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BOARD OF DIRECTORS PAPER – COVER SHEET
Meeting Date:
28 July 2010
Agenda Item: 12
Item No: I
Title:
CONTRACT PERFORMANCE REPORT
Purpose:
To report on Trust activity and contracted performance to end June
2010.
Summary:
This report is produced for the first time to supplement the level of
contract performance reporting previously provided through the
Finance report.
The report summarises activity trends previously provided through the
Trust Performance report, which will now concentrate upon key
performance indicators, and Trust performance against the contracts
held with five Primary Care Trusts.
The contract for supply of services to each of the five PCT’s within the
local consortium was signed on 14th July 2010.
The Trust is over performing against non-elective contracted activity
targets (4%), including A&E, but underperforming on elective inpatient
volumes (-3%).
Outpatient activity volumes are below contracted targets generally,
specifically for first outpatients, though performance will be skewed by
the adjustment to targets proposed by the two Dorset-based PCT’s.
The financial value of net overperformance at full tariff is approx
£670,000 with most arising from our contract with Dorset PCT.
Recommendation: For discussion and noting
Prepared
by:
KATE THOMAS
PAUL STEBBINGS
Presented
by:
HEATHER HAUSCHILD
Director of Operations
This report is relevant to: (Please tick relevant box)
Assurance Framework
Risk Register I/D No.
Healthcare Standards:
Please specify which standard
Monitor compliance
Financial implications
YES / NO
9
Human Resources implications
YES / NO
Internal monitoring
9
Legal implications
YES / NO
POOLE HOSPITAL NHS FOUNDATION TRUST
DIRECTORATE OF OPERATIONS
Report to the Board of Directors – 28 July 2010
TRUST CONTRACT PERFORMANCE REPORT
1.
INTRODUCTION
1.1
This report is provided for the first time and is intended to supplement the information on
contract performance previously provided only through the Finance report. It focuses
now upon Trust activity levels in respect of the contract the Trust has agreed with the five
members of the local consortium namely Bournemouth & Poole, Dorset, Hampshire,
Wiltshire and Somerset Primary Care Trusts.
1.2
The report commences with a summary of activity trends as previously reported through
the Trust Performance report.
2.
ACTIVITY TRENDS
2.1
Appendix 1 provides a summary of activity trends comparing this financial year with the
last three. This has previously been reported as part of the Trust Performance
Report, but is now presented here to place contract performance in context.
2.2
PbR contract targets for 2010/11 are essentially defined at 2009/10 outturns as
estimated by the two Dorset-based PCTs and by Poole Hospital in respect of the
associated members of the consortium. An exception is for emergency activity which
comprises the largest part of all non-elective activity, for which targets are restricted to a
financial valuation based on casemix and activity levels in 2008/09. Whilst non-elective
admissions are thus seen to be substantially below last year, they are more appropriately
monitored alongside 2008/09 levels rather than last year for contract purposes. Maternity
admissions provide the main exception and are shown separately.
2.3
Elective inpatient targets are based on last year estimated outturns with further
adjustment for the anticipated full year effect of demand management initiatives
introduced last summer/autumn and in recognition of the move from a maximum 13
weeks to 18 weeks RTT target. Actual elective activity is thus planned to remain below
2009/10 levels, particularly in the first half of the year, though a shift from inpatient to day
case work is planned within our transformation programme.
2.4
First outpatients will provided the forward demand for our elective volumes and again are
expected to fall below last year levels. The largest proportion of these arise from GP
referrals and so these are monitored to ensure demand management inititatives continue
to operate.
3.
CONTRACT NEGOTIATION
3.1
The contract for provision of health services (the contract) was signed with Bournemouth
& Poole PCT, as co-ordinating commissioner on behalf of all associate members, on 14th
July.
3.2
The respective total values of the five contracts including block funding are shown below:
• Bournemouth & Poole £115.9m
• Dorset £ 46.4m
• Hampshire £3.7m
• Wiltshire £451,000
• Somerset £107,000
3.3
Each contract includes a schedule of a range of activity and income targets defined on a
cost per case basis for a range of services subject to Payment by Results, including the
majority of our inpatient and outpatient activity and all A&E attendances, and those
services covered by a block funding allocation.
3.4
A summary of the PbR elements of the five contracts together with year to date
performance to end June 2010 is shown in Appendix 2 Table 1. With 97% of our PbR
contracted income falling within the two Dorset-based contracts, we will initially
concentrate on the relevant performance of these contracts. Summaries for
Bouremnouth & Poole nad Dorset PCT’s are included as Appendices 3 and 4.
4.
CONTRACT PERFORMANCE FOR PERIOD 1ST APRIL 2010 TO 30TH JUNE 2010
4.1
The total value of activity undertaken across the five contracts exceeds target by
£670,000 with the major contributor Dorset PCT who are in excess of £639,000 above
contracted value. Each contract is subject to terms for marginal payment/refunds for
financial values in excess/below contracted targets. The net effect of this is monitored by
the Finance department and will be shown in future reporting.
4.2
4.3
4.4
4.5
4.6
Contract Profiles
Activity and financial targets are profiled over the twelve months and take into account
known variations eg winter/summer pressures, working and calendar days in the month,
but in respect of elective activity only, the Dorset-based PCT’s have sought to ‘front-load’
targets to reflect the need to reduce the underlying run-rate of activity in anticipation of a
more stringent financial settlement next year. Elective performance during the first
quarter needs then to be considered in the context of marginally inflated targets during
the first quarter.
Elective Activity
Total contracted elective activity is 2.9% below target as a result of the 15%
underperformance on inpatient admissions. Day case activity remains on target. In
financial terms however, the Trust is on target after the first quarter because of casemix
differences and some high cost spells arising from excess bed days.
Elective activity on behalf of Dorset PCT is only marginally higher than plan, but is
generating substantially higher income which balances the underperformance seen in
respect of our main contract with Bournemouth & Poole. The disproportionate impact
seen here implies excess bed days may be a particular problem in respect of Dorset
PCT patients and this will be explored with the PCT.
Non Elective Activity
Non elective activity targets are summarised in terms of emergency activity, for which
financial thresholds have been defined nationally at 2008/09 levels, and other nonelective activity, largely in Obstetrics. Overall, we are already exceeding emergency
activity and financial targets by 1.6% and 4.6% respectively.
Over performance against contract lines which are essentially defined at historic activity
levels represents a major risk this year and this is particularly visible when comparing the
relative performance of the two Dorset-based PCT’s. Emergency activity for Dorset PCT
patients is 6.3% above target, but this is a target which was set some 5% below last
year’s outturn in order to impose the national threshold. This risk was discussed during
contract negotiations and the Dorset-based PCT’s have accepted that additional
payments, at nationally defined marginal tariffs (30%) will be made. In contrast,
Bournemouth & Poole are on target.
4.7
Whilst overperformance of emergency activity is restricted to short stay admissions of 01 days, there is a disproportionate overperformance in income terms arising from
increased excess bed days. The problems we have experienced in discharging patients
promptly have been raised. It is expected the financial impact upon PCT’s may prompt
action to review care services available in the community.
4.8
Other non elective performance is substantially above contracted levels arising from the
increase in maternity admissions which is shown the in the activity trends. This increase
appears to be in the Bournemouth & Poole PCT catchment area only. Again, this
overperformance was anticipated in contract negotiations and a marginal of 70% of
valuation above target was agreed.
4.9
4.10
Outpatient Activity
Total outpatient activity is around 1.4% below target dictated by underperformance
against the Bournemouth & Poole contract in particular and more specifically for all
Dorset’s patients in respect of first attendances. With evidence that measures to reduce
GP referrals have reduced levels below previous year levels, the contract targets
currently fail to reflect the reduction in first outpatients arising in a full year from demand
management initiatives and a reduction in access times targets from 13 to 18 weeks.
This anomaly is being discussed with the two Dorset-based PCT’s.
In contrast, activity targets for follow up attendances were subject to substantial
reductions from previous years outturns based on the assumption that follow up to first
ratios will be reduced. This is a major plank of our reconfiguration programme for
Outpatient services.
4.11
Accident and Emergency attendances
A&E attendances are substantially above contracted targets but constitute a relatively
small increase in income.
4.12
Contract Performance Summary
In financial terms, overperformance against targets across the five contracted PCT’s
amounts to £670,000 before the application of marginal tariff rates.
•
•
•
Bournemouth & Poole £-56,000
Dorset £ 639,000
Other PCT’s £87,000
HEATHER HAUSCHILD
Director of Operations
July 2010
KATE THOMAS
Analytics and Intelligence Manager
PAUL STEBBINGS
ADO Information and Performance
APPENDIX 1 - ACTIVITY AND REFERRALS SUMMARY
1.
INTRODUCTION
1.1
Details are shown below of the Trust’s activity for 2007/08, 2008/09, 2009/10 and the
current year to date for;
1.2
2.
•
•
•
•
•
•
•
Emergency Department attendances
Non Elective admissions (excluding obstetrics and paediatrics)
All Elective admissions
Day case admissions
Maternity Admissions
First Outpatient Attendances
GP Referrals
A&E ATTENDANCES
A&E Attendances
6000
5500
5000
4500
4000
2.1
Apr
May
June
2010/11
4837
5489
5152
July
Aug
Sept
Oct
Nov
Dec
Jan
Feb
Mar
2009/10
4853
5210
2008/09
4554
5003
5112
5299
5213
4963
4932
4545
4914
4461
4149
4966
4866
5115
5027
4588
4609
4532
4445
4264
4165
2007/08
4996
4906
5098
4883
5033
5150
4826
4649
4269
4443
4395
4224
4692
The analysis shows that there was an increase of 303, (2%) in attendances in the period
1st April 2010 to 30th June 2010 compared to the period 1st April 2009 to 30th June 2009.
The year on year increase is due almost entirely to attendances in May 2010.
3.
TOTAL NON-ELECTIVE ADMISSIONS
Non-Elective Admissions
3000
2800
2600
2400
2200
2000
3.1
4.
Apr
May
June
2010/11
2399
2521
2421
July
Aug
Sept
Oct
Nov
Dec
Jan
Feb
Mar
2009/10
2635
2669
2008/09
2465
2538
2554
2430
2482
2534
2690
2530
2753
2433
2302
2659
2404
2613
2433
2497
2569
2706
2733
2613
2428
2007/08
2560
2567
2905
2398
2489
2512
2355
2451
2588
2598
2421
2290
2410
The analysis shows that there was a decrease of 517 (7%), in emergency admissions in
the period 1st April 2010 to 30th June 2010 compared to the period 1st April 2009 to 30th
June 2009. This continues the trend seen in previous months, although the gap between
the current and previous year has decreased over the last 3 months.
TOTAL ELECTIVE ADMISSIONS
Elective Admissions (incl daycases)
2600
2400
2200
2000
1800
1600
1400
1200
1000
4.1
Apr
May
June
2010/11
1759
1763
2048
July
Aug
Sept
Oct
Nov
Dec
Jan
Feb
Mar
2009/10
2257
2203
2008/09
1960
1737
2290
2276
2020
2196
2238
2211
1966
1876
1852
2089
1898
2006
1770
1963
2045
1885
1927
2183
2168
2007/08
1523
1734
2521
1619
1812
1664
1691
1920
1874
1458
1999
1965
1775
The analysis shows that there was a decrease in elective admissions of 1180 (17%) in the
period 1st April 2010 to 30th June 2010 compared to the period 1st April 2009 to 30th June
2009. The increase in activity seen in June is due mainly to daycase work.
5.
TOTAL DAY CASE ADMISSIONS
Daycases
2200
2000
1800
1600
1400
1200
1000
800
600
Apr
May
June
2010/11
1390
1368
1671
July
Aug
Sept
Oct
Nov
Dec
Jan
Feb
Mar
2009/10
1796
1742
2008/09
1448
1338
1743
1749
1538
1706
1790
1768
1552
1464
1449
1658
1440
1507
1354
1481
1560
1417
1513
1722
1683
2007/08
1115
1300
1992
1191
1329
1278
1256
1457
1385
1108
1519
1500
1360
5.1
The analysis shows that there was a decrease of 852 (16%) in day case admissions in the
period 1st April 2010 to 30th June 2010 compared to the period 1st April 2009 to 30th June
2009. The increase in day case work is a result of a concerted effort to reduce length of
stay, as part of the transformation programme.
6.
MATERNITY ADMISSIONS
Maternity Admissions
1300
1200
1100
1000
900
800
2010/11
6.1
Apr
May
June
1103
1252
1114
July
Aug
Sept
Oct
Nov
Dec
Jan
Feb
Mar
2009/10
998
1110
1126
1071
1130
1089
1047
1049
1049
1059
970
1126
2008/09
1029
1155
1060
1124
981
1063
1028
934
988
1106
935
1094
2007/08
992
1011
994
1059
948
1011
1056
995
968
981
998
1026
The analysis shows that there was an increase (235 or 7%) in maternity admissions in the
period 1st April 2010 to 30th June 2010 compared to the period 1st April 2009 to 30th June
2009, and is following the same seasonal trend as the 2 previous years, albeit at a higher
level.
7.
FIRST OUTPATIENT ATTENDANCES
New Outpatient Attendances
7500
7000
6500
6000
5500
5000
4500
4000
Apr
May
June
2010/11
5396
5188
6309
July
Aug
Sept
Oct
Nov
Dec
Jan
Feb
Mar
2009/10
6241
6089
2008/09
6131
5685
7106
7049
5871
6551
6588
6027
5502
5493
5325
5899
6122
6434
5536
6350
6491
5635
5773
6168
5609
2007/08
5051
5788
6508
5233
5545
5411
5338
6148
5957
4781
5855
5445
4965
7.1
The analysis shows that there was a decrease (2543 or 13%) in first outpatient
appointments admissions in the period 1st April 2010 to 30th June 2010 compared to the
period 1st April 2009 to 30th June 2009. This continues the trend seen in recent months, in
line with elective admissions and referrals.
8.
GP/GDP REFERRALS
GP Referrals
5000
4500
4000
3500
3000
2500
2000
8.1
Apr
May
June
2010/11
3404
3481
3784
July
Aug
Sept
Oct
Nov
Dec
Jan
Feb
Mar
2009/10
4163
4090
2008/09
3774
3733
4690
4598
3631
4310
4023
3378
3094
3420
3382
4021
4097
4059
3568
4007
4216
3613
3377
4002
3834
2007/08
3212
3370
4423
3288
3619
3454
3252
3791
3896
2809
3879
3426
3387
The analysis shows that there was a decrease (2274 or 18%) in GP Referrals period 1st
April 2010 to 30th June 2010 compared to the period 1st April 2009 to 30th June 2009. This
continues the trend seen in recent months.
APPENDIX 2 – CONTRACT SUMMARY
Details are shown below of the Trust’s performance against contract, for the Payment by
Results element of the contracts for the 5 PCT’s.
Table 1 : Contract Performance for PbR Element of 5 aggregated PCT contracts
Poole Hospital NHS Foundation Trust
Contract Performance 2010/11
All Contracted PCT's : 2010/11 year to date (month 3)
2010/11 Contract activity Elective
Inpatients
Day Case
£
Year to Date Contract
activity £
Actual
activity £
over/under performance
diff
% diff
activity £
activity
£
22,312
5,120
17,192
£22,367,296 5,580
£10,255,930 1,281
£12,111,366 4,300
£5,594,211 5,416
£2,565,077 1,084
£3,029,134 4,332
£5,584,774 ‐ 164
£2,391,464 ‐ 197
£3,193,310 32
‐£9,437
‐£173,613
£164,176
‐2.9%
‐15.3%
0.7%
‐0.2%
‐6.8%
5.4%
Non Elective
42,792
Emergency 29,174
Other
13,618
£67,317,384 10,582
£53,360,761 7,187
£13,956,623 3,395
£16,624,976 10,968
£13,145,380 7,301
£3,479,596 3,667
£17,429,827 386
£13,746,634 114
£3,683,193 272
£804,851
£601,254
£203,597
3.6%
1.6%
8.0%
4.8%
4.6%
5.9%
Outpatients
First
Followup
168,584
64,200
104,384
£21,342,305 42,164
£11,498,679 16,057
£9,843,626 26,107
£5,337,854 41,566
£2,875,897 14,451
£2,461,957 27,115
£5,161,642 ‐ 598
£2,604,427 ‐ 1,606
£2,557,215 1,008
‐£176,212
‐£271,470
£95,258
‐1.4%
‐10.0%
3.9%
‐3.3%
‐9.4%
3.9%
A&E Attds
55,068
£4,701,346 13,729
£1,172,116 14,542
£1,223,005
£50,889
5.9%
4.3%
Cost per Case Contract Total
£115,728,331
£28,729,158
813
£29,399,248
£670,090
2.3%
Notes : excl udes Non contra cted acti vi ty
Chart 1 : Contract Performance for ELECTIVE PbR Element of 5 PCT contracts
Total Elective
25,000
Contract Target 10/11
Contract Actuals 10/11
20,000
PbR Spells
15,000
10,000
5,000
0
apr
may
jun
jul
aug
sep
oct
nov
dec
jan
f eb
mar
Chart 2 : Contract Performance for NON ELECTIVE PbR Element of 5 PCT contracts
Total Non Elective
45000
40000
Contract Target 10/11
35000
Contract Actuals 10/11
PbR Spells
30000
25000
20000
15000
10000
5000
0
apr
may
jun
jul
aug
sep
oct
nov
dec
jan
f eb
mar
DETAILED CONTRACT POSITION
The following tables provide detail for the five aggregated PCT contracts expanding each
line in Table 1 to HRG chapter level for inpatients or specialty level for outpatients.
Appendix 2 (contd)
•
•
•
Table 2 : Elective inpatients
Table 3 : Daycases
Table 4 : Total Elective Inpatients (inpatient plus daycases)
•
•
Table 5 : Non Elective inpatients - Emergency
Table 6 : Non Elective inpatients – “other” (this will include maternity and transfers
for example)
Table 7 : Total Non Elective inpatients (emergency plus “other”)
•
•
Tables 8 & 9 : Outpatient attendances , one table each for new and follow up
attendances
The following two financial summaries focus on the overall position for the two main local
purchasers, who together make up 97% of the Trusts contracted income.
Appendix 3
•
Bournemouth and Poole PCT Contract Summary (PbR elements)
Appendix 4
•
Dorset PCT Contract Summary (PbR elements)
A ‐ Nervous System
B ‐ Eyes and Periorbita
C ‐ Mouth Head Neck and Ears
D ‐ Respiratory System
E ‐ Cardiology, Cardiothoracic Surgery
F ‐ Digestive System
G ‐ Hepatobiliary and Pancreatic System
H ‐ Musculoskeletal System
J ‐ Skin, Breast and Burns
K ‐ Endocrine and Metabolic System
L ‐ Urinary Tract and Male Reproductive System
M ‐ Female Reproductive System and Assisted Reproduction
N ‐ Obstetrics
P ‐ Diseases of Childhood and Neonates
Q ‐ Vascular System
S ‐ Haematology, Chemotherapy, Radiotherapy
V ‐ Multiple Trauma, Emergency and Urgent Care
W ‐ Immunology, Infectious Diseases and other contacts
U ‐ uncoded
Grand Total
Elective Inpatients
£ £351,652
£54,489
£1,954,666
£254,927
£370,517
£2,059,336
£391,900
£2,051,492
£905,119
£155,133
£131,957
£1,088,215
£0
£98,626
£31,813
£279,281
£20,716
£56,091
£10,255,930
IP activity 199
33
1234
127
134
855
243
769
411
91
145
576
0
51
17
190
8
37
5,120
2010/11 Contract Year to Date Contract
Actual
£
activity £
activity
50
£87,951
38
£60,323
8
£13,628
6
£10,244
309
£488,875
248
£574,841
32
£63,759
27
£50,994
34
£92,669
26
£67,860
214
£515,054
180
£462,943
61
£98,017
47
£88,607
192
£513,092
164
£417,401
103
£226,376
95
£229,773
23
£38,800
28
£48,192
36
£33,003
34
£32,341
144
£272,170
138
£262,983
0
£0
1
£2,539
13
£24,667
15
£15,130
4
£7,957
2
£8,787
48
£69,850
30
£48,954
2
£5,181
9
£14,029
5
£9,552
0
£0
1,281
£2,565,077
1,084
£2,391,464
Contract Performance 2010/11
Analysis by HRG chapter : 2010/11 year to date (month 3)
Poole Hospital NHS Foundation Trust
over/under performance
diff
% diff
activity
£
activity ‐12
‐£27,628
‐24%
‐2
‐£3,384
‐27%
‐61
£85,966
‐20%
‐5
‐£12,765
‐15%
‐8
‐£24,809
‐22%
‐34
‐£52,111
‐16%
‐23%
‐14
‐£9,410
‐28
‐£95,691
‐15%
‐8
£3,397
‐8%
5
£9,392
23%
‐2
‐£662
‐6%
‐6
‐£9,187
‐4%
1
£2,539 2
‐£9,537
18%
‐2
£830
‐53%
‐18
‐£20,896
‐37%
‐2
‐£5,181
‐100%
‐4
‐£4,477
‐46%
0
£0 ‐197
‐£173,613
‐15%
‐7%
‐39%
10%
‐30%
‐100%
‐32%
£ ‐31%
‐25%
18%
‐20%
‐27%
‐10%
‐10%
‐19%
2%
24%
‐2%
‐3%
APPENDIX 2 (contd) Table 2 : Elective inpatients
A ‐ Nervous System
B ‐ Eyes and Periorbita
C ‐ Mouth Head Neck and Ears
D ‐ Respiratory System
E ‐ Cardiology, Cardiothoracic Surgery
F ‐ Digestive System
G ‐ Hepatobiliary and Pancreatic System
H ‐ Musculoskeletal System
J ‐ Skin, Breast and Burns
K ‐ Endocrine and Metabolic System
L ‐ Urinary Tract and Male Reproductive System
M ‐ Female Reproductive System and Assisted Reproduction
N ‐ Obstetrics
P ‐ Diseases of Childhood and Neonates
Q ‐ Vascular System
S ‐ Haematology, Chemotherapy, Radiotherapy
V ‐ Multiple Trauma, Emergency and Urgent Care
W ‐ Immunology, Infectious Diseases and other contacts
U ‐ uncoded
Grand Total
Day Cases
£ £1,432,110
£83,554
£2,223,224
£89,516
£281,474
£3,338,125
£225,283
£1,076,326
£1,728,645
£29,917
£306,081
£748,468
£2,695
£79,479
£71,026
£346,500
£0
£48,943
£12,111,366
2282
110
2833
160
255
5817
169
754
2413
49
469
895
3
98
71
716
6
92
17,192
DC 2010/11 Contract Year to Date Contract
Actual
£
activity £
activity
571
£358,180
632
£394,496
28
£20,897
32
£25,111
709
£556,043
607
£512,183
40
£22,389
55
£29,376
64
£70,399
62
£62,877
1,455
£834,887
1,365
£785,913
42
£56,345
67
£92,807
189
£269,196
286
£431,757
604
£432,346
544
£432,453
12
£7,482
15
£7,559
117
£76,553
121
£74,032
224
£187,197
233
£176,781
1
£674
25
£19,878
48
£37,063
18
£17,764
15
£11,524
179
£86,662
235
£113,524
2
£0
23
£12,241
15
£5,854
0
£0
4,300
£3,029,134
4,332
£3,193,310
Contract Performance 2010/11
Analysis by HRG chapter : 2010/11 year to date (month 3)
Poole Hospital NHS Foundation Trust
32
£164,176
1%
over/under performance
diff
% diff
activity
£
activity 61
£36,316
11%
4
£4,214
16%
‐102
‐£43,860
‐14%
15
£6,987
37%
‐2
‐£7,522
‐3%
‐90
‐£48,974
‐6%
25
£36,462
59%
97
£162,561
52%
‐60
£107
‐10%
3
£77
22%
4
‐£2,521
3%
9
‐£10,416
4%
‐1
‐£674
‐100%
23
£17,185
96%
‐3
‐£6,240
‐16%
56
£26,862
31%
‐2
£0
‐100% ‐8
‐£6,387
‐35%
5%
‐52%
£ 10%
20%
‐8%
31%
‐11%
‐6%
65%
60%
0%
1%
‐3%
‐6%
‐100%
86%
‐35%
31%
APPENDIX 2 (contd) Table 3 : Daycases
A ‐ Nervous System
B ‐ Eyes and Periorbita
C ‐ Mouth Head Neck and Ears
D ‐ Respiratory System
E ‐ Cardiology, Cardiothoracic Surgery
F ‐ Digestive System
G ‐ Hepatobiliary and Pancreatic System
H ‐ Musculoskeletal System
J ‐ Skin, Breast and Burns
K ‐ Endocrine and Metabolic System
L ‐ Urinary Tract and Male Reproductive System
M ‐ Female Reproductive System and Assisted Reproduction
N ‐ Obstetrics
P ‐ Diseases of Childhood and Neonates
Q ‐ Vascular System
S ‐ Haematology, Chemotherapy, Radiotherapy
V ‐ Multiple Trauma, Emergency and Urgent Care
W ‐ Immunology, Infectious Diseases and other contacts
U ‐ uncoded
Grand Total
Total Elective
Elective 2,481
143
4,067
287
389
6,672
412
1,523
2,824
140
614
1,471
3
149
88
906
14
129
0
22,312
£ £1,783,762
£138,043
£4,177,890
£344,443
£651,991
£5,397,461
£617,183
£3,127,818
£2,633,764
£185,050
£438,038
£1,836,683
£2,695
£178,105
£102,839
£625,781
£20,716
£105,034
£0
£22,367,296
2010/11 Contract Year to Date
Contract
Actual
activity £
activity
£
621
£446,131
670
£454,819
36
£34,525
38
£35,355
1,017
£1,044,918
855
£1,087,024
72
£86,148
82
£80,370
97
£163,067
88
£130,737
1,669
£1,349,941
1,545
£1,248,856
103
£154,362
114
£181,414
381
£782,288
450
£849,158
706
£658,722
639
£662,226
35
£46,282
43
£55,751
154
£109,556
155
£106,373
368
£459,367
371
£439,764
1
£674
1
£2,539
37
£44,545
63
£52,193
22
£25,721
17
£20,311
227
£156,512
265
£162,478
4
£5,181
0
£0
32
£26,270
20
£15,406
0
£0
0
£0
5,580
£5,594,211
5,416
£5,584,774
Contract Performance 2010/11
Analysis by HRG chapter : 2010/11 year to date (month 3)
Poole Hospital NHS Foundation Trust
over/under performance
diff
% diff
activity
£
activity 49
£8,688
8%
2
£830
6%
‐162
£42,106
‐16%
10
‐£5,778
14%
‐9
‐£32,330
‐10%
‐124
‐£101,085
‐7%
11
£27,052
11%
69
£66,870
18%
‐67
£3,504
‐10%
8
£9,469
23%
1
‐£3,183
1%
3
‐£19,603
1%
0
£1,865
33%
26
£7,648
69%
‐5
‐£5,410
‐23%
38
£5,966
17%
‐4
‐£5,181
‐100%
‐12
‐£10,864
‐38%
0
£0 ‐164
‐£9,437
‐3%
0%
2%
2%
4%
‐7%
‐20%
‐7%
18%
9%
1%
20%
‐3%
‐4%
277%
17%
‐21%
4%
‐100%
‐41%
£ APPENDIX 2 (contd) Table 4 : All Elective Inpatients
A ‐ Nervous System
B ‐ Eyes and Periorbita
C ‐ Mouth Head Neck and Ears
D ‐ Respiratory System
E ‐ Cardiology, Cardiothoracic Surgery
F ‐ Digestive System
G ‐ Hepatobiliary and Pancreatic System
H ‐ Musculoskeletal System
J ‐ Skin, Breast and Burns
K ‐ Endocrine and Metabolic System
L ‐ Urinary Tract and Male Reproductive System
M ‐ Female Reproductive System and Assisted Reproduction
N ‐ Obstetrics
P ‐ Diseases of Childhood and Neonates
Q ‐ Vascular System
S ‐ Haematology, Chemotherapy, Radiotherapy
V ‐ Multiple Trauma, Emergency and Urgent Care
W ‐ Immunology, Infectious Diseases and other contacts
U ‐ uncoded
Grand Total
Non Elective Inpatients
Emergency £
£4,100,023
£243,372
£1,823,939
£5,032,510
£5,152,307
£6,622,353
£1,332,351
£13,433,496
£2,050,876
£524,455
£1,891,841
£828,269
£212,660
£4,854,958
£525,656
£982,081
£1,506,107
£2,243,507
£53,360,761
Emerg
1452
84
1346
2230
3495
3208
504
5266
1112
283
829
759
200
6141
142
389
354
1380
29,174
2010/11 Contract activity
358
21
332
549
861
790
124
1,297
274
70
204
187
49
1,513
35
96
87
340
0
7,187
Actual
7,301
activity
375
26
378
498
766
817
116
1,411
335
63
254
180
61
1,389
49
126
82
375
Year to Date £
£1,010,037
£59,954
£449,326
£1,239,755
£1,269,267
£1,631,411
£328,224
£3,309,331
£505,232
£129,199
£466,053
£204,043
£52,389
£1,196,015
£129,495
£241,935
£371,028
£552,686
£0
£13,145,380
Contract
Contract Performance 2010/11
Analysis by HRG chapter : 2010/11 year to date (month 3)
Poole Hospital NHS Foundation Trust
£13,746,634
£ 1,026,693
48,141
594,062
1,176,953
1,203,023
1,584,524
313,630
3,685,003
645,253
92,681
524,641
210,748
43,220
1,112,108
147,065
259,725
347,729
731,435
over/under performance
diff
% diff
activity £ activity 17
16,656
5%
5
‐11,813
26%
46
144,736
14%
‐51
‐62,802
‐9%
‐95
‐66,244
‐11%
27
‐46,887
‐8
‐14,594
‐7%
114
375,672
9%
61
140,021
22%
‐7
‐36,518
‐10%
50
58,588
‐7
6,705
12
‐9,169
24%
‐124
‐83,907
14
17,570
40%
30
17,790
‐5
‐23,299
‐6%
35
178,749
10%
0
0
114
601,254
2%
5%
‐6%
32%
14%
‐18%
‐4%
11%
28%
‐28%
£ 2%
‐20%
32%
‐5%
‐5%
APPENDIX 2 (contd) Table 5 : Non Elective inpatients - Emergency
A ‐ Nervous System
B ‐ Eyes and Periorbita
C ‐ Mouth Head Neck and Ears
D ‐ Respiratory System
E ‐ Cardiology, Cardiothoracic Surgery
F ‐ Digestive System
G ‐ Hepatobiliary and Pancreatic System
H ‐ Musculoskeletal System
J ‐ Skin, Breast and Burns
K ‐ Endocrine and Metabolic System
L ‐ Urinary Tract and Male Reproductive System
M ‐ Female Reproductive System and Assisted Reproduction
N ‐ Obstetrics
P ‐ Diseases of Childhood and Neonates
Q ‐ Vascular System
S ‐ Haematology, Chemotherapy, Radiotherapy
V ‐ Multiple Trauma, Emergency and Urgent Care
W ‐ Immunology, Infectious Diseases and other contacts
U ‐ uncoded
Grand Total
Non Elective Inpatients
Other £259,218
£0
£62,021
£78,643
£145,860
£95,498
£20,249
£313,808
£52,131
£34,583
£46,231
£67,330
£11,108,785
£1,131,008
£155,156
£99,145
£37,491
£249,466
£13,956,623
13,618
£
88
0
24
33
48
36
6
85
15
14
17
53
12031
533
24
61
13
537
Other
2010/11 Contract 22
0
6
8
12
9
1
21
4
3
4
13
3,000
133
6
15
3
134
0
3,395
activity
Contract
£64,627
£0
£15,463
£19,607
£36,365
£23,809
£5,048
£78,237
£12,997
£8,622
£11,526
£16,786
£2,769,587
£281,977
£38,683
£24,718
£9,347
£62,196
£0
£3,479,596
£
£3,683,193
114,303
3,093
5,658
11,740
29,385
2,801,356
258,521
86,739
21,952
10,063
60,700
28
1
3
5
22
3,245
112
16
14
2
127
3,667
£ 139,335
997
15,759
22,389
41,191
60,012
Actual
40
1
8
9
16
18
activity
Year to Date
Contract Performance 2010/11
Analysis by HRG chapter : 2010/11 year to date (month 3)
Poole Hospital NHS Foundation Trust
over/under performance
diff
% diff
activity £ activity £ 18
74,708
82%
116%
1
997 2
296
34%
2%
1
2,782
9%
14%
4
4,826
34%
13%
9
36,203
‐1
‐5,048
‐100% ‐100%
7
36,066
32%
46%
‐3
‐9,904
‐73%
‐76%
0
‐2,964
‐14%
‐34%
1
214
9
12,599
245
31,769
8%
1%
‐21
‐23,456
10
48,056
167%
124%
‐1
‐2,766
‐1
716
‐38%
8%
‐7
‐1,496
‐5%
‐2%
0
0
272
203,597
8%
6%
APPENDIX 2 (contd) Table 6 : Non Elective inpatients – “Other”
A ‐ Nervous System
B ‐ Eyes and Periorbita
C ‐ Mouth Head Neck and Ears
D ‐ Respiratory System
E ‐ Cardiology, Cardiothoracic Surgery
F ‐ Digestive System
G ‐ Hepatobiliary and Pancreatic System
H ‐ Musculoskeletal System
J ‐ Skin, Breast and Burns
K ‐ Endocrine and Metabolic System
L ‐ Urinary Tract and Male Reproductive System
M ‐ Female Reproductive System and Assisted Reproduction
N ‐ Obstetrics
P ‐ Diseases of Childhood and Neonates
Q ‐ Vascular System
S ‐ Haematology, Chemotherapy, Radiotherapy
V ‐ Multiple Trauma, Emergency and Urgent Care
W ‐ Immunology, Infectious Diseases and other contacts
U ‐ uncoded
Grand Total
Non Elective Inpatients
Total
Nonelec
1,540
84
1,370
2,263
3,543
3,244
510
5,351
1,127
297
846
812
12,231
6,674
166
450
367
1,917
0
42,792
£
£4,359,241
£243,372
£1,885,960
£5,111,153
£5,298,167
£6,717,851
£1,352,600
£13,747,304
£2,103,007
£559,038
£1,938,072
£895,599
£11,321,445
£5,985,966
£680,812
£1,081,226
£1,543,598
£2,492,973
£0
£67,317,384
2010/11 Contract activity
380
21
338
558
873
799
126
1,318
278
73
208
200
3,049
1,646
41
111
90
474
0
10,582
Actual
activity
415
27
386
507
782
835
116
1,439
336
66
259
202
3,306
1,501
65
140
84
502
0
10,968
Year to Date £
£1,074,664
£59,954
£464,789
£1,259,362
£1,305,632
£1,655,220
£333,272
£3,387,568
£518,229
£137,821
£477,580
£220,830
£2,821,976
£1,477,992
£168,178
£266,653
£380,375
£614,882
£0
£16,624,976
Contract
Contract Performance 2010/11
Analysis by HRG chapter : 2010/11 year to date (month 3)
Poole Hospital NHS Foundation Trust
£ £1,166,028
£49,138
£609,821
£1,199,342
£1,244,214
£1,644,536
£313,630
£3,799,306
£648,346
£98,339
£536,381
£240,133
£2,844,576
£1,370,629
£233,804
£281,677
£357,792
£792,135
£0
£17,429,827
over/under performance
diff
% diff
activity £ activity 35
91,364
9%
6
‐10,816
30%
48
145,032
14%
‐51
‐60,020
‐9%
‐91
‐61,418
‐10%
36
‐10,684
‐10
‐19,642
‐8%
121
411,738
9%
58
130,117
21%
‐7
‐39,482
‐10%
51
58,801
2
19,303
257
22,600
8%
‐145
‐107,363
24
65,626
59%
29
15,024
‐7%
‐6
‐22,583
28
177,253
6%
0
0
386
804,851
4%
5%
‐6%
29%
39%
1%
‐6%
12%
25%
‐29%
£ 9%
‐18%
31%
‐5%
‐5%
APPENDIX 2 (contd) Table 7 : Total Non Elective inpatients
APPENDIX 2 (contd) Tables 8 & 9 : Outpatient attendances
Table 8
Poole Hospital NHS Foundation Trust
Contract Performance 2010/11 ‐ PbR
First Outpatient Attendances by Specialty : 2010/11 year to date (month 3)
2010/11 Contract
Treatment Specialty
attds
£
100 ‐ General Surgery
6414 £1,316,075
101 ‐ Urology
1134
£220,204
107 ‐ Vascular Surgery
495
£130,719
110 ‐ Trauma & Orthopaed
13089 £1,936,557
120 ‐ ENT
6034
£758,795
130 ‐ Ophthalmology
1421
£176,417
140 ‐ Oral Surgery
5677
£724,685
171 ‐ Paediatric Surgery
203
£41,552
191 ‐ Pain Management
884
£141,465
300 ‐ General Medicine
4603 £1,020,696
301 ‐ Gastroenterology
224
£60,039
303 ‐ Clinical Haematology
637
£196,637
320 ‐ Cardiology
3482
£748,537
321 ‐ Paediatric Cardiology
141
£30,306
330 ‐ Dermatology
423
£54,371
370 ‐ Medical Oncology
313
£87,988
410 ‐ Rheumatology
3752
£942,200
420 ‐ Paediatrics
3670
£865,962
430 ‐ Elderly
2264
£581,776
501 ‐ Obstetrics
2255
£307,435
502 ‐ Gynaecology
4652
£657,436
800 ‐ Clinical Oncology
2433
£498,827
Grand Total
64,200 £11,498,679
Year to Date
Contract
attds
1,604
284
124
3,274
1,509
355
1,420
51
221
1,151
56
159
871
35
106
78
938
918
566
564
1,163
609
16,057
Actual
£
£329,159
£55,075
£32,694
£484,346
£189,780
£44,123
£181,249
£10,392
£35,381
£255,283
£15,016
£49,180
£187,214
£7,580
£13,599
£22,006
£235,651
£216,583
£145,506
£76,892
£164,429
£124,760
£2,875,897
attds
£
1,438 £294,914
140
£27,160
94
£24,816
3,077 £455,284
1,232 £156,547
318
£39,431
1,066 £136,690
57
£11,628
231
£37,002
1,091 £239,014
72
£19,296
154
£47,586
879 £188,825
34
£7,310
77
£9,166
56
£15,792
710 £179,330
973 £229,628
494 £126,876
581
£79,170
1,043 £148,992
634 £129,970
14,451 £2,604,427
over/under performance
diff
% diff
activity
£
activity
£
‐166
‐34,245
‐10%
‐10%
‐144
‐27,915
‐51%
‐51%
‐30
‐7,878
‐24%
‐24%
‐197
‐29,062
‐6%
‐6%
‐277
‐33,233
‐18%
‐18%
‐37
‐4,692
‐11%
‐11%
‐354
‐44,559
‐25%
‐25%
6
1,236
12%
12%
10
1,621
4%
5%
‐60
‐16,269
‐5%
‐6%
16
4,280
29%
29%
‐5
‐1,594
‐3%
‐3%
8
1,611
1%
1%
‐1
‐270
‐4%
‐4%
‐29
‐4,433
‐27%
‐33%
‐22
‐6,214
‐28%
‐28%
‐228
‐56,321
‐24%
‐24%
55
13,045
6%
6%
‐72
‐18,630
‐13%
‐13%
17
2,278
3%
3%
‐120
‐15,437
‐10%
‐9%
25
5,210
4%
4%
‐1,606
‐271,470
‐10%
‐9%
Table 9
Poole Hospital NHS Foundation Trust
Contract Performance 2010/11 ‐ PbR
Follow up Outpatient Attendances by Specialty : 2010/11 year to date (month 3)
2010/11 Contract
attds
Treatment Specialty
100 ‐ General Surgery
6354
101 ‐ Urology
1310
107 ‐ Vascular Surgery
277
110 ‐ Trauma & Orthopaed
15068
120 ‐ ENT
9480
130 ‐ Ophthalmology
1389
140 ‐ Oral Surgery
8315
171 ‐ Paediatric Surgery
199
191 ‐ Pain Management
2827
300 ‐ General Medicine
10537
301 ‐ Gastroenterology
2
303 ‐ Clinical Haematology
4363
320 ‐ Cardiology
4281
321 ‐ Paediatric Cardiology
24
330 ‐ Dermatology
2000
370 ‐ Medical Oncology
2712
410 ‐ Rheumatology
7886
420 ‐ Paediatrics
6127
430 ‐ Elderly
1307
501 ‐ Obstetrics
3950
502 ‐ Gynaecology
5625
800 ‐ Clinical Oncology
10351
Grand Total
104,384
£
£614,689
£125,836
£33,251
£1,253,313
£852,815
£95,683
£662,158
£19,881
£237,426
£1,098,312
£209
£497,463
£440,879
£3,205
£268,609
£322,940
£870,892
£735,330
£160,780
£258,189
£505,073
£786,693
£9,843,626
Year to Date Contract
attds
1,589
328
69
3,769
2,371
347
2,080
50
707
2,635
1
1,091
1,071
6
500
678
1,972
1,532
327
988
1,407
2,589
26,107
£
£153,738
£31,472
£8,316
£313,462
£213,295
£23,931
£165,610
£4,972
£59,382
£274,695
£52
£124,419
£110,267
£802
£67,181
£80,769
£217,816
£183,911
£40,212
£64,575
£126,322
£196,757
£2,461,957
Actual
attds
1,401
167
51
3,822
1,875
400
2,760
49
792
3,445
£
£134,592
£16,032
£6,120
£317,967
£165,881
£26,893
£230,647
£4,900
£67,034
£371,086
1,116 £127,224
1,083 £111,769
7
£931
98
£11,684
644
£76,636
2,145 £234,790
1,818 £218,160
320
£39,360
1,203
£78,250
1,417 £127,107
2,502 £190,152
27,115 £2,557,215
over/under performance
diff
% diff
activity
£
activity
£
‐188
‐19,146
‐12%
‐12%
‐161
‐15,440
‐49%
‐49%
‐18
‐2,196
‐26%
‐26%
53
4,505
1%
1%
‐496
‐47,414
‐21%
‐22%
53
2,962
15%
12%
680
65,037
33%
39%
‐1
‐72
‐2%
‐1%
85
7,652
12%
13%
810
96,391
31%
35%
‐1
‐52 ‐100% ‐100%
25
2,805
2%
2%
12
1,502
1%
1%
1
129
17%
16%
‐402
‐55,497
‐80%
‐83%
‐34
‐4,133
‐5%
‐5%
173
16,974
9%
8%
286
34,249
19%
19%
‐7
‐852
‐2%
‐2%
215
13,675
22%
21%
10
785
1%
1%
‐87
‐6,605
‐3%
‐3%
1,008
95,258
4%
4%
42,455
A&E Attds
Notes : Cost per Case Contract Total
£15,197,861 29,788
£8,183,739 11,380
£7,014,122 18,408
119,103
45,502
73,601
Outpatients
First
Followup
£82,361,266
£3,571,130 10,585
£48,651,844 7,854
£37,697,723 5,204
£10,954,121 2,649
Non Elective
31,753
Emergency 21,126
Other
10,627
activity £14,940,431 3,894
£6,377,463 806
£8,562,968 3,087
£
activity £3,736,702 3,716
£1,595,046 649
£2,141,656 3,067
£
Year to Date £20,445,957
£890,337 11,138
£3,801,087 28,916
£2,046,808 10,032
£1,754,279 18,884
£12,017,831 8,124
£9,286,803 5,182
£2,731,027 2,942
Contract
15,568
3,224
12,344
Elective
Inpatients
Day Case
activity 2010/11 Contract Actual
£20,389,694
£933,002
553
£3,616,837 ‐ 872
£1,821,731 ‐ 1,348
£1,795,106 476
£12,252,963 270
£9,466,584 ‐ 22
£2,786,379 293
£3,586,892 ‐ 178
£1,375,520 ‐ 157
£2,211,372 ‐ 20
£
‐£56,263
£42,665
‐£184,250
‐£225,077
£40,827
£235,132
£179,781
£55,352
‐£149,810
‐£219,526
£69,716
‐0.3%
4.8%
‐4.8%
‐11.0%
2.3%
‐2.9%
‐11.8%
2.6%
5.2%
2.0%
1.9%
2.0%
‐4.0%
‐13.8%
3.3%
3.4%
‐0.4%
11.0%
‐4.6%
‐19.5%
‐0.7%
over/under performance
diff
% diff
activity £
activity
£
Contract Performance 2010/11
Appendix 3 Bournemouth & Poole PCT Summary : 2010/11 year to date (month 3)
Poole Hospital NHS Foundation Trust
APPENDIX 3
11,124
A&E Attds
Notes : excl udes Non contra cted a cti vi ty
Cost per Case Contract Total
£5,585,531 11,162
£3,016,552 4,218
£2,568,979 6,944
44,629
16,863
27,766
Outpatients
First
Followup
£29,983,167
£1,007,287 2,773
£16,656,995 2,446
£13,981,842 1,769
£2,675,153 677
Non Elective
9,895
Emergency 7,181
Other
2,714
activity £6,733,354 1,538
£3,480,555 422
£3,252,799 1,116
£
Contract
6,150
1,689
4,461
Elective
Inpatients
Day Case
activity 2010/11 Contract activity £7,443,539
£251,132 3,022
£1,396,979 11,385
£754,460 3,959
£642,519 7,426
£4,111,371 2,541
£3,444,415 1,881
£666,956 660
£1,684,057 1,564
£870,510 396
£813,547 1,168
£
Year to Date Actual
£8,082,776
£258,767
249
£1,398,344 223
£706,744 ‐ 259
£691,600 482
£4,588,013 95
£3,775,993 112
£812,020 ‐ 17
£639,237
£7,635
£1,365
‐£47,716
£49,081
£476,642
£331,578
£145,064
£153,595
£63,588
£90,007
9.0%
2.0%
‐6.1%
6.9%
3.9%
6.3%
‐2.5%
1.7%
‐6.3%
4.7%
8.6%
3.0%
0.1%
‐6.3%
7.6%
11.6%
9.6%
21.8%
9.1%
7.3%
11.1%
over/under performance
diff
% diff
activity £
activity
£
£1,837,652 26
£934,098 ‐ 26
£903,554 52
£
Contract Performance 2010/11
Dorset PCT Summary : 2010/11 year to date (month 3)
Poole Hospital NHS Foundation Trust
Appendix 4