Other Performance Standards A&E:-

1. Other Performance Standards A&E:- A&E performance deteriorated in February and the Trust failed to achieve for the first time in several months most of the A&E standards. Patient flow was severely tested on numerous days in February, resulting in breaches of the A&E standard and some long waits for assessment and referral. The reason for this was outbreak of noro virus across several wards in the hospital. This resulted in several wards being closed, often for a week at a time, which reduced the number of beds available to the Trust and also increased the length of stay on wards for patients that were affected with the virus. The escalation ward remained fully opened and further additional beds had to be opened on ward F9 and G8. There was also an increase in the rate of cancelled operations. Surgical beds were used for medical patients and it meant that some routine elective patients had their operations cancelled. There was not an overall increase in emergency admissions, although A&E attendances remained high, which obviously placed significant pressure on the A&E department. Staff sickness also increased as a result of the noro virus. Escalation took place as detailed within the Hospital plan, with the opening of additional beds, cancellation of non urgent surgery, consultants undertaking additional ward rounds in the evenings and weekends and a focus on any delayed transfers of care and complex discharges. The single longest wait in the department was a patient waiting for a mental health bed. This continues to be a problem for the mental health trust and it Is not envisaged that from referral to the mental health trust, making a decision to admit and then identification and transfer to a suitable bed can be achieved in 4 hours. However both organisations are committed to improving the pathway and management of patients who require admission. Performance for March has improved significantly as the noro virus appears to have reduced in the community and in the Trust. (As of 23rd March, no wards are closed due to noro virus) Performance for most of the standards in March have and are expected to improve. There has been improvement in Ambulance handover, A&E 4 hour waiting time, reduction in cancelled operations and we are expecting to achieve the A&E performance standard for the quarter.

2. Other OTHER PERFORMANCE STANDARDS Overall, performance against other standards remains good. • All cancer targets were achieved. The digital breast screening programme commenced as the new equipment has been installed. The first phase is on women between 47-49. The formal opening of the unit will be in April. • Stoke performance was also good in February. The stroke unit had additional beds opened on some days as a result of the noro virus. The only standard that was not achieved was the proportion of patients admitted directly to an acute stroke unit within 4 hours. Performance was in the upper quartile for the region for this target. ( to be confirmed by the stroke network. • 18 week performance remains good. There are challenges with diagnostic waiting times for endoscopy, but performance is within the tolerance allowed 1% of patients waiting over 6 weeks. • The Trust also achieved all of the key maternity standards.