Annual Members’ Meeting 27 September 2018 Gillian Norton, Chairman Outstanding Care, Every Time – Annual Members’ Meeting 2018
Council of Governors’ update Kathryn Harrison, Lead Governor Outstanding Care, Every Time – Annual Members’ Meeting 2018
Celebrating the NHS at 70 A short film Outstanding Care, Every Time – Annual Members’ Meeting 2018
Patient story Libby Keating “I’ve had nothing but kindness and compassion.” Outstanding Care, Every Time – Annual Members’ Meeting 2018
Outstanding Care, Every Time – Annual Members’ Meeting 2018
Outstanding Care, Every Time – Annual Members’ Meeting 2018
Outstanding Care, Every Time – Annual Members’ Meeting 2018
2017/18 – a year of progress Jacqueline Totterdell, Chief Executive Outstanding Care, Every Time – Annual Members’ Meeting 2018
Overview � Introduction � Who we are and what we do/a year of progress � Cardiac surgery at St George’s � Outstanding Care, Every Time – delivering on our objectives � Personal reflections/the future Outstanding Care, Every Time – Annual Members’ Meeting 2018
Who we are: St George’s cares for a population of 1.3 million across south west London. Two main hospitals, plus a range of community settings. Queen Mary’s Hospital St George’s Hospital We share our Tooting campus with We share our Tooting campus with As well as our two main As well as our two main St George’s, University of London. St George’s, University of London. hospitals, we provide care in the hospitals, we provide care in the community community Outstanding Care, Every Time – Annual Members’ Meeting 2018
What we do Key services, and an organisation to be proud of � Local, tertiary and specialist services: - Centre of excellence for neurosciences , fetal medicine , plus renal transplantation - Major trauma and heart attack centre - 24/7 thrombectomy service for stroke - Growing influence in research - Trusted services for local people; including Emergency Department and maternity service Outstanding Care, Every Time – Annual Members’ Meeting 2018
A year of progress � Stabilised executive and senior team � Reduced vacancy rate and spending on agency staff � Launched Quality Improvement Plan � Reduced financial deficit � Rolling programme of operating theatre and ward refurbishment � Friends and Family Test scores improving � Upgraded to Requires Improvement by CQC � But…..a huge amount still to do Outstanding Care, Every Time – Annual Members’ Meeting 2018
Cardiac surgery at St George’s � T aking action to deliver much needed improvements � We commissioned independent external review � We are implementing recommendations at pace � Taken steps to stabilise the service , including: - Transferring complex cardiac surgery to other hospitals - Removing cardiac surgery trainees - New programme director appointed � Separate HR review is looking at team behaviours � External independent panel convened by NHS Improvement Outstanding Care, Every Time – Annual Members’ Meeting 2018
Outstanding Care, Every Time – Annual Members’ Meeting 2018
Treat the patient, treat the person � Delivering fundamentals of patient care : - MRSA/Clostridium difficile rates below national average - Mortality rates better than many other teaching hospitals - Dementia carers passport launched - Ward accreditation scheme introduced � CQC upgraded Trust from Inadequate to Requires Improvement in July 2018 � Working with Institute for Healthcare Improvement and our own Quality Improvement Academy Outstanding Care, Every Time – Annual Members’ Meeting 2018
Right care, right place, right time Indicator Target 16/17 17/18 18/19 to date ED 4 hour >= 95% 91.6% 87.56% 91.75% Referral to >=92% We are not currently reporting our RTT position due to Treatment (RTT) data quality challenges incomplete pathways 62 day wait for >=85% 84.9% 82.60% 88.90% first treatment for urgent GP cancer referral Diagnostic waits >=1% 2.9% 0.2% 0.2% MRSA 0 2 5 0 Outstanding Care, Every Time – Annual Members’ Meeting 2018
Balance the books, invest in our future � Finished 2017/18 with deficit of £53.1 million (£78.7 million in 16/17) � Plan to reduce the deficit to £29 million by March 2019 � We will do this by: - Increasing the number of patients we treat - Reducing waste and inefficiencies � By balancing our books, we can invest in our future � Benefiting from generosity of St George’s Hospital Charity Outstanding Care, Every Time – Annual Members’ Meeting 2018
Build a better St George’s � New strategy in development DEVELOPMENT OF � TRUST STRATEGY Improving our IT – including the roll-out of electronic patient administration system 2019 -2024 � Renovated theatres at St George’s � Rolling ward refurbishment programme � Opened Energy Centre on Tooting site � Improving response to small-works requests Outstanding Care, Every Time – Annual Members’ Meeting 2018
Champion Team St George’s � Reduced vacancy rate from 17% to 10% � Staff Appreciation Awards with St George’s Hospital Charity � New health and wellbeing initiatives for staff � Improved Staff Friends and Family Test scores � King’s Fund leadership development � Appointed Guardian of Safe Working � Highest staff flu vaccination rate in London Outstanding Care, Every Time – Annual Members’ Meeting 2018
What our staff are telling us Outstanding Care, Every Time – Annual Members’ Meeting 2018
Develop tomorrow’s treatments today � Surgical firsts , including first robotic hysterectomy � Highest ever increase in recruitment to clinical trials � Staff recognised in academic promotions � Training partnership with Royal College of Surgeons � Trial of artificial intelligence in fetal medicine � Part of 100,000 Genomes project Outstanding Care, Every Time – Annual Members’ Meeting 2018
Celebrating what we do Outstanding Care, Every Time – Annual Members’ Meeting 2018
Personal reflections � A year of progress – but more to do � Some problems are years in the making – and will take longer to resolve � Priority is to make life easier for our staff – from the hospital estate to information technology � The job is challenging and rewarding – and fun! � The support we have from local people is tremendous Outstanding Care, Every Time – Annual Members’ Meeting 2018
The future � Development of our 2019-2024 strategy � Return to financial balance and improve key services � Exit ‘special measures’ regime for quality and finance � Support and champion our 9,500 staff � Greater focus on patient and public engagement Outstanding Care, Every Time – Annual Members’ Meeting 2018
Annual accounts 2017/18 Andrew Grimshaw, Chief Financial Officer Outstanding Care, Every Time – Annual Members’ Meeting 2018
Audit opinion � Present the Accounts for year ended 31 March 2018 � Audit undertaken by Grant Thornton � Conclusions of the Audit; - Unqualified audit conclusion - Adverse conclusion in relation to the arrangements for securing economy, efficiency and effectiveness in the use of resources - Emphasis of matter opinion due to the Trust’s dependence on cash support from the NHS � The Auditors noted that the production of the Financial Statements had improved again from the previous year � The Trust continues to be in Financial Special Measures with NHS Improvement (NHSI) Outstanding Care, Every Time – Annual Members’ Meeting 2018
Key elements of financial performance Financial duty 2017/18 2016/17 Comment Deficit £53.1m £78.7m Expectation from NHS Improvement is • that Trusts should aim plan to be in financial balance. • Failure to identify and deliver cost improvement plans Failure to qualify for additional funding • Income £820.3m £799.1m • Increase of £21.2 million (2.6%) Expenditure £873.4m £877.8m Decrease of £4.6 million (0.5%). • Capital £53.2m £34.0m • Investment in IT Investment • New Energy Centre at St George’s • Medical Equipment Borrowings £79.7m £86.0m • Borrowings were to support working capital, as well as to support finance urgent capital investment. Outstanding Care, Every Time – Annual Members’ Meeting 2018
Actions to deliver improvements � Financial performance - Financial plan agreed with NHSI to reduce 2018/19 deficit to £16.4 million - This includes £12.6m of Provider Sustainability funding, which is dependent on delivery of financial and performance metrics - Process in place to identify and deliver Cost Improvement Plans � Borrowing - NHSI have agreed to support working capital in line with the deficit � Capital investment - Investing £18.5 million of internally generated capital funding in 2018/19. We will continue to seek additional resources for further investment � Systems and processes - Actions in place to improve the working of the Finance Department, including upgrade of the financial system Outstanding Care, Every Time – Annual Members’ Meeting 2018
Annual audit letter Paul Dossett, Partner, Grant Thornton Outstanding Care, Every Time – Annual Members’ Meeting 2018
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