Poole Hospital NHS Foundation Trust complete AMM 2015 23.9.15.pdf · Poole Hospital NHS Foundation Trust Annual Members Meeting ... Forecast Year 2 2014-15 Actual Year 1 Operating

Annual Members’ Meeting 24 September 2015

Poole Hospital NHS Foundation Trust

Annual Members Meeting 24 September 2015

Agenda Annual Members’ Meeting

2.00pm Welcome – Chair Angela Schofield

2.05pm A review: 2014 -15 to today – Chief Executive Debbie Fleming

2.20pm Annual accounts – Finance Director Mark Orchard

2.30pm Membership and governor update – Deputy Chairman of Council of

Governors, Geoffrey Carleton

2.40pm Q&A

2.50pm Developing more joined-up services

3.20 pm Research and Clinical Trials –

Deputy Medical Director Dr Angus Wood

3.30pm The Emergency Department –

Clinical Director Dr Gary Cumberbatch & Matron Geoff Walker

3.45pm Q&A

3.55 pm Close


Welcome to our Annual Members’ Meeting

Chair Angela Schofield


A review: 2014 -15 to today

Chief Executive Debbie Fleming


3

What we do…

• Provide acute general hospital services for the population of Poole, East Dorset and Purbeck

• Provide a number of key services for the whole East Dorset population: – Major Trauma Unit

– Ear, nose and throat services

– Children’s services

– Maternity services

• Provide a number of key services for the whole population of Dorset: – Dorset Cancer Centre

– Oral surgery

– Neurological care


A busy hospital!

• 66,118 patients in our emergency department

• 4,599 babies delivered (including 134 home births)

• 8,728 children under 18 admitted to our children’s unit

• 35,894 radiotherapy attendances

• 75,830 new outpatients

• 130,963 follow-up outpatients

• 3,677 elective inpatients

• 33,005 non-elective inpatients

• 30,090 day patients

• Served 560,000 patient meals

• 832,000 calls to our switchboard

• 3700 staff

• 300+ volunteers

• £215 million turnover


3

Delivering clinical

excellence as standard

Delivering clinical

excellence as standard

Award-winning models of care Award-winning models of care

Nationally recognised

nursing standards

Nationally recognised

nursing standards

World-class keyhole surgery

World-class keyhole surgery

Innovative day care services

Innovative day care services

Pioneering clinical research

Pioneering clinical research

State-of-the-art cancer centre

State-of-the-art cancer centre

A commitment to improvement and innovation

A commitment to improvement and innovation

What we’re about...

“Friendly, professional, patient-centred care with dignity and respect for all”


Our Values – The Poole Approach

• Friendly, professional, patient-centred care with dignity and respect for all

– Listening to our staff, patients and the public

– Giving information that is relevant and accessible

– Safeguarding patient privacy, confidentiality and choice

– Welcoming and involving families, carers and friends to participate in care

– Treating each other with respect and consideration

– Valuing and benefiting from diversity in beliefs, cultures and abilities

– Continually improving the quality of our services by learning from what we do

– Taking responsibility and being accountable for our own actions

– Expecting staff and patients to take their share of responsibility for their own health

– Working with and supporting all organisations that are committed to promoting the health of local people.


Some of our successes

Award-winning models of innovative care eg medical investigations unit and older people’s rapid access unit

Consistently receive excellent feedback from doctors in training

Amongst the best in the country for the standard of our cancer care (National Cancer Patient Experience Survey, 2014)

One of the best in the country for our treatment of hip fractures (National Hip Fracture Audit, 2014)

Only hospital trust in England to gain Practice Development Unit (PDU) status across the whole Trust

Rated Band 6 by the Care Quality Commission – best rating


Other 2014-5 highlights

• May: Refurbishment of edoscopy unit - £500,000 investment to improve patient experience and which included refurbishment of recovery wards, waiting areas and toilets to improve patient privacy; the introduction of patient monitoring systems for every bed; 3D technology in procedure rooms and a self-service check-in system.

• July: National Institute for Health Research Clinical Research

Network published a league table showing the Trust increased the number of studies involving patients from 83 in 2012/13 to 91 in 2013/14.


Highlights..2

• August 2014: Opening of extended aseptic lab, which provides ‘ready to use’ cytotoxic drugs used in chemotherapy

• October: £4m refurbishment of St Mary’s maternity unit

celebrated. Investment allowed the maternity service to support up to 6,000 births each year; provided additional 13 beds and three additional birthing pools; refurbishment and relocation of the Haven Suite, the trust’s midwife-led birthing unit, and the neonatal unit for sick and premature babies.

• October: Diabetes centre celebrated 20 years of care with

more than 100 guests attending, including the youngest and oldest patients.


Highlights..3

• October: A state-of-the-art digital mammography unit - one only 10 in the UK at that time - installed at the Dorset Breast Screening Unit. The unit produces 3D images which improve accuracy in the diagnosis of breast cancer.

• October: Joined national sign up to safety campaign aimed at Improving patient care by reducing avoidable harm by 50 %

• February: A new community service managed by the Hospital reported impressive results in February 2015, cutting the number of hospital visits made by one group of patients. The assertive outreach alcohol team targets people who are recurring attendees at the emergency department or their GP because of long-term alcohol misuse.


Trust Board changes

Nick Ziebland

Jean Lang

Ian Marshall

Angela Schofield Chairman

Calum McArthur

Guy Spencer Philip Green

Debbie Fleming Chief Executive

Mark Orchard Director of Finance

Mark Mould Chief Operating Officer

Tracey Nutter Director of Nursing & Patient Experience

Paul Miller Director of Strategy

Judy Sanders Director of Workforce & Development

Robert Talbot Medical Director

Non-executive directors

Directors NEW APPOINTMENTS


Poole Hospital Staff Awards

• Recognise excellence of staff, volunteers and fundraisers - 11 award categories

• 110 attendees including Mayor and Mayoress

• Moving tributes from patients and families about the care received

Long Service Awards

• 40 staff representing 1,200 years of NHS services

• Mix of 24 and 40 year service

• Outstanding contribution to patient care


Clinical performance 2014-15

• Performance generally good

• Delivered all our key clinical objectives - apart from the A&E four hour target

• Ranked amongst the best trusts for our performance in waiting times and access for cancer patients

• Maintained low rates of hospital-acquired infections,

• 95% of patients in the Friends and Family Test said they would recommend us to their friends and family


So far this year…

• One of few hospitals to meet all clinical targets including A&E 4 hour and cancer - fantastic achievement by staff

• Announced a satellite radiotheraphy treatment centre to be established in Dorchester run by Dorset Cancer Centre

• Massive recruitment effort, attracting talent at all levels

• Working with colleagues in other Trusts to identify the best, sustainable healthcare solution for Dorset

– Clinical Services Review

– Vanguard application

• Investing in patient care, safety and quality



Annual Accounts 2014-15

Mark Orchard, Director of Finance


Income

0

50

100

150

200

2014-15 2013-14

Clinicalactivity

Educationand training

Other

91% relates to clinical activity

an increase of 2.3% on last year

the Trust received just over £215 million in income

over £190 million paid to the Trust by clinical commissioning groups and NHS England

£215.3 million

£210.4 million


Expenditure

0

50

100

150

200

2014-15 2013-14

£217.5 million £207.5 million

£39m spent on clinical services and supplies

£142m spent on staff

increase of 4.8%


Financial Performance

£ million 2014-15 2013-14

Income 215.3 210.4

Expenditure (217.5) (207.4)

Finance costs (2.8) (2.8)

(Deficit)/ surplus (4.9) 0.1

Impairments 1.5 0.8

Operating (deficit)/ surplus

(3.4) 0.9

Note 2014-15 2013-14

Cash balance 10.7 10.1

Cost improvement plan (CIP)

6.6 3.6

Loan (£20 million total) 4.8 n/a

Capital expenditure 8.7 13.2

the total value of Impairments in the accounts is £1.5 million

£4.9 million reported deficit includes Impairments

“the Trust has a strong history of performing in line with plan. The Trust achieved in excess of 90% of their CIPs in 2014-15. This places them in the top quartile of Trust’s that we have benchmarked against.”

Deloitte, External audit report

to the Audit and Governance Committee

operating deficit of £3.4 million (improvement against planned £3.8 million deficit)


Investment

October 2014: A better environment for mums to be

October 2014: New breast-screening equipment offers more accurate diagnosis

May 2014: Endoscopy unit is refurbished to improve patients’ experience


Looking Forward £ million 2015-16

Forecast

Year 2

2014-15 Actual

Year 1

Operating (deficit)/ surplus

(6.7) (3.4)

Cost improvement plan (CIP)

7.1 6.6

Capital expenditure 14.0 8.7

Cash balance 6.9 10.7 positive cash position up to the end of 2016 as a minimum

a further £7 million efficiency requirement

focus on delivering year two of our two-year plan

key priority to develop a sustainable future for Poole Hospital


Membership and Governor Update

Deputy Chairman of Council of Governors, Geoffrey Carleton (Public Governor: Purbeck, East Dorset & Christchurch)


Membership facts and figures (31 March 2015)

• 6,336 public members

• 3,858 staff and volunteer members

• Met target to achieve public membership of 6,260

• Met target to focus on increasing younger membership

• Target for 2015-6 is a total membership of 6,500 public members


Representative membership

• Membership broadly reflects the populations we serve in terms of gender and diversity with proportionally slightly more members in the female and older age groups

• Eligibility for membership is set out in the Constitution

• Membership applications may be submitted electronically or in paper format


Progress on the membership strategy

• Governors used the following opportunities for recruiting and engaging with members:

– Talking with patients and visitors in hospital areas

– Through the governor column in Foundation Talkback

– Through members attending clinical presentations held at the hospital

– Through attendance at the Annual Members’ Meeting


Progress on the membership strategy

• Attendance at local events and groups including: – Coeliac UK AGM

– Local women’s institutes and townswomen guilds

– WRVS café

– Fresher's Week and Health & Social Care induction day for students

• Opportunities to encourage younger members were explored

• Part of the membership recruitment activity was outsourced to an external agency to increase the membership


Elections 2014 -15

• Successful elections were held in May 2014 in line with the Trust’s election rules for two public seats in the Poole constituency to commence a three year term of office in June 2014

• A notice of election was published in February 2015 for a further two public seats to commence a three year term of office in May 2015


Council of Governor activities

• On the recommendation of the Nominations, Remuneration and Evaluation Committee, the Council of Governors approved:

– Re-appointment of the chairman and non-executive directors

– The appointment of new non-executive directors & vice chairman

– Remuneration and allowances for chairman and non-executive directors

– Outcome of the Chairman and non-executive directors appraisals


Council of Governor activities

• The Council of Governors also:

– Received the Annual Report and Accounts

– Approved changes to the Constitution

– Received a disputes procedure

– Set up a new Governor Training and Development Reference Group

– Attended training and networking events organised by the hospital or local/national groups


Looking to the future 2015 -16

• Hold an extended programme of clinical presentations with members invited to attend with governors

• Establish a quality reference group

• Increase recruitment activity to achieve agreed target

• Continue the focus to recruit younger members


Looking to the future 2015 -16

• No proposed changes to the structure of the Council of Governors and Board of Directors

• Continue to support the Board of Directors and Trust staff in the implementation of changes across the NHS by engaging with members and the public.


How to contact a governor

Members can contact the Council of Governors through the Membership Office by:

01202 448723

[email protected]

Poole Hospital NHS Foundation Trust Longfleet Road Poole Dorset BH15 2JB


Questions & Answers


Developing more joined-up services

Chief Executive Debbie Fleming


Progress so far….

• We have a long history of working collaboratively together in the interest of patients

– Current configuration of acute services

– Provision of services within community hospitals

– Development of services within primary care

– Older Peoples services

– Community Paediatric services

– Specialist outreach teams

– Dorset-wide Clinical networks


Progress so far…2

• This work has “stepped up” in recent years

– Dorset ‘Better Together’ Programme

– Dorset Clinical Services Review

• Application to join the Vanguard Programme

– New post established in conjunction with Dorset Healthcare University NHS FT to support the development of integrated services within Poole and the surrounding area

• We know that patients are best served when organisations work together


Group discussion:

How could patient care be improved locally by different parts of the NHS working closer together


Feedback


Research and Innovation at Poole Hospital

Clinical Lead for Research and Innovation Deputy Medical Director Dr Angus Wood


Why do we do research?

• Quality

– Attracting high quality staff

• Choice for patients

– Important issue for patients particularly in cancer care

• Improvement of clinical outcomes


NIHR national strategy


What do we do?

• Most recently 1223 patients in over 90 active trials, plus 480 in non ABF priority studies

0

500

1000

15001185 1207

1304 1223

820

Numbers

2015/16 data to 31st August 2015


How did it all start?

• On 20th May 1747 James Lind began the first ever clinical trial testing the theory that citrus fruit cured scurvy

• 12 sailors suffering from scurvy were divided into 6 groups of 2 and randomised into different treatment arms


James Lind and the first clinical trial

• Normal diet plus cider

• Normal diet plus sulphuric acid

• Normal diet plus vinegar

• Normal diet plus seawater

• Normal diet plus citrus fruit

• Normal diet plus spice

After 6 days sailors on citrus fruit were nearly cured


Modern clinical trials


Sources of funding

• Wessex CRN budget

• Grant income eg ART

• Universities/other healthcare

• DOH RCF

• Commercial income – backfill costs

• Reserves

• Challenging times throughout the NHS, particularly in Research and Innovation


What do we do? All of these

Ageing Dermatology Injuries and Emergencies

Anaesthesia Diabetes Musculoskeletal

Cancer ENT Neurological

Cardiovascular disease Gastroenterology Reproductive Health

Children Haematology Respiratory

Critical care Health services and delivery

Stroke

Dementias and neurodegeneration

Hepatology Surgery (+ Orthopaedics)


Other advances

• Active commercial clinical trials:

– Currently seven, up from five last year

• Investigating others

• Improved metrics for speed of acceptance of trials

• Specialty Leads for Research and Innovation

• Protected SPA time for this role


Oscars

• Thanks to all our team for their contribution

• If the picture of a particular speciality isn’t here…


Oncology

• 100 trials on-going


Oncology trials


Oncology trials


Critical care

• Research has high level of integration with clinical throughput


Critical care

• Breathe

• LeoPARDS

• Crash 3

• POPPI


Dermatology

• What are they doing?


Dermatology

• AWARE A World-wide Antihistamine-Refractory chronic urticarial patient Evaluation

• First UK patient recruited in Poole Hospital


Rheumatology

• What are they up to?


Rheumatology

• Current research studies in:

– Rheumatoid arthritis

– Lupus

– Ankylosing spondylitis

– Chronic fatigue syndrome


We are currently recruiting in the following areas:

• Diabetes

• Sepsis and Severe Infection

• Immune Thrombocytopenic Purpura (ITP)

• Weight management (Obesity)

• Oncology

• Gastroenterology

• Influenza/Flu-like illness in children with underlying conditions (during ‘Influenza season’)

• Inborn errors of Metabolism

• Rheumatology


International Clinical Trials Day

• A day to publicise our work to members of staff and some patients

• Stands in the ‘dome’ and cafeteria

• Chocolate trial – is white chocolate more satisfying than milk chocolate?

• Also had stands at Poole Hospital open day.


International Clinical Trials Day May 2015


International Clinical Trials Day May 2015


Innovations

• Dentest – now commercially adopted

• Finger traction

• Bone clamp

• Neuravatar - AHSN

• Epilepsy project - AHSN

• Top Secret


Future vision

• Self generated projects

• Ties in with promotion of hospital and branding


Wrap up

• Research is hugely important

– To our patients

– To our reputation as a hospital


The emergency department

Clinical Director Dr Gary Cumberbatch

Matron Geoff Walker


95% target

What does it mean?


What makes Poole ED special

• Avoiding waiting times

• Swift Triage and assessment

• Skilled medical and nursing staff

• Occupational therapy support

• Single point of access to the hospital specialties such and trauma, and paediatrics

• Putting the patient first!


What are we doing to improve services

• Investment in emergency care practitioner nurses.

• Increasing the nursing staff establishment

• Agreement to increase the consultant body

• investing in the infrastructure to avoid trolleys in the corridor, and a new enlarged resuscitation area

• Improving waiting times through emergency nurse practitioners seeing patients and supporting the medical staff

• Working as a team

• Investment in training and updates

• Close cooperation with the ambulance service and local GPs

• Never standing still


Even at times of crisis we give friendly professional care and always

put the patient first


Questions & Answers


Thank you

Chair Angela Schofield

Documents

Poole Hospital NHS Foundation Trust complete AMM 2015 23.9.15.pdf · Poole Hospital NHS Foundation Trust Annual Members Meeting ... Forecast Year 2 2014-15 Actual Year 1 Operating