Guildford and Waverley CCG update

16th July 2015

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SuccessesRSCH• Lower than expected rate of Clostridium difficile cases (<40% also lapse in

care)• Excellent mortality rates (actual and indexed)• Increased timely reporting of serious incidents and significant

improvement in quality of investigation• High performing for overall results of NHS staff survey• Reduced mixed sex accommodation breaches• Good Compliance to NICE guidelines• Low numbers of upheld complaints and timely responses to complainants• Improved response to PALS• ‘Good’ rating for CQC Inspection• ‘Good’ A&E Patient Survey (December 2014)• Good Inpatient, accident and emergency and maternity friends and family

test ratings

Mount Alvernia• Significantly improved CQC Inspection Report

CAMHS• Good compliance at Q2 to CQUIN standards.

ChallengesRSCH• Referral to treatment waits –

particularly cancer two week wait (ENT/Dermatology) and some specialities for 18 weeks

• A&E – significant improvement but more work needed.

• Cancelled Operations – bed capacity remains an issue so elective lists being cancelled.

• Workforce – all except staff survey.

Mount Alvernia• Significantly improved CQC inspection

report but four compliance actions

CAMHS• Actions required from CQC inspection

report• On-going challenges for under 18

admissions to adult facilities

HIGH QUALITY SERVICES

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Accident and Emergency

• Strong performance over the winter overall despite failing Q4.

• New emergency pathway agreed

• Increased staffing in A&E

• Colocation of Out of Hours

Current performance is 95.17% for the year.

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Benchmark Position for Emergency Admissions

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Unplanned Care

• Care Planning in Primary Care and Uploading to IBIS has reduced the conveyance rate for over 75’s from 73% on average to 49%

• Current Frailty initiative is reducing admissions from care homes

• Emergency admissions reducing for over 65’s by approx. 6 per week.

• Implementation of new DVT pathway will reduce admissions by 600.

• Enhanced discharge pathway for A&E will reduce admission by a further 200

• The Localities development will reduce admissions by a further 5 per locality per week.

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Unplanned Care - LOS• In the acute hospital we have

reduced LOS for over 65’s by 1 day

• This is in combination with a LOS reduced in the community hospitals from in excess of 60 days to 21 days with an increased bed occupancy rate of 85%.

• Excess bedday costs have reduced in the hospital by an average of £30,000 per month.

• The HIG continues to drive improvements in discharge arrangements.

• A new integrated H&SC integrated discharge team start work in April 2015.Shaping healthcare for you … and your family

Planned Care

New DVT pathway to be launched summer 2015

MSK pathway reducing new Consultant OPD appointments

Planned Care

Community Dermatology services significantly reducing T&O New outpatient activity

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Parity of Esteem• Improved IAPT Waiting times.

• 15% target has not been met but will be delivered by Q2 in 2015/16

• Community Mental Health Team response to referrals are within 1 day.

• Psychiatric liaison has been extended across 7 days a week 8am until midnight.

• A new ‘Crisis Cafe’ is being implemented at RSCH.

• Dementia Diagnosis Rate for G&W currently at 50%.

• Pharmacist and GP trainee will be targeting practices with low diagnosis rates and high dementia care homes to improve target.

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Five Year Forward View

Provision• We have developed five

Localities to provide a consolidation of services to support the Frail and Elderly.

• Our local GP Federation provide ideal strategic support to develop these localities into an MCP.

• We have excellent provider relationships across health and Social Care.

Commissioning• We have established a local

Joint Commissioning Group, mandated by the Membership for the purposes of managing the BCF.

• We are now pursuing a structural integration of Health and Social Care commissioning

• Exploring the benefits and options regarding an Accountable Care Organisation (ACO)

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