Integrated Joint Board Performance Report (May 2022)

Argyll and Bute Council · 8 June 2022
Back to Mid Argyll, Kintyre & the Islands Area Committee — 8 June 2022 and its agenda

Text extracted from the council's PDF. Layout and reading order may differ from the original.

Original council PDF · Download plain text

Page 1

1   
Mid Argyll, Kintyre and the Islands Area Committee   
Date of Meeting:    8 June 2022 
Title of Report:  Integration Joint Board Performance Report (May 2022) 
Presented by: HSCP    
The Committee is asked to:
 Consider the HSCP performance progress presented to the IJB on 25 May
regarding remobilisation of activity in line with NHS Highland performance
target for 2021/22 agreed with Scottish Government to 70%-80% of 2019/20
activity as at November 2021
 Consider Waiting Times Performance and a further reduction in Consultant
and Nurse Led Outpatient breaches >12 weeks
 Note performance with regards to both Argyll & Bute and Greater Glasgow
and Clyde current Treatment Time Guarantee for Inpatient/Day Case
Waiting List and activity
 Note Scottish Government’s advice on timescales for the publication of
2021/22 Annual Performance Report (APR). 
1. EXECUTIVE SUMMARY 
The remobilisation of services across both health and social care is a Scottish Government priority
and frontline staff and managers are working hard to achieve this across the Health & Social Care
Partnership. This report therefore provides the committee with an update on the impact on service
performance and the progress made with regard to remobilising health and social care services in
Argyll & Bute up to 31st March 2022. 
The committee are also asked to note future performance reporting arrangements associated with
the development and roll out of the HSCP’s Integrated Performance Management Framework, and
also Scottish Government’s advice on timescales for the publication of 2021/22 Annual Performance
Report (APR). 
2. INTRODUCTION
NHS Highland’s (NHSH) Remobilisation plan focuses on the areas agreed as priorities with the
Scottish Government and includes information on 10 work streams and associated projects.
Alongside this the Framework for Clinical Prioritisation has been established to support Health
Boards with prioritising service provision and framing the remobilisation of services against 6 key
principles within a Covid19 operating environment as below:

Page 2

2
1. The establishment of a clinical priority matrix – as detailed below, at the present time
NHSGG&C & NHS Highland are focusing on the P1 & P2 category:
 Priority level 1a Emergency and 1b Urgent – operation needed within 24 hours
 Priority level 2 Surgery/Treatment – scheduled within 4 weeks
 Priority level 3 Surgery/Treatment – scheduled within 12 weeks
 Priority level 4 Surgery/Treatment – may be safely scheduled after 12 weeks.
NHS Boards can decide to pause non urgent or elective services (P3 & P4) to ensure they retain
capacity to cope with Covid19 emergency need and NHS Highland implemented this in August at
Raigmore.
2. Protection of essential services (including critical care capacity, maternity, emergency
services, mental health provision and vital cancer services)
3. Active waiting list management (Consistent application of Active Clinical Referral Triage
(ACRT) and key indicators for active waiting list management, including addressing demand
and capacity issues for each priority level)
4. Realistic medicine remaining at the core (application of realistic medicine, incorporating
the six key principles)
5. Review of long waiting patients (long waits are actively reviewed (particularly priority
level four patients)
6. Patient Communication (patients should be communicated with effectively ensuring they
have updated information around their treatment and care)
3. DETAIL OF REPORT
The report details performance for March 2022 with regards to the Health & Social Care Partnership,
NHS Greater Glasgow & Clyde and NHS Highland.
4. RELEVANT DATA & INDICATORS
4.1 Remobilisation Performance
The tracker below summarises the HSCP service remobilisation performance against agreed SGHD
target (70-80%) for April 2021 to March 2022
HSCP Remobilisation Tracker April 2021 to March 2022

Page 3

3    
(Please note that not all MH community and AHP activity is captured due to data lag and some services are not yet on automated
systems) 
Remobilisation Performance Assessment: 
The information presented shows good progress with regards to the scale of mobilisation of our
services in the HSCP with increasing activity across our health and care system. Some points to
note:
 Cumulative total outpatient activity across new and return notes a (59%) increase against
target
 Total urgent suspicion of cancer referrals received notes a (31%) increase in activity for
March (55) against the previous month (42)
 Lorn & Islands Hospital total percentage of attendances at A&E seen within 4 hrs notes a 
(5%) reduction for March against target (95%)
 Total number of adult referrals note a (22%)increase for March against previous month 
 Total number of assessments completed note a (20%) increase for March against previous
month 
 Cumulative total Endoscopy and Radiology activity notes a (11%) increase against target
Target Apr-21 May-21 Jun-21 Jul-21 Aug-21 Sep-21 Oct-21 Nov-21 Dec-21 Jan-22 Feb-22 Mar-22 Target Total
Ref
TTG 1 44 34 36 39 41 36 35 24 36 37 35 49 41 528 443
Ref
R-1 803 807 780 846 705 780 706 818 798 667 691 729 997 9636 9324
R-2 28 47 26 58 47 45 46 44 43 44 29 42 55 336 526
OP-1 652 602 685 723 630 682 668 642 810 525 600 661 634 7824 7862
OP-2 904 1319 1286 1454 1424 1446 1459 1479 1631 1233 1419 1425 1526 10848 17101
OP-3 556 889 926 1020 874 964 953 893 992 818 849 894 1066 6672 11138
OP-4 1312 2660 2691 2821 2368 2619 2549 2343 2527 2087 2014 2033 2455 15744 29167
Ref
DI-1 50 67 88 66 58 65 61 63 62 55 15 52 51 600 703
DI-2 462 485 509 581 560 503 508 468 528 463 410 469 699 5544 6183
Ref
CA-1 9 3 4 7 10 2 4 3 1 4 3 4 3 108 48
Ref
UC-1 685 552 729 812 786 813 745 660 598 591 622 608 759 8220 8275
UC-2 1244 1880 2152 2234 2276 1986 2190 1882 1882 1823 1793 1741 2022 14928 23861
UC-3 95% 98% 96% 96% 95% 91% 93% 92% 96% 96% 97% 92% 90%
UC-4 165 151 176 200 177 203 175 176 167 151 159 157 188 1980 2080
UC-5 148 178 180 176 204 192 182 188 203 183 163 174 178 1776 2201
Total 31 Days Cancer - First Treatment Monitoring
Total A&E Attendances Monitoring (LIH)
Total A&E Attendance (AB Community Hospitals)
Total % A&E 4 Hr (LIH)
Total Emergency Admissions IP Activity Monitoring
Emergency Admissions IP Activity Monitoring (AB
UNSCHEDULED CARE
CANCER
OUT PATIENTS
Key Performance Indicators
Description
TTG
TTG Inpatient & Day Case Activity (All Elective
REFERRALS
Total Outpatient Referrals
Total Urgent Suspicion of Cancer Referrals Received
Total New OP Activity Monitoring
Total Return OP Activity Monitoring
Total AHP New OP Activity Plan
Total AHP Return OP Activity Plan
DIAGNOSTICS
Cumulative Apr 2021 - Mar 2022
Total Endoscopy Activity Monitoring
Total Radiology Activity Monitoring
A&B HSCP - Remobilisation Plan Tracker
Performance Overview
Ref
AC-1 716 517 549 585 628 618 576 598 686 573 583 592 758 8592 7263
AC-2 224 275 288 344 216 257 252 235 264 174 196 209 261 2688 2971
AC-3 24 24 24 21 24 28 32 27 42 28 19 36 32 288 337
AC-4 36 40 39 32 46 28 29 29 24 28 38 35 52 432 420
AC-5 16 22 22 20 14 24 17 27 18 21 9 13 37 192 244
AC-6 5 4 4 5 7 8 13 12 10 4 10 13 16
AC-7 5 8 7 12 13 13 9 15 14 18 13 11 18
Ref
CH-1 80 52 60 59 64 76 69 38 41 50 41 60 48 960 658
CH-2 584 885 828 881 769 794 747 735 851 757 689 685 794 7008 9415
CH-3 92 130 136 123 150 124 112 101 112 93 105 91 82 1104 1359
CH-4 4032 4490 4428 4634 4883 5046 4715 4758 4628 4677 4429 4054 4411 48384 55153
CH-5 276 350 352 410 373 388 356 375 441 337 311 374 384 3312 4451
CH-6 3096 2895 3083 3354 3289 3247 3514 3365 3820 3309 3350 2940 3763 37152 39929
Ref
CF-1 196 248 238 280 173 275 347 257 306 326 287 176 248 2352 3161
CF-2 88 85 109 101 59 125 88 96 108 60 81 90 73 1056 1075
CF-3 38 31 28 29 32 31 32 37 36 31 33 25 27
Total Number of Child Request for Assistance
Total Number of New Universal Child Assessments
Total Number of Children on CP Register
Total DN – New Episodes
Total DN – Patient Contact Notes
Total AHP - New Episodes
Total AHP - Patient Contact Notes
CHILDREN & FAMILIES SOCIAL CARE
Total No of Delayed Discharges Awaiting Care Home
Total No of Delayed Discharges Awaiting Homecare
COMMUNITY HEALTH
Total Mental Health – New Episodes
Total Mental Health – Patient Contact Notes
Total New Care Home Placements
ADULT CARE
Total Number of Adult Referrals
Total Number of UAA Assessments
Total Adult Protection Referrals
Total New People in Receipt of Homecare

Page 4

4
 Total mental health patient contacts notes an increase a (16%) increase in March (794)
against previous month (685) 
 Total number of child requests for assistance notes a (41%) increase for March (248)
against the previous month (176)
 Total new child universal assessments notes a (19%) reduction in March (73) against the
previous month (90)
 The number of delayed discharges has increased for those awaiting both Homecare (18)
and Care Homes (16) 
4.2 Waiting Times Performance
The tables below identifies the New Outpatient Waiting List and times by main speciality as at the
23rd March 2022, Comparator data for February in red is used identify changes across specialities
and waits. 
A&B Group Totals Extracted 23rd March 2022  
New Outpatient Waiting List 
Length of Wait (weeks)
Total on List Long Waits
(over26)
% Breaches of
each Group
OPWL Main Specialty Over 12 Under 12
Consultant Outpatient 305(275) 938 (905) 1243 (1180) 53 (49) 24.5% (23.3%)
AHP 226(220) 370 (347) 596 (567) 109 (98) 37.9% (38.8%)
Mental Health 486 (470) 247 (194) 733 (664) 324 (316) 66.3% (70.8%)
Nurse Led Clinics 23 (23) 163 (148) 186 (171) 3 (1) 12.4% (13.5%)
Other/Non MMI 380 (356) 702 (577) 1082 (933) 154 (142) 35.1% (38.2%)
TOTAL OPWL
Previous Month 
1420
(1344) 
2420
(2171)
3840
(3515)
643
(606)
37%
(38.2%)       
Length of Wait (weeks)
Total on List Long Waits
(over26)
% Breaches of
each Group
OPWL
Main Specialty Over 6 Under 6
Scopes *
Previous Month 
196
(149)
130
(108)
326
(257)
32
(23)
60.1%
(58.0%)       
Length of Wait (weeks)
Total on List Long Waits
(over26)
% Breaches of
each Group
OPWL Main Specialty Over 4 Under 4
MSK **
Previous Month 
1068
(1171)
443
(467)
1511
(1638)
252
(280)
70.7%
(71.5%) 
Waiting Times Performance Assessment: 
 Total new outpatient waiting list notes a reduction of percentage breaches of (1.2%) for
February against the previous month
 Scopes note a 23% increase in those on the waiting list for February (326) against the
previous month (257)
 Musculoskeletal physiotherapy waits note a reduction across all their waits for February,
including a (8%) reduction of total number of waits on the list and a (1.5%) reduction in total
percentage breaches.

Page 5

5
 Total waits greater than 12 weeks has increased by (6%) against the previous month with an
associated increase in those waiting less than 12 weeks of (11%)
 Overall percentage breaches  note that Nurse lead clinics note a further reduction (1.1%) for
February against the previous month, this also include reduction in Mental Health (4.5%),
Allied Health Professionals (0.9%) and Other (3.1%) 
4.3 Virtual Outpatient Performance 
The table below illustrates monthly cumulative virtual new and return consultant outpatient
performance for Lorn & Islands Hospital and Community Hospitals in Argyll and Bute. 
(Data Source- NHS Highland Remobilisation Plan Data- Cumulative Virtual New and Return Outpatient- March 2022) 
Performance Assessment: 
 Cumulative Virtual Consultant Outpatient activity for Lorn & Islands Hospital notes a (15%)
increase in virtual appointments for March against the previous month
 Cumulative Virtual Consultant Outpatient activity for Community Hospital notes a (19%)
increase in virtual appointments for March against the previous month 
4.4 Greater Glasgow & Clyde Outpatient Remobilisation Performance
This report notes the current Greater Glasgow and Clyde Performance with regards to targets
identified with their Remobilisation Plan (RMP3) for April 2022.
NHS GG&C Waiting Times (February 2021- February 2022) 
(Data Source - NHS GREATER GLASGOW & CLYDE BOARD MEETING/ Performance Assurance information- April 2022) 
28.3%
27.4% 27.4% 27.4%
28.5% 28.5% 28.5%
29.6% 29.3%
30.0% 30.0% 29.8% 29.8%29.7%
27.5% 27.5% 27.5%
30.0% 30.0% 30.0%
31.0%
32.1% 32.4% 32.6%
32.2% 32.2%
24.0%
25.0%
26.0%
27.0%
28.0%
29.0%
30.0%
31.0%
32.0%
33.0%
0
20000
40000
60000
80000
100000
120000
140000
FEB 2021 MAR 2021 APR 2021 MAY 2021 JUN 2021 JUL 2021 AUG 2021 SEP 2021 OCT 2021 NOV 2021 DEC 2021 JAN 2022 FEB 2022
New Outpatient Waiting Times - February 2021 to February 2022
0-12 Weeks 12-26 weeks 26-52 Weeks >52 Weeks % of NHS Scotland Waiting List % of NHS Scotland over 12 Weeks
Cumulative Virtual Consultant Outpatient Activity 
Reporting
Period
Lorn &
Islands
Hospital
New
Lorn &
Islands
Hospital
Return 
Community
Hospitals
New 
Community
Hospitals
Return
January  640 1800 194 827
March 769 2030 230 987
Variance +129 +230 +36 +160

Page 6

6
Performance Assessment: 
 At the end of February 2022, 123,757 patients were on the new outpatient waiting list, of this
total 72,469   were waiting >12 weeks against the RMP4 target of 70,000. The number of
patients waiting >12 weeks is 3.5% above the RMP4 target.
 29.8% of the total patients waiting across NHS Scotland for a first new outpatient appointment
were NHSGGC patients at the end of February 2022. 
4.5  Treatment Time Guarantee (TTG) - Inpatient/Day Case Waiting List 
Argyll & Bute Inpatient/Day Case Activity 
The graph below identifies current performance with regards to Inpatient /Day Case -12 week
breaches and current overall performance as at 17th February 2022 in Argyll and Bute at LIH, Oban 
Greater Glasgow & Clyde- Treatment Times Guarantee (TTG) - Waiting Times 
The graph below notes current performance with regards to TTG Inpatient and Day Case Activity
against trajectory from Feb 2021 to Feb 2022 
(Data Source - NHS GREATER GLASGOW & CLYDE BOARD MEETING/ Performance Assurance information- April 2022) 
28.4% 28.5% 28.3%
27.9%
27.2%
26.3%
25.9%
26.7%
27.3% 27.2% 27.0% 27.0% 27.2%
29.2%
28.9%
29.4%
29.7% 29.6%
28.7%
27.5%
27.8%
28.4%
28.7%
28.4% 28.2% 28.1%
24.0%
25.0%
26.0%
27.0%
28.0%
29.0%
30.0%
0
5000
10000
15000
20000
25000
30000
35000
40000
FEB 2021 MAR 2021 APR 2021 MAY 2021 JUN 2021 JUL 2021 AUG 2021 SEP 2021 OCT 2021 NOV 2021 DEC 2021 JAN 2022 FEB 2022
TTG Patients Waiting List - February 2021 to February 2022
0-12 Weeks 12-26 weeks 26-52 Weeks >52 Weeks % of NHS Scotland Waiting List % of NHS Scotland over 12 Weeks

Page 7

7
Performance Assessment:
Argyll & Bute
 Total breaches > 12 weeks on the TTG waiting list note 3.3% as at 13th April with 40.2 %
noted as booked.
 NHS Scotland Board Level Performance for TTG is identified in Appendix 1
Greater Glasgow & Clyde
 At the end of February 2022, there were 34,899 patients on the overall waiting list.
Currently 24,401 patients waiting >12 weeks against a target of 19,154. Above target by
27%.
 Currently 28.1% of the >12 weeks national waiting list at the end of February 2022.
4.6 Future Performance Reporting Arrangements
The IJB is asked to note following future performance reporting arrangements:
 The HSCP’s Integrated Performance Management Framework (IPMF) will be rolled out
across the HSCP with a collaborative and consultative approach adopted across the Senior
Leadership Team over 2022/23, in line with timescales agreed by SLT.
 IPMF governance will be applied through the Clinical and Care Governance Committee.
 Current IJB Performance Report will remain extant until the IPMF, its associated Key
Performance Indicators (KPIs), and the governance & scrutiny arrangements are fully
embedded within SLT.
 As per previous 2 years, using the mechanisms as laid out in the Coronavirus Scotland Act
(2020), Schedule 6, Part 3, the Scottish Government have confirmed the 2021/22 Annual
Performance Report (APR) will be due for publication by November 2022.
5. CONTRIBUTION TO STRATEGIC PRIORITIES
The monitoring and reporting of performance with regards to Argyll & Bute HSCP, Greater
Glasgow & Clyde and NHS Highland ensures the HSCP is able to deliver against key strategic
priorities.
6. GOVERNANCE IMPLICATIONS
6.1 Financial Impact
NHS Highland remobilisation plan has received additional funding from the Scottish Government
and this includes direct funding to the HSCP of £590,840.
6.2 Staff Governance
There has been a variety of staff governance requirements throughout this pandemic which have
been identified and continue to be progressed and developed include health and safety, wellbeing
and new working practices within national Covid19 restrictions as part of our mobilisation plans.

Page 8

8
6.3 Clinical Governance
Clinical Governance and patient safety remains at the core of prioritised service delivery in response
to the pandemic and subsequent remobilisation. 
7. PROFESSIONAL ADVISORY 
Data used within this report is a snapshot of a month and data period, where possible data trends
are identified to give wider strategic context. 
8. EQUALITY & DIVERSITY IMPLICATIONS
EQIA not required
9. GENERAL DATA PROTECTION PRINCIPLES COMPLIANCE 
Data use and sharing within this report is covered within the A&B & NHS Highland Data Sharing
Agreement 
10. RISK ASSESSMENT
Risks and mitigations associated with data sources and reporting are managed and identified within
the monthly Performance & Improvement Team- Work Plan
11. PUBLIC & USER INVOLVEMENT & ENGAGEMENT
Full access to this report for public is via A&B Council and NHS Highland websites 
12. CONCLUSIONS 
The Integration Joint Board is asked to consider the work to date with regards to improved
performance against Remobilisation and Waiting Times targets. Consideration should also be given
to the potential impact of the new Omicron variant with regards to future performance reporting and
prioritisation of service delivery. 
REPORT AUTHOR AND CONTACT 
Author Name: Stephen Whiston
Email: stephen.whiston@nhs.scot

Page 9

9
Appendix 1- Board Level KPI’s – 10th April 2022

Page 10

10 
Appendix 2- Proportion of Outpatients Waiting Over 12 Weeks by Health Board
(10/04/2022)