Agenda item

Simon Knight, Director of Planning and Performance, UCLH Foundation Trust was present and made a presentation to the Committee, copy interleaved

During discussion the following main points were made –

·         UCLH services are provided from a number of sites

·         MRSA bacteraemia cases have reduced significantly since 2006 to a very low level in 207/18. There are none to date in 2018/19

·         Clostridium difficile – 43 cases reported as at the end of November 2018 against year to date threshold of 62. 1 case was found to be a lapse of care by the Trust. The current worst case position is 22 cases, against the November year to year threshold of 62

·         The 2017 in patient survey rated UCLH as the best provider as measured against its peers

·         Referral to treatment time – the % of patients who have been waiting less than 18 weeks – the standard was not met in 2018, however UCLH continue to perform above the national average. Performance has been challenging, by longer waiting times at Eastmans Dental Hospital and national specialist services in neurosurgery and uro-gynaecology. A recovery plan is in place to achieve the standard overall at trust level by March 2019

·         Diagnostic waits – the % of diagnostic waiting list within 6 months – this was driven by a combination of patient cancellations an DNA’s, due to the severe weather in March and scanner breakdown, as well as technical issues following upgrade of imaging software. UCLH regained compliance in October 2018

·         Access to timely patient cancer care % of patients seen within 14 days of referral – the trust sustained performance against the two week wait standard

·         In terms of the % of patients treated on cancer care within 31 days of decision to treat, the trust met the standard in most months of the year, and months of underperformance were driven by sector wide surge in demand for robotic prostate cancer surgery. The urology team increased capacity to reduce waiting times following a surge and robots had been introduced that had improved the waiting times for treatment

·         UCLH has continued to experience challenges in delivering the 62 day treatment service standard. An action plan is in place

·         With regard to A&E access times, waiting times continue to be challenging, as is the case for many Trusts and work is taking place with partners to address the multi factorial issues. Key actions are in place to deal with these

·         Delayed transfers of care in 2018 – Camden and UCLH have improved shared understanding of demand for out of hospital services, there is good joint working on discharge to assess pathways and improved collaborative working with external partners to identify and resolve external delays

·         There are significant financial challenges and in 2018/19 the Trust is forecasting a defecit of £6.2m before sustainability funding of £14.5m, a net position of an £8.3m surplus. The financial challenge for 2020/21 is significant as there are estimated costs of £20m for the introduction of the new patient administration system, costs relating to moving services, loss of transitional funding following the move of cardiac services to Barts, loss of undergraduate training and an efficiency factor of 1.6% built into the income received. An in depth review is currently being looked at in relation to new expenditure in 2019/20

·         The Trust has also been working closely with NHSI to obtain relief (through reduced financial targets), to reflect some of the further funding losses

·         Reference was made to the loss of undergraduate funding and its effect on the Trust, and UCLH stated that they would provide further details on this for Members

·         The introduction of a new patient administration system would be a significant change

·         In response to a question, it was stated that the Trust had not pursued the proposal to buy out the PFI funding provider

The Chair thanked Simon Knight for his presentation