Acute and specialist trust overview

Key targets

The key targets are available via the indicator links on the left hand side of this page. They include details of why the indicator is included, the data source, the period of time assessed by the indicator and the technical specification (construction). These were announced in March 2004 before the start of the financial year to be assessed.

The key targets are:

• 12 hour waits for emergency admission via A&E post decision to admit
• All cancers: two week wait
• Elective patients waiting longer than the standard
• Financial management
• Hospital cleanliness
• Outpatient and elective (inpatient and daycase) booking
• Outpatients waiting longer than the standard
• Total time in A&E: four hours or less

Balanced scorecard indicators

These indicators have been chosen to provide a balance across a broad range of areas. In the final ratings model, the balanced scorecard indicators will be divided into three separate focus areas.

The balanced scorecard indicators are available via the indicator links on the left-hand side of this page. They include details of the rationale, the data source, the data period and the technical specification (construction) for all of the indicators.

The balanced scorecard indicators are:

Clinical Focus

• Child protection
• Clinical risk management
• Composite of participation in audits
• Deaths following a heart bypass operation
• Deaths following selected non-elective surgical procedures
• Emergency readmission following discharge (adults)
• Emergency readmission following discharge for a fractured hip
• Indicator on stroke care
• MRSA
• Thrombolysis - composite of 60 minute call to needle time and 30 minute door to needle time

Patient Focus

• A&E emergency admission waits (four hours)
• Better hospital food
• Breast cancer: one month diagnosis to treatment
• Breast cancer: two month GP urgent referral to treatment
• Cancelled operations
• Delayed transfers of care
• Outpatient and A&E patient surveys: access and waiting
• Outpatient and A&E patient surveys: better information, more choice
• Outpatient and A&E patient surveys: building closer relationships
• Outpatient and A&E patient surveys: clean, comfortable, friendly place to be
• Outpatient and A&E patient surveys: safe, high quality, coordinated care
• Patient complaints
• Patients waiting longer than standard for revascularisation
• Six month inpatient waits
• Thirteen week outpatient waits
• Waiting times for rapid access chest pain clinic

Capacity and Capability

• Data quality on ethnic group
• Information governance
• Staff opinion survey: health, safety and incidents
• Staff opinion survey: human resource management
• Staff opinion survey: staff attitudes
• Workforce indicator

Clinical governance review (CGR) scores and 2005 performance ratings

In February 2005, the Healthcare Commission made the decision to exclude the assessment scores from all clinical governance reviews (or the follow up of action plans where more appropriate) from the performance ratings for all organisations in 2004/2005. This decision reflects feedback received from strategic health authorities and trusts. The Healthcare Commission continues to support the importance of clinical governance and this is reflected in the core standards assessment that will form part of the annual review of trusts in 2006 and beyond.

Indicators that are not applicable to all trusts

Some key targets and balanced scorecard indicators may only be appropriate for some individual specialist trusts. For instance, accident and emergency (A&E) waits do not apply to hospitals without A&E services. A trust rating will be allocated on the basis of those key targets and indicators that are appropriate to the trust concerned.

Specialist trusts

The key targets and balanced scorecard indicators are the same for specialist trusts as those for acute trusts.

Combined trusts

Combined trusts (those that provide services in mental health as well as acute or primary care) need to refer to the indicator lists for both trust types and will be star rated in all sectors (acute and mental health and ambulance, or primary care and mental health).

Queries

Please direct any queries to the performance indicator mailbox: performance.indicators@healthcarecommission.org.uk