Annual Members Meeting 12 October 2016 Excellence in specialist and - PowerPoint PPT Presentation

Annual Members’ Meeting 12 October 2016 Excellence in specialist and community healthcare

Sir David Henshaw, Chair Introduction Excellence in specialist and community healthcare

St George’s – Challenging times  New leadership team  CQC draft report  Estates, IT, performance and governance  St George’s staff and patients  Our strategy/the future Annual Members’ Meeting/ St George’s University Hospitals NHS Foundation Trust

New leadership team  A distressed organisation  Lack of cohesive strategy and vision  New Chair appointed March 2016 Priorities  Refreshed Board confronting the reality  Non-executive directors to be appointed soon  Strengthening leadership at every level Annual Members’ Meeting/ St George’s University Hospitals NHS Foundation Trust

CQC inspection report  Inspection carried out in June 2016  A difficult report, but no surprises  We were open with the CQC about the problems we face  Final report to be published in November Annual Members’ Meeting/ St George’s University Hospitals NHS Foundation Trust

Estates  Major investment required  Maintenance regime resumed  Moving services to ensure patient/staff safety IT  Basic tasks often difficult due to poor IT infrastructure  £1.3 million invested to stabilise the situation  Long-term IT strategy being developed Annual Members’ Meeting/ St George’s University Hospitals NHS Foundation Trust

Performance  Emergency Department performance much improved  Reduced waiting lists through better use of theatres Governance  Data quality issues identified  Overarching Quality Improvement Plan  Accountability lines (Board to ward, and ward to Board) now priority focus Annual Members’ Meeting/ St George’s University Hospitals NHS Foundation Trust

Our staff and patients  These are challenging times for staff  Patients continue to praise the care they receive – which is fantastic  We will continue to involve them in re-shaping and modernising our services Annual Members’ Meeting/ St George’s University Hospitals NHS Foundation Trust

Our strategy/the future  Focus on getting the basics right  Major issues to resolve across the organisation  Developing a strategy to equip St George’s for the future  We need to make St George’s better  Staff and our stakeholders are a key part of this mission Annual Members’ Meeting/ St George’s University Hospitals NHS Foundation Trust

Professor Simon Mackenzie, CEO Review of 2015/16 Excellence in specialist and community healthcare

St George’s cares for a population of 1.3 million across south west London. Two main hospitals, plus a wide range of community settings. Queen Mary’s Hospital St George’s Hospital We share our Tooting site with As well as our two main St George’s University of London. hospitals, we provide care in health centres, GP surgeries, schools, people’s homes and HMP Wandsworth. Annual Members’ Meeting/ St George’s University Hospitals NHS Foundation Trust

We are a teaching hospital, a tertiary referral centre, and a community provider. We touch the lives of thousands of people. 637,000 outpatients 9,000 staff treated each year 5,200 babies delivered per year 21,500 Foundation Trust members 28,500 elective procedures every year 330 volunteers Emergency We provide Department sees 400 services from 12 patients each day health centres Annual Members’ Meeting/ St George’s University Hospitals NHS Foundation Trust

2015/16 in review  A difficult year  Financial challenges  Failure to deliver waiting times  Hard working staff providing good care  Some positive outcomes Annual Members’ Meeting/ St George’s University Hospitals NHS Foundation Trust

Financial position 2015/16  Lost control of our finances in 2014/15  Serious weaknesses in finance and management systems (PwC)  Monitor found Trust in breach of license  KPMG turnaround support  Deficit of £55 million for 2015/16 - Continuing to lose money every month Annual Members’ Meeting/ St George’s University Hospitals NHS Foundation Trust

Performance 2015/16 Indicator Target 15/16 performance ED 4 hour >= 95% 90.44% RTT incomplete pathways >=92% 90.25% 62 day wait for first >=85% 82.5% treatment for urgent GP cancer referral Chlostridium Difficile <31 cases 29 MRSA 0 3 SHMI (Oct14- Sept 15) <1.0 0.91 Annual Members’ Meeting/ St George’s University Hospitals NHS Foundation Trust

Service developments 2015/16  Charles Pumphrey Unit for cardiology patients  Wolfson Rehabilitation Unit opened at Queen Mary’s Hospital  Gordon Smith cancer ward opened at St George’s Hospital  Youth violence project in ED  Improving cancer services with Macmillan Annual Members’ Meeting/ St George’s University Hospitals NHS Foundation Trust

Organ donation at St George’s  Highest organ donation rate in the UK  Excellent renal transplant outcomes  Tree of life annual celebration event at St George’s Annual Members’ Meeting/ St George’s University Hospitals NHS Foundation Trust

External recognition 2015/16  Hyper Acute Stroke Unit: Sentinel Stroke National Audit  Haematology: VTE Exemplar Network membership  Mortality: one of only two Trusts with no ‘avoidable deaths’ in a study published in 2015  Foetal monitoring team wins Health Service Journal award  C4’s 24 Hours in A&E profiles work of our Emergency Department at St George’s Annual Members’ Meeting/ St George’s University Hospitals NHS Foundation Trust

Learning from 2015/16 to Make St George’s Better  We need to do: - Improve quality and - Deliver access targets and - Meet financial goals  We must: - Do these together - Do these with our staff - Do these with our community Annual Members’ Meeting/ St George’s University Hospitals NHS Foundation Trust

Margaret Pratt, Chief Financial Officer Financial summary – 2015/16 Excellence in specialist and community healthcare

2015/16 results • The NHS Trust accounts show STATEMENT OF COMPREHENSIVE INCOME 2015/16 2014/15* Change Change a deficit of £55.1m for 2015/16. £m £m £m % • When compared to the Operating income from patient care activities 621.59 612.66 8.94 1% previous year, operating Other operating income 129.36 98.40 30.96 31% income went up by 6% but Total operating income 750.95 711.06 39.90 6% operating expenses rose by Operating expenses -795.00 -716.89 -78.11 11% 11%. Operating surplus/(deficit) -44.05 -5.84 -38.21 655% • The key issues contributing to Finance income 0.09 0.16 -0.07 -45% a rise in operating expenses, Finance expenses -4.26 -3.29 -0.96 29% and in the absence of PDC dividends payable -6.90 -7.69 0.79 -10% increased operating income, were the introduction of safer Net finance costs -11.07 -10.82 -0.24 2% staffing levels in nursing, and Surplus/(deficit) for the year -55.12 -16.66 -38.45 231% inflation. Other comprehensive income • £3.1m of costs associated with Revaluations -1.18 0.00 -1.18 100% 2014/15 were reported within Other recognised gains and losses 0.00 -0.15 0.15 -100% the 2015/16 position. A Total other comprehensive expense for year -56.30 -16.81 -39.49 235% decision was taken with the auditors not to reopen the *2014/15 figures are the totals for the 10 month and 2 month accounts for comparative purposes accounts due to immateriality.

Where did St George’s get its income from? INCOME FROM PATIENT CARE ACTIVITIES 2015/16 2014/15* Change Change • There was an increase of 1% in £m £m £m % income from patient care CCGs and NHS England 592.42 571.61 20.81 4% activities. Local authorities 10.94 0.17 10.77 6450% NHS Trusts & NHS FTs 1.78 28.05 -26.27 -94% • The big increase in income from Private patients 3.61 3.93 -0.32 -8% local authorities relates to the Overseas visitors 2.28 1.22 1.06 87% change in the commissioning of NHS injury scheme 3.69 4.47 -0.78 -17% Other clinical income 6.87 3.21 3.66 114% GUM services effective from April TOTAL - FROM PATIENT CARE ACTIVITIES 621.59 612.65 8.94 1% 2015. OTHER OPERATING INCOME 2015/16 2014/15* Change Change • Other operating income increased £m £m £m % by £31m however this includes an Education, training and research 47.36 50.98 -3.62 -7% accounting change and the Charitable donations 2.92 0.88 2.04 231% Non-patient care services to other bodies 45.83 31.07 14.76 48% recharge to other trusts of the Income in respect of staff costs - gross basis (new cat) 26.79 0.00 26.79 100% cost of GP trainees paid on their Other income 6.46 15.47 -9.01 -58% behalf (since Aug 15). When this TOTAL - OTHER OPERATING INCOME 129.36 98.40 30.96 31% item is excluded the increase in other operating income is £4.2m. TOTAL OPERATING INCOME 751.0 711.1 39.9 6% • Overall total operating income *2014/15 figures are the totals for the 10 month and 2 month accounts for comparative purposes increased by 6%. 23