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Q2 2015/16 CCG Quarterly Report Hayley Wardle Director of Quality & Patient Care Ashgate Hospice 29/10/2015 2 ASHGATE HOSPICE Key Messages by Project - Summary Q2 2015 – 2016 This summary report highlights the key messages from the data we have provided. It highlights trends and demonstrates how we are doing against targets set by the CCG. • 23 Acute admissions avoided, over KPI target (29 YTD) Add beds • Average patient wait is 0.69 days for Q1 15/16 H@H • 175 acute admissions avoided YTD (Q1 & Q2) against a full year target figure of 202 • All other KPI's achieved • SPCC Referrals starting to rise in Quarter 2 3rd Cons • Data sharing between Ashgate & CRHFT to started in Q2 • IPU continues to meet all targets set in the SLA SLA - IPU • Patient Survey for Q1 15/16 ; 100% positive feedback • Average attendances have been increasing in 2015/16 SLA - DH • Occupancy rate consistently around 77 - 80% in Q2 15/16 SLA -CNS • Q2 Referrals remain consistent for both community and hospital teams Ashgate Hospice | North Derbyshire Clinical Commissioning Group Quarterly Report 2015/16 3 Additional Inpatient Unit beds 2015-16 9 Key Performance Indicators Ref Description Threshold Q1 DATA Q2 DATA AD1 Waiting time from referral to admission Patients admitted within 2 working days >=80% (increasing by 5% annually to upper threshold of 90%) 0.68 Days (Average) 0.69 Days (Average) AD2 Admission numbers No of admissions Actual numbers 120 Admissions 110 Admissions AD3 Bed occupancy levels % based on bed days utilised against bed days available >=80% 89% 89% AD4 Length of stay Average number of days for all patient types Actual numbers 14.8 Days (Average) 15.0 Days (Average) AD5 Acute admission avoidance Current Vs 3 yearly average at 17 beds N=85 (based on 4 beds) 33 in Q1 23 in Q2 As recorded on admission to hospice 80% (from admissions and deaths in same financial year) 85% (Annual data) 85% (Annual data) AD7 Patient / carer experience No of surveys with a satisfactory score using QH tool >=80% increasing year on year to upper threshold of 90% 100% 100% AD8 No of patients with a diagnosis other than cancer Split by disease group, renal, neurology, respiratory, cardiovascular, other 12 12 No of patients with a cancer diagnosis Split by disease group, renal, neurology, respiratory, cardiovascular, other 108 98 AD6 AD9 Measure Death in preferred place of care / outside an acute environment IPU Diagnosis Split Q2.xlsx Ashgate Hospice | North Derbyshire Clinical Commissioning Group Quarterly Report 2015/16 4 Additional Data – Historic Requirement Ref Measure Description Threshold Q1 DATA Q2 DATA SLA (C) Activity split by CCG Admissions split by locality Standard ND = 94 HH = 26 ND = 80 HH = 28 SLA (F) Discharge destination breakdown Split by discharge locations Standard Home = 42 Hospital = 3 Nursing home = 0 Home = 44 Hospital = 2 Nursing home = 4 SLA (G) Deaths within hospice Number of deaths Standard 71 Deaths 65 Deaths Ashgate Hospice | North Derbyshire Clinical Commissioning Group Quarterly Report 2015/16 5 Hospice At Home Report 2015-16 10 Key Performance Indicators Ref Measure Description Threshold Q1 DATA Q2 DATA H1* Number of patient’s supported by H@H service Activity Numbers split by CCG and by practice 2013/14 baseline of 360 referrals ND = 80 HH = 18 ND = 102 HH = 22 H2 Number of referrals avoiding hospital admissions Admission avoidance - 202 75 Achieved in Q1 15/16 100 Achieved in Q2 15/16 H4 Reason for referral Numbers CR = 36 EE = 47 SNC = 62 CR = 51 EE = 61 SNC = 73 CNS = 66 OHT = 11 Cons = 10 GP = 5 Other = 5 100% based on internal surveying, QH survey to come in 2015/16 CNS = 91 OHT = 26 Cons = 4 GP = 3 Other = 2 100% based on internal surveying, QH survey to come in 2015/16 H5 Referral source Split by carer respite, supportive nursing care and emergency equipment Split by:- Carer respite (CR), emergency equipment (EE), supportive nursing care (SNC) Split by:- CNS & other hospice teams (OHT), consultant, GP, DN, Community Matron Numbers Patient / Carer experience No of surveys with a satisfactory score using Quality Health tool >80% increasing year on year by 5% to upper threshold of 90% H7 Response times Response times split by urgent and emergency Emergency within 4 hours, urgent within 1 working day 2= Emergency 45 = Urgent 1= Emergency 60 = Urgent H8 Time from referral to response time For standard referrals with the parameter being 2 working days >85% increasing to 90% by 2016 0.93 (Average) 1.12 (Average) 10 10 88 114 H6 H9 H10 Patients with a primary diagnosis other than cancer Patients with primary diagnosis of cancer Non cancer split by body site Cancer split by body site H@H Diagnosis Split Q2.xlsx Ashgate Hospice | North Derbyshire Clinical Commissioning Group Quarterly Report 2015/16 6 H1* - Activity Numbers split by CCG and by practice:- Referrals by GP Practice - Q2 2015-16.xlsx Historical Data Report 2015/16 Additional Day Hospice & CNS data Ref Measure Description Thres hold Q1 DATA Q2 DATA SLA (H) Day Hospice Referrals Number of referrals Standard 57 Referrals 65 Referrals SLA (I) Day Hospice Attendances Number of attendances including average per session Standard 652 Attendances 678 Attendances SLA (J) Day Hospice Non attendances Number of DNA’s including % rate Standard 75 DNA’s, Av 10% rate 61 DNA’s, Av 8% rate SLA (K) Day Hospice Attendee’s from IPU Number of attendances via IPU patients Standard 14 17 CNS – Referrals Referrals from both community and hospital teams Standard Com = 334 Hosp = 266 Com = 365 Hosp = 300 SLA (L) Ashgate Hospice | North Derbyshire Clinical Commissioning Group Quarterly Report 2015/16 7 Specialist Palliative Care Consultant 2015-16 10 Key Outcome measures Ref SP1 SP2 Measure No of patients with a primary diagnosis other than cancer No of patients with primary diagnosis of cancer Description Threshold Non cancer diagnosis’s split by disease group Split into MDS groupings Cancer diagnosis’s split by disease group SP3 Location where patients are seen Split by Outpatients, Domiciliary visit, Hospital consultant led service SP4 Urgent referrals Split into MDS groupings Q1 DATA SPCC Diagnosis Split - Q1.xlsx Q2 DATA SPCC Diagnosis Split - Q2.xlsx Actual DV’s = 20 referrals Outpatient = 13 referrals DV’s = 25 referrals Outpatient = 19 referrals Offered slot within 2 working days >=80% 100% 100% SP5 Non urgent referrals Offered appointment to be seen within 2 weeks >=80% 100% 100% SP6 Reduction of number of avoidable admissions per year Where admission to an acute setting would have occurred without access to this service N=92 33 Admissions avoided 44 Admissions avoided Referral source Referral to Consultant from, GP / primary care, Other hospital, Consultant Numbers split by outpatients, domiciliary, other GP = 4 CNS = 19 Cons = 9 Oth = 1 GP = 4 CNS = 29 Cons = 9 Oth = 2 SP7 Ashgate Hospice | North Derbyshire Clinical Commissioning Group Quarterly Report 2015/16 8 SP8 SP9 SP10 Educational support for professionals Patient / Carer experience measures Proportion of patients achieving death outside an acute setting Structured educational sessions to be offered to primary care, community, care homes and acute hospital colleagues Minimum of 10 structured educational sessions offered a year and numbers attending 3 educational sessions (CPD events) 6 educational sessions (CPD events) No of surveys with a satisfactory score using the Quality Health tool >=80% increasing year on year by 5% (to upper threshold of 90%) FamCare now started Results of FamCare expected within Q3 2015/16 Numerator: number of patients who have been referred as OP or DV in the financial year who die outside acute care Denominator: number of patients who have been referred as OP or DV who die in the financial year >=80% increasing year on year by 5% (to upper threshold of 90%) 85% (annual stat completed in Q2 15/16) 85% (annual stat completed in Q2 15/16) Ashgate Hospice | North Derbyshire Clinical Commissioning Group Quarterly Report 2015/16