Setting the Scene: Progress Towards Delivery Mike Lyon Deputy Director of Delivery/Head of Access Support Team

23 rd December letter of agreement on waiting time improvements (measurement) “The critical ‘back-stop’ date for having very high completeness for 18 weeks RTT measurement is late summer 2010 the following actions should be in place by that date: 1.90 % of outcome codes recorded at a new or return OP - by 31/03/10 2.All outcomes occurring outside OP setting – identified & quantified by 30/06/10 & recording rapidly in place.

23 rd December letter of agreement on waiting time improvements (measurement) 3.99% of UCPNs for SCI gateway in place 4.99% of UCPNs for non-SCI Gateway referrals within Board area by June 2010 at latest 5.Rapid available of UCPN for non-SCI referrals between Boards during Updates to information systems in place to ensure UCPN and 18 weeks RTT outcome code is recorded and available for analysis and reporting within systems by late summer 2010.

23 rd December letter of agreement on waiting time improvements (measurement) £5 million distributed to NHS Boards to support effective measurement of the 18 weeks referral to treatment standard and achievement of the measurement milestones set out in the letter.

‘Calum Campbell’ Report – July 2010 “Each NHS Board has a competent plan to deliver high levels of measurement completeness for 18 weeks RTT within the required timescales.” “All of these plans are pragmatically based on the opportunities available from existing systems. NHS Boards must ensure that this pragmatic approach is maintained and adjustments made to systems when required.”

‘Calum Campbell’ Report – July 2010 “Timescale is critical … individual NHS Board’s critical paths for measurement are reliant on complex interactions between information system suppliers, IT Departments, Information Managers, Service Managers and Clinicians. It is essential that NHS Boards ensure that timescales are adhered to and all parties involved are fully sighted and committed to these timescales. NHS Boards must ensure that they maintain effective performance management and contingency plans, and effectively implement contingencies where required.”

‘Calum Campbell’ Report – July 2010 Some Boards are implementing interim measures prior to implementation of TRAK. These Boards must ensure that these interim solutions are fit for purpose and work. Some Boards are ‘backing more than one horse’ when selecting systems to link & measure 18 weeks. These Boards must ensure they have adequate focus on the system of choice and do not dissipate efforts.

‘Calum Campbell’ Report – July 2010 National Issues National leadership on timescales for TRAK & iSoft upgrades. Project support & co-ordination for SCI products and electronic population and transfer of minimum data set between Boards. Adequate improvement support should be available to embed acceptance and use of 18 weeks measurement systems.

GENERATE HOLDLINK UCPN - record for: OUTCOME CODE - create at Examples of systems required to hold UCPN & outcome code Examples of 'linking' options 1. GP/GDP REFERRALS 2. NON-GP/GDP WITHIN BOARD 3. AHP REFERRALS 4. CROSS BOUNDARY REFERRALS 1. NEW OUTPATIENT CLINIC 2. RETURN OUTPATIENT CLINIC 3. NOT IN AN OUTPATIENT CLINIC 1. WITHIN PAS SYSTEMS 2. WITHIN RADIOLOGY SYSTEMS 3. WITHIN ENDOSCOPY SYSTEMS 4. WITHIN OTHER DIAGNOSTIC SYSTEMS 5. WITHIN AHP SYSTEMS 6. WITHIN AUDIOLOGY SYSTEMS 7. WITHIN DENTAL SYSTEMS 8. WITHIN OTHER SYSTEMS 1. LINK WITHIN PAS 2. LINK WITHIN LOCAL dBASE 4. LINK WITHIN LOCAL WAREHOUSE 5. LINK WITHIN NATIONAL WAREHOUSE 3. LINK WITHIN AHRIDIA 6. LINK WITHIN OTHER SYSTEM Generate – Hold – Link Matrix

Notes: Indicative expected volume of clock stops against reported clock stops. Estimated clock stops can be influenced by seasonality and return appointments.

DERMATOLOGY - NON-ADMITTED - CLOCK STOPS – AUGUST 2010 Board NON-ADMITTED CLOCK STOPS – August 2010 <= 18 weeks> 18 weeks Unknown (Resident) Unknown (Non Resident) Estimated Unknown A3,7951,8541, ,330 B2, C1, D1, E F G H I J K L M18000 N Total10,3063,1762, ,837

Tolerances Cabinet secretary approval of a combined tolerance of 90% Board audit of admitted and non-admitted performance by speciality to minimise outliers Proactive performance management arrangements for low performance in admitted and non-admitted pathways and of significant outliers beyond 18 weeks

Who owns the wait? 1 st choice by Boards –Board of receipt of referral 2 nd choice –Board of residence 3 rd choice –Board of treatment