odt performance report - microsoft...• the dcd referral rate increased by 2.5pp to 86% (q1=85%,...

ODT Performance Report Monthly – March 2017

Data production date: April 7, 2017 Publication date: April 13, 2017

ODT SMT Monthly Performance Report (March 2017) of 18

1. EXECUTIVE SUMMARY FOR APRIL ODT SMT MEETING – END OF YEAR PERFORMANCE HEADLINES

• Thank you to everyone for making 2016/17 another record year for deceased donors and transplants. 3712 patients received a deceased donor transplant thanks to the generosity of 1413 deceased donors and their families, and the dedication of everyone in the donation and transplantation communities. We achieved a 3.6% increase in deceased donors and a 5.1% increase in deceased donor transplants.

• There were 182 fewer patients on the transplant waiting list at 31 March 2017 compared with 31 March 2016. This equates to 87 fewer active patients (-1%) and 95 fewer suspended patients (-3%).

ACHIEVEMENTS ALONG THE PATHWAY

Consent/authorisation: • There was an 18% decrease in the number of ODR overrides in 2016/17. 88 families (-19) overruled their loved ones' decision to be an organ donor (25 DBD, 63 DCD; 64

SNOD involved, 24 SNOD not involved). Average monthly overrides per quarter: Q1=9, Q2=7, Q3=6, Q4=7. • The overall consent rate increased by 1 percentage point (pp) in 2016/17 to 63% (Q1=62%, Q2=60%, Q3=64%, Q4=65%). There is no change in the DBD consent rate

compared with last year (69%) due to the decrease in the first half of the year (Q1=67%, Q2=64%, Q3=72%, Q4=72%). An average 72% DBD consent rate was however sustained for the second half of 2016/17.

• The DCD consent rate increased by 1pp to 58.5% (Q1=59%, Q2=57%, Q3=57%, Q4=61%). Note the average 61% DCD consent rate achieved in Q4. • There was a 2pp increase in the consent rate for patients on the ODR (91%), due to the occasions where a SNOD was involved. The consent rate for patients on the ODR

when a SNOD was involved is 93% (Q1=92%, Q2=91%, Q3=95%, Q4=92%). • There was a 1pp increase in the BAME consent rate (104/297=35%), with a recent upward trend (Q1=32%, Q2=30%, Q3=35%, Q4=41%).

Brain stem death testing, referral and SNOD involvement: • The brain stem death testing rate increased by 1pp to 86%, with 17 fewer occasions where tests were not performed. • The DBD referral rate increased by 1pp to 97% (Q1=97%, Q2=98%, Q3=97%, Q4=98%). There were 17 fewer missed DBD referral opportunities. • The DCD referral rate increased by 2.5pp to 86% (Q1=85%, Q2=86%, Q3=84%, Q4=86%). There were 205 fewer missed DCD referral opportunities. • There was a 2pp increase in DBD SNOD involvement to 93% (Q1=93%, Q2=92%, Q3=95%, Q4=93%), with 26 fewer clinician-only approaches. • Moreover, the DCD SNOD involvement rate increased by 3pp to 80.5% with a sustained improvement in the latter 3 quarters (Q1=75%, Q2=82%, Q3=82%, Q4=83%).

There were 78 fewer clinician-only DCD approaches.

Utilisation: • Of the 1413 actual donors, there were 1346 occasions where at least one organ was transplanted (95%); 1pp increase on last year.

POTENTIAL MISSED OPPORTUNITIES

• Best practice was followed more often in 2016/17. There is still however a long way to go to ensure no opportunity is missed. • There were approximately 1500 patients in 2016/17 with at least one missed opportunity. • For example, there were 256 occasions where brain stem death tests were not performed, 939 occasions where patients were not referred (893 DCD) and 443 occasions

where families were approached for a formal organ donation discussion without a SNOD. The missed opportunities occur at all Trust/Board levels, for example in Level 1 Trusts/Boards the number of missed referral opportunities ranged from 0 to 50 (median 11) and for level 4 this ranged from 0 to 28 (median 2).

• Together let’s miss no opportunity to make a transplant happen. With 4 to 5 donors every day we can save or improve the lives of more than 4000 people in 2017/18.


2. ODT STRATEGIC OBJECTIVES

2013/14 2014/15 2015/16 Apr-16 May-16 Jun-16 Jul-16 Aug-16 Sep-16 Oct-16 Nov-16 Dec-16 Jan-17 Feb-17 Mar-17

1. Consent / authorisation 80% March2020 59.4% 57.7% 61.9% 59.5% 63.0% 64.4% 62.5% 58.8% 59.3% 61.4% 66.0% 63.4% 66.4% 63.9% 65.7% 63.0%

2. Donors pmp 26 pmp March2020 20.7 20.1 21.2 21.4 21.4 21.3 21.4 21.3 21.4 21.2 21.6 21.6 21.7 21.5 21.8 21.8

3. Organ utilisation Increase of 5%

March2020 3.1% -0.1% 0.1% 0.6% -0.5% 0.1% 0.9% -2.4% -1.0% 2.0% 1.1% -0.6% -2.9% -1.0% -2.0% -0.5%

4. Transplants pmp 74 pmp March2020 55.1 52.4 54.9 55.3 55.1 55.2 55.4 55.6 55.8 55.0 56.1 56.2 56.3 56.2 57.3 57.3

5. Living donors pmp 26 pmp March2020 17.9 17.1 16.7 16.8 17.0 16.6 16.5 16.4 16.3 16.3 16.3 16.2 16.1 16.1 16.1

2016/17YTDStrategic Objectives Final

Target

Final Target Date

Actual Performance 2016/17 PerformanceChart begins from Apr-14

50%60%70%80%

18

20

22

-6%-4%-2%0%2%4%6%

50

60

1617181920

Objective 1 – Consent^ for organ donation – aim for consent rate above 80%. Objective 2 – Deceased organ donation – aim for 26 deceased donors per million population# Objective 3 – Organ utilisation – aim to transplant 5% more of the organs offered from consented, actual donors. Objective 4 – Patients transplanted – aim for a deceased donor transplant rate of 74 per million population# Objective 5 – Living Donation – aim for 26 living donors per million population# Note: # Based on rolling 12 month period. ^ Please read consent as consent/authorisation throughout the report.


3. SUMMARY OF DECEASED DONOR PATHWAY

Potential donors

Patients referred

Eligible donors

Families approached

Families consenting Actual donors Utilised

donorsConversion

rate*

Consented patients who

did not proceed to donation

Actual donors where no

organs were transplanted

Total consented

patients from whom no


Total consented



%

DBD 152 151 122 113 82 76 76 62% 6 0 6 7%

DCD 528 457 359 161 98 47 43 12% 51 4 55 56%

Total 680 608 481 274 180 123 119 25% 57 4 61 34%

2016/17 YTD

Potential donors

Patients referred

Eligible donors

Families approached

Families consenting

Actual donors Utilised donors

Conversion rate*

Consented patients who

did not proceed to donation

Actual donors where no


Total consented



Total consented



%

DBD 1,777 1,731 1,445 1,331 919 829 809 56% 90 20 110 12%

DCD 6,195 5,302 4,236 1,814 1,061 584 537 13% 477 47 524 49%

Total 7,972 7,033 5,681 3,145 1,980 1,413 1,346 24% 567 67 634 32%

March 17

0%10%20%30%40%50%60%70%80%90%

100%Conversion rate*

DBD

DCD

* The conversion rate represents the proportion of eligible donors from whom at least one organ was transplanted (utilised donors).


0

20

40

60

80

100

120

140

160

180

Apr-1

4M

ay-1

4Ju

n-14

Jul-1

4Au

g-14

Sep-

14Oc

t-14

Nov-

14De

c-14

Jan-

15Fe

b-15

Mar

-15

Apr-1

5M

ay-1

5Ju

n-15

Jul-1

5Au

g-15

Sep-

15Oc

t-15

Nov-

15De

c-15

Jan-

16Fe

b-16

Mar

-16

Apr-1

6M

ay-1

6Ju

n-16

Jul-1

6Au

g-16

Sep-

16Oc

t-16

Nov-

16De

c-16

Jan-

17Fe

b-17

Mar

-17

Num

ber o

f pat

ient

s/fa

milie

s

Summary of potential for DBD donation

No. of patients neurological death suspected No. of patients referred (DBD)

No. of patients tested No. of eligible DBD donors

No. of families approached (DBD) No. of families consenting (DBD)

0

100

200

300

400

500

600

700

Apr-1

4M

ay-1

4Ju

n-14

Jul-1

4Au

g-14

Sep-

14Oc

t-14

Nov-

14De

c-14

Jan-

15Fe

b-15

Mar

-15

Apr-1

5M

ay-1

5Ju

n-15

Jul-1

5Au

g-15

Sep-

15Oc

t-15

Nov-

15De

c-15

Jan-

16Fe

b-16

Mar

-16

Apr-1

6M

ay-1

6Ju

n-16

Jul-1

6Au

g-16

Sep-

16Oc

t-16

Nov-

16De

c-16

Jan-

17Fe

b-17

Mar

-17

Num

ber o

f pat

ient

s/fa

milie

s

Summary of potential DCD donation

No. of patients death anticipated No. of patients referred (DCD)

No. of eligible DCD donors No. of families approached (DCD)

No. of families consenting (DCD) Actual DCD donors (UKTR data)

Utilised DCD donors (UKTR data)

4 2 1 1 1 1 2 1 1 0 3 1 2 4 2 3 2 2 2 1 2 0 3 0 0 2 0 2 2 3 2 4 2 1 2 0

8

6

2

11

4

11

1

11 11

8

7

7

118

8 7

1011

14

5

11

5

8

8

5

10

5

10

2

57

6

16

13

56

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

0

2

4

6

8

10

12

14

16

18

20

Apr-1

4M

ay-1

4Ju

n-14

Jul-1

4Au

g-14

Sep-

14Oc

t-14

Nov-

14De

c-14

Jan-

15Fe

b-15

Mar

-15

Apr-1

5M

ay-1

5Ju

n-15

Jul-1

5Au

g-15

Sep-

15Oc

t-15

Nov-

15De

c-15

Jan-

16Fe

b-16

Mar

-16

Apr-1

6M

ay-1

6Ju

n-16

Jul-1

6Au

g-16

Sep-

16Oc

t-16

Nov-

16De

c-16

Jan-

17Fe

b-17

Mar

-17

%N

Non-proceeding consented DBD

Consented patients who did not proceed to donation

Actual donors where no organs were transplanted

Consented patients from whom no organs were transplanted %

4 4 2 5 2 7 9 3 5 7 5 1 4 5 1 6 5 5 4 6 1 7 9 5 2 4 2 4 2 5 4 5 3 6 6 4

54

37

47 45

36

5051

33

38

5251

42

46

3643

47

31

44

54

43

39

4951

51

44

36

4841

33 29 2830

43

51

43

51

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

0

10

20

30

40

50

60

70

Apr-1

4M

ay-1

4Ju

n-14

Jul-1

4Au

g-14

Sep-

14Oc

t-14

Nov-

14De

c-14

Jan-

15Fe

b-15

Mar

-15

Apr-1

5M

ay-1

5Ju

n-15

Jul-1

5Au

g-15

Sep-

15Oc

t-15

Nov-

15De

c-15

Jan-

16Fe

b-16

Mar

-16

Apr-1

6M

ay-1

6Ju

n-16

Jul-1

6Au

g-16

Sep-

16Oc

t-16

Nov-

16De

c-16

Jan-

17Fe

b-17

Mar

-17

%N

Non-proceeding consented DCD

Consented patients who did not proceed to donation

Actual donors where no organs were transplanted

Consented patients from whom no organs were transplanted %


4. ODT BALANCED SCORECARD (ET MEASURES ONLY)

Dimension / CSFs Measure description 2015/16

Actual2016/17

YTDMar-16 Apr-16 May-16 Jun-16 Jul-16 Aug-16 Sep-16 Oct-16 Nov-16 Dec-16 Jan-17 Feb-17 Mar-17 Commentary

Balanced Scorecard: ODT - as at the end of March 2017

Referral rates (DBD and DCD)DBD

96.4% 97.4% Actual 95.5% 95.7% 97.4% 96.6% 98.6% 97.8% 97.1% 97.3% 98.8% 94.9% 97.4% 97.8% 99.3%

DCD

83.1% 85.6% Actual 86.2% 85.3% 87.6% 83.0% 87.4% 85.7% 86.1% 84.6% 84.6% 84.4% 84.6% 87.7% 86.6%

Number of missed referral opportunities (DBD and DCD) DBD

63 46 Actual 6 6 4 5 2 3 4 4 2 8 4 3 1

DCD

1,098 893 Actual 86 80 63 86 64 66 68 82 77 84 93 59 71

Cust

omer

Deliv

er m

ore

dono

rs

- The DBD referral rate increased by 1 percentage point in 2016/17 when compared with 2015/16 to 97% (Q1=97%, Q2=98%, Q3=97%, Q4=98%). There were 17 fewer missed DBD referral opportunities in 2016/17.- The DCD referral rate has increased by 2.5 percentage points to 86% (Q1=85%, Q2=86%, Q3=84%, Q4=86%). There were 205 fewer missed DCD referral opportunities in 2016/17.- A number of initiatives have been put in place in the regional teams to address referral rates which has contributed to the increase, those being:- Scotland phone all of the units within their region on a daily basis to ask if any potentials for that day (including weekends). This has identified at least 2 donors within the month who may not have been referred if this phone call was not in place. It should be noted that other regions (Midlands, South Central, South Wales, South East and Northern Ireland) phone selected units on days when embedded SNODs are not present.- Scotland provide a list of missed potentials to CLODs at regional collaboratives. They have also implemented an 'Idea into Action' whereby the duty office will inform the SNOD if a clinician calls to check the ODR for a patient. This has enabled the team to attend 2 potentials in the last month that may not have been referred otherwise.- South East team at St Georges, the CLOD emails consultants responsible for missed referrals to reiterate best practice. This is also replicated in the North West region whereby any missed referrals are sent to the RCLODs and CLODs to follow up.- Eastern, Midlands and Scotland have information sheets/posters documenting exact information required for referral to speed up the referral process.- South central, South East, North West and Yorkshire's stretch goals were focused on increasing referrals, all had buy-in from the regional collaboratives and it is felt that this reinvigorated all stakeholders to focus on referrals. All have seen an improvement in referral rates.- South Central introduced a CQUIN in Oxford where there had been particular issues with referral. Reimbursement was only given if donors were referred. Although it is felt that this had some impact, the biggest influence was due to a change in the CLOD and chair in the level 1s (Oxford and Southampton) which led to a positive culture of donation.- The visibility of the RCLOD and RM in South Central was felt to have had a positive impact on referral rates and this is to be rolled out across other regions.Future actions planned are: - South Central and Midlands to pilot the missed opportunities report- Scotland implementing a letter to be sent to CLODs for every missed referral. This was agreed to be trialled in the other regions.- Northern Ireland are to discuss at collaborative changing stretch goal to focus on referral.

0

50

100

150

200 DBD DCD

60%

70%

80%

90%

100%

DBD DCD

Note: * denotes metric is also a strategic target. Chart begins from Apr-14



Actual2016/17



Number of eligible donorsTarget

5,609 5,681 Actual 515 492 461 467 461 432 442 478 478 517 546 426 481

Number of new opt-in registrants on the ODR (million) * 2.000 1.600 Target 0.200 0.095 0.095 0.095 0.125 0.115 0.165 0.155 0.165 0.195 0.135 0.130 0.130

1.332 1.111 Actual 0.112 0.111 0.100 0.101 0.098 0.103 0.110 0.084 0.075 0.064 0.099 0.079 0.086

- The number of eligible donors is provided for information. There were 72 more eligible donors in 2016/17 compared with 2015/16 (+41 DBD, +31 DCD). Eligible donor numbers have returned to 2014/15 levels but the balance has shifted between DBD and DCD: There has been a 5% increase in the number of eligible DBDs compared with two years ago (1373 to 1445) and 1% decrease in eligible DCD (4290 to 4236). - However, it has been agreed that an adjusted eligible donor pool needs to be calculated to reflect patients excluded due to the DCD exclusion criteria or where kidney screening deemed them unsuitable for organ donation. This will be a useful adjustment when data allows.-The disparity between teams in relation to the trend of eligible donors remains with six regions seeing a decrease in the number of eligible donors whilst six have seen an increase. In previous months it has been identified that late submission of PDA is a contributing factor however improvement has been noted following regional training of SNODs. Further work is being undertaken to ensure the eligible donor measure is reflective of the actual potential for donation e.g. PDA definitions and work with Statistics and Clinical Studies.

- There were 86,252 new registrations recorded in March 2017. 33% of these can be attributed to comms and marketing activity. In March we had paid for advertising running on Facebook and the Sign for Life campaign started on 24 March. We also had advertising running in the hothouse areas - Manchester, Rotherham, Salford, Derby, Nottingham, Burton and Leicester). - 1.1 million new registrations have gone onto the ODR in the last 12 months. While this is behind the target set for the year, it has become increasingly clear that such high targets are unrealistic based on the budget levels. The target for 2017/18 is 1.1 million registrations.- It is important to note that two ODR data feeds are currently inactive: - Scottish GP Services inactive; impact estimated to be up to 15,000 unprocessed new registrations (resolution expected – End of May 2017) - England/Wales GP Service inactive since December 2016; impact estimated to be up to 80,000 unprocessed new registrations (resolution expected - TBC)- The NHS Tracing Service & De-Duplication Process have been inactive since May 2015 and the impact of this is currently being investigated. This may result in significant numbers of duplicate registrations on the live ODR i.e. over-reporting the number of registrants. An impact assessment is underway and resolution timeline to be determined.

Cust

omer

Deliv

er m

ore

dono

rs

350

450

550

0

0.050

0.100

0.150

0.200

0.250




Actual2016/17



Proportion of approaches led by a SNOD (from Referral Record)

79.0% 83.0% Target 79.0% 83.0% 83.0% 83.0% 83.0% 83.0% 83.0% 83.0% 83.0% 83.0% 83.0% 83.0% 83.0%

78.5% 80.5% Actual 77.7% 77.6% 80.5% 75.7% 80.4% 82.1% 80.0% 81.5% 84.9% 81.6% 82.4% 79.0% 78.9%

Number of consented eligible donors2,125 #N/A Target 177 #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A

2,004 1,980 Actual 163 157 167 159 163 140 143 162 177 180 196 156 180

- The proportion of approaches led by a SNOD increased by 2 percentage points in 2016/17 compared with 2015/16 to 80.5%. We have seen a 2 percentage point increase in DBD SNOD involvement to 93% (Q1=93%, Q2=92%, Q3=95%, Q4=93%) and a 3 percentage point increase in DCD SNOD involvement to 80.5% with a sustained improvement in the latter 3 quarters (Q1=75%, Q2=82%, Q3=82%, Q4=83%). - Six teams had 100% DBD SNOD involvement in month and two teams (NI & SC) had 100% SNOD involvement in both DBD and DCD in month. - South East have identified an increased trend in consultant only approaches but these incidences correlate with multiple activity in region resulting in units having to wait for a SNOD to attend.- NI and South East have been using Approach AIDE to planning consent conversation, S Wales examining communication tools in relation to approach and probing and Scotland RCLOD writing to all CLODs re best practice and missed opportunities.- Scotland have been analysing the timings of referrals and fed this back to units. This has led to a shift in the timings of referrals e.g. move from afternoon referrals to morning referrals which has enabled planning of SNODs to attend to be involved in the approach. This action is to be reviewed by all regions with further exploration of SNOD travel time and deploying staff to understand if delays in SNOD attending is the root cause.- South West have seen a large increase in DCD SNOD involvement which was their stretch goal. This involves a planned approach utilising a huddle to get the SNODs into the room.- All regions felt that Team Managers taking referrals has led to quicker deployment of staff and has had a positive impact on SNOD involvement. It was noted however that this has an impact on resources as Team Managers need to have more time to focus on strategic development. At the next RM meeting, options to be explored with regard to referral taking and deployment of staff. - Exploration with HR re contractual changes for SNODs to facilitate cross regional working to ensure timely attendance of SNODs and to ensure teams remain at full establishment.- Data to be presented to each region using a pie chart to show the spread of approaches where no SNOD was involved across the hospitals in region.

- Consent/authorisation was ascertained for 1980 eligible donors in 2016/17; 1% fewer than last year (i.e. 24 fewer consents/ authorisations: +28 DBD, -52 DCD). - 3145 families were approached for a formal organ donation discussion; 3% fewer than last year (i.e. 93 fewer approaches: +35 DBD, -128 DCD).

Cust

omer

Del

iver

mor

e do

nors

60%

80%

100%

120

160

200




Actual2016/17



Overall consent rate *64.0% 70.0% Target 64.0% 70.0% 70.0% 70.0% 70.0% 70.0% 70.0% 70.0% 70.0% 70.0% 70.0% 70.0% 70.0%

61.9% 63.0% Actual 63.2% 59.5% 63.0% 64.4% 62.5% 58.8% 59.3% 61.4% 66.0% 63.4% 66.4% 63.9% 65.7%

DBD consent rate72.5% 72.0% Target 72.5% 72.0% 72.0% 72.0% 72.0% 72.0% 72.0% 72.0% 72.0% 72.0% 72.0% 72.0% 72.0%

68.8% 69.0% Actual 69.4% 62.0% 73.2% 65.7% 66.7% 62.5% 64.1% 69.2% 71.5% 74.2% 74.2% 69.9% 72.6%

DCD consent rate58.5% 68.0% Target 58.5% 68.0% 68.0% 68.0% 68.0% 68.0% 68.0% 68.0% 68.0% 68.0% 68.0% 68.0% 68.0%

57.3% 58.5% Actual 60.1% 57.9% 55.6% 63.3% 59.3% 56.0% 55.8% 56.1% 60.9% 55.5% 61.1% 59.6% 60.9%

- The overall consent/authorisation rate increased by 1 percentage point in 2016/17 to 63% (Q1=62%, Q2=60%, Q3=64%, Q4=65%).- There is no change in the DBD consent/authorisation rate compared with last year (69%) due to the decrease in the first half of the year (Q1=67%, Q2=64%, Q3=72%, Q4=72%). An average 72% DBD consent/authorisation was however sustained for the second half of 2016/17.- The DCD consent/authorisation rate increased by 1 percentage point in 2016/17 to 58.5% (Q1=59%, Q2=57%, Q3=57%, Q4=61%). An average 61% DCD consent/authorisation rate was achieved in Q4.- South East and South West achieved combined consent rates of 69% and 68% respectively in 2016/17.- The top three cited reasons for non consent for DBD donation are 1.patient's previously expressed wish, 2.Not sure patient would have agreed with donation, 3.Family did not want surgery to body. These are the same reasons as cited in 2015/16 and are cited in the same order. - The top three cited reasons for non consent for DCD donation are 1.patient's previously expressed wish, 2.Family felt process too long, 3. Unsure of patient's agreement. These are the same three reasons as 2015/16 although reasons 2 & 3 have changed order.- There were some concerns raised about the number of new SNODs in some regions. South East, London and Eastern are sharing resources and practice across team to ensure better deployment of staff with the right skills to approach families and maximise consent.- The majority of teams debrief after each non consenting family to understand what could have been done differently, what worked well etc. Midlands team to implement this approach.- Working patterns of specialist requestors are being reviewed to ensure optimal deployment of staff. - South Wales are holding communication day for CLODs and SNODs on using positive language during approach conversations. - South East team re-explore/reapproach families who initially refuse donation to ensure that they fully understand the rationale for refusal.- South Central and Midlands new stretch goal is focused on consent with each trust requiring to identify which part of the donation pathway they can address to improve consent.

Cust

omer

Del

iver

mor

e do

nors

50%

60%

70%

80%

60%

70%

80%

40%

50%

60%

70%




Actual2016/17



Number of families overruling patient consent 50 #N/A Target 4 #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A

107 88 Actual 8 9 8 10 9 4 9 5 3 9 6 6 10

Consent rate when patient on ODR *95.0% #N/A Target 95.0% #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A

88.6% 90.6% Actual 89.7% 86.8% 90.1% 87.8% 87.7% 93.5% 88.0% 93.1% 95.9% 90.0% 93.7% 91.7% 89.1%

Consent rate when patient not on ODR * 51.0% #N/A Target 51.0% #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A

51.0% 51.3% Actual 51.7% 50.0% 51.1% 52.7% 52.7% 46.6% 46.4% 49.5% 54.9% 51.0% 53.5% 52.3% 53.8%

Number of deceased donors (DBD/DCD) * 1,365 1,440 Target 114 120 120 120 120 120 120 120 120 120 120 120 120

1,364 1,413 Actual 104 108 121 106 112 105 109 127 141 121 132 108 123

Deceased donors pmp *21.0 22.0 Target 21.0 21.5 21.6 21.7 21.9 22.0 22.0 22.0 22.0 22.0 22.0 22.0 22.0

21.2 21.8 Actual 21.2 21.4 21.4 21.3 21.4 21.3 21.4 21.2 21.6 21.6 21.7 21.5 21.8

Cust

omer

Deliv

er m

ore

dono

rs- 88 families overruled their loved ones' decision to be an organ donor in 2016/17 (25 DBD, 63 DCD; 64 SNOD involved, 24 SNOD not involved); 18% decrease. The average monthly overrides per quarter are as follows: Q1=9, Q2=7, Q3=6, Q4=7. - There was a 2 percentage point increase in the consent/ authorisation rate for patients on the ODR, due to the occasions where a SNOD was involved. - On ODR and SNOD involved (93%): Q1=92%, Q2=91%, Q3=95%, Q4=92%. - On ODR but SNOD not involved (65%, 8 percentage point decrease): Q1=63%, Q2=64%, Q3=63%, Q4=75%.- The decrease in ODR overrides has been felt to be due to the actions identified above in consent with specific reference to communication training, legislation training and the use of probing techniques. Future actions for consideration have been identified. - The length of the donation process has been identified as a cause for override in some cases. There is a national piece of work addressing the length of the donation process.

- There has been no improvement in the consent/authorisation rate for patients not on the ODR. - Not on ODR and SNOD involved (57%, 1 percentage point decrease): Q1=58%, Q2=55%, Q3=58%, Q4=59%. - Not on ODR and SNOD not involved (21%, no change from 2015/16): Q1=25%, Q2=16%, Q3=14%, Q4=27%.- See above actions for consent.

- There were 1413 deceased donors in 2016/17; 49 more than 2015/16 (3.6% increase). - This is another record year for deceased donors. - Monthly averages per quarter are as follows: Q1=112, Q2=109, Q3=130, Q4=121.

0

5

10

15

80%

90%

100%

30%

40%

50%

60%

70%

80

100

120

140

18

20

22




Actual2016/17



Number of deceased donors where at least one organ was transplanted 1,300 #N/A Target 108 #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A

1,283 1,346 Actual 99 106 115 104 106 101 101 121 132 116 125 100 119

Number of living donors *1,223 1,155 Target 102 105 105 105 105 105 105 105 105 105 105 105

1,074 950 Actual 96 91 80 89 92 73 91 92 115 68 82 77

Living donors pmp19.0 19.3 Target 19.0 17.0 17.4 17.5 17.6 18.0 18.0 18.3 18.4 18.6 18.8 19.3

16.7 16.1 Actual 16.7 16.8 17.0 16.6 16.5 16.4 16.3 16.3 16.3 16.2 16.1 16.1

Consent rate of BAME families45.0% 50.0% Target 45.0% 50.0% 50.0% 50.0% 50.0% 50.0% 50.0% 50.0% 50.0% 50.0% 50.0% 50.0% 50.0%

33.8% 35.0% Actual 47.1% 25.9% 33.3% 37.0% 31.8% 42.9% 17.4% 57.1% 24.0% 34.6% 37.1% 42.9% 46.2%

Family survey results90% 90% Target 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90%

93% 91% Actual 94% 91% 90% 92%

- There was a 1 percentage point increase in the BAME consent/ authorisation rate in 2016/17 (104/297=35%), with a recent upward trend. Q1=32%, Q2=30%, Q3=35%, Q4=41%.- A number of actions have been taken both locally and nationally:- All new SNODs now receive cultural awareness training in cohort training.- Diversity Lead Nurse Specialist now in post.- London are focussing on religious cultural aspects to approach in Team education using Multi ethnic communities handbook

- Of the 1413 actual donors, there were 1346 occasions where at least one organ was transplanted (95%). - This is a 1 percentage point improvement on the 94% last year.

- End of year information will be available in the next report as living donor data are available a month in arrears. - YTD there have been 950 living donors.- The monthly trends in activity for 2016/17 mirror those for 2015/16 with lower activity in August, December and February and a peak in November. These relate to seasonal variations, donor and recipient choice as well as increased uptake of the UKLKSS. Transplants identified in the January matching run will be reflected in March activity.- The LDKT 2020 strategy implementation plan has focused primarily on professional, patient and public engagement throughout 2016/17, with all the key actions in these domains fully achieved. This should result in increased rates of LDKT in 2017/18.

Ensu

re d

onor

s ref

lect

so

ciet

yEn

hanc

e D

onor

Fam

ily

Expe

rien

ce

- This metric is reported quarterly, a quarter in arrears. - Currently, of the 1584 forms sent YTD, 434 have been returned (27%). - 395 (91%) of the returned forms scored at least 9 for overall satisfaction. Any feedback with an overall score of less than 9 is reviewed in detail by the ODST Team Manager. Where appropriate this is reported formally via Complaints and, if the family have agreed, they will be contacted to discuss the feedback given to ensure any wider learning to improve the service is gained.- YTD only 12 forms have been sent to non-consenting families.

Cust

omer

Del

iver

mor

e do

nors

6080

100120140

60

110

10%

30%

50%

1617181920

60%

80%

100%




Actual2016/17



Organ utilisation (improvement against 2012/13 baseline) 1.0% 1.0% Target 1.0% 1.0% 1.0% 1.0% 1.0% 1.0% 1.0% 1.0% 1.0% 1.0% 1.0% 1.0% 1.0%

0.1% -0.5% Actual -0.8% 0.6% -0.5% 0.1% 0.9% -2.4% -1.0% 2.0% 1.1% -0.6% -2.9% -1.0% -2.0%

Number of deceased donor transplants * 3,694 3,900 Target 308 325 325 325 325 325 325 325 325 325 325 325 325

3,531 3,712 Actual 254 283 320 285 284 292 275 325 379 322 345 279 323

Deceased donor transplants pmp *57.0 60.0 Target 57.0 55.9 56.0 56.5 57.4 58.1 58.2 58.3 58.5 58.6 58.7 59.1 60.0

54.9 57.3 Actual 54.9 55.3 55.1 55.2 55.4 55.6 55.8 55.0 56.1 56.2 56.3 56.2 57.3

Growth in total (active and suspended) transplant waiting list (^at end of month)

Target

-390 -182 Growth +25 -33 -1 -5 +43 +3 +58 -119 -41 -25 -87 +13 +12

Cust

omer

Deliv

er p

rodu

cts

pati

ents

nee

d- The organ utilisation rate continues to fluctuate from month to month and there has been no improvement this year. - The Taking Organ Utilisation to 2020 Strategy has been launched and is available here: http://www.odt.nhs.uk/pdf/organ_utilisation_strategy.pdf

- 3712 patients benefitted from a deceased donor transplant in 2016/17; 181 more than last year (5.1% increase). - This is another record year for deceased donor transplants. - The monthly number of transplants per quarter were as follows: Q1=296, Q2=284, Q3=342, Q4=316.

- There were 182 fewer patients on the transplant waiting list at 31 March 2017 compared with 31 March 2016. - There are currently 9746 patients on the list (6389 active, 3357 suspended), compared with 9928 at 31 March 2016 (6476 active, 3452 suspended). - This equates to 87 fewer active patients (-1%) and 95 fewer suspended patients (-3%).

-6%-4%-2%0%2%4%6%

200

300

400

50

55

60

-200

0

+200


http://www.odt.nhs.uk/pdf/organ_utilisation_strategy.pdf



Actual2016/17



18.16 17.90 Target 18.16 17.90 17.90 17.90 17.90 17.90 17.90 17.90 17.90 17.90 17.90 17.90 17.90

18.39 Actual 18.39 17.63 17.63 17.63 18.91 18.99 18.99 18.26 18.28 18.21 17.90 18.01

Target #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A

Actual 149 #N/A #N/A 139 #N/A #N/A 138 #N/A #N/A 164 #N/A #N/A

Target #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A

Actual 22 #N/A #N/A 50 #N/A #N/A 38 #N/A #N/A 53 #N/A #N/A

100.0% 100.0% Target 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0%

74.6% Actual 74.6% 100.0% 100.0% 100.0% 117.8% 120.0% 114.6% 126.4% 130.6% 131.5% 136.4% 130.4%

End of year data are not yet available.Re

duce

net

tax-

paye

r bur

den

Quarterly average number of organs retrieved per abdominal team (Qtrly in arrears)

This metric is reported quarterly, a month in arrears.

Quarterly average number of organs retrieved per cardiothoracic team (Qtrly in arrears)

Inve

st fo

r the

long

-te

rm

Transformation forecast spend vs plan

Reso

urce

s

Deliv

er b

ette

r VF

M fo

r the

NHS

Cost per transplant (£000s) - Annual forecast *

End of year data are not yet available.

120

140

160

180

20

40

60

60%80%

100%120%140%

15

20

25




Actual2016/17



0 0 Target 0 0 0 0 0 0 0 0 0 0 0 0 0

7 6 Actual 0 1 0 0 0 1 1 0 2 1 0 0 0

Target

Actual 8 #N/A #N/A 13 #N/A #N/A 10 #N/A #N/A 12 #N/A #N/A #N/A

0 0 Target 0 0 0 0 0 0 0 0 0 0 0 0 0

3 3 Actual 0 0 0 1 0 0 0 0 1 0 0 1 0

Ope

rate

saf

ely

Ope

ratio

ns

Ope

rate

a s

ingl

e 24

/7 b

usin

ess

Number of occasions where ODT did not offer organs in accordance with allocation policy

- There were 6 occasions in 2016/17 where organs were offered outside of the allocation policy; 1 fewer than last year. - There were no occasions in Q4.

Man

age

Dai

ly

Impr

ovem

ent

Number of planned improvement activities i.e. LEAN & PDSA events (Qtrly in arrears)

This metric is reported quarterly, a month in arrears.

- There were 3 serious incidents in 2016/17; the same number as 2015/16.- 83 incidents were reported in March (a number of these were related to transport perfusion fluid which accounts for the significant increase). 5 SAEARs (3 x SAR and 2 x SAE) were reported to our regulator under our Assisted Function role.

Number of serious incidents

0

5

0

10

20

0

1

2

3




Actual2016/17



#N/A #N/A Target

6% 6% Actual 6% 6% 6% 6% 7% 6% 6% 6% 7% 7% 7% 6% 6%

4.0% 4.0% Target 4.0% 4.0% 4.0% 4.0% 4.0% 4.0% 4.0% 4.0% 4.0% 4.0% 4.0% 4.0% 4.0%

3.5% 2.9% Actual 3.4% 2.8% 2.7% 1.4% 2.7% 3.1% 4.1% 3.2% 2.8% 3.6% 3.3% 2.2% 2.2%

10.0% 10.0% Target 10.0% 10.0% 10.0% 10.0% 10.0% 10.0% 10.0% 10.0% 10.0% 10.0% 10.0% 10.0% 10.0%

14.8% 13.1% Actual 14.8% 15.4% 14.4% 14.7% 16.1% 14.7% 15.4% 14.9% 14.3% 14.7% 13.0% 13.5% 13.1%

95.0% 95.0% Target 95.0% 95.0% 95.0% 95.0% 95.0% 95.0% 95.0% 95.0% 95.0% 95.0% 95.0% 95.0% 95.0%

87.8% 85.4% Actual 87.8% #N/A #N/A 82.8% #N/A #N/A 83.3% #N/A #N/A 84.1% #N/A #N/A 85.4%

95.0% 95.0% Target 95.0% 95.0% 95.0% 95.0% 95.0% 95.0% 95.0% 95.0% 95.0% 95.0% 95.0% 95.0% 95.0%

87.2% 90.5% Actual 87.2% #N/A #N/A 66.9% #N/A #N/A 87.2% #N/A #N/A 89.2% #N/A #N/A 90.5%

- There has been a reduction in mandatory training compliance in 2016/17; 85.4% compared with 87.8% last year.- Mandatory training has however increased this month from 83% to 85.4% with a range of 62% to 100% compliance. - The Organ Donation function has progressed compliance in the Adult Basic Life Support increasing from 34 to 49% and more targeted work is on-going. - Manual Handling continues to cause a challenge until the training can be provided across the teams.

PDPR(Qtrly) 12-months rolling period

- There has been an improvement in PDPR compliance in 2016/17; 90.5% compared with 87.2% last year.- Of our 24 functional teams, 12 have 100% compliance and a further 5 teams have 90% or above

- Currently there are 17 chair and 4 CLOD vacancies. Actions relating to CLODs, chairs and committees:- Regional Management team to meet with donation committee chairs to set expectations- National event to be held for donation committee chairs to share knowledge, set expectations and reinvigorate donation committees- Scotland's stretch goal is to reinvigorate their Organ Donation committees with away days for chairs and lay members- National initiative to explore possibility of taking Team Managers off of the on call rota to provide capacity to enable them to attend all ODCs.

Lead

mot

ivat

ed e

mpl

oyee

s

Sickness absence - There has been a reduction in sickness absence in 2016/17; 2.9% compared with 3.5% last year.- In month, TSS and ODT Commissioning have had significant reductions: TSS from 3.11% in February to 0.39% in March and ODT Commissioning from 8.67% to 0.46%. Clinical support services have absence at 7.18%. - OD remain within target overall. Four teams: Midlands, South Central, South Wales and South West have 4% absence.

% annual turnover - There has been a reduction in % annual turnover in 2016/17; 13.1% compared with 14.8% last year.- In month, turnover overall in ODT has decreased slightly from 13.52% to 13.13%. OD turnover has decreased from 11.36% in February to 10.55%. TSS however has experienced a steady increase in turnover this year to 26%.

Peop

le

Lead

em

ploy

ees

driv

ing

impr

ovem

ent

% vacant Clinical Lead - Organ Donation (CLOD) and Donation Committee Chair posts

% mandatory training compliance(Qtrly) 12-months rolling period

0%

2%

4%

6%

8%10%12%14%16%18%

4%

6%

8%

80%

90%

100%

60%70%80%90%

100%




Actual2016/17



85.0% 85.0% Target 85.0% 85.0% 85.0% 85.0% 85.0% 85.0% 85.0% 85.0% 85.0% 85.0% 85.0% 85.0% 85.0%

75.3% 69.1% Actual 75.3% 77.8% 75.8% 74.3% 74.3% 70.0% 66.5% 68.3% 67.4% 67.4% 69.7% 68.7% 69.1%

Target

#N/A 7.0 Actual #N/A #N/A #N/A #N/A #N/A #N/A 10.3 17.3 12.3 12.3 15.8 16.0 7.0

Target

Actual 13.60 16.60 11.10 10.17 8.54 12.81 18.90 15.27 11.92 10.69 12.67 18.30 8.71

0 0 Target 0 0 0 0 0 0 0 0 0 0 0 0

0 0 Actual 0 0 0 0 0 0 0 0 0 0 0 0

#N/A 1 Target

0 1 Actual 0 #N/A #N/A 1 #N/A #N/A 2 #N/A #N/A 1 #N/A #N/A 1

#N/A 20 Target #N/A #N/A #N/A #N/A #N/A #N/A 19 #N/A #N/A 19 #N/A #N/A 20

17 19 Actual 17 #N/A #N/A 18 #N/A #N/A 20 #N/A #N/A 18 #N/A #N/A 19

In the last week of March there were 7 WTE SNOD vacancies reported by the regional teams.

- There is currently 1 BAME manager in ODT; 1 more than last year. - There are currently 19 BAME staff in ODT; 2 more than last year.- A clear recruitment dashboard is currently being developed to track the impact of the specific positive action initiatives which will be available for the next reporting period. Positive actions include offering feedback to every BAME applicant at shortlisting and assessment stage, developing careers website and enabling informal visits. - Our Management Graduate is building on the recruitment initiatives to develop further during her placement and also working on targeted research to understand any potential barriers for attracting, securing and retaining a more diverse workforce into Specialist Nurse posts in Organ Donation. The outcome of this will be available at the end of the Summer and recommendations will be developed into action planning and implementation.

Number of BAME staff

Average time taken to fill vacancies (in weeks)

There were 2 ODT appointments made in March (66.7% successful recruitment) with an average of 8.71 weeks to fill the vacancies.

H&S incidents (Level 1 & 2 only) This metric is reported a month in arrears. YTD there have been no level 1 or 2 incidents.

Crea

te F

lexi

ble

Empl

oyee

Bas

eProportion of SNOD establishment competent on the rota

- 58 SNODs were supervised on the rota during March. - There are 49 training SNODS: 20 from Cohort 5 completed Module 1 and 29 remaining from Cohort 4 (although 16 of these were signed off during March leaving 13 continuing to be supervised going forward).- 9 other SNODs supervised - 3 returning from Mat leave and 6 returning from long term sick leave.

Number of BAME managers≥1 (2017)

Peop

le

Recr

uit a

nd R

etai

n Ex

pert

, Car

ing

Empl

oyee

s

Number of SNOD vacancies (WTE)

60%

80%

100%

0

1

2

3

15

16

17

18

19

20

0

1

58

11141720

0

10

20



5. OD KEY PERFORMANCE MEASURES: MONTHLY AND YTD SUMMARIES OD Regional Performance Dashboard IN-MONTH

OD Regional Dashboard (in-month) Month Reported: Date Production Date:

DonorsApprox*

donor targetDifference*

Utilised donors

BSD testing Referral ApproachSNOD

PresentConsent /

Authorisation

Consent / Authorisation

for eyes(Quarterly in

arrears)

Combined 70.0% 85.0%

DBD 72.0%

DCD 68.0%

Combined 9 12 -3 8 48.4% 43% 50.6%

DBD 4 4 77.8% 100.0% 100.0% 71.4% 71.4%

DCD 5 4 84.1% 50.0% 70.8% 41.7%

Combined 16 13 3 16 65.6% 58% 63.3%

DBD 14 14 96.3% 100.0% 91.7% 100.0% 54.5%

DCD 2 2 95.6% 32.3% 80.0% 90.0%

Combined 15 13 2 14 68.4% 31% 65.4%

DBD 6 6 84.6% 100.0% 90.0% 77.8% 88.9%

DCD 9 8 81.9% 53.7% 65.5% 62.1%

Combined 18 14 4 16 72.7% 48% 76.3%

DBD 11 11 68.2% 100.0% 100.0% 100.0% 85.7%

DCD 7 5 87.7% 43.2% 89.5% 63.2%

Combined 4 8 -4 4 64.3% 56% 89.2%

DBD 2 2 100.0% 100.0% 85.7% 100.0% 33.3%

DCD 2 2 96.9% 38.1% 75.0% 87.5%

Combined 4 5 -1 4 62.5% 20% 69.2%

DBD 4 4 83.3% 100.0% 100.0% 100.0% 60.0%

DCD 0 0 66.7% 37.5% 100.0% 66.7%

Combined 13 8 5 13 57.1% 44% 90.0%

DBD 7 7 92.9% 92.9% 91.7% 90.9% 81.8%

DCD 6 6 87.1% 60.7% 76.5% 41.2%

Combined 9 9 0 9 77.8% 71% 60.6%

DBD 8 8 90.9% 100.0% 88.9% 100.0% 100.0%

DCD 1 1 85.7% 41.7% 100.0% 60.0%

Combined 15 13 2 15 74.2% 53% 62.5%

DBD 7 7 85.7% 100.0% 88.9% 93.8% 68.8%

DCD 8 8 88.7% 45.5% 73.3% 80.0%

Combined 4 5 -1 4 58.3% 38% 58.3%

DBD 2 2 80.0% 100.0% 50.0% 0.0% 0.0%

DCD 2 2 89.3% 50.0% 90.9% 63.6%

Combined 5 9 -4 5 63.6% 53% 69.1%

DBD 2 2 100.0% 100.0% 100.0% 75.0% 75.0%

DCD 3 3 80.8% 41.2% 100.0% 57.1%

Combined 11 10 1 11 72.2% 46% 77.8%

DBD 9 9 76.9% 100.0% 100.0% 100.0% 90.0%

DCD 2 2 84.5% 27.6% 87.5% 50.0%

Combined 123 120 3 119 65.7% 47% 69.1%

DBD 76 71 5 76 85.5% 99.3% 92.6% 92.9% 72.6%

DCD 47 49 -2 43 86.6% 44.8% 79.5% 60.9%* Rounded to the nearest integerConsent / Authorisation for eyes is the last reported quarterly figure.

Northern Ireland

March 2017Competent SNODs on

the rota

Targets

National

Scotland

South Central

South East

South Wales

South West

Yorkshire

March 2017 07/04/2017

Deceased Donor Pathway

Midlands

North West

Northern

Eastern

London


OD Regional Performance Dashboard End of year performance

OD Regional Dashboard (YTD) Month Reported: Date Production Date: 07/04/2017

Deceased donors

pmpDonors

Approx* donor target

Difference*Utilised donors

BSD testing Referral ApproachSNOD

PresentConsent /

Authorisation

Consent / Authorisation

for eyes(Quarterly in

arrears)

Combined 22.0 70.0% 85.0%

DBD 72.0%

DCD 68.0%

Combined 131 140 -9 121 65.1% 39% 50.6%

DBD 57 56 74.3% 97.3% 96.4% 91.4% 77.8%

DCD 74 65 83.6% 43.5% 80.4% 59.8%

Combined 161 160 1 154 56.8% 58% 63.3%

DBD 111 110 90.8% 97.5% 88.0% 94.7% 58.7%

DCD 50 44 88.5% 45.9% 84.8% 54.3%

Combined 157 160 -3 154 58.0% 35% 65.4%

DBD 85 85 77.2% 93.2% 89.3% 90.3% 68.7%

DCD 72 69 81.2% 47.2% 71.1% 52.6%

Combined 181 170 11 175 64.1% 42% 76.3%

DBD 106 104 81.5% 98.7% 96.1% 97.7% 68.8%

DCD 75 71 85.0% 36.9% 89.4% 60.6%

Combined 86 90 -4 82 61.9% 52% 89.2%

DBD 55 53 95.1% 100.0% 96.9% 96.8% 63.4%

DCD 31 29 92.8% 28.5% 76.0% 60.4%

Combined 42 60 -18 40 64.4% 33% 69.2%

DBD 32 31 84.4% 100.0% 92.5% 93.9% 71.4%

DCD 10 9 73.2% 38.4% 89.5% 55.3%

Combined 133 100 33 126 63.1% 35% 90.0%

DBD 77 75 89.0% 93.4% 94.1% 90.1% 78.4%

DCD 56 51 81.0% 57.5% 66.2% 52.2%

Combined 109 110 -1 103 64.0% 74% 60.6%

DBD 67 67 87.7% 99.2% 97.2% 93.3% 71.2%

DCD 42 36 82.4% 39.0% 78.3% 58.7%

Combined 158 155 3 144 69.4% 46% 62.5%

DBD 89 82 83.8% 96.1% 92.2% 90.2% 67.3%

DCD 69 62 89.6% 45.0% 87.7% 71.3%

Combined 49 65 -16 48 62.1% 52% 58.3%

DBD 32 31 89.1% 100.0% 89.1% 95.1% 75.6%

DCD 17 17 86.6% 37.4% 80.7% 55.4%

Combined 91 105 -14 89 68.0% 46% 69.1%

DBD 51 49 90.7% 99.1% 86.0% 92.5% 77.5%

DCD 40 40 89.1% 53.4% 83.8% 61.5%

Combined 115 125 -10 110 63.1% 33% 77.8%

DBD 67 66 89.1% 100.0% 89.8% 92.5% 68.9%

DCD 48 44 89.2% 44.7% 85.9% 59.1%

Combined 21.8 1,413 1,440 -27 1,346 63.0% 44% 69.1%

DBD 12.8 829 855 -26 809 85.6% 97.4% 92.1% 93.2% 69.0%

DCD 9.0 584 585 -1 537 85.6% 42.8% 80.5% 58.5%* Rounded to the nearest integerConsent / Authorisation for eyes is the last reported quarterly figure.

March 2017

2016/17 YTD

Deceased Donor Pathway

Competent SNODs on

the rota

Targets

Eastern

London

Midlands

North West

Northern

Yorkshire

National

Northern Ireland

Scotland

South Central

South East

South Wales

South West

odt performance report - microsoft...• the dcd referral rate increased by 2.5pp to 86% (q1=85%,...

Documents