Key Issues to date Sample Clauses

Key Issues to date. HRA Implementation The PA validation exercise shows that within the acute sector, only 23% of the additional hours are cash- releasing with the balance being attributed to productivity gains. This plan stretches the delivery of additional hours to 40% of available hours. In 2014, there have been some productivity factors which have militated against demonstration of true savings, within the Acute Services Division. It is important that there is a clear understanding of these factors and how they can be addressed, if the ‘stretch’ performance targets for the Division are to be realised fully in 2014. These include the following; • ECF Control Measures are limiting the ability of managers to deploy staff effectively to offset the cost of agency and overtime. To put this into context, in a number of small to medium size hospitals, up to 15 % of their core workforce is agency. Accordingly, in the absence of targeted agency conversion plans, it has been difficult to show traction in agency spend, as a result of additional HRA hours • Winter Capacity Requirements - in order to meet the ED targets consistently and address the risks associated with overcrowding and long wait times within Emergency Departments, it has been necessary to open additional overflow capacity in most hospitals over the winter months. Such capacity is typically opened on an emergency basis with associated costs in terms of overtime and agency. The consistent increase in ED attendances (2%) and ED admissions (4%) by comparison with the same period in 2013, has necessitated the opening of additional overflow capacity in most hospitals over the winter months in order to meet the ED targets consistently and address the risks associated with overcrowding and long wait times within Emergency Departments. Overflow capacity is typically opened on an emergency basis with associated costs in terms of overtime and agency. While there has been a significant contribution from HRA hours to support the opening of this additional capacity, the hours typically been defined as productivity gains rather than cash releasing savings. • Reliance on Agency Junior Doctors - the growth in agency junior doctor spend of over 100% between 2013 vs 2014 is attributable to two key factors as follows: o Shortage of Junior Doctors - the January 2014 intake pointed up a shortfall in recruitment particularly in rural areas where the vacancy factor was up 30%. A further trend in being observed, notably in rural areas, whereb...