Agenda and supporting papers - Plymouth Hospitals NHS Trust
Agenda and supporting papers - Plymouth Hospitals NHS Trust
Agenda and supporting papers - Plymouth Hospitals NHS Trust
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Item 9<br />
Diagnostics & surveillance (Section C6 of Performance Dashboard)<br />
3.5 Diagnostic wait performance has deteriorated in May with 2.8% of the total waiting list<br />
(173 patients) waiting longer than 6 weeks for a diagnostic test at the end of May.<br />
Of the 173 breach patients, the majority (79) were waiting for an Echocardiogram. A<br />
number of options are being considered to address the capacity issues identified by a<br />
review of this modality. These options include employing external cardiology<br />
technicians to carry out tests using our facilities although this additional support would<br />
not be available until August. In the meantime, the department are putting on<br />
additional lists to provide extra capacity.<br />
31 patients were waiting for an Endoscopy due to a complex mix of issues ranging<br />
from patient choice to staff availability for specialist paediatric <strong>and</strong> general<br />
anaesthetic cases.<br />
52 patients were waiting for Imaging - 12 MRI scans <strong>and</strong> 14 CT scans were delayed<br />
due to staff availability for specialist cases <strong>and</strong> breakdown of the Alliance scanner<br />
whilst 26 ultrasound delays were due to unusual levels of staff unavailability.<br />
A more detailed report on diagnostic delays is being developed with the service line<br />
<strong>and</strong> will be made available to the Board when complete.<br />
4 Finance & Efficiency –<br />
4.1 A separate report on the <strong>Trust</strong>’s financial position is being presented to the <strong>Trust</strong><br />
Board by the Director of Finance.<br />
4.2 This section of the report will provide the Board with an update on key contract issues<br />
including activity variances as well as full details on contract penalties <strong>and</strong> CQUIN<br />
achievement.<br />
4.3 Contract Position<br />
4.4 If the <strong>Trust</strong> was on a fully variable contract it would, at Month 2 owe commissioners<br />
£1.4m. Key issues to highlight from this high level analysis are the continuing<br />
significant underperformance on elective care, <strong>and</strong> the level of contractual penalties<br />
incurred.<br />
4.5 Elective activity is underperforming at Month 2 by 126 spells (1.2%) under plan <strong>and</strong><br />
£1m under on income. This income underperformance is significant being 8% below<br />
plan. Key specialties with underperformance are cardiac surgery (£189k) where they<br />
are still suffering cancellations. In April, 43 theatre slots were lost, <strong>and</strong> in May 25 slots<br />
were lost. ITU capacity was a key issue, but staffing levels have now been addressed<br />
so performance should improve back to contract level in future. However, if the lost<br />
capacity from the first few months is not recovered through future over-performance<br />
the <strong>Trust</strong> will continue to under-perform for the year. In Neurosurgery the activity is<br />
only slightly under plan but the income variance is £275k under plan due to case mix.<br />
Neurosurgery has capacity gaps that are being addressed through extended days<br />
<strong>and</strong> more formalised weekend working. Plastic Surgery is continuing to underperform<br />
(£221k) with reduced theatre capacity <strong>and</strong> under-utilisation of the plastics trauma<br />
theatre. Waiting lists are beginning to rise slightly. Further work is being done to<br />
underst<strong>and</strong> the picture more fully.<br />
7