13july 2017 annual public meeting for hinchingbrooke ...... · deficit of £21.17m against a...
TRANSCRIPT
13/07/17
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Welcome!
13July 2017
Annual Public Meeting for
Hinchingbrooke Health
Care NHS Trust
Welcome
Rob Hughes Trust Chairman
13/07/17
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Looking back over the last year
Tonight’s presentation
features the
achievements
of the previous board
of directors, and pays
tribute to the efforts of
staff in 2016/17
Thank you to the board
of Hinchingbrooke
Health Care NHS Trust
for their support as we merged to form North West Anglia
NHS Foundation Trust on 1 April 2017
Agenda for this evening
6.05pm: Review of 2016/17 and merger update
– Caroline Walker, Deputy CEO
6.20pm: Spotlight on Survivorship – Karen Moseley,
Team Leader for Cancer Community
Nurses (Hunts) and Eileen Murphy,
Macmillan Project manager for
Survivorship
6.40pm: Question-and-Answer session
7pm: Close
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Review of 2016/17
Caroline Walker Deputy Chief Executive/
Finance Director
The year in numbers
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The year in numbers
The year’s highlights
Coming out of Special Measures with a rating of ‘Good’
from the Care Quality Commission (Aug 2016)
Winning the national Health Business Award for
Outstanding Achievement in Healthcare
Introducing Schwartz Rounds to support staff in their
wellbeing at work – which has been well received
Expanding our ambulatory care model to see a greater
number of urgent care patients
Making positive changes to the care of patients with
dementia – including having one of the country’s first
Admiral Nurses
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The year’s highlights
CQC National Inpatient survey (published June 2016)
placed Hinchingbrooke in the top 20% of NHS Trusts
nationally for good patient experience
Patient Services Team reached finals of the Health
Estates and Facilities Management Association Awards
(People Development Award category) and our Head of
Facilities (Soft Services) was a finalist in the Leader of
the Year category
Hospital Head Chef was a finalist in the Craft Guild of
Chefs Awards 2017
The year’s highlights
Successful completion of phases 1 and 2 of the
Woodlands Cancer Centre, in conjunction with
Macmillan, which opened in Sept 16
Successful refurbishment of the pathology lab which
completed in Mar 2017
Compliance with Cancer Waiting Times standards is
good – all standards achieved for 11 consecutive months
of the year
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The year’s challenges
Failing the 4 hour waiting time standard for A&E patients
(79.78% against the 95% target)
Lack of bed capacity and issues with the flow of
patients through our hospitals have contributed to this
Deficit of £21.17m against a planned deficit of £9.8m
Increased reliance upon high cost agency staff
(medical and nursing) to meet gaps in rotas and
support increases in activity had driven much of this
increased expenditure
Cost Improvement Plan savings not delivered in full
(£5m savings delivered against a £6.2m target)
The year’s challenges
Recruitment – some hard-to-fill specialty posts, plus hot-
spot areas identified – hence greater reliance upon
agency staff
Quality Surveillance Rating (a quality performance
indicator considered by NHS providers’ regulator and
commissioners) saw Hinchingbrooke Hospital’s risk
profile heightened from ‘regular’ to ‘enhanced’ in final
quarter of the year due to some quality concerns – this
reflected on the risk rating of our new Trust post merger
Managing staff morale – in the light of the merger with
Peterborough and Stamford Hospitals NHS Foundation
Trust
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Formed 1 April 2017
+
Recap – our local health system
Peterborough and Stamford Hospitals NHS FT
clinically and operationally sustainable (with
specific challenges) BUT not financially
sustainable
Hinchingbrooke Health Care NHS Trust neither
clinically nor financially sustainable in current
form
Cambridgeshire and Peterborough is one of the
most financially-challenged health systems in the
country – source: NHS England and NHS Improvement
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Brief history of our hospitals Ongoing regulatory oversight – no solution
Hinchingbrooke Peterborough & Stamford 2005: Trust in financial deficit and
clinically unsustainable 2009: Strategic Health Authority
announces Hinchingbrooke franchise tender
2010: Peterborough in joint bid with Serco to operate Hinchingbrooke
2012: Circle awarded franchise and begins managing Hinchingbrooke
2015: CQC rates it inadequate with lack of clinical sustainability
2015: Circle withdraws early from contract, citing unsustainable losses
2002-2008: In financial surplus 2010: Move to PFI building, Trust
reports a £45m deficit in 2010/11 2012: Monitor-appointed
Contingency Planning Team (CPT) finds Trust clinically/operationally sustainable, but financially unsustainable
2012: National Audit Office and CPT identify approx £20-25m shortfall between PFI cost and tariff
Working together
2015: Regulator-led strategic outline case
recommends closer collaboration between
Hinchingbrooke and Peterborough & Stamford
Nov 2015: Both trusts commence business case
and agree to explore four levels of collaboration:
Option 1 - Do nothing for now
Option 2 - Shared back office function
Option 3 - As per option 2, plus two boards,
one executive team and one operational
organisation
Option 4 - One organisation
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Working Together
May 2016: Outline Business Case approved by
both Trust boards – agreement given to proceed
to Full Business Case
Nov 2016: Both Trust boards agree Full Business
Case and set merger date as 1 April 2017
The clinical case for change
Some services in both organisations deemed
clinically fragile pre-merger - further services at
risk in medium-term
Contributory factors:
Smaller teams compared to teaching trusts/
larger hospitals can make recruitment harder
Agency spending caps
7-day working requirements
Junior Doctors’ contract/provision of rest
For both organisations, collaboration largely
resolves clinical sustainability issues
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Increasingly unsustainable services
As identified in the Business Case:
Hinchingbrooke
Acute Medicine
Cardiology
Diagnostic Imaging
Interventional
Radiology
Haematology
Nephrology
Neurology
Ortho-Gerontology
Palliative care
Stroke
Peterborough & Stamford
Diagnostic Imaging
Gastroenterology - 7 day
bleed service
Interventional radiology
Ortho-Gerontology
Stroke
Clinical benefits of merging
Merging joins all clinical teams under a single
operational management structure:
larger teams
medical staff working equitably across sites
shared workload, rotas, out of hours cover
Merger maximises opportunities for: Single governance arrangements
Greater opportunities for training/sub-specialism
Recruitment/retention and reduce agency use
Clinical consistency through shared best
practice
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Merger benefits in summary
Addresses service vulnerability – particularly for
the population of Huntingdon, which has been
disproportionately disadvantaged
Clinical collaboration strengthens the provision of
a number of services across both sites to ensure
long term, sustainable, high quality health
services for the populations of Peterborough,
South Lincolnshire and Huntingdonshire
Merger saves £9m recurrently
Part of journey to financial sustainability
Our hospitals
Hinchingbrooke Hospital 304 beds, A&E Dept, 23-bed Treatment Centre, The Park
Maternity Unit, private patient ward, outpatient services
Peterborough City Hospital 635 beds, Emergency Dept, Women’s and Children’s Unit
(inc maternity), Cancer Unit, Renal Unit, outpatient
services
Stamford and Rutland Hospital 22 beds, Minor Injuries Unit, day case surgery and
outpatients services
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The area we serve
Serving a
growing
catchment of
700,000 people
Two main clinical
commissioning
groups
6,000 staff
450 volunteers
Executive Team
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Non-Executive Team
Local voices represented
Public governors elected in three constituencies – 6 representing Greater Peterborough
– 6 representing Huntingdonshire
– 5 representing South Lincolnshire
Staff governors elected by colleagues – 3 at Hinchingbrooke Hospital
– 3 at Peterborough City Hospital
– 1 at Stamford Hospital
Council of Governors meetings held quarterly – first meeting took place in May
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Our vision
Working together to be
the best at providing
outstanding care
for local communities
Our goals
Working together to be
the best at providing
outstanding care for local communities
Delivering outstanding
care & experience
Recruiting, developing & retaining
our workforce
Improving & developing our services
& infrastructure
Delivering financial
sustainability
Working together
with local health &
social care providers
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Our shared values
Our shared values are based on suggestions and themes from: 30 staff listening events held across all three hospitals
Public and staff engagement stands at all sites
Staff values survey, which received over 650 responses
We put patients first
We are caring and compassionate
We work positively together
We are actively respectful
We seek to improve and develop
The first day – Saturday 1 April 2017
Trust leadership structure was in place from Day 1
Executive team and senior leaders were present on
all three hospital sites to support teams on duty on
the first weekend and beyond
New North West Anglia NHS FT signage up at all
three hospitals
New website went live (www.nwangliaft.nhs.uk)
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The first month – April 2017
Focus firmly upon continuing delivery of safe services
from Day 1 – detailed plan drawn up to support clinical
and operational teams
No unanticipated issues encountered
Staff briefings and exec walkabouts took place to get to
know Hinchingbrooke teams better
Integration of corporate services began following
consultation process
New patient administration system contract signed -
implementation programme began 3 April
May /June 2017
Corporate service integration well under way
(for example: finance and procurement, HR,
Estates and Facilities, Executive Support team etc)
Operational structure decided following
consultation – move to three divisions:
Emergency and Medicine
Surgery
Family and Integrated Support Services
New divisions in operation from 3 July
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Operational Divisions
management
Looking ahead – widening services
Trust to take over the provision of outpatients and
imaging services at Princess of Wales Hospital, Ely
and Doddington Hospital
We will also provide imaging services at North
Cambs Hospital, Wisbech and dermatology services
at the City Care Centre, Peterborough
These staff will transfer under TUPE to our Trust on
1 Sept 2017
Path lab team at Hinchingbrooke will transfer from
the Pathology Partnership to our Trust on 1 August
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Looking ahead – using our estates HINCHINGBROOKE HOSPITAL
Board of Hinchingbrooke Health Care NHS Trust
announced that Ryhurst Ltd had been chosen as the
preferred partner for the Strategic Estates
Partnership in Summer 2016
No agreement signed – board did not have business
case approval from the regulator, NHS Improvement
This remains the case today
North West Anglia NHS FT board currently looking
at the opportunities within the plan
No decisions made at present
Strategic Estates Partnership recap
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Strategic Estates Partnership plan
Looking ahead – using our estates STAMFORD & RUTLAND HOSPITAL
£2m redevelopment programme due to complete at the end of July
Includes new MRI scanner and imaging dept, new outpatients dept, second ultrasound room, improved physiotherapy gym, new pain management dept, new clinic rooms and waiting areas
Serving more patients closer to home
Open day planned for Autumn to showcase the facilities
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Looking ahead – using our estates
PETERBOROUGH CITY HOSPITAL
New build facility at the front of the Emergency
Department (ED) to provide a GP streaming
service
To be operational in readiness for winter – and
help reduce demand on the busy ED
Trust successfully bid for £650,000 funding to
provide this service at the PCH site - announced
in April
Spotlight on Survivorship
Karen Moseley and
Eileen Murphy
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Next year….
One Annual Public Meeting to review our first full year of
operation as North West Anglia NHS Foundation Trust
Members events to be held at all three hospital sites over
the remainder of this year and next
Focus on subjects that are of the most interest to you
Please feedback to our staff members in the room on
the subjects you want to know more about
Please also tell us what you thought to this event so
we can improve for the future – feedback forms
provided
Your questions?
Please remember to fill out a
feedback form and hand to a
member of staff on your way out