Wk 60 Active Active WCP/insigned IC Fast Track Subtotal Backlog Converted Total aware of. CHC Turnaround Project The backlog conversion, which is the proportion of people on a waiting list that we estimate will become eligible is showing a reduction. The backlog has seen a substantial decrease since w21 but the proportion of people allocated to assessor has increased, and the chance of them becoming eligible is higher (50%) than if they were waiting to be allocated (30%). This is the reason why the estimated converted backlog is not reducing in the same proportion as the backlog. Note that there tends to be a lag on notification of deceased patients, for which a number of patients may be currently deceased and the CHC team are not yet 11/03/2014 4

5 CHC Key KPI Dash Board Graph 2 Notes: Graph 2 shows the total weekly cost of active CHC eligible patients in Norfolk from week 21 onwards plus an additional estimate in monetary terms on how the backlog converts to a yes eligibility decision. This cost reflects the impact of weekly fluctuations in the number of patients and average costs. Costs have increased in the last month due to the higher number of active patients on the caseload as explained in the previous slide. Please note that the weekly cost also contains a cost estimate of patients on 0 cost. Net budget as per week 16 is included for comparative purposes. CHC Turnaround Project 11/03/2014 5

6 CHC Key KPI Dash Board Backlog Graph 3 CHC Turnaround Project 18/02/2014 6

7 Average cost NNCCG Data North Norfolk Average Cost 2,000 1,800 1,600 1,400 1,200 1, LD MH PD - W25 W27 W29 W31 W33 W35 W37 W39 W41 W43 W45 W47 W49 W52 W54 W56 W58 W60 Graph 4 Shows the average cost per case by category for NNCCG Key: LD: Learning Difficulty MH: Mental Health PD: Physical Disability CHC Turnaround Project 18/02/2014 7

8 Wk 25 Wk 27 Wk 29 Wk 31 Wk 33 Wk 35 Wk 37 Wk 39 Wk 41 Wk 43 Wk 45 Wk 47 Wk 49 Wk 52 Wk 54 Wk 56 Wk 58 Wk 60 AV COST NNCCG Data North Norfolk - > 100,000 Series1 Series Graph 5 Shows the number of patients costing over 100K per year within NNCCG CHC Turnaround Project 18/02/2014 8