Performance Analysis
As part of the Annual Report, we are required to review key indicators that we used to measure performance and quality of delivered care during 2024/25. A summary of these measures is included below.
The Information is taken from our Quality and Performance Report focusing on those metrics that in April 2024 were agreed by the Executive Leadership Team as of priority and that would provide the Board and its committees with assurance, or otherwise that the Trust was providing effective and safe care.
Key issues and risks affecting the Trust’s delivery of objectives
We have outlined the key risks to achieving our objectives in the Annual Governance Statement.
Challenges to performance
It is important that we are open about the challenges that we have faced and the context in which we, and the wider NHS, are operating.
We have continued to see pressures across the Trust, particularly in our community and urgent care pathway. Patients are presenting to services in crisis with higher acuity of illness, and are often waiting in unsuitable environments for an inpatient admission. We are then seeing longer lengths of stay in our acute wards, which is further impacting capacity. Waiting lists across Community and Children and Young People’s services also remain a significant challenge that impacts on patients, carers and our communities.
We have continued to make significant progress on vacancies and retention, and we have reduced our reliance on agency staff. However, we need to reduce temporary staffing yet further.
While we have made progress on staffing, our use of private sector beds has seen us block purchase external beds in South West London which has deteriorated our financial position. While we met our financial targets, this will become increasingly difficult next year with our reliance on external bed use.
How do we monitor and manage performance?
The care of the people we serve is central to performance monitoring and management. Each of our Key Performance Indicators (KPIs) is only in place to directly ensure our patients and staff receive the right care and support, at the right time, in the right place.
Our performance is comprehensively monitored by external stakeholders such as NHS England, local commissioners, local authorities and joint management groups across a wide domain of performance areas.
Internally, we have a robust governance structure for managing performance from floor to Board. This includes monthly reviews by service lines. This year we have worked hard to improve our performance reporting across the Trust and at Board, committee and working levels. The Finance and Performance Committee scrutinise performance on behalf of the Board providing oversight and assurance as do the Quality and Safety Assurance and People Committees.
Reporting was adapted at the beginning of 2024/25 to align with priority KPIs set by the Trust Executive. The priority metrics are aligned to Operations, Quality, Workforce and Finance domains.
Quality and performance metrics are assigned a theme. Each theme is reported under a domain (see below) and reviewed by committees reporting to board.
|
Domain |
Theme |
|
Two top priorities |
Adult Patient Journey and Great Place to Work |
|
Operations |
Access and flow |
|
Quality |
Patient safety, patient experience and outcomes and fundamental standards of care |
|
Workforce |
Recruitment and attraction, staff skills and development, staff retention, support, and satisfaction |
|
Finance |
Length of Stay, Agency Costs and Productivity |
We aim for high levels of performance to ensure we deliver the best care, and base our strategy on these principles:
· Creating an improvement culture: Support the development of a culture of continuous performance improvement. The approach is integrated, action orientated and focused on delivering improved performance for the benefit of patients.
· Integrated information: The overall performance of the organisation, directorates, departments, teams and individuals is assessed across a range of clinical and nonclinical operational performance metrics, quality indicators and outcome measures.
· Health inequalities: To support our ambition to reduce health inequalities, particularly race inequality, we are working to ensure our data is available via ethnicity
· Benchmarking: Wherever possible, performance is measured against external standards, internal and external benchmarks.
Below are a set of high level summaries of our performance, following by more detailed narrative reports into key areas (including operational, quality, workforce, environmental and health inequalities performance).
