ITEM 11 Q1 Performance Report
North Lanarkshire Council · 18 October 2023
Back to IJB Performance, Finance and Audit Committee — 18 October 2023 and its agenda
Text extracted from the council's PDF. Layout and reading order may differ from the original.
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1 REPORT Item No: 11 SUBJECT: Performance Update – Quarter 1 (April – June 2023) TO: IJB Performance, Finance & Audit Committee Lead Officer for Report: Morag Dendy, Head of Planning, Performance and Quality Assurance Author(s) of Report Stephen Forrest, Performance Manager DATE: 18th October 2023 1. PURPOSE OF REPORT This paper is coming to the IJB for: For approval ☐ For endorsement ☐ To note ☒ 2. ROUTE TO THE BOARD This paper has been: Prepared By: ☒ Reviewed By: ☒ Endorsed By: ☐ Prepared by: Performance Manager Reviewed by: Senior Manager, Strategy & Performance 3. RECOMMENDATIONS It is recommended that the IJB/IJB PFA Committee: (1) Note the contents of the report and the appendix.
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2 4. VARIATIONS TO DIRECTIONS? 5. BACKGROUND/SUMMARY OF KEY ISSUES The Chief Officer has joint quarterly performance review meetings with the Chief Executives of NHS Lanarkshire and North Lanarkshire Council. These meetings are supported by a Chief Executives Performance Framework, comprising a range of performance measures taken from across both the health and social work systems, including relevant targets and trajectories for the measures presented. Each quarter there are areas for improvement identified within the performance framework; these are identified using a RAG rating and those measures that are flagged as Red or Amber are subject to improvement or corrective action. The performance review meetings are used as a means for jointly agreeing these actions. 6. CONCLUSIONS The areas for improvement and corrective action are attached as Appendix 1. The areas for improvement identified in Appendix 1 are being progressed as a matter of priority, and progress updates will be reported at future meetings of the Board and the Performance, Finance & Audit Committee. 7. IMPLICATIONS 7.1 NATIONAL OUTCOMES Link(s) to National Health and Wellbeing Outcomes People are able to look after and improve their own health and wellbeing and live in good health for longer ☒ People, including those with disabilities or long-term conditions, or who are frail, are able to live, as far as reasonable practicable, independently and at home or in a homely setting in their community ☒ People who use Health and Social Care Services have positive experiences of those services, and have dignity respected ☒ Health and Social Care Services are centred on helping to maintain or improve the quality of life of people who use those services ☒ Health and Social Care Services contribute to reducing health inequalities ☒ People who use Health and Social Care Services are safe from harm ☒ People who work in Health and Social Care Services feel engaged with the work they do and are supported to continuously improve the information, support, care and treatment they provide ☒ Resources are used effectively and efficiently in the provision of Health and Social Care Services ☒ Yes ☐ No ☐ N/A ☒
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3 7.2 ASSOCIATED MEASURE(S) None. 7.3 FINANCIAL This paper has been reviewed by Finance: 7.4 RISK ASSESSMENT/RISK MANAGEMENT Relevant Risk Register Details Current Risk Level Risk Owner IJB 11.21 - Oversight of Performance Activity Low Ross McGuffie NHSL 2014 - Recovery of Performance 2021/22 Very High NHSL Corporate NLC RIA0000460 – Performance & planning High NLC – Social Work/Social care 7.5 ENGAGEMENT & PARTICPATION Please tick the engagement and participation objectives that link(s) with this piece of work and provide further details regarding the engagement and participation that was undertaken. Objectives Further Details ☐ Involve stakeholders in the development work aimed at achieving the national outcomes ☐ Provide stakeholders with information on how to get involved ☐ Ensure a diverse range of engagement and participation and opportunities are in place to suit different needs ☐ Measure how well we involve community stakeholders in the planning, design and delivery of our services ☐ Provide regular feedback on how stakeholder engagement and participation is shaping and influencing service development and delivery ☒ Provide support to enable stakeholder representatives to participate meaningfully and confidently at meetings The performance information, with the corresponding improvement and corrective actions will enable stakeholder representatives to participate in wider discussion about performance. ☐ Develop participation guidelines to ensure a common understanding and set of Yes ☐ No ☐ N/A ☒
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4 expectations for both stakeholders and partnership staff ☒ Support engagement planning and participation in localities, taking account of other engagement activity and local plans across the Community Planning Partnership The performance information, with the corresponding improvement and corrective actions supports locality planning. 7.6 INEQUALITIES & FAIRER SCOTLAND DUTY EQIA Completed & Fairer Scotland Impact Assessment Form Completed and attached to report: EQIA added to website: 8. BACKGROUND PAPERS None. 9. APPENDICES Appendix OneAreas for Improvement (Quarter 1, April – June 2023) CHIEF ACCOUNTABLE OFFICER (or Depute) Head of Planning, Performance and Quality Assurance Members seeking further information about any aspect of this report, please contact the following; Stephen Forrest – Performance Manager Stephen.Forrest@lanarkshire.scot.nhs.uk Yes ☐ No ☐ N/A ☒ Yes / Date added ☐ No ☐ N/A ☒
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5 Appendix One Appendix One– Areas for Improvement (Quarter 1, April – June 2023) 1. Alcohol Brief Interventions Target 2022/23 2022/23 Q4 2023/24 Q1 Performance Compared to Previous Quarter Performance Compared to Same Quarter Previous Year RAG Status Alcohol Brief Interventions North 4072 292 718 Alcohol Brief Interventions (all settings) NHSL 7381 647 1098 Narrative & Corrective Action The Scottish Government (SG) and Public Health Scotland (PHS) have confirmed that the NHS Lanarkshire annual ABI target is to remain at 7381 for 2023/24. To reflect structural and organisational changes, the Information Services team have completed a mapping exercise detailing the teams in their localities, which allows for the provision of agreed trajectories for each locality and the many teams who contribute toward achieving the overall target number of ABI. This will allow for local scrutiny of performance by service managers at their team meetings. A SOP for recording ABIs on each of the recording systems has been finalised and will be disseminated to localities and teams by Service Managers. An evaluation of the training provided to community staff has been shared with the Steering Group and the recommendations are now being considered as it will not be possible to implement them fully within the current level of resource available. 2. Cervical Screening Target 2022/23 2022/23 Q4 2023/24 Q1 Performance Compared to Previous Quarter Performance Compared to Same Quarter Previous Year RAG Status Cervical Screening 80% 72.5% 72.3% Narrative & Corrective Action Analysis was carried out using MiLan data to understand the cervical screening uptake across Lanarkshire. The chart below shows the uptake for North Lanarkshire Council by locality for quarter 1. No locality achieved the recommended target of 80%.
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6 Data analysed from MiLan for the time period 1st April 2023 – June 2023 – Quarter 1 Data for cervical screening is available at a practice level. Of the 50 GP practices in North Lanarkshire, only 3 GP practices achieved the national target of 80% in Quarter 1. The breakdown by locality is provided below. Airdrie (6 practices) – no practices achieved the 80% uptake target Bellshill (9 practices) – no practices achieved the 80% uptake target Coatbridge (6 practices) – no practices achieved 80% uptake target Motherwell (6 practices) – 1 practice achieved above 80% uptake target North (12 practices) – 2 practices achieved 80% or above Wishaw (11 practices) – no practices achieved the 80% uptake target Health Improvement Activity Information Provision/Communications 62.0% 64.0% 66.0% 68.0% 70.0% 72.0% 74.0% 76.0% 78.0% 80.0% 82.0% Airdrie Bellshill Coatbridge Motherwell North Wishaw 2023 Locality Uptake by Quarter 2023 Quarter 1 Jan - March 2023 Target
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7 Information was circulated to partners as part of Cervical Screening Awareness Week (19th-24th Jun) to support awareness raising and informed choices. Two Cancer and Screening Inequalities Workshops were delivered by Health Improvement. This includes cervical cancer and screening information; these sessions are available to staff and organisations across North Lanarkshire. Community Engagement. o Two community projects were appointed through the VANL commission process in June 2023. These were appointed to deliver a 12-month programme of activity in North Lanarkshire, specifically Airdrie and Bellshill, using a community development approach to improve awareness and engagement with the national cervical and breast screening programme. Airdrie – Bear Necessities: A project manager will work with local women’s community groups and settings where women already attend to explore barriers to attending screening, and to raise awareness around cervical and breast screening. Engagement with primary care to support women attend cervical screening will be offered. Existing links with Airdrie Action Partnership and Airdrie Consortium will be used to extend the reach of the work. Bellshill – Culture Junction: A community arts approach delivering workshops and pop up events, empowering women to discuss their thoughts around their bodies, to address any fears, shame or stigmas they may face when accessing cancer screening, or fears, shame or stigma more generally. Using creative engagement approaches e.g., creative writing, arts and craft, to engage women on the topic, and to provide a safe, relaxed environment to share stories, learn from one another and gain confidence to access their screening. In addition, a focus group will be supported to create a resource for women. 3. Child Immunisations Target 2022/23 2022/23 Q4 2023/24 Q1 Performance Compared to Previous Quarter Performance Compared to Same Quarter Previous Year RAG Status Immunisations – %s of 5 year olds 95% 92.2% 91.4% Narrative & Corrective Action The Community Nursing Management Team are carrying out further analysis of DNA at a locality level to try and determine whether there are patterns, or trends at the level of localities that might increase the organisational intelligence around non-attendance. It should be noted that regardless, in each instance of DNA, there is an appropriate and proportionate action plan for each child following up on that non-attendance. The intelligence gained through previous analysis has identified that more novel and focussed approaches may be desirable, and the team is looking at how home immunisations and “pop-up” immunisation clinics might improve performance in the areas of highest non-attendance. This is supported by the findings of a self-assessment by the Immunisation Inclusivity Group and Dr Henry Prempeh, who conducted a session around nine thematic areas (local insights, eligible population, reminders/recall, catch-up activity, declines/opt-outs, delivery models, inclusion activity, marketing and
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8 communications and workforce education) to better understand the performance and what improvements might be found. The findings of this review will inform future improvement activity. It should be noted that there are known anomalous aspects of the data held regarding childhood immunisations; for example, where a child has had all immunisations except MMR due to choice, the calculation for this metric may return that case as the child having had no immunisations. Work is ongoing to address these issues, with further development of SIRS and Morse recording practices to ensure accurate performance data is produced and published. 4. 6-8 Week Reviews Target 2022/23 2022/23 Q4 2023/24 Q1 Performance Compared to Previous Quarter Performance Compared to Same Quarter Previous Year RAG Status Percentage of people who have completed 6-8 week review 90% 71.1% Quarterly/ 1 quarter behind Narrative & Corrective Action An SBAR has been prepared detailing recommendations for improvements to the Universal Health Visiting Pathway (UHVP) and the Child Health Surveillance Programme Pre-School system (CHSP-PS). One of the drivers for this work is the level of performance in this area; the PHS monthly reporting indicates that completion of the 6 to 8-week assessment by 10 weeks of age is consistently below 75% across North Lanarkshire. 6-8 week assessments are not being undertaken in the required timescales and are not being delivered consistently across NHS Lanarkshire. UHVP is a minimum standard for core home visiting offered to all families consisting of 11 home visits; 8 within the first year of life and 5 Child Health Reviews between birth and starting school. CHSP-PS supports the delivery of the child health programme by facilitating the automated call and recall of children for the agreed schedule of child health reviews for pre-school children. Both programmes are evidence based and agreed best practice. The visit at 6 to 8-week review is a home visit that is in addition but complimentary to the review undertaken by General Practitioners (GP) at 8 weeks in the surgery or clinic. Completion and return of the Child Health Surveillance Programme form is the joint responsibility of the GP and Health Visitor (depending on local arrangements) and the review form should be completed fully and accurately then promptly returned to the local child health department for timely data entry into the CHSP-PS. Quality control and validation is in place to ensure the accuracy of data, however this does result in situations where records or forms identified as requiring further attention not being captured in reporting, therefore there is often incomplete reporting for this metric, or misleading performance information. An in-depth review was carried out by each Health Visiting Team Leader for children born within their localities between October 2022 and December 2022; the review used a case-study approach for 6-8 week reviews that were thought either not to have taken place, or information had not been received by the Child Health Department for recording into the CHSP-PS. These cases were reviewed for accuracy and any trends or common themes for
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9 those cases. The results are summarised in the table below; 82% of babies identified within the time frame did receive a full HV/GP assessment, of those 39% were out with the timeframe: The overall findings highlighted that the paper-based system that is in place is not easy to navigate, nor does it allow for ease of monitoring at a local level. The review found that implementing an electronic system would reduce the risk of lost information, avoid confusion and provide a clear monitoring system. The SCAR concludes with the following recommendations: The implementation of a CHSP forms as part of an electronic system would reduce dependency on paper assessment sheets and reduce the duplication of forms, provide assurance that assessments were being completed and ensure prompt return. It would allow for easier monitoring of what was completed/outstanding. Develop a Standard Operating Procedure to ensure 6-8 week assessments are completed within agreed timescales and completed forms are promptly returned to the local child health department for timely data entry into the Child Health Surveillance Programme Pre-School system (CHSP-PS). Wishaw Motherwell Bellshill North Coatbridge Airdrie Total % No. on List 21 24 22 45 13 27 152 No. completed by HV 21 22 21 45 12 27 148 97% No. with full HV and GP review within timescales 14 10 7 21 4 9 65 43% No who had a late review/or no full GP/HV Review Late: 4 No: 3 Late: 9 No: 5 Late: 8 No: 7* *1 child not discharged from hospital Late: 24 No: 0 Late: 6 No: 3 Late: 8 No: 10 Late:59 No: 28 39% 18%
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10 Remind Health Visitors and GP’s/CHS clinics of the tight timescales for completion to ensure assessments are completed timeously. Ensure outcome of assessments shared – GP should be returning HV part of form to the Health Visitor for information. Health Visiting Teams to follow the journey of the 6 to 8-week Assessment form to ensure process is followed. Ensure GP Practices and CHS clinics have enough appointments to accommodate demand for assessments so that there is assurance that they will be completed within approved timescales. Once both HV and GP assessments are completed this should be recorded as a significant event in the child’s Health Visiting record. The SBAR is being considered through the service’s internal governance before proceeding to implementation of the recommendations. 5. Reablement and rehabilitation services Target 2022/23 2022/23 Q4 2023/24 Q1 Performance Compared to Previous Quarter Performance Compared to Same Quarter Previous Year RAG Status Reablement - Number Of People Completing Reablement Process 2000 (500 per quarter) 1418 376 Reablement - % Of New or Increased Home Support Packages Which Are Reablement 70% 61.20% 64.00% Reablement - % Of People With No or Reduced Home Support Service Required At End Of Process 70% 28.80% 21.30% Balance Of Care - % Of People (Age 65+) 45% 42.60% 40.20% IEAS - % Deliveries Achieved Within 7 Working Days Quarterly 80% 51.50% 47.50% Narrative & Corrective Action It is widely acknowledged that Reablement support provided within North Lanarkshire produces good outcomes for service users completing the Reablement process, however further consideration of performance in this area has highlighted clear recording issues in some localities and teams. In essence, Reablement demand and support is not always being recorded appropriately, with both Cumbernauld and Airdrie identified as not accurately reporting Reablement progress, and there is an undoubted subsequent impact on the data for these performance metrics. The service is now experiencing a delay in Home Support Teams moving service users off of Reablement if it has been identified that a provider may be required for ongoing support should the locality teams not have the resource required. This is mainly due to the directive that an indicative budget requires to be approved and agreed before a service user can be allocated to a provider via the SDS model of support. This is impacting on locality teams taking on additional cases for Reablement.
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11 All Reablement teams are highlighting the lack of Occupational Therapy support to Reablement received from each of the locality teams; prior to the creation of IRT, Occupational Therapists worked in partnership with Home Support Reablement teams, with joint screening meetings and home visits accepted practice. All locality teams are reporting that this support is now limited due to the demands on IRT. Locality SDM’s have highlighted the significant and sustained vacancies in Reablement teams that are unable to be filled, particularly Home Support Worker vacancies. This is in part due to the current cap on recruitment, which is restricting the number of service users who can be supported at any given time via the Reablement process. The expansion of the Home Assessment Team (HAT) and the HAT approach continues to impact on the wider system. The number of referrals per month to HAT continued to increase until March 2023, where it appears to have plateaued and then subsequently reduced in July 2023. The largest input service for HAT is Home Support (65% of referrals received), followed by O.T. (49%). Both of these figures have remained constant since the start of the service.
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12 846 people were noted as completing HAT, 85% of the total referrals. The locality with the largest number of people recorded at completion stage was Wishaw. Of the 304 showing further service being required, the service with the highest number was C.A.S. with 131 (15% of total completing). With regard to IEAS, a Programme of improvement works is still in progress, with improvements to premises and focussed recruitment activity in progress at the time of reporting. Sustained workforce challenges, specifically recruitment and retention of suitably skilled and experienced IEAS staff have resulted in challenges with the delivery and uplift of equipment. 6. Delayed Discharges Target 2022/23 2022/23 Q4 2023/24 Q1 Performance Compared to Previous Quarter Performance Compared to Same Quarter Previous Year RAG Status Delayed discharge bed days - standard delays 31,796 8,178 8,438 Narrative & Corrective Action For 2023/24, North Lanarkshire HSCP has set a target to reduce the 2022/23 target for number of delayed discharge bed days for standard delays by 5%. This is on top of the 10% reduction target in the previous year. During April – July 2022/23, cumulatively, there were 1527 more delayed discharge standard bed days than trajectory – 11,234 against the target of 9,797. Input SW 4% OT 49% Physio 17% AHP Support Staff 9% Home Support 65% CAS 24% Technology 4% Pharmacy 3% Com. Nursing Team 10% Med. Realignment 2% Service at Completion HS - Reablement 9% HS - Mainstream 13% IRT - Physio 7% IRT - OT 11% Rehabilitation - Other 1% CAS 15% Locality SW Referral 1% IDS 1% LSS 1% District Nurse 7% NL Leisure 1% Third Sector 4%
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13 Standard Bed Days against trajectory Figures 6 and 7 show that North Lanarkshire performance has improved on the July census date and was below the national average for the rate of delayed discharge for the entire adult population and >75. Lower is better
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14 Rate Per 100,000 Over 18s Rate Per 100,000 Over 75s* The work initially being undertaken as part of the ‘Discharge Without Delay’ programme is now being subsumed within Operation Flow and should see improvement across a number of areas which will assist in improving patient flow through the hospital which, in turn, will assist significantly in reducing delayed discharges. Through the use of accurate Planned Date of Discharge (PDD), early involvement of social work staff in discharge planning and an associated reduction in ‘unplanned referrals’, so the number and time associated with delayed discharges should improve.
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15 Recently reported work associated with ‘Discharge without Delay’ and associated developments to support earlier discharge and potential admission avoidance are anticipated to assist in bringing further improvements in this position. Throughout July, above 94% of all patients from North Lanarkshire were discharged without delay (target 98%). All inpatient discharges In the middle of the month of July patients aged 65+ with a Planned Date of Discharge (PDD) was 61%. Unplanned referrals peaked at 41% in the first week of July. Discussion is ongoing with acute colleagues in seeking to support improvements in these areas such that there is sufficient time to plan discharges and therefore reduce the level of subsequent delay. Work includes the provision of dedicated social work support to ward-based Multidisciplinary Team reviews with an aim of improving the number of people with PDDs and accuracy of same.
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16 Current Inpatients (at time of census) with a Planned Date of Discharge
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17 Current Inpatients (at time of census) with a SW referral that is unplanned Factors affecting performance include: Recent challenges with increases in sickness absence levels in in-house Home Support services Continued reduced capacity of Reablement services Recruitment and retention to posts at all grades in Home Support has been challenging and there has been a higher than usual turnover. In particular Home Support Worker, Support Officer and Service Delivery Coordinators have been difficult to recruit and retain. Highest referral rates on record – w/b 16th January, the North partnership received 158 referrals (peak winter pre-pandemic average was 77) A wide range of activity is underway, both locally and nationally, to drive further improvement in performance, these include: Whole system improvement work on the PDD process, including development of PDD metrics for inclusion in future reports Home Support recruitment
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18 Lanarkshire is a demonstrator site for Home First/Discharge without delay. Staff involved in the development of the Discharge without delay measurement plan Rapid response, focused on supporting people at home, is having an impact. Home Assessment Teams are now up and running with over 660 individuals now supported home since May 2022. 60% of individuals the Home Assessment Team has worked with required no further support or service at the end of the process. Further work is ongoing to accelerate the implementation of Home Assessment Teams across all localities. Expanding Hospital at Home service and considering expanding to under 65s Additional CSWs are being recruited so that District Nursing Teams can enhance the care offering to those on both Home Support and District Nursing caseloads, freeing up further Home Support capacity to concentrate on other cases New approach to interim care home placements introduced in December 2022. Establishment of additional review capacity to free up mainstream Home Support service Efforts continue to ensure Reablement capacity within the service is protected with Reablement and rehabilitation key priorities for the future of the operating model. 7. CAMHS Target 2022/23 2022/23 Q4 2023/24 Q1 Performance Compared to Previous Quarter Performance Compared to Same Quarter Previous Year RAG Status 18 Week RTT Performance – CAMHS NHSL (NORTH HOSTED) 90% 28.7% 28.1% Narrative & Corrective Action The Waiting List Initiative has continued to evidence a steady downward trajectory in children and young people who are waiting to be seen. This, in collaboration with the delivery of increased capacity for initial assessment (Choice Appointment), is evidencing regular incremental monthly reductions in the waiting list and the longest waits. A regular weekly meeting is in place that will continue to focus on longest waits, as well as the distribution of choice and partnership appointments being offered. The service has currently paused the additional capacity being offered for Choice appointments (initial assessment). The service has assured itself that Choice appointment capacity is embedded in the CAPA booking process and this will continue to be scrutinised to ensure it is maintaining capacity against demand.
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19 It is likely that the WLI will need to flex to provide the additional capacity required to address ongoing challenges around the RTT target. Work is ongoing with CAMHS Clinical Managers and Team Coordinators to ensure CAPA partnership appointment capacity is maximised across the whole system. There has been a drop off in RTT performance in Q1; this was anticipated due to the increased activity through waiting list initiative and it expected that there will not be significant improvement in RTT in Q2. This is due to a culmination of higher levels of DNA due to school holidays and staff annual leave; however, the weekly focus on longest waits, CAPA appointments and additional out-of-hours capacity should start to realise a consistent positive trajectory in future quarters. 8. Adult Mental Health Target 2022/23 2022/23 Q4 2023/24 Q1 Performance Compared to Previous Quarter Performance Compared to Same Quarter Previous Year RAG Status Consultant Outpatient WT - Adult Mental Health - 12wks (NHSL) (NORTH HOSTED) 90% 63.5% 57.4% Narrative & Corrective Action Psychiatry performance continues to be impacted by significant challenges around the recruitment and retention of Consultants, which is a national issue. Performance in this area is subject of the MH & LD Risk Register. Sustained levels of high demand and recovery works focussed on those patients waiting the longest have seen improvements in the longest waits.
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20 The service continues to focus improvement activity on improving current staffing levels and retaining staff through personal development and training opportunities. 9. Medical Paediatrics Target 2022/23 2022/23 Q4 2023/24 Q1 Performance Compared to Previous Quarter Performance Compared to Same Quarter Previous Year RAG Status Medical Paediatrics WT - 12 wks (NHSL) (NORTH HOSTED) 90% 49.2% 49.5% Narrative & Corrective Action The Paediatric Modernisation Board has been established. A preliminary workshop followed by the first meeting of new Board has taken place. It is chaired by AMD for NLHSP and reports directly to Head of Health who has responsibility for delivery of the ongoing improvements required to assure future service models. Membership and agreed TOR now in place. Programme of work identified. A Horizon 1- 3 approach is being taken. Initial Work Streams have now been established. These include: - Care Assurance Work Stream- Chaired by AND for Children and Young People Services. Rota Sustainability Continence Service Model review (which has a big impact on community paediatric waiting times) There continues to be robust vetting of all referrals into General and Paediatric services and some recovery of waiting time is being achieved. However, there are increasing numbers of referrals being sent to the department so impact of what is being delivered has not yet balanced and will require further scope of capacity and demand to evidence the growth ask beyond current resource. This will be a focus of Paediatric Modernisation Board as we consider and progress new sustainable models of working. Performance for July shows 45.3% with 802 children waiting over 12 weeks. Longest wait is 51 weeks.
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21 10. Paediatrics – Speech and Language Therapies Target 2022/23 2022/23 Q4 2023/24 Q1 Performance Compared to Previous Quarter Performance Compared to Same Quarter Previous Year RAG Status SLT - Paediatrics - 12wks (NORTH HOSTED) 90% 39.4% 25.1% Narrative & Corrective Action Speech and Language Therapy continues to face significant challenges to meet the waiting times target. A service improvement plan is in progress and the management team have been provided with additional support to implement the improvements. A service improvement workshop and subsequent process mapping session was facilitated by a project lead and service improvement colleague; these colleagues are providing ongoing dedicated support for the improvement work. There are now six discreet areas of improvement work: - 1. Communication and Engagement - SLT colleagues already have a dedicated website and share many support materials via YouTube. This work stream will be led by NHS Communications Team and supported by the SCHSU Engagement Officer to ensure voices of children, young people and family are considered within this process. 2. Waiting List - The Team are not consistently using Trakcare across their full system. This makes it difficult for them to apply consistent waiting time measurement processes across the service. Service Improvement and Waiting List Management colleagues have been involved in supporting improvement work in this area. 3. Accommodation - The Team are based across several community bases and are also on acute sites. A review will be undertaken of currently allocated space with a particular focus on appropriate capacity of clinical rooms to meet clinical demand. 4. HR and Workforce - The team are similar to many areas within healthcare; recruitment and retention is an important area of focus due to difficulties recruiting, training and retaining suitable skilled and experienced staff. This work will be supported by NHS Lanarkshire HR and workforce colleagues. Scoping will be undertaken of the workforce demography to ensure we are building a sustainable future model for workforce and service delivery. This will include considered expansion of non-registered roles with the input of further education partners, who
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22 are involved in supporting the work; it is hoped that their inclusion in workforce planning will support increased partnership working and sharing of experience that will be mutually beneficial. 5. Administration - Currently the OSM workforce is managed across 2 separate OSP portfolios. The administration group will focus on scoping of tasks against current capacity and demand, as well as insuring that both OSM’s are kept informed of developments that may affect their teams. eHealth - eHealth colleagues will lead this group and develop a plan of improvement. The initial focus will be testing the current Trakcare build and expanding this to all parts of service. Thereafter, the focus will be on ensuring all people being seen by SLT will have their care and interventions documented on Morse, so that they can inform shared working with other colleagues involved in direct care.
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23 Direction from North Lanarkshire Integration Joint Board (IJB) 1 Reference Number 2 Report Title 3 Date direction issued by IJB 4 Date from which direction takes effect 5 Direction to: 6 Does this direction supersede, revise or revoke a previous direction – if yes, include reference number(s) 7 Functions covered by direction 8 Full text of direction 9 Budget allocated by Integration Joint Board to carry out direction 10 Performance Management / Governance arrangements
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24 11 Date direction will be reviewed