1. Chief Operating Officer’s Report
BOD 80/2016
(agenda item: 6)
Dominic Hardisty
June 2016

2. Issues of Potential Concern
Adult Directorate
Areas of Excellence
Issues of Potential Concern
Quality
(safe, effective, caring)
DToCs for adult service remain low.
CQC re-inspection visit took place 14th-16th June across inpatient acute, rehabilitation and community services. Initial feedback has been very positive and we are hopeful that this will be reflected in the CQC report.
EDPS has achieved PLAN accreditation.
OATS remain high in Buckinghamshire, we are working with RESPONSE housing to look at the development of 24hr stepdown from our wards to deal with the issues in patient flow.
Finance/CIPs
Bed management, patient flow and stepdown accommodation have had a positive effect in managing the Oxfordshire bed stock.
We have submitted a bid to be a pilot site for tertiary commissioning of forensic services. The bid is to manage forensic services across Oxon, Bucks, Berks, Hampshire, Dorset, IOW and MK with a value around £80m.
Finance: OCCG have arbitrated on the disputed non-OBC placement costs and this has removed the potential £500k pressure against our budget (OCC have been paying during the dispute).
Pressure on OATS in Buckinghamshire is creating an adverse position at month 2.
Additionally we have spent £170k on replacement furniture for ward areas across both counties.
Workforce
The effort all staff gave prior to and during the CQC visit was exemplary. It should be noted that the inspectors said that patients universally commented that the care they were receiving was good.
PPST for adults is above 85%
PDRs are 100%
Kingfisher and Kestrel wards continue to have a worrying level of vacancies despite the directorate investing in dedicated senior HR business partner time to lead on recruitment and retention..
Performance
(against key trust targets)
Monitor targets are being met on CPA, EIP, IAPT, & day follow-up. Internal CPA target on 4 measures is at 100% in Forensic and is improving in low 90%s in adults.
CPA 12 month reviews needs to improve 0.5% to continue to meet the target.

3. Children and Young People’s Directorate
Areas of Excellence
Issues of Potential Concern
Quality
(safe, effective, caring)
Reconnect Service in Buckinghamshire which works with parents and infants up to 2 years of age was awarded best service in the first national infant mental health awards.
The future in Mind recommendations re CAMHS have informed the redesign of CAMHS in Buckinghamshire and Oxfordshire. The service in Buckinghamshire has been operational for 9 months. New specialist eating disorder teams for young people are being formed across all 5 counties in line with recommendations from the Future in Mind.
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.
Waiting times for adults with an eating disorder are also of concern – having redesigned the ED service for CYP we are now about to start to work on joining the services more closely and redesigning the pathways for adults
Care notes has been adding to pressure on staff work loads as they struggle to work with the system
Finance/CIPs
CIPs 1.1 M identified within the Directorate for 16/17 – plans in place with high degree of confidence that we will deliver.
Month 2 adverse position 200k - cost of locum, agency medical staff & use of agency off framework – reviewing all of these posts and have plans to interview for permanent staff
Workforce
Next round of interviews for community CAMHS taking place week 20th June
HFU are actively recruiting and reviewing skill mix to see if can improve recruitment
High nursing staff vacancy in HFU – leading to increased use of agency staff
Abingdon CAMHS have raised concerns about pressures on the team and impact on ability to meet this demand.
Performance
(against key trust targets)
We are meeting 12 weeks waits in south west
Meeting activity contractual targets
CQUIN agreed for 16/17
Not meeting Trust PPST targets
Case load sizes remain high in CAMHS – work being done to cleanse data to ensure is correct.

4. 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 due to commence during May
Sustainability and Transformation Plans for frailty / long term care / urgent care in Oxfordshire progressing well
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)
Rise to 422 delayed close-down of incidents (more than 5 days) or overdue actions from RCA (64)
Finance/CIPs
Month 2 position is £10k adverse
CIP planning progressing well, with clear objectives for consultancy support / critical review
£276k of CIP going through challenge and confirm process: rest of CIP has plans in place to deliver
Workforce
Pathway team for flow within community hospitals being established
First cohort of band 7 and & clinical and operational leaders have completed the “Planning for the Future” leadership development course, with very positive feedback on content and relevance
Interface medical capacity
Podiatry recruitment
Peaks in staff sickness in some clinical areas (8-10%): most common reasons are psychological / MSK
Performance
(against key trust targets)
Trajectory and actions for reducing length of stay and DTOC numbers in community hospitals confirmed (as part of system-wide DTOC reduction initiative)
GP OOH NQRs underperformance
Reablement contract going out to tender