NORTHERN HEALTH AND SOCIAL CARE TRUST

Transcription

1 NORTHERN HEALTH AND SOCIAL CARE TRUST Trust Corporate Performance Report June 2013 Date Issued: 24/07/13

2 Contents 1.0 Introduction / Summary 2.0 Commissioner Targets and Associated Activity 3.0 Access / Waiting Time Targets 4.0 Emergency Department Targets 5.0 Cancer 62 Day Target 6.0 Children s Services CAMH s and Unallocated Cases 2

3 1.0 INTRODUCTION/SUMMARY As the Trust Board does not meet in July, this is a shortened version of the Trust Board Performance Report. This report focuses on key under performance areas and waiting list breaches. Elective (Planned) Hospital Services Reporting against SBA Volumes The position at 28 th June in respect of the combined Elective Inpatients and Daycases, shows an under performance of -384 (-8%) Admissions. General Surgery is presenting an under performance of 20% (277 patients). Complex General Surgery cannot be carried out at Whiteabbey & Mid Ulster hospitals for patient safety reasons and this has resulted in vacant slots on both theatre lists. The cumulative position for endoscopy at 30 th June shows an under performance of 14% (398 patients). May s cum position was 14% (254 patients). The position for 28 th June New Outpatient Services shows an under performance of -3% attendances. New General Surgery (Breast) attendances shows an under performance of -12% (80 patients), and Gynae -8% (115 patients). Performance for Outpatient Reviews was above draft target by 3183 (15%) attendances. -8% compared to SBA Volume -14% compared to SBA Volumes -3% compared to New SBA Volume 15% above Review SBA Draft Volume Elective (Planned) Waiting Times for Hospital Services 70% of patients to wait within 13 weeks for Inpatient / Day Case treatment increasing to 80% by March June s position presents a 2% increase from that of May and currently remains 10% above target. 70% of patients to wait within 9 weeks for 1 st outpatient appointment, increasing to 80% by March The end of June position is 2% below target compared to 1% below target at the end of May. No patient to wait longer than 9 weeks from referral to commencement of AHP treatment. The 30 th June position shows 718 patients waiting > 9 weeks, this is an increase of 135 patients since 31 st May when there were 583 patients waiting > 9 weeks (202 OT patients, 10 Orthoptic patients, 320 Physio patients & 51 SLT patients) 80% within 13 weeks 68% within 9 weeks 718 pats > 9 wks 3

4 Emergency Department (A&E) Positive progress has been made in the number of patients being seen and treated within 4hrs and 12 hrs in the acute Emergency Departments. Both Antrim Hospital and Causeway Hospitals have achieved improvements from the May position of 75.3% and 78.3% respectively. The number of patients waiting over 12 hrs for the completion of their treatment in the ED has improved again from last month with a total of 14, from 82 in May & 466 in April. The position to the 12 th July has remained encouraging with 1 such case in Causeway Hospital and 0 in Antrim Hospital. Cancer 95% of urgent patients with a suspected cancer should begin treatment within 62 days of referral. 78% was achieved in June from 83% in May. At the end of June, 7 patients were exceeding 85 days. The longest wait was a Gynae patient who waited 127 days and was first treated in Belfast on the 03/07/2013. Under 4hrs Antrim Hosp 77.8% Causeway Hosp 82.4% Over 12 hrs Antrim 0 Causeway 14 78% commenced treatment within 62 days Children s Services CAMH s and Unallocated Cases No patient to wait longer than 9 weeks to access CAMH s 16 patients waited > 9 weeks to access CAMH s at the end of June. This is an increase of 3 patients from the May figure of 13 patients. Latest Weekly Waiting List Activity at the 19 th July show 36 patients waiting > 9 weeks All Family Support & Disability Referrals be allocated to a Social Worker within 20 working days. At the end of June there were 131 unallocated referrals > 20 working days this is an increase 14 cases from May Planned reduction in unallocated cases has been impacted on by increased demand. Interviews have been held to refresh the Social Worker waiting list. Analysis of caseload weighting measures indicate potential to temporarily redirect staff to reduce the level of unallocated cases. 94% within 9 weeks 131 Unallocated Cases > 20 WD 4

5 2.0 COMMISSIONER TARGETS AND ASSOCIATED ACTIVITY TABLE 1A: The following presents detailed progress against our Service and Budget Agreement activity and Waiting List position at the 28 th June /14 Activity Comparison for NHSCT Inpatient and Daycase compared to 13/14 HSCB volumes. (Based on HSCB monitoring) Elective Inpatient activity is based on Admissions (1st FCE only) Cumulative Period 13 30th March th June 2013 (13 weeks) Specialty NHSCT Core expected Target / Vol Actual Cum Activity % Core expected Target / Vol Actual Cum Activity % Core expected Target / Vol Actual Cum Activity Cardiology % % % Dermatology % % % ENT % % % Gastroenterology % % % General Medicine % % % General Surgery (includes paed surg) % % % Breast Surgery % % % Geriatric Medicine % n/a % Haematology n/a % % Nephrology % % % Neurology (excludes VC C'way & PNeur) n/a % % Obs and Gyn (Gynaecology) % % % Paed Med (excludes MUH amb) % % % Pain Management % % % Rheumatology % % % Thoracic Medicine % % Urology (incl Nurse Led Activity) % % % Total for listed specialties % % % NOTE: The following specialties exclude scopes: Gastro, GS & Medicine, which have been identified by procedure code on PAS Elective Inpatients Daycases Combined Elective and Daycase % TABLE 1B: Endoscopy performance against HSCT target: 01/04/ /06/2013 (3 months) NHSCT April May June Cumulative Actual Activity to Date Expected SBA Monthly Volume Monthly % -20.5% -5.2% -14.7% -13.5% 5

6 TABLE 2: 13/14 Comparison for NHSCT Outpatient Activity compared to 13/14 HSCB volumes (Based on HSCB monitoring) Cumulative Period 13 30th March th June 2013 (13 weeks) NHSCT New Outpatients Review Outpatients Specialty Core expected Target / Vol Actual Cum Activity % Core expected Target / Vol Actual Cum Activity % Cardiology % % Dermatology % % Diabetes / Endocrinology % % ENT % % Gastroenterology % % General Medicine % % General Surgery (includes paed surg) % % Breast Surgery % % Geriatric Medicine % % Haematology % % Nephrology % % Neurology (excludes VC C'way & PNeur) % % Obs and Gyn (Gynaecology) % % Gynae - Colposcopy % n/a Gynae - Urodynamics % n/a Orthodontics % % Paed Med (excludes MUH amb) % % Pain Management % % Rheumatology % % Thoracic Medicine % % Urology (incl Nurse Led Activity) % % Total for listed specialties % % 6

7 TABLE 3: Northern Health and Social Care Trust SBA Volume Breakdown Specialty Total Elect Adms Total Day Cases Combined Elect Adms & DC New Outs Review outs Cardiology ,634 3,779 Dermatology ,398 5,849 Diabetes / Endocrinology ,328 2,171 ENT ,222 6,222 Gastroenterology ,000 6,000 General Medicine ,476 4,952 General Surgery (includes paed surg) ,484 10,944 Breast Surgery ,738 3,340 Geriatric Medicine ,006 1,006 Haematology ,731 Nephrology ,448 Neurology (excludes VC C'way & PNeur) Obs and Gyn (Gynaecology) ,460 5,460 Gynae - Colposcopy ,692 0 Gynae - Urodynamics Orthodontics ,000 Paed Med (excludes MUH amb) ,468 8,046 Pain Management ,302 Palliative Medicine Rheumatology ,744 6,104 Thoracic Medicine ,390 4,780 Urology (incl Nurse Led Activity) ,930 4,395 Total 5,832 13,198 19,030 53,756 84,157 not yet agreed with HSCB Endoscopes 11,167 (Source: HSCB; Based on NHSCT Capacity & Demand Report) - The majority of Elective activity volumes for 2013/14 have been agreed with HSCB for inpatients, day cases and new outpatients. Draft volumes are used in the interim for review outpatients until 2013/14 volumes have been confirmed. Inpatient / Day Case volume split has not yet been agreed, HSCB draft percentage split has been used in the interim. - The 2013 / 14 volumes are based mainly on 2012/13 volumes with a 2% increase for productivity. 7

8 TABLE 4: Non Elective Activity 13/14 Non Elective Activity Comparison for NHSCT compared to 12/13 Outturn. Cumulative Period NHSCT 1st April th June 2013 Non Elective Inpatients Specialty Outturn 12/13 Actual Cum Activity Accident and Emergency (ssw) Anaesthetics (ICU Antrim) Cardiology 1,273 1, Dermatology 1 1 Diabetic / Endocrinology ENT Gastroenterology General Medicine 3,066 3, General Surgery (includes paed surg) 1,529 1, Geriatric Medicine Haematology (Clinical) Nephrology Neurology excludes VC C'way & PNeur) Obs and Gyn (Gynaecology) Paed Med 950 1, Pain Management 2-2 Palliative Medicine Rheumatology Thoracic Medicine Urology Total Non Elective Inpatients 9,280 11, Non-Elective Activity is for reference only and is not included in SBA monitoring - 13/14 activity is compared to 12/13 activity. - Based on activity recorded on PAS as at 2 nd July From 1 st May all ICU admissions will remain designated in PAS as under the referring consultant, this will be reflected in 2013/14 FCE activity in ICU, General Medicine & General Surgery. TABLE 5: Regular Day / Night Attendances 13/14 Non Elective Activity Comparison for NHSCT compared to 12/13 Outturn. Cumulative Period NHSCT Regular Day/Night Attendances Specialty Outturn 12/13 Actual Cum Activity Clinical Oncology Haematology (Clinical) Medical Oncology Nephrology 4,774 4, Total Regular Day/Night Attendances 5,739 5, Regular Day/Night Activity is for reference only and is not included in SBA monitoring. - 13/14 activity is compared to 12/13 activity. - Based on activity recorded on PAS as at 2 nd July

9 TABLE 6: Nurse Led Activity Commissioner: Total HSCB Cumulative Period 30th March th June 2013 (13 Weeks) Total Nurse Led Activity SPECIALTY New Atts Rev Atts Cardiology Dermatology Gynae 209 Pre-Assessment 3,767 Obs-Midwife A/N 1, Respiratory Rheumatology 177 Stoma Breast Care TOTAL 1,194 5,222 9

10 TABLE 7A: Quarters 1&2 Additional In-House IP/DC Activity delivered in support of achieving Backstop Waiting Times position (Information based on activity recorded on PAS) COMMISSIONER : Total HSCB POSITION FROM : 1st April - 28th June 2013 Specialty ADDITIONAL INHOUSE INPATIENTS & DAYCASES Actual Activity (IP/DC) Additional Inhouse Volume / Target Q1 & Q2 (13 Weeks) % Completed Cardiology % Dermatology % ENT % Gastro 1 n/a GS 12 n/a Breast Surgery % Gynae % Pain Management % Rheumatology % Urology 3 n/a TOTAL % (Source: Performance & Improvement Dept; Business Objects Additional & IS Activity Report) Note 1: Volume is for 26 weeks (Qtrs 1 & 2 Plan) Note 2: Based on activity recorded on PAS as at 2nd July 2013 TABLE 7B: Quarters 1&2 Additional In-House New Outpatients Activity delivered in support of achieving Backstop Waiting Times position (Information based on activity recorded on PAS) COMMISSIONER : Total HSCB POSITION FROM : 1st April - 28th June 2013 Specialty Actual Activity NEW OUTPATIENTS ONLY Volume / Target Additional Inhouse Q1 & Q2 (13 Weeks) % Completed Cardiology % Dermatology % Diabetes / Endo % ENT % GS % Breast Surgery % Elderly % Neurology % Gynae % Orthodontics % Pain Management % Rheumatology % TOTAL % (Source: Performance & Improvement Dept; Business Objects Additional & IS Activity Report) Note 1: Volume is for 26 weeks (Qtrs 1 & 2 Plan) Note 2: Based on activity recorded on PAS as at 2nd July

11 TABLE 7C: Quarters 1&2 Independent Sector Activity delivered in support of achieving Backstop Waiting Times position Inpatients / Day Cases (Information based on Independent Sector Returns) POSITION FROM : 1st April - 26th June 2012 INDEPENDENT SECTOR INPATIENTS & DAYCASES Specialty Actual Activity (IP/DC) Volume/ Provider target Q1 & Q2 (13 Weeks) % Completed ENT 22 n/a Gastroenterology / Medicine % GS % Gynae % Pain Management % TOTAL % (Source: Performance & Improvement Dept; Business Objects Additional & IS Activity Report) Note 1: Volume is for 6 months (Qtrs 1 & 2 contracts with providers, 13 weeks pro rata) Note 2: Based on IS datasets returned at 26th June Note 3: Activity is based on Patients referred to IS for Q1 Note 4: Pain Mgt Volume reduced to 25 from 50, 25 not sent out due to insufficient numbers. TABLE 7D: Quarters 1&2 Independent Sector Activity delivered in support of achieving Backstop Waiting Times position New Outpatients (Information based on Independent Sector Returns) POSITION FROM : 1st April - 26th June 2013 NEW OUTPATIENTS Only Volume/ Specialty Actual Activity Provider target Q1 & Q2 % Completed (13 Weeks) Dermatology % ENT % Gastro % GS % Gynae % Neurology % Pain Management % TOTAL % (Source: Performance & Improvement Dept; Business Objects Additional & IS Activity Report) Note 1: Volume is for 6 months (Qtrs 1 & 2 contracts with providers, 13 weeks pro rata) Note 2: Based on IS datasets returned at 26th June 2013 Note 3: Activity is based on Patients referred to IS for Q1 Note 4: GS Volume reduced from 1014 to 821 due to provider capacity, keep under review. 11

12 TABLE 8: Variation Report on SBA Activity variations submitted 2013/14 Month Hospital Specialty APRIL 2013 CAUSEWAY Urology APRIL 2013 CAUSEWAY Gastroenterology MAY 2013 Which Service is affected WHITEABBEY / MID ULSTER ENT / Gynae / GS Day Case What is the issue / problem? What impact will this have on delivering the SBA? Inpatient / Day Case / Outpatient Unable to recruit into vacant post Underperformance in all areas Ongoing Inpatient / Day Case / Outpatient Unable to recruit into vacant post Underperformance What time period will be affected? December September 2013 Inability in filling core waiting lists efficiently due to high number of patients who require more complex care within a day surgical facility which non acute hospitals site cannot provide ENT / Gynae / GS will have difficulty delivering current SBA Volume Ongoing 12

13 AHP Activity TABLE 9A: Service & Budget Agreement (SBA) for New AHP Face to Face (FTF) Contacts CUMULATIVE POSITION: 1 st April 30 th June 2013 (Commissioning targets have been agreed for new FTF contacts only. These have been based on 11/12 activity and include any additional investment received within the current year) AHPs (New) 13/14 New FTF Contacts Activity 13/14 SBA New FTF Target Additional Investment FTF Target (New) Total 13/14 New FTF Target Year End Projected % Year End Dietetics 3,499 2, , ,238 30% Occupational Therapy 5,406 4, , ,708 14% Orthoptics % Physiotherapy 10,730 9, ,559 1,171 4,684 12% Podiatry 2,534 2, , % Speech & Language Therapy 1,298 1, , % * Based on 11/12 Outturn TABLE 9B: Additional Investment 2013/14 Additionality - Full Year Effect New Review SLT New Post from 12/13 recurrent To be Confirmed Dietetics DAFNE Dietetics CAWT Performance Notes: Speech & Language Therapy SLT staff have relocated from Community Services to Antrim Hospital which impacts on elective target Staff are endeavouring to balance the needs of new referrals and meeting targets with managing the risks with delayed reviews Adult Services are recruiting additional staff, in the interim 2 temporary staff have been employed and additional hours have been made available to other staff Pressure continues on SLT services, but waiting list position expected to improve by September. Occupational Therapy Community, Dementia and Learning Disability OT services are all breaching 9 week target 3 new peripatetic OT s have been employed, 2 have commenced and 1 is starting mid July The 4 th new peripatetic OT has pulled out so post has to be recruited to again 8 additional temporary OT s have been agreed for 4 months for Community, these are being recruited to One temporary OT for Dementia Services has been agreed for 4 months, this is being recruited to Learning Disability have recruited a permanent OT to their service and 1 temporary agency OT OT is unlikely to improve over the next few months given this is the holiday period and recruitment to temporary posts takes at least 8 weeks Physiotherapy Demand for the service continues to increase Physiotherapy does not have the funded capacity to service this increase in referrals An IPT is presently being prepared to secure additional funding 13

14 TABLE 9C: AHP Supporting Information - Review Face to Face (FTF) Contacts CUMULATIVE POSITION: 1 st April 30 th June 2013 (Review activity is not part of SBA activity however the following activity is provided in support of the new activity in the table above. Review targets have been based on 11/12 activity and include any additional investment received within the current year) AHPs (Review) 13/14 Review FTF Contacts Activity 13/14 Review FTF Target Additional Investment FTF Target (Review) Total 13/14 Review FTF Target Year End Projected % Year End Dietetics 5,159 4, , ,897 23% Occupational Therapy 12,230 9, ,784 2,446 9,784 25% Orthoptics 2,444 2, , % Physiotherapy 41,170 40, , % Podiatry 19,850 21, ,106-1,256-5,024-6% Speech & Language Therapy 10,864 10, , % * Based on 11/12 Outturn OT Contacts (Mental Health) (New) (excluding Dementia)* 185 OT Contacts (Mental Health) (Review) (excluding Dementia)* 5,760 (Info not yet available for June 13) TABLE 9D: Community Health Services The following table is for information only and details at a high level Community Health Servicess. Activity provided is for 1 st April 31 st May 2013(June Information not yet available) Community Health Services 13/14 FTF Contacts Activity (12/13 Volume used) Health Visitors 7,056 District Nurses 49,172 Community Midwifery 13,509 Community Nurses Learning Disability 169 Community Psychiatric Nurses 7,782 Community Dental 3,943 Clinical Psychology 3,267 Family Planning 1,378 (Tables 9A 9D Source: Corporate Information Services; AHP & Community Health Service Monthly (FTF Contact) Activity) 14

15 3.0 ACCESS / WAITING TIMES TARGETS TABLE 10A: IP/ DC Patients by Weeks Waiting at 28/06/2013 As at 28/06/2013 there were 821 NHSCT patients waiting over 13 weeks Inpatient / Day Case 179 NHSCT patients breached the backstop positions 143 NHSCT patients waiting over 26 weeks 80% NHSCT patients were waiting less than 13 weeks Patients waiting in the >13 week column are waiting days, 14 weeks: days etc. DAYCASES > CARDIOLOGY (C) 1 1 DENT LEARN DIS/SPEC NEEDS (C) DENTAL CHILDRENS (C) DERMATOLOGY (C) EAR, NOSE & THROAT- ADULT (C) EAR, NOSE & THROAT PAEDIATRIC (C) 2 2 EAR, NOSE & THROAT (IS) GENERAL SURGERY (C ) IS GENERAL SURGERY (C) GYNAECOLOGY (C ) IS GYNAECOLOGY (C) OBS & GYN (GYNAECOLOGY) (WLIO) PAIN MANAGEMENT (C) PAIN MANAGEMENT (WLI) 1 1 THORACIC MEDICINE (C) 1 1 UROLOGY (C) INPATIENTS > EAR, NOSE & THROAT- ADULT (C) EAR, NOSE & THROAT PAEDIATRIC (C) GENERAL SURGERY (C ) IS GENERAL SURGERY (C) GENERAL SURGERY BREAST (C) GYNAECOLOGY (C ) IS GYNAECOLOGY (C) OBS & GYN (GYNAECOLOGY) (WLIO) 1 1 UROLOGY (C ) IS 1 1 UROLOGY (C) TOTAL IP/DC = 13 wk PFA target or agreed backstop for certain specialties. These patients are not yet breaching. (Source; Information Services Acute, PTLIPDC _28 th June 2013) NOTE: Waiting list figures have not yet been validated by operational staff. Table 9A excludes Visiting Consultant waiters. Patients are grouped into weeks waiting, ie. 18 weeks equals days. Patients waiting >18 weeks ( days) will therefore be included in the 18 week group. Only those waiting exactly 18 weeks in this column are not breaches. WEEKS Total > 13 Weeks Total > 13 Weeks 15

16 TABLE 10B: Endoscopy Patients by Weeks Waiting at 28/06/2013 As at 28/06/2013 there were 268 NHSCT Endoscopy patients waiting over 9 weeks 84% NHSCT Endoscopy patients were waiting within 9 weeks Specialty WEEKS > GASTROENTEROLOGY (C) GASTROENTEROLOGY (IS) GENERAL SURGERY (C) GENERAL SURGERY (IS) Total (Source; Information Services Acute, PTLIPDC_28 th June 2013) NOTE: Waiting list figures have not yet been validated by operational staff. TABLE 10C: Visiting Consultant IP/DC Patients by Weeks Waiting at 28/06/2013 DAYCASE WEEKS Total > 9 Weeks OPHTHALMOLOGY (C) UROLOGY BHSCT (C) UROLOGY BHSCT (WLI) 1 1 Total TABLE 11: Waiting Times for Inpatient / Daycases Backstop Specialties June 13 Total > 13 Weeks Specialty WEEKS Specialty WEEKS Breast Surgery 26 General Surgery 26 Dermatology 11 ENT 18 Endoscopy 9 Gynae 26 Urology 26 All Other Specialties 13 16

17 TABLE 12A: OP Core Patients by Weeks Waiting at 28/06/2013 As at 28/06/2013 there were 5,291 NHSCT patients waiting over 9 weeks Outpatients (inc. IS Transfers) 2,091 NHSCT patients breached the backstop positions (inc. IS Transfers) 1,683 NHSCT patients waiting over 15 weeks (inc. IS transfers) Patients waiting in the >9 week column are waiting days, 10 weeks: days etc. Specialty Description > CARDIOLOGY (C) CHEMICAL PATHOLOGY (C) COLPOSCOPY - GYNAE (C) DERMATOLOGY (C ) IS DERMATOLOGY (C) DIABETIC (C) EAR, NOSE & THROAT (C ) IS EAR, NOSE & THROAT (C) ENDOCRINOLOGY (C) GASTROENTEROLOGY (C ) IS GASTROENTEROLOGY (C) GENERAL MEDICINE (C) 1 1 GENERAL SURGERY (C ) IS GENERAL SURGERY (C) GENERAL SURGERY BREAST (C) GERIATRIC ASSESSMENT (C) 1 1 GERIATRIC/CC (C) 1 1 GYNAECOLOGY (C ) IS GYNAECOLOGY (C) HYSTEROSCOPY (C) 1 1 MIRENA - GYNAE (C) NEPHROLOGY (C) NEUROLOGY (C ) IS NEUROLOGY (C) ORTHODONTICS (C) PAEDIATRIC MEDICINE (C) PAIN MANAGEMENT (C ) IS PAIN MANAGEMENT (C) RHEUMATOLOGY (C ) IS RHEUMATOLOGY (C) THORACIC MEDICINE (C) URACYST (C) 1 1 URODYNAMICS - GYNAE (C) UROLOGY (C) TOTAL = 9 wk PFA target or agreed backstop for certain specialties. These patients are not yet breaching. (Source; Information Services Acute OP_Breach_28 June 2013) NOTE: Waiting list figures are validated weekly by operational staff. Table 11A excludes ICATS and Visiting Consultant waiters. Patients are grouped into weeks waiting, ie. 15 weeks equals days. Patients waiting >15 weeks ( days) will therefore be included in the 15 week group. Only those waiting exactly 15 weeks in this column are not breaches. Community Paediatric (NON PAS) included from 31 st March Total > 9 Weeks

18 TABLE 12B: OP Visiting Consultant Patients by Weeks Waiting at 28/06/2013 Specialty Description DENTAL SURGERY (C) NEUROLOGY (C) OPHTHALMOLOGY (C) ORTHOPAEDICS (C) PAEDIATRIC CARDIOLOGY (C) TRAUMA & ORTHOPAEDICS (C) Total (Source; Information Services Acute OP_Breach_28 June 2013) WEEKS Total > 9 Weeks TABLE 13: Waiting Times for Outpatient Backstop Specialties June 13 Specialty WEEKS Specialty WEEKS Specialty WEEKS Breast Surgery 13 Cardiology 15 Chem Path/Diabetic/Lipid 15 Dermatology 15 Endocrinology 15 ENT 15 Gastro 15 General Surgery 15 Gynae 15 Gynae - Colposcopy 10 Nephrology 10 Neurology (Dr Esmonde) 15 Orthodontics 15 Pain Management 15 Rheumatology 12 Urology 15 All Other Specialties 9 18

19 TABLE 14: WAITING TIMES Allied Health Professionals Waiting List at 12/07/2013 Patients still waiting to be seen/treated 0-3 Weeks (0-21 days) >3 to 6 weeks (22-42 days) >6 to 9 weeks (43-63 days) > 9 to 13 weeks (64-91 days) > 13 weeks (> 91 days) Total waiters Longest Wait (Days) Dietetics Occupational Therapy Orthoptics Physiotherapy Podiatry Speech and Language Therapy Multi-Disciplinary Teams (Source: Corporate Information Services; Priority 2 AHP Waiting Times Fortnightly Return ) NOTE: At 30 th June there were 718 patients waiting over 9 weeks 19

20 4.0 EMERGENCY DEPARTMENT TARGETS INDICATOR 95% of people who attend A&E are treated, admitted or discharged home within 4 hours; no patient should wait longer than 12 hours. Trusts should ensure that the 95% standard is achieved in individual hospital sites. TABLE 15: NEW AND UNPLANNED REVIEW PATIENTS WHO DEPART FROM A&E IN THE MONTH of June 2013 Department Antrim* Attendance Type Total 0-4 hours %0-4 hours Total 4-12 hours % 4-12 hours Total 12 hours + % 12 hours + Total Attendances (exc incorrect DT) New/ Unpl Rev % % 0 0.0% 5889 Causeway* Mid Ulster** Whiteabbey** New/ Unpl Rev % % % 3543 New/ Unpl Rev % 0 0.0% 0 0.0% 707 New/ Unpl Rev % 0 0.0% 0 0.0% 691 Trust Total New/ Unpl Rev % % % (Source: Acute Hospital Information Services; Monthly AE Performance Report) Includes unplanned review patients, Please note Planned reviews (Clinic Reviews) are excluded. 12 hr+ breaches include ambulance breaches which are attributed to NHSCT. Excludes those attributed to the Ambulance Service. GRAPH 1: Monthly % Departing A&E within 4 hours Antrim & Causeway Hospital Sites 100% 95% 90% 85% 80% 75% % 70% 65% 60% 55% 50% 45% 40% 81.9% 80.2% 85.0% 82.2% 78.2% 67.8% 67.1% 68.5% 67.1% 63.9% 61.7% ED - % Seen 0-4 Hours 70.9% 71.9% 77.9% 61.5% 60.5% 59.7% 71.1% 62.8% 70.2% 75.3% 78.3% 77.8% 82.4% Jul-12 Aug-12 Sep-12 Oct-12 Nov-12 Dec-12 Jan-13 Feb-13 Mar-13 Apr-13 May-13 Jun-13 ANT CAU Target (Source: Acute Hospital Information Services; Monthly AE Performance Report) 20

21 TABLE 16: A&E 12 HOUR BREACHES July 12 June 13 (Number of Patients Waiting >12 Hours) Site Jul 12 Aug 12 Sept 12 Oct 12 Nov 12 Dec 12 Jan 13 Feb 13 Mar 13 Apr 13 May 13 Jun 13 Antrim Causeway* Trust Total (Source: Acute Hospital Information Services; Monthly AE Performance Report) 5.0 CANCER 62 DAY TARGETS TABLE 17: Patients with Confirmed Cancers with completed waits over 62 day target as at 9/07/13 Patients 62 Day Target DATE STARTED FIRST TREATMENT Within Target Breachers Total % Within Target % Target Jul % 95% Aug % 95% Sep % 95% Oct % 95% Nov % 95% Dec % 95% Jan % 95% Feb % 95% Mar % 95% Apr % 95% May % 95% Jun % 95% (Source: Cancer Services; Completed Waits 62 days) From CaPPs & Cancer Waits Database Patients shared with another Trust count as 0.5 These figures are subject to change as patient notes are updated The main reasons for Breach of the cancer target are due to Delay in TRUS biopsy, Endoscopic investigation, Hysteroscopy diagnostic test and complex cases. 7 patients waited >85 days at the end of June 1 patient waited 127 days to begin treatment 21

22 6.0 CHILDREN SERVICES TABLE 18: CAMH S Patients Waiting By Weeks No. of waiters > 9 wks CAMHS Weekly WL Position Overall no. of waiters /05/13 07/06/13 14/06/13 21/06/13 28/06/13 05/07/13 12/07/13 19/07/13 Date 9 wks + Total Waiters (Source: Corporate Information Weekly MH Waiting List) NOTES: As at 30 th June there were 16 patients waiting over 9 weeks Breach position remains fragile Referral rates and referral accepted rates have increased significantly Contact NI continue recruitment processes and hope to renew service delivery in coming weeks TABLE 19: Unallocated Cases Category Jun-12 Jul-12 Aug-12 Sep-12 Oct-12 Nov-12 Dec-12 Jan-13 Feb-13 Mar-13 Apr-13 May-13 Jun-13 19/07/2013 Gateway Family Support / Family Intervention Team Disability Total (Source: Corporate Information Monthly Priority 5 Children s Return & Weekly Unallocated Cases Return) NOTES: 100 % of Child Protection referrals to be allocated to a social worker within 24 hours of receipt of referral. June 13 = 100% Unallocated cases > 20 days have increased to 134 as at 19 th July New reduction plan is now in place with 2013 / 2014 year end target of 31 unallocated cases Figures include assessed cases not yet allocated to a named social worker but allocated to other staff (e.g. family support workers) and in receipt of services. Includes Initial Assessments completed within Gateway but not yet allocated to a named social worker for Pathway Assessment etc 22