memo status - nmh...chief executive’s report 6-5 october 2015 ytd last month variance ytd actual...

Chief Executive’s Report 6-1

Status This report contains: For decision Update Regular report

For information

MEMO

To: Board Members

From: Peter Bramley, Acting Chief Executive

Date: 16 November 2016

Subject: Chief Executive’s Report

1. INTRODUCTORY COMMENTS Nelson Marlborough Health’s financial performance remains on track with a year to date surplus of $1,177k which is $23K favourable to budget. This result includes the additional Ministry of Health (MOH) efficiency target, the savings initiatives budgeted, and also accruals for planned new investments. We continue to meet our MOH requirements by way of elective surgery, and are compliant with the expectation that no one waits longer than four months for either a first specialist assessment or an elective procedure once wait listed for surgery. 2. KEY ISSUES TO NOTE

2.1 Earthquake

At the time of writing the region is still recovering from the impact of the significant earthquake of Monday 14 November. Our emergency response teams did a remarkable job of ensuring our services were maintained, and our clinical teams continued to provide patient care in the midst of disruption, damage to buildings and personal distress. Our buildings, thankfully, only suffered superficial damage, and all have been checked by engineers to ensure they are safe to occupy. There were a few surgical procedures deferred for reasons of patient safety. Attention is being given to supporting staff in the midst of ongoing seismic activity.

2.2 Resident Doctor Strike

Further strike notices were issued for two days but subsequently withdrawn. Negotiations continue between DHBs and Resident Doctor’s Association. It should be noted that strike action creates a significant demand on our services by way of preparation and planning to ensure that clinical care is provided over the strike period.

2.3 Annual Plan The Annual Plan for NMDHB 2016/17 has been agreed to and signed by the Minister of Health.

2.4 System Level Outcome Measures

The System Level Outcome Measures plan for NMH was finalised and signed by the three Chief Executives of the Top of the South Health Alliance. The plan which includes improvement measures for Acute Hospital bed days per capita, Ambulatory


Sensitive Hospital admission rates for 0-4 years olds, patient experience of care, and amenable mortality rates, was approved by the Ministry of Health.

2.5 Primary and Community Health Strategy

Twelve community engagement meetings around our Primary and Community Health Strategy have been held across the region, including three hui on marae. General feedback about the direction of the strategy has been positive, with some elements identified as needing to be added or given greater emphasis, eg the role of nursing, mental health, youth health and the profile of community organisations. The forums provided an excellent opportunity to hear from our community about what was important to them in the provision of health care. A final strategy is expected to be presented for approval at the first meeting of the Board in 2017.

2.6 Health Pathways The Health Pathways website was visited by 884 visitors in October. Reviews were

completed for 10 pathways and a further seven pathways were updated. The Health Pathways group has identified key work activities for 2016/17 aligned to system and organisational priorities.

2.7 Maori Health Six key priorities have been identified in conjunction with the Iwi Health Board. They are: (a) A need for the DHB to lift its performance against Maori Health priority

indicators. Currently we are only meeting 1 of the 13 key indicators for Maori Health

(b) A need for the DHB to move resources to where the greatest population’s health need is within our district

(c) A need for the DHB to strengthen its work with other sectors around the wider determinants of health – housing, employment, welfare, education and justice.

(d) Building Maori Health workforce capacity (e) Strengthening Maori Health providers (f) Focus to young Maori population.

NMH needs to focus on closing the gap on the inequity of health outcomes for Maori compared to the wider population.

2.8 Radiology The Radiology Design group has met twice for the purpose of specifying the requirements of a district wide radiology service.

2.9 Clinical Administration Planning is underway for the next phase of a district wide referral centre, with Allied Health referrals targeted for the New Year. An induction training programme for clerical administration teams has been developed. This would see all new recruits go through a structured 3 week training programme.

2.10 Aged Residential Care In the last 12 months total Aged Residential Care (ARRC) volumes have continued to

reduce with a total of 1,155 residents in ARRC at the end of October, down by 41 at the same time as last year.


2.11 Facilities The first stage of the hospital re-development business case, the Strategic

Assessment, is being prepared for Board approval in February 2017. Arthur Wicks fit-out and strengthening work is progressing according to plan, with

Monday 5 December being planned as the move in date for the 1st floor. Strengthening work is on track for completion by the end of the calendar year.

Work continues around determining the scope of the Learning and Development

Centre along with the short term requirements for clinical delivery. Scope has been defined as:

(a) core Learning & Development Centre (b) acute admitting unit beds (6-11) (c) expansion of Emergency Department (d) relocation of orthopaedic consulting rooms. We will now re-engage architects with the intention of providing a concept design and

high level costing. 2.12 Information Technology

Health Connect South (HCS) HCS remains on track for a “technical go live” before the end of the calendar year, with a February roll-out to Clinicians

A workshop has been scheduled to initiate the transformation of the paper medical chart to an electronic version. This will involve implementing a new document management system which would be linked to HCS.


3. PERFORMANCE INFORMATION 3.1 Health Targets

The Health Target for September, as confirmed by the Ministry of Health, was 1,995 discharges against a plan of 1,859.


October 2015

YTD

Last

Month

Variance

YTD

Actual Planned # % # %

Caseweighted Discharges

Acute

Medical 2,615 2,812 (197) (7.01%) 2,726 (111) (4.07%) (3.35%)

Neonatal / Maternity 662 667 (5) (0.75%) 529 133 25.14% (4.57%)

Surgical 1,549 1,718 (169) (9.84%) 1,613 (64) (3.97%) (7.07%)

Total Acute 4,826 5,197 (371) (7.14%) 4,868 (42) (0.86%) (4.75%)

Elective

Medical 236 291 (55) (18.90%) 252 (16) (6.35%) (30.09%)

Neonatal / Maternity 0 0 0 0.00% 0 0 #DIV/0! 0.00%

Surgical 2,159 2,274 (115) (5.06%) 2,175 (16) (0.74%) 0.06%

Total Elective 2,395 2,565 (170) (6.63%) 2,427 (32) (1.32%) (3.52%)

Total Caseweighted Discharges 7,221 7,762 (541) (6.97%) 7,295 (74) (1.01%) (4.35%)

Outpatients

First Specialist Assessments

Medical* 1,825 2,182 (357) (16.36%) 2,708 (883) (32.61%) (17.41%)

Neonatal / Maternity 282 278 4 1.44% 252 30 11.90% 3.65%

Surgical 4,078 4,090 (12) (0.29%) 4,314 (236) (5.47%) 4.03%

Total First Specialist Assessments 6,185 6,550 (365) (5.57%) 7,274 (1,089) (14.97%) (3.32%)

Follow Ups

Medical * 4,300 4,644 (344) (7.41%) 4,926 (626) (12.71%) (12.70%)

Neonatal / Maternity 281 287 (6) (2.09%) 248 33 13.31% (7.08%)

Surgical 7,333 7,292 41 0.56% 7,161 172 2.40% 4.20%

Total Follow Ups 11,914 12,223 (309) (2.53%) 12,335 (421) (3.41%) (2.68%)

Total Outpatient Assessments 18,099 18,773 (674) (3.59%) 19,609 (1,510) (7.70%) (2.90%)

ED Attendances

- Nelson 9,068 9,349 (281) (3.0%) (2.43%)

- Wairau 6,347 7,051 (704) (10.0%) (12.00%)

Total ED Attendances 15,415 16,400 (985) (6.0%) (6.63%)

Bed Nights

- Nelson 12,718 13,675 (957) (7.0%) (4.51%)

- Wairau 5,707 5,818 (111) (1.9%) (15.71%)

Total Bed Nights 18,425 19,493 (1,068) (5.5%) (8.08%)

Day Cases

- Nelson 3,365 3,249 116 3.6% (3.13%)

- Wairau 1,537 1,522 15 1.0% (13.35%)

Total Day Cases 4,902 4,771 131 2.7% (6.35%)

Bed Nights & Day Cases

- Nelson 16,083 16,924 (841) (4.97%) (4.23%)

- Wairau 7,244 7,340 (96) (1.31%) (15.23%)

Total Bed Nights & Day Cases 23,327 24,264 (937) (3.86%) (7.72%)

* Cardiology Volumes have been corrected in the current year as there was some duplicate counting

This means comparison to last year is not valid.

October 2016 YTD Variance Variance To Last Year


3.2 Mental Health

3.2.1 High and Complex Needs Progress has been made towards outlining a pathway for better supporting

clients with high and complex needs. The pathway involves a multi-service assessment team.

3.2.2 Mental Health and Addictions Steering Group The Steering Group are prioritising recommendations from various reviews

with clear timeframes. Key work streams have been identified and a change facilitator appointed

3.2.3 Seclusion Reduction Te Pou, a national workforce development agency, presented their final

Report with recommendations to the Steering Group. The admission unit had a period of 80 days being seclusion free. Since then seclusion levels continue to remain low.

Staff are continuing to be trained in SPEC (Safe Practice and Effective Communication) which provides staff with alternative methods of intervention, contributing to the reduced seclusion rates.

3.2.4 Activity – Specialist


3.2.5 Activity – NGO

3.3 Disability Support Services

Intellectual & Physical Disabilities

Contracted Services IDSS PDSS Total ID & PD Total ID & PD

Current Moh

Contract

As per Contracts at month

end 168 15 183

Beds – Moh

Individual contracts


end 9 1 10

Beds – P&F -

Chronic Health

Conditions


end 3 9 12

Beds – Individual

contracts with ACC


end 1 1 2

Total number of

service users

contracted

Residential contracts -

Actual at month end 181 26 207

Vacant Beds Actual at month end 12 2 14

Total available beds 193 28 221

Total number of

service users

supported

Residential service users -

Actual at month end 181 26 207

Beds – Respite Service users at month end 2 0 2

Personal cares service

users - Actual at month end 0 1 1

Total service users

supported 183 27 210 Last month 210

Total available bed days 6,014 837 6,851 27,122

Total Occupied Bed

days

Actual for full month -

includes respite 5,669 758 6,427 25,135 Note: **2 PDSS service

users occupy ID beds &

1 ID SU in PD bed

Total Occupied Beds

Based on actual bed days

for full month (includes

respite volumes) 94% 91% 94% 93%

Service provided

Current October 2016 YTD October 16


3.4 Emergency Department Presentations

In October 95.8% of patients were admitted and discharged within the six hour guideline.

90.0%

92.0%

94.0%

96.0%

98.0%

100.0%

120

125

130

135

140

145

Jan

-14

Feb

-14

Mar

-14

Ap

r-1

4

May

-14

Jun

-14

Jul-

14

Au

g-1

4

Sep

-14

Oct

-14

No

v-1

4

De

c-1

4

Jan

-15

Feb

-15

Mar

-15

Ap

r-1

5

May

-15

Jun

-15

Jul-

15

Au

g-1

5

Sep

-15

Oct

-15

No

v-1

5

De

c-1

5

Jan

-16

Feb

-16

Mar

-16

Ap

r-1

6

May

-16

Jun

-16

Jul-

16

Au

g-1

6

Sep

-16

Oct

-16

NMDHB ED Performance

Presentations Per Day NMDHB 6 Hr Target Results ED 6 Hour Target

90.0%

92.0%

94.0%

96.0%

98.0%

100.0%

64

69

74

79

84

89

Jan

-14

Feb

-14

Mar

-14

Ap

r-1

4

May

-14

Jun

-14

Jul-

14

Au

g-1

4

Sep

-14

Oct

-14

No

v-1

4

De

c-1

4

Jan

-15

Feb

-15

Mar

-15

Ap

r-1

5

May

-15

Jun

-15

Jul-

15

Au

g-1

5

Sep

-15

Oct

-15

No

v-1

5

De

c-1

5

Jan

-16

Feb

-16

Mar

-16

Ap

r-1

6

May

-16

Jun

-16

Jul-

16

Au

g-1

6

Sep

-16

Oct

-16

Nelson ED Performance


91.0%

92.0%

93.0%

94.0%

95.0%

96.0%

97.0%

98.0%

48

50

52

54

56

58

60

62

64

Jan

-14

Mar

-14

May

-14

Jul-

14

Sep

-14

No

v-1

4

Jan

-15

Mar

-15

May

-15

Jul-

15

Sep

-15

No

v-1

5

Jan

-16

Mar

-16

May

-16

Jul-

16

Sep

-16

Wairau ED Performance


0

500

1000

1500

2000

2500

3000

Jan

-14

Feb

-14

Mar

-14

Ap

r-1

4

May

-14

Jun

-14

Jul-

14

Au

g-1

4

Sep

-14

Oct

-14

No

v-1

4

De

c-1

4

Jan

-15

Feb

-15

Mar

-15

Ap

r-1

5

May

-15

Jun

-15

Jul-

15

Au

g-1

5

Sep

-15

Oct

-15

No

v-1

5

De

c-1

5

Jan

-16

Feb

-16

Mar

-16

Ap

r-1

6

May

-16

Jun

-16

Jul-

16

Au

g-1

6

Sep

-16

Oct

-16

Nelson ED Attendances by Triage Category

Triage 1 Triage 2 Triage 3 Triage 4 Triage 5

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%

Jan

-14

Feb

-14

Mar

-14

Ap

r-1

4

May

-14

Jun

-14

Jul-

14

Au

g-1

4

Sep

-14

Oct

-14

No

v-1

4

De

c-1

4

Jan

-15

Feb

-15

Mar

-15

Ap

r-1

5

May

-15

Jun

-15

Jul-

15

Au

g-1

5

Sep

-15

Oct

-15

No

v-1

5

De

c-1

5

Jan

-16

Feb

-16

Mar

-16

Ap

r-1

6

May

-16

Jun

-16

Jul-

16

Au

g-1

6

Sep

-16

Oct

-16

Nelson ED Attendances by Triage Category - %

Triage 5

Triage 4

Triage 3

Triage 2

Triage 1

0

500

1000

1500

2000

2500

Jan

-14

Feb

-14

Mar

-14

Ap

r-1

4

May

-14

Jun

-14

Jul-

14

Au

g-1

4

Sep

-14

Oct

-14

No

v-1

4

De

c-1

4

Jan

-15

Feb

-15

Mar

-15

Ap

r-1

5

May

-15

Jun

-15

Jul-

15

Au

g-1

5

Sep

-15

Oct

-15

No

v-1

5

De

c-1

5

Jan

-16

Feb

-16

Mar

-16

Ap

r-1

6

May

-16

Jun

-16

Jul-

16

Au

g-1

6

Sep

-16

Oct

-16

Wairau ED Attendances by Triage Category

Triage 1 Triage 2 Triage 3 Triage 4 Triage 5

0.0%10.0%20.0%30.0%40.0%50.0%60.0%70.0%80.0%90.0%

100.0%

Jan

-14

Mar

-14

May

-14

Jul-

14

Sep

-14

No

v-1

4

Jan

-15

Mar

-15

May

-15

Jul-

15

Sep

-15

No

v-1

5

Jan

-16

Mar

-16

May

-16

Jul-

16

Sep

-16

Wairau ED Attendances by Triage Category - %

Triage 5

Triage 4

Triage 3

Triage 2

Triage 1

15.0%

20.0%

25.0%

30.0%

35.0%

40.0%

45.0%

Jan

-14

Feb

-14

Mar

-14

Ap

r-1

4

May

-14

Jun

-14

Jul-

14

Au

g-1

4

Sep

-14

Oct

-14

No

v-1

4

De

c-1

4

Jan

-15

Feb

-15

Mar

-15

Ap

r-1

5

May

-15

Jun

-15

Jul-

15

Au

g-1

5

Sep

-15

Oct

-15

No

v-1

5

De

c-1

5

Jan

-16

Feb

-16

Mar

-16

Ap

r-1

6

May

-16

Jun

-16

Jul-

16

Au

g-1

6

Sep

-16

Oct

-16

% of ED Attendances Admitted

Total ED Admissions Nelson ED Admissions Wairau ED Admissions


3.6 Acuity / Workload

0

100

200

300

400

500

600

700

800

900

1,000

May

-14

Jul-

14

Sep

-14

No

v-1

4

Jan

-15

Mar

-15

May

-15

Jul-

15

Sep

-15

No

v-1

5

Jan

-16

Mar

-16

May

-16

Jul-

16

Sep

-16

Acute CWDs Nelson

Medical Acute CWDs Surgical Acute CWDs Neonatal & Maternity Acute CWDs

0

100

200

300

400

500

600

700

800

900

1,000

May

-14

Jul-

14

Sep

-14

No

v-1

4

Jan

-15

Mar

-15

May

-15

Jul-

15

Sep

-15

No

v-1

5

Jan

-16

Mar

-16

May

-16

Jul-

16

Sep

-16

Elective CWDs - Nelson

Medical Elective CWDs Surgical Elective CWDs

0

50

100

150

200

250

300

350

400

450

May

-14

Jul-

14

Sep

-14

No

v-1

4

Jan

-15

Mar

-15

May

-15

Jul-

15

Sep

-15

No

v-1

5

Jan

-16

Mar

-16

May

-16

Jul-

16

Sep

-16

Acute CWDs - Wairau

Medical Acute CWDs Surgical Acute CWDs Neonatal & Maternity CWDs

0

50

100

150

200

250

300

350

400

450

May

-14

Jul-

14

Sep

-14

No

v-1

4

Jan

-15

Mar

-15

May

-15

Jul-

15

Sep

-15

No

v-1

5

Jan

-16

Mar

-16

May

-16

Jul-

16

Sep

-16

Elective CWDs - Wairau

Medical Elective CWDs Surgical Elective CWDs

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%

May

-14

Jun

-14

Jul-

14

Au

g-1

4

Sep

-14

Oct

-14

No

v-1

4

De

c-1

4

Jan

-15

Feb

-15

Mar

ch 1

5

Ap

r-1

5

May

-15

Jun

-15

Jul-

15

Au

g-1

5

Sep

-15

Oct

-15

No

v-1

5

De

c-1

5

Jan

-16

Feb

-16

Mar

-16

Ap

r-1

6

May

-16

Jun

-16

Jul-

16

Au

g-1

6

Sep

-16

Oct

-16

Bed Utilisation - Trendcare

Nelson Hospital Utilisation Wairau Hospital Utilisation

Mental Health & Alex Utilisation

-1,500

-1,000

-500

-

500

1,000

1,500

2,000

2,500

May

-14

Jun

-14

Jul-

14

Au

g-1

4

Sep

-14

Oct

-14

No

v-1

4

De

c-1

4

Jan

-15

Feb

-15

Mar

ch 1

5

Ap

r-1

5

May

-15

Jun

-15

Jul-

15

Au

g-1

5

Sep

-15

Oct

-15

No

v-1

5

De

c-1

5

Jan

-16

Feb

-16

Mar

-16

Ap

r-1

6

May

-16

Jun

-16

Jul-

16

Au

g-1

6

Sep

-16

Oct

-16

Trendcare Clinical Hours Variance - Nelson

SCBU Nn

Paeds Nn

Post Natal Nn

Delivery Nn

DSU& ON overflow Nn

AT&R Nn

ICCU Nn

MU Nn

Ward 9

Ward 10 Nn


-1,500

-1,000

-500

-

500

1,000

1,500

2,000

May

-14

Jun

-14

Jul-

14

Au

g-1

4

Sep

-14

Oct

-14

No

v-1

4

De

c-1

4

Jan

-15

Feb

-15

Mar

ch 1

5

Ap

r-1

5

May

-15

Jun

-15

Jul-

15

Au

g-1

5

Sep

-15

Oct

-15

No

v-1

5

De

c-1

5

Jan

-16

Feb

-16

Mar

-16

Ap

r-1

6

May

-16

Jun

-16

Jul-

16

Au

g-1

6

Sep

-16

Oct

-16

Trendcare Clinical Hours Variance - Wairau

DSU

Paeds

Postnatal

Delivery

HDU/AAU

IPU Surgical

Inpatient Medical

Inpatient/AT&R


3.7 Elective / Acute Arranged Services

3.7.1 MOH Elective / Acute Arranged Discharges

NMDHB

MoH / Production Plan Elective Discharges

October 2016

Service

Unit

CodeDescription Type Annual Plan Budget YTD Actual YTD YTD Volume

Variance

Actual %

Complete vs

YTD Plan

Last FY-

YTD

Actual

Budget

Month

Actual

Month

Medical M00001 General Medicine - Discharges Elective Disch 17 6 2 -4 34% 2 1 0

Arranged Admit 10 4 4 0 108% 7 1 1

General Medicine - Discharges Total 27 10 6 -4 62% 9 2 1

M10001 Cardiology - Discharges Elective Disch 98 33 22 -11 67% 26 7 8

Arranged Admit 15 6 7 1 127% 3 2 4

Cardiology - Discharges Total 113 38 29 -9 75% 29 9 12

M15001 Dermatology - Discharges Arranged Admit 6 2 0 -2 0% 0 1 0

Dermatology - Discharges Total 6 2 0 -2 0% 0 1 0

Medical Total 146 50 35 -15 70% 38 12 13

Surgical D01001 Dental - Discharges Elective Disch 18 6 2 -4 32% 3 1 1

Arranged Admit 1 0 2 2 683% 2 0 2

Dental - Discharges Total 19 7 4 -3 61% 5 1 3

MS02016 Skin Lesions excisions Elective Disch 475 161 194 33 120% 201 39 68

Arranged Admit 0 0 2 2 0% 5 0 2

Skin Lesions excisions Total 475 161 196 35 122% 206 39 70

S00001 General Surgery - Discharges Elective Disch 1210 410 460 50 112% 410 99 70

Arranged Admit 264 89 58 -31 65% 62 20 17

General Surgery - Discharges Total 1474 499 518 19 104% 472 119 87

S05001 Anaesthetics - Discharges Arranged Admit 60 20 12 -8 60% 18 5 0

Anaesthetics - Discharges Total 60 20 12 -8 60% 18 5 0

S25001 ENT - Discharges Elective Disch 680 207 226 19 109% 213 41 38

Arranged Admit 20 6 5 -1 83% 5 1 0

ENT - Discharges Total 700 213 231 18 109% 218 42 38

S40001 Ophthalmology - Discharges Elective Disch 690 215 239 24 111% 185 55 56

Arranged Admit 26 9 14 5 161% 10 2 2

Ophthalmology - Discharges Total 716 223 253 30 113% 195 57 58

S45001 Orthopaedics - Discharges Elective Disch 1108 379 348 -31 92% 391 103 85

Arranged Admit 334 111 111 0 100% 107 28 22

Orthopaedics - Discharges Total 1442 490 459 -31 94% 498 131 107

S70001 Urology - Discharges Elective Disch 446 144 193 49 134% 149 36 36

Arranged Admit 170 56 95 39 170% 68 13 18

Urology - Discharges Total 616 200 288 88 144% 217 49 54

S75001 Vascular - Discharges Elective Disch 70 8 6 -2 77% 10 8 0

Arranged Admit 31 3 3 0 87% 0 3 2

Vascular - Discharges Total 101 11 9 -2 80% 10 11 2

Surgical Total 5603 1823 1970 147 108% 1839 456 419

W C & Y M55001 Paediatric Medical - Discharges Elective Disch 0 0 0 0 0% 0 0 0

Arranged Admit 1 0 0 0 0% 0 0 0

Paediatric Medical - Discharges Total 1 0 0 0 0% 0 0 0

S30001 Gynaecology - Discharges Elective Disch 825 287 246 -41 86% 304 68 54

Arranged Admit 151 48 72 24 150% 58 14 1

Gynaecology - Discharges Total 976 335 318 -17 95% 362 82 55

W C & Y Total 977 335 318 -17 95% 362 82 55

Grand Total 6726 2209 2323 114 105% 2239 549 487

The Elective Health Target section in the CSR reflects MoH criteria.

Where discharge type is one of the following:

1. Elective discharge from a surgical purchase unit

2. Elective surgical discharge from a non surgical purchase unit

3. Arranged discharge from a surgical purchase unit


3.7.2 Caseweighted Discharges

3.7.3 Elective Service Performance Indicators

Caseweights

NMDHBOctober 2016 Year to Date

Type ServiceAnnual

Plan

Budget

YTDActual YTD

Vol

Variance

Last YTD

Actual

Against

2016/17

Plan

Against

Oct 2015

Actual

Acute Med 7240 2645 2408 -237 2539 91% 95%

Surg 4940 1640 1473 -167 1527 90% 96%

W C & Y 2635 912 945 33 803 104% 118%

Acute Total 14815 5196 4825 -370 4869 93% 99%

Elective Med 782 266 221 -44 233 83% 95%

Surg 6154 1996 1924 -73 1880 96% 102%

W C & Y 870 303 251 -53 314 83% 80%

Elective Total 7806 2565 2396 -170 2427 93% 99%

Grand Total 22621 7761 7221 -540 7296 93% 99%

Variance Year to Date


3.8 Theatre Cancellations


Cancellation by reason and speciality over a rolling 13 months is as follows:


3.9 Enhanced Access to Diagnostics

3.10 Improving Diagnostic Waiting Times – Colonoscopy

0

20

40

60

80

100

Oct

-15

No

v-1

5

De

c-1

5

Jan

-16

Feb

-16

Mar

-16

Ap

r-1

6

May

-16

Jun

-16

Jul-

16

Au

g-1

6

Sep

-16

Oct

-16

Diagnostic Reporting Template - CT (DHB wide) Total Number accepted referrals

waiting outside 6 weeks (excluding referrals for scans that are planned patient

events)

Diagnostic Reporting Template - CT (DHB wide) Total Number accepted

referrals waiting outside 6 weeks (excluding referrals for scans that are planned patient events)

0

100

200

300

Oct

-15

No

v-1

5

De

c-1

5

Jan

-16

Feb

-16

Mar

-16

Ap

r-1

6

May

-16

Jun

-16

Jul-

16

Au

g-1

6

Sep

-16

Oct

-16

Diagnostic Reporting Template - MRI Total Number accepted referrals

waiting outside 6 weeks (excluding

referrals for scans that are planned patient events)

Diagnostic Reporting Template - MRI Total Number accepted referrals

waiting outside 6 weeks (excluding referrals for scans that are planned patient events)

0

5

10

15

20

25

30

35

Oct

-15

No

v-1

5

De

c-1

5

Jan

-16

Feb

-16

Mar

-16

Ap

r-1

6

May

-16

Jun

-16

Jul-

16

Au

g-1

6

Sep

-16

Oct

-16

Diagnostic Reporting Template - CTCTotal number accepted referrals waiting outside 6 weeks (excluding referrals for scans that are planned patient events

Series2

0.0%

20.0%

40.0%

60.0%

80.0%

100.0%

Oct

-14

Dec

-14

Fe

b-1

5

Ap

r-1

5

Jun-

15

Au

g-1

5

Oct

-15

Dec

-15

Fe

b-1

6

Ap

r-1

6

Jun-

16

Au

g-1

6

Oct

-16

Urgent Diagnostic Colonoscopy

Actual % treated < 14 days Target % treated < 14 days

0.0%

20.0%

40.0%

60.0%

80.0%

100.0%

Oct

-14

Nov

-14

Dec

-14

Jan

-15

Feb

-15

Mar

-15

Apr

-15

Ma

y-1

5

Jun

-15

Jul-

15

Au

g-1

5

Se

p-1

5

Oct

-15

Nov

-15

Dec

-15

Jan

-16

Feb

-16

Mar

-16

Ap

r-16

May

-16

Jun

-16

Jul-

16

Au

g-1

6

Se

p-1

6

Oct

-16

Non Urgent Diagnostic Colonoscopy


0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

Surveillance Colonoscopy



3.11 Outpatient – First Specialist Assessments

3.12 Oral Health

Legend: Blue line represents arrears; Red line represents target for arrears (10%); Green line represents DNAs

Outpatient Attendances

First Specialist Assessments

NMDHBOctober 2016

Service Unit Code Description Annual Plan Budget YTD Actual YTDYTD Volume

Variance

Act %

Complete

vs YTD Plan

Last FY-

YTD

Actual

Budget

Month

Actual

Month

Month

Volume

Variance

Last FY

Month

Actual

Medical M00002 General Medicine - 1st attendance 1500 521 379 -142 73% 471 112 86 -26 122

M10002 Cardiology - 1st attendance 790 265 200 -65 75% 264 59 40 -19 65

M15002 Dermatology - 1st attendance 290 97 114 17 118% 83 24 33 9 18

M20004 Diabetes - 1st attendance 103 36 30 -6 84% 27 8 9 1 6

M25002 Gastroenterology - 1st attendance 1000 347 189 -158 54% 314 75 44 -31 106

M30002 Haematology - 1st attendance 116 40 57 17 141% 23 9 14 5 5

M40002 Infectious Diseases - 1st attendance 44 15 10 -5 65% 17 3 1 -2 1

M45002 Neurology - 1st attendance 350 122 85 -37 70% 89 26 13 -13 26

M50020 Oncology - 1st attendance 400 139 138 -1 99% 140 30 33 3 33

M50022 Radiation Oncology - 1st 170 59 55 -4 93% 55 13 10 -3 8

M60002 Renal Medicine - 1st attendance 50 17 20 3 115% 8 4 2 -2 4

M65002 Respiratory - 1st attendance 215 75 67 -8 90% 24 16 9 -7 19

M70002 Rheumatology (incl immunology) - 1st att 320 111 161 50 145% 125 24 41 17 44

Medical Total 5348 1844 1505 -339 82% 1640 403 335 -68 457

Surgical S00002 General Surgery - 1st attendance 2800 949 884 -65 93% 872 230 205 -25 228

S25002 Ear Nose and Throat - 1st attendance 1300 395 542 147 137% 544 78 135 57 103

S40002 Ophthalmology - 1st attendance 1400 435 573 138 132% 580 112 118 6 164

S45002 Orthopaedics - 1st attendance 1900 650 579 -71 89% 591 177 118 -59 143

S45004 Fracture Clinic - 1st attendance 2100 718 661 -57 92% 752 195 147 -48 176

S70002 Urology - 1st attendance 1300 419 278 -141 66% 438 104 56 -48 117

S75002 Vascular Surgery 1st Attendance 240 27 63 36 236% 29 27 5 -22 9

Surgical Total 11040 3594 3580 -14 100% 3806 922 784 -138 940

W C & Y M55002 Paediatric Medical Outpatient - 1st at 950 338 320 -18 95% 328 79 86 7 78

S30002 Gynaecology - 1st attendance 1425 496 498 2 100% 508 118 122 4 121

W03002 1st obstetric consults 775 278 282 4 101% 252 59 55 -4 76

W C & Y Total 3150 1111 1100 -11 99% 1088 256 263 7 275

Grand Total 19538 6549 6185 -364 94% 6534 1581 1382 -199 1672

43

34

30

2525

22

2121 2122

2423 2322 21 20

18

15

13

1516

1918 18 18

1716 16 16

1415 15 15

17 1718 18

16

13

1112 12

1314

1718

1716

15 15 1514 14

13

0

5

10

15

20

25

30

35

40

45

50

Feb

-12

Mar

-12

Ap

r-1

2

May

-12

Jun

-12

Jul-

12

Au

g-1

2

Sep

-12

Oct

-12

No

v-1

2

De

c-1

2

Jan

-13

Feb

-13

Mar

-13

Ap

r-1

3

May

-13

Jun

-13

Jul-

13

Au

g-1

3

Sep

-13

Oct

-13

No

v-1

3

De

c-1

3

Jan

-14

Feb

-14

Mar

-14

Ap

r-1

4

May

-14

Jun

-14

Jul-

14

Au

g-1

4

Sep

-14

Oct

-14

No

v-1

4

De

c-1

4

Jan

-15

Feb

-15

Mar

-15

Ap

r-1

5

May

-15

Jun

-15

Jul-

15

Au

g-1

5

Sep

-15

Oct

-15

No

v-1

5

De

c-1

5

Jan

-16

Feb

-16

Mar

-16

Ap

r-1

6

May

-16

Jun

-16

Jul-

16

Au

g-1

6

Sep

-16

Oct

-16

Arr

ear

s A

ve %

of

5 cl

inic

s an

d 2

mo

bil

e u

nit

s

Community Oral Health Service, NMDHB - Arrears


3.13 Faster Cancer Treatment – Oncology

Community Oral Health Service Arrears 2016 2016 TCR Arrears % PSR

October

Nelson 4189 444 11 % 1417

Stoke 3158 555 18 % 1003

Richmond 3647 208 6 % 920

Motueka 1774 62 3 % 568

Tasman Mobile 2162 122 6 % 565

Blenheim 4987 1005 20 % 1682

Mobile 1863 375 20 % 584

Totals 21780 2771 13 % 6739

Treatment Visits DNA'S

Oct-16 Pre School Total

Nelson 91 298 389 31 8 %

Stoke 107 383 490 30 6 %

Richmond 73 435 465 44 9 %

Motueka 53 194 247 21 9 %

Tasman Mobile 49 131 180 7 4 %

Blenheim 93 412 505 57 11 %

Marlborough Mobile 33 115 148 4 3 %

Total 499 1968 2467 194 8 %

FCT Monthly Report - October 2016 Reporting Month: September 2016 - Quarter 1 2015-2016

As at 26/10/2016

62 Day Indicator Records

TARGET SUMMARY

Within 62 Days Exceeded 62 Days Within 62 Days Exceeded 62 Days Within 62 Days Exceeded 62 Days Within 62 Days Exceeded 62 Days Within 62 Days Exceeded 62 Days

88% 13% 82% 18% 86% 14% 88% 13% 83% 17%

Number of Records 14 2 18 4 19 3 14 2 237 50

Total Number of Records 16 22 22 16 287

57 70 57 57 63

Within 62 Days Exceeded 62 Days Within 62 Days Exceeded 62 Days

1 85% 15% 56% 44%

64 11 141 109

75 250

62 108

YEAR TO DATE

Tumour Stream % Within 62 Days

Within

62 Days

% Exceeded

62 Days Exceeded 62 Days

Total

Records Column1 Ethnicity Column2 % Within 62 Days

Within

62 Days

% Exceeded

62 DaysExceeded 62

Days

Total

Records

Brain/CNS #DIV/0! 0 #DIV/0! 0 0 asian not further defined 100% 1 0% 0 1

Breast 98% 88 2% 2 90 don't know 0% 0 100% 1 1

Gynaecological 100% 17 0% 0 17 european not further defined 55% 6 45% 5 11

Haematological 93% 14 7% 1 15 latin american /hispanic #DIV/0! 0 #DIV/0! 0 0

Head & Neck 53% 10 47% 9 19 not stated #DIV/0! 0 #DIV/0! 0 0

Lower Gastrointestinal 89% 24 11% 3 27 nz european 85% 194 15% 34 228

Lung 59% 22 41% 15 37 nz maori 65% 15 35% 8 23

Other 50% 1 50% 1 2 other Asian #DIV/0! 0 #DIV/0! 0 0

Sarcoma 0% 0 100% 1 1 other ethnicity 100% 1 0% 0 1

Skin 83% 35 17% 7 42 other european 94% 16 6% 1 17

Upper Gastrointestinal 100% 12 0% 0 12 response unidentifiable 50% 1 50% 1 2

Urological 54% 13 46% 11 24 samoan 100% 1 0% 0 1

Blank 100% 1 0% 0 1 southeast asian 100% 1 0% 0 1

All Streams 83% 237 17% 50 287 tongan #DIV/0! 0 #DIV/0! 0 0

N/A 100% 1 0% 0 1

Grand Total 83% 237 17% 50 287

Completed Records

62 Day Indicator Records

Oct -2016

(in progress)Sep-16 Aug-16

Quarter 2

(in progress)Year to Date

85% of patients had their 1st

treatment within: # days

Quarter 1 Previous Year


3.14 Service User Compliments and Complaints There were 21 complaints and 29 compliments received for the month of October.

A breakdown of reasons for complaints for the period since Safety 1st was introduced at NMDHB (March 2015) is noted as follows:

Category Heading Total

Treatment 124

Access & Funding 79

Communication 66

Consent/Information 26

Discharge & Transfer Arrangements 25

Disabilities/other issues 22

Medication 19

Miscellaneous 17

Management of Facilities 8

Fees and Costs 7

Privacy/Confidentiality 6

Professional Conduct 6

Medical Records/Reports 2

Grievance/Complaints process 1

Grand Total 408


3.15. Human Resources 3.15.1 Performance Appraisals


3.15.2 Staff Engagement:Working Together The Building Respect programme is being established with 20+ staff

attending a workshop to enable them to support the programme.

3.15.3 Management and Administration FTE Cap

Cap

October 2016

Variance

Established 371 353 18

Surrendered to support DHBSS priorities 2012/13

3 (3)

Surrendered to support SIAPO 2013/14 1 (1)

PICS Unit 8 (8)

TOTALS 359 353 6

3.16 NMDHB At A Glance The NMDHB at a Glance for October is attached as agenda item 6.1. Peter Bramley ACTING CHIEF EXECUTIVE RECOMMENDATION: THAT THE CHIEF EXECUTIVE’S REPORT BE RECEIVED

memo status - nmh...chief executive’s report 6-5 october 2015 ytd last month variance ytd actual...

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