Integrated Performance Report - November 2024
Meeting: Trust Board – Public Meeting
Date: 6 November 2024
Report Title: Integrated Performance Report
Agenda Item: PUB24/11/2.1
Author: Emma Smith – Head of Information and Analytics
Lead Director: Dr Hein Scheffer – Director of Strategy and Transformation
Purpose: Discussion/review
Assurance: Reasonable
Link to CQC domain:
- Caring
- Responsive
- Effective
- Well Led
- Safe
Link to Strategic Objective:
- Be an exceptional place to work, volunteer and learn
- Provide outstanding quality of care and performance
- Be excellent collaborators and innovators as system partners
- Be an environmentally and financially sustainable organisation
Link to Strategic Risk:
- SR1a: If we do not ensure our people are safe and their wellbeing prioritised, there is a risk that we will be unable to attract, retain and keep all our people safe and well
- SR1b: If we do not ensure our leaders are developed and equipped, there is a risk that we will not be able to change our culture, and value, support, develop and grow our people
- SR2: Failure to achieve continuous quality improvements and high-quality care delivery
- SR4: Failure to deliver an efficient, effective and economic service
- SR5: If we do not clearly define our strategic plans, we will not have the agility to deliver the suite of improvements needed
- SR6: Ability to ensure sufficient capacity and capability to ensure sustainable change
Equality Impact Assessment: No negative impact identified
Previously considered by: N/A
Recommendation: The Board is asked to note the areas of improvement and decline and seek assurance on plans to improve.
Purpose: To enable the Board to discuss the performance areas identified and the actions offered to gain assurance or sufficient oversight.
Introduction / Background:
The Integrated Performance Report consists of core metrics to monitor the performance across all main functions of the organisation in the pursuit of achievement of our strategic goals. Each of the relevant Executive Directors will provide a short overview of the key critical areas outlined in the section below and in the first executive summary page of the IPR document.
Executive Summary:
The Integrated Performance Report (IPR) comprises September 2024 data across the key areas of the Trust.
Our performance improvement for 2024-25 is supported by the Trust Integrated Performance Report (Appendix 1.) with some modifications to support better scrutiny and oversight now implemented. This includes:
- Newly colour-coded assurance matrix at the beginning of each section. This enables the easy identification of key areas that should be focussed on, and areas where performance is positive.
- Metrics that are no longer appropriate are removed with new more appropriate metrics replacing them.
- Additional metrics that support better oversight and scrutiny.
- Process limits are refreshed as normal annually. This may see sustained linear performance come out of special cause improvement as the limits of performance have narrowed alongside the indicator being above or not hitting target.
Work continues to create IPRs for each of the governance Committees in the Trust. Initial work to aggregate out relevant data from the Trust IPR is complete and this will enable conversations with Committee chairs to understand additional data requirements of the Committee when considering performance oversight. The People Committee IPR is now live, with the next focus being Finance and Sustainability Committee to have its own IPR.
Looking forward into 2024-25 and focusing on the Trust’s four goals, the key high-level areas of positive performance and areas the Trust is or should focus on are below. This should be considered in conjunction with the more detailed executive summary and IPR in the attached Appendix 1., as follows:
| Goal | Areas of positive performance | Areas of focus |
|---|---|---|
| Goal 1 – Be an Exceptional Place to Work, Volunteer and Learn | Staff Vacancy Rates have reduced significantly, continuing in special cause improvement, at 6.7% against a mean line of 12.67%, it continues to be below the 2024-25 target of 10%. The Sickness Absence Rate remained in common cause variation in September 2024, reporting at 7.57% against a mean line of 7.92% and an overall target of 8.6%. Resus Adults compliance is above target at 85% and is showing special cause improvement. Reconciled secondments across EEAST have decreased in September 2024, reporting at 102.01 WTE against a mean of 142.23 WTE and a target of 180 WTE. | Staff turnover continues to demonstrate special cause improvement in September 2024, reporting at 9.26% against a mean line of 10.02% and an overall Trust target of 10%. Employee Relations Case volume increased in September 2024, and is showing special cause concern, reporting at 143 (145 August) live cases against a mean line of 113.32 and target of 100. The proportion of ER cases closed within recommended timescales is at 59% against a target of 70%. Mandatory training remains at 84% for September 2024 for the fourth month in a row, below the target of 85% and continues to be in special cause concern. The overall trajectory is downwards. Appraisals percentage remains at 67%, this metric has been below target for the last 2-years. |
| Goal 2 – Providing Outstanding Care and Performance to Our Patients | September 2024 saw a decrease in Complaints per 10,000 patient interactions received (from 5.77 in August to 4.98 in September). Compliance with timescales for complaint responses has increased significantly to 80% from 55% last month. ROSC for all patients rose to 34.9%; it remains above target and is at its highest value in the last 2-years. Level 2 (adults and children) is 93% and is consistently exceeding the 90% compliance target. Hear-and-Treat, including Access to the Stack and Urgent Care Hubs, increased slightly to 11.27% in September from 9.71% in August. | The Trust premises audits % fell and remains below the 95% target at 80%. This metric is in special cause concern. Vehicle audits achieved 91% which is 4% below compliance target. Uniform compliance achieved the 94% which is 1% below the target. Average call pick-up times increased in September to 19.97 seconds compared to 11.41 seconds in July. This was alongside an increase in call volumes from 3,658 to 3,931 average daily contacts. Mobilisation times for C1, C2 and C3 continue to show special cause concern C1 Average On-Scene Time – Not Conveyed has deteriorated from last month and C2 and C3 Average On-Scene Time – Not Conveyed also show a slight deterioration. |
| Goal 3 – Be Excellent Collaborators and Innovators as System Partners | PTS data is now updated to reflect more appropriate information for assurance. PTS costs are above budget but are closer to budget than last month. This is a better position than last year and work to decrease costs is now embedded with further opportunity to be explored. | September showed a total of 3,580 calls passed – a 12.2% decrease from August. Acceptance rate in nearly all systems exceeded 5% acceptance rate with a 74% regional average. All calls accepted or declined with 20-minute KPI auto reject lowest ever at 5%. The Community First Responder volunteer daily hours within the Trust has seen a decline for the fifth month in a row. |
| Goal 4 – Be an Environmentally and Financially Sustainable Organisation | In Month 6 (September 2024), the YTD plan is for a surplus of £1.7m. The actual YTD position is a surplus of £2.1m, a surplus to plan of £0.4m. The main risks to the financial plan for the year are the overspends on Patient Transport Services (PTS) and Operations Support, and delivery of QCIP savings. Capital spend at the end of August 2024 is £4.4m. Forecast capital spend at the end of March 2025 is £27.5m. Invoices paid within 30-days remains below target but has improved over the last 3-months. Data produced by NHS England put NHS Providers on average around 90%, which we are averaging 2% less than. | QCIP is reporting £7.2 million against a target of £8.5 million. The primary reasons for the YTD shortfall against target of £1.3m relates to Emergency Operations. Most of the savings delivered both in Month 6 and YTD were non-recurrent in nature. The PTS YTD expenditure deficit to budget at Month 6 is £(0.8)m, this is due to the continued use of PAS, Taxis and other flexible resources. The situation in PTS remains a key risk to the financial plan for the Trust despite increased contract income secured for 2024-25. |
Options:
- Note the areas of progress.
- Consider the critical issue areas highlighted to gain assurance on the plans for mitigation.
