For Acute, Ambulance, Community and Mental Health

2012/13 NHS STANDARD CONTRACT

FOR ACUTE, AMBULANCE, COMMUNITY AND MENTAL HEALTH

AND LEARNING DISABILITY SERVICES

(MULTILATERAL)

SECTION B PART 8 - QUALITY

Section B Part 8.1: Quality Requirements

Technical Guidance Reference / Quality Requirement / Threshold / Method of Measurement / Consequence of breach /
PHQ27 (In dashboard) / Meticillin resistant Staphylococcus Aureus (MRSA) bacteraemia / Acute
The centrally set trajectory for the reduction in the incidences of MRSA is 0 for TRFT
Community
Requirement to take part in all Multi Disciplinary Team Root Cause Analysis exercises when MRSA is identified in the community. / Monthly Contract Monitoring / Acute
Removed commercially sensitive
Community
No specific sanction.
The Contract Management process set out in Clause 47 (pE34) to be applied.
PHS17 / Number of health visitors / 43 / Monthly Contract Monitoring / No Sanction in year see Health Visiting Information under Documents relied on.
National 1 / A&E indicators (1):
The Provider shall satisfy at least one of the following Patient Impact Indicators, and at least one of the following Timeliness Indicators:
Patient Impact Indicators:
1. Unplanned re-attendance rate
2. Left department without being seen [rate]
Timeliness Indicators:
1. Total time spent in A&E department
2. Time to initial assessment (95th percentile)
3. Time to treatment in department (median) / Patient Impact Indicators:
1. A rate above 5%
2. A rate at or above 5 %
Timeliness Indicators:
1. 95% of patients waiting less than 4 hours for admitted patients and with the same threshold for non-admitted
2. A 95th percentile time to assessment above 15 minutes
3. A median time to treatment above 60 minutes / Monthly Contract Monitoring
Monthly Contract Monitoring / Removed commercially sensitive
1.  As per PHQ23 2% service line revenue
2 & 3 No specific sanction.
The Contract Management process set out in Clause 47 (pE34) to be applied
National 2 / A & E indicators (2):
1. percentage of A& E attendances for cellulitis and DVT that end in admission
2. number of admissions for cellulitis and DVT per head of weighted population
3. percentage of Patients presenting at type 1 and 2 (major) AE sites in certain high risk categories who are reviewed by an emergency medicine consultant before being discharged
4. A & E service experience / NHSR need to work with TRFT to understand 11/12 baseline position for these indicators.
1. To be agreed
2. To be agreed
3. To be agreed
4. To be agreed / Monthly Contract Monitoring / No specific sanction.
The Contract Management process set out in Clause 47 (pE34) to be applied
National 3 / Provider cancellation of Elective Care operation for non-clinical reasons either before or after Patient admission / 0.8% / Monthly Performance contract / No specific sanction.
The Contract Management process set out in Clause 47 (pE34) to be applied
National 4 / Provider failure to ensure that “sufficient appointment slots” are made available on the Choose and Book system / >4% Slot Unavailability / Contract Monitoring / No specific sanction.
The Contract Management process set out in Clause 47 (pE34) to be applied
National 5 / Breach of Clause 40.5 of the Core Legal Clauses (cancelled operations) / 0 / Monthly Performance contract / Provider must pay for the relevant Patient’s treatment by another provider of the Patient’s choice.(National)
If evidence of the patient being offered a date within 28 days and refused by the patient – No Sanction. If this is not the case and TRFT provide the procedure NHSR will not pay (local)
National 6 / Delayed transfers of care to be maintained at a minimal level / 3.5% / Monthly Performance contract / No specific sanction.
The Contract Management process set out in Clause 47 (pE34) to be applied
National 7 / Percentage of SUS data altered in period between (a) 5 Operational Days after month-end, and (b) the Inclusion Point for the month in question / No Threshold set in 12-13, to be monitored in-year. / Monthly Performance contract / No specific sanction.
The Contract Management process set out in Clause 47 (pE34) to be applied
National 8 / Satisfaction of the Provider’s obligations under each Ambulance Services Handover Plan / TBC Discuss with TRFT how this can be monitored / TBC / TBC
National 9 / Failure to agree the EMSA Plan in accordance with Clause 30.2 of the Core Legal Clauses / Non Agreement of Plan / Contract Quality Discussion / Withholding of up to 1% of all monthly sums payable under Clause 7 (Prices and Payments) of the Core Legal Clauses for each month, or part month, that the breach continues
National 10 / Breach of an EMSA Plan milestone / N/A / Monthly Performance contract / Agreed consequence or retention of agreed sum under Clause 30 (E20) of the Core Legal Clauses where consequence not otherwise agreed and set out in the EMSA Plan
Local 1 / Access to GUM Clinics - The percentage of patients attending GUM clinics who are OFFERED an appointment within 48hrs of contacting a service / 100% offered within 48 hours / Monthly Performance contract / No specific sanction.
The Contract Management process set out in Clause 47 (pE34) to be applied
Local 2 / Access to GUM Clinics - The percentage of patients attending GUM clinics who are SEEN within 48hrs of contacting a service. / Target 85% seen within 48 Hours / Monthly Performance contract / No specific sanction.
The Contract Management process set out in Clause 47 (pE34) to be applied
Local 3 – CQUIN PHQ29 / VTE - percentage of all adult in patients who have had a VTE risk assessment on admission to hospital. / 90% achievement / Monthly Performance contract / No specific sanction.
However linked to 12/13 CQUIN
Local 4 – CQUIN / VTE - The number of patients receiving appropriate prophylaxis based on national guidance from NICE and RCOG. / Target -. 95% monthly / Monthly Performance contract / No specific sanction.
However linked to 12/13 CQUIN
Local 5 / Data quality on ethnic group - Completeness of trust coding for ethnicity in patient data sets. Using valid 2001 census coding for ethnicity category. / Target 85% / Monthly Performance contract / No specific sanction.
The Contract Management process set out in Clause 47 (pE34) to be applied
Local 6 / Infant health & inequalities: smoking during pregnancy and breastfeeding initiation: Definition of Breast Feeding : The mother is defined as having initiated breast feeding if, within the first 48hrs of birth, either she puts the baby to the breast or the baby is fed breast milk . / 66% / Monthly Performance contract / No specific sanction.
The Contract Management process set out in Clause 47 (pE34) to be applied
Local 7 / Smoking during Pregnancy / Q1 20%
Q2 19.7%
Q3 19.41%
Q4 19.1% / Monthly Performance contract / No specific sanction.
The Contract Management process set out in Clause 47 (pE34) to be applied
Local 8 / Maternity 12 weeks screening - Percentage of women who have seen a midwife or a maternity healthcare professional, for assessment of health and social care needs, risks and choices by 12 weeks and 6 days of pregnancy. / 90% of all women / Monthly but sanction applied Quarterly Performance contract / No specific sanction.
The Contract Management process set out in Clause 47 (pE34) to be applied.
Local 9 / Waiting times for Rapid Access Chest Pain Clinic - Percentage of patients with new onset chest pain thought to be angina seen in a RACPC within 2 weeks of referral. / 100% 2 Weeks / Monthly Performance contract / No specific sanction.
The Contract Management process set out in Clause 47 (pE34) to be applied
Local 10 / Breast Screening - Extension of breast screening program to women aged 47-49 and 71-73 / Q1 42%
Q2 50%
Q3 58%
Q4 66% / Monthly Performance contract / No specific sanction.
The Contract Management process set out in Clause 47 (pE34) to be applied
Local 11 / Bowel Screening - Extension of bowel screening program to men and women aged 70 up to 75 birthday / TBC / Monthly Performance contract / No specific sanction.
The Contract Management process set out in Clause 47 (pE34) to be applied
Local 12 / Implementation of Stroke Strategy - Percentage of patients who spend at least 90% of their time on a stroke unit. The agreed annual target of 80% is required for NHS Rotherham by quarter 1 11/12 and to be maintained throughout 11/12. / 80% / Monthly Performance contract / No specific sanction.
The Contract Management process set out in Clause 47 (pE34) to be applied
Local 13 / TIA's 24hrs- percentage of higher risk TIA cases who are treated within 24 hours of first contact with any healthcare professional. This target only applies to non-admitted patients. The agreed annual target of 60% is required for NHS Rotherham by quarter 1 11/12 and to be maintained throughout 11/12. / 60% / Monthly Performance contract / No specific sanction.
The Contract Management process set out in Clause 47 (pE34) to be applied
Local 14 / Stroke Metrics: Proportion of patients presenting with stroke with AF anti-coagulated on discharge / 60% / Monthly Performance contract / No specific sanction.
The Contract Management process set out in Clause 47 (pE34) to be applied
Local 15 / Stroke Metrics: Proportion of patients admitted directly to an acute stroke unit within 4 hours of hospital arrival / 90% / Monthly Performance contract / No specific sanction.
The Contract Management process set out in Clause 47 (pE34) to be applied
Local 16 / Stroke Metrics: Proportion of stroke patients scanned within one hour of hospital arrival / 50% / Monthly Performance contract / No specific sanction.
The Contract Management process set out in Clause 47 (pE34) to be applied
Local 17 / Stroke Metrics: Proportion of stroke patients scanned within 24 hrs of hospital arrival / 100% / Monthly Performance contract / No specific sanction.
The Contract Management process set out in Clause 47 (pE34) to be applied
Local 18 / Stroke Metrics: Proportion of patients supported by a stroke skilled ESD team / 40% / Monthly Performance contract / No specific sanction.
The Contract Management process set out in Clause 47 (pE34) to be applied
Local 19 (PHQ 21) / RTT waits incomplete % within 18 weeks / 92% / Monthly Performance contract / No specific sanction.
The Contract Management process set out in Clause 47 (pE34) to be applied
Local 20 (PHQ 15) / Unplanned hospitalisation for chronic ACS conditions rate / 100,000 / Data collection Q1 compare against peers and national average from Q2 onwards. / Monthly Performance contract / No specific sanction.
The Contract Management process set out in Clause 47 (pE34) to be applied
Local 21 (PHQ 16) / Unplanned Hospitalisation for asthma, diabetes and epilepsy in under 19's per 100,000 / Data collection Q1 compare against peers and national average from Q2 onwards. / Monthly Performance contract / No specific sanction.
The Contract Management process set out in Clause 47 (pE34) to be applied
Local 22 (PHQ 17) / Emergency Admissions for acute conditions that should not usually require hospital admission / Data collection Q1 compare against peers and national average from Q2 onwards. / Monthly Performance contract / No specific sanction.
The Contract Management process set out in Clause 47 (pE34) to be applied
Local 23 (PHS 16) / Numbers waiting on an incomplete reffreal to treatment pathway / Data collection Q1 compare against peers and national average from Q2 onwards. / Monthly Performance contract / No specific sanction.
The Contract Management process set out in Clause 47 (pE34) to be applied
Local 24 (PHQ 30) / Stopping Smoking - Number of clients of NHS Stop Smoking Services who report that they are not smoking four weeks after setting a quit date - / TBC end of Q1 / Monthly Performance contract / No specific sanction.
The Contract Management process set out in Clause 47 (pE34) to be applied
Local 25 / Stopping Smoking - Number of clients of NHS Stop Smoking Services who report that they are not smoking four weeks after setting a quit date - As a Conversion Rate of All Seen / 50% / Monthly Performance contract / No specific sanction.
The Contract Management process set out in Clause 47 (pE34) to be applied
Local 26 / Prevalence of breastfeeding at 6-8 weeks - The percentage of infants being breastfed at 6-8 weeks / TBC / Monthly Performance contract / No specific sanction.
The Contract Management process set out in Clause 47 (pE34) to be applied
Local 27 / Alcohol Intake - Percentage of patients on a caseload who have been screened for alcohol intake by community service staff as part of their assessmenr or personalised care planning. / 95% / Monthly Performance contract / No specific sanction.
The Contract Management process set out in Clause 47 (pE34) to be applied
Local 28 / Chlamydia Screening Positivity - Percentage of total numbers screened. / 8% / Monthly Performance contract / No specific sanction.
The Contract Management process set out in Clause 47 (pE34) to be applied
Local 29 / Chlamydia Screening Coverage - Percentage of population aged 15-24. / 21% (need to agree which population figures we are working from) / Monthly Performance contract / No specific sanction.
The Contract Management process set out in Clause 47 (pE34) to be applied
Local 30 / Postnatal depression in mothers - The percentage of new mothers with an assessment for postnatal depression. / 100% / Monthly Performance contract / No specific sanction.