Daniel Elkeles, Chief Executive

WHAT WE DO WELL AND WHAT WE ARE STRENGTHENING

November 2015

WELCOME

Great care to every patient, every day

South West London Elective

Orthopaedic Centre

(SWLEOC)

One district general hospital on two

sites

• Catchment 482,000

• Serving two health economies with

two host clinical commissioning

groups

• c4,800 staff

Renal two million

people 1,000 dialysis

patients Nine locally

located dialysis units, including St

Helier

HISTORY – 15 YEARS OF STRATEGIC UNCERTAINTY

1999

Trust formed

through

merger of

Epsom Health

Care NHS

Trust and The

St. Helier

NHS Trust

Dec 2010

Trust Board

concludes no

viable route

to FT for

combined

trust or for

either site

individually

Mar 2011

ESTH

Transaction

Board

agrees NHS

contested

transaction

process

Nov 2011

Bids received

from Ashford

and St Peter’s

(ASPH) for

Epsom and St

George’s

(SGH) for St

Helier 30 Jan 2012

SGH withdraws bid

stating “unable to

proceed at this time” and

citing uncertainties about

BSBV outcome etc

Mar 2010

St Helier

Redevelop-

ment OBC

approved

by DH and

Treasury

Oct 2010

Comprehensive Spending

Review re-affirms Govt

commitment to

St Helier redevelopment

May 2011

Better

Services

Better Value

(BSBV)

South west

London review

launched

Jun 2012

ASPH

named as

preferred

bidder for

Epsom

Aug 2012

BSBV preferred

configuration

identifies St

Helier as “4th

site” – Elective

Centre

Nov 2012

Epsom

Hospital and

Surrey

Downs CCG

incorporated

into scope of

BSBV

Feb 2015

NHS TDA

Gateway review

– confirmed not

candidate for

transaction

April 2015

Long-term

estates

strategy

review

commenced

for period

beyond 5-

year horizon April 2015

Trust five year

strategy based on

provision of

services across

two-sites confirmed

Oct 2012

ASPH

transaction

halted

Nov 2013

Surrey

Downs CCG

withdraws

from BSBV

following

vote from

GPs Feb 2014

BSBV

closure

Apr 2014

South West

London

Commissioning

Collaborative

(SWLCC)

established

Jan 2015

South West

London Acute

Provider

Collaborative

established

Apr 2014

Matthew

Hopkins

(CEO)

seconded

to BHR

Trust

Jan 2015

Daniel

Elkeles

takes up

appointment

as CEO

15 YEARS OF STRATEGIC UNCERTAINTY IN A HIGHLY SENSITISED ENVIRONMENT

11TH CEO SINCE 1999

Why did I take the challenge?

Great care to every patient, every day

• Both Epsom and St Helier hospitals will continue to provide consultant-led, 24/7 A&E, maternity and inpatient paediatric services

• St Helier will provide specialist and emergency care, such as acute surgery, for our most sick patients

• Epsom will expand its range of planned care

• We will work with GPs to provide significantly more care in community settings so that people only come to hospital when it is absolutely necessary

LOOKING FORWARD: 2015-2020

A message for all staff

OUR OBJECTIVES 1. Deliver safe and effective care

with dignity and respect

2. Create a positive experience that meets the expectations of our patients, their families and carers

3. Provide responsive care that delivers the right treatment, in the right place at the right time

4. Maintain financial sustainability

5. Work in partnership with our patients, commissioners, other health and care providers, and local authorities

OUR STRATEGY: 2015-2020

1. Strengthen staffing in key areas

2. Provide consistently high quality clinical care

3. Improve our buildings and facilities

4. Maintain strong finances

So what have we

done since April…

OUR CHALLENGES

• Increasing our substantive workforce

• Increases clinical quality AND decreases costs

• Q2 Staff Friends and Family Test 545 responses - 80% of our staff would recommend our services to their family and friends the highest we have ever achieved

• Over 200 staff recognised for their work

1. INVESTING IN OUR PEOPLE

3,921 3,942 3,961 3,980

3,976

4,211

4,434

3,500

3,600

3,700

3,800

3,900

4,000

4,100

4,200

4,300

4,400

4,500

Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar

WT

E

Substantive Workforce 2014-15/16

2014/15

2015/16

Since April 235 additional staff

CORE SERVICES

URGENT AND EMERGENCY SERVICES

What we do well for our patients: • Delivery of four hour standard - top

three for London, consistent over two years

• Patient experience • Increased consultant presence –

consultants on site 14 hours a day (Mon to Fri)

• Middle grade medical posts now filled at St Helier

What we are strengthening for our patients: • Physical layout of the departments • Re-attendance rates

A&E resus simulation training

What we do well for our patients: • Orthogeriatrics pathway – top hip fracture unit

in London • VitalPac a clinical software system enabling

healthcare professionals to use handheld devices to record inpatient observations

• Electronic prescribing • Community Assessment Diagnostic Unit – new

GP led service at Epsom

What we are strengthening for our patients: • Management of patients with Naso-Gastric

tubes following a Never Event • Improve junior doctor support/ supervision • Wards Chuter Ede, Alexandra at Epsom • Wards C3 and C5 at St Helier

MEDICAL CARE & OLDER PEOPLES’ CARE

Focus on falls awareness with special training sessions

SURGERY

What we do well for our patients: • Separation of acute and elective surgery • Hip fracture and emergency surgery outcomes • Low percentage of operations cancelled • Urology centre • Acute pain service

What we are strengthening for our patients: • Theatre efficiency • 18 weeks for T&O and Urology • Cancer 62-day target • Surgical ambulatory pathways • Ward B5 and B4 St Helier

Mr Zaidi in theatre

What we do well for our patients: • Lower than average mortality rates

of <100 • Greater than 70% of nursing staff

with critical care course • 97-99% on Safer Staffing Levels • Low numbers of out of hours

discharges What we are strengthening for our patients: • ITU environment • Timely transfer from critical care • Development of a rapid response

service • Intensivist cover on Epsom site

CRITICAL CARE

A senior staff nurse processing an arterial blood sample for a patient in ITU

MATERNITY AND GYNAECOLOGY

What we do well for our patients: • Consultant presence 98 hours • Three consultant midwives • UNICEF Baby Friendly Initiative (stage 3

accreditation) both sites • Friends and Family Test scores for birth

consistently 98-100% What we are strengthening for our patients: • Reducing Caesarean section rate • Integrated midwifery model

commencing Nov 2015 • Sign Up To Safety: strengthening foetal

monitoring

Mum Ebere with Noah, the 100th baby born in the Epsom Birth Centre

What we do well for our patients: • Eight paediatric emergency consultants • Paediatric early warning system Children's

Observation and Severity Tool used in all areas

• Pants and tops (children's feedback) • Play specialists – Elmer the elephant trail What we are strengthening for our patients: • Nurse staffing numbers • Multi disciplinary working for care

for self harm, learning disabilities and mental health

• Improving transition to adult services

SERVICES FOR CHILDREN AND YOUNG PEOPLE (CYP)

Pants and tops: feedback from our young people

Elmer the Elephant theatre trail

What we do well for our patients: • Teaching - mandatory 1/2 day for all

new nurses • Memorial service for bereaved relatives

twice yearly on both sites • Six day onsite Clinical Nurse Specialist

and seven day consultant on call service • EOLC strategy board includes

community stakeholders What we are strengthening for our patients: • Personalised care plans for dying

patients incorporating Five Priorities of Care

• Seven day onsite Clinical Nurse Specialist (by February 2016)

• Consultant-led outreach to Acute Medical Units.

END OF LIFE CARE (EOLC)

Our Palliative Care team, Care of the Elderly team, Bereavement service, Chaplaincy and Portering team are just some of the services in our hospitals that support patients and their families through the last months, weeks and days of life

What we do well for our patients: • Modern ophthalmology suites at both Epsom and St

Helier • All medical records are tracked with Radio Frequency ID • Lower than the national average Did Not Attend (DNA)

rates and six week diagnostic waits • Newly enhanced seven day radiology services What we are strengthening for our patients: • Completeness of medical notes • Communication with GPs • Improvement of waiting times in clinic • Dedicated directorate from Dec • Waiting areas in x-ray

OUTPATIENTS AND DIAGNOSTIC IMAGING

Our CEO Daniel welcomes Princess Alexandra to Epsom Hospital for the opening of our state-of-the-art Urology Centre

SOUTH WEST LONDON ELECTIVE ORTHOPAEDIC CENTRE (SWLEOC) What we do well for our patients: • Deep wound infection rates 0.2%;(UK 0.6%, USA 3%) • Clinical Outcome database 2nd largest in the world • Friends and Family Test (FFT) 99.4% year to date • Strong partnership collaboration across four trusts What we are strengthening for our patients: • Improving post discharge patient support • 18 week Referral to Treatment (RTT) • Strengthening leadership across nursing

A physiotherapy session

What we do well for our patients: • The highest one and three year patient

survival following Kidney Transplant in UK • 3rd largest home therapies programme • Nine locally located dialysis units, including

St Helier • Strengthened infection control

management of lines • Renal patient medical records access What we are strengthening for our patients: • Acute haemodialysis at Epsom • Quiet rooms needed for ‘breaking bad

news’ and day rooms on wards required • St Helier - cramped facilities and poor

environment • North Croydon - new satellite unit required

RENAL SERVICES

Staff and patients are delighted with our new state-of-the-art dialysis machine

WE ARE PROUD OF OUR COMMUNITIES

• 550 local people volunteer delivering 78,000 hours of support per year

• Our staff volunteer to help all over the world

• £M raised by hospital charities

Joan Harridge recognised for 40 years service as a volunteer

Mealtime buddies Adam and Deborah

Pat and Val in the new look League of Friends for St Helier Hospital café at St Helier

• Clinical services

• Corporate services

• Patient administration services

• Our partners, eg Mitie and G4S

THANK YOU TO OUR STAFF

We have highly committed staff

A clear plan for the next five years

Understand the challenges

Aspire to deliver our mission

Great care to every patient, every day