Chief Operating Officer’s Report BOD 63/2016 (agenda item: 7) Chief Operating Officer’s Report Dominic Hardisty May 2016

Issues of Potential Concern Adult Directorate Areas of Excellence Issues of Potential Concern Quality (safe, effective, caring) Oxford MHP event on 12th May celebrated a number of successes, including the Recovery College, which received the OCVA Partnership Award. MIND, Connection and Elmore workers are working closely AMHTs, and Response and Restore workers engaging with services.. Pre-CQC Visits have taken place to all areas, and 13 peer reviews been completed. The Director of Nursing has begun a new series of visits to areas and the CEO will also be visiting services. Directorate Linking leaders event took place on 25th April, was well attended and there were many areas of good practice shared across all adult services. There has been severe pressure on beds, particularly for female admissions, leading >10 patients being out of area at the time of writing. The Whistleblowing report on Ashurst ward was signed off by the Exec. There are 14 areas for improvement and these are being actioned. The Directorate has replaced the modern matron and has developed a clear plan with milestones to address the issues raised. Dr Sue Llewelyn will be working with the clinical team with a focus on team working and cultural development. Finance/CIPs CIP meetings are all scheduled and external consultancy support is agreed by the COO, they will start working with the Directorates in the near future. OCCG have agreed to provide arbitration for those cases where funding is disputed (they are viewed by OH as outside the scope of the MHOBC). Placements for these are still being made and funding is met by OCC currently. Month 1 financial position if £170k adverse, this overspend is against OATS, Ashurst Ward and non-pay. Workforce Training performance improving across most areas – overall there has been a 3% increase in MT completed and 1% increase in PDRs. Fire safety training levels need to improve, L&D have now agreed extra sessions to support improvement. Recruitment continues to be problematic . Despite centralising the function to speed up processes and get some consistency in approach, the organisation faces severe challenges in getting staff. Performance (against key trust targets) Monitor targets are met on CPA (96%), EIP (52%), IAPT, and 7 day follow-up (96%). Internal CPA target on 4 measures is at 100% in Forensic and is improving in low 90%s in adults. Waiting targets for adults all met (4hr, 7 day, 28day). PTP step 4 waits remainl large (c.1000 patients waiting for treatment up to 1 year). Bids for increased resource to meet waits made to Oxon and Bucks (circa £550k). In the interim additional resources being put into each AMHT to start the process of reducing these waits and improving the therapy offering in these teams.

Older People’s Directorate Areas of Excellence Issues of Potential Concern Quality (safe, effective, caring) Pressure ulcer action plan progressing well: preparation phase completed, and training to teams to commence during May Review of NICE guidance: new process in place to ensure this is completed in timely fashion by all clinical teams (status at a glance board in place) Clinical audit: all actions are compliant with Trust internal standard of completion within 6 weeks April saw the lowest number of reported incidents since February 2015, 494, although this is still within statistical boundaries. The top three incident types were Skin Integrity (29%), Falls (16%) and Violence & Aggression (12%). Acquired pressure ulcer damage variation in community nursing teams Diabetes – rise in numbers of unstable patients in community settings: actions to mitigate underway Bed pressures in OAMH, driven in part by single sex accommodation needs GP OOH - at periods of high demand / limited clinical capacity, patient experience is reduced (slower response times for patients with non-urgent needs) Finance/CIPs Budgets set and agreed. CIP planning progressing well, with clear objectives for consultancy support / critical review £700k of FY17 CIP to be determined once contract settlement is achieved (address current cost pressures) Workforce Workforce plan for the Directorate to achieve full establishment underway; focus on recruitment to “hot spots” and development of senior clinical staff Pathway team for flow within community hospitals being established Interface medical capacity Rapid recruitment and induction of GPs to work in GP OOH service Podiatry recruitment 83% compliance with clinical care competencies training in April. To reach the 90% target, employees need to attend 592 courses of which 452 have already been booked. Performance (against key trust targets) Continued improvement in delivery of 48 hour access standards for urgent swallow assessment in community Reduction in OAMH DTOCs in Buckinghamshire GP OOH NQRs underperformance Reablement contract going out to tender

Children and Young People Directorate Areas of Excellence Areas of Concern Quality (safe, effective, caring) The Family Nurse Partnership annual review took place this month – this was an extremely successful event with the national team highlighting the excellent work that takes place within the service as well as service users taking part to explain the difference the service has made to them and their babies. Service users have made films to describe their experience and many young parents and parents to be attended the review with their babies from across Oxfordshire Waiting times for routine referrals in Oxfordshire to CAMHS remain a concern – an action plan is in place and we are carefully monitoring progress against this. The longest waits are for those waiting for an assessment for ASD. Care notes implementation continues to be problematic but staff do recognise the hard work happening to address the problems Finance/CIPs CIPs £1.1 M identified within the Directorate for 16/17 – high confidence that can deliver Opportunities in 2017 to gain new services - entering & reviewing competitive tender opportunities to provide services Month 1 adverse position 113k Cost of locum and agency medical staff & use of agency off framework – reviewing all of these posts and have plans to interview for permanent staff Workforce Appointed Consultant Psychiatrists to the Highfield, Abingdon , Cotswold House Marlborough and Melkshum. We have strong applicants for next round of interviews for community CAMHS Significant development required to ensure we are attractive to potential candidates and reduce turnover across all areas both within the Directorate and across the Trust Performance (against key trust targets) We are in process of agreeing CQUIN for this years contracts PDRs 84% completed YTD Waiting times for routine referrals in CAMHS in Oxfordshire not met – target 75% in 12 weeks Not meeting all PPST targets ( at 86%) – Resus, Infection control and fire awareness. are low - Target re 6 month CPA review not met target - we are targeting teams for improvement