Action plan/discussions in progress to implement Aderma Heel pads as a preventative measure. 2.7 Patient Feedback 2.7.1 Complaints Complaints management is critical to ensuring the Trust not only responds to the complainant in a timely manner, but to ensure the learning from complaints is translated into action. Complaints data enables the Trust to determine if there are any trends in subject matter, location or personnel. Table 2 portrays that the total number of complaints received in January was 16. The number of complaints received equate to 0.6% of all inpatients in over this period. This is against inpatient activity of 2,793, Emergency Department attendance of 3,777, Outpatient Department attendance of 9,058 and Day case activity of 1,241. The Trust was also pleased to receive and record 83 compliment letters during January. All complainants are offered the opportunity to meet with relevant staff should they wish. Three complaint resolution meetings were held in January resulting in satisfactory resolution for the complainant. Should complainants remain unsatisfied with the final response from the Trust, and all options for internal resolution have been exhausted, complainants are advised of the option to refer their complaint to the Complaints Ombudsman. One complaint was referred to the Complaints Ombudsman in January. One decision was received by the Ombudsman following an investigation this month. The decision was to uphold the complaint against the Trust and a recommendation for financial redress of £15,000 was made. Table 2: Year Jan Feb Mar Apr May Jun Jul Aug Sept Oct Nov Dec Total 2012 22 28 26 16 36 25 25 18 26 21 19 16 278 2013 17 22 21 19 11 14 17 21 12 24 12 18 208 2014 16 16 The Trust aims to provide a full response to all complainants within 30 working days. The response time to complaints as demonstrated in Figure 10 demonstrates the commitment of the Trust to resolve complaints in a timely manner. The response rate of 77% in January achieved by
The Trust continues to work with health and social care partners in North Somerset to manage the ‘Green to Go’ list, and where gaps in services are discovered, work with the Clinical Commissioning Group to identify how future commissioning can be organised to close these gaps, providing higher quality joined up care between all partners. 3.7.2 Morning Discharges In January both clinical divisions experienced a significant increase in the level of Morning Discharges with Emergency & Urgent Care achieving 27.2% and Planned Care achieving 20%. This is as a result of monitoring and critical evaluation of the ‘Home by 11am’ performance target at the daily operational performance meeting. The additional Winter Money has also enabled the Trust to undertake a number of additional initiatives including improved seven day working and the introduction of a registered nurse led discharge lounge which has supported the drive for ‘Home by 11am’. Trust Action: The Trust will continue to critically review performance against the ‘Home by 11am’ target daily, putting in place the necessary pathways and services to support further improvements in performance. 3.7.3 Bed Occupancy Bed Occupancy continues to be inconsistent however; this is one of the top key actions for the Trust. Action: The Trust is developing and implementing a programme of work to further improve bed occupancy for both divisions including: Implementation of Milliman best practice pathways for key conditions to further improve the delivery of timely and effective care enabling patients to regain independence and return home earlier. Introduction of pathway within Ambulatory Emergency Care and the Emergency Department for a set of key conditions where intensive diagnosis and treatment can enable patients to receive high quality care without admission to an acute bed. Improve the day case rate against the basket of 25 through improvements in scheduling, timetabling and pre-op assessment.
Section 4 Human Resources 4.1 Executive Summary Headlines The temporary staffing costs in December was 12.7% and in January 11.2% of the total pay bill, this includes temporary staffing posts funded through winter funding. Sickness has increased over the past two months to 4.32% in December and 4.39% in January. The appraisal rate decreased in December 80.80% and has increased in January to 83.21%. The training compliance rate has decreased from 82% in November to 81.89% in December and 81.62% in January. 4.2 Workforce Figure 40 shows the pay expenditure for contracted staff, for agency staff, and for staff funded through winter monies. Figure 40: Figure 41 demonstrates a decrease in the temporary staffing (excluding winter funding) over the past two months. The continued decrease in spend and use of temporary staffing continues to show a positive step in ensuring the Trust improves the stability of its workforce. The Trust has recently appointed to a number of difficult to recruit consultant posts, including; a Respiratory Consultant and two Care of the Elderly Consultants prior to Christmas, and more recently two Paediatric Consultants and a Microbiology Consultant. However, there remains significant pressure in the Emergency Department as the Staff Grade rota becomes more difficult to sustain due to recent resignations. The overseas recruits will not join the ED team until July/August and the challenge remains to fill these gaps in the interim period which is incurring high agency costs for the Trust. Figure 41:
2014: 10 Months ending January 2014 Activity and Income Report Volumes including ACC Annual Activity Plan YTD Activity Plan YTD Activity Actual YTD Activity variance Volume Variance % Elective Day 12,255 10,165 11,019 854 8.4% Elective Inpatients 1,789 1,476 1,393 (83) -5.6% Non-Elective Inpatients 12,551 10,371 12,686 2,315 22.3% Outpatients 38,407 32,275 34,744 2,469 7.6% Follow Up Outpatients 62,326 51,884 52,423 539 1.0% Emergency Department attendances 53,093 44,556 42,271 (2,285) -5.1% April 2013 the ACC activity has been recorded as below and this has not been incorporated in the activity plans as the likely volumes were not finalised during the contractual operating framework. For comparative purposes only the impact of the volumes excluding ACC activity is shown on the table below. 5.7 Penalties 5.7.1 A provision of £1108k for fines has been included above as an estimate of the potential penalties in the 10 months ending 31st January 2014 for Referral to Treatment, Cancer access, Emergency Department 4 & 12 hour waits and Ambulance handovers. This continues to be updated as the validation of performance in these areas is finalised. The emerging risk is the penalties that may be incurred should the Clostridium Difficile target be