18 Week 92% Open Pathway Recovery Plan and Backlog Clearance

Transcription

1 18 Week 92% Open Pathway Recovery Plan and Backlog Clearance Page 1 of

2 1.0 Background 18-Week 92% Open Pathway RECOVERY PLAN The Trust has achieved compliance against the admitted and non-admitted standards throughout 2011/12. However operational pressures and the change to the 92 percentile have caused the backlog of patients waiting over 18 week to increase. The size of the backlog now means that the Trust will not achieve the 92%18 week standard for all open pathways from April onwards. This paper outlines the options to reduce the backlog. There are a number of options as to how this could be achieved. The decision to select an option will be made jointly with NCL and both parties will submit a joint statement to NHS London outlining the commitment to and sustainability of this plan. This plan should be read in conjunction with the original plan we sent to NCL at the beginning of this financial year. 2.0 Option 1 RNOH admitted waiting list backlog and performance May March 2012 Scenario 1 - clearing backlog completely (65% RTT performance in June 2012) No. patients % 90.00% 80.00% 70.00% 60.00% 50.00% 40.00% 30.00% 20.00% 10.00% 0.00% Adm Backlog RTT Performance % Mar 2011 Apr 2011 May 2011 Jun 2011 Jul 2011 Aug 2011 Sep 2011 Oct 2011 Nov 2011 Dec 2011 Jan 2012 Feb 2012 Mar 2012 Apr 2012 May 2012 Jun 2012 Jul 2012 Aug 2012 Sep 2012 Oct 2012 Nov 2012 Dec 2012 Jan 2013 Feb 2013 Mar 2013 The extra activity to clear the backlog equals 370 patients. This equates to 62 patients per week until the June. Number of additional operating sessions is 180 totally or 722 hours of operating time over a six week period. This is 30 extra sessions per week. This clears the backlog in 6 weeks but results in a dip in the admitted RTT performance to around 50%. Page 2 of

3 18-Week 92% Open Pathway RECOVERY PLAN 3.0 Option 2 Scenario 2 Extra activity to clear backlog May - June and maintain backlog at around 275 Estimated extra operations a week: 20 In order to maintain the backlog at 275 patients. Extra activity to clear the back log will be 124 patients. This equates to 20 patients per week to clear the backlog by the end of June. The number of additional session is 58 totally 232 hours of operating. 10 extra sessions per week Page 3 of

4 18-Week 92% Open Pathway RECOVERY PLAN 4.0 Option 3 RNOH estimated growth in admitted waiting list backlog May March 2012 Scenario 3 - clear backlog gradually and maintain 85% RTT target No. patients % 94.00% 92.00% 90.00% 88.00% 86.00% 84.00% 82.00% 80.00% Mar 2011 Apr 2011 May 2011 Jun 2011 Jul 2011 Aug 2011 Sep 2011 Oct 2011 Nov 2011 Dec 2011 Jan 2012 Feb 2012 Mar 2012 Apr 2012 May 2012 Jun 2012 Jul 2012 Aug 2012 Sep 2012 Oct 2012 Nov 2012 Dec 2012 Jan 2013 Feb 2013 Mar 2013 Adm Backlog RTT Performance % The extra activity to clear the backlog will be 370 patients. This equates to 37 patients per week. The number of additional operating sessions is 107 totalling 429 hours of operating time over a six week period. This is 18 sessions per week until March this clears the backlog completely but results in an admitted RTT performance of around 85% until the end of the Q4. Page 4 of

5 18-Week 92% Open Pathway RECOVERY PLAN 5.0 Option 4 The graph below shows the impact of the do nothing. The known historic monthly increase in backlog has also been predicted. This shows that backlog will continue to increase to 470 patients at the end of the next financial year; this is likely to relate to an open pathway performance of 95 %. No. patients RNOH estimated growth in admitted waiting list backlog March April 2012 Scenario 1 - no extra activity and 18 week performance at 90% % 94.00% 92.00% 90.00% 88.00% 86.00% 84.00% Mar 2011 Apr 2011 May 2011 Jun 2011 Jul 2011 Aug 2011 Sep 2011 Oct 2011 Nov 2011 Dec 2011 Jan 2012 Feb 2012 Mar 2012 Apr 2012 May 2012 Jun 2012 Jul 2012 Aug 2012 Sep 2012 Oct 2012 Nov 2012 Dec 2012 Jan 2013 Feb 2013 Mar 2013 Adm Backlog Clock Stops > 18wks RTT Performance % Page 5 of

6 6.0 Monitoring and Sustainability 18-Week 92% Open Pathway RECOVERY PLAN Conclusion Option 1 This option would dip the performance to an unacceptable level and it is not physically possible to obtain the amount of sessions required to complete the work. Option 2 Although performance will dip initially the maintaining of a 200 patient backlog is sustainable. This is a weeks worth of activity for the Trust Option 3 This option makes the RHOH non compliant all year. Although the backlog will completely cleared the performance will be maintained at just above 85% Option 4 Do nothing. 7.0 Recommendations The RNOH option would be option 2 as although performance will dip to around 75% a compliant position can be maintained from July onwards. Extra capacity has been secured since yesterday at Spire Harpenden for JRU patients and at the Clementine Churchill for JRU and Sarcoma. This will contribute to the delivery of option 2. Page 6 of