Balance Score Card Acute Hospitals Division

Balance Score Card Acute Hospitals Division

Balanced Score Card Review of October 2015 Data Balanced Scorecard Finance Finance Report October 2015 Actual outturn YTD - October 2015

Group budget 235.2m (2014 228.3m) Group actual expenditure 236.5m (2014 235.8m) Group actual deficit 1.3m ( 2014 : 7.5m) Less: Additional bad debts provision re MOU 1.1m Loss of earnings Radiation therapists 150k Waiting list penalties 170K

Adjusted group surplus YTD Oct 0m CUH Budget 220.8m (2014:212.5m) CUH /SMOH actual expenditure 222.6m (2014 219.6m)

CUH /SMOH actual deficit 1.8m (2014 7.1m) Adjusted deficit (excl bad debt/LOE)ytd Oct 0.4m Mallow Budget 14.4m (2014:13.9m) Mallow actual expenditure 13.9m (2014 14.3m) Mallow actual surplus 460k ( 2014 deficit 372k) CUH Group Surplus / (Deficit) percentage %

(October) CUH Group Summary Budget v Actual Expenditure YTD - October 2015 CUH SMOH CUH-SMOH Mallow Total Pay k

Non-Pay k Income k Total -2,816 -7,615 8,579

-1,852 0 -24 73 49 -2,816

-7,639 8,652 -1,805 -4 -504 968

460 -2,820 -8,143 9,620 -1,343 CUH Budget v Actual Pay YTD October 2015

2015 2015 Variance % 2014 v 2014 Budget k Actual k k Variance Actual k Variance k Medical/Dental Nursing/ Midwifery 53,447

54,344 -(897) -1.7% 52,797 -(1,547) 72,386

73,002 -(616) -.9% 72,862 -(140) Paramedical

26,739 27,016 -(277) 1% 26,918 -(98)

Housekeeping 5,479 5,652 -(173) -3% 5,324

- (327) Care Assistants 5,053 5,567 -(514) -10%

5,324 -(243) Catering 3,303 3,382 -79

-2.4% 3,482 100 Portering 4,814 4,827

-13 -.3% 4,981 154 Administration 14,865

15,075 -210 -1.4% 14,757 -319 Other Staff

2,908 2,945 -37 -1.3% 2,978 33

188,994 191,810 -2,816 -1.5% 189,424 -2,386

Total CUH Actual Non-pay Expenditure k YTD 2015 CUH AGENCY COSTS k 2013 YTD 2015 CUH AGENCY WTE YTD 2015 CUH Average Nursing & HCA Agency WTEs per Week 2013-15 CUH Average Specials /Other Nursing & HCA Agency WTEs per Week 2014-15

Patient Income 2013 YTD 2015 CUH Debtor days YTD 2015 Mallow Budget v Actual YTD October 2015 Budget Pay 12,631 Non Pay 3,604 16,235

Income -1,869 Total 14,366 Actual Variance 12,635 -4 4,108 -504 16,744 -509

2,837 968 13,907 459 % Variance 0.0% -14.0% -3.1% 51.8% 3.2%

Forecast Group Budget 283.0m (2014 284.9m)

Group projected expenditure 286.4m (284.2m) Collection of EU Charges 0.7m Group Projected Deficit 2.6m ( surplus 0.7m) Less: Additional bad debts provision re MOU 2.2m Loss of earnings Radiation therapists 0.4m Waiting list penalties 170k Add National service contracts 210k Adjusted group projected surplus 0.4m

CUH Budget 265.8m (2014:265.1m) CUH projected actual 268.7m (265.3m) CUH projected Deficit 2.9m (0.2m) Mallow Budget 17.2m (2014:17.5m) Mallow Projected Actual 16.9m (16.8m) Mallow Projected Surplus 0.3m (0.7m)

Patient Access CUH Weekly INMO Trolley Report Week ending 13th November 2015 Ambulance Turnaround Times - October ED 6hr & 9hr Target All Patients (January October ) R

ED 6hr & 9hr Target Non Admitted Patients (January October ) ED 6hr & 9hr Target Admitted Patients (January October ) Delayed Discharges - 2015 January - October (10th November) Inpatient Day case Waiting Lists

Inpatient & Daycase Breaches 31st December 2015 Outpatient Waiting Lists OPD Potential Breaches 21st December 2105 Date Speciality planned in house 21/12/2015 Cardiology

Diabetes Mellitus Endocrinology Gastro-Enterology General Medicine General Surgery Gynaecology Neurosurgery Ophthalmology Paediatric Neurology Paediatrics Plastic Surgery Respiratory Medicine

Rheumatology Urology Vascular Surgery 4 0 0 0 0 0 0 3

0 0 8 2 8 7 0 0 28/12/2015 Rheumatology 4

Insourcing number 2 286 22 23 1 remaining Balance 0

155 38 0 0 89 850 0 286 22 23 136 0

5 0 0 0 To be Outsourced breaching Column1 155 38

50 850 ?Bon Secours Limerick 39 850 90 ?0 ?0 46

11 Scope Waiting List Scopes Urgent September G Scopes Routine - September R

Medical ALOS (September Dashboard) A New Patients Treated with Radiation Oncology in Target - October Reasons for Treatment Delay - October New Patients Treated within Target 2014 Vs 2015

Brachytherapy Activity January 2015 October 2015 Quality & Safety Day Surgery Admission Rate (September Dashboard) G Surgery Length of Stay

(September Dashboard) A ALOS Excluding LOS over 30 days (September Dashboard) A Cancer KPI Breast-Lung-Prostate January October OPAT

Outpatient Parenteral Antimicrobial Therapy IV antibiotics/antifungals/antivirals given at home Reduces patients length of stay in hospital Avoids Admission for long period Reduces healthcare associated infection risk Patients can return to work Bed Days Saved Quality and Safety Appointment of Clinical Director for Women and Children Directorate

Appointment of Lead for Clinical Audit External Expert for Radiology Review identified Improvement Programme on Complaints Management Housekeeping Services Project Group Principals agreed Pilot project on risk assessment , risk escalation and risk register using module on Q Pulse (medium term plan is an electronic system) Quality Improvement programme for Outpatient services Interviews for post of Risk Manager, Quality Assurance Manager and Quality Improvement Manager Patient Experience Report Jan June 2015

Complaints by Directorate Compliance with Timeframes Compliments Complaint Management Review Group Lean mapping project June 2015 Pilot project November 2015 on improvements in the Triage administration support pooling of investigative resources

data capture on process recommendations for improvements monitoring of recommendations Risk Register Risk Register update submitted 22nd October 11 on-going investigations Three new risks escalated to Group CEO in November Risk Assessment Grade 3 Pressure Ulcer Risk Assessment Grade 4 Pressure Ulcer

Risk Assessment Sexual Assault HIQA Announced Visit Antimicrobial Stewardship Programme Site visit on Tuesday 20th October 2015 Acknowledged good progress with Antimicrobial Stewardship Programme that ties in with the National Stewardship programme Challenges Medication Safety officer Infection Control Nurse staffing levels Clinical Pharmacist resources Lack of surgical site surveillance

Laboratory surveillance of multi-drug resistant organisms not performed Reducing Healthcare Acquired Infection (MRSA) (September Dashboard) R Reducing Healthcare Acquired Infection- C diff (August Dashboard) R

Antibiotic Consumption Rate (September Dashboard) G Human Resource Management Sick Leave October 2015 Staffing & Costs October 2015

EWTD Compliance (Jan October) Nursing - Starters/Leavers 2015 Capital Projects Project Status MRI Unit Completed and operational

Paediatric Unit Phase 1 - build programme commenced in July Phase 2 submitted for capital funding Mental Health Unit Completed and operational Acute Medical Assessment Unit Phase 3 & Endoscopy Unit

Completed and operational Radiation Oncology Unit Cystic Fibrosis/ Respiratory Ward Completed

Education and Training Centre Statement of Need being developed Blood Sciences Project Design Team appointed request for managed service approved Oncology Service

Planning permission granted Enabling works to commence in November 2015 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 Helipad Interim helipad in place - final solution being assessed by CAA. Transitional Care Unit Completed Key Issues

Reopening of 31 inpatient beds Recognition of Budgetary performance Dependency on patient income

2016 Estimates Undergraduate Training costs - 6.5m per annum Management of Unscheduled Care Implementation of Change Programme Initiatives

Scheduled Care Implementation of plan to meet waiting list targets Hospital Group approach to maximise capacity

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