april 2016 data · april 2016 and require that 75% of people are treated within six weeks of...

Board Integrated Performance Report September 2015 Board Integrated Performance Report October 2015 Board Integrated Performance Report October 2015 Board Integrated Performance Report November 2015 Board Integrated Performance Report December 2015 Board Integrated Performance Report January 2016 Board Integrated Performance Report March 2016 1 of 36 Board Integrated Performance Report - May 2016

1.2 NHS Improvement

Governance

Rating

Board Integrated Performance Report

26th May 2016

April 2016 Data

Summary NHS

Improvement Quality

Business Unit

Change Programme

Finance

Good

1.1 CQC Compliance 1.3 NHS Improvement

Sustainability and Performance

Risk Rating

Minimum Requirement: 3

4

Agenda Item: 10

Lead Director: Director of Finance,

Contracting and Facilities

Presented For: Discussion


Summary NHS

Improvement Quality

Business Unit

Change Programme

Finance

The purpose of this Integrated Performance Report is to assist the Board in assessing the Trust’s performance and progress in

delivery of a broad range of key targets and indictors.

Board Action Key Highlights Slides

NHS Improvement

Assurance • All NHS Improvement performance requirements for month one have been met.

4 - 6

Quality

Exception

Assurance

Exceptions

• One Duty of Candour incident was reported in April 2016, concerning the inappropriate application of a wound

dressing.

• The draft reports relating to the Care Quality Commission (CQC) focussed inspection conducted in January

2016 were received by the Trust on 5 May 2016. The draft reports confirm that the Trust is now rated as good

for the safe domain; this provides the Trust with a rating of good across all five domains.

• Labour turnover remains above the Trust target of 10%. The report outlines issues and actions relating to the

retention of staff.

• Sickness absence remains above the Trust’s 4.0% target, but shows a continued reducing trend. The report

outlines issues and actions relating to responses to both long and short term absence.

7

13

15

Business Unit

Updates • In early May, the Improving Access to Psychological Therapies (IAPT) service moved onto a new clinical

system, PCMIS. Whilst performance monitoring is continuing at the business unit performance meeting it has

been jointly recognised by Commissioners and the Trust that there are likely to be temporary reported

reductions in performance during implementation of the new system.

• April performance was reviewed at the business unit performance meetings. The issues identified for

escalation to the Board relate to financial pressures and risks captured within the finance report and Business

Unit Risk Logs that will be used to track mitigating actions.


Summary NHS

Improvement Quality

Business Unit

Change Programme

Finance

The purpose of this Integrated Performance Report is to assist the Board in assessing the Trust’s performance and progress in

delivery of a broad range of key targets and indictors.

Board Action Key Highlights Slides

Change Programme

Information • Six of the eleven projects being monitored by the Change Programme Board are rated green. Four projects

are rated amber with actions and mitigation in place to manage the risks and issues.

• The Intensive Therapy Centre project continues to be red rated. Change Programme Board received a report

outlining arrangements the Trust has set in train to close the unit to new admissions from mid April. This

means that the unit will close when current admissions are discharged. The Programme Board discussed

actions to mitigate resulting trading losses and to ensure the safe ongoing treatment of service users on the

unit.

23 - 25

Finance

Exceptions

• Performance at the end of April highlights the level of challenge anticipated when the 2016/17 Annual Plan

was approved and signifies the need for urgent remedial actions.

• The Month 1 position on all key indicators is rated amber, with the exception of the Statement of Financial

Position which is rated green.

• The Trust planned to make a surplus of £111k at the end of the period but has reported a £100k deficit and

adverse plan variance of £211k.

• Cost Improvements are £103k behind plan at the end of the period with further details and mitigating actions

highlighted.

• Capital Expenditure is £81k below plan year to date, reflecting E-Rostering billing slippage and uncommitted

contingency reserves (for anticipated in-year pressures) of £240k.

• The position reflects achievement of a Financial Sustainability Risk Rating of 3, compared to a plan rating of

4, with the forecast position being an achievement of a rating of 4, but noting elevated risks relating to

achievement of the planned surplus and attendant cash impacts.

27

28

33 – 35

36

32

Summary and Recommendations

The Board integrated performance report shows strong performance against non financial targets in April 2016 but a number of financial

pressures that will require robust ongoing financial management if the Trust is to achieve a challenging financial plan in 2016/17. The Trust is

introducing revised Performance Management arrangements to increase the opportunity for detailed financial discussion and action planning.

Correlation of quality information (including patient experience and safety related measures), performance, finance, workforce and health and

safety information has taken place and did not identify any other areas of particular concern.

The Board is recommended to:

• review and consider the exceptions highlighted and note the actions and mitigations.


Indicator M4: In April 2016 there were 0.5% delayed transfers of care including patients on Section 3.

Indicator M6: The number of new psychosis cases seen by early intervention teams has been removed because from April 2016 the

indicator has been replaced by the new national standard, indicator M7.

Indicator M7: Data is provided in relation to the waiting time element of the new standard for Early Intervention in Psychosis (EIP). This

shows patients who started treatment in April 2016 within two weeks of referral. The number of incomplete pathways (patients waiting) at the

end of April 2016 was 16; 13 of these patients have been waiting for more than two weeks. RAG rating has not been applied as although the

waiting time element of the new standard is being met, the other components of the standard (extended age range and provision in

accordance with NICE recommendations) are not yet in place. All components must be met for the standard to be deemed to have been

achieved. Additional CCG investment in EIP was confirmed from 1 April 2016; allowing staff recruitment and training to commence. This will

enable the Trust to extend the age range for EIP services to adults up to 65 and to provide a full package of NICE recommended care. As a

result of the recent investment the Trust therefore projects meeting all components of the new standard from

quarter 3 of 2016/17.

NHS Improvement Indicators

Summary NHS

Improvement Quality

Business Unit

Change Programme

Finance

0.0%

50.0%

100.0%

150.0%

200.0%

250.0%

May14

Jun14

Jul14

Aug14

Sep14

Oct14

Nov14

Dec14

Jan15

Feb15

Mar15

Apr15

May15

90.0%

92.5%

95.0%

97.5%

100.0%

May14

Jun14

Jul14

Aug14

Sep14

Oct14

Nov14

Dec14

Jan15

Feb15

Mar15

Apr15

May15

75.0%

80.0%

85.0%

90.0%

95.0%

100.0%

May14

Jun14

Jul14

Aug14

Sep14

Oct14

Nov14

Dec14

Jan15

Feb15

Mar15

Apr15

May15

Q2 Q3 Q4 Apr May Jun Q1 Q1 Q1

Outturn Outturn OutturnNumerator

Outturn

Denominator

OutturnOutturn

M3

RTT dental 18 weeks waits - incomplete

pathways

(Number of patients who have waited 18

weeks or less/Number of patients waiting)

92.0% 96.3% 212 220 96.3%92.1%

as of Feb 16

M4 Mental Health Delayed Transfers of Care <=7.5% 0.0% #DIV/0! #DIV/0! 0 5488 0.0%

M5

Admission to inpatients services had

access to Crisis Resolution Home

Treatment Teams

95.0% 100.0% 50 50 100.0%

98.3% as of Q4

15/16

Next publication date:

June 2016

M7

Early intervention in Psychosis (EIP):

People experiencing a first episode of

psychosis treated with a NICE approved

care package within two weeks of referral

50.0%

73%

March

2016

Data

86.9% 20 23 86.9%

GraphNational

Benchmark

Indicator

No.

Indicator

Target

80.0%

85.0%

90.0%

95.0%

100.0%

Apr15

May15

Jun15

Jul15

Aug15

Sep15

Oct15

Nov15

Dec15

Jan16

Feb16

Mar16

Apr16

90.0%

92.5%

95.0%

97.5%

100.0%

Apr15

May15

Jun15

Jul15

Aug15

Sep15

Oct15

Nov15

Dec15

Jan16

Feb16

Mar16

Apr16

80.0%

85.0%

90.0%

95.0%

100.0%

Apr15

May15

Jun15

Jul15

Aug15

Sep15

Oct15

Nov15

Dec15

Jan16

Feb16

Mar16

Apr16

80.0%

85.0%

90.0%

95.0%

100.0%

Apr15

May15

Jun15

Jul15

Aug15

Sep15

Oct15

Nov15

Dec15

Jan16

Feb16

Mar16

Apr16

90.0%

92.5%

95.0%

97.5%

100.0%

Apr15

May15

Jun15

Jul15

Aug15

Sep15

Oct15

Nov15

Dec15

Jan16

Feb16

Mar16

Apr16

80.0%

85.0%

90.0%

95.0%

100.0%

Apr15

May15

Jun15

Jul15

Aug15

Sep15

Oct15

Nov15

Dec15

Jan16

Feb16

Mar16

Apr16

0.0%

2.0%

4.0%

6.0%

8.0%

10.0%

Apr15

May15

Jun15

Jul15

Aug15

Sep15

Oct15

Nov15

Dec15

Jan16

Feb16

Mar16

Apr16

80.0%

85.0%

90.0%

95.0%

100.0%

Apr15

May15

Jun15

Jul15

Aug15

Sep15

Oct15

Nov15

Dec15

Jan16

Feb16

Mar16

Apr16

0.0%

1.0%

2.0%

3.0%

4.0%

5.0%

6.0%

7.0%

8.0%

Apr15

May15

Jun15

Jul15

Aug15

Sep15

Oct15

Nov15

Dec15

Jan16

Feb16

Mar16

Apr16

90.0%

92.5%

95.0%

97.5%

100.0%

Apr15

May15

Jun15

Jul15

Aug15

Sep15

Oct15

Nov15

Dec15

Jan16

Feb16

Mar16

Apr16

0.0%

50.0%

100.0%

150.0%

200.0%

250.0%

Apr15

May15

Jun15

Jul15

Aug15

Sep15

Oct15

Nov15

Dec15

Jan16

Feb16

Mar16

Apr16



Indicator M8: April 2016 performance has improved significantly, with 62 out of 63 clients on Care Programme Approach (CPA) followed

up within seven days of discharge.

Indicators M10 and M11: The new national waiting time standards for Improving Access to Psychological Therapies (IAPT) apply from

April 2016 and require that 75% of people are treated within six weeks of referral and 95% are treated within 18 weeks of referral.

The quarterly targets provided in column 3 were local trajectories for 2015/16 to support achievement of the new standards from April

2016.

The Health and Social Care Information Centre is due to publish February 2016 IAPT data on 20 May 2016.

NHS England Benchmark

Target

Key

Summary NHS

Improvement Quality

Business Unit

Change Programme

Finance

0.0%

50.0%

100.0%

150.0%

200.0%

250.0%

May14

Jun14

Jul14

Aug14

Sep14

Oct14

Nov14

Dec14

Jan15

Feb15

Mar15

Apr15

May15

90.0%

92.5%

95.0%

97.5%

100.0%

May14

Jun14

Jul14

Aug14

Sep14

Oct14

Nov14

Dec14

Jan15

Feb15

Mar15

Apr15

May15

75.0%

80.0%

85.0%

90.0%

95.0%

100.0%

May14

Jun14

Jul14

Aug14

Sep14

Oct14

Nov14

Dec14

Jan15

Feb15

Mar15

Apr15

May15

0.0%

50.0%

100.0%

150.0%

200.0%

250.0%

May14

Jun14

Jul14

Aug14

Sep14

Oct14

Nov14

Dec14

Jan15

Feb15

Mar15

Apr15

May15

90.0%

92.5%

95.0%

97.5%

100.0%

May14

Jun14

Jul14

Aug14

Sep14

Oct14

Nov14

Dec14

Jan15

Feb15

Mar15

Apr15

May15

75.0%

80.0%

85.0%

90.0%

95.0%

100.0%

May14

Jun14

Jul14

Aug14

Sep14

Oct14

Nov14

Dec14

Jan15

Feb15

Mar15

Apr15

May15

0.0%

50.0%

100.0%

150.0%

200.0%

250.0%

Jun14

Jul14

Aug14

Sep14

Oct14

Nov14

Dec14

Jan15

Feb15

Mar15

Apr15

May15

Jun15

90.0%

92.5%

95.0%

97.5%

100.0%

Jun14

Jul14

Aug14

Sep14

Oct14

Nov14

Dec14

Jan15

Feb15

Mar15

Apr15

May15

Jun15

75.0%

80.0%

85.0%

90.0%

95.0%

100.0%

Jun14

Jul14

Aug14

Sep14

Oct14

Nov14

Dec14

Jan15

Feb15

Mar15

Apr15

May15

Jun15

0.0%

50.0%

100.0%

150.0%

200.0%

250.0%

Jul14

Aug14

Sep14

Oct14

Nov14

Dec14

Jan15

Feb15

Mar15

Apr15

May15

Jun15

Jul15

90.0%

92.5%

95.0%

97.5%

100.0%

Jul14

Aug14

Sep14

Oct14

Nov14

Dec14

Jan15

Feb15

Mar15

Apr15

May15

Jun15

Jul15

75.0%

80.0%

85.0%

90.0%

95.0%

100.0%

Jul14

Aug14

Sep14

Oct14

Nov14

Dec14

Jan15

Feb15

Mar15

Apr15

May15

Jun15

Jul15

0.0%

50.0%

100.0%

150.0%

200.0%

250.0%

Jul14

Aug14

Sep14

Oct14

Nov14

Dec14

Jan15

Feb15

Mar15

Apr15

May15

Jun15

Jul15

90.0%

92.5%

95.0%

97.5%

100.0%

Jul14

Aug14

Sep14

Oct14

Nov14

Dec14

Jan15

Feb15

Mar15

Apr15

May15

Jun15

Jul15

75.0%

80.0%

85.0%

90.0%

95.0%

100.0%

Jul14

Aug14

Sep14

Oct14

Nov14

Dec14

Jan15

Feb15

Mar15

Apr15

May15

Jun15

Jul15

0.0%

50.0%

100.0%

150.0%

200.0%

250.0%

Jul14

Aug14

Sep14

Oct14

Nov14

Dec14

Jan15

Feb15

Mar15

Apr15

May15

Jun15

Jul15

90.0%

92.5%

95.0%

97.5%

100.0%

Jul14

Aug14

Sep14

Oct14

Nov14

Dec14

Jan15

Feb15

Mar15

Apr15

May15

Jun15

Jul15

75.0%

80.0%

85.0%

90.0%

95.0%

100.0%

Jul14

Aug14

Sep14

Oct14

Nov14

Dec14

Jan15

Feb15

Mar15

Apr15

May15

Jun15

Jul15

0.0%

50.0%

100.0%

150.0%

200.0%

250.0%

Jul14

Aug14

Sep14

Oct14

Nov14

Dec14

Jan15

Feb15

Mar15

Apr15

May15

Jun15

Jul15

90.0%

92.5%

95.0%

97.5%

100.0%

Jul14

Aug14

Sep14

Oct14

Nov14

Dec14

Jan15

Feb15

Mar15

Apr15

May15

Jun15

Jul15

75.0%

80.0%

85.0%

90.0%

95.0%

100.0%

Jul14

Aug14

Sep14

Oct14

Nov14

Dec14

Jan15

Feb15

Mar15

Apr15

May15

Jun15

Jul15

Q2 Q3 Q4 Apr May Jun Q1 Q1 Q1

Outturn Outturn OutturnNumerator

Outturn

Denominator

OutturnOutturn

M8

CPA patients receiving

follow-up contact within 7

days of discharge

95.0% 98.4% 62 63 98.4%

95.7% as of

Q4

15/16


June 2016

M9

CPA patients having

formal review within 12

months

95.0% 97.1% 1744 1795 97.1%

77.1% as of

Nov 15


To be confirmed

M10

2.a. People with common

mental health conditions

referred to the IAPT

programme will be treated

within 6 weeks of referral

Q1 - 10%

Q2 - 20%

Q3 - 30%

Q4 - 60%

69.1%

Q2

85.0%

Q3

88.4%

Jan &

Feb

0.0%

84.3% as at

Jan 2015


20th May 2016

M11

2.b. People with common

mental health conditions

referred to the IAPT

programme will be treated

within 18 weeks of referral

Q1 - 50%

Q2 - 60%

Q3 - 70%

Q4 - 80%

92.4%

Q2

94.7%

Q3

97.6%

Jan &

Feb

0.0%

96.4% as at

Jan 2015Next publication date:

20th May 2016

Indicator

No.

Indicator

TargetNational

BenchmarkGraph

75.0%

80.0%

85.0%

90.0%

95.0%

100.0%

Apr15

May15

Jun15

Jul15

Aug15

Sep15

Oct15

Nov15

Dec15

Jan16

Feb16

Mar16

Apr16

90.0%

92.5%

95.0%

97.5%

100.0%

Apr15

May15

Jun15

Jul15

Aug15

Sep15

Oct15

Nov15

Dec15

Jan16

Feb16

Mar16

Apr16


Indicator M17: Compliance for the Mental Health Minimum Dataset (MHMDS) Part 2 has reduced slightly from 79.5% to 78.9%. This is

due to a slight increase in the denominator for all three measures; accommodation status, HoNos (clinical outcome measure) and

employment status. The numerator for all three measures has not increased significantly.


Summary NHS

Improvement Quality

Business Unit

Change Programme

Finance

Q2 Q3 Q4 Apr May Jun Q1

M12Access to health care for people with a learning

disability 6 Green 6 Green 6 Green

M13 Data completeness Referral to treatment information 50.0%64.2%

Q2

65.0%

Q3

M14 Data completeness Referral information 50.0%91.9%

Q2

92.9%

Q3

M15 Data completeness treatment activity information 50.0%99.7%

Q2

99.7%

Q3

M16 Data Completeness: identifiers (MHMDS Part 1) 97.0% 99.6% 99.6%

M17Data Completeness: outcomes for patients on CPA

(MHMDS Part 2)50.0% 78.9% 78.9%

Indicator

No.

Indicator 16/17

Outturn Target

National

BenchmarkTrend

Q1 Data available in June 2016



99.4% as of Nov

2015

Q2 Q3 Q4 Apr May Jun Q1

M12Access to health care for people with a learning

disability 6 Green 6 Green 6 Green

M13 Data completeness Referral to treatment information 50.0%64.2%

Q2

65.0%

Q3

66.6%

Q4

M14 Data completeness Referral information 50.0%91.9%

Q2

92.9%

Q3

92.5%

Q4

M15 Data completeness treatment activity information 50.0%99.7%

Q2

99.7%

Q3

99.7%

Q4

M16 Data Completeness: identifiers (MHMDS Part 1) 97.0% 99.6% 99.6%

M17Data Completeness: outcomes for patients on CPA

(MHMDS Part 2)50.0% 78.9% 78.9%

Q1 Data available in July 2016



99.4% as of Nov

2015

TrendIndicator

No.

Indicator 16/17

Outturn Target

National

Benchmark


The rating on 'button' 1.3 on slide 1 of the report reflects the outcome

of the CQC focussed inspection conducted in January 2016 (as a

follow up to the previous full inspection conducted in June 2014).

The January 2016 reports were received by the Trust on 5 May 2016.

The main points to note are a) it is confirmed that the Trust is now

rated as GOOD for the safe domain; this provides us with a rating of

GOOD across all five domains and b) there are no 'should do' or 'must

do' actions identified in any of the three reports.

Three reports were provided as follows (see below). These are

currently in draft format; the Trust is able to comment on / challenge

any issues of factual accuracy (deadline 19 May) prior to publication.

Report summaries:

Acute Wards - there was a particular focus on the implementation of

the Continuous Care Medical Model (there was a previous compliance

action against this element); the CQC were assured in relation to the

way this is working and therefore rated the 'responsive' domain for the

acute wards as 'good' (previously rated as 'requires improvement' for

the acute wards and 'good' for the Trust).

Crisis Services & Health Based Places of Safety - despite the

report title, only the two HBPoS were inspected (there was a previous

compliance action against this element); the CQC were assured in

relation to the improvements made to the environments and therefore

rated the 'safe' domain for the service as 'good' (previously rated as

'requires improvement' for the service and for the Trust overall).

Trust report - this provides a summary of the above reports and also

information against the well-led domain (though no rating was given

for this domain).

CQC Compliance, Period : Current Position (Indicator Number Q2)

Summary NHS

Improvement Quality

Business Unit

Change Programme

Finance


This data is monitored in more detail via the

Quality and Safety Committee (QSC) on a

quarterly basis.

At its 6 May 2016 meeting, the QSC

requested a deep dive report into the

reasons for the rise in pressure ulcers.

Indicator No.15/16

outturn April 2016 Performance

16/17

YTD

Q3 141 15 15

Serious Incident Numbers

Summary NHS

Improvement Quality

Business Unit

Change Programme

Finance


Indicator Q4: Four Serious Incident reports were completed in the month, with all achieving the 12 week target and no themes

or trends.

Summary NHS

Improvement Quality

Business Unit

Change Programme

Finance

No. Closed this

month within

target

(Numerator)

Total number

completed in

month

(Denominator)

Percentage

completed in

target time

Q4(a)

Serious incident reports

completed(Total):

Q4(b) + Q4(c)

48.9% 100% 4 4 100.0% 100.0%

Q4(b)Serious incident reports

completed (Pressure Ulcers) 33.3% 100% 3 3 100.0% 100.0%

Q4(c)Serious incident reports

completed (all others causes) 90.9% 100% 1 1 100.0% 100.0%

Indicator

No.Indicator

15/16

outturn

16/17

Target

16/17

YTD

FOT

16/17

Q5 Never events 0 0 00

Number of Never events

FOT

16/17

April 2016 Performance

Serious incident reporting timescales: Percentage of reports completed within target time

Indicator

No.Indicator

15/16

outturn

16/17

Target

16/17

YTD

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%

Apr 15 May 15 Jun 15 Jul 15 Aug 15 Sep 15 Oct 15 Nov 15 Dec 15 Jan 16 Feb 16 Mar 16 Apr 16

Pressure Ulcers Others target

Serious Incident Reporting, and Never Events


Indicator

NumberIndicator

15/17

outturn

16/17

Target

April 2016

Performance

16/17

YTD

Q6 Claims Numbers 8 N/A 1 1

Q8 Complaints numbers 74 N/A 4 4

Q9 Compliments numbers 658 N/A 40 40

Indicator Q6: 1 claim was received this month. Indicator Q8: 4 complaints were received this month, with no pattern with regards to the distribution of the complaints.

Indicator Q9: 40 compliments were received in total; 12 related to podiatry, as did the significant fall in overall numbers of

compliments. The increase in compliments in the previous two months was attributed to podiatry.

Summary NHS

Improvement Quality

Business Unit

Change Programme

Finance

Claims, Complaints and Compliments


Workforce

Summary NHS

Improvement Quality

Business Unit

Change Programme

Finance

Indicator Q17b: Agency providers were advised that from 1 April 2016 the Trust would not deploy Tertiary Staff who are non-compliant with

information governance training.

All tertiary staff who worked during April have been confirmed as compliant and performance for Tertiary Staff is therefore 100%.

Indicator

No. Indicator

15/16

outturn

16/17

Target Numerator Denominator

Current

Performance

FOT

16/17 Graph

Q17

% Mandatory training

(excl. Information

Governance

Compliance)

91.90% 80.00% 9037 10193 88.66%

Q17a

% Information

Governance Training -

Substantive Staff Only

97.94% 95.00% 2408 2553 94.43%

Q17b

% Information


Tertiary Staff Only

85.83% 95.00% 321 321 100.00%

Q17c

% Information


Substantive and

Tertiary Staff

Combined

96.50%

95.00%

2729 2874 94.96%

Q18 % Staff Receiving

Appraisal 83.14% 80.00% 2084 2532 82.31%


Workforce – Top 3 / Bottom 3 Service Areas - Mandatory Training

Summary NHS

Improvement Quality

Business Unit

Change Programme

Finance

Information Governance (IG) Training

IG training compliance has fallen below the

95% target. There are currently 145 staff who

are non compliant. 84 have fallen out of date

since last month. 78 of the 145 are at the top

of their pay band. 17 staff need to renew IG

training to achieve the 95% target. Workforce

development team reminders are issued and

senior managers are being alerted to this, and

when staff are due to lapse, in their one to

one meetings with the HR Team. In Business

Units where compliance has slipped, the HR

Business Partners are liaising with the Head

of Operations to ensure appropriate action is

taken. HR Business Partners have cascaded

the email link to managers to distribute to staff

so that they can access the IG Training with

ease.

Moving & Handling & Fire Safety training

10 out of 12 Business Units are compliant

with the 80% target for Moving & Handling.

11 out of 12 Business Units are compliant

with the 80% target for Fire Safety.

Appraisal

Whilst appraisal rates have dropped by 0.8%

in month, this represents a 2.5% increase

since April 2015.

3 out of 12 Business Units show an increase

in appraisal rates since last month.

Information Governance Current performance 94.43% Fire Safety Current performance 90.04%

Change from the previous month -3.51% Change from the previous month -2.93%

% Change % Change

Service Governance 100.00% 0.00% Service Governance 100.00% 0.00%

Research & Development 100.00% 0.00% Childrens Services 92.63% -1.23%

Specialist Services & Nursing 100.00% 0.00% Commercial Directorate 92.16% -5.92%

Specialist Inpatient Services, Dentistry and Administration93.87% -5.76% Estates, Facilities & Finance 85.64% -4.92%

Mental Health - Acute Inpatient and Community Services92.81% -3.57% Research & Development 83.33% -1.28%

Trust Management 86.36% -4.94% Medical 50.00% -36.67%

94.43% -3.51% 90.04% -2.93%

Infection Prevention Current performance 86.08% Moving & Handling Current performance 84.04%

Change from the previous month -3.85% Change from the previous month -2.64%

% Change % Change

Research & Development 100.00% 0.00% Research & Development 91.67% -0.64%

Medical 100.00% 0.00% Specialist Services & Nursing 91.30% -5.25%

Specialist Services & Nursing 95.83% 2.61% Service Governance 91.30% -4.35%

Adult Physical Health Community Services 88.83% -3.53% Mental Health - Acute Inpatient and Community Services80.37% -3.01%

Childrens Services 87.02% -3.48% Trust Management 78.95% 5.26%

Mental Health - Acute Inpatient and Community Services75.10% -6.71% Medical 50.00% -27.78%

86.08% -3.85% 84.04% -2.64%

Appraisal Current performance 82.31%

Change from the previous month -0.83%

% Change

89.80% 1.09% Key

88.91% -0.10% Top three teams and above target

88.46% -3.21% Above target - but in bottom three

Research & Development 78.57% 11.90% Below target and in bottom three

Commercial Directorate 70.59% -6.33%

Trust Management 44.44% -22.22%

82.31% -0.83%

Business Unit

Business Unit

Business Unit

Grand Total

Grand Total

Business Unit

Grand Total

Grand Total

Business Unit

Grand Total

Specialist Services & Nursing

Specialist Inpatient Services, Dentistry and Administration

Service Governance


Indicator

No. Indicator

15/16

outturn

16/17


Current

Performance

FOT

16/17 Graph

Q19 % Labour Turnover 11.62% 10.00% 298.87 2485.35 12.03%

Summary NHS

Improvement Quality

Business Unit

Change Programme

Finance

Workforce – Labour Turnover

Indicator Q19: Labour Turnover (LTO) is calculated on a rolling 12 month basis and has increased by 0.4% to 12.03% compared to last

month. A total of 243.1 WTE leavers were recorded for the 12 months to April 2015 compared to 298.9 WTE for the 12 months to April

2016. This is an increase of 55.8 WTE leavers and accounts for the overall increase in LTO over the last 12 months. There have been

367.1 WTE new starters over the last 12 months, indicating ‘net’ recruitment of 68.18 WTE more than were lost through LTO.

The next slide analyses the reasons staff have given for leaving. The top 3 reasons over the last 12 months are (with the exception of Not

Known/Other); relocation (58.7 WTE or 19.7%), retirement (53.4 WTE or 17.9%) and work/ life balance (32.6 WTE or 10.9%), with the

number of retirements consistent with the Trust’s age profile. Reason codes for bank and agency cover are being reviewed and will be

included in future monthly reports. A new process is being developed to increase numbers of staff who engage with the exit interview

process so that the Trust can develop appropriate interventions to increase staff retention rates.

The next slide provides an initial analysis of areas that account for highest absolute numbers of leavers. More than 52% of Trust leavers in the

12 month rolling period were attributed to the five areas listed, as were 56% of the Trusts new starters over the same time period. These areas

have also recorded high levels of sickness and high volumes of recruitment activity over the last 12 months. 16.3% (48.6 WTE) of leavers left the

Trust within 12 months of employment. A deeper dive to assess the impact of internal staff ‘leavers’ within turnover was undertaken for Specialist

Inpatient Services and identified some of the wards as having high levels of staff movement within teams and also across to wider services.

Current actions to mitigate the increase in labour turnover include:

• Rolling recruitment adverts in hot spot areas to help ensure vacancies are filled as quickly as possible;

• Piloting the new exit interview process;

• Drilling down and further analysis to review LTO alongside vacancy, sickness and temporary staffing levels ongoing together with a deeper

dive into reasons for staff leaving within 12 months of employment.

Indicator

No. Indicator

15/16

outturn

16/17


Current

Performance

16/17

YTD

FOT

16/17

Q21

%

Vacancy

rate

7.17% 10% 215.59 2700.94 7.98% 7.98%

Indicator: Q21 – The current vacancy rate of 7.98%

equates to approximately 215.6 WTE with current

recruitment activity levels remaining highest across

Inpatient Nursing and District Nursing areas.


Summary NHS

Improvement Quality

Business Unit

Change Programme

Finance

Reasons for leaving - 12 months (May 15 to Apr 16)

Reasons for Leaving WTE %

VR - Relocation 58.73 19.65

VR - Other/Not Known 57.73 19.32

Retirement 53.38 17.86

VR - Work Life Balance 32.63 10.92

VR - Promotion 29.51 9.87

Dismissal 15.00 5.02

End of Fixed Term Contract 12.49 4.18

VR - Better Reward Package 9.00 3.01

VR - To undertake further education or training 8.10 2.71

VR - Health 7.92 2.65

VR - Child Dependants 4.06 1.36

Death in Service 3.00 1.00

VR - Lack of Opportunities 2.91 0.97

VR - Incompatible Working Relationships 2.40 0.80

VR - Adult Dependants 2.02 0.68

298.87

Hotspot areas / ExceptionsTurnover percentage starters and leavers WTE per month - May 15 to Apr 16

Labour

Turnover Leavers Starters

% WTE WTE

Specialist Inpatient Specialist - Inpatient 20.91% 52.37 70.70453 Daisy Hill Intensive Therapy Centre - ITC (113019) 28.72%

453 Dementia Assessment Unit - DAU (113501) 46.69%

453 Bracken Ward (OPMH) - (113600) 52.23%

453 Medical Psychology (OPMH) (113701) 18.52%

Adult Physical Health Community Nursing 14.92% 47.79 55.31453 DN Team Windhill MC (115027) 44.35%

453 DN Team WG1 (115036) 30.00%

453 DN Team Thornton Road (115039) 25.84%

453 DN Team Parklands Team 2 (115042) 32.57%

453 DN Team Queensbury and Odsal (115045) 23.83%

453 DN Team Haigh Hall MC (115057) 47.23%

453 DN Team Moorside (115059) 64.60%

MH Acute and Community Acute - Inpatient 14.15% 33.83 45.11453 Ashbrook Ward (AMH) - (113003) 16.89%

453 Oakburn Ward (AMH) (113005) 29.66%

453 Clover (PICU) (113010) 42.11%

MH Acute and Community IAPT 10.72% 13.03 26.55453 Centre for MH Project (114708) 20.00%

453 Mental Health PC Airedale (115225) 53.78%

453 Mental Health PC South (115228) 52.82%

MH Acute and Community CMHT - Adult 9.14% 11.89 10.62453 Airew harfe CMHT Medical Staff (113035) 35.71%

453 South & West CMHT Medical Staff (113038) 26.32%

453 CMHT Community 7 (114040) 33.33%

Hotspot area Leavers Total (WTE) 158.90 208.29Trustwide Leavers Total (WTE) 298.87 Trustwide Starters Total (WTE) 367.05

% Hotspot area total against Trustwide total 53.17% % Hotspot area total against Trustwide total 56.75%

Hotspot area Starters Total (WTE)

Business Unit Service Area

Number of leavers - leaving within first 12 months of employment

Reason for Leaving WTE

Dismissal - Capability 4.00

Dismissal - Conduct 2.00

Employee Transfer 1.84

Redundancy - Compulsory 0.60

Retirement Age 0.45

Voluntary Resignation - Adult Dependants 0.95

Voluntary Resignation - Better Rew ard Package 1.50

Voluntary Resignation - Child Dependants 1.00

Voluntary Resignation - Health 3.20

Voluntary Resignation - Incompatible Working Relationships 1.60

Voluntary Resignation - Other/Not Know n 10.16

Voluntary Resignation - Promotion 2.50

Voluntary Resignation - Relocation 9.80

Voluntary Resignation - To undertake further education or training 3.00

Voluntary Resignation - Work Life Balance 6.00

48.60


Workforce

Summary NHS

Improvement Quality

Business Unit

Change Programme

Finance

Indicator

No. Indicator

15/16

outturn

16/17


Current

Performance

16/17

YTD

FOT

16/17

Q20

%

Sickness

absence

rate

4.53% 4% 3251.92 74634.14 4.36% 4.36%

Indicator Q20: The sickness absence rate for April

2016 shows a reduction of 0.17% from the revised

March figure of 4.53% (originally reported in last

month’s Board report as 4.38%). This continues a

reducing trend over the last 3 months.

Long Term Absence the number of cases has

increased in month to 86, with stress and anxiety

being the main cause. The number of life threatening

cases has increased to 5. 15.12% of long term

sickness is attributed to musculoskeletal / back

concerns. Analysis is being undertaken to correlate

sickness related to agile working to ensure support

and prevention good practice is embedded.

Short Teem Absence The Bradford Factor Score

table opposite demonstrates that short term absence

is reducing and details the number of cases being

managed under each stage of the Bradford Factor

Score system. There were 271 new episodes of

sickness absence in April 2016: 38.0% of those were

due to either gastrointestinal problems (18.8%) or

cold/flu (19.2%). 54 of those episodes remain open;

16.7% of those are due to musculoskeletal problems,

24.1% are due to stress/anxiety.

The Bradford Score data demonstrates that short

term cases are being managed through to capability

review meetings (those with a score of 300+) in a

timely manner.

Bradford Factor Score PointsPrevious

Month

Current

Month

Informal process: 20 - 99 points 588 427

Informal process: 100 - 299 points 127 131

Formal process: 300 points and above 68 45

3.5%

4.0%

4.5%

5.0%

5.5%

6.0%

6.5%

Apr-

15

May-1

5

Ju

n-1

5

Ju

l-15

Aug

-15

Sep

-15

Oct-

15

Nov-1

5

Dec-1

5

Ja

n-1

6

Feb

-16

Mar-

16

Apr-

16

Sickness Absence Rate

Sickness Rate Target


Workforce – Top 3 / Bottom 3 Service Areas - Sickness

Summary NHS

Improvement Quality

Business Unit

Change Programme

Finance

Mental Health – Acute Inpatient and Community Services

In month: short term 2.26%, long term 3.27%. Long term

absence has increased, with 30 long term cases currently being

actively managed. 11 cases have been closed since March 2016

with 14 new cases now being monitored. 12 relate to stress and

2 are life threatening. 14 of the 30 cases are within Inpatient –

Acute Care Services. The top hot spot areas are Heather,

Oakburn, Clover and Intensive Home Treatment Team Airedale.

All exceed 8% sickness, with short term sickness predominantly

due to cold/flu or stress.

Specialist Inpatient Services, Dentistry & Administration

In month: short term 2.53%, long term absence 2.32%. Long

term absence has increased, with 23 long term cases currently

being actively managed. 4 cases have been closed since March

2016 with 14 new cases now being monitored. 10 relate to stress

and 2 are life threatening. 11 of the 23 cases are within Inpatients

– Specialist Services. The top 3 hotspot areas are Dementia

Assessment Unit, Bracken and Thornton. All exceed 5%

sickness, with short term sickness predominantly due to cold/flu,

stress or gastrointestinal.

Estates, Facilities & Finance

In month: short term 1.33%, long term absence 2.78%. Long

term absence has increased, with 9 long term cases currently

being actively managed. 2 cases have been closed since March

2016 with 4 new cases now being monitored. 6 relate to MSK. 6

of the 9 cases are within Hotel Services. The main hotspot area

is Airedale Housekeeping, with short term sickness

predominantly due to cold / flu, musculoskeletal or chest /

respiratory problems.

Research & Development Whilst the team shows the highest

sickness absence rate the small size of the business unit means

that this represents just 1 long term sickness absence.

Absence Current performance 4.36%

Current YTD 4.36%

Change from the previous month -0.17%

% Change

Service Governance 0.00% -2.28%

Commercial Directorate 0.52% -0.40%

Medical 0.59% 0.36%

Specialist Inpatient Services, Dentistry and Administration4.85% 0.57%

Mental Health - Acute Inpatient and Community Services5.54% 0.40%

Research & Development 6.16% 5.48%

4.36% -0.17%

Key

Top three teams and above target

Above target - but in bottom three

Below target and in bottom three

Grand Total

Business Unit

0.50%

1.00%

1.50%

2.00%

2.50%

3.00%

3.50%

4.00%

Apr-

15

May-1

5

Ju

n-1

5

Ju

l-15

Aug

-15

Sep

-15

Oct-

15

Nov-1

5

Dec-1

5

Ja

n-1

6

Feb

-16

Mar-

16

Apr-

16

Long Term/ Short Term - Sickness Absence Rate

Long Term Short Term


Q23a - Safer Staffing: Inpatient Services

Summary NHS

Improvement Quality

Business Unit

Change Programme

Finance

Risks:

- High number of vacancies (particularly in DAU)

meaning safe staffing levels cannot be

sustained long term without posts being

permanently recruited to.

Contingency / Mitigating Actions:

- Roster review / risk assessment in place on a

daily basis

- Staff re-distributed across services as required.

- New eRostering system will allow baseline

requirements to be amended in real time.

- Redeployment of staff from ITC/ATU to fill

vacancies

No. shifts

Exact/ Over Compliance 2336

Under Compliance 327

Non Compliance 0

Narrative on data extracts regarding staffing levels on 13 wards during April 2016

Exact/over compliant shifts - Over compliant shifts recorded in April were mainly attributed

to the acute wards, Dementia Assessment Unit (DAU), and Clover (PICU), due to the acuity

(complexity of need) of the ward and the requirement for skill mix within the units. 30% of all

shifts worked were bank or agency filled with 62% of these shifts requesting unregistered

staff. The main requirement reasons for bank and agency are; Vacancy (48%) - although

this should reduce over the next few weeks following completion of the pre-employment

process for 13.5wte Support Worker roles and 14.5wte Qualified Nursing roles from the

recent recruitment drive for Inpatient services. Regarding Observations/Specialling (37%) –

DAU, Clover and Ashbrook have recorded the highest requirement in April.

'Under compliant' shifts - There were 62 incidents reported relating to staffing shortages in

April (this is consistent with previous months). 35 of which related to the Dementia

Assessment Unit due to the ward having a number of long terms sick cases and vacancies;

with acute services reporting 27 incidents mostly relating to a specialling requirement and

vacancy. Work is underway to fill the vacancies. However, this is being impacted by the

recent notice to close the Intensive Therapy Centre (ITC) and reduce additional beds on the

Assessment and Treatment Unit (ATU). The wider issues are being addressed

organisationally through the overtime scheme for substantive staff working within Inpatient

services and also development of a peripatetic / relief team to fill urgent shift requirements.

The internal Staff Bank is also now live, with the new eRostering system (inclusive of the

Bank module) currently being implemented.

'Non-compliant shifts' - No shifts were recorded as non-compliant in April. However, there

were two days overall (Maplebeck on 16 April and Oakburn on 25 April), recorded with very

low levels of staff due to sickness. Care was not compromised on the wards and was

managed internally through the re-distribution of staff.


Q23a - Safer Staffing: Inpatient Services

Summary NHS

Improvement Quality

Business Unit

Change Programme

Finance

Total

monthly

planned staff

hours

Total

monthly

actual staff

hours

Total

monthly

planned staff

hours

Total

monthly

actual staff

hours

Total

monthly

planned staff

hours

Total

monthly

actual staff

hours

Total

monthly

planned staff

hours

Total

monthly

actual staff

hours

Fern710 - ADULT MENTAL

ILLNESS982.5 1095 817.5 667.5 511.5 446.4 604.5 641.7 111.5% 81.7% 87.3% 106.2%

Heather710 - ADULT MENTAL

ILLNESS915 1297.5 900 922.5 279 279 837 771.9 141.8% 102.5% 100.0% 92.2%

Bracken710 - ADULT MENTAL

ILLNESS907.5 1012.5 1335 1342.5 279 279 837 846.3 111.6% 100.6% 100.0% 101.1%

Ashbrook710 - ADULT MENTAL

ILLNESS937.5 1230 1320 1515 279 288.3 837 1116 131.2% 114.8% 103.3% 133.3%

Maplebeck710 - ADULT MENTAL

ILLNESS922.5 975 1320 1290 316.2 390.6 790.5 892.8 105.7% 97.7% 123.5% 112.9%

Oakburn710 - ADULT MENTAL

ILLNESS960 1170 1267.5 1185 288.3 325.5 818.4 864.9 121.9% 93.5% 112.9% 105.7%

Baildon710 - ADULT MENTAL

ILLNESS960 930 1065 945 279 279 558 688.2 96.9% 88.7% 100.0% 123.3%

Ilkley710 - ADULT MENTAL

ILLNESS900 735 1087.5 990 279 297.6 558 595.2 81.7% 91.0% 106.7% 106.7%

Thornton710 - ADULT MENTAL

ILLNESS907.5 840 900 1140 279 288.3 837 604.5 92.6% 126.7% 103.3% 72.2%

Assessment & Treatment

Unit (LD)

700- LEARNING

DISABILITY900 855 1350 1950 279 288.3 1116 1041.6 95.0% 144.4% 103.3% 93.3%

Clover (PICU)710 - ADULT MENTAL

ILLNESS915 1050 1732.5 2295 279 306.9 1116 1385.7 114.8% 132.5% 110.0% 124.2%

Step Forward (Rehab)710 - ADULT MENTAL

ILLNESS525 750 600 727.5 288.3 288.3 269.7 269.7 142.9% 121.3% 100.0% 100.0%

Dementia Assessment Unit

(DAU)

710 - ADULT MENTAL

ILLNESS900 847.5 1800 2617.5 279 520.8 1116 1515.9 94.2% 145.4% 186.7% 135.8%

Average fill

rate - care

staff (%)

Average fill

rate -

registered

nurses/mid

wives (%)

Average

fill rate -

care staff

(%)

Fill rate indicator returnStaffing: Nursing, midwifery and care staff

Specialty 1

Day Night

Ward name

Registered

midwives/nursesCare Staff

Registered

midwives/nursesCare Staff

Average fill

rate -

registered

nurses/mid

wives (%)

Day Night


Q23b - Staffing Ratio (Trends): Community Services

Recommended Ratio

The recommended ratio for Family Nurse Partnership (FNP) is based on the national licensing agreement.

The Health Visitor ratio is based upon nationally recommended levels amended to reflect local needs.

The School Nursing ratio has been locally developed based on pupil numbers and numbers of pupils in pre-determined priority support

needs and is reflective of the school nursing staff mix, not just school nurses.

Special Needs School Nursing does not have a national recommendation and has therefore been set locally.

EIP/AOT, CMHT and CAMHS ratios are based on national standards.

The Matrons and Case Managers ratio is based on the Bradford & North Commissioning Alliance Service Delivery Plan.

The red, amber, green thresholds have been established by local managers using their professional judgement.

April Actual

Service Arearecommend

ratio

Ratio of

Cl ients to

s taff

Amber i f

greater

than

Red i f

greater

than

M J J A S O N D J F M A

FNP 25:1 18 25 28

Health Visitors 312:1 293 312 362

School Nursing New Ratio 2200:1 2245 2200 2500

Special Need School Nursing 75:1 55 85 90

EIP 15:1 16 15 18

AOT 15:1 17 15 18

CMHT 35:1 30 33 35

CAMHS 40:1 47 35 40

Community Matrons 70:1 74 77 84

Case Managers 70:1 54 77 84

Summary NHS

Improvement Quality

Business Unit

Change Programme

Finance


0 10 20 30

FNP

0 5 10 15 20

EIP/AOT

0 100 200 300 400 500

Health Visitors

0 20 40 60 80 100

Special Needs School Nursing

0 20 40 60 80 100 120

Matrons and Case Managers

0 10 20 30 40

CMHT

0 10 20 30 40 50

CAMHS

0 1000 2000 3000

School Nursing

Deputy Director

Nursing, Children’s and Specialist Services

School Nursing: Improvements to working

practices in school nursing are being established

to free up resources. The new pupils to staff ratio

is now being used.

FNP: No concerns, work progressing on

developing the new service delivery model

known as ADAPT.

Health Visitors: Remains green – no concerns.

Following completion of the review of the health

visiting service by the Local Authority in mid June

2016, the ratios used to measure the service and

method of presentation may change.

Q23b - Staffing Ratio: Community Services

Deputy Director

Mental Health Acute and Community EIP and

AOT: the team has been joined by a new starter

(Local Authority staff). The post occupied by a

member of staff on long term has been backfilled

by agency staff,

CAMHS: 4 Primary Mental Health worker posts

are currently being recruited; agency staff are

covering priority vacancies.

Deputy Director

Adults Community Physical Health Matrons

and Case Managers: In the short term, to

mitigate risks the workload is being shared

across the team. The figures are skewed by the

work style in the South and West team which is

concentrated on care homes.

Legend / Glossary:

FNP: Family Nurse Partnership

EIP: Early Intervention in Psychosis

AOT: Assertive Outreach Team

CAMHS: Child and Adolescent Mental Health Services

CMHT: Community Mental Health Teams

Summary NHS

Improvement Quality

Business Unit

Change Programme

Finance


Indicator Q40: Service User Experiences

The Friends and Family Test (FFT) questionnaire asks if service users: “felt safe”; “were treated with kindness and

compassion”; “were involved in their care as much as they would have liked”; if “they were treated with kindness and

compassion”. Where a reviewer responds to these questions with “Totally” a score of 5 is recorded, where the

response is “Not at all” then a score of 1 is recorded. The charts show the average score for business units, and

starts at 3 (a neutral opinion).

Over 11,000

reviews have

been received

since recording

began.

In January and April 2016 the average score for “were you involved as much as you liked?” for the Inpatient Services, Dental and Administration

business unit fell below the Board’s target of 4 out of 5. In January this was as a result of the impact of 5 reviewers (from 62) who offered a score

of 1 out of 5. Of these 2 were extremely likely to recommend the service, 2 were likely and 1 was extremely unlikely to recommend the services. 4

of these were for Bracken Ward and 1 for Thornton. No comments were provided to explain why the users did not feel involved. For the reviewer

who was unlikely to recommend the service, although they said the “hospital needs better facilities” they scored being ‘treated with kindness and

compassion’ as 5 out 5, being ‘treated with dignity and respect’ as 4 out of 5. In April 1 reviewer from 29 received scored 1 out of 5 in response to

the ‘were you involved’ question. This review was for Assessment and Treatment Unit. Their scores for the other questions were 3 out of 5. In

using the option to provide a commentary this reviewer said “no comment”, thus no reason for the low score was offered. Any themes or trends

that have been identified are reported to operational manager.

Summary NHS

Improvement Quality

Business Unit

Change Programme

Finance


Quality Assurance

Summary NHS

Improvement Quality

Business Unit

Change Programme

Finance

Indicator

Number Target Target met this month

Q7 Meet Central Alert System (CAS) timelines Y

Q10 No MRSA bacteraemia cases Y

Q11 No Methicillin sensitive staphylococcus aureus (MSSA) bacteraemia cases Y

Q12 No Clostridium difficile (C.diff) cases Y

Q15 Meet nationally mandated Commissioning for Quality and Innovation (CQUINs) –

Forecast 2016/17.

Y

Q15 Meet CCG local Commissioning for Quality and Innovation (CQUINs) – Forecast

2016/17 Y

Q16 Meet NHS England Commissioning for Quality and Innovation (CQUINs) – Forecast

2016/17 Y

Q32 No Complaints to Information Commissioners Office (ICO) Y

Q33 No Information Governance Serious Incidents (STEIS) Y

Q34 Maintain Mixed sex accommodation status Y

Q35 Meet Dental Referral To Treatment within 52 weeks Y

Q36 Meet IAPT Recovery rate N

Q37 Maintain Publication of the Formulary on Provider’s website Y

Q38 No duty of candour incidents (see slide 2) N


Programme summary: 2016/17

Summary NHS

Improvement Quality

Business Unit

Change Programme

Finance

There are currently 11 transformational projects and 29 transactional cost improvement projects (CIP) that are being monitored by the

Change Programme Board during 2016/17.

In May 2016, six of the transformational projects are progressing to plan and are rated green. Four projects are rated amber with

actions and mitigations in place to manage the risks and issues. The Intensive Therapy Centre (ITC) project is rated red. A decision

to close the unit to new admissions was taken during April, with closure plans confirmed at the Change Programme Board in May.

The purpose of the Change Programme is to effectively govern the Trust's strategic transformation projects. Projects for major change

activities are reported to and monitored by the Change Programme Board and have project management arrangements in place to

ensure project delivery and a consistent approach to Quality Impact Assessments.

Specific tasks of the Change Programme are to:

• Monitor both Transformational and Transactional Change Programme Board Projects;

• Provide highlight reports for transformational projects;

• Approve detailed Project Initiation Documents to reflect emerging and new Change Programme Board projects;

• Provide appropriate and effective governance arrangements including reporting structure and highlights reports;

• Review the overall programme risks and ensure appropriate mitigation is in place;

• Monitor the Quality Impact Assessment status of the projects in the Change Programme.

Overall Programme Summary

Mar-16 Apr-15 May-15


Summary NHS

Improvement Quality

Business Unit

Change Programme

Finance

PTP PP SE M KPI RM BR QIA PTP PP SE M KPI RM BR QIA



Closure report Action Plan received and approved at Change Programme

Board. The first meeting of the ITC Closure Steering Group held 10/05/2016

and monthly meetings scheduled.

Complete closure of the Centre likely 2nd September 2016 (this date is

indicative and is based on completion of all 6 month programmes).

The centre is closed to further admissions from this point onwards. Lessons

Learned to be scheduled August 2016

No Highlight Report monitoring as part of performance monitoring.

Project allocated as Transformational Monitor

1.2 Agile Resource Reductions K Jolaoso & D Gilderdale 2.1.3 Out of Area Placements D Gilderdale

Capital funding for the agile programme has been removed from 2016/17

project budget and IM&T and Estates capital funds are to provision the agile

working environments.

The Project Initiation Document (PID) has been updated to reflect this.

Estates provision of Touchdown Points is behind forecast due to focus work on

flood remediation. Replan required

Steering Group meetings have not taken place due to not being quorate.

Funding secured to align System1 to new clusters and merge 5 Health

Visitor modules into one. This is due to go live before end May

Remaining IT workstream (Patient communications secure email,

Audio and Video conferencing, Text,) is delayed and pending

resources. A business case being developed for email).

Estates workstream awaiting outcome of revised estates

rationalisation plan.

Children and Young People and parent friendliness/marketing of

BDCFT web presence; the delivery/scope plan is to be developed and

resourced.

Key issue: Progress in delivery of Technology to support service re-

1.2 Agile Project K Jolaoso & D Gilderdale 1.11 Children's Schemes - C Woffendin

3.1.1 ITC1 A Bingham 3.3 Substance Misuse % reductions K Jolaoso

Staffing reductions have been quality impact assessed and on track to reduce

as per the original business case for the financial year 2016/17. Clinical

increase in face to face time and performance indicators are being tracked and

monitored by the agile steering group.

No Highlight Report as thnis projec tis now in monitoring phase and

forms part of performance and service improvement workstream.


Quality

Summary NHS

Improvement Quality

Business Unit

Change Programme

Finance




PTP Project Team Performance

PP Project Plan

SE Stakeholder Engagement

M Milestones

KPI Key Performance Indicators(including Cost Improvement Programme)

RM Risk Management

BR Benefits Realised

QIA Quality Impact Assessment

Key

Plan developed however not signed off by agile steering

group/business units as phasing of estates release has needed to be

revised.

No Highlight Report as no Steering Group set up however meeting scheduled

for 26th may to baseline and establish scope.

Project allocated as Transformational Monitor

5.5.3 Reduction in SLA costs for pharmacy A Tinto 5.20 Bank + Agency Fiona Sherburn

No Highlight Report as project is in mobilisation phase.

Project Initiation Document , guiding principles, strategy and Terms of

Reference are drafted for the steering group to mobilise during May will

define a number of elements in scope of the project and delivery

phases/dependencies on procurement of telephony elements (mobile,

Infrastructure, landlines etc.).

No Highlight Report completed for May 2016 as project Steering Group

is yet to meet and agree milestone plan and steering group TOR on

23rd May 2016. Terms of Reference and plan of delivery is drafted.

5.2.1 Estates Rationalisation A Morris5.1 IM&T - Telephony Mark Gregson

5.7 CPPP C Risdon-Transfer to D Gilderdale planned May 2016

Project Steering Group has in the last few months not been quorate however

the group met in April 2016 to refocus the work plan for 2016/17. There have

been significant resource changes. The confirmation of 2017/18 payment

approach to be used at BDCFT is still to be agreed with commissioners.

Performance demonstrating clustering is still well below target at 85.9% but

demonstrating a year on year improvement.

Operational Deputy Director Project lead to take the project forward and

integrate Clustering within performance monitoring.


Summary NHS

Improvement Quality

Business Unit

Change Programme

Finance

Executive Summary

Proposed Board RAG Rating Year to

Date Forecast 2016/17

Commentary

Statement of Comprehensive

Income (SoCI)

A deficit of £100k for the period is £211k below the planned surplus of

£111k. This reflects the degree of challenge in the financial plan for

2016/17 and will require rapid, ongoing and robust action planning to

ensure delivery of the planned surplus.

Statement of Financial Position

(SoFP)

Current assets (including receivables, accruals, prepayments) are

£6,548k above plan. Current liabilities are £3,881k above plan. These

variances underpin the adverse year to date cash flow variance.

Statement of Cash Flows

(SoCF)

Cash balances are £2,717k below plan at the end of the period,

largely driven by delayed contract payments following the relatively

late agreement of 2016/17 contracts (during April). The forecast is still

achievement of the cash target of £14,589k but noting elevated risks

relating to achievement of the planned surplus.

Financial Sustainability Risk

Rating (FSRR)

Achievement of a Financial Sustainability Risk Rating (FSRR) of 3 in

Month 1 with the forecast being the achievement of a rating of 4.

Cost Improvement

Programmes (CIPs)

Under achievement of £102k compared to planned CIPs reflects

further work now needed to secure financial savings. This includes

schemes rated RED when the plan was approved. Full delivery of the

annual CIP of £5,789k is forecast, with Programme Leads now

progressing required (mitigating) actions to ensure delivery.

Capital Expenditure

Capital expenditure is £81k below plan at the end of the period mainly

due to the timing of expenditure for the E-rostering systems and no

calls on the capital contingency at this early point in the year. Plans

are in place to fully commit the capital programme.


Summary NHS

Improvement Quality

Business Unit

Change Programme

Finance

Plan Actual Variance Plan Actual Variance

Operating income (inc in EBITDA)

NHS Clinical income (8,717) (8,795) 78 (104,952) (105,494) 542

Non-NHS Clinical income (1,626) (1,591) (35) (19,510) (19,013) (497)

Non-Clinical income (440) (598) 158 (6,150) (7,270) 1,121

Total (10,783) (10,984) 201 Green (130,612) (131,777) 1,165 Green

Operating expenses (inc in EBITDA)

Employee expense 8,540 8,604 (64) 103,878 102,973 904

Non-Pay expense 1,705 2,066 (361) 20,285 22,345 (2,059)

PFI / LIFT expense 17 17 0 199 199 0

Total 10,262 10,687 (425) Red 124,362 125,517 (1,155) Amber

EBITDA (521) (297) (224) Green (6,250) (6,260) 10 Green

EBITDA Margin % 4.83% 2.70% Green 4.79% 0 Green

Operating expenses (exc from EBITDA)

Depreciation & Amortisation 262 264 (2) 3,143 3,153 (10)

Total 262 264 (2) Green 3,143 3,153 (10) Green

Non-operating income

Finance income (5) (4) (1) (63) (63) 0

Total (5) (4) (1) Green (63) (63) 0 Green

Non-operating expenses

Interest expense (PFI / LIFT) 13 13 0 158 158 0

PDC expense 140 124 16 1,678 1,678 0

Total 153 137 16 Green 1,836 1,836 0 Green

(Surplus) / Deficit after tax (111) 100 (211) Red (1,335) (1,335) 0 Amber

Statement of Comprehensive Income

Year to Date£000's

Forecast

RAG

Year End ForecastYTD RAG


Summary NHS

Improvement Quality

Business Unit

Change Programme

Finance

Statement of Comprehensive Income

Area Impacted Risk Mitigation

Children’s

Services

Risks relating to 2 CIPs (Better Start and Use of Technology) are

outlined in the CIP section of this report including mitigations. An issue

relating to potential loss of income as a consequence of loss of paper

records in the floods is being followed up.

The Business Unit log has been developed and mitigations for the CIP issues have

been identified.

The need for actions relating to impacts form the floods will be explored once this issue

is better understood.

Specialist

Inpatients,

Dental &

Admin

Anticipated trading risks relating to the ITC, admin hub agency staffing /

reception pressures, DAU and Bracken Ward, Inpatient specialling and

Ward therapy costs were identified as risks for escalation/action

The Business Unit risk log has been developed. Mitigations are now being explored.

Work to review the admin hub issues is in train. Change Programme Board discussed

the ITC closure and options to further mitigate attendant non-recurrent trading risks.

Acute &

Community

Mental Health

Projected pressures relating to IAPT room hire, drugs, medical locums,

CAMHS and EIP agency (pending recruitment), Police Control Room

and First Response travel costs were identified as risks for

escalation/action

The Business Unit log has been developed. Mitigations are now being explored.

Estates are helping to identify alternatives to room hire. The Head of Pharmacy is

supporting drugs cost analysis and actions. A decision on Police Control Room

Funding is due in June. Controls and actions to minimise Medical Locum costs are

being led by the DD, Head of Service and Medical Director.

Adult Physical

Health

Projected pressures relating to District Nursing pay and non-pay,

Continence products, Nursing Support Team recharges & £188k Agile

CIP rated RED at plan were identified as risks for escalation/action.

The Business Unit log has been developed and mitigations are now being.

Corporate

Functions

Estates Engineering maintenance pressures and unachieved CIPs are

contributing to the adverse variance in non pay expenditure.

Detailed Engineering analysis and forecasting is now underway to assess the impacts

of mitigations and bring the costs in line with plan. CIP mitigations/actions are outlined

on the CIP slides

Agency/fixed term staff costs to cover vacancies/providing year end

cover following the Finance restructure/3 retirements.

Adverts, shortlisting/recruitment is being progressed as quickly as possible. 2 contracts

are due to end by the start of June. Non pay mitigations will be progressed to offset

and residual pressure.

Non pay CIPs slippage for Finance SLAs, IM&T Telephony & SMS

external accommodation recharges.

Mitigations/actions are outlined on the CIP slides.


Summary NHS

Improvement Quality

Business Unit

Change Programme

Finance

Key Risks Key Mitigations & Action Plans

Cashflow – The adverse cash variance for April relates to

Local Authority and Airedale CCG Commissioners not paying

block contract invoices in Month 1. This reflects the late

agreement of financial contract values due to slippage in

contracting deadlines for 2016/17.

Other liabilities includes accruals that have been made for

NHS Property services for 2015/16 and Month 1 of 2016/17.

Receivables continue to be monitored closely with escalation

plans are in place. Both contract invoice issues have been

resolved in May 2016.

A national newsletter was issued by the DH on 5th April

providing clear guidance on charging principles to be adopted

by NHSPS. The Trust wrote immediately to NHSPS to

request applying these principles to outstanding and

previously disputed charges.


Non-current Assets

Intangible assets 0 0 0 0 0 0

Property, Plant & Equipment 49,398 48,882 516 50,520 50,520 0

On-balance sheet PFI 4,649 4,578 71 4,220 4,220 0

Other 0 0 0 0 0 0

Total 54,047 53,460 587 Green 54,740 54,740 0 Green

Current Assets

Cash and cash equivalents 14,978 12,261 2,717 14,589 14,589 0

Other current assets 4,645 11,193 (6,548) 3,830 3,830 0

Total 19,623 23,454 (3,831) Green 18,419 18,419 0 Green

Current Liabilities

Overdrafts and drawdowns in committed facilities0 0 0 0 0 0

PFI / LIFT leases-CA (343) (343) 0 (339) (339) 0

Other borrowings-CA 0 0 0 0 0 0

Other current liabilities-CA (11,673) (15,555) 3,881 (10,253) (10,253) 0

Total (12,016) (15,898) 3,881 Green (10,592) (10,592) 0 Green

Non-current Liabilities

PFI / LIFT leases-NCA (3,033) (3,061) 28 (2,721) (2,721) 0

Other borrowings-NCA 0 0 0 0 0 0

Other non-current liabilities-NCA (630) (672) 42 (630) (630) 0

Total (3,663) (3,733) 70 Green (3,351) (3,351) 0 Green

Total Assets Employed 57,991 57,283 708 Green 59,216 59,216 0 Green

Reserves 57,991 57,283 708 Green 59,216 59,216 0 Green

Statement of Financial Position

Forecast

RAG£000's

Year to Date Year End ForecastYTD RAG


Summary NHS

Improvement Quality

Business Unit

Change Programme

Finance


The cash position for April is £2.7m below plan, reflecting balances

outstanding from AWC CCG (£1.6m) and BMDC (£1.2m) – see

previous slide.

The cashflow position will continue to be monitored on a monthly

basis, with variations from plan being thoroughly investigated.

Actions will be identified to rectify variances from plan at an early

stage.

Specifically in respect of key Commissioners the Head of

Contracting is liaising personally with counterparts to ensure that

cash receivable is remitted in full going forward.


Surplus (Deficit) from Operations 261 (91) 352 Green 3,141 3,141 0 Green

0

Operating activities 263 264 (1) Green 3,155 3,155 0 Green

0

Movements in working capital (1,829) (4,432) 2,603 Green (2,223) (2,223) 0 Green

0

Investing activities (266) (190) (76) Green (3,795) (3,795) 0 Green

0

Financing activities (42) (38) (4) Amber (2,280) (2,280) 0 Green

0

Opening cash and cash equivalents less bank overdraft 16,591 16,748 (157) 16,591 16,591 0 Green

Closing cash and cash equivalents less bank overdraft 14,978 12,261 2,717 Amber 14,589 14,589 0 Green

£000'sYear to Date Forecast

RAG

Statement of Cash FlowsYear End ForecastYTD

RAG


Summary NHS

Improvement Quality

Business Unit

Change Programme

Finance

Description of Key Metrics

Capital Service Cover: Metric currently weighted at 25% and shows how many times income covers the servicing of capital costs.

Liquidity: Metric currently weighted at 25% and shows how liquid the Trust is in respect of days’ operating expense cover.

I & E Margin: Metric currently weighted at 25% and shows normalised surplus as a % of income.

I & E Margin Variance From Plan: Metric currently weighted at 25% and shows I & E Margin actual compared to planned.

Overall Rating: Aggregate rounded average of all metrics.

Key Risks, Mitigations & Actions

Key risks stem from the requirement to achieve a 1% surplus in the period to maintain an I&E Margin metric of 4. The I&E margin %

rating is 1.93% below plan to date. This reflects a RED rating due to the Monitor formula used for variation.

The Trust will report a FSRR of 3 for April and by bringing the forecast back in line with plan projects achieving an outturn rating of 4

against the FSRR for 2016/17. Mitigating action plans are being progressed as a priority.


Capital Service Cover

Revenue Available for Capital Service 529 301 (228) 6,360 6,323 (37)

Capital Service (185) (166) 19 (2,218) (2,184) 34

Capital Service Cover metric 2.86 1.81 (1.05) 2.87 2.90 0

Capital Service Cover rating 4 3 4 4 Amber

Liquidity

Working Capital for FSRR 7,589 7,538 (50) 7,809 7,809 0

Operating Expenses within EBITDA, Total (10,259) (10,687) (428) (124,316) (125,517) (1,201)

Liquidity metric 22.2 21.2 (1) 1.9 1.9 (0.02)

Liquidity rating 4 4 4 4 Green

I & E Margin

Surplus/(deficit) before impairments,

disposal on FA & restructuring costs 110 (100) (210) 1,335 1,335 (0)

Total operating & non operating income 10,788 10,988 200 130,676 131,840 1,164

I & E Margin % metric 1.02% -0.91% -1.93% 1.02% 1.01% -0.01%

I & E Margin % rating 4 2 4 4 Red

I & E Margin Variance

I & E Margin 1.02% -0.91% -1.93% 1.02% 1.01% (0)

I & E Margin variance from plan -0.02% -0.89% -0.87% -0.02% 1.03% 1.06%

I & E Margin Variance From Plan Rating 3 3 3 4 Green

Financial Sustainability Risk Rating 4 3 4 4 Amber

Financial Sustainability Risk Ratings

£000'sYear to Date Year End Forecast RAG

Rating

(YTD)


Summary NHS

Improvement Quality

Business Unit

Change Programme

Finance

Business Unit & CIP Scheme

Plan Actual Variance Plan Actual VarianceRAG

RatingAdult Physical Health Community Services : 56 56 0 1,250 1,250 0

1.2-Agile project staffing 44 44 0 776 776 0 Green

1.2-Agile project staffing - (No plans for CIP) 16 16 0 187 187 0 Green

1.2-Agile project staffing - RED rated 0 0 0 168 168 0 Green

1.2b-Agile project staffing (phasing for OD) (30) (30) 0 (193) (193) 0 Green

1.1.3-SLT Income generation contribution 2 2 0 25 25 0 Green

3.3-Substance Misuse % reductions 24 24 0 287 287 0 Green

Childrens : 88 51 38 1,058 1,058 (0)

1.11-Childrens - New models for FNP 29 0 29 352 352 (0) Green

1.11-Childrens - Secondments & career breaks 4 4 0 45 45 0 Green

1.11-Childrens Management overhead reduction 15 15 0 180 180 0 Green

1.11-Childrens Non pay procurement savings 3 3 0 30 30 0 Green

1.11-Childrens -Reduction in staff hours 6 6 0 71 71 0 Green

1.11-Childrens Skill mix efficiencies 23 23 0 281 281 0 Green

1.11-Childrens Use of technology to free clinical time 8 0 8 99 99 0 Green

Corporate : 15 10 5 488 487 1

2.1.2-CAMHS Eating disorders contribution (contract income) 2 2 0 20 20 0 Green

5.4.2-Corporate overheads - Executive PAs 4 4 0 49 49 0 Green

5.5.1-Drug pricing target reductions 4 0 4 50 50 0 Amber

5.21-Executive director savings 4 4 0 49 49 0 Green

5.5.3-Pharmacy SLA savings 0 0 0 81 81 0 Green

5.4.1-Salary sacrifice increased income from new and existing schemes 0 0 0 226 226 0 Green

5.22-Trust Board efficiencies 1 0 1 13 12 1 Amber

Estates & Facilities : 36 11 25 557 557 0

1.2-Agile - Estates Project 20 0 20 235 235 0 Amber

5.2.1-Estates rationalisation 0 0 0 125 125 0 Green

5.23-Mitigate Stoney Ridge cost pressure by CIP 5 0 5 61 61 0 Amber

5.9-Release of NHS property services overhead costs 11 11 0 136 136 0 Green

Cost Improvement Schemes 2016/17

Year to date April 2016 Year End Forecast


Summary NHS

Improvement Quality

Business Unit

Change Programme

Finance

Business Unit & CIP Scheme


RAG

RatingFinance : 13 10 3 250 250 0

5.15-Reduce computer maintenance & support 3 3 0 30 30 0 Green

5.17-Reduce finance training budget 1 1 0 10 10 0 Green

5.14-Reduce Finance SLA costs 3 0 3 30 30 0 Amber

5.16-Reduce trust wide finance budget 3 3 0 35 35 0 Green

5.18-Restructure finance team 4 4 0 45 45 0 Green

5.13-Salary sacrifice increased income from new and existing schemes 0 0 0 100 100 0 Green

Human Resources : 12 12 0 210 210 0

5.11-HR Childcare cost reduction 2 2 0 25 25 0 Green

5.11-HR Contribution from CCG's HR/OD Contract 6 6 0 74 74 0 Green

5.11-HR non pay efficiencies 4 4 0 42 42 0 Green

5.11-Salary sacrifice increased income from new and existing schemes 0 0 0 69 69 0 Green

IM&T : 32 5 28 389 389 0

5.6-CHIS cost reduction from CSU contract 5 5 0 55 55 0 Green

5.20-IM&T Agency savings 0 0 0 0 0 0 Green

5.1-IM&T Strategy CIP (telephony) 28 0 28 334 334 0 Amber

Medical Director : 19 19 0 223 223 0

2.1.1-Locum budget reserve reduction 13 13 0 150 150 0 Green

5.8.1-Research & Development recurrent reduction 1 1 0 6 6 0 Green

5.8.1-Research & Development non recurrent vacancy reduction 3 3 0 40 40 0 Green

5.8.1-Research & Development reduce BDCT provision 2 2 0 27 27 0 Green

Mental Health Acute & Community Services : 61 61 0 813 813 0

1.2b-Agile NR reserve (phasing for OD) (10) (10) 0 (63) (63) 0 Green

1.2-Agile project staffing 37 37 0 447 447 0 Green

2.1.4-IAPT post reductions 0 0 0 29 29 0 Green

2.1.3-Out of area placements reduction 33 33 0 400 400 0 Green

Specialist Inpatients : 4 4 0 44 44 0

3.6-Dental savings 4 4 0 44 44 0 Green

Trust wide : 42 37 5 506 509 (3)

1.2-Agile - Travel cost reductions 8 11 (3) 96 99 (3) Green

5.5.2-Procurement savings 19 19 0 224 224 0 Green

5.4.2-Reduction in operational management costs 8 8 0 92 92 0 Green

5.10-SMS external accomodation recharge 8 0 8 94 94 0 Amber

Total 377 274 103 5,787 5,789 (2)

Cost Improvement Schemes 2016/17

Year to date April 2016 Year End Forecast


Summary NHS

Improvement Quality

Business Unit

Change Programme

Finance

Current Status, Key Risks & Mitigations Current Status, Key Risks & Mitigations

Children's Business Unit: £352k CIP relating to Better Start

Bradford will not commence until month 3. The shortfall will be

mitigated from vacancies within the FNP teams and adjusted for

reporting at Month 2.

Plans for the £99k Use of technology to free clinical time CIP are

being completed. The shortfall will be mitigated from vacancies

from the Shipley team and adjusted at Month 2.

Estates: The Agile Estates CIP is expected to achieve in full, but

from quarter 2, incorporating mitigations that are now being

agreed. The team is confident that the annual savings will be

delivered in line with plan. An assurance report is planned for the

next Change Programme Board. The Stoney Ridge CIP was

agreed in March to mitigate cost pressures. Savings from the site

closure are not expected until the end of the year when the site is

vacant. Mitigations including energy re-contracting are being

progressed and are expected to fully offset.

Substance Misuse Services External Recharge - Negotiations

are underway but there is a risk of underachievement that may

require substitution.

Reduce Finance SLA values - A meeting is being arranged to

commence negotiations – the CIP is expected to achieve later in

the year and will be mitigated from other substitute savings.

IM&T Strategy CIP (telephony) – The CIO is confident of being

able to deliver the CIP and is preparing an assurance report for the

next Change Programme Board.

Drugs - Drugs cost reductions have not been realised in Month 1.

A plan is being be drawn up with the Head of Pharmacy to identify

mitigations.

312624

9641,350

1,7402,188

2,6393,094

3,5524,022

4,4964,973

016

31

110

189

268

347

425

504

603

703

816

0

1,000

2,000

3,000

4,000

5,000

6,000

7,000

M01 M02 M03 M04 M05 M06 M07 M08 M09 M10 M11 M12

Actual Forecast Forecast Forecast Forecast Forecast Forecast Forecast Forecast Forecast Forecast Forecast

£000

's

CIP Plans Deliverability

Unachieveable - substitution required Achievable but risks identified Delivered/deliverable Target


Summary NHS

Improvement Quality

Business Unit

Change Programme

Finance


Capital under spending – under spending on capital could be

interpreted by the regulator that there would be minimal impact from

introducing a capital control total.

Close management of all capital schemes is required to ensure

that the schemes are brought in on budget and also in the months

that expenditure has been profiled, as all funding in the first 6

months represents anticipated minimum capital requirements.

Uncertainty regarding the timing or value of any 2016/17 capital

control total

The capital plan has been constructed to phase £700k into the last

6 months of the financial year to mitigate against nationally set

control totals.


Capital expenditure

Plant and equipment - Information Technology 97 41 56 723 723 0

Plant and equipment - Other 20 0 20 940 940 0

Property, plant and equipment - other expenditure 154 149 5 2,193 2,193

Total 271 190 81 Amber 3,856 3,856 0 Green

Capital expenditure funding sources

Disposal Proceeds (pure cash flows) 0.000 0 0

Depreciation 263 264 (1) 3,155 3,155 0

Other 8 (74) 82 701 701 0

Total 271 190 81 Amber 3,856 3,856 0 Green

Variance 0.000 0.000 0.000 0.000 0.000 0.000

£000'sYear to Date Forecast

RAG

Capital ExpenditureYear End ForecastYTD

RAG


Summary NHS

Improvement Quality

Business Unit

Change Programme

Finance

Monitor Agency Price Cap

Key Risks, Mitigations & Action Plans

Monitor introduced price caps for all agency staff from 23 November 2015. The price cap rates for clinical staff reduced in 2 subsequent

stages; from 1st February 2016 and 1st April 2016. The purpose of the caps is to reduce premium hourly rates paid for agency staff

relative to permanent staffing. There is an escalation procedure for approval of non compliant agency staff however patient safety is the

only reason viewed as being acceptable by NHS Improvement for non compliance.

Current performance : 35 nursing shifts are above the Monitor Price Cap – 11 of the shifts are only marginally outside of the cap (less

than 10p per hour) and the Trust will ensure that these are negotiated to within the cap immediately. For the remaining 24 shifts, urgent

conversations are being taken forward with Retinue to ensure that rates quoted by them are accurate and that staff are placed with

agencies that are compliant with the price cap arrangements.

There are 26 non compliant non clinical shifts – Plans are in place to stop using agencies for 16 of the shifts by the end of June and a

further 5 shifts in July.

Medical Locum agencies remain the high risk area with expected ongoing compliance breaches. Issues are being experienced at a local

and national level due to Medical agencies failing to respond to the NHS price caps..

0

50

100

150

200

23/11 30/11 07/12 14/12 21/12 28/12 04/01 11/01 18/01 25/01 01/02 08/02 15/02 22/02 29/02 07/03 14/03 21/03 28/03 04/04 11/04 18/04 25/04

Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual

Agency shifts worked that cost over the monitor price cap

Clinical contracts Non Clinical contracts Medical & Dental Scientific, Therapeutic & Technical (AHPs) Administration and Estates Other Nursing, Midwifery & Health Visiting