The current Trust financial position is showing a surplus of £133k as at February ‘12. This now projects a year end surplus of £145k and continues to marginally exceed the breakeven position required by HSCB. This reflects the improving financial management of the budgets and the availability of nonrecurring funds.
The Trust will continue to focus on delivering recurrent savings plans so as to establish a recurrent breakeven position for 2012/13. The Trust will do this through: identifying contingencies for any
Savings slippage, having set Internal Control Totals for each directorate, monthly financial accountability meetings with Directorates and monthly monitoring of the Modernisation and Recovery Plan.
Patients Safety. Throughout 2011/12 NHSCT will continue to progress towards the full implementation of approved quality improvement plans and the achievement of Trust-specific targets for ventilator associated pneumonia, surgical site infection, central line infection, the crash calls rate and mental health inpatient care. A summary of progress is presented in section 3.0, including summarised narratives.
The HCAI Performance Report demonstrates the Trust's performance against regional targets and our performance in other areas related to the reduction of health associated infections; these are hand hygiene compliance, environmental cleanliness scores, anti-microbial prescribing and High Impact Interventions. This information is presented in Section 3.1
Complaints received for February 2012 totalled 58, with 43 (74%) being responded to within 20 working days. The target for 2010/11 was 72% within 20 working days and the Trust achieved 64%.
Patients waiting in A&E over 12hrs for treatment must be reported as Serious Adverse Incidents under DHSSPS guidance. There were 260 cases reported to DHSSPS for March 2012. 20 of these cases were related to Ambulance breaches which were attributed to the Trust.
March 2012 absence position is 5.32%, which is slightly above the target of 5.0% for 11/12. The cumulative position for 10/11 was 5.19%.
Access Targets/Waiting Times
With significant financial pressure and requirement for savings it has been necessary to impose financial restrictions within the Trust. This has impacted on waiting times targets. The HSCB has now identified additional funding to achieve backstops by March 12. The Trust will use additional Inhouse and Independent Sector activity to achieve these.
Elective In-patients and daycases – As at the 31st March there were 1,138 NHSCT patients waiting over 13 weeks. There were no patients were breaching the agreed backstop positions at the end of March 2012. 83% of patients were waiting within 13 weeks. (Information validated weekly by operational staff). New backstops applied as per HSCB letter, 22nd December.
Out-patients - As at the 31st March there were 4,115 NHSCT patients waiting over 9 weeks. An additional 204 patients were waiting over 9 weeks for ICATS specialties. There were no patients breaching the agreed backstop positions at the end of March 2012. (Information validated weekly by operational staff) New backstops applied as per HSCB letter, 22nd December.
Diagnostics – As at 31st March there were 233 Cardiology patients and 1 Respiratory Physiology patient waiting over 9 weeks.
AHPs - As at 31st March there were 11 Speech & Language breaches. All had appointment dates in April - 2 on 3rd April, 1 on 6th and 8 on 19th April. The longest wait for these at 31st March was 80 days (11.43 wks) and the longest wait at 19th April was 98 days (14 wks).
Mental Health waiting list – As at 31st March, there were 110 (CAMHS) patients in breach of the 9 week target. Psychological Therapies continues to be monitored against the 13 week target and there were no patients in breach of this target.
From April ‘11 at least 60% of existing patients to have dialysis via a fistula and at least 50% of new patients to have dialysis via a fistula. Cooperation is ongoing with the Belfast and Western Trust regarding additional sessions. This will however be effected by Patient suitability. This is a shared target.
98% Patients diagnosed with Cancer should commence treatment within 31 days of decision to treat. In addition to this target, 95% of patients urgently referred with suspected cancer should begin first definitive treatment within 62 days. Latest information up to the 18th April 2012 shows that 100% has been achieved for the 31 day target in March and 72% has been achieved for the 62 day target. (This position can change as patient records become updated).
Suspected Breast Cancer patients referred urgently should be seen within 14 days of referral. Monthly reports are provided in Table 11 (Access / Waiting Time Targets Section) with March 2012 having 97% seen within 14 days, with no one waiting over 16 days. This target was consistently achieved throughout 09/10 and 10/11.
Accident & Emergency
All patients should be seen within 12 hours. During March the Trust had 260 patients in excess of this target. 20 of these breaches were requests to the NI Ambulance Service (NIAS) outside of a 4 hour request target. Within the overall Trust A&E sites there were 72.2% of patients who had been seen and discharged within 4 hours for March. The target is 95% at each individual site. Both Antrim and Causeway sites continue to fall below the target. An Unscheduled Care Programme Board has been setup including an Improvement group to identify and implement actions for A&E. Responsibility for 12-hour breaches for patients who require ambulance transport from the
Emergency Department is as follows:
- Where a patient requiring NIAS transport from the Emergency Department waits longer than 12 hours, the breach will be attributed to NIAS if the transport was requested within four hours of the patient presenting to the Emergency Department.
- If however the request for ambulance transport is made after four hours of the patient presenting at the Emergency Department, the breach will be attributed to the relevant Trust.
Community Care Services
90% of complex cases are to be discharged from hospital with a suitable care package within 48 hours of being determined medically fit. The Trust has achieved 86.7% for March. For non-complex cases the target remains 100% within 6 hours. The Trust has achieved 95.9%. All other discharges should be achieved within seven days. The Trust had 28 patients which waited over seven days during March (Antrim 24 patients, longest wait was 37 days, Causeway 2 patients, longest wait 13 days, Mid Ulster 1 patient, longest wait 37 days and Whiteabbey 1 patient, longest wait 7 days).
Older people with continuing care needs should wait no longer than eight weeks for assessment to be completed and have the main components of their care needs met within a further 12 weeks. At the 31st March the Trust achieved 100% of clients being assessed within 8 weeks and 97% having had their main care components met within 12 weeks.