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FINANCE, CONTRACTING, QIPP & PERFORMANCE REPORT - JANUARY 2018.

FINANCE , CONTRACTING & QIPP

Finance

The key points regarding the full year forecast financial position of each CCG based on the

information available on current year activity are:

Airedale, Wharfedale & Craven CCG

i) On the basis that any further financial risk can be appropriately managed, the

CCG is forecasting to meet its financial targets for 2017/18.

ii) The full year forecast overspend has decreased by £255k to £6,368k mainly due

to the confirmation of premises cost charges for void space and the re-

assessment of non-pay administration commitments. Forecast prescribing spend

has also reduced again.

Whilst there has been on overall reduction in the budget overspend, acute

contract spend has increased by a further £353k related to non-contracted

activity.

iii) The forecast overspend is funded by using all uncommitted reserves and there is

a reduced residual financial risk of £683k (last month £939k) that needs to be

managed to ensure delivery of 2017/18 financial targets.

iv) Identification of £3.3m of additional savings to address the underlying recurrent

deficit position that will be taken into 2018/19 remains a priority for the Airedale

Accountable Care Board and Clinical Executive.

v) A significant part of the reserves used to support the financial position in 2017/18

are non-recurrent and as a result, we are currently forecasting that we will take

an underlying deficit of £3.3m into 2018/19.

vi) All new expenditure commitments will continue to require prior approval by the

Clinical Executive.

Bradford Districts CCG

i) The CCG is forecasting to meet its financial targets for 2017/18. This is based on

forecast budget performance which includes a savings programme shortfall of

£5.5m (last month £4.9m).

ii) The forecast net budget overspend has decreased by £0.2m to £7.5m due to the

confirmation of premises cost void space charges and an underspend on the

Virtual Ward budget. These expenditure reductions have more than offset

increases in forecast continuing care and primary care spend.

iii) Potential in year financial risk has been assessed at £7.7m (last month, £7.9m),

with reserves of £9.3m (last month, £9.3m) available to manage this risk. This

leaves a margin of £1.6m for managing any further in year financial risk.

iv) The priority remains to address the savings scheme shortfall of £5.5m, both to

manage in year financial performance and to provide a strong financial base for

2018/19. Programme Boards will need to continue to identify additional savings

schemes and prioritise the implementation of current schemes.

v) New expenditure commitments will continue to require prior approval by the

Clinical Board.

Bradford City CCG

i) The CCG is forecasting to meet its financial targets for 2017/18. This is based on

forecast budget performance which includes an over-performance on the savings

programme of £0.04m (last month £0.4m).

ii) The forecast net budget overspend has decreased by £0.1m to £0.3m with small

increases in forecast continuing care and primary care spend being offset by

reductions in forecast acute and community contract spend. Reserves are still

forecast to fully spend to maintain the forecast break-even position.

iii) Potential in year financial risk has been assessed at £0.3m (last month, £0.4m),

with reserves of £3.3m (last month, £3.8m) available to manage this risk. This

leaves a margin of £3m for managing any further in year financial risk.

iv) Uncommitted reserves are being retained until the financial position on the

Bradford Hospital contract for 2017/18 has been finalised.

Contracting

i) Across acute contracts there is an overall full year forecast over-trade for

Airedale, Wharfedale & Craven CCG of £3.8m. The full year forecast has

increased from the £2.5m previously reported due to increased activity at

Airedale Hospital and the Yorkshire Clinic.

For Bradford Districts CCG, the acute contract position shows a full year forecast

overtrade of £1.6m, which is the same as previously reported. The main contract

overtrades are with Airedale Hospital and the Yorkshire Clinic.

For Bradford City CCG, the acute contract position shows a full year forecast

overtrade of £0.8m, which is £0.2m less than previously reported. The main

overtrades are with Bradford Hospitals and the Yorkshire Clinic.

ii) Following the issue of a Contract Performance notice to Bradford Teaching

Hospitals Foundation Trust on the 6th December 2017 and the subsequent

receipt of a ‘Reporting Action Plan’ from the Trust on the 16th February 2018, the

CCGs are now assured that the Trust will be able to meet the requirements of

the contract regarding quality performance monitoring, except for diagnostic

waiting times and CQUIN Sepsis recording. Plans are in place to address both of

these issues.

Contract activity data submissions (SUS and SLAM) remain an issue.

Submissions can be made by the Trust, but there are significant data quality

issues. The Trust has indicated that August 2018 is the earliest date by which full

activity reporting will resume. The Contract Management Board sub-groups will

continue to monitor the implementation of the activity reporting plan and will

update the Governing Body on progress.

In light of the data quality issues, forecast performance on the Bradford Hospitals

contract is based on the CCGs’ assessment of September activity data, which

has now been re-run to correct the allocation of specialised services activity to

the correct Commissioner. A full year contract position for 2017/18 is now being

finalised with the Trust.

iii) Significant contract activity queries being addressed with our two main acute

Providers include:

- Increased number of orthopaedic outpatient procedures at Airedale Hospital

which AWC CCG views as a coding and counting change and therefore not

chargeable in 2017/18. Discussions are continuing with the Trust on this as

part of agreeing a full year position for 2017/18; and

- A national activity coding issue relating to Sepsis interventions which is

leading to increased activity costs. Guidance on how to calculate the value of

the impact to be neutralised has been issued by NHS Improvement and the

CCGs are working with Bradford Hospitals and Airedale Hospital Trusts to

agree a position for 2017/18.

Following further analysis of activity trends, the previously reported issue

concerning Maternity Pathway activity and the increase in reported birth

complexities at Bradford Hospitals has now been resolved.

iv) Yorkshire Clinic activity continues to be significantly above plan for Airedale,

Wharfedale and Craven CCG due to shift in orthopaedic and general surgery

referrals from Airedale Hospital, and also due to the impact of the EPR

implementation at Bradford Hospitals. To help manage patient activity, the CCGs

have agreed with the Yorkshire Clinic to monitor adherence to agreed clinical

referral pathways and have put in place a clinical working group to address the

levels of follow-up outpatient activity across all specialities.

v) Contract negotiations are well underway with all Providers for 2018/19. At this

stage, we have not highlighted a need to use the national mediation process and

expect all contracts and/or contract variations to be signed by the 23rd March

2018.

CCG PERFORMANCE

Dashboards are included for each CCG (Appendix G) which show performance against the key operational plan performance indicators. Issues to draw to the attention of the Governing Body relate to NHS Constitution targets and these are described below.

a) A&E Waiting times.

- Both Airedale Hospital and Bradford Hospitals failed to achieve the 4 hour target in January, achieving 90.9% and 83% respectively (target, 95%). A number of measures have been put in place to help manage non-elective activity which include: - weekly surge and escalation calls; - Implementation of the 9 point urgent and emergency care plan (monitored by

the A&E Delivery Board); and - progressing the transformation work of the urgent care programme.

- An escalation meeting with NHS England has taken place to discuss BTHFT’s current challenges and actions being taken to address under performance. Following this meeting a further number of actions have been agreed that should translate into better headline performance.

b) Referral to Treatment (RTT) Waiting Times. - Airedale - AHFT continue to deliver the RTT target overall (92.1% in January),

but pressures remain in General Surgery and Trauma & Orthopaedics where options for securing additional capacity are being explored for 2018/19.

- Bradford - Reporting issues continue following the implementation of the new EPR system and therefore the latest CCG scorecard position is not a true reflection of performance. The Trust has made a formal 18 week RTT return for January which shows performance at 79.26% (a deterioration since September). Also, there has been a significant increase in the size of the waiting list for patients waiting both under and over 18 weeks. The Trust is continuing to validate 18 week waiters and reviews the position of patients who have waited over 39 weeks on a weekly basis.

c) Cancer 62 Day Standard. - Airedale Hospital – achieved the 62 day target in December.

- Bradford Hospitals – Has now re-commenced national cancer performance

submissions. The return submitted for December 2017 shows the Trust reporting failures against the 2 week wait (69.8%) and 62 day first treatment (78.3%) targets. For the 2 week wait target, the sites of concern continue to be Skin (8.3%), Lower GI (81%) and Gynaecology (80.2%).

We are continuing to work with the Trust on an action plan to address performance in this area.

d) Diagnostic Waiting Times.

- Airedale - AFT did not achieve the target in January due to the previously

reported demand and service pressures in Ultrasound. Additional evening and weekend sessions are being run to meet the demand pressures.

- Bradford - BTHFT did not achieve the target in January with most of the

breaches relating to Non-Obstetric Ultrasound for a specialised Rheumatology led test.

Reported waiting times performance continues to exclude endoscopy and neurophysiology.

e) Mixed Sex Accommodation.

There was one breach in December for AWC CCG which was at Wrightington Hospital and early indication is that following the considerable operational pressures at AHFT, there were two breaches of the Mixed Sex Accommodation standard in January. This standard is exempt from contractual penalties during the winter period, as notified by NHS England and NHS Improvement.

f) Improving Access to psychological therapies (IAPT).

IAPT waiting times continue to be delivered across the three CCG areas and access continues to be near to the new 2017/18 target of 16.8% (although the contractual performance level is 15%). Recovery rates in Bradford City CCG (41%) and Bradford Districts CCG (47.7%) are below the target rate of 50%, but through work carried out by the Community Mental Health Team and the My Wellbeing College at Bradford District Care Trust to improve triage and assessment processes, local data is now indicating recovery rates above 50% for all CCGs.

g) Better Care Fund.

The national BCF data for Q2 has been published as part of the NHS-Social Care Interface Dashboard (see Appendix 3). Key points to note are:

At the time of initial publication, Bradford was ranked 2nd nationally for performance against the new BCF composite measure. This position has slipped to 5th at Q2;

Delayed discharges remain low with Bradford ranked 9th out of 150 local authorities nationally (previously 7th);

Bradford is ranked 4th nationally and 1 of 16 compared with statistical neighbours for the new non-elective admissions - weekend discharges;

Bradford is also ranked 4th nationally and 1 of 16 compared with statistical neighbours for the non-elective admissions - length of stay;

However, emergency admissions continue to be a challenge across the district, with a ranking at Q2 of 99 out of 150 local authorities. The district wide Urgent Care Programme, overseen by the A&E Delivery Board, continues to work on system wide solutions including: A&E GP streaming and ambulatory care pathways. Work also continues across the CCGs on pathways and new models of care in the community setting, to see improved outcomes for patients and reduced non-elective demand on acute services. In addition, plans for extended weekday opening and training and development of the primary care workforce are in place.

SYSTEM PERFORMANCE

The Accountable Care Dashboards are presented as Appendix J. Issues to draw to the

attention of the Governing Body are:

There is still some work required to map all the KPIs across the accountable care

programmes;

Work is also underway to further develop the dashboards to reflect accountable care

communities;

As the current KPIs become sustainable, it is envisaged that they will evolve and

change to reflect KPIs which better reflect outcomes associated with new models of

care and accountable care systems.

RECOMMENDATIONS The Governing Body is asked to: Airedale, Wharfedale & Craven CCG

a) Note the year to date and full year forecast financial position as at Month 10;

b) Note that there is a residual financial risk of £683k that needs to be managed to

ensure achievement of 2017/18 financial targets;

c) Note the level of non-recurrent savings supporting the financial position in 2017/18

and the impact on the CCG’s underlying recurrent financial position;

d) Note the continued need to identify further savings of £3.3m to address the non-

recurrent savings used to support the 2017/18 financial position and to establish a

sound financial baseline for 2018/19;

e) Note the issues in relation to acute contract performance and the action being taken

to manage them;

f) Note the performance against waiting times targets and the action being taken to

improve performance where required; and

g) Note the good performance against the Better Care Fund metrics, whilst

acknowledging the work that is being done to manage non-elective activity.

Bradford Districts CCG


b) Note the assessment of financial risk and the actions being taken to manage this

risk;

c) Note that the CCG is now assured that Bradford Hospitals will now be able to meet

the contract requirements for quality performance monitoring, except for diagnostic

waiting times and CQUIN Sepsis recording issues (plans in place to resolve these

issues).

d) Note that contract activity data submissions for Bradford Hospitals are not expected

to be resolved in full until August 2018 and that progress with this will continue to be

overseen by the Contract Management Board;

e) Note the performance against waiting times targets and the action being taken to

improve performance; and

f) Note the good performance against the Better Care Fund metrics, whilst


Bradford City CCG


b) Note the continued retention of all uncommitted reserves to manage financial risk;

c) Note that the CCG is now assured that Bradford Hospitals will now be able to meet

the contract requirements for quality performance monitoring, except for diagnostic

waiting times and CQUIN Sepsis recording issues (plans in place to resolve these

issues).

d) Note that contract activity data submissions for Bradford Hospitals are not expected

to be resolved in full until August 2018 and that progress with this will continue to be

overseen by the Contract Management Board;

e) Note the performance against waiting times targets and the action being taken to

improve performance; and

f) Note the good performance against the Better Care Fund metrics, whilst


APPENDICES

Summarised Financial Performance:

Appendix A Airedale, Wharfedale & Craven CCG

Appendix B Bradford Districts CCG

Appendix C Bradford City CCG

Savings Scheme (QIPP) Dashboard

Appendix D Airedale, Wharfedale & Craven CCG

Appendix E Bradford Districts CCG

Appendix F Bradford City CCG

Performance Dashboard

Appendix G Airedale, Wharfedale & Craven CCG

Appendix H Bradford Districts CCG

Appendix I Bradford City CCG

Appendix J ACO Bradford draft system dashboard

Appendix A

Summary Financial Performance for the period to 31st January2018

Full Year

Forecast

AWC CCGAnnual

Budget

YTD

Budget

(Under) /

Over

(Under) /

Over

(Under) /

OverMvt

£'000 £'000 £'000 £'000 £'000 £'000

Acute Care 112,241 93,533 3,271 3,801 3,448 353

Urgent Care 7,457 6,213 -23 -6 -3 -3

Community Services 16,042 13,371 111 146 196 -50

Continuing Healthcare 9,192 7,620 693 1,113 963 4

Mental Health Services 18,072 15,059 24 76 97 -21

Prescribing 27,277 22,854 651 370 550 -180

Primary Medical Care 20,399 16,998 49 167 56 111

Other Primary Care 553 461 0 0 0 0

Non-Recurrent Programme 1,083 880 -10 -24 -24 0

Other Commissioning 6,366 5,095 447 -13 391 -152

QIPP Savings Balance -1,102 0 0 1,102 1,102 0

Residual Financial Risk to Manage 0 0 -450 -683 -939 402

Total Operating Costs 217,580 182,084 4,763 6,049 5,837 464

Contingency Reserves 1,145 1,145 -1,145 -1,145 -1,145 0

Non-Recurrent Reserve (1%) 1,266 857 0 -130 -130 0

Other Reserves 4,591 3,515 -3,499 -4,410 -4,409 -278

Total Reserves 7,002 5,517 -4,644 -5,685 -5,684 -278

Total Healthcare Expenditure 224,582 187,601 119 364 153 186

CCG Running Costs 3,415 2,848 -185 -364 -153 -186

Target In Year Surplus 1,857 1,548 -1,548 -1,857 -1,857 0

Total Expenditure 229,854 191,997 -1,614 -1,857 -1,857 0

Last Month Full Year

ForecastYear to Date

OPERATING WITHIN: IN YEAR ALLOCATION

RUNNING COST ALLOCATION

CASH LIMIT

ACHIEVING : PLANNED SURPLUS

QIPP 90.86%

UNDERLYING POSITIONRECURRENT SURPLUS -1.44%

Y

Y

Y

N

N

Y

Appendix B

Summary Financial Performance for the period to 31st January 2018

Full Year

Forecast

Bradford Districts CCGAnnual

Budget

YTD

Budget

(Under) /

Over

(Under) /

Over

(Under) /

OverMvt

£'000 £'000 £'000 £'000 £'000 £'000

Acute Care 230,819 192,420 615 1,612 1,630 -18

Urgent Care 17,294 14,342 -268 -280 -278 -2

Community Services 37,520 31,273 -266 -277 53 -330

Continuing Healthcare 25,041 20,727 1,388 814 596 218

Mental Health Services 45,595 37,996 261 256 264 -8

Prescribing 52,968 44,378 1,849 1,807 1,901 -94

Primary Medical Care 49,031 40,857 -775 -593 -723 130

Other Primary Care 1,168 971 0 0 0 0

Non-Recurrent Programme 1,022 806 6 13 3 10

Other Commissioning 16,236 13,223 207 -114 85 -199

QIPP Savings Balance -4,291 0 0 4,291 4,291 0

Residual Financial Risk to Manage 0 0 0 0 0 0

Total Operating Costs 472,403 396,993 3,017 7,529 7,822 -293

Contingency Reserves 2,490 943 -943 -639 -862 223

Non-Recurrent Reserve (1%) 4,041 3,367 -1,322 -1,586 -1,586 0

Other Reserves 6,449 1,735 -681 -5,248 -5,248 0

Total Reserves 12,980 6,045 -2,946 -7,473 -7,696 223

Total Healthcare Expenditure 485,383 403,038 71 56 126 -70

CCG Running Costs 6,586 5,487 -295 -56 -126 70

Target In Year Surplus 3 0 0 -3 -3 0

Total Expenditure 491,972 408,525 -224 -3 -3 0



FINANCIAL PERFORMANCE TARGETS - FULL YEAR FORECAST



CASH LIMIT

ACHIEVING: PLANNED SURPLUS

QIPP 58.73%

UNDERLYING POSITION RECURRENT SURPLUS 0.13%

Y

Y

N

Y

Y

Y

Appendix C

Summary Financial Performance for the period to 31st January 2018

Full Year

Forecast

Bradford City CCGAnnual

Budget

YTD

Budget

(Under) /

Over

(Under) /

Over

(Under) /

OverMvt

£'000 £'000 £'000 £'000 £'000 £'000

Acute Care 66,277 55,198 1,283 781 882 -101

Urgent Care 5,893 4,889 -92 -94 -97 3

Community Services 11,414 9,515 -56 -60 62 -122

Continuing Healthcare 7,623 6,308 420 252 184 68

Mental Health Services 13,413 11,183 169 150 139 11

Prescribing 18,675 15,647 22 -48 11 -59

Primary Medical Care 20,844 17,368 -661 -659 -759 100

Other Primary Care 425 358 0 0 0 0

Non-Recurrent Programme 1,233 596 -24 -23 -33 10

Other Commissioning 5,297 4,316 -489 -254 -182 -72

QIPP Savings Balance -230 0 0 230 230 0

Residual Financial Risk to Manage 0 0 0 0 0 0

Total Operating Costs 150,864 125,378 572 275 437 -162

Contingency Reserves 1,578 800 -800 0 0 0

Non-Recurrent Reserve (1%) 1,208 634 0 0 0 0

Other Reserves 1,444 53 1 -224 -370 146

Total Reserves 4,230 1,487 -799 -224 -370 146

Total Healthcare Expenditure 155,094 126,865 -227 51 67 -16

CCG Running Costs 2,404 2,003 -139 -51 -67 16

Target In Year Surplus 0 0 0 0 0 0

Total Expenditure 157,498 128,868 -366 0 0 0



FINANCIAL PERFORMANCE TARGETS - FULL YEAR FORECAST



CASH LIMIT

ACHIEVING: PLANNED SURPLUS

QIPP 101.22%

UNDERLYING POSITION RECURRENT SURPLUS 0.68%

Y

Y

Y

Y

Y

Y

Appendix D - Airedale Wharfedale & Craven CCG

Appendix E – Bradford Districts CCG

Bradford District CCG - QIPP Dashboard Financial Year 2017/1812 RAG Rating Key

Reporting Month -January 18 FOT savings achieve or exceed plan

QIPP Target £13,392 FOT savings but less than plan

QIPP Forecast Achievement £7,681 No savings achieved

QIPP shortfall -5,711 4

Previous Month -4,913

Improvement/decline -£798

Revised

plan value -

£000

Forecast

Achivement

full year -

£000

Full year

variance to

plan - £000

Year to date

Plan - £000

Previous

YTD Savings

In month

savings

Year to date

acheivement -

£000

YTD variance -

£000

Movement

on previous

month

Scheme Name/Programme Programme Board Scheme lead

Cash Releasing Schemes

Out of Hospital Out of Hospital Walter O'Neill 113 - 113- 66 - - - 66- -

Urgent care & Emergency Urgent Care Louise Atherton 578 246 332- 337 381 -265 116 221- 337-

Diabetes Kath Helliwell - - - - - - - -

Bradford Healthy Hearts Kath Helliwell 64 - 64- 37 - - - 37- -

Self care and Prevention Self Care Collette Connelly - - - - - - - - -

Planned Care Planned Care Ian Wallace 2,107 383 1,724- 868 212 -147 65 803- 452-

Planned Care - Tariff Impact on Follow Ups Planned Care Ian Wallace 1,126 2,983 1,857 500 1,393 407 1,801 1,301 190

Cancer Ian Wallace - - - - - - - - -

Bradford breathing better Kath Helliwell 337 - 337- 196 - - - 196- -

Primary Care (OOH) Out of Hospital Vicki Wallace 542 - 542- 127 - - - 127- -

Prescribing prescribing Tracey Gaston 3,974 3,179 795- 2,318 2,772 -46 2,726 408 199-

Children Ruth Hayward - - - - - - - - -

Mental Health Mental Health Sasha Bhat 33 - 33- 19 - - - 19- -

Learning Disabilities mental Health Mairead O'Donnell - - - - - - - - -

Estates and Facilities Other Robert Madden - - - - - - - - -

IT Other Simon Wilson - - - - - - - - -

Continuining Health Other - - - - - - - - -

Commissioning Support Savings Other Julie Lawreniuk 259 259 - 151 194 22 216 65 -

Primary Care Other Diane Lawlor - 307 307 - 281 9 290 290 -

Out of Area schemes Mental Health Kris Farnell - 323 323 - 203 40 243 243 -

Unidentified QIPP 4,259 - 4,259- 2,484 - - - 2,484- -

Non Cash Releasing Schemes

Total Expected QIPP 13,392 7,681 5,711- 7,103 5,436 20 5,456 1,647-

RAG

Rating

Appendix F – Bradford City CCG

Bradford City CCG - QIPP Dashboard Financial Year 2017/1812 RAG Rating Key 3

Reporting Month -January 18 FOT savings achieve or exceed plan

QIPP Target £3,519 FOT savings but less than plan

QIPP Forecast Achievement £3,512 No savings achieved

QIPP shortfall -7

Movement from previous Month 410

Improvement/decline -£417

Revised

plan value -

£000

Forecast

Achivement

full year -

£000

Full year

variance to

plan - £000

Year to date

Plan - £000

Previous

YTD Savings

In month

savings

Year to date

acheivement -

£000

YTD variance -

£000

Movement

on previous

month

Scheme Name/Programme Programme Board Scheme lead

Cash Releasing Schemes

Out of Hospital Out of Hospital Walter O'Neill 23 - 23- 13 - - - 13- -

Urgent care & Emergency Urgent Care Louise Atherton 214 222 8 125 255 -151 104 21- 234-

Diabetes Kath Helliwell - - - - - - - - -

Bradford Healthy Hearts Kath Helliwell 21 - 21- - - - - - -

Self care and Prevention Self Care Collette Connelly - - - - - - - - -

Planned Care Planned Care Ian Wallace 587 324 263- 178 157 -51 106 72- 129-

Planned Care - Tariff Impact on Follow Ups Planned Care Ian Wallace 320 662 342 - 24 348 372 372 4

Cancer Ian Wallace - - - - - - - -

Bradford Breathing Better Kath Helliwell 77 - 77- 45 - - - 45- -

Primary Care (OOH) Out of Hospital Vicki Wallace 341 - 341- 199 - - - 199- -

Prescribing prescribing Tracey Gaston 1,468 1,987 519 856 1,392 313 1,705 849 57-

Children Ruth Hayward - - - - - - - -

Mental Health Mental Health Sasha Bhat 17 - 17- 10 - - - 10- -

Learning Disabilities mental Health Mairead O'Donnell - - - - - - - -

Estates and Facilities Other Robert Madden - - - - - - - -

IT Other Simon Wilson - - - - - - - - -

Continuining Health Other - - - - - - - -

Commissioning Support Savings Other Julie Lawreniuk 218 218 - 127 164 18 182 55 -

Out of Area schemes Mental Health Kris Farnell 100 100 - 63 12 75 75 -

-

Unidentified QIPP 233 - 233- 117 - - 117- -

-

Non Cash Releasing Schemes

Total Expected QIPP 3,519 3,512 7- 1,670 2,055 489 2,544 874

RAG

Rating

Appendix G

NHS Airedale, Wharfedale And Craven CCG Number of Providers w ithin DCO 31

Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17

<87% 91.7% 92.0% 91.6% 91.9% 91.7% 92.0% 92.3% 92.0% 91.4% 92.1% 93.0% 92.9% 92.6%

87% to 92% 92.5% 92.8% 92.2% 92.7% #N/A #N/A #N/A

>=92% Rank 9/23 9/23 8/23 8/23 7/23 7/23 7/23 61/207 44/207 35/207

>10

1 to 10

0 Rank 1/23 1/23 1/23 1/23 1/23 1/23 15/23 20/207 53/207


<6% 0.3% 0.5% 0.3% 1.0% 2.0% 2.9% 3.9% 4.4% 1.4% 0.7% 0.9% 1.0% 4.8%

1% to 6% 0.2% 0.3% 0.3% 0.2% 0.0% 0.2% #N/A

>=1% Rank 5/23 6/23 4/23 10/23 10/23 16/23 19/23 59/207 113/207 193/207


<88% 98.0% 96.7% 97.8% 97.7% 97.1% 95.2% 95.0% 92.3% 89.2% 96.4% 95.6% 79.1% 75.0%

88% to 93% 97.7% 96.7% 97.8% 96.9% #N/A #N/A #N/A

>=93% Rank 4/23 6/23 3/23 3/23 13/23 9/23 54/207 203/207 207/207

<88% 100.0% 98.8% 98.1% 93.5% 100.0% 100.0% 100.0% 97.9% 93.3% 100.0% 96.3% 95.2% 96.4%

88% to 93% 97.8% 95.1% 98.3% 98.8% #N/A #N/A #N/A

>=93% Rank #N/A 9/23 18/23 #N/A #N/A 1/23 5/207 134/207 96/207

<91% 100.0% 100.0% 100.0% 98.9% 98.4% 100.0% 98.8% 100.0% 100.0% 98.5% 100.0% 96.8% 96.9%

91% to 96% 100.0% 97.6% 100.0% 100.0% #N/A #N/A #N/A

>=96% Rank 1/23 1/23 7/23 9/23 1/23 9/23 74/207 148/207 156/207

<89% 100.0% 100.0% 100.0% 94.3% 100.0% 100.0% 93.8% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0%

89% to 94% 100.0% 100.0% 100.0% 96.9% #N/A #N/A #N/A

>=94% Rank 1/23 1/23 15/23 1/23 1/23 18/23 18/207 23/207 26/207

<93% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0%

93% to 98% 100.0% 100.0% 100.0% 100.0% #N/A #N/A #N/A

>=98% Rank 1/23 1/23 1/23 1/23 1/23 1/23 29/207 32/207 34/207

<89% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0%

89% to 94% 100.0% 100.0% 100.0% 100.0% #N/A #N/A #N/A

>=94% Rank 1/23 1/23 1/23 1/23 1/23 1/23 22/207 28/207 #31/207

<80% 93.9% 80.9% 83.3% 89.7% 90.9% 83.3% 88.5% 77.8% 94.1% 85.7% 86.7% 83.0% 75.6%

80% to 85% 93.0% 87.8% 89.2% 92.3% #N/A #N/A #N/A

>=85% Rank 1/23 9/23 4/23 2/23 9/23 3/23 63/207 99/207 185/207

<85% 92.3% 100.0% 0.0% 75.0% #N/A 100.0% 100.0% 100.0% 88.9% 75.0% 100.0% 100.0% 100.0%

85% to 90% 100.0% 100.0% 100.0% 100.0% #N/A #N/A #N/A

>=90% Rank #N/A #N/A 19/23 1/23 1/23 165/207 17/207 20/207

NA 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 66.7% 100.0% 80.0% 100.0% 100.0% 80.0% 66.7%

66.7% 66.7% 66.7% 66.7% #N/A #N/A #N/A

Rank #N/A #N/A #N/A #N/A #N/A #N/A 10/207 146/207 176/207


>10

1 to 10

0 Rank 1/23 1/23 1/23 1/23 1/23 1/23 1/23 14/207 83/207

14-15 Q3 14-15 Q4 15-16 Q1 15-16 Q2 15-16 Q3 15-16 Q4 16-17 Q1 16-17 Q2 16-17 Q3 16-17 Q4 17-18 Q1 17-18 Q2 17-18 Q3

<90%

90% to 95%

>=95% Rank 11/23 23/23 19/23 12/23 7/23 8/23 1/23 10/23 1/23 1/23 1/23 6/207 81/207

Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17 Jan-18

<62% 73.4% 73.5% 73.7% 78.7% 78.5% 78.2% 78.2% 78.0% 78.4% 77.5% 78.6% 78.2% 77.5%

62% to 67% 75.0% 75.0% 75.0%

>=67% Rank 11/23 11/23 11/23 7/23 7/23 7/23 - - - 30/207 28/207

98.2% 96.1% 96.8% 96.4% 98.0% 98.1% 100.0%

Mental Health

Mixed Sex Accommodation

Breaches of Mixed-Sex Accommodation

Maximum 62-day wait from referral from an NHS screening service

to first definitive treatment for all cancers

0 0 0

RTT

Patients on incomplete non-emergency pathways (yet to start

treatment) waiting no more than 18 weeks from referral

0 0 0

Maximum 62-day wait from urgent GP referral to first definitive

treatment for cancer

Commissioner data with CCG plans in grey. CCGs are ranked out of 23 Yorkshire & Humber CCGs until Jun 17 and then out of 207 CCGs nationally

100 0

Number of patients waiting more that 52 weeks on incomplete

pathways

1 0 10 1 1 1 10 0

Diagnostic

Maximum two-week wait for first outpatient appointment for

patients referred urgently with breast symptoms (where cancer was

not initially suspected)

Maximum 31-day wait from diagnosis to first definitive treatment

for all cancers

Maximum 31-day wait for subsequent treatment where that

treatment is surgery

Maximum 31-day wait for subsequent treatment where the

treatment is an anti-cancer drug regimen


treatment is a course of radiotherapy

Percentage of patients waiting 6 weeks or more for a diagnostic

test (15 key tests)

Cancer Monthly


patients referred urgently with suspected cancer by a GP

Dementia

Dementia diagnosis rate

Care Programme Approach (CPA): Percentage of people under

adult mental illness specialities on CPA who were followed up

within 7 days of discharge from psychiatric inpatient care during

the period

Maximum 62-day wait for first definitive treatment following a

consultants decision to upgrade the priority of the patients (all

cancers)

0 0 0 0 0 0

97.9% 100.0% 100.0% 100.0% 100.0% 97.6%

Oct-16 Nov-16 Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17

<70%

70% to 75%

>=75% Rank 9/23 1/23 1/23 7/23 7/23 5/22 8/23

<90%

90% to 95%

>=95% Rank 1/23 1/23 1/23 1/23 20/23 1/22 1/23


<3.75% 4.3% 4.4% 4.7% 4.8% 4.4% 4.2% 4.0% 4.6% 4.6% 4.6% 4.1% 3.8% 3.8%

3.8% 3.8% 3.8% 3.8% 3.8% 3.8% 4.2% 4.2% 4.2%

>=4.20% Rank 6/23 6/23 4/23 3/23 2/23 8/23 11/23

<45%

45% to 50%

>=50% Rank 2/23 3/23 3/23 2/23 1/23 1/23 2/23


<45%

45% to 50%

>=50% Rank 20/23 17/23 21/23 13/23 18/23 15/23 144/207 133/207


>0 0 0 0 0 0 0 0 0 0 0 0 0 0

Rank 1/23 1/23 1/23 1/23 1/23 1/23 1/23 19/207 34/207 30/207

>Ceiling 5 4 3 1 7 2 1 2 0 2 2 0 3

<=Ceiling Rank 13/23 11/23 5/23 1/23 15/23 6/23 1/23

Ceiling 3 3 3 3 3 3 3 22/207 202/207 122/207


<70%

70% to 75%

>=75%

NA 77.6% 66.0% 83.9% 78.6% 81.1% 78.0% 80.7% 67.6%

NA NA NA NA NA NA NA NA

NA 65.1% 64.9% 69.0% 70.3% 68.5% 70.8% 68.3% 67.6%


69.2%

100.0% 100.0% 100.0% 100.0%

97.1% 100.0% 100.0% 96.8% 96.4% 96.7%

55.6% 54.6% 55.1% 56.5% 61.4% 61.2%

70.6%

IAPT Monthly

IAPT 6 Weeks First Treatment

IAPT 18 Weeks First Treatment100.0% 100.0% 100.0% 100.0% 96.4% 100.0% 100.0% 100.0% 100.0%

95.5% 100.0% 100.0% 96.6% 91.7% 100.0% 96.6%

IAPT (Rolling 3 month)

IAPT Access (rolling 3 months)

IAPT Recovery rate (rolling 3 months)

Safe Environment and Protecting from Avoidable Harm

Early Intervention Psychosis - 2 Week Waits (rolling quarter )

Early intervention in psychosis - 2 week wait (Rolling quarter)61.1% 71.4% 57.9% 75.0% 63.2% 70.6% 66.7% 63.6% 65.0% 55.6% 66.7%

66.4% 61.2% 67.6% 59.8% 60.0% 70.3% 67.7% 60.2%

60.0% 58.7% 59.4% 59.7% 59.7% 54.4% 50.0%

** YAS have been participating in a pilot which has involved new call categories. The initial pilot ran from 21st April 2016 until 19th October 2016 and the second phase began on 20th October 2016. Due to the changes in categories direct comparison between the different phases cannot

be done because they don't necessarily represent the same activity. Currently no performance target has been set for the 2R and 2T categories.

Ambulance Calls (Pilot Phase 2.2) **

Category 1 - Response within 8mins

Category 2R - Response within 19mins by a resource.

Category 2T - Response within 19mins by DCA unless RRV arrives

and DCA is not required

Incidence of healthcare associated infection (HCAI) ii) C.difficile

Incidence of healthcare associated infection (HCAI) i) MRSA -

Cases which have been assigned to the CCG following a Post

Infection Review

Appendix H

NHS Bradford Districts CCG Number of Providers w ithin DCO 31


<87% 90.0% 89.4% 89.7% 90.0% 89.3% 90.2% 89.7% 89.5% 87.3% 92.8% 93.0% 93.2% 92.8%

87% to 92% 94.1% 94.1% 94.1% 94.1% #N/A #N/A #N/A

>=92% Rank 16/23 16/23 15/23 15/23 16/23 15/23 15/23 38/207 38/207 28/207

>10

1 to 10

0 Rank 1/23 1/23 1/23 1/23 1/23 13/23 1/23 1/23 23/207 24/207


<6% 0.5% 1.2% 0.6% 1.4% 2.4% 3.1% 3.5% 3.3% 4.0% 1.3% 1.1% 1.3% 2.3%

1% to 6% 0.4% 0.4% 0.4% 0.4% 0.4% 0.4% #N/A

>=1% Rank 9/23 12/23 9/23 13/23 13/23 18/23 17/23 121/207 131/207 163/207

Jan-17 Feb-17 Dec-16 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17

<88% 96.8% 96.8% 96.8% 96.4% 93.8% 94.8% 94.2% 94.2% 91.8% 98.5% 97.3% 71.6% 76.0%

88% to 93% 95.6% 95.6% 95.6% 95.6% #N/A #N/A #N/A

>=93% Rank 2/23 11/23 12/23 12/23 14/23 14/23 8/207 206/207 206/207

<88% 94.7% 94.7% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 91.7% 92.3% 91.7%

88% to 93% 96.6% 96.6% 96.6% 96.6% #N/A #N/A #N/A

>=93% Rank #N/A 1/23 1/23 #N/A #N/A 1/23 7/207 177/207 170/207

<91% 99.1% 99.1% 96.6% 98.4% 99.1% 99.3% 99.2% 97.0% 100.0% 98.1% 90.3% 97.6% 100.0%

91% to 96% 98.5% 98.5% 98.5% 98.5% #N/A #N/A #N/A

>=96% Rank 4/23 19/23 9/23 5/23 5/23 3/23 93/207 107/207 10/207

<89% 91.7% 91.7% 94.9% 93.5% 96.4% 97.0% 100.0% 100.0% 100.0% 100.0% 100.0% 92.9% 91.3%

89% to 94% 100.0% 100.0% 100.0% 100.0% #N/A #N/A #N/A

>=94% Rank 15/23 16/23 18/23 14/23 15/23 1/23 21/207 159/207 162/207

<93% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0%

93% to 98% 100.0% 100.0% 100.0% 100.0% #N/A #N/A #N/A

>=98% Rank 1/23 1/23 1/23 1/23 1/23 1/23 32/207 35/207 37/207

<89% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0%

89% to 94% 97.4% 97.4% 100.0% 100.0% #N/A #N/A #N/A

>=94% Rank 1/23 1/23 1/23 1/23 1/23 1/23 24/207 31/207 33/207

<80% 79.4% 79.4% 78.1% 91.5% 78.9% 82.8% 77.8% 79.1% 83.3% 84.4% 41.7% 72.4% 81.3%

80% to 85% 86.1% 86.1% 85.1% 85.1% #N/A #N/A #N/A

>=85% Rank 16/23 16/23 2/23 14/23 11/23 19/23 85/207 191/207 142/207

<85% 100.0% 100.0% 71.4% 93.8% 93.3% 100.0% 100.0% 100.0% 100.0% 100.0% 81.0% 100.0%

85% to 90% 100.0% 100.0% 100.0% #N/A #N/A #N/A

>=90% Rank 1/23 #N/A 13/23 #N/A 1/23 1/23 29/207 164/207 22/207

NA #N/A 100.0% 100.0% 50.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 0.0% 75.0% 100.0%

100.0% 100.0% 100.0% 100.0% #N/A #N/A #N/A

Rank #N/A #N/A #N/A #N/A #N/A #N/A 183/207 162/207 12/207


>10

1 to 10

0 Rank 21/23 1/23 1/23 1/23 1/23 1/23 17/207 17/207

14-15 Q3 14-15 Q4 15-16 Q1 15-16 Q2 15-16 Q3 15-16 Q4 16-17 Q1 16-17 Q2 16-17 Q3 16-17 Q4 17-18 Q1 17-18 Q2 17-18 Q3

<90%

90% to 95%

>=95% Rank 9/23 1/23 14/23 4/23 6/23 21/23 20/23 8/23 14/23 10/23 1/23 105/207 95/207


<62% 81.4% 81.3% 81.5% 81.6% 82.0% 81.9% 82.0% 82.1% 82.4% 83.0% 83.5% 82.9% 82.3%

62% to 67% 75.0% 75.0% 75.0%

>=67% Rank 4/23 4/23 4/23 1/23 1/23 1/23 13/207 14/207

0 0 0

98.8% 100.0% 97.1% 98.0%98.3% 100.0% 98.0% 99.1% 98.9% 93.7% 96.0% 98.3% 97.0%


Mental HealthCare Programme Approach (CPA): Percentage of people under



the period

Breaches of Mixed-Sex Accommodation0 0 0 0 0 0 2 0 0 0




cancers)

Diagnostic


test (15 key tests)


pathways

Dementia









for all cancers



0 0



0 0 0 0



RTT

Cancer Monthly






0 1 0 0 0 00


<70%

70% to 75%

>=75% Rank 16/23 13/23 15/23 14/23 #N/A 7/22 9/23

<90%

90% to 95%

>=95% Rank 1/23 18/23 19/23 17/23 16/23


<3.75% 3.7% 3.7% 3.9% 3.8% 3.9% 3.9% 3.8% 4.1% 4.0% 3.9% 3.6% 3.5% 4.0%

3.8% 3.8% 3.8% 3.8% 3.8% 4.2% 4.2% 4.2% 4.2%

>=4.20% Rank 12/23 13/23 11/23 14/23 12/23 13/23 14/23

<45%

45% to 50%

>=50% Rank 16/23 13/23 10/23 10/23 9/23 11/23 11/23


<45%

45% to 50%

>=50% Rank 18/23 15/23 13/23 9/23 11/23 11/23 138/207 121/207


>0 1 0 0 1 1 1 0 0 1 0 0 0 0

Rank 22/23 1/23 1/23 22/23 21/23 18/23 19/23 199/207 33/207

>Ceiling 6 9 6 7 4 6 8 7 1 3 4 5 4

<=Ceiling Rank 16/23 19/23 18/23 18/23 10/23 19/23 19/23

Ceiling 9 9 9 11 7 14 8 105/207 91/207


<70%

70% to 75%

>=75%

NA 89.4% 82.8% 81.3% 89.7% 82.5% 86.8% 83.9% 83.9%

NA NA NA NA NA NA

NA 80.3% 77.6% 78.3% 83.4% 81.8% 79.2% 73.8% 69.4%

NA NA NA NA NA NA

70.0% 74.1% 61.4%

70.0% 71.7% 64.9% 67.6% 74.4% 70.8% 77.2% 71.0%

79.5% 80.4% 71.7%

100.0% 100.0% 100.0% 97.9%

51.6% 52.1% 56.0% 54.2% 51.1%

90.7% 92.9% 93.0% 91.1% 94.6% 93.9% 94.6%












Infection Review

Early Intervention Psychosis - 2 Week Waits (rolling quarter)

Early intervention in psychosis - 2 week wait (Rolling quarter)

46.8% 46.2% 47.7%

68.8% 68.5%64.3% 73.8% 73.2% 82.9% 76.5%

45.9% 47.5% 49.7% 50.7% 51.7%



IAPT Monthly

IAPT 6 Weeks First Treatment94.4% 95.3% 95.9% 97.8% 95.8% 94.3%

100.0% 98.2% 97.7% 98.2% 98.2% 100.0%IAPT 18 Weeks First Treatment


98.1% 98.0% 98.2%

Appendix I

NHS Bradford City CCG Number of Providers w ithin DCO 31


<87% 90.1% 89.7% 89.4% 89.7% 88.4% 89.0% 88.7% 87.7% 88.8% 90.5% 92.0% 91.8% 91.9%

87% to 92% 93.4% 93.4% 93.4% 93.4% #N/A #N/A #N/A

>=92% Rank 15/23 15/23 16/23 17/23 17/23 17/23 17/23 113/207 84/207 51/207

>10

1 to 10

0 Rank 1/23 1/23 1/23 1/23 1/23 1/23 1/23 26/207 26/207

Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Jan-00 Dec-17

<6% 0.3% 1.1% 0.7% 1.3% 2.3% 3.1% 4.1% 4.2% 3.6% 1.6% 1.2% 1.1% 2.1%

1% to 6% 0.3% 0.3% 0.3% 0.3% 0.3% 0.3% #N/A

>=1% Rank 6/23 11/23 13/23 12/23 11/23 17/23 21/23 137/207 120/207 152/207

Jan-17 Feb-17 Dec-16 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17

<88% 94.3% 94.9% 94.9% 96.2% 97.8% 92.9% 94.7% 96.6% 93.9% 90.5% 100.0% 68.3% 80.7%

88% to 93% 96.4% 96.4% 63.7% 96.4% 96.4% #N/A #N/A #N/A

>=93% Rank 20/23 14/23 16/23 2/23 16/23 15/23 5/23 1/207 207/207 204/207

<88% #N/A #N/A 100.0% 100.0% #N/A #N/A 100.0% 100.0% 100.0% 100.0%

88% to 93% 100.0% 100.0% 100.0% 100.0% 100.0% #N/A #N/A #N/A

>=93% Rank 1/23 1/23 1/23 8/207 6/207 -

<91% 91.7% 82.4% 82.4% 100.0% 93.8% 96.2% 100.0% 100.0% 100.0% 96.8% 100.0% 88.2% 86.7%

91% to 96% 100.0% 100.0% 100.0% 100.0% 100.0% #N/A #N/A #N/A

>=96% Rank 23/23 23/23 1/23 23/23 17/23 1/23 1/23 6/207 206/207 207/207

<89% 100.0% 60.0% 60.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 96.3% 100.0% 100.0%

89% to 94% 100.0% 100.0% 100.0% 100.0% 100.0% #N/A #N/A #N/A

>=94% Rank 1/23 23/23 1/23 1/23 1/23 1/23 1/23 - 26/207 29/207

<93% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0%

93% to 98% 100.0% 100.0% 100.0% 100.0% 100.0% #N/A #N/A #N/A

>=98% Rank 1/23 1/23 1/23 1/23 1/23 1/23 1/23 35/207 38/207 40/207

<89% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0%

89% to 94% 100.0% 100.0% 100.0% 100.0% 100.0% #N/A #N/A #N/A

>=94% Rank 1/23 1/23 1/23 1/23 1/23 1/23 1/23 27/207 34/207 36/207

<80% 85.7% 66.7% 66.7% 63.6% 62.5% 76.9% 68.8% 90.0% 72.7% 85.9% 100.0% 80.0% 71.4%

80% to 85% 100.0% 100.0% 100.0% 100.0% 100.0% #N/A #N/A #N/A

>=85% Rank 8/23 21/23 23/23 22/23 18/23 23/23 1/23 2/207 136/207 197/207

<85% 100.0% 66.7% 66.7% #N/A 100.0% 100.0% 100.0% 100.0% 66.7% 100.0% 100.0% 0.0%

85% to 90% #N/A #N/A #N/A #N/A #N/A #N/A #N/A

>=90% Rank #N/A 22/23 1/23 #N/A 1/23 1/23 - 20/207 194/207

#N/A #N/A #N/A #N/A #N/A #N/A #N/A 100.0% 100.0% 100.0%

#N/A #N/A #N/A #N/A #N/A #N/A #N/A

Rank - 12/207 -


>10

1 to 10

0 Rank NA NA NA NA NA NA NA 20/207 20/207

14-15 Q3 14-15 Q4 15-16 Q1 15-16 Q2 15-16 Q3 15-16 Q4 16-17 Q1 16-17 Q2 16-17 Q3 16-17 Q4 17-18 Q1 17-18 Q2 17-18 Q3

<90%

90% to 95%

>=95% Rank 14/23 17/23 17/23 23/23 19/23 12/23 21/23 1/23 1/23 #N/A 1/23 7/207 196/207


<62% 80.6% 81.8% 80.8% 81.0% 80.3% 81.4% 81.8% 82.3% 81.1% 80.9% 83.0% 82.1% 81.8%

62% to 67% 75.1% 75.1% 75.1%

>=67% Rank 1/23 1/23 1/23 2/23 2/23 2/23 20/207 16/207 16/207

0 0


0 0 0 0 0

Breaches of Mixed-Sex Accommodation




RTT



Cancer Monthly


pathways

Diagnostic


test (15 key tests)

0 0 0 0 0 0 00



100.0% 100.0% 89.6%


for all cancers








cancers)

0



00 0 0 0 1





0 0 0 0


Dementia

Mental HealthCare Programme Approach (CPA): Percentage of people under



the period

98.0% 97.1% 95.2% 89.7% 94.6% 97.5% 92.7% 100.0% 100.0% 96.5%


<70%

70% to 75%

>=75% Rank 1/23 11/23 1/23 1/23 1/23

<90%

90% to 95%

>=95% Rank 1/23 1/23 1/23 1/23 1/23


<3.75% 3.3% 3.3% 3.8% 4.0% 4.3% 4.4% 5.0% 5.4% 5.1% 4.7% 4.3% 4.2% 4.3%

3.8% 3.8% 3.8% 3.8% 3.8% 4.2% 4.2% 4.2% 4.2%

>=4.20% Rank 17/23 19/23 13/23 8/23 6/23

<45%

45% to 50%

>=50% Rank 13/23 20/23 16/23 15/23 13/23


<45%

45% to 50%

>=50% Rank 16/23 13/23 16/23 12/23 12/23 10/23 143/207 103/207


>0 0 0 0 0 0 0 0 0 1 0 0 0 0

Rank 1/23 1/23 1/23 1/23 1/23 1/23 1/23 132/207 40/207 36/207

>Ceiling 1 1 2 1 1 1 1 2 0 0 1 1 1

<=Ceiling Rank 1/23 1/23 1/23 1/23 3/23 2/23 1/23

Ceiling 2 2 2 9 1 1 0 1/207 185/207 181/207


<70%

70% to 75%

>=75%

NA 83.6% 80.5% 92.7% 91.2% 90.2% 84.5% 84.3% 87.6%


NA 82.9% 82.0% 81.4% 86.5% 84.2% 83.3% 78.5% 78.5%


57.1% 62.5% 67.7% 77.8% 63.0%

100.0% 100.0% 100.0% 100.0%

50.0% 48.6% 45.2% 41.9%

IAPT Monthly



100.0% 94.4% 100.0% 100.0% 100.0% 91.7% 100.0% 90.9% 85.7% 92.9% 92.9% 92.9% 93.3%



100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0%


Early Intervention Psychosis - 2 Week Waits (rolling quarter)

Early intervention in psychosis - 2 week wait (Rolling quarter)70.4% 74.1% 71.0% 78.3% 73.9% 83.3% 75.0% 69.2%

48.9% 43.5% 46.5% 47.5% 50.0% 47.2% 45.5% 44.1% 48.3%




Infection Review


73.6% 77.3% 74.3% 81.8% 79.1% 79.5% 80.5% 74.2%








21

Appendix J – ACO System Dashboards

Mapping across Programmes/Workstreams

Metric Programme

Reducing 1st:FU ratios

Reducing A&E attendances

Planned Care

Reducing DTOC

Reducing average LOS (elective)

Achieving 18 weeks RTT target

Reducing average LOS (NEL)

Reducing GP referrals

Planned care

Provider Alliance

Planned care

Urgent care

Planned care - referral efficiency, procedures of limited clinical value, pathway adherence

Planned Care - 1st:FU ratios

Note: Data is for the 2 Bradford CCGs unless otherwise indicated as: *1

Trust level, *2

DTOC at Bradford level, CCG NEL activity at BTHFT, *3

CCG referrals to BTHFT, G&A referrals to

all providers Note due to ongoing data quality issues with EPR activity is only availab le to September so only A&E & DTOC figures can be updated.

Out of Hospital - reduced practice variation

Workstream

Achieving the A&E target

Reducing NEL admissions

Out of Hospital - developing community provision through community/intermediate care beds & integrated care

team workstreams

Urgent care - primary care streaming

Urgent care - urgent care centre, ACSC pathway work, children's pathway work

Out of Hospital - extended primary care access and primary care at scale

Urgent care - ACSC pathway work, children's pathway work

Urgent care

Urgent care

Out of Hospital

Provider Alliance

Bradford Accountable Care

The Urgent Care System

The Planned Care System

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

0

2000

4000

6000

8000

10000

12000

14000

16000

A M J J A S O N D J F M A M J J A S O N D J

16/17 17/18

A&E*1

Attendances Admissions 4 hour performance Admission rate

A&E target Trend (attendances) Trend (admissions)

0%

2%

4%

6%

8%

10%

12%

14%

16%

0

1,000

2,000

3,000

4,000

5,000

6,000

7,000

A M J J A S O N D J F M A M J J A S

16/17 17/18

NEL Admissions

NEL admissions - BTHFT NEL Admissions - ALL

30 day re-admission rate - BTHFT Linear (NEL Admissions - ALL)

2.0

2.1

2.2

2.3

2.4

2.5

2.6

2.7

2.8

2.9

3.0

0

5000

10000

15000

20000

25000

30000

35000


16/17 17/18

Outpatients

1st OP - all FU OP - ALL1st - CCG @ BTHFT FU - CCG @ BTHFTRatio 1st:FU - ALL Ratio 1st:FU - CCG @ BTHFTTrend (1st OP) Trend (FU OP)

0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0

0

1000

2000

3000

4000

5000


16/17 17/18

Inpatients

Elective - ALL Daycase - ALLElective - BTHFT Daycase - BTHFTAverage LOS - ALL Average LOS - BTHFTLinear (Elective - BTHFT) Linear (Daycase - BTHFT)Trend (LOS)

0

20

40

60

80

100

120

140

160

180

0

1000

2000

3000

4000

5000

6000

A M J J A S O N D J F M A M J J A S O N D

16/17 17/18

Delayed Transfers*2

NEL admissions - BTHFT Rate/100,000 population

Trend (NEL admissions) Linear (Rate/100,000 populat ion)

2.0

2.2

2.4

2.6

2.8

3.0

3.2

3.4

3.6

4200

4400

4600

4800

5000

5200

5400

5600

5800

6000


16/17 17/18

Average LOS

NEL admissions Average LOS - ALL

Average LOS - CCG @ BTHFT Trend (LOS)

Linear (Average LOS - ALL) Linear (Average LOS - CCG @ BTHFT)

84.0%

85.0%

86.0%

87.0%

88.0%

89.0%

90.0%

91.0%

92.0%

93.0%

A M J J A S O N D J F M A M J J A

16/17 17/18

18 week RTT*1

18 weeks RTT Target

0

2000

4000

6000

8000

10000

12000

14000

Apr

May

Jun

Jul

Aug

Sep

Oct

Nov

Dec

Jan

Feb

Mar

Apr

May

Jun

Jul

Aug

Sep

Oct

Nov

Dec

2016/17 2017/18

Referrals*3

All referrals - 3 CCGs GP referrals - 3 CCGsGP Referrals - District CCG GP Referrals - City CCGCity - All referrals (G&A) Districts - All referrals (G&A)

22

Mapping across Programmes/Workstreams

Metric Programme

Note: Data is for the AWC CCG unless otherwise indicated as: *1

Trust level, *2

DTOC at Trust level, *3

CCG referrals to ANHSFT, G&A referrals to all providers

Workstream

Achieving the A&E target Urgent care Urgent care - primary care streaming

Reducing A&E attendances Urgent careUrgent care - urgent care centre, ACSC pathway work, children's pathway work

Primary & Community ?

Reducing NEL admissions Urgent care Urgent care - ACSC pathway work, children's pathway work

Reducing DTOCPrimary &

Community?

Reducing average LOS (NEL) ? ?

Reducing average LOS (elective) ? ?

Achieving 18 weeks RTT target Planned care

Reducing GP referrals Planned care

Planned care - referral efficiency, procedures of limited clinical value, pathway adherence

Primary & Community ?

Reducing 1st:FU ratios Planned Care Planned Care - 1st:FU ratios

Airedale, Wharfedale & Craven Accountable Care

The Urgent Care System

The Planned Care System

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

0

1000

2000

3000

4000

5000

6000

7000

A M J J A S O N D J F M A M J J A S O N D J

16/17 17/18

A&E*1

Attendances Admissions 4 hour performance Admission rate

A&E target Trend (attendances) Trend (admissions)

0%

2%

4%

6%

8%

10%

12%

14%

16%

0

500

1,000

1,500

2,000

2,500


16/17 17/18

NEL Admissions

NEL admissions - ANHSFT NEL Admissions - ALL

30 day re-admission rate - ANHSFT Linear (NEL Admissions - ALL)

1.0

1.2

1.4

1.6

1.8

2.0

2.2

2.4

2.6

2.8

3.0

0

2000

4000

6000

8000

10000

12000

14000


16/17 17/18

Outpatients

1st OP - all FU OP - ALL1st - CCG @ ANHSFT FU - CCG @ ANHSFTRatio 1st:FU - ALL Ratio 1st:FU - CCG @ ANHSFTTrend (1st OP) Trend (FU OP)

0.0

1.0

2.0

3.0

4.0

0

500

1000

1500

2000

2500

3000

3500


16/17 17/18

Inpatients

Elective - ALL Daycase - ALLElective - ANHSFT Daycase - ANHSFTAverage LOS - ALL Average LOS - ANHSFTLinear (Elective - ANHSFT) Linear (Daycase - ANHSFT)Trend (LOS)

0.0%

0.5%

1.0%

1.5%

2.0%

2.5%

3.0%

3.5%

4.0%

4.5%

5.0%

0

200

400

600

800

1000

1200

1400

1600

1800

2000


16/17 17/18

Delayed Transfers*2

NEL admissions - ANHSFT DTOC rate

Trend (NEL admissions) Linear (DTOC rate)

2.0

2.5

3.0

3.5

4.0

4.5

5.0

0

500

1000

1500

2000

2500


16/17 17/18

Average LOS

NEL admissions Average LOS - ALL

Average LOS - CCG @ ANHSFT Trend (LOS)

Linear (Average LOS - ALL) Linear (Average LOS - CCG @ ANHSFT)

89.5%

90.0%

90.5%

91.0%

91.5%

92.0%

92.5%

93.0%

93.5%

94.0%


16/17 17/18

18 week RTT*1

18 weeks RTT Target

0

500

1000

1500

2000

2500

3000

3500

4000

4500

5000


16/17 17/18

Referrals*3

All referrals - 3 CCGs GP referrals - 3 CCGsGP Referrals - AWC CCG AWC - All referrals (G&A)Linear (GP Referrals - AWC CCG) Linear (AWC - All referrals (G&A))

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