Agenda item

Dr. John Radford, Director of Public Health

(9.15 a.m.)

Dr. John Radford, Director of Public Health, gave the following powerpoint presentation on Performance Management:-

 

Performance Management

-          Clear accountability for each performance measure – 1 accountable lead

-          Targets, action plans and milestones track progress and direction of travel

-          Performance monitoring – current performance, RAG status and direction of travel

-          Governance arrangements play a fundamental role managing performance/risk

-          Concerns and outliers are identified to prompt necessary action including clinics

-          Trigger points for a performance clinic:

·           If performance is below target/is predicted to not meet the year end target

·           On target but due to a known event/issue is predicted to n ot meet the year end target

-          The clinic will develop and agree a remedial action plan with the accountable lead

-          Service improvement work takes place immediately upon agreement of the plan

-          Progress monitored and reported to provide assurances that issue is under control necessary improvements in performance are delivered

-          Latest available Public Health data used as a ‘can opener’ to prompt where performance clinics could take place

 

Public Health Outcome Framework Scorecard Summary – 110 National Public Health Outcome Framework Measures

-          National Benchmark RAG Status

·           32 Indicates rated Red

·           27 Indicators rated Amber

·           35 Indicators rated Green

-          Regional Benchmark RAG Status

·           23 Indicators rated Red

·           46 Indicators rated Amber

·           24 Indicators rated Green

 

Green Measures

-          Wider determinants of health

1.02i/ii School Readiness

1.06i LD Settle Accommodation

1.06II MH Settled Accommodation

1.06ii LD/MH Employment (Gap)

1.10 Killed and Seriously injured casualties on England’s roads

1.15i/ii Statutory Homelessness – Acceptances/Households in temporary accommodation

1.17 Fuel Poverty

1.18i Social Isolation

 

-          Health improvement

2.07ii Rate of Emergency Admissions caused by unintentional and deliberate injuries in young people aged 15-24 years

2.20i/ii Cancer Screening Coverage (Breast/Cervical)

2.22i/ii NHS Health Checks – Take up/Offered

2.24i/ii/iii Injuries due to falls in people aged 65 and over

 

-          Health protection

3.02i/ii chlamydia Diagnoses (15-24 year olds)

3.03iii/iv/v/vivii/x/xii/xiii/xiv/xv Vaccination Coverage

3.05ii Incidence of TB

 

-          Healthcare and premature mortality

4.1 Suicide Rate

 

Amber Measures

-          Wider determinants of health

1.09i Sickness Absence – the % of employees who had at least 1 day off in the previous week

1.18ii Loneliness and Isolation Carers

 

-          Health improvement

2.04 Teenage Conceptions

2.06i Excess Weight in 45 year olds

2.07i Rate of Emergency Admissions caused by unintentional and deliberate injuries in children aged 0-14 years

2.12 Excess Weight in Adults

2.13i % of physical active and inactive adults – active adults

2.15ii Successful completion of Drug Treatment – non-opiate users

2.18 Alcohol-related Hospital Admissions

2.23i/ii/iii/iv Wellbeing response from Integrated Household Survey

 

-          Health protection

3.03viii/ix MMR Vaccination Coverage

3.04 People presenting with HIV at a late stage of infection

 

-          Healthcare and premature mortality

4.01 Infant Mortality

4.06i/ii U-75 Mortality Rate from Liver Disease/considered preventable

4.07ii U-75 Mortality Rate from Respiratory Diseased considered preventable

4.14i/ii/iii Hip Fractures in People aged 65 and over

4.15i/ii/iii/iv Excess Winter Deaths Index

 

Red Measures

-          Overarching Indicators

0.1i/ii Health Life Expectancy at Birth

0.2i/ii Life Expectancy at Birth

0.2 vi Gap in Live Expectancy at Birth between each Local Authority and England as a whole

 

-          Wider Determinants of Health

1.01ii % of all dependent children under 20 in relative poverty

1.02ii School Readiness (Y1 pupils)

1.09ii Sickness absence - % of working days lost to sickness absence

1.12i Violent crime (including sexual violence) – hospital admissions for violence

1.14 % of the population affected by noise

1.16 Utilisation of outdoor space for exercise/health reasons

 

-          Health Improvement

2.01 % of all live births at term with low birth weight

2.02i/ii Breastfeeding initiation/prevalence

2.03 Rate of smoking at time of delivery per 100 maternities

2.06ii Excess weight in 10-11 year olds

2.13ii % of physically active and inactive adults – inactive adults

2.14 Smoking prevalence (adults) over 18

2.15i Successful completion of drug treatment – opiate users

2.17 Recorded diabetes

2.21 vii Access to non-cancer screening programmes – diabetic retinopathy

 

-          Healthcare and Premature Mortality

-          4.02 Tooth decay in children aged 5

-          4.03 Mortality rate from causes considered preventable

-          4.04i/ii U-75 mortality rate from all cardiovascular disease/considered preventable

-          4.05i/ii U-75 mortality rate from cancer/considered preventable

-          4.07i U-75 mortality rate from respiratory disease

-          4.08 mortality from communicable diseases

-          4.11 Emergency readmissions within 30 days of discharge

 

Health and Wellbeing Board Priorities – Red Measures

Smoking

-          % smoking at delivery

2012-13 outturn (19.2%)

Last update Q3 2013/14 (21.1%) against a target of 18.2%

 

Alcohol

-          Number of FPN waivers which result in attendance at binge drinking course

2012-13 outturn (86)

Last update Q3 2013/14 (17)

Lower than last year

 

Fuel Poverty

-          The number of properties receiving energy efficiency measures through Community Energy Saving Programme (CESP)

A3 2014-14 (16) against a target of 236

-          The number of properties receiving energy efficiency measures through Department of Energy and Climate Change (DECC)

Q2 2013-14 (68) against a target of 320

 

Obesity

-          Percentage of overweight and obese children in Reception

2011-12 outturn (16.1%)

Last update 2012-13 (22.2%)

2013-14 not available but deterioration in direction of travel between 2011-12 and 2012-13

-          Percentage of overweight and obese children in Year 6

2011-12 outturn (33.0%)

Last update 2012-13 (35.2%)

2013-14 not available but deterioration in direction of travel between 2011-12 and 2012-13

-          Healthy eating prevalence (Integrated Household Survey/Active People Survey)

2011-12 outturn 21.3% against a target of 28.7%

 

Future Performance Clinics

-          The following Indicators have been identified as requiring focus/action – either Red or Amber with deterioration and/or in the bottom quartile regionally:-

Obesity

Low birth weight babies

Breastfeeding

Drug treatment

School readiness

Emergency readmissions

Sickness absence

Smoking

Mortality

Access to non-cancer screening programmes

Children in poverty

Violent crime

Noise

Tooth decay

Alcohol (binge drinking course)

Energy Efficiency

 

-          3 areas identified as priority areas for first performance clinics – Obesity, Drug Treatment and Breast Feeding

-          Obesity and Drug Treatment had taken place during May, 2014 and Breastfeeding to be held shortly

 

Discussion ensued on the presentation with the following issues raised/clarified:-

 

·           Importance of joint working to develop strategies

·           Need to work with the voluntary sector to ascertain what was available in the community in order to maximise resources

·           Possible use of local businesses/supermarkets

·           The need to think differently/interventions that would hopefully reduce the need for urgent health care

·           Engagement with Parish Councils and inclusion in Parish Plans

·           Need for performance clinics to be radical – “what would the effect be if stop doing what we are doing?”

·           Hold current structures to account – there were a whole host of disparate processes across the Local Authority and partners.  Engaging Scrutiny would be extremely positive as they gave a fresh view on issues

·           Performance clinic to be held on Maternity Health

 

Chris Edwards reported that NHS England had requested the CCG to set up a System Resilience Group on which all partners were represented.  The membership was clearly defined. 

 

Resolved:-  (1)  That the report be noted.

 

(2)  That the results of performance clinics, the procedures followed and the work undertaken be reported to future Board meetings.

 

(3)  That a report be submitted to the next Board meeting on the System Resilience Group.

 

(4)  That NHS England submit a report to the next Board meeting on Diabetic Retinopathy screening.