Performance Management Division
T: 0131-2443568
E: /
NHS Board Local Delivery Plan Contacts
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Your ref:
Our ref:F1884349
Date: 23 December 2008
Dear LDP Contacts,
Copy Territorial NHS Board Chief Executives
John Connaghan
LDP 2009/10 Additional Target Guidance
As outlined in the original guidance, I am writing to provide additional guidance on the following targets:
H8 Inequalities targted cardiovascular Health Checks
E8 Reduce Emissions : 2% reduction in energy consumption
A9 62 day suspicion of cancer referrals and 31 day cancer treatment
A10 18 weeks RTT
T11 MRSA & C.diff
A summary of the additional guidance is set out below, and revised Methods and Sources, and Annex 3 LDP Delivery Trajectories are attached.
H8 Achieve agreed number of inequalities targeted cardiovascular Health Checks during 2009–10.
The number and content of health checks and the inequalities targeting required will be agreed with each NHS Board as part of the LDP sign-off process. This will reflect local circumstances, eligible population and the stage of engagement with appropriate programmes in each Board area.
In order to develop meaningful, board-specific target trajectories, Keep Well wave 1 and 2 project managers have been asked to indicate the availability of information regarding health checks completed each month since the month of local inception. This will in turn be expressed as a percentage of available target population in each respective month. These figures will be used to project a percentage of the target population in each health board area that should receive an inequalities-targeted cardiovascular health check. This projection will be the starting point for negotiations with local health boards on what the H8 target will be.
We will be in touch with Boards in the first half of January to begin the negotiations on the target figures for inequalities-targetted health checks. If you have any queries in the meantime, please contact Tim Warren (Scottish Government) at 0131 244 3015 or .
E8: NHS Scotland to reduce emissions over the period to 2011
NHS Boards are expected to commit to a total energy consumption of 5,664,825 (million GJ) climatically adjusted for 2009/10 which equates to a total climatically adjusted carbon dioxide equivalent of 395,020 Tonnes of CO2.
The initial baseline is the energy used by only the hospitals in each Board during 2007-08 as recorded by eMART and will be measured in gigajoules (GJ). The date for reporting against the HEAT target is May 2010, and the report will be the energy usage (and equivalent CO2 emissions) for the year 2009-10.
For 2009-10 the performance measure will not apply to NHS24, NHS Education, NHS Health Scotland, NHS National Services, NHS QIS, and Scottish Ambulance Service. Although these Special Health Boards are asked to develop their own SMART interim energy consumption targets for LDP 2009/10.
Further detailed guidance including the target data for each Board with the list of hospitals that are included in the baseline, a revised Methods and Sources, and Annex 3 LDP Delivery Trajectories are attached.
For further advice or help contact John Dunlop at 0141 352 5543 or by email to at Health Facilities Scotland.
A9: The maximum wait from urgent referral with a suspicion of cancer to treatment is 62 days; and the maximum wait from decision to treat to first treatment for all patients diagnosed with cancer will be 31 days from December 2011.
The National Cancer Waiting-Times Delivery group is considering the delivery strategy including changes to definitions, implementing these changes, and the impact on official statistics. The intention is to start to implement the new definitions from April 2009.
For 2009/10, the performance measure for 62 days suspicion of cancer referrals will not include referrals from screening services, expected performance is 95% each quarter.
For 2009/10, the performance measure for 31 days from decision to treat to treatment will be based on diagnosis to treatment. Indicative levels of performance have been included in the delivery trajectories and these will be discussed with NHS Boards as part of the LDP process.We intend to move (once data are robust enough) to the decision-to-treat definition. We anticipate that data will start to become available for decision-to-treat to treatment by second/third quarter of 2009/10.
The Methods and Sources and delivery trajectory templates have been updated accordingly.For further advice or help contact Isobel Neil on 0131 244 2035 or by email .
A10: Deliver 18 weeks referral to treatment from 31 December 2011. No patient will wait longer than 12 weeks from referral to a first outpatient appointment from 31 March 2010. No patient will wait longer than 12 weeks from being placed on a waiting list to admission for an inpatient or day case treatment from 31 March 2010.
There are four performance measures for the 18 weeks RTT part of this target. For each of the admitted and non-admitted 18 week RTT patient pathways there is a performance and completeness measure. Access Support Team are arranging meetings with NHS Boards in January and February to agree delivery trajectories for 2009/10. Indicative levels of performance and completeness for March 2010 are set out below:
- 80% Admitted performance
- 95% Admitted completeness
- 85% Non-admitted performance
- 95% Non-admitted completeness
These performance and completeness measures will be reviewed in 2009/10. Details of the performance measures are set out in the Methods and Sources, and the delivery trajectory templates have been revised accordingly.
Guidance for the 18 weeks RTT statistical collection is due for issue in early January following consultation with NHS Boards.For further advice or help contact Colin Lauder on 0131 244 5646 or by email .
T11: To reduce all staphylococcus aureus bacteraemia (including MRSA) by 30% by 2010; to introduce and comply with local antimicrobial policies by 2010; and to reduce the rate of C.diff infection in hospitals by at least 30% by 2011.
It should be noted that although the target title refers to ‘in hospitals’, HPS surveillance covers C.diff reports from a wider range of healthcare settings. Therefore, the measure used will be rates in all healthcare settings, the Methods and Sources now reflects this fact. The target wording willl be reviewed for HEAT 2010/11.
MRSA/MSSA performance measure baselines for ForthValley and Lothian have been revised to tak account of the latest data. Performance data for other NHS Boards have also been revised but this has had no impact on the baselines.
For further advice or help contact Kevin Hanlon on 0131 244 5998 or by email .
John Connaghan has asked me to copy this letter to territorial Chief Executives because of the high profile of the A9 and A10 targets.
I am happy to discuss
Yours sincerely
ROBERT WILLIAMS
St Andrew’s House, Regent Road, Edinburgh EH1 3DG/
eRDM F1141226