Balanced Score Card Report Review of June 2017 Data Finance Finance - - PowerPoint PPT Presentation

Balanced Score Card Report Review of June 2017 Data

Finance

Finance Report – June 2017

CUH Actual outturn 1H 2017 PAY & NONPAY

• Gross pay & non pay budget €176.7m (2016 :€170.5m)
• Actual pay & non pay €181.9m (2016: €174.4m)
• Actual Deficit €5.2m (-3%) (2016 :€3.9m/-2.3%)

Less Adjustments €3.87m increase in Bad debts provision €2.1m PCRS Drugs €0.85m LRA Restoration unfunded €0.94m Adjusted Deficit €1.34m(-0.76%) (2016 :€1.8m/-1%)

INCOME

• Income budget €39.74m (2016 :€40m)
• Actual Income €38.97m (2016 :€39.1m)
• Actual Deficit €0.77m (-2%) (2016 :€0.9m/-2%)

CUH –Pay & Non pay Budget Surplus/(Deficit) %

0.51%

• 0.91%
• 0.18%
• 0.75%
• 0.72%
• 0.76%
• 0.40%
• 1.86%
• 1.94%
• 1.96%
• 2.88%
• 2.95%
• 0.81%
• 0.84%
• 0.66%
• 1.01%
• 1.22%
• 1.04%
• 0.85%
• 1.32%
• 1.36%
• 0.85%
• 0.28%
• 1.14%
• 2.01%
• 2.03%
• 2.42%
• 2.27%
• 2.30%
• 2.27%
• 2.86%
• 2.92%
• 2.43%
• 0.52%
• 3.5%
• 3.0%
• 2.5%
• 2.0%
• 1.5%
• 1.0%
• 0.5%

0.0% 0.5% 1.0% Jan Feb Mar April May June July Aug Sept Oct Nov Dec

2017(adj) 2017 2016(adj) 2016

5

CUH AGENCY WTE 2014-7

Jul-14 Sep-14 Dec-14 Jan-15 Mar-15 Jun-15 Sep-15 Dec-15 Jun-16 Jul-16 Aug-16 Sep16 Oct 16 Nov-16 Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 June-17 Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual

Radiotherapist

9.40 4.00 4.87 2.78 0.95 0.9

Radiographer

0.09 0.05 0.06

Labs

12.04 13.40 11.0 12.19 1.0

Cardiac Techs

3.80 3.80 1.0

Physio

1.60 1.50

Pharmacy

2.00 1.00

Admin

23.40 9.08 9.36 14.1 9.3

Nursing

46.20 33.0 34.7 37.8 40.0 30.4 28.6 26.1 31.6 32.1 28.7 27.6 29.6 31.5 25.5 33.3 33.3 32.7 31.7 34.3 37.3

HCA

34.80 16.2 22.7 23.2 24.4 29.8 30.8 38.2 38.4 45.7 52.1 52.1 56.9 32.1 17.7 26.1 25.3 34.5 34.5 33.9 36.6

House-Keeping

10.40 0.16

Physics

4.30 2.6 1.6 1.09 0.92 0.75 0.66 0.46 0.83 0.83 0.83 0.83 0.83 0.83 0.83 0.83 0.83 0.23

Catering

3.00 8.5 2.0 2.7 1.8 6.9 3.9 0.9 1.2

Social Work

1.00 0.5

Occ Therapy

1.00 0.37

Dietician

0.50 0.3 1 1 1 1 1 1 1 1 1 1 1 1 1

Medical

11.00 5.27 4.77 4.4 6.35 5.86 7.97 15.73

Consult

0.25 0.95 4.44 0.38 1.62 0.6 0.34

NCHD

2.47 4.45 5.13 6.7 2.99 2.84 1.87 1.82 2.83 2.94 2.15 2.34 1.54 164.5 99.7 91.1 98.26 84.7 74.6 71.9 81.4 76.75 85.03 92.20 88.23 91.70 69.89 46.9 63.05 63.26 71.37 69.95 71.88 76.4

CUH AGENCY COSTS €k 2015 - 2017

Acute Nursing Agency WTE 2015 to 2017

Acute HCA Agency WTE 2015 to 2017

7

31.4 31.3 30.7 29.8 30.8 33.8

34.2 31.7 32.6 31.1 30.5 30.4 30.5 27.8 25.2 27.6 29.5 23.8

35.9 32.9 40 34.4 32.2 31.3 30.5 26.8 27.6 29.3 30.4 25.5

10 20 30 40 50

Jan Feb Mar April May June July Aug Sept Oct Nov Dec 2017 2016 2015

26.1 25.3 34.5 34.5 33.9 36.6 37.2 35.2 37.7 36.9 41.1 38.4 45.7 52.1 52.1 56.9 32.1 17.7 23.2 19.3 24.4 26.8 31.0 29.8 34.7 32.7 30.8 32.4 34.5 38.2

10 20 30 40 50 60 70

Jan Feb Mar April May June July Aug Sept Oct Nov Dec 2017 2016 2015

CUH Average Nursing & HCA Agency WTE’s per Week 2015-17

8

CUH Average Specials /Other Nursing & HCA Agency WTE’s per Week 2016-17

57.4 56.6 65.2 64.2 64.6 70.4

71.4 66.9 70.4 68 71.6 68.8 76.2 79.9 77.3 84.5 61.6 41.5

59.1 52.2 64.4 61.2 63.2 59.9 65.1 59.3 58.4 61.7 64.9 63.7

10 20 30 40 50 60 70 80 90

Jan Feb Mar April May June July Aug Sept Oct Nov Dec 2017 2016 2015

51.3 45.6 51.9 43.1 48.2 57.8 43.7 50.4 49.2 52.4 32.4 20.5

28.5 27.6 31.9 33.7 34.1 32.8

20 21.3 18.7 24.9 23.4 11 32.4 29.5 28.1 32.2 29.2 20.9

29 28.9 33.3 30.6 30.5 37.5

10 20 30 40 50 60 70 Jan Feb Mar April May June July Aug Sept Oct Nov Dec Specials 2016 Specials 2017 Other 2016 Other 2017

CUH Non-Pay Budget v Actual June 2017

CUH Actual Non-pay expenditure €k June 2017 v 2016

CUH Private Bed Occupancy 2017 v 2016

147 145 139 151 128 130 120 123 125 124 115 111 114 120 126 118 121 102 111 110 115 113 111 114 110 111 100 110 120 130 140 150 160 Jan Feb Mar Apr May Jun Jul Aug Sep 12th Oct 19th Oct 26th Oct 2nd Nov 9th Nov 16th Nov 23rd Nov 30th Nov 7th Dec 14th Dec 21st Dec

CUH Bed Occupancy 2017 v 2016

2016 2017

Patient Income 2015 –2017

CUH Debtor Days Consultant Claims

June 2017

35 42 42 40 42.0 44 41 43 43 39 30 41

44 41 40 40 42.0 42

44 44 44 46 49.0 42 44 41 44 41 43 43

20 25 30 35 40 45 50 Jan Feb Mar April May June July Aug Sept Oct Nov Dec

2016 2017 Target (old) 2015

MGH - Finance Report – June 2017

Mallow YTD June 2017 outturn

• Gross pay & non pay budget €10.03m (2016:€10m)
• Actual pay & non pay €10.32m (2016:€10.1m)
• Actual deficit €287k (-2.9%) (2016:€118k -1.2%)
• Less Adjustments €246k

increase in Bad debts provision €186k LRA Restoration unfunded €60k Adjusted deficit €41k (-0.4%) Mallow Income outturn

• Income budget €1.77m (2016:€1.92m)
• Actual Income €2.09m(2016:€1.91m)
• Actual surplus €315k (18%) (2016:Surplus €91k 6%)

BGH - Finance Report – June 2017

Bantry YTD June 2017 outturn

• Gross pay & non pay budget €10.3m
• Actual pay & non pay €10.48m
• Actual deficit €181k (-1.8%)

– Less Adjustments €199k – increase in Bad debts provision €41k –

• St. Josephs ward €111k

– LRA Restoration unfunded €45k – Waiting list initiative €2k

• Adjusted surplus €18k (0.2%)

Bantry Income outturn

• Income budget €1.79m
• Actual Income €1.81m
• Actual surplus €23k (1%)

17

Relocation of HBS Storage to the National Distribution Centre

CUH Project-go live 12th June

CUH - NDC Implementation Committee

The CUH - NDC Implementation Committee is being established to: Oversee the implementation of residual actions set out in HBS Local project plan Address the specific service issues arising from the project Monitor the achievement of the HBS Cost Containment target

• f €700k

Monitor the introduction of barcode/scanning to all stock locations Develop the suite of appropriate user reports for all levels of Management

CUH - NDC Implementation Committee

This committee will operate on behalf of the EMB

The core membership will comprise:

• Mr. Brendan O’Reilly, Operations Manager
• Mr. Terry Kiely ,Finance Manager
• Mr. Stephen Lynch ,Assistant Head of Logistics & Inventory
• Management
• Mr. Michael Coleman, Logistics Operations Manager .Cork
• City & County
• A/ Director of Nursing Nominee

Other individuals and departments will be called on as required

Patient Access – Emergency Department

CUH 30 Day Moving Average 2016 - 2017 (14/07/2017)

30 Day Moving Average (21/07/2017)

6 Hour PET & 8AM TrolleyGAR

per 100 ED Attends

23

PET Monthly Comparison (Non Admitted)

PET Monthly Comparison (Admitted)

PET > 24hrs

50 100 150 200 250 300 350 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17

320 316 264 328 85 97 57

PET >24 hours

>75 years Bed Wait >9 hours

50 100 150 200 250 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 218 199 200 215 129 120 46

>75yrs Bed Wait >9 hrs (2017)

**Up to 18th July

Delayed Discharges – April – June 2017

Bed Days Used by inpatients for Associated Date with

LOS > 14 days

>14 Day Target Reduction

31

Overview of CUH In-Patients Awaiting Cardiac Surgery

Numbe r Ward Adm. Date Patients in Hospital in excess of 14 days Referring Consultant Cardiologist Intended Surgical Procedure & Consultant Surgeon Current Status Patient 1. SDU 21/06/ 2016 

• Dr. E.

McFadden AVR TA Surgery Date Wednesday 19/07/2017 Patient 2. SDU 10/07/ 2017

• Dr. P.

Kearney CABG KD Surgery Date (TBC) Referral rec’d 17/07/17 Patient 3. 3D Card. Ward 17/07/ 17

• Dr. E.

McFadden CABG - KD Referral received @ 4.00pm this afternoon referral on Mr Doddakula desk for his attention

Patient Flow Improvement Plan - PF 17

• Whiteboards (completed)
• >14 Day Patient Review

– Discharge Coordinator Staffing (completed) – Weekly >14 Day Review(work in progress) – Delayed Discharges (18 patients >100 days) – Long Term Care Process (MUH Meeting 20th June) – Early identification of patients with LOS >14 days (work in progress)

• Acute Surgical Pathway (work in progress)
• Cardiothoracic Pathway (completed)
• Orthopaedic Pathway (to be progressed)
• Integrated Care Pathways (work in progress)
• Acute Floor Interface Group (work in progress)
• Communication Plan (work in progress)

Patient Access - Outpatient Waiting Lists

Total Medical Patients to be seen by 15 Month Target

(as of June 2017) (205)

64 31 28 20 18 14 9 6 4 3 2 2 1 1 1 1 10 20 30 40 50 60 70

Total Surgical Patients to be seen by 15 Month Target

(as of June 2017) (3398)

546 532 401 353 309 192 184 164 154 147 146 111 107 22 20 3 3 1 1 1 1 100 200 300 400 500 600

Patients Currently Waiting Longer Than 12 Months

as of June 2017 (6719) ()

2298 1633 717 643 277 260 194 149 138 103 90 83 35 34 23 16 10 7 7 2 500 1000 1500 2000 2500

Ophthalmology Waiting List Validation (Sample)

Number of Patients validated – 101 Request to stay on list 52 Request removal from list 3 RIP 2 Return not known 1 Attended 1 Cancelled 1 No Response 41

Patient Access - Inpatient Waiting List

Patients to be treated by October 2017 (20/072017)

Patients to be treated by 15/10/2017 (373)

(as of 20/07/2017)

Urology Waiting List

Plastic Surgery Waiting List

General Surgery Waiting List

Scope Breaches

Gastroenterology – 25 have a Pre admit date Surgery - 5 have a Pre admit date

Quality & Safety

ALOS All Inpatients – May 2017

R

Hand Hygiene – May 2017

G

National Early Warning Score – May 2017

G

Cancer KPI – Breast-Lung-Prostate

January – June 2017

Risk Management – June KPI data

• Serious Reportable Events reported – 2
• Medication Safety Incidents reported - 6
• Complaints – 8 complaints raised in October with 38% closed

within 30 day timeframe

• New claims notified to hospital – 10

Risk Register

• Risk Register updated in June – no new risks added
• Updated Risk Register to be submitted to the Group

Quality and Safety

Pressure Ulcer Working Group

• meetings are on-going with the group quality and Safety Manager

System Analysis Review

• commence review of implementation of the recommendations

Falls Prevention

• Introduce on a trial basis fall prevention socks

National Patient Satisfaction Survey CUH – 45% response rate as of 7th July – one immediate trend is the Discharge process (national response rate 47%) Quality Survey - survey patients accessing our services

Human Resource Management

CUH Sick Leave 2016 v 2017

4.65 4.59 4.53 3.91 3.39 4.27 3.78 3.77 3.94 4.04 4.08 4.98 4.77 3.84 3.92 4.22 4.17 3.9

2 4 6

Jan Feb Mar April May June July August Sept Oct Nov Dec

%

CUH – Total % Sick Leave 2016 v 2017

2016% 2017% % Target

35.06 35.6 40.76 35.76 38.81 32.49 41.8 43.96 44.55 34.55 28.89 31.14 35.38

10 20 30 40 50

Jun-16 Jul-16 Aug-16 Sep-16 Oct-16 Nov-16 Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17

WTE’s

CUH Long Term Sick Leave – WTE’s

EWTD Compliance –January - May 2017

Capital Projects

Project Status Paediatric Unit Phase 1 - build programme completed Phase 2 – funding received Radiation Oncology Unit  Builder commenced on site on Monday 20th February Education and Training Centre Draft Statement of Need completed and discussion

• ngoing with UCC

Meeting held with UCC Blood Sciences Project Design Team appointed infrastructural works are near completion Oncology Service  Expansion of Day Unit – plan signed off – submitted for Philanthropic funding (ACT)  Refurbishment of Ward 2D – capital funding in place  Medical Oncology Centre – developing Statement of Need Ophthalmology Transfer – Phase 2  Project group in place  Application for planning permission submitted  Tender Pack being prepared Helipad Interim helipad in place – preferred site identified – Meeting with the IAA to be arranged

Key Issues

Implementation of SAP Structured Overtime Pay controls clearly working Need for change in accounting for PCRS funded drugs Bad Debts

PF17 working well challenge with complex discharges Ophthalmology service risk Plastic Surgery/SIVUH Lung Cancer CT's /Calculation

• f KPI's

CAMHS Pharmacy Review Quality Strategy Early Indications form National Quality Survey Complaints Register Unscheduled Care Process Day Surgery Unit Cardio Thoracic Surgery Waiting Lists

No outstanding third party hearings INMO relations working well Implementation of change programme in Catering/Housekeeping Sick Leave Focus HR recruitment workload Grading of staff must be addressed

Finance Patient Access Quality & Safety

Patient and Service User

Human Resource