Trust Board papers November 2012 - Barking Havering and ...

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2. CLINICAL INCOME Key points: • In line with guidance from the SHA, the Trust and Commissioners’ have agreed a monthly profile plan based on Commissioners’ QIPP schemes; as such the Budget has been re-profiled to reflect this change. • Income for Month 6 has been forecast using first cut activity for the Month. Activity for A&E, OP and IP were all taken at day 31. This has ensured that activity is more accurate and gives greater assurance around Income for the current month. • There was an under- performance of £1.8m in the month, with a year to date over-performance of £4m, on an ‘activity times price’ basis. Final Month 5 actual income came in at £30.9m, £1.2m more than was accrued, and as such, the YTD position reflects the actual activity for Months 1 – 5 and the current month forecast. Business Unit Performance In Month Year to date Forecast Actual Var Actual Var Actual Var (7,223) 919 Acute Medicine (44,732) 3,240 (89,557) 7,894 (1,950) 223 Anaethetics (11,101) (47) (22,180) (197) (1,781) (127) Children (11,430) (736) (22,709) (1,347) (2,318) 192 Emergency Care (14,437) (219) (28,853) 331 (2,257) (56) Neurosciences (13,991) (461) (28,034) (817) (784) 42 Pathology (4,912) 25 (9,945) 27 (1,062) 61 Radiology (6,191) 493 (12,484) 1,088 (2,734) 538 Specialist Medicine (16,017) 1,825 (32,324) 3,758 (3,546) 457 Specialist Surgery (21,402) 1,248 (43,127) 2,569 (3,484) 222 Surgery (21,756) 293 (43,835) 965 (4,393) 494 Women (26,601) 1,107 (53,424) 2,693 547 (1,129) Corp (1,168) (2,695) (2,042) (10,108) (30,984) 1,837 Total (193,737) 4,074 (388,514) 6,855 • The forecast reflects an £8.7m FOT over- performance on the ONEL contract, with an FOT under-performance of £1.8m on other ‘non- ONEL’ contracts. The over-performance for the ONEL contract is now being renegotiated as the likely outturn has increased by c.£2m due to increased activity. The £8.7m is net of £4.3m shortfall on transitional funding (i.e. £13m gross over-performance) • The Trust is currently negotiating for additional income with ONEL for Best Practice Tariff, Breast Screening and Commissioners’ failure to move births to other providers. Discussions with the cluster are still on-going. • On the East of England Contract, there has been a reduction in the Non Elective Activity partially offset by an increase in the use of Devices; the net effect is an FOT under performance of £1.5m. • A&E activity has grown by 7% year on year, but this is primarily due to the full-year effect of the Queen’s UCC, which was taken on by BHRUT in August 2012. • There is a growth of 4% in Day cases year on year as a result of the achievement of the 18 weeks targets, coupled with the Trust undertaking work that went to the ISTC last year. • Non Elective admissions activity has declined by 3% year on year. 6
Income by POD In Month Year to date Forecast Actual Var Actual Var Actual Var (1,708) 199 AandE (10,595) (9) (21,173) 628 (64) (3) Ambulatory Care (451) 6 (912) 10 (216) 50 Breast Screening (1,026) (77) (2,077) (165) (217) 0 Challenge Trust Board (1,300) 0 (2,600) 0 (378) 0 CQUIN (2,268) 0 (4,536) 0 (2,419) 295 Critical Care (13,598) 191 (26,971) 117 (2,617) 234 Daycases (16,480) 749 (33,366) 1,380 (945) (11) Devices & Drugs (5,876) 545 (11,880) 1,249 (1,292) 170 Direct Access (7,859) 448 (15,913) 865 (1,798) 36 Elective (11,690) 147 (23,667) 198 (355) 0 HIV Contract (2,132) 0 (4,264) 0 (33) (12) ISTC Contract (211) (59) (412) (128) (10,931) 767 Non Elective (67,412) 707 (134,441) 3,984 (2,720) 494 OP First Attendances (16,353) 1,557 (33,109) 3,103 (2,875) 528 OP Follow Ups (17,555) 1,989 (35,543) 3,967 (513) 118 OP Procedures (3,040) 428 (6,154) 844 (480) (993) Other (6,972) (1,867) (14,041) (3,637) Patient Transport (308) 27 Services (1,762) 78 (3,523) 157 (342) 53 Radiotherapy (2,060) 158 (4,109) 249 496 0 Readmissions 2,976 0 5,953 0 (519) 97 Regular Day Attenders (2,911) 135 (5,806) 173 (92) (147) Road Traffic Accidents (1,168) (264) (2,000) (864) 0 0 Transitional Funding 0 0 0 (4,300) (659) (65) XBD (3,993) (790) (7,969) (976) (30,984) 1,837 Total (193,737) 4,074 (388,514) 6,855 Note: Other includes the 65% marginal rate adjustment in respect of ONEL performance (£7.1m) Activity POD Group 2011-12 2012-13 Var % Change AandE 95,652 110,117 14,465 7% Ambulatory Care 1,458 1,527 69 2% Breast Screening 10,482 10,360 (122) -1% Critical Care 13,383 13,857 474 2% Daycases 20,254 22,110 1,856 4% Direct Access 2,447,662 2,401,471 (46,191) -1% Elective 3,827 3,848 21 0% Non Elective 39,972 37,897 (2,075) -3% OP First Attendan 85,277 89,951 4,674 3% OP Follow Ups 201,644 200,710 (934) 0% OP Procedures 16,201 18,147 1,946 6% Other 41,071 43,931 2,860 3% Radiotherapy 8,931 10,806 1,875 9% Regular Day Atten 6,912 7,221 309 2% XBD 20,319 15,084 (5,235) -15% Total 3,013,045 2,987,037 (26,008) 7
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TRUST BOARD MEETING Wednesday, 7 No
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2 Following Mr White’s concerns r
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4 forecast in terms of community be
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6 The Trust Board noted the Plan fo
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8 The Co-Chair of the Improving Pat
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TRUST BOARD MEETING Actions from Mi
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Agenda Item Action Deadline Date Da
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Question: Mr Skillman was pleased t
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CQC Trust-wide Action Plan Review a
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1.0 PURPOSE 1.1 Background This rep
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• Review the Senior Responsible O
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APPENDIX 1 ‐ CQC ACTION PLAN - EX
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RECORDS records management to ensur
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CQC Update Report 2012 Theme CQC Re
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CQC Update Report 2012 ASSESSING &
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CQC Update Report 2012 ASSESSING &
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CQC Update Report 2012 pathways thr
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CQC Update Report 2012 identified i
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CQC Update Report 2012 outlining th
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CQC Update Report 2012 improvements
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CQC Update Report 2012 aware of the
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CQC Update Report 2012 are now supe
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CQC Update Report 2012 autumn. RECO
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CQC Update Report 2012 of the pilot
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EXECUTIVE SUMMARY TITLE: Informatio
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INFORMATION GOVERNANCE STRATEGY 201
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Information is a vital asset in ter
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starters as well as being mandatory
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The standards are split into the ar
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10a Reapproval of IG training progr
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343 Directorate Anaesthetic: Risk:
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Table of Contents TRUST PRINCIPAL O
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BHRUT STRATEGIC OBJECTIVES WITH EAC
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DIRECTORATES RISKS REVIEW 12 10 8 6
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RISKS DETAILS PRINCIPAL RISK What c
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PRINCIPAL RISK What could prevent t
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RISK DESCRIPTORS OBJECTIVE SAFE, HI
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BOARD ASSURANCE FRAMEWORK ELEMENTS
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EXECUTIVE SUMMARY TITLE: Risk Manag
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Contents Section Page 1 Introductio
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incorporate mitigation controls wit
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“Risk Register” “Risk Registe
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potential risks they may face in ac
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4.1.1 Quality and Safety Committee
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• Financial risks: risks associat
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Proactive risk assessment enables t
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Trust’s risk matrix and will popu
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Risk Grading Staff Group Evidence R
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4.8 RISK REGISTER The Risk Register
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5.1 Consultation and Communication
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The Trust recognises the importance
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timescale with supporting evidence
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Checklist for the Review and Approv
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Equality Impact Assessment Tool To
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Plan for Dissemination of Procedura
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Consequence score (severity levels)
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Frequency How often might it/does i
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Appendix 3 Framework for Risk Manag
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Risk Register inventory they are ex
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2. DECISION REQUIRED: CATEGORY: The
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• A review of data capture to ens
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Pilot Wards Division Discharges Per
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Workforce Appraisals - the actions
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Delayed transfers of care (DTOC) -
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EXECUTIVE SUMMARY TITLE: Emergency
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• Training competencies are being
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Appendix A: Trajectory for all type
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would welcome feedback from the Tru
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Maternity Services Monthly Performa
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4. Capping The maternity service is
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7. Obstetric Assessment Unit (OAU)
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10. Serious Incidents Reported Inci
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12. Maternity Dashboard The dashboa
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It should also be noted that the ta
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Priority Action Lead Monitoring Too
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Priority Action Lead Monitoring Too
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Contents Section No: Description Pa
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3. Complaints Activity 3.1 Total Co
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3.5 Themes General care issues and
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Corporate Non Clinical Category Num
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order to resolve concerns. Particul
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The findings of the review were tha
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SELF-CERTIFICATION RETURNS Organisa
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12 AA - Quality Improvement Strateg
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TFA Progress BHR University Hospita
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25 TFA - Final IBP /; LTFM Dec-12 H
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Effectiveness GOVERNANCE RISK RATIN
Page 179 and 180: Safety 4b MRSA Enter Are you below
Page 181 and 182: FINANCIAL RISK RATING BHR Universit
Page 183 and 184: CONTRACTUAL DATA BHR University Hos
Page 185 and 186: 4 Single Sex Accommodation Breaches
Page 187 and 188: TITLE: EXECUTIVE SUMMARY BOARD/GROU
Page 189 and 190: causes/ Not specified' will be remo
Page 191 and 192: Staff In Post Starters & Leavers FT
Page 193 and 194: TURNOVER Actual Versus Target Annua
Page 195 and 196: FTE Lost due to Sickness Absence by
Page 197 and 198: The data on the previous page has b
Page 199 and 200: Indicator Target Apr-12 May-12 Jun-
Page 201 and 202: Starters *¹ 7.00 3.60 5.00 7.43 6.
Page 203 and 204: EXECUTIVE SUMMARY TITLE: COST IMPRO
Page 205 and 206: Month 6 CIP Performance Workstream
Page 207 and 208: Governance The Cost Improvement Pro
Page 209 and 210: 1 REPORT TO: REPORT FROM: Trust Boa
Page 211 and 212: 3 Preparations for winter planning
Page 213 and 214: 5 Preparing the Payment by Results
Page 215 and 216: 7 People with dementia to receive m
Page 217 and 218: 9 Clinical Patient Management and H
Page 219 and 220: 102/2012 Apologies Apologies were r
Page 221 and 222: Action Members were advised that ac
Page 223 and 224: Action 115/2012 Any Other Business
Page 225 and 226: EXECUTIVE SUMMARY TITLE: Finance Re
Page 227 and 228: 1. EXECUTIVE SUMMARY Monthly I&E Ru
Page 229: Trust I&E summary by Division/Direc
Page 233 and 234: Devolved income Annual Budget Forec
Page 237 and 238: 4. BALANCE SHEET Balance Sheet Curr
Page 239: 6. Business Unit Summaries Attached
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