NHS Performance Ratings. Acute Trusts 2000/01

Transcription

1 NHS Performance Ratings Acute Trusts 2000/01

2 NHS Performance Ratings Acute Trusts 2000/01 Introduction In July 2000 the Government set out, in The NHS Plan, a blueprint for the modernisation and reform of the NHS over the next ten years. We made clear our determination to deliver a convenient and high quality service that fully meets the needs of patients. We also made clear our commitment to provide both patients and the general public with more comprehensive, easily understandable information on the performance of their local health services. We said that we would annually and publicly classify all parts of the NHS according to a new system of performance measures. Today s publication of NHS Performance Ratings takes forward this commitment. This is an important step towards delivering a more open and accountable National Health Service. Performance between NHS hospitals, as every patient knows, is extremely variable. That is not fair. It must be put right. Every hospital should be a good hospital. This is not primarily about money. It is about management and organisation. Why do we need NHS Performance Ratings? Patients and the public have a right to know how well NHS organisations are performing. Different NHS organisations also need to know how well they are doing in comparison with others, so that successes can be shared and weaknesses can be identified and acted upon. The NHS Performance Ratings represent, for the first time, a high level summary of the overall performance of nonspecialist acute NHS hospital trusts (general hospitals) against a number of key targets. In this first year of Performance Ratings we are only covering acute hospital trusts on a limited range of measures. Our focus for this year is limited to a number of indicators largely related to the experience of NHS patients. The independent Commission for Health Improvement has looked at the performance ratings for those organisations it has inspected and has confirmed that they provide a fair assessment based on the available data. The system is not primarily a commentary on the quality of clinical care although we have included indicators relating to clinical negligence, deaths in hospital and emergency readmission rates. A poor performance rating does not necessarily mean that Trusts are failing to provide a good standard of care to their patients but that the overall patient experience is poor. How will the NHS Performance Ratings system develop? The criteria for assessing performance will be refined and improved in the years ahead. The Department will be working with the Commission for Health Improvement to achieve this. This is the first year these assessments have been made. They are not perfect but they are based on the best available data to provide a balanced assessment of each

3 hospital. They do not mean that a poorly performing hospital is unsafe, does not contain some very good clinical services or that the staff are not working hard in often difficult circumstances. These performance assessments do show however, that performance has to be raised in a number of important areas across a significant number of general hospitals. Next year the assessment will apply to all local NHS organisations. The Performance Ratings system will be further developed for 2002 and beyond to cover other NHS bodies, such as specialist NHS Trusts and Primary Care Trusts. We are working on the range of measures, or performance indicators, which we use to assess performance. Next year will see a wider range of measures with a particular focus on patient and staff issues; these will be based on information drawn from comprehensive patient and staff surveys. We are continuing to improve the range of available clinical indicators, which reflect the quality of clinical treatment that patients receive. Patients, the public and NHS staff will have the opportunity to influence these developments since we are committed to consulting annually on the development of performance indicators for the NHS. Reports from the Commission for Health Improvement will have an increasingly important bearing on the performance rating of local NHS organisations. The Commission has so far visited only a relatively small number of NHS Trusts, but this will increase significantly so their recommendations will cover many more organisations than now. How does the NHS Performance Ratings system work? The NHS Performance Ratings system places all non-specialist hospital trusts in England into one of four categories: Trusts with the highest levels of performance are awarded a performance rating of three stars; Trusts that are performing well overall, but have not quite reached the same consistently high standards, are awarded a performance rating of two stars; Trusts where there is some cause for concern regarding particular key targets are awarded a performance rating of one star; Trusts that have shown the poorest levels of performance against key targets are awarded a performance rating of zero stars. All trusts have been assessed on their performance during 2000/01 against the following key targets, which are the most significant factors in determining their overall performance rating for this year: shorter inpatient waiting lists no patients waiting more than 18 months for inpatient treatment reduction in outpatient waiting fewer patients waiting on trolleys for more than 12 hours less than 1% of operations cancelled on the day no patients with suspected breast cancer waiting more than two weeks to be seen in hospital commitment to improving the working lives of staff hospital cleanliness a satisfactory financial position not receiving a critical report from the Commission for Health Improvement (CHI) Performance against targets is assessed in terms of whether the target has been achieved (a in the table), whether there has been some degree of underachievement (a -) or whether the

4 target was significantly underachieved (a ). Trust performance is considered to be of concern if there are: a sizeable number of targets with some degree of underachievement or, a smaller number of targets against which there has been significant levels of underachievement or a combination of both. The second set of measures has been used to refine the judgement between those trusts which are performing well overall (performance rating of two stars) and those trusts which are performing very well (performance rating of three stars). These measures have a particular clinical, staff and patient focus: Clinical Focus low risk of clinical negligence emergency re-admission rates deaths in hospital within 30 days of surgery for patients admitted on an unplanned basis Staff Focus compliance with the New Deal on junior doctors hours (working a maximum 56 hour week) the sickness/absence rate for directly employed NHS staff the rates of vacancies for the following key staff groups: consultants; qualified nurses, midwives and health visitors; qualified allied health professionals. Patient Focus the percentage of inpatients waiting less than six months for treatment the percentage of outpatients seen within 13 weeks the percentage of patients in A&E who wait more than 4 hours on a trolley before being admitted the percentage of complaints resolved within 4 weeks. Clinical Governance Taken together with the key target measures, the measures of clinical, staff and patient focus constitute a balanced scorecard approach. This means that a Trust which has received a performance rating of three stars will have demonstrated high standards of performance against the key targets and the three areas above. Similarly, Trusts with a performance rating of two stars will have demonstrated good standards of performance in most, if not all, of these areas. It is important that NHS performance is measured in such a balanced and rounded way to ensure that high performance scores are only awarded to trusts which genuinely merit them. However, it is equally important to note that this balanced scorecard approach represents a high level summary of performance in these key, but so far limited, areas only. The role of the independent watchdog, the Commission for Health Improvement is crucial in determining the rating a Trust receives. In order to be confirmed as 3 star organisation, strong performance needs to be demonstrated across the areas that CHI inspects ie, the Trust systems and process for monitoring and improving services. Where CHI has a final report on a Trust, this information is used

5 alongside clinical indicators in determining the star rating of a Trust. For Trusts without a final report, their star rating is subject to revision following a CHI review. How will the NHS Performance Ratings help to improve the quality of services? This information provides the basis for action to improve performance across the NHS. For the first time in the NHS there will be more rewards for good performance and more support to sort out poor performance. The Government is backing the NHS Performance Ratings system with extra money to invest in improved performance. Each part of the health service is guaranteed a fair share of the new NHS Performance Fund. For the first year of operation of the fund, 155m has been allocated to the all NHS Trusts, including community, mental health and ambulance Trusts, to support incentive schemes. The fund will rise to 500m by 2003/4. Although all NHS bodies will receive their fair share of the Performance Fund, how they are able to spend it will depend on their performance rating. The best performing Trusts those with three stars - will get extra rewards and new freedoms to help them become even better. As part of the Government s devolution of power to frontline services the best performing trusts will be free to spend extra cash on developing services and rewarding staff. The best performers will be able to propose which central controls they would like to be freed from. As performance across the NHS improves year on year so more devolution will take hold. Under this system of earned autonomy, control will switch from the centre to the local health service. The best performing NHS bodies this year will immediately benefit from a wider range of earned autonomy measures, including: less frequent monitoring from the centre; fewer and better co-ordinated inspections; development of their own investment programmes without receiving prior approval; retention of more of the proceeds of local land sales for re-investment in local services; becoming pilot sites for new initiatives such as team bonuses for staff; receiving extra cash for central programmes without having to bid for it; receiving extra resources if they are required to take over and improve the performance of persistently failing Trusts; using powers in the 2001 Health and Social Care Act, 3 star Trusts will receive specialist advice to assist the creation of new spin-out business ventures. 3 star Trusts will be supported to create new companies to extend their research strengths, or sell services to other organisations. There will be no question of selling services to NHS patients. Trading profits from these ventures will be reinvested in patient care. the Chief Executives of 3 star NHS trusts will be invited to provide direct advice and input to Ministers and the NHS Chief Executive into the preparation of new national policies and the review of existing ones. the Chief Executives will be invited to join the learning set which will consider additional freedoms for their organisations. Experience from similar peer groups in other branches of the public sector shows that with a process of mutual support and challenge significant new freedoms are likely to be identified. Furthermore these Chief Executives, as representative of the most successful Chief Executives in the NHS, will be given early involvement in the succession planning and development programme being constructed by the NHS Chief Executive.

6 Trusts with two stars will need to agree their plans for spending their share of the Performance Fund on improving performance with Regional Offices to ensure that resources are targeted at those areas where there is the greatest need for performance improvement. Trusts with a performance rating of one star will be required to produce a performance improvement plan, agreed with the NHS Modernisation Agency before they are able to spend their share of the Performance Fund. This plan will set out the specific action they need to take to address their areas for improvement and milestones against which the pace and scale of improvement can be measured. Progress will be reviewed on a regular basis. The Modernisation Agency will provide focused external support, advice and assistance to enable trusts performance to improve. If one star Trusts do not improve, having received this extra assistance, they may be subject to more direct forms of intervention. What NHS Performance Rating have trusts received? NHS Performance Ratings are being awarded to all non-specialist NHS trusts in England, based on their performance during 2000/1. Trusts are listed according to their performance rating in the table below. Further information is available on the following Department of Health website: The handful of Trusts with zero stars will receive the extra help and external intervention necessary to turn them around. It would not be right to local patients to let poor performance continue. The Modernisation Agency will bring in expertise from elsewhere in the NHS and will deploy these Trusts share of the Performance Fund. Local managers will be put on notice that they have to develop immediate plans to improve performance. If this does not happen, the management of the hospital will be put out to franchise. The new system of NHS franchising will allow the best managerial teams to compete to take over the management of poorly performing Trusts. There will be extra cash for doing so. Their franchise contract will stipulate tough criteria to deliver visible improvements in performance.

7 Delivery of key targets: achieved; - underachieved; significantly underachieved TRUST NAME * indicates the trust merged in April 2001 PERFORMANCE RATING Total number of patients waiting for an inpatient appointment (% of planned target achieved) Reduction in outpatient waiting (% of planned target achieved) Number of patients waiting more than 18 months for an inpatient appointment % of patients waiting less than 2 weeks from urgent GP referral to outpatient appointment for suspected breast cancer Financial performance against plan based on the provisional 2000/01 audited accounts. Number of patients waiting on trolleys for more than 12 hours Operations cancelled on the day as a percentage of elective admissions Addenbrooke s NHST - Basildon & Thurrock General Hospitals NHST 1 - Bassetlaw Hospital & Community Services NHST* Blackburn, Hyndburn & Ribble Valley Health Care NHST - Blackpool Victoria Hospital NHST - Bradford Hospitals NHST Calderdale Healthcare NHST* - Central Sheffield University Hospitals NHST* - Chesterfield & N Derbyshire Royal Hospital NHST 1 - City Hospitals Sunderland NHST 1 Countess of Chester Hospital NHST 1 - E Gloucestershire NHST - Frimley Park Hospital NHST - Greenwich Healthcare NHST - Huddersfield NHST* - King s Healthcare NHST 1 Kings Mill Centre for Health Care Services NHST (now Sherwood Forest Hospitals) Luton & Dunstable Hospital NHST - Mid Essex Hospital Services NHST - Morecambe Bay Hospitals NHST - N Tees and Hartlepool NHST1 - Norfolk & Norwich Health Care NHST - Northampton General Hospital NHST -

8 Performance on balanced scorecard Performance Fund - STAFF FOCUS PATIENT FOCUS CLINICAL FOCUS YEAR 1 SCHEMES Commitment to improving Working Lives (attainment of pledge status) Hospital cleanliness (Patient environment team inspection score) Sickness/Absence rate for directly employed NHS staff. Consultant Vacancy (3 month vacancy rate) Qualified nursing, midwifery and health visiting staff vacancy (3 month vacancy rates). Qualified Allied Health Professionals (3 month vacancy rates). Compliance with the new deal on junior doctor's hours Percentage of patients waiting less than 6 months for an inpatient appointment at the end of Q4. Patients seen within 13 weeks of GP written referral for 1st outpatient appointment. Trolley waits greater than 4 hours as a percentage of all non-elective admissions Resolution of written complaints (% completed within 4 weeks) Clinical negligence: Level of compliance achieved against CNST risk management standards. Emergency readmission rates within 28 days of discharge (age and sex standardised). Deaths in hospital within 30 days of Surgery (non-elective admissions) (age & sex standardised) INVESTMENT 2002/02 REWARD 2002/03,000s where trusts have merged the values are captured under only one of the trust names

9 Delivery of key targets: achieved; - underachieved; significantly underachieved TRUST NAME * indicates the trust merged in April 2001 PERFORMANCE RATING Total number of patients waiting for an inpatient appointment (% of planned target achieved) Reduction in outpatient waiting (% of planned target achieved) Number of patients waiting more than 18 months for an inpatient appointment % of patients waiting less than 2 weeks from urgent GP referral to outpatient appointment for suspected breast cancer Financial performance against plan based on the provisional 2000/01 audited accounts. Number of patients waiting on trolleys for more than 12 hours Operations cancelled on the day as a percentage of elective admissions Northern Devon Healthcare NHST (now North Devon Healthcare NHST) Northumbria Health Care NHST - Peterborough Hospitals NHST - Princess Alexandra Hospital NHST Royal Devon & Exeter Healthcare NHST S Devon Healthcare NHST - S Durham Heath Care NHST S Tyneside Health Care NHST Southern Derbyshire Acute Hospitals NHST Taunton & Somerset NHST - W Suffolk Hospitals NHST - Winchester & Eastleigh Health Care NHST - Aintree Hospitals NHST (now Mersey Care) - Airedale NHST - Barnsley District General Hospital NHST - Barts and The London NHST - - Bedford Hospital NHST Birmingham Heartlands & Solihull (Teaching) NHST - Bromley Hospitals NHST - Burnley Health Care NHST - Burton Hospitals NHST - Bury Health Care NHST Carlisle Hospitals NHST* - -

10 Performance on balanced scorecard Performance Fund - STAFF FOCUS PATIENT FOCUS CLINICAL FOCUS YEAR 1 SCHEMES Commitment to improving Working Lives (attainment of pledge status) Hospital cleanliness (Patient environment team inspection score) Sickness/Absence rate for directly employed NHS staff. Consultant Vacancy (3 month vacancy rate) Qualified nursing, midwifery and health visiting staff vacancy (3 month vacancy rates). Qualified Allied Health Professionals (3 month vacancy rates). Compliance with the new deal on junior doctor's hours Percentage of patients waiting less than 6 months for an inpatient appointment at the end of Q4. Patients seen within 13 weeks of GP written referral for 1st outpatient appointment. Trolley waits greater than 4 hours as a percentage of all non-elective admissions Resolution of written complaints (% completed within 4 weeks) Clinical negligence: Level of compliance achieved against CNST risk management standards. Emergency readmission rates within 28 days of discharge (age and sex standardised). Deaths in hospital within 30 days of Surgery (non-elective admissions) (age & sex standardised) INVESTMENT 2002/02 REWARD 2002/03,000s where trusts have merged the values are captured under only one of the trust names

11 Delivery of key targets: achieved; - underachieved; significantly underachieved TRUST NAME * indicates the trust merged in April 2001 PERFORMANCE RATING Total number of patients waiting for an inpatient appointment (% of planned target achieved) Reduction in outpatient waiting (% of planned target achieved) Number of patients waiting more than 18 months for an inpatient appointment % of patients waiting less than 2 weeks from urgent GP referral to outpatient appointment for suspected breast cancer Financial performance against plan based on the provisional 2000/01 audited accounts. Number of patients waiting on trolleys for more than 12 hours Operations cancelled on the day as a percentage of elective admissions Central Manchester Healthcare NHST (now Central Manchester & Manchester Children s University Hospitals) - City Hospital (Birmingham) NHST - Dewsbury Healthcare NHST - Doncaster Royal Infirmary & Montagu Hospital NHST* - Dudley Group of Hospitals NHST - - E Cheshire NHST - - E Kent Hospitals NHST - E Somerset NHST - Ealing Hospital NHST Eastbourne Hospitals NHST - - Essex Rivers Healthcare NHST - Forest Healthcare NHST (now Whipps Cross University Hospital) - Gateshead Health NHST - George Eliot Hospital NHST - Gloucestershire Royal NHST - - Guy s & St Thomas NHST - Halton General Hospital NHST* - Hammersmith Hospitals NHST - Harrogate Health Care NHST - - Heatherwood & Wexham Park Hospitals NHST - - Hereford Hospitals NHST Hinchingbrooke Health Care NHST - -

12 Performance on balanced scorecard Performance Fund - STAFF FOCUS PATIENT FOCUS CLINICAL FOCUS YEAR 1 SCHEMES Commitment to improving Working Lives (attainment of pledge status) Hospital cleanliness (Patient environment team inspection score) Sickness/Absence rate for directly employed NHS staff. Consultant Vacancy (3 month vacancy rate) Qualified nursing, midwifery and health visiting staff vacancy (3 month vacancy rates). Qualified Allied Health Professionals (3 month vacancy rates). Compliance with the new deal on junior doctor's hours Percentage of patients waiting less than 6 months for an inpatient appointment at the end of Q4. Patients seen within 13 weeks of GP written referral for 1st outpatient appointment. Trolley waits greater than 4 hours as a percentage of all non-elective admissions Resolution of written complaints (% completed within 4 weeks) Clinical negligence: Level of compliance achieved against CNST risk management standards. Emergency readmission rates within 28 days of discharge (age and sex standardised). Deaths in hospital within 30 days of Surgery (non-elective admissions) (age & sex standardised) INVESTMENT 2002/02 REWARD 2002/03,000s where trusts have merged the values are captured under only one of the trust names

13 Delivery of key targets: achieved; - underachieved; significantly underachieved TRUST NAME * indicates the trust merged in April 2001 PERFORMANCE RATING Total number of patients waiting for an inpatient appointment (% of planned target achieved) Reduction in outpatient waiting (% of planned target achieved) Number of patients waiting more than 18 months for an inpatient appointment % of patients waiting less than 2 weeks from urgent GP referral to outpatient appointment for suspected breast cancer Financial performance against plan based on the provisional 2000/01 audited accounts. Number of patients waiting on trolleys for more than 12 hours Operations cancelled on the day as a percentage of elective admissions Homerton Hospital NHST Hull and E Yorkshire Hospitals NHST - Ipswich Hospital NHST - James Paget Hospital NHST - Kettering General Hospital NHST - King s Lynn & Wisbech Hospitals NHST - Kingston Hospital NHST - Leeds Teaching Hospitals NHST - - Lewisham Hospital NHST - - Mayday Health Care NHST - Mid Cheshire Hospitals NHST - - Milton Keynes General Hopital NHST N Durham Heath Care NHST N E Lincolnshire NHST* N Hampshire Hospitals NHST N Manchester Healthcare NHST - - N Staffordshire Hospital NHST - - N W London Hospitals NHST - - Newcastle upon Tyne Hospitals NHST Newham Healthcare NHST Northallerton Health Services NHST Nottingham City Hospital NHST - - Oldham NHST - Plymouth Hospitals NHST -

14 Performance on balanced scorecard Performance Fund - STAFF FOCUS PATIENT FOCUS CLINICAL FOCUS YEAR 1 SCHEMES Commitment to improving Working Lives (attainment of pledge status) Hospital cleanliness (Patient environment team inspection score) Sickness/Absence rate for directly employed NHS staff. Consultant Vacancy (3 month vacancy rate) Qualified nursing, midwifery and health visiting staff vacancy (3 month vacancy rates). Qualified Allied Health Professionals (3 month vacancy rates). Compliance with the new deal on junior doctor's hours Percentage of patients waiting less than 6 months for an inpatient appointment at the end of Q4. Patients seen within 13 weeks of GP written referral for 1st outpatient appointment. Trolley waits greater than 4 hours as a percentage of all non-elective admissions Resolution of written complaints (% completed within 4 weeks) Clinical negligence: Level of compliance achieved against CNST risk management standards. Emergency readmission rates within 28 days of discharge (age and sex standardised). Deaths in hospital within 30 days of Surgery (non-elective admissions) (age & sex standardised) INVESTMENT 2002/02 REWARD 2002/03,000s where trusts have merged the values are captured under only one of the trust names

15 Delivery of key targets: achieved; - underachieved; significantly underachieved TRUST NAME * indicates the trust merged in April 2001 PERFORMANCE RATING Total number of patients waiting for an inpatient appointment (% of planned target achieved) Reduction in outpatient waiting (% of planned target achieved) Number of patients waiting more than 18 months for an inpatient appointment % of patients waiting less than 2 weeks from urgent GP referral to outpatient appointment for suspected breast cancer Financial performance against plan based on the provisional 2000/01 audited accounts. Number of patients waiting on trolleys for more than 12 hours Operations cancelled on the day as a percentage of elective admissions Poole Hospital NHST 2 - Preston & Chorley Hospitals Princess Royal Hospital NHST Queens Medical Centre, Nottingham, \University Hospital NHST - Rochdale Healthcare NHST Rotherham General Hospitals NHST Royal Berkshire & Battle Hospitals NHST 2 - Royal Bournemouth & Christchurch Hospitals NHST Royal Cornwall Hospitals NHST Royal Free Hampstead NHST (now Royal Free NHST) Royal Liverpool & Broadgreen University Hospitals NHST - Royal Shrewsbury Hospitals NHST - Royal Surrey County & St Luke s Hospital NHST Royal W Sussex NHST - Royal Wolverhampton Hospitals NHST S Buckinghamshire NHST - - S Manchester University Hospitals NHST - - S Tees Acute Hospitals NHST - - S Warwickshire General Hospitals NHST 3 - Salford Royal Hospitals NHST - - Salisbury Health Care NHST Sandwell Healthcare NHST Scunthorpe & Goole Hospitals NHST*

16 Performance on balanced scorecard Performance Fund - STAFF FOCUS PATIENT FOCUS CLINICAL FOCUS YEAR 1 SCHEMES Commitment to improving Working Lives (attainment of pledge status) Hospital cleanliness (Patient environment team inspection score) Sickness/Absence rate for directly employed NHS staff. Consultant Vacancy (3 month vacancy rate) Qualified nursing, midwifery and health visiting staff vacancy (3 month vacancy rates). Qualified Allied Health Professionals (3 month vacancy rates). Compliance with the new deal on junior doctor's hours Percentage of patients waiting less than 6 months for an inpatient appointment at the end of Q4. Patients seen within 13 weeks of GP written referral for 1st outpatient appointment. Trolley waits greater than 4 hours as a percentage of all non-elective admissions Resolution of written complaints (% completed within 4 weeks) Clinical negligence: Level of compliance achieved against CNST risk management standards. Emergency readmission rates within 28 days of discharge (age and sex standardised). Deaths in hospital within 30 days of Surgery (non-elective admissions) (age & sex standardised) INVESTMENT 2002/02 REWARD 2002/03,000s where trusts have merged the values are captured under only one of the trust names

17 Delivery of key targets: achieved; - underachieved; significantly underachieved TRUST NAME * indicates the trust merged in April 2001 PERFORMANCE RATING Total number of patients waiting for an inpatient appointment (% of planned target achieved) Reduction in outpatient waiting (% of planned target achieved) Number of patients waiting more than 18 months for an inpatient appointment % of patients waiting less than 2 weeks from urgent GP referral to outpatient appointment for suspected breast cancer Financial performance against plan based on the provisional 2000/01 audited accounts. Number of patients waiting on trolleys for more than 12 hours Operations cancelled on the day as a percentage of elective admissions Southampton University Hospitals NHST - Southport & Ormskirk Hospital NHST St Helens & Knowsley Hospitals NHST - Stockport NHST - Swindon & Marlborough NHST - Tameside & Glossop Acute Services NHST - - Trafford Healthcare NHST - - United Lincolnshire Hospitals NHST University College London Hospitals NHST - - University Hospital Birmingham NHST - University Hospitals of Leicester NHST - - W Cumbria Health Care NHST* - - W Dorset General Hospitals NHST - - W Middlesex University Hospital NHST - Walsall Hospitals NHST Warrington Hospital NHST* - West Hertfordshire NHST - Whittington Hospital NHST Wigan & Leigh Health Services NHST (now Wrightington, Wigan & Leigh) Wirral Hospital NHST - - Worcestershire Acute Hospitals NHST Worthing & Southlands Hospital NHST - - York Health Services NHST -

18 Performance on balanced scorecard Performance Fund - STAFF FOCUS PATIENT FOCUS CLINICAL FOCUS YEAR 1 SCHEMES Commitment to improving Working Lives (attainment of pledge status) Hospital cleanliness (Patient environment team inspection score) Sickness/Absence rate for directly employed NHS staff. Consultant Vacancy (3 month vacancy rate) Qualified nursing, midwifery and health visiting staff vacancy (3 month vacancy rates). Qualified Allied Health Professionals (3 month vacancy rates). Compliance with the new deal on junior doctor's hours Percentage of patients waiting less than 6 months for an inpatient appointment at the end of Q4. Patients seen within 13 weeks of GP written referral for 1st outpatient appointment. Trolley waits greater than 4 hours as a percentage of all non-elective admissions Resolution of written complaints (% completed within 4 weeks) Clinical negligence: Level of compliance achieved against CNST risk management standards. Emergency readmission rates within 28 days of discharge (age and sex standardised). Deaths in hospital within 30 days of Surgery (non-elective admissions) (age & sex standardised) INVESTMENT 2002/02 REWARD 2002/03,000s where trusts have merged the values are captured under only one of the trust names

19 Delivery of key targets: achieved; - underachieved; significantly underachieved TRUST NAME * indicates the trust merged in April 2001 PERFORMANCE RATING Total number of patients waiting for an inpatient appointment (% of planned target achieved) Reduction in outpatient waiting (% of planned target achieved) Number of patients waiting more than 18 months for an inpatient appointment % of patients waiting less than 2 weeks from urgent GP referral to outpatient appointment for suspected breast cancer Financial performance against plan based on the provisional 2000/01 audited accounts. Number of patients waiting on trolleys for more than 12 hours Operations cancelled on the day as a percentage of elective admissions Bolton Hospitals NHST - Chelsea & Westminster Healthcare NHST - Good Hope Hospital NHST Hastings & Rother NHST - Havering Hospitals NHST* - Hillingdon Hospital NHST Isle of Wight Healthcare NHST Maidstone and Tunbridge Wells NHST - Mid Staffordshire General Hospitals NHST - Mid Sussex NHST - N Bristol NHST - N Middlesex Hospital NHST - - Northern General Hospital NHST* - Pinderfields & Pontefract Hospitals NHST - Queen Mary s, Sidcup NHST - - Redbridge Health Care NHST* - Royal United Hospital, Bath NHST - Scarborough & N E Yorkshire Healthcare NHST - - Southend Hospital NHST - - St George s Healthcare NHST St Mary s NHST - - Surrey & Sussex Healthcare NHST - Weston Area Health NHST - Ashford & St Peter s Hospitals NHST -

20 Performance on balanced scorecard Performance Fund - STAFF FOCUS PATIENT FOCUS CLINICAL FOCUS YEAR 1 SCHEMES Commitment to improving Working Lives (attainment of pledge status) Hospital cleanliness (Patient environment team inspection score) Sickness/Absence rate for directly employed NHS staff. Consultant Vacancy (3 month vacancy rate) Qualified nursing, midwifery and health visiting staff vacancy (3 month vacancy rates). Qualified Allied Health Professionals (3 month vacancy rates). Compliance with the new deal on junior doctor's hours Percentage of patients waiting less than 6 months for an inpatient appointment at the end of Q4. Patients seen within 13 weeks of GP written referral for 1st outpatient appointment. Trolley waits greater than 4 hours as a percentage of all non-elective admissions Resolution of written complaints (% completed within 4 weeks) Clinical negligence: Level of compliance achieved against CNST risk management standards. Emergency readmission rates within 28 days of discharge (age and sex standardised). Deaths in hospital within 30 days of Surgery (non-elective admissions) (age & sex standardised) INVESTMENT 2002/02 REWARD 2002/03,000s where trusts have merged the values are captured under only one of the trust names

21 Delivery of key targets: achieved; - underachieved; significantly underachieved TRUST NAME * indicates the trust merged in April 2001 PERFORMANCE RATING Total number of patients waiting for an inpatient appointment (% of planned target achieved) Reduction in outpatient waiting (% of planned target achieved) Number of patients waiting more than 18 months for an inpatient appointment % of patients waiting less than 2 weeks from urgent GP referral to outpatient appointment for suspected breast cancer Financial performance against plan based on the provisional 2000/01 audited accounts. Number of patients waiting on trolleys for more than 12 hours Operations cancelled on the day as a percentage of elective admissions Barnet & Chase Farm Hospitals NHST - - Brighton Health Care NHST Dartford & Gravesham NHST - - E & N Hertfordshire NHST - - Medway NHST - Oxford Radcliffe Hospital NHST Portsmouth Hospitals NHST Stoke Mandeville Hospital NHST - - United Bristol Healthcare NHST - Walsgrave Hospitals NHST 5 (now University Hospitals of Coventry & Warwickshire NHST) - Epsom and St Helier NHST 4 Footnotes: 1 - In CHI s assessment, performance across clinical governance is consistent with a 3 star rating. 2 - In CHI assessment, the Trust did not perform strongly across the elements of clinical governance and lacked strategic capacity to improve significantly their performance. They have consequently been classified as two stars. 3 - Significant concerns regarding data quality in this trust last year has led to reclassification from 3 to 2 stars. 4 - In CHI s assessment, Epsom and St. Helier Trust performed poorly across the elements of clinical governance and lacked strategic capacity to remedy these weaknesses. They have consequently been reclassed as no stars. 5 - In CHI s assessment, Walgrave (University Hospitals of Coventry & Warickshire) Trust performed poorly across the elements of clinical governance and lacked strategic capacity to remedy these weaknesses. They have consequently been reclassified as no stars.

22 Performance on balanced scorecard Performance Fund - STAFF FOCUS PATIENT FOCUS CLINICAL FOCUS YEAR 1 SCHEMES Commitment to improving Working Lives (attainment of pledge status) Hospital cleanliness (Patient environment team inspection score) Sickness/Absence rate for directly employed NHS staff. Consultant Vacancy (3 month vacancy rate) Qualified nursing, midwifery and health visiting staff vacancy (3 month vacancy rates). Qualified Allied Health Professionals (3 month vacancy rates). Compliance with the new deal on junior doctor's hours Percentage of patients waiting less than 6 months for an inpatient appointment at the end of Q4. Patients seen within 13 weeks of GP written referral for 1st outpatient appointment. Trolley waits greater than 4 hours as a percentage of all non-elective admissions Resolution of written complaints (% completed within 4 weeks) Clinical negligence: Level of compliance achieved against CNST risk management standards. Emergency readmission rates within 28 days of discharge (age and sex standardised). Deaths in hospital within 30 days of Surgery (non-elective admissions) (age & sex standardised) INVESTMENT 2002/02 REWARD 2002/03,000s where trusts have merged the values are captured under only one of the trust names

23 Delivery of key targets: 3 achieved; - underachieved; 5 significantly underachieved TRUST NAME * indicates the trust merged in April 2001 PERFORMANCE RATING Total number of patients waiting for an inpatient appointment (% of planned target achieved) Reduction in outpatient waiting (% of planned target achieved) Number of patients waiting more than 18 months for an inpatient appointment % of patients waiting less than 2 weeks from urgent GP referral to outpatient appointment for suspected breast cancer Financial performance against plan based on the provisional 2000/01 audited accounts. Number of patients waiting on trolleys for more than 12 hours Operations cancelled on the day as a percentage of elective admissions

24 Performance on balanced scorecard Performance Fund - Year 1 schemes STAFF FOCUS PATIENT FOCUS CLINICAL FOCUS Commitment to improving Working Lives (attainment of pledge status) Hospital cleanliness (Patient environment team inspection score) Sickness/Absence rate for directly employed NHS staff. Consultant Vacancy (3 month vacancy rate) Qualified nursing, midwifery and health visiting staff vacancy (3 month vacancy rates). Qualified Allied Health Professionals (3 month vacancy rates). Compliance with the new deal on junior doctor's hours Percentage of patients waiting less than 6 months for an inpatient appointment at the end of Q4. Patients seen within 13 weeks of GP written referral for 1st outpatient appointment. Trolley waits greater than 4 hours as a percentage of all non-elective admissions Resolution of written complaints (% completed within 4 weeks) Clinical negligence: Level of compliance achieved against CNST risk management standards. Emergency readmission rates within 28 days of discharge (age and sex standardised). Deaths in hospital within 30 days of Surgery (non-elective admissions) (age & sex standardised) INVESTMENT 2002/02 REWARD 2002/03,000s where trusts have merged the values are captured under only one of the trust names

25 Further copies of this booklet may be obtained from: Department of Health PO Box 777 London SE1 6XH or fax: or you can call NHS Careers on: it is also available on our web site: Crown Copyright Produced by Department of Health P.100k.XXX 9999 Chlorine Free Paper