Balanced Score Card Review of July 2016 Data

1

Balanced Scorecard

Finance Patient Access

Quality

&

Safety

Human Resource

Management

Patient and Service User

2

Finance

3

CUH Finance Report – July 2016

Actual outturn July 2016- CUH

Gross pay & non pay budget €199.6m (2015 :€191.3m)

Actual pay & non pay €204.1m (2015: €197.7m)

Actual Deficit €4.5m (-2.3%) (2015 :€6.3m /3.3%)

Less Drug costs refunded by PCRS €2.6m.

Expenditure on transitional care €224k

Adjusted Deficit €1.69m (-1%)

4

Income Outturn July - 2016

Income outturn July 2016- CUH Income budget €46.8m (2015 :€37.1m)

Actual Income €45.5m (2015 :€43.0m)

Actual Deficit €1.3m (-2.3%)

Less accelerated income target €2.01m

Adjusted Surplus €710k (2.0%) (2015 :€5.9m /16%)

Patient Income outturn July 2016- CUH Income budget €37.9m (2015 :€31.0m)

Actual Income €37.8m (2015 :€35.7m)

Actual deficit €96k (-0.3%) (2015 Surplus :€4.7m/15%)

5

HSE Revised Expenditure limit 2016-CUH

Pay: Adjusted Pay expenditure limit is €236.763m; Increase of €3m on Budget €233.7m Projected pay outturn €236.988m Projected overrun of €225k (1%) on revised pay limit Actual pay expenditure 1H 2016 €117.6m - €1.4m above budget.

Non pay: Adjusted Non pay expenditure limit is €114.3m Increase of €5.4m on Budget €108.9m Projected non pay outturn €115.3m Projected overrun of €1m (1%) on revised pay limit Actual non pay expenditure 1H 2016 €56.8m - €2.5m above budget. Drugs & medicines: Gross spend est €30m partly offset by PCRS /other rebates est €4m Bloods : 22% increase in Haematology patient activity reflected in 9% higher spend Pathology: higher costs due to 15% increase in GP tests requires favourable adjustment Transitional care :€0.9m in forecast to year end. Bad debts provision of €1.3m down on 2015 figure € 2.9m

Project that CUH pay & non-pay spend marginally higher than revised expenditure limit for 2016.

6

CUH Group Summary – Budget v Actual Expenditure July 2016

Pay €k Non-Pay €k

Total Gross Income €k Net €k

CUH (inc SMOH) 1,479 -3,060 -4,539 -1,281 -5,819

Less adj 0 2,842 2,842 2,011 4,853

CUH adj -1,479 -281 -1,697 730 -966

Mallow 43 -110 -67 -82 -149

Total Group adj -1,435 -329 -1,764 648 -1,115

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CUH –Pay & Nonpay Budget Surplus/(Deficit) %

8

CUH – Patient Income Budget Surplus %

9

CUH Budget v Actual – YTD July 2016

YTD 2016 Budget €k

YTD 2016 Actual €k

Variance €k

% Variance

YTD Actual

€k

Variance 2016-2015

Act €k

Pay 135,960 137,439 -1,479 -1.1% 133,230 4,209

Non Pay 63,602 66,651 -3,049 -4.8% 64,421 2,230

Gross Spend 199,562 204,089 -4,528 -2.3% 197,651 6,438

Income 46,837 45,536 -1,302 2.8% 43,049 2,487

Net 152,725 158,554 -5,829 -3.8% 154,602 3,952 10

CUH Budget v Actual Pay YTD July 2016

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CUH AGENCY WTE – 2016

July-14 Sep-14 Dec-14 Jan-15 Feb-15 Mar-15 Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Nov-15 Dec-15 Jan-16 Feb-16 Mar-16 Apr-16 May-16 Jun-16 July-16

Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual Actual

Radiotherapist 9.40 4.00 4.87 2.78 2.0 0.95 0.95 0.95 0.9 0.95 0.24

Radiographer 0.09 0.05 0.06

Labs 12.04 13.40 11.0 12.19 3.0 1.0 0.95 1.0

Cardiac Techs 3.80 3.80 1.0

Physio 1.60 1.50

Pharmacy 2.00 1.00

Admin 23.40 9.08 9.36 14.1 14.0 9.3 3.0 0.93

Nursing 46.20 33.0 34.7 37.8 34.4 40.0 35.0 32.8 30.4 31.0 28.4 28.6 29.3 31.2 26.1 35.2 32.9 33.8 34.2 31.8 31.6 32.1

HCA 34.80 16.2 22.7 23.2 19.3 24.4 26.8 31.0 29.8 34.7 32.7 30.8 32.4 34.5 38.2 37.2 35.2 37.7 36.9 41.1 38.4 45.7

House-Keeping 10.40 0.16

Physics 4.30 2.6 1.6 1.09 1.0 0.92 0.87 0.92 0.75 0.59 0.62 0.66 0.25 0.5 0.46 0.46 0.47 0.47 0.47 1 0.83 0.83

Catering 3.00 8.5 2.0 2.7 1.8 1.8 2.6 2.7 6.9 8.4 8.4 3.9 1.2 1.1 0.9 1.2 1.2 1.2 1.4 1.1 1.2 1.0

Social Work 1.00 0.5

Occ Therapy 1.00 0.37

Dietician 0.50 0.3

Medical 11.00 5.27 4.77 4.4 3.92 6.35 4.7 5.1 5.86 3.39 5.79 7.97 14.34 10.35 15.73 9.0 Consultant 0.72 1.74 1.72 0.5 0.25 0.95

NCHD 10.28 8.53 6.08 3.27 2.47 4.45

164.5 99.7 91.1 98.26 79.4 84.7 74.9 75.4 74.6 79.0 76.2 71.9 77.5 77.7 81.4 83.1 80.8 83.4 80.8 78.77 76.75 85.03

CUH AGENCY COSTS €k 2014-16

13

Acute Nursing Agency WTE 2014 to 2016

Acute HCA Agency WTE 2014 to 2016

14

CUH Average Nursing & HCA Agency WTE’s per Week 2014-16

CUH Average Specials /Other Nursing & HCA Agency WTE’s per Week 2015-16

15

NON-PAY -YTD 2016 Budget Actual Variance Actual YTD 15 Diff 2016-15

Medicines (see note) 15,564 17,491 -(1,927) 14,833 -(2,657) Medical & Surgical 16,449 16,363 86 16,081 -(283) Blood 2,660 3,153 -(493) 2,727 -(426) Medical Gases 246 244 2 225 -(19) Medical equipment 2,652 2,659 -(7) 2,341 -(318) Radiology 3,070 3,178 -(108) 3,139 -(39) Provisions 1,117 1,135 -(19) 1,060 -(75) Catering 206 283 -(77) 208 -(75) Cleaning/Waste 2,158 2,193 -(35) 2,135 -(58) Laundry 1,087 1,076 11 1,067 -(8) Energy 1,986 1,920 66 2,285 365 Bedding/ clothing 224 228 -(4) 240 12 Furniture 166 182 -(16) 139 -(44) Pathology 6,576 6,933 -(357) 6,431 -(503) Maintenance /Grounds 413 528 -(115) 460 -(68) Transport /staff travel 1,077 1,242 -(165) 1,028 -(214) Office expenses 1,241 1,155 85 1,270 114 Telecommunications 273 231 42 288 57 Computer 734 728 6 664 -(64) Admin expenses incl bad debts 4,403 4,362 42 6,154 1,793 Staff recruitment/training 498 407 91 636 229 Miscellaneous 800 958 -(158) 1,009 51 TOTAL NON-PAY 63,602 66,651 -(3,049) 64,421 -(2,230)

Less PCRS drugs /Ward 2A -2,842 2,842 2,842

TOTAL NON-PAY 63,602 63,809 -(207) 64,421 612

Note :Bad debts in Admin exps 1,222 751 471 3,287 2,53616

CUH Actual Non-pay expenditure €k YTD 2016 v 2015

17

Patient Income 2014 –2016

18

Patient Income 2014 –2016

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Consultant Claims

Directorate Value €k Prev

Value €k Current

Diagnostics 18 13

Medicine 4,061 3,563

Surgery 2,472 1,980

Women and Children CUH 370 327

Total-CUH Primary 6,921 5,883

Women & Children CUMH 1,100 899

Total-CUH /CUMH Primary

8,021 6,782

O/s Consultant claims at 31st July 2016

Consultants at 11th Aug No of claims

Value €k

HINCHION, JOHN 30 393,803

TAYLOR, COLM 78 249,102

MCFADDEN, EUGENE 67 215,625

FLEMING, PAT 33 190,855

KEARNEY, PETER 46 190,144

CAHILL, MARY 24 188,112

O'MAHONY, DENIS 12 187,738

HENRY, MICHAEL 35 171,698

HARTY, JAMES 57 163,438

DODDAKULA, KISHORE 22 161,885

KELLY, LOUISE 43 153,663

O'REILLY, SEAMUS 112 144,361

MAZUR, MAREK 6 139,836

ANDREWS, EMMET J. 23 131,034

MCSWEENEY, NIAMH 29 127,832

O'HALLORAN, D. J. 28 123,828

MCCOURT, MORGAN 38 121,664

FULTON, GREG 20 119,049

HARNEDY, NORMA 15 116,349

MANNING, BRIAN 12 115,814

KAAR, GEORGE 17 102,066

KHAN, HAMID 14 100,105

3,608,001 20

CUH Debtor days Consultant Claims – July 2016

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Mallow Finance Report – July 2106

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Patient Access

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Weekly INMO Trolley Report Week ending 19th August 2016

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ED – 6hr & 9hr Target – All Patients (Quarter 4 2015 Jan –July 2016)

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ED – 6hr & 9hr Target – Admitted Patients (Quarter 4 2015 Jan – July 2016)

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ED – 6hr & 9hr Target – Non admitted Patients (Quarter 4 2015 Jan – July 2016)

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PET > 24hrs - Weekly – May to July 17th

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>75 years Bed Wait >9 hours

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Ambulance Clinical Handover Performance Jan – August

30

Ambulance Distribution 2016

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Outpatient Waiting Lists

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Total Medical Patients to be seen by 15 Month Target

end of August 2016

33

Total Surgical Patients to be seen by 15 Month Timeline end of August 2016

34

Women and Children Patients to be seen by 15 Month Timeline end of August 2016

35

Patients Currently Waiting Longer Than 12 Months as of 09/08/2016

36

New and Return DNA Rate in CUH

37

Scope Waiting List

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Scopes Urgent – June 2016 G

39

Scopes Routine - June 2016 R

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Inpatient Waiting List

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Total Inpatient & Day case Waiting List (18th August 2016)

Wait category

Hospital Name W/LType ACTIVE PREADMIT SUSPENSION Grand Total

Cork University Hospital Adult 1854 366 57 2277

Child 77 19 3 99

GI Scope 161 170 10 341

Cork University Hospital Total 2092 555 70 2717

Grand Total 2092 555 70 2717

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Patients to be treated by 23rd December 2016 (516)

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Patients to be treated by 23rd December Consultant Breakdown

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CAPACITY PLANNER FOR PATIENTS WAITING GREATER THAN 15 MONTHS BY END DEC 2016

CONSULTANT

Number Theatre

Sessions from

01/09/2015-18/12/2015 PTL Per List

Number of PTL

can be treated

Extra

Capacity

Number

of PTL TOTAL Shortfall

Emmet Andrews 21 Full Sessions 1 21 None 0 21 0

Morgan McCourt 20 Full Sessions 1 20 1 MGH Lists 3 23 2

Prof. Redmond 23 Full Sessions 1 23 None 0 23 26

Sean T. O'Sullivan 3.5 Full Sessions 1 4 SIVUH 4 8 36

James Clover 9 Full Sessions 1 9 7 BGH Lists 0 9 0

Michael

O'Shaughnessy 6 Full Sessions 1 6 SIVUH 2 8 0

Jason Kelly 4 Full Sessions 1 4 SIVUH 4 8 0

Eoin O'Broin 14 Full Sessions 1 14

BGH &

SIVUH 7 21 2

Ciaran Brady 5 Full Sessions 1 5 None 0 5 39

Frank O'Brien 21 Full Sessions 1 21 MUH 4 25 0

Eamon Kiely 26.5 Full Sessions 1 26 None 0 26 0

George Kaar 16 Full Sessions 1 16 None 0 16 0

M.G.J.O'Sullivan 32 Full Sessions 1 32 None 0 32 0

Chris Lim 32 Full Sessions 1 32 None 0 32 0

John Hinchion 40 Full Sessions 1 40 None 0 40 0

Kishore Doddakula 40 Full Sessions 1 40 None 0 40 0

Tom Aherne 40 Full Sessions 1 40 None 0 40 0

Greg Fulton 30 Full Sessions + 15 AVC 1+2 45 4 MGH Lists 12 57 0

Brian Manning 14 Full Sessions + 16 AVC 1+2 46 7 MGH Lists 14 60 0

Gynaecology

TOTALS 444 50 494 105 45

Quality & Safety

46

Surgical ALOS – June 2016 R

47

Medical ALOS – June 2016

48

ALOS All Inpatients - June A

49

Risk Management – July KPI data

• Serious Reportable Events reported - 2

• Medication Safety Incidents reported - 3

• Complaints – 24 complaints raised in June with 12.5% closed within 30 day timeframe

• New claims notified to hospital – 4

Risk Register

Risk Register updated in June - 0 new risks added

2 existing risks were amended

50

Cancer KPI – Breast-Lung-Prostate January – July 2016

51

Quality and Safety

Lean Review of Endoscopy Service Patient Pathway

Ms. D. Feehely has completed the review and the key findings are to be presented to the EMB

Housekeeping Services Project Group

Post of Health Care Assistant - interviews completed and 25 panelled.

Health Care Assistant Facilitator Work programme agreed

10 places in Dementia Care training assigned to CUH

52

Monthly trend of stroke events in CUH

(March 2014- June 2016)

53

Human Resource Management

54

Medical Sick Leave – June 2106

4.01 3.79

3.74

3.16 3.073.86

3.75 3.91 3.72 3.81 4.084.324.65 4.59 4.53

3.913.39

4.27

0

2

4

6

Jan Feb Mar April May June July August Sept Oct Nov Dec

%

CUH – Total % Sick Leave 2015 v 2016

2015% 2016% % Target

29.95

31.7 29.5

19.03

28.37

28 27.39

34.06

32.07

37.99

28.8924.99

36.59

34.31

27.64

35.52

35.06

0

10

20

30

40

Feb-15

Mar-15

Apr-15

May-15

Jun-15

Jul-15

Aug-15

Sep-15

Oct-15

Nov-15

Dec-15

Jan-16

Feb-16

Mar-16

Apr-16

May-16

Jun-16WTE’s

CUH Long Term Sick Leave – WTE’s

55

Support Services - Sick Leave – June 2015

7.145.46

5.37

6.12

7.116.818.16

6.734.81

2.38

1.50

2.612.26

1.692.40

1.44

2.45 2.68

10.75

7.90 8.00

10.17

12.34

9.74

13.04

9.95

11.44

0

2

4

6

8

10

12

14

Oct-15 Nov-15 Dec-15 Jan-16 Feb-16 Mar-16 Apr-16 May-16 Jun-16

Month

%

Housekeeping Portering Catering Target56

Support Services - Sick Leave – June 2015

5.54

4.74

8.74

1.54

3.4

5.27

6.12

2.59

4.6

2.36

3.23

3.121.9

1.71.392.01

0.55 0.69

3.833.52

2.65

3.32

5.09

3.48

4.14

5.38

4.94

0

1

2

3

4

5

6

7

8

9

10

Oct '15 Nov '15 Dec '15 Jan-16 Feb-16 Mar-16 Apr-16 May-16 Jun-16

Month

%

HSSD Security Paramedical Target

57

Medically V's Self Certified Sick Leave - June 2016

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

H'ke

ep

ing

Po

rterin

g

Ca

terin

g

HSSD

Security

HC

A'S

Nu

rsing

Ad

min

Dire

c

Pa

ram

ed

Ad

min

Co

nsu

ltants

NC

HD

'S

5.33 6.7310.89

4.940

15.15 15.13

23.61

13.05

4.170

4.35

94

.67

93

.27

89

.11

95

.06

10

0

84

.85

84

.87

76

.39

86

.95

95

.83

10

0

95

.65

Self Certified Hrs Med Certified Hrs

58

EWTD Compliance –Jan - July 2016

59

Capital Projects Project Status

Paediatric Unit Phase 1 - build programme to be completed by

November 2016

Phase 2 – funding received to progress to Design stage

Radiation Oncology Unit

Planning permission granted

Contractor appointed for enabling work

Funding received for Bracktherapy Equipment

Education and Training Centre Draft Statement of Need completed

Blood Sciences Project

Design Team appointed Funding for interim

infrastructural works approved

Oncology Service

Expansion of Day Unit – plan signed off –

submitted for Philanthropic funding (ACT)

Refurbishment of Ward 2D – capital funding in

place

Medical Oncology Centre – developing Statement

of Need

Ophthalmology Transfer – Phase 2

Project group in place

Application for planning permission submitted

Helipad

Interim helipad in place – contractor to be appointed in

March 2016

Replacement Autoclaves & RO Project Commenced 60

Key Issues

• Retention of 30 inpatient beds (Transitional Care Unit)

• Dependence on patient income

• Potential loss of €300,000 income

• Undergraduate Training costs - €6.5m per annum

• Management of Unscheduled Care/Scheduled Care

• Implementation of Change Programme Initiatives

61