NHS Eastern Cheshire CCG Deepdive presentation GBAF17

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Deep Dive GBAF17 Risk:

Elective, Diagnostic and Outpatient Access to Services

Sally RogersExecutive Nurse and Quality Director (interim) 27 July 2016

Current Performance vs National requirementRecent reports indicate that, under the NHS Constitution, the CCG is unable to meet its statutory duty to provide patients with timely access to treatment in some specialities across its providers:18 weeks RTT 91.5% vs. 92% patients seen within 18 weeks including ENT, gastroenterology, trauma & orthopaedics, vascular surgery, urology, gynaecology, plastic surgery which commonly are the areas where cancellations occur when hospitals are under pressure Cancer Waits 2 weeks waits achieving at 99% vs. 93% 62 day waits fluctuates 76.5% vs. 85% and 62 day screening 66.7% vs 90%A & E 4 Hour Wait Not achieving 83.57% vs. 95% patients being seen. Similar situation with all other local acute providersDiagnostics achievingNHSE Cheshire & Merseyside Provider Performance May 2016

Summary of key actions takenAny Qualified Provider (AQP) process in order to secure more capacityAdditional patient capacity was secured for; Ophthalmology, Elective Surgery and GastroenterologyThe CCG undertook a redesign of access criteria to direct patients to appropriate services to support access and improve safetyRisk first reported November 2015Risk reduced in March 2016 following AQP process

Request that the risk level be raised due to continued high numbers of referrals still going to East Cheshire NHS Trust where capacity exists elsewhere

Summary of new actions to be takenWork with and support Primary Care to increase the number of e-Referrals

Work with Primary Care to support patients to use the e-Referral system (eRs) and make informed choices

Work with ECT to increase the number of existing specialities to be included on the eRs

Undertake a review of the CCG Commissioning Policy Criteria 2014/15

Work with both ECT and private providers to facilitate additional activity

Revisit the Kings Fund 2010 referral management recommendations

Recommendation regarding level of riskApprove the increased re-grading of the risk in to a Risk Score of at least 16 (Likelihood 4 x Impact 4) as a consequence of the CCG being unable to meet its statutory duty to provide patients with timely access to treatment under the NHS Constitution

Endorse the actions suggested in order to support the reduction of the risk level in the near future