clean hands. safe hands. · southern health and social care trust 4 southern health and social care...

Southern Health andSocial Care Trust Annual Report 2008-2009

New uniforms for Domiciliarycare workers 0

New cancer vaccinePage 19

National award for disability project Page 15

Clean Hands. Safe Hands.

Southern Health and Social Care Trust

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ContentsWho’s who on the Trust Board 2Acute Services 7Older People and Primary Care Services 10Mental Health and DisabilityServices 14Good Governance 18Children and Young People’s Services 19Medical Leadership 23ICT Reform andModernisation 23Financial Information 24Remuneration Report 25Financial Commentary 27Summary FinancialPerformance 28Summary FinancialStatements 29

Contact usSouthern Health andSocial Care TrustHeadquartersCollege of NursingCraigavon Area Hospital68 Lurgan RoadPortadownBT63 5QQ

Telephone: (028) 3833 4444 Fax: (028) 3833 5496

www.southerntrust.hscni.net

CommentsIf you have any commentsabout this report or wouldlike extra copies,telephone: (028) 3861 3965

Different FormatsThis report can be madeavailable on request on disk,in large print, via e-mail, inBraille, on audiocassette orin minority languages foranyone not fluent in English.

Telephone:(028) 3861 3965 for details.

A declaration of Board members’ interests has been completed and is available on request from theChief Executive’s office, Trust Headquarters, College of Nursing, Craigavon Area Hospital, 68 LurganRoad, Portadown, BT63 5QQ. Telephone 028 3861 3960.

The Chief Executive has confirmed that there is no relevant audit information of which the Trust’sauditors are unaware. A full statement of internal control is available from the Chief Executive’s office.

Who’swho on the Trust Board

ChairmanMrs Anne BalmerTel: (028) 3861 [email protected]

Executive DirectorsMr Colm DonaghyChief ExecutiveTel: (028) 3861 [email protected]

Mr Martin DillonDirector of Financeand ProcurementTel: (028) 3861 [email protected]

Mr Brian DornanDirector of Childrenand Young People’sServices/ ExecutiveDirector of Social WorkTel: (028) 3839 [email protected]

Trust DirectorsMrs Mairead McAlindenDirector of Performance and ReformTel: (028) 3861 [email protected]

Mr Kieran DonaghyDirector of Human Resources andOrganisational DevelopmentTel: (028) 3861 [email protected]

Dr Gillian RankinDirector of Older People and Primary CareTel: (028) 3861 [email protected]

Mrs Joy YouartActing Director of Acute ServicesTel: (028) 3861 [email protected]

Mrs Elizabeth Mahood

Mrs Deirdre Blakely Mrs Roberta Brownlee Mr Edwin Graham

Mr Alistair Joynes Mrs Hester Kelly Dr Raymond Mullan

Non Executive Directors

Mr Francis RiceDirector of MentalHealth & Disability/Executive Director of NursingTel: (028) 3883 [email protected]

Dr Patrick LoughranMedical DirectorTel: (028) 3861 [email protected]

ANNE BALMER, CHAIRMAN, ANDCOLM DONAGHY, CHIEF EXECUTIVE

Message from...

The Southern Trust’s second year was characterised byreform and modernisation designed to improve quality ofcare for patients and clients. £1.3 million was investedevery day delivering routine services to our population andwe continued to meet challenging targets ensuring thatpatients receive timely, quality care.

We invested heavily in services and facilities, including£12m to develop the award-winning Bluestone Unit forpeople with mental health problems, and £2.5m to build anew children’s home in Newry. £3.5m was secured formaternity services and £1.5m allocated for the expansionof Daisy Hill Hospital’s renal unit, to name just a few.

While implementing these major changes, Trust staffcontinued to deliver excellent services. We are verygrateful to the many thousands of people who took thetime to thank our staff for the care and compassion theyprovide every day.

Bringing about change on this scale is never easy and theSouthern Trust, like all other Trusts in Northern Ireland,has to find significant savings by 2011 in order to fundthese new developments. This year we consulted on anumber of proposals to achieve a large proportion ofthese savings. These were important discussions as wewere committed to sharing our proposals with those whowould be most affected by them. We listened carefully toeveryone who gave us their views and we amended ourplans when strong arguments were made for better waysforward. The result is a new strategic plan for the Trustwhich sets out our direction for the next five years. Theplan entitled ‘Changing for the better’ assures you that nomatter which service you need or when you need us, wewill deliver quality care for you, with you and we lookforward to working in partnershjp with you in the deliveryof our services.

Anne Balmer Colm DonaghyChairman Chief Executive


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Directors’ Report

Location and type of facilities provided

Map of N.I. showing the SouthernHealth and Social Care Trust

The Southern Health and Social Care Trust was formed on 1 April 2007 and is responsiblefor the services which were formerly delivered by four Trusts, namely Armagh andDungannon Trust; Craigavon and Banbridge Community Trust; Craigavon Area HospitalGroup Trust and Newry and Mourne Trust.

Staff ProfileThe Trust employs approximately 12,852 staff; 71.5% of staff provide direct hands oncare to patients and clients. The sickness and absenteeism rate for the Trust is 4.94%.

The Trust provides healthand social care services tothe council areas ofArmagh, Banbridge,Craigavon, Dungannon andSouth Tyrone, and Newryand Mourne.

The Trust provides a widerange of hospital,

community and primarycare services. Main in-patient hospital servicesare located at CraigavonArea Hospital and DaisyHill Hospital. Working incollaboration with GPs andother agencies, staff deliverlocally based services inTrust premises, in people’s

own homes and in thecommunity. The Trustpurchases some servicesincluding domiciliary,residential and nursing carefrom independent andcommunity/voluntaryagencies.

Southern Health andSocial Care Trust

Reproduced fromO.S.N.I.data withpermission fromH.M.S.O. © CrownCopyright NIMAES&LA 210.4

Population figures based on 2007 mid-year estimates for Northern Ireland

POPULATION

Age Population

Under 16 79,335

16-59 204,074

60+ 59,345

Total Population 342,754

EXPENDITURE

In 2008/09 the Trust incurredexpenditure of £491 million.

ProtectingPatientInformation.The Trust takes datasecurity and confidentiality ofall patient and clientinformation extremelyseriously. The ChiefExecutive has written to allstaff reminding them of theirresponsibility to protect dataand of their duty ofconfidentiality, which isoutlined at induction stageand is also part of thecontract of employment.

During the year the Trustinvested significantly inimproving its ICT datasecurity. All of the Trust'slaptops are now encryptedand staff also now useencrypted memory sticks(data travellers) so that ifthese laptops or memorysticks are lost or stolen, thedata remains secure. TheTrust has also restricteduse of the internetand Hotmailaccounts, tofurther improvedata security on itsinformationsystems.

To ensure a highlevel of staffawareness andunderstanding of datasecurity and

confidentialityresponsibilities, the Trust hasundertaken targeted traininginitiatives and hasintroduced a trainingprogramme for all Trust staffthrough an e-learning tool(CETIS). Robust governancearrangements are in place,with an ICT Steering Groupwhich includes seniorrepresentation across allDirectorates, withresponsibility for decisionsrelating to ICT investment,risk management proposalsand change management.These informationgovernance arrangementsare available in more detailin the Trust’s Statement ofInternal Control.

A range of policies havebeen finalised and madeavailable on the Trustintranet, relating to dataprotection and security.These include DataProtection, ICT Security, Useof the Intranet and Email,

RecordsManagement andtransportation ofrecords paperand electronicrecords. The

Trust iscommitted toensuringinformationgovernanceand reducingthe risk of loss

of data and will

continue to review this andmake improvements wherenecessary.

The Trust has not had anyinformation governancebreaches which havewarranted reporting to theinformation Commissioner’sOffice for the period 1 April2008 to 31 March 2009.

COMPLAINTSDuring 2008/09 theSouthern Trust received571 complaints; 68% ofwhich were resolvedwithin 20 working days.There has been anincrease in thecomplexity of complaintsover the 2008/2009 year,with a number ofcomplaints requiring aresponse to multipleissues highlighted in asingle complaint letter.The Trust is in theprocess of implementingthe new complaintsprocedures which cameinto operation in April2009. One key change isthe removal of theindependent reviewprocess. The Trust willcontinue to work withpatients, clients andmembers of the public tolearn lessons fromcomplaints and use thisinformation to improveour services.


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Southern TrustFacts and FiguresThe Trust spends £1.3 million per day delivering services to local people. During thepast year:

• The Trust's GP Out ofHours Service received109,146 calls. 49,843 ofthese were given adviceover the phone, 52,108attended a centre and7,195 received a homevisit.

• 4,685 people in theSouthern Trust receivedomiciliary care services –home helps (practical andpersonal care), respite andday care.

• The Southern Trust is the

second largest provider of‘intensive’ domiciliary care(i.e. people receiving 10 ormore hours and 6 or morevisits per week).

• 76,245 people attendedthe Accident andEmergency Department atCraigavon Area Hospital,while 36,064 attendedDaisy Hill Hospital’s A & Edepartment.

• There were 3,880 births inCraigavon Area Hospital,while in Daisy Hill Hospital

there were 2,194 births.

• The Trust recorded 26,414attendances at its 3 MinorInjuries Units in the pastyear; 7,036 at ArmaghCommunity Hospital;2,689 at Mullinure and16,689 at South Tyronehospital.

• The Trust received 8,526child care referrals.

• Trust drivers bring 12,000clients to and from ourfacilities every day.

The Trust continues to meetits commitment as set out inthe Equality Scheme, toensure equality ofopportunity for all.

This commitment isreinforced throughout theTrust throughcommunication, training andspecific projects.

A disability action plan hasalso been developed topromote positive attitudes topeople with disabilities andencourage their participationin public life. A number ofworkstreams have beenestablished to take forwardthe actions contained withinthe Disability Action Plan,one of which is the

Employment Workstreamchaired by the SouthernTrust's Head of Equality andinvolving Trust officers, othergovernment agencies,disabled people and/or theirrepresentatives and statutoryagencies.

This group is developing andconsulting upon a DisabilityPolicy as well as a revisedguide for managers onreasonable adjustments anda revised Disability Etiquettebooklet for all staff. The Trusthas also an identifiedDisabled Persons LiaisonOfficer (DPLO) based withinthe Equality Assurance Unitwho provides advice andsupport to employees withdisabilities in terms of

facilitating reasonableadjustments etc.

The Trust also has in placean Equal Opportunity Policythat covers all elements ofequality within employment,including the Trust'sobligations under disabilitydiscrimination legislation.

Committed to Equality

Staff Communication

During 2008/09 the Trustcontinued to communicatewith staff using a range ofchannels including the staff‘e’ brief, newsletter, intranetand information posted tohomes. A staff survey wasalso completed.

Controls assurance standardsDuring 2008/09, the Trust achieved substantive compliance with 22 of the 22 controlsassurance standards.

Management CommentaryAchievement ofMinisterial PrioritiesDuring 2008/09 the Trustcontinued to furtherdevelop and improve manykey services and metmany targets. The Trust isdedicated to improvingeveryone’s health andwellbeing with betteraccess to high qualityhealth and social careservices. Some of our keyachievements are asfollows:

• At the end of March 09 nopatients were waitinglonger than 13 weeks forinpatient or daycasetreatment.

• At the end of March 09,three patients had waitedlonger than nine weeks foran outpatient appointment

and five patients hadwaited longer than nineweeks for a diagnostictest. However thesepatients were all seen andsince May the Trustachieved and sustainedthe nine-week maximumwaiting time position.

• Nine out of ten patientsattending our A&Edepartments were treatedand admitted ordischarged within fourhours.

• 99% of patients aredischarged within 48hours. (Patients ready toreturn home when hospitaltreatment is complete.)

• An additional 72 fostercarers are now in place,giving a total of 287 fostercarers in the Trust area.

• No patients are waitinglonger than 13 weeks forAllied Health Professionservices such asOccupational Therapy.

• All urgent GP referrals forBreast Cancer are seenwithin 14 days.

• No patients wait longerthan 13 weeks forCommunity Mental HealthServices.

• Every older person withcontinuing care needs hadassessments carried outwithin eight weeks.

• Ongoing re-settlement ofadults with learningdisabilities – with tenpeople re-settled fromLongstone Hospital,Armagh to communitysettings.

The Trust's EnvironmentalStrategy 2009-2011 will helpensure compliance withGovernment standards forenergy, waste andenvironmental management.The Strategy will promote aproactive approach to themanagement of theenvironment and willencourage clients, staff,visitors and contractors to dotheir part for the environment.

Alan Metcalfe, Assistant

Director of Estate Services,says, "The strategy placesemphasis on best practiceand participation in order todrive improvements inenvironmental performanceacross Trust activities. It alsooutlines how the Trust intendsto meet its legal and moralobligations in waste, water,energy and environmentalmanagement.

The Trust has a positive effecton the local community

through a number of initiativesincluding partnerships with80/20 Recycling in Newry andBusiness in the Community.

“We're committed to deliveringhealthcare in anenvironmentally friendlymanner and in thepartnerships we have withsuppliers, the Southern GroupEnvironmental HealthCommittee, local Councils andcommunity organisations."

Environmental Policy

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ACUTE SERVICES ACUTE SERVICES

HospitalStaff goBareBelowtheElbows

A new dress code for allstaff working in Trusthospitals was introducedthis year. The new policyapplies to staff who havedirect physical contact withpatients or clients and theirimmediate environment, forexample doctors, nurses,midwives, therapists andhealthcare assistants.

Medical Director Dr PatrickLoughran says the newpolicy will play a vital role inimproving patient safety andreducing healthcare

associated infections. “Thispolicy is the latest in arange of measuresdesigned to improve publicconfidence and help staff topromote a professionalimage. It will also contributeto our drive to reduceinfections.”

The dress code includesten key points to help staffin promoting a professionalimage at all times. Theseinclude all clinical staffwearing short sleeves orshirts rolled up to the

elbow; long hair being tiedback; no jewellery with theexception of a single plainband ring and low heeled,enclosed shoes.

The policy also requeststhat staff do not undertakeshopping, socialising orsimilar activities in publicwhilst wearing a SouthernTrust uniform. A postercampaign advising staff togo ‘Bare Below the Elbows’was launched alongside thepolicy to remind staff of thenew dress code.

Going bare below the elbows are MaggieMarkey, Infection Control Nurse, Daisy HillHospital; Dr Nizam Damani, ClinicalDirector of Infection Prevention andControl; and Elizabeth Rennie, InfectionControl Nurse, Craigavon Area Hospital.

Hospital car parkimprovementsWork has continued thisyear on both the Daisy Hilland Craigavon AreaHospital sites to increaseand upgrade car parking

provision as more andmore people accessservices at our acutehospitals.

In Daisy Hill, a new 87place car park has beenbuilt on land adjacent tothe main hospital site.During the last year, morethan 400 additional spaces

were created aroundCraigavon Hospital,representing an investmentin excess of £0.5m.Improvements in trafficmanagement around bothsites is a priority for theTrust, as we work toimprove access forpatients and visitors.

Work is well underway onthe latest stage of ourfracture servicedevelopment, whichopened on theCraigavon site in 2008.

A brand new wardcomplex is currentlyunder construction atthe rear of the hospital,one of the biggestsingle developments onthe site in the last tenyears. It will include two newtheatres, a ward which hasbeen designed toincorporate the latest ward

layout standards, with anemphasis on infection

control and privacy forpatients, with about half ofthe bed complement insingle rooms. There is also

additional administrativespace for the service’s

support team.

During the first year ofoperation, almost 1,500inpatients and 221daycases were treatedin the unit, these arepatients who wouldpreviously have had totravel to Belfast fortreatment, but who wehave been able to care

for locally. We expect totreat even more patientswhen our new facility is upand running.

Development of fracture services

In January, the Trustlaunched ‘Clean Hands.Safe Hands.’ – a campaignto encourage staff,patients and visitors topractice good handhygiene.

The distinctive orangebranding of ‘Clean Hands.Safe Hands’ was designedto draw people’s attentionto the important handhygiene message. Sincethe introduction of thecampaign along with arange of other measuresto improve hand hygiene,the Trust has seen theamount of hand rub usedincrease by up to 72.6%.

Lead Infection Control

Nurse, Trudy Reidsaid, “Thiscampaign is part ofour ongoingstrategy to tacklehealthcare –associatedinfection.

Everyone usinghealthcare facilitieshas a significantrole to play inreducing thespread of infection.We are asking staff,patients andvisitors to please take thetime to carry out thesimple hand-hygienesteps that we areadvising. Your help canmake a real difference.”

CLEAN HANDS.SAFE HANDS.

The Clean Hands. Safe Hands– billboard at the entrance toCraigavon Area Hospital.

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ACUTE SERVICES OLDER PEOPLE AND PRIMARY CARE SERVICES

As part of ongoinginvestment in domiciliarycare, the Trust hasintroduced uniforms forTrust domiciliary careworkers in the Armagh andDungannon region.

Alongside new uniforms,domiciliary care workershave been issued withidentification badges. Bothof these measures willmake Trust employeeseasily identifiable and willhelp protect vulnerableolder people in their ownhomes from the threat of‘bogus callers’.

The Trust is also currentlyrolling out wider changes tothe way domiciliary care isdelivered to people inSouthern Trust localities.Mr Brendan Whittle,Assistant Director of OlderPeople’s services, explains,“These changes aredesigned to improve theexperience of local peoplewho receive domiciliarycare as well as improvingthe overall efficiency of theservice. This process isalmost complete and thebenefits of the newarrangements are alreadybeing seen by our staff andthe local people whoreceive this service. TheTrust has committed toproviding more health andsocial care services topeople in their own homesin the future and domiciliarycare workers are a vitalpart of this strategy.”

New uniforms for Domiciliary care workers

Left to right:Domiciliary care workers: Helena Casey, Geraldine Symington, YvonneMcKay, Anna Archer modelling the new uniforms!

Christina says thank youNovember 2008Dear Trust Home Care Team,

I am writing to express my sincere thanks for the provision ofthe Trust Home Care Support Service. In particular, I want tothank Evelyn, who quietly but very efficiently supports mumin an unobtrusive manner. I’m sure it can be appreciatedhow it can be difficult to adjust to ‘outside agencies’ cominginto your home, particularly when there are other familymembers living in the home as well as the Service user.However this has been very minimal in our case, mainlybecause of the fashion in which Evelyn carries out her role.Also, the other replacement workers, i.e. Margaret and thosewho carry out the teatime visits, also certainly deserveparticular mention.Once again, many thanks for the help and support that hasbeen provided and the services put in place for mum. Pleaseknow that it is all deeply appreciated.

Yours truly, Christina Portadown

MaternityServicesThere were 6,074 births inthe Southern Trust in2008/2009 – 78 more thanthe previous year, makingthis Trust one of the busiestin Northern Ireland.

While maternity units atCraigavon Area Hospitaland Daisy Hill Hospitalcontinue to be very busy, wehave been at the forefront ofdeveloping new ways ofmanaging and providingmaternity services.

The Trust is the first inNorthern Ireland tointroduce a new scheme forrecruiting and trainingmidwives. With the supportof the Department ofHealth, the Trust is currentlytraining 12 nurses alreadyliving and working in thisarea to become midwives.They will finish their trainingin March, and will then beworking in areas across theTrust.

We have also been the firstTrust to introduce MaternitySupport Workers – specially

trained staff who support thework of midwives and workclosely with mums on ourwards.

Work is underway on a£3.5m upgrade of thematernity unit at CraigavonArea Hospital, and a £0.5mprogramme of improvementwork was undertaken atDaisy Hill Hospital.

This has improved thedelivery suite and maternitytheatre areas and is part ofour ongoing investment inimproving maternity services.

New home fordermatologyserviceThe Trust’s dermatologyservice has moved fromLurgan Hospital to a new,purpose designed facility onthe Craigavon site.

Our dermatology serviceprovides outreach servicesacross the Southern Trust,with clinics in South Tyroneand Banbridge Polyclinic forover 23,000 patients eachyear.

The new unit in Craigavonhas five single rooms, adedicated theatre and a newoutpatient facility.

A brand new theatre wasplanned, designed and builtat Craigavon Area Hospitalduring the last year.

The theatre features anumber of ‘firsts’ for theatredesign and construction inthe UK, offering our patientsthe very best environmentfor their surgery.

Health Minister, MrMcGimpsey, said: “This is anexcellent new facility, one

which will bring significantbenefits to patients and staff.The innovative design andfinish of the theatre make itone of the most modern inthe UK and it is a greatexample of the investment inhealth service modernisationin Northern Ireland.”

The new developmentincludes the theatre, a scrubarea, preparation room,anaesthetic room along withutility and storage space.

New theatre one of themost modern in the UK

Trust Chief Executive Colm Donaghy with theatre staff.

Health Minister Michael McGimpseyis welcomed by Loraine Adair, Dr Art

O’Hagan and Jeanette Collins.

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COPD Team wins awardsfor excellence During the year a specialistteam from the Trustreceived a prestigiousaward at the NorthernIreland Healthcare AwardsCeremony. The ChronicObstructive PulmonaryDisease (COPD) servicewas announced as jointwinner of the RespiratoryCOPD Project of the yearawards. The team alsoscooped third place at theInstitute of HealthcareManagement QualityAwards.

COPD is the term used forpatients who previouslywould have been diagnosedwith emphysema orbronchitis. The team work inpartnership with GPpractices, pharmacy, socialservices, occupationaltherapy, community nursingteams, intermediate care,home care support and

voluntary organisations toensure delivery of a high-quality, cost-effectiveservice. Earlier identificationand more appropriatemanagement of patientswith COPD are at the coreof our proactive approach.A high level of alertness forCOPD amongst particularpatient groups is leading tomany patients beingdiagnosed earlier.

The COPD service has ledto a decrease in the numberof patients with COPDneeding to be admitted tohospital and has facilitatedother patients to bedischarged earlier fromhospital. It has enabledpatients to be cared for intheir own home and hasempowered patients tomanage their own condition.The team is also triallingleading-edge technology

with a monitoring systemplaced in the patient’s hometo record daily observations,including blood pressure,heart rate, pulse oximetryand temperature. Thecommunity team accessesthis information daily andmonitors for early signs ofdeterioration, allowing forprompt intervention andpreventing the need forunnecessary hospitaladmission.

The Northern Ireland Dementia Forum held its 8th Annual Conference with the theme“There’s no Place like Home”. The Conference was hosted by the Southern Trust andchaired by Dr Gillian Rankin, Director of Older People and Primary Care. Expert speakersincluded Dr Briscoe from the DHSSPS, who talked about the Northern Ireland RegionalDementia Strategy.

In keeping with the theme, there were presentations on issues such as housing optionsfor people with dementia, Assistive Technology and Reminding Systems designed tosupport and maintain people in their own homes for as long as possible.The Women’s Health Initiative performed a humorous yet poignant drama demonstratingthat remaining at home can be a real option for people with dementia, given the rightpartnership between family and community services.

Delores McFadden, (BoehringerIngelheim), Elaine Mulligan andRoyanne Dickson, Southern Health Trust

OLDER PEOPLEATTENDWELLBEINGWORKSHOPSOlder People and Primary Care Servicesorganised a series of wellbeing workshopsacross the Trust region.

The workshops were organised by The OlderPeople’s Mental Health Forum, which plansand develops programmes and activitiesaimed at improving coping capabilities amongolder people. Other wellbeing workshops tookplace in Armagh/Dungannon andCraigavon/Banbridge areas in March 2009.Older people’s wellbeing workshop in Newry.

OLDER PEOPLE AND PRIMARY CARE SERVICES OLDER PEOPLE AND PRIMARY CARE SERVICES

There’s noPlace likeHome...

Back row (left to right): Danny McQuillan, Area Manager, Alzheimer’s Society; Dr David Craig, Consultant Geriatrician;Barbara Taylor, Telecare Consultant; Brendan Whittle, Assistant Director of Older People’s Services. Front Row (left toright): Siobhan Donaghy, Memory Service Team Leader; Dr Gillian Rankin, Director of Older People and Primary Care,Cathy Mawhinney, Head of Dementia Services.

John Fogarty was recentlypresented with the Nabarromedal from Diabetes UK forbeing on insulin therapy for50 years. John, who lives inPortadown, was delightedwith the honour but wasquick to offer thanks to allthe NHS staff who havecared for him and helped inhis diabetes treatment since1957. As part of hiscondition, John has lost hissight three times, but eachtime it came back followingtreatment. He still regularlyattends the eye clinic atCraigavon Area Hospital. Healso attends the diabetesout-patients clinic inCraigavon Hospital and hasregular appointments withdieticians, podiatrists,specialist diabetic nurses

and other healthprofessionals who are alldedicated to managing hiscondition effectively.John said that diabeticmanagement has improveddramatically since 1957when treatment was “basicbut caring”. John added, “Inthose days you had to boilneedles and insulin came inglass syringes. Nowthey are easy toadminister and I havegiven myself myinsulin shots inaeroplanes,shoppingcentreswithout anyfuss ortrouble.” Hefinished bysaying

“Thankfully the condition isnow easier to control and thecare is much moreadvanced.”

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Stroke Strategy Workshop

Portadown man gets medal from Diabetes UK

In November 2008, theTrust facilitated a workshopon the implementation ofthe Northern Ireland StrokeStrategy. Half of those whoattended had had a strokeor were carers of someonewho had had a stroke. Theservice users and carerswere facilitated to attend byNorthern Ireland ChestHeart and Stroke andSpeechmatters. There wasrepresentation frompractitioners working inhospital and communityservices. The workshopopened with a presentationon how the Trust is takingforward the implementationof the Stroke Strategy.

Those attending took partin a workshop designed togather information onusers’ and carers’experiences of strokeservices and areas forfurther development inrelation to prevention, acutecare, rehabilitation,information on emotional

and psychological supportand longer-term care.

Responses were collatedand fed back to all thosewho had attended. Thisinformation is helping toinform the implementationof the Stroke Strategy inthe Trust.

‘Teamwork’ at the Stroke StrategyWorkshop in the Armagh City Hotel

Mr Fogarty pictured with some of themedical staff at Craigavon AreaHospital: (back row) Dr Ritchie, LindaIrwin, Caroline Bamford (front row)Denise Russell and Dr McConnell

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OLDER PEOPLE AND PRIMARY CARE SERVICES MENTAL HEALTH AND DISABILITY SERVICES

Change inMind

A Change in Mind projectwas set up to modernisemental health services inthe Trust area and theintroduction of four clearlevels of support. Serviceswill support theimprovement of access,intervention, treatment andcare to patients and serviceusers, whether they are ina community or hospitalsetting. It will provide afocus on early interventionand signposting patientsand service users to themost appropriate care andservices provided by theTrust or by other partnersin the independent sector.A new booking and referralcentre became operationalon 1 March.

BLUESTONE UNIT OPENS

The first in-patients were treated at theBluestone Unit in May and Health MinisterMichael McGimpsey officially opened the£12 million state-of-the-art facility inDecember.

Speaking at the event, the Minister saidthat the Bluestone Unit is a model ofexcellence providing high-quality treatmentand care to people with mental healthproblems, “I am particularly pleased that

service users have been involved in thedevelopment of this impressive buildingright from the outset. Their involvement inthe planning, delivery, monitoring andevaluation of services is a keyrecommendation from the BamfordReview.” The unit won Best Design for aMental Health Building at the prestigiousBuilding Better Healthcare Awards duringthe year.

Bluestoneat night

SELF-HELP BOOKSCHEME LAUNCHEDIt is estimated that at anytime one out of six adultshas a psychological problemand that in 90% of casestreatment is provided solelyin the primary care setting. Ascheme prescribing self-helpbooks for individualsexperiencing mental healthproblems was extended toGP practices and libraries inFivemiletown, Newry,Craigavon and Crossmaglenin December.

The scheme was developedin partnership with theSouthern Health Board andthe Southern Education andLibrary Board’s LibraryService. The libraries stockbooks and leaflets onaddiction, anger

management, bereavement,depression, eating disorders,relationship and stressmanagement and manyother topics. You can alsoaccess the booklets on theTrust’s website atwww.southerntrust.hscni.net

Dr Hunter; John Conlon, BrownlowLibrary; Lynda Stewart, BrownlowLibrary; (standing) Daphne Harra,SHSSB; Lorraine Hughes, PracticeManager and Angela Corr,Southern Trust

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MENTAL HEALTH AND DISABILITY SERVICES MENTAL HEALTH AND DISABILITY SERVICES

New respite unit opensWoodlawn House inDungannon, a £1 millionpurpose-built respite unit foradults with a learningdisability, becameoperational in December andwas officially opened by theHealth Minister MichaelMcGimpsey in March.

The Minister said,“Woodlawn House providesa flexible approach to respiteand is therefore ideal forfamilies and carers of adultswith a learning disability.Reforming learning disabilityservices is a top priority forme. I am committed tomaking a difference to thelives of people with alearning disability by

modernising the servicesthey receive and helpingthem to live independently inthe community.”

Coalisland mum Mary Duffin,who gets respite when herdaughter stays at Woodlawn

House, says, “I’m delightedthat the new respite unit isup and running. Like otherparents, I know that thisfacility will bring much-needed support and help forthe carers of adults withlearning disabilities.”

Offical opening of Woodlawn House

NATIONAL AWARD FORLEARNING DISABILITY PROJECT

Front row: Julie Nelson; Wendy McGregor, Community Learning Disability Sister;and Shaun McCarron; back row: Rosemary Murray, 6th Sense; Ann Nelson;Dawn Connolly, Senior Nurse, Practice Development and Geraldine McCarron

A project aimed atimproving the quality ofcare for patients with alearning disability using theservices at Daisy Hill andCraigavon Area Hospitalswon the National Networkfor Learning DisabilityNurses Award.

Service users, Trust staff,an education consultantand voluntary sectorrepresentatives focused onthe training and educationof hospital staff, equipment,communication and staffrecruitment.

Local mum GeraldineMcCarron and her sonShaun were part of theproject group. MrsMcCarron said, “It has

been very important forcarers to be involved in theproject as we have workedwith staff and helped raiseawareness of the needs ofpeople with severedisabilities.

“In the past, attending A&Ecould be very traumatic butthat anxiety has abated asstaff have been trained andequipment and policies areput in place in help withadmissions.”

Peter moves into hisnew home

SupportedLivingmanagerValerie Ritchiewith Peter andhis mum Clare

considerable personalattention from the kind andunderstanding staff. He hashis own bedroom withensuite shower room andwhen he lived in LongstonePeter lived in a ward with 13residents but shared abedroom with three othermen.”

Mrs Patton adds that sheowes the Longstone staff ahuge debt of gratitude. “Ican’t thank them enough forthe care and attention thatthey gave to Peter while helived at Longstone. But I’mdelighted that Peter got theopportunity to move at thistime and thrilled that he hassettled in so well.”

Peter enjoys outings, helpingwith the laundry and doingjigsaws. His behaviour andgeneral health haveimproved since moving to hisnew home.

“Peter enjoys an outingevery day whether it’s a visitto Warrenpoint or GosfordForest Park, shopping, afootball match or out for ameal. He loves to watchpeople and has even usedpublic transport to go intoNewry. Having theopportunity to do everydayactivities like these is justthrilling to see.”

Currently 57 residents live inLongstone Hospital and theTrust is continuing with plansto resettle the remainingresidents. Assessment andtreatment services continuein a separate unit.

This year the Trust resettledten long-stay residents with alearning disability fromLongstone Hospital into newhomes in Bessbrook, Newryand Richhill through theSupported Living scheme.

Peter Robb moved to hisnew home in January afterhaving lived at Longstone

Hospital for 17 of the last 19years. Peter’s mum Claresays, “I really think Peter hassettled in wonderfully well.He is active, performing welland coping with everythingand it is clear he is happy.

Peter lives in a house withthree others and it is quiet,spacious and he has

ON THEROADThe Transport Department’srole is vital to the success ofthe Trust. Drivers ensure thataround 12000 clients travel toand from our facilities safelyevery week. They work withbus escorts to care for clientswith diverse andcomplex needs,includingwheelchair usersand those withchallengingbehaviour.

Drivers are also involved intransporting freight for otherdepartments includinglaboratory, pharmacy, laundry,clinical waste, stores andcatering. During the year, 17drivers in the Armagh andDungannon areas attainedNVQ 2 accreditation in RoadPassenger Transport andcarrying and delivering goods.

NVQ Level IIrecipients

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Work underway at £3.7millioncentre in Newry Construction work on the new SocialEducation Centre in Newry began inJanuary 2009. The new £3.7million daycentre on Rathfriland Road replaces theexisting Social Education Centre. The newbuilding will provide modern state-of-the-artfacilities for up to 40 adults with learningdisabilities and will mean a significantimprovement in the standard ofaccommodation.

This day-care and resource centre willprovide daytime opportunities for adultswith a learning disability and those whohave complex care needs and challengingbehaviours.

The aim of the centre is to help promoteindependence and social inclusion for allthose using it.

SALSA IN COALISLAND!A six-week dance course was organisedfor ten participants at Coalisland’s CraicTheatre under the direction of facilitatorCaroline Creggan from BardicEducation Arts and Media inDonaghmore. Patricia McDonnell wasone of those who took park in thecourse and she summed it up by saying"I loved the dancing, especially theSalsa. Coming to the classes was greatfun and the music was brilliant. Ourtutor, Caroline, was very kind andpatient and showed us lots of newmoves in each 90-minute class."

MENTAL HEALTH AND DISABILITY SERVICES MENTAL HEALTH AND DISABILITY SERVICES

NURSE OF THE YEAR AWARDSFour Southern Trust nurses won awardsat the Royal College of Nursing NorthernIreland Nurse of the Year Awards in June.Community Children’s Nurse Marie Allenwon the Patient’s Choice Award. Mariewas nominated by the mother of a boywho was diagnosed with a brain tumourwhen he was eight. For two and a halfyears Marie co-ordinated his care, givingsupport to the whole family, which theysay far surpassed the paid hours of anyjob. Haemovigilance Practitioner Patricia

Watt won the Chief Nursing Officer’sAward for Patient Safety. Patricia ensuressafe practice in all processes associatedwith the administration of blood. TrudyReid, Lead Infection Control Nurse, andChristine Armstrong, PracticeDevelopment Facilitator, were commendedin the main Nurse of the Year Award.They were nominated for their work intackling healthcare associated infectionsand enhancing patient safety and qualityof care.

Participants at the dance course

The Trust’s governance teamis responsible for promotingsafe and effective care,enhancing the quality ofservices and training andworkforce development fornurses, midwives, social workstaff and Allied HealthProfessionals (AHPs). Theteam has led a range ofprojects across theorganization this yearincluding:

•25 senior nurses andmidwives completed trainingto enhance patientexperience.

•Nursing and midwifery staffcontributed to thedevelopment of the Trust’sNursing and MidwiferyStrategy.

•Published a supervisionpolicy for nurses and

midwives and deliveredtraining to help itsimplementation.

• Implemented the Nursingand Midwifery CouncilStandards to further supportlearning and assessment.

•250 AHP studentscompleted placements incommunity and hospitalsettings.

•Piloted leadership skillstraining in supervision whichwill help to improve thequality of services.

•Develop guidelines for jointworking between AHPs andindependent and privatepractitioners to ensure highquality safe practices are inplace for children and adultswith disabilities.

•394 of the Trust’s 526qualified social work staffhave achieved a post-qualifying award in socialwork.

•Three Principal Social WorkPractitioners have beenappointed to help improveoutcomes for children whoreceive personal socialservices.

•706 staff have been trainedin the new regionalassessment process forsafeguarding children.

•10 trainee social workerswere recruited and 14trainees graduated andcame back to work in keyareas of social services.

•100 domiciliary care staffachieved NVQ Level 2 insocial care.

Mary McIntosh, Assistant Director of Social Work and Social CareGovernance; Carmel Harney, Assistant Director for Allied HealthProfessions’ Governance, Workforce Development and Training; IanMontgomery, Assistant Director of Social Services, WorkforceDevelopment and Training; Fiona Wright, Assistant Director ofNursing and Midwifery Governance; and Glynis Henry, AssistantDirector for Nursing Workforce Development and Training.

Opportunitiesfor allwebsiteA website –www.opportunitiesforall.org– aimed at people withphysical and sensorydisabilities and which is thefirst of its kind in NorthernIreland was developedduring the year. AndrewMartin from the Birches

area of Portadown, says,“The site provides awonderful opportunity to findout about college courses,community groups, activitiesorganised by voluntarygroups and servicesprovided by the SouthernTrust. There’s informationabout sports and leisureactivities, urban andcommunity transport, andlocal computer accessibilityand courses.”

Attendees at Manor Centre in Lurgan,staff and Kevin Doherty, Director ofServices, Disability Action; and ColmDonaghy, Chief Executive, SHSCT atthe website launch

GOOD GOVERNANCE

2019

SINGLESERVICETELEPHONENUMBER 0800 783 7745 TO CHILDREN’SSOCIAL WORKGATEWAYSERVICE

The Trust received 8,526childcare referrals during theyear. A freephone number forall new referrals to theChildren’s Social WorkGateway Service has beenset up. The new telephonenumber will provide a centralpoint of contact for anymember of the public whowishes to make contact witha concern about a child or ayoung person. The newtelephone number is 0800783 7745 and will be openfor calls Monday to Fridayfrom 9am to 5pm exceptBank or Public Holidays.

Left to Right: Paul Morgan, AssistantDirector of Family Support &Safeguarding; Hazel Quinn, TeamLeader Gateway Services for Newry& Mourne locality; Brian Dornan,Director of Children & YoungPeople’s Services; Claire Howard,Team Leader Gateway Services forCraigavon & Banbridge locality; andStephen Sherry, Team LeaderGateway Services for Armagh &Dungannon locality.

It is very important that theTrust is able to identify andassess the needs of allvulnerable children at anearly stage in order toprovide appropriateservices and assistance toprevent situations reachinga crisis point. The Trust hasfully implemented the newregional assessmentprocess.

Following a singleassessment, all necessaryservices can be provided asquickly as possible,resulting in earlier and moreeffective intervention.

This new assessmentprocess has helped improvethe sharing of informationwith the family and allprofessionals involved withthe child.

SAFEGUARDING CHILDREN

CHILDREN AND YOUNG PEOPLE’S SERVICES CHILDREN AND YOUNG PEOPLE’S SERVICES

A group of young adultsused their combinedknowledge and experiencesfrom being in care to puttogether a DVD. The DVDhighlights what it feels liketo be on the receiving endof social work intervention.

It addresses areas such asconflict, communication,stigma, powerlessness andsupport services available.The DVD andaccompanying workbookwill be used in the trainingof both student social

workers and current socialwork and social care staffto reflect on practice,examine values, attitudesand the impact they asprofessional staff havewhen working with youngpeople.

Care in the System DVD

The rewards of Fostering

Frank and Susan Gervin, foster carers from Coalisland

Fostering provides childrenwho cannot live with theirown families withalternative care where theycan benefit from a loving,safe and stable home foras long as they need it. Inthe Southern Trust 361children and young peopleare in care. 276 of theseare placed in foster careand are cared for by 287foster carers.

Frank and Susan Gervinfrom Coalisland have beenfoster carers for 32 years.Over that time they havecared for over 100 childrenand there’s no sign of themgiving up.

Frank and Susan have 10children, four of whom areadopted, so they live verybusy lives.

The Gervins are clearlycommitted to supportingyoung people. Susanbelieves that fostering is

highly rewarding. She says,“You get so much back. It isso satisfying to be part ofthat child’s life and to makea difference.” Frank alsorelishes the role “I feel thatwe should put a bit backinto the society we live in.”

There is a constant needfor more foster carersthroughout the SouthernTrust area and we needmore people like Frank andSusan to come forward tooffer a child a loving family.

To find out more,contact your local Family PlacementTeam:Armagh andDungannon Tel: 028 8775 2033

Craigavon andBanbridge Tel: 028 3833 7181

Newry and MourneTel: 028 3083 2692/3

STOP PRESS – Congratulations to Southern Trust coupleMary and John McGrane from Keady whowere announced as Foster Carers of theyear by the Fostering Network.

The death of reality TV starJade Goody at a young agehighlighted the issue ofcervical cancer. Cervicalcancer is the second mostcommon cancer of youngwomen. It is caused by avirus called the humanpapillomavirus or HPV.Around 1000 women diefrom cervical cancer in theUK each year. In NorthernIreland every year,approximately 80 new casesof cervical cancer arediagnosed resulting inbetween 30 and 40 deathsper year.

The programme toimmunise girls against HPV,which was launched inSeptember 2008, is groundbreaking as this is the firstcancer preventing vaccine.The programme has been amassive success in theSouthern Trust area, withthe school nursing serviceadministering approximately6500 vaccines to 2119 girls

in Year 9. The uptake rate of89.55% would not havebeen achieved without theco-operation of parents,schools and the youngpeople themselves.

It is reassuring that the HPVvaccine has already beengiven to hundreds ofthousands of womenworldwide and has beenfound to be safe andeffective. The current HPVvaccine does not protectagainst all types of HPVinfection, so it is vital that inthe future those who havebeen vaccinated go forroutine cervical screening.

Emma receives her HPV vaccine

NEW CANCERVACCINE

2221

Minister Cuts Sod for newChildren’s Home in NewryIn February, Minister forHealth, MichaelMcGimpsey cut the first sodof the new Children’sHome at Rathfriland Road,Newry. This £2.5mpurpose-built facility willprovide residential care andintensive support for eightyoung people with learningdisabilities/challengingbehaviour aged betweentwelve and eighteen years.”The home will be situatedin its own private groundsand will be fully landscapedto include a sensory

garden. Each of the youngpeople will have their ownensuite bedroom includingall necessary adaptationsto meet their individualneeds .They will share alounge, kitchen and diningarea. There will also be anart therapy room, a softplay area and a sensoryroom. The home will alsoinclude a therapy room forOccupational Therapy,Speech and LanguageTherapy and Physiotherapy.

EXPANSIONOF AUTISMSERVICESFollowing the Minister’sannouncement in Januaryof £2 million investment,the Trust will be extendingits dedicated AutisticSpectrum Disorder (ASD)service to include olderchildren and adults.

This service will build uponexisting diagnostic andfamily support serviceswhile increasing staff andcommunity and voluntaryresources.

During the year, the Trustestablished a local ASDforum made up of serviceusers, parents and a rangeof health and social carestaff. In addition a numberof parents, carers and staffbenefited from a trainingprogramme run by theTrust in Partnership withAutism NI.

Over 100 young people incare participated in aspecial celebration eventto mark theirachievements.

This included youngpeople who have beensuccessful in the transfertest to secondary schools,young people receiving

their ‘A’ levels anddegrees, and manysporting achievements,including one youngperson being asked torepresent Ulster in theunder 16s for badminton.

Colm Donaghy, ChiefExecutive of the Trust,congratulated all the

young people and said, “Itis a privilege to share inthis important occasionwhich highlights the valuethe Trust places oneducation for youngpeople in residential andfoster care.“

CELEBRATING THE ACHIEVEMENTSOF YOUNG PEOPLE IN CARE

CHILDREN AND YOUNG PEOPLE’S SERVICES CHILDREN AND YOUNG PEOPLE’S SERVICES

Minister cuts first sod

Best care for babies

Baby Poppy Reid with mum WendyPhotograph courtesy of Portadown Times

All expectant parents hopethat their babies will behealthy. Being bornprematurely, having a difficultdelivery or antenatal orpostnatal concerns, mayrequire a baby to beadmitted to a unit that willprovide specialised care andtreatment. An increase in thebirth rate over the lastnumber of years hasresulted in more babiesneeding neonatal care. In theSouthern Trust there are twounits providing 21 neonatalcots. A specialist team

provides high-quality care toensure all babies receive thecare they need.

At times of high demand forcots and for certain medicalconditions, a baby may haveto be transferred to anotherunit. Local mother DeniseMorrison has experiencedthis service at first hand.Baby Mia was bornprematurely and at the timethere was no cot available,so both mum and baby hadto be transferredto Altnagelvin

until a cot became availablewithin the Southern Trust.

Mia is now thriving andDenise says, “Being far awayfrom home particularly in theearly days was hard but allstaff provided Mia withexcellent care and were ofgreat support to my husbandand me. We reallyappreciate everything theydid for us.”

Wendy Reid fromJordanstown was transferred

from the MaterHospital toCraigavon AreaHospital aftershe went intolabour early anddaughter Poppywas born at 27weeks weighing2lb 6oz. Wendysaid, “It was a veryworrying time andwith the help of the

staff, who were veryapproachable andinformative, we soonbecame familiar with theequipment and procedures.We were very impressed athow specialised the medicalcare is for such tiny babiesand how dedicated the staffin the unit are.

Poppy finally came home on27 March nearly 10 weeksafter her birth. She is nowthriving and we are verygrateful to all the staff inCraigavon neonatal unit.”

PARENTS HAVETHEIR SAY ATDAISY HILLHOSPITALChildren, young peopleand those who care forthem help us shape anddeliver our services. Duringthe year, a Parents’ Focusgroup was established,made up of parents,medical and nursing stafffrom Daisy Hill Hospitalchildren’s ward andrepresentatives from thesenior management team.

The Parents’ Focus Groupprovides a forum forparents and carers toshare their experiences ofchildren's services at DaisyHill Hospital, and for Truststaff to take forward theissues identified.

The Group meets fourtimes a year and wouldwelcome anyone whowould like to contributeeither by attending orpassing on their views. Forfurther information contactthe Children's Ward on 0283083 5058.

Mia Morrison

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ImprovingPatient SafetySince 2007 the Trust hasbeen involved with theregional Patient Safetyforum. Internationalevidence-basedinterventions have beenused as part of the Trust’sPatient/Client Safety

Programme. The Trustimplemented sixinterventions in 2008/2009:

• improving central linemanagement

• improving care for acutemyocardial infarction

• improving care forventilator-associatedpneumonia

•prevention of surgical site

infections for caesareansections and orthopaedicprocedures

• improving medicinesmanagement

• improving mental healthadmissions and dischargearrangements.

The Trust is committed toimproving patient safetyacross all its service areas.

MEDICAL LEADERSHIP Southern Health and Social Care Trust

DIRECTORS’ REMUNERATIONFees and allowances paid to the Chairman and other Non-Executive Directors areas prescribed by the Department of Health, Social Services and Public Safety.

The remuneration and other terms and conditions ofExecutive Directors are determined byrecommendation from the Remuneration and Termsof Service Committee. Its membership includes theChair and all Non-Executive Directors. The terms ofreference of the Committee are based on CircularHSS (PDD) 8/94 Section B.

For the purposes of this report the pay policy refersto Senior Executives, defined as Chief Executive,Executive Director and Functional Director and isbased on the guidance issued by the Department ofHealth, Social Services and Public Safety on jobevaluation, grades, rate for the job, payprogression, pay ranges and contracts.

Pay progression is determined by an annualassessment of performance. It is the responsibilityof the Remuneration and Terms of ServiceCommittee to monitor and evaluate theperformance of the Chief Executive ensuring thatany discretionary awards in terms of performancerelated pay are justifiable in light of the Trust’soverall performance against the annual TrustDelivery Plan. During 2008/09, there was particularemphasis on patient safety, ministerial targets andfinancial balance. The Chief Executive in turn isresponsible for the assessment of performance ofthe Senior Executives based on the attainment ofindividual objectives established at the outset of theyear, and for the submission of recommendations tothe Remuneration and Terms of Service Committeefor its annual review of salaries which areconducted in accordance with the relevant circularsissued by the Department of Health, SocialServices and Public Safety.

Each year an inflationary uplift is applied to therelevant salary points and performance related payis also applied to those individuals whoseperformance is rated as being fully acceptable orbetter. No award is made for unsatisfactoryperformance. The annual uplift rates and levels ofperformance pay permitted to be applied by theRemuneration and Terms of Service Committee areprescribed by Department of Health, SocialServices and Public Safety.

During 2008/09, all contracts were permanent andprovide for three months’ notice for both parties,with the exception of one Senior Executive, whowas appointed on secondment to cover a vacancy.

As far as all Senior Executives are concerned, theprovisions for compensation for early termination ofcontract are in accordance with the appropriateDepartmental guidance.

Referral andBooking CentreFor the past 2 years, the Southern Trusthas been working to centralise referralsand booking management for AcuteOutpatients.

Before the Trust formed, every legacyTrust had a range of processes andsystems for booking outpatientappointments.

In total, there were 37 routes across theTrust for GPs to make referrals for Acuteoutpatient appointments. This resulted indelayed receipt of referrals to the Trust byan average of ten days, which needed tobe addressed to minimise outpatientwaiting times.

The preferred option was to create acentralised Referral and Booking centrefor the Trust that would be open withextended hours so that patients phoningto make their appointments could do thisoutside the normal working hours of 9amto 5pm, Monday to Friday.

In March 2009, the Trust opened itsReferral and Booking Centre for acuteoutpatient referrals and appointments.Extended opening hours have also beenphased in and it is anticipated that byautumn 2009 the centre will open from8am until 8pm Monday to Friday and 9amto 1pm on Saturday.

This improved patient access to bookappointments across the entire SouthernTrust. It has also reduced the length oftime that it takes for GPs to make areferral, therefore helping to reducewaiting times for patients.

ICT REFORM AND MODERNISATION

In January this year, the Trust introduced a new way of organising patient care at night inCraigavon Area Hospital. The project is called ‘Hospital at Night’ and looks at how clinicalstaff are best managed to ensure the hospital runs as efficiently as possible. Hospital atNight means a better management system to support staff working in a busy acutehospital outside normal working hours, providing more responsive care for patients.Hospital at Night already runs successfully in Daisy Hill Hospital and is being introducedin hospitals across the United Kingdom.

HOSPITAL AT NIGHT


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REMUNERATION REPORTSenior Employees’ Remuneration (Audited)

2008-09 2007-08Salary, including Benefits in Kind Salary, including Benefits in KindPerformance Pay (Rounded to the Performance Pay (Rounded to the

£’000 nearest £100) £’000 nearest £100)

Non-Executive MembersMrs A Balmer 25-30 0 25-30 0Mrs D Blakely 5-10 0 5-10 0Mrs R Brownlee 5-10 0 5-10 0Mr E Graham 5-10 0 5-10 0Mr A Joynes 5-10 0 5-10 0Mrs H Kelly 5-10 0 5-10 0Mrs E Mahood 5-10 0 5-10 0Dr R Mullan 5-10 0 5-10 0

Executive MembersMr C Donaghy – 115-120 1,600 105-110 1,400Chief ExecutiveMr B Dornan – 90-95 0 85-90 0Director Children & Young People’s ServicesMr F Rice – 90-95 0 75-80 0Director Mental Health & DisabilityMr M Dillon – 80-85 1,600 75-80 300Director Finance &ProcurementDr P Loughran – 185-190 0 170-175 0Medical Director

Other MembersMrs M McAlinden – 80-85 0 75-80 0Director Performance & ReformMr J McCall – 15-20 300 95-100 1,600Director Acute Services (105-110 full year equiv)(until 21 May 2008)Mrs J Youart – 90-95 0 N/a N/aActing Director Acute ServicesDr G Rankin – 85-90 0 75-80 0Director Older People& Primary CareMr K Donaghy – 75-80 0 65-70 0Director Human Resources & Organisational Development

Senior Employees’ Remuneration (Audited) (Cont’d)

2008-09Real increase Total accruedin pension and pension at age Real

related lump sum 60 and related CETV CETV increase at age of 60 lump sum 31/03/08 at 31/03/09* in CETV

£’000 £’000 £’000 £’000 £’000

Executive MembersMr C Donaghy – 0-2.5 plus 5.0-7.5 40-45 plus 125-130 571 834 263Chief Executive lump sum lump sumMr B Dornan – 0-2.5 plus 5.0-7.5 40-45 plus 125-130 700 1,009 309Director Children & Young lump sum lump sumPeople’s ServicesMr F Rice – 0-2.5 plus 2.5-5.0 7.5-10.0 plus 20-25 81 121 40Director Mental Health lump sum lump sum& DisabilityMr M Dillon – 0-2.5 plus 2.5-5.0 20-25 plus 70-75 339 465 126Director Finance & lump sum lump sumProcurementDr P Loughran – 0-2.5 plus 2.5-5.0 60-65 plus 185-190 1,032 1,405 373Medical Director lump sum lump sum

Other MembersMrs M McAlinden – 0-2.5 plus 2.5-5.0 20-25 plus 80-85 327 433 106Director Performance & Reform lump sum lump sum

Mr J McCall – 0-2.5 plus 0-2.5 40-45 plus 120-125 656 705 49Director Acute Services lump sum lump sum(until 21 May 2008)Mrs J Youart – 0-2.5 plus 0-2.5 25-30 plus 75-80 334 459 125Acting Director Acute Services lump sum lump sumDr G Rankin – 0-2.5 plus 2.5-5.0 30-35 plus 90-95 503 685 182Director Older People lump sum lump sum& Primary CareMr K Donaghy – 0-2.5 plus 2.5-5.0 25-30 plus 90-95 443 600 157Director Human Resources & lump sum lump sumOrganisational Development

As Non-Executive members do not receive pensionableremuneration, there will be no entries in respect ofpensions for Non-Executive members.

A Cash Equivalent Transfer Value (CETV) is theactuarially assessed capital value of the pensionscheme benefits accrued by a member at a particularpoint in time. The benefits valued are the member'saccrued benefits and any contingent spouse's pensionpayable from the scheme. A CETV is a payment madeby a pension scheme, or arrangement to securepension benefits in another pension scheme orarrangement when the member leaves a scheme andchooses to transfer the benefits accrued in their formerscheme. The pension figures shown relate to thebenefits that the individual has accrued as aconsequence of their total membership of the pensionscheme, not just their service in a senior capacity towhich the disclosure applies. The CETV figures and theother pension details, include the value of any pensionbenefits in another scheme or arrangement which theindividual has transferred to the HPSS pension scheme.They also include any additional pension benefit

accrued to the member as a result of their purchasingadditional years of pension service in the scheme attheir own cost.

CETVs are calculated within the guidelines prescribedby the institute and Faculty of Actuaries.

Real Increase in CETV - This reflects the increase inCETV effectively funded by the employer. It takesaccount of the increase in accrued pension due toinflation, contributions paid by the employee (Includingthe value of any benefits transferred from anotherpension scheme or arrangement) and uses commonmarket valuation factors for the start and end of theperiod.

* The figures may be different from the closing figure in last year’s accounts.This is due to the CETV factors being updated to comply with theOccupational Pension Schemes (Transfer Values) (Amendment) Regulations2009.


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FINANCIAL COMMENTARYThe year under review

The Trust has a target to break even (balance itsbooks) each year. Against this target, the Trust hasrecorded a surplus of £670k. The Trust’sperformance against this target is measuredbefore the impact of provisions are taken intoaccount. One of the provisions £443k relates tooutpatients costs to be incurred in 2009/10. If theimpact of this provision on break-even is ignored,then the surplus falls to £227k.

The recording of a surplus in what was a verychallenging year for financial management was nomean achievement and the credit for this belongsto Directors, Managers and Budget Holdersthroughout the Trust. The achievement is all thegreater when it is taken into account that the Trustcarried forward unfunded pressures into 2008/09and was required to deliver year 1 of the 3-yearComprehensive Savings Target, (CSR), whichtotalled £9.7m.

The Trust entered its second year of operation(2008/09) with not insignificant underlying fundingdifficulties and the requirement to deliver majorcash releasing savings, but through the applicationof good budgetary control, a range of costcontainment measures, the use of in-yearreserves and the receipt of non-recurring income,the Trust secured a good outturn. Expendituretotalled £491 million (equivalent is to £1,433 forevery member of the Trust’s population).

Some highlights are shown below:• Fixed assets additions of some £25m, including

£5m on Portadown Health & Care Centre,£2.8m on Trauma & Orthopaedics and £1.9m onTheatre 5 at Craigavon Hospital

• Purchase of care from non HPSS bodies andgrants to voluntary organisations of some £91mup from £79m in 2007/08. New servicesincluded the Regional Suicide helpline £3m

• Purchase of clinical supplies and services£30m.

Looking Forward2009/10 will see the Trust entering into the secondyear of the CSR period, when the Trust is requiredto generate some £22m of savings recurrently,which will be reinvested in new services across allprogrammes of care, e.g. improving mental health,learning disability and children’s services. This isbecause we have entered into a period when theGovernment is constraining the growth in publicspending and asking public sector bodies to fundreform and service development using moneyfreed up through measures to increase efficiencyand productivity. The recurring cost savingsrequired by 2010/2011 grow to some £36m or 9%of the Trust’s total income. Generating thesesavings (which must be delivered as the money is

already being reinvested in service reform) willpresent a huge, unprecedented challenge.

The Trust has made significant progress indeveloping plans that will achieve these targetsand work continues to refine these. However,during 2009/10 as further proposals aredeveloped, refined and implemented, the Trust willbe preparing a non-recurring contingency plan toaddress slippage in any of these schemes in orderthat financial balance can be achieved. About £6million of the savings are to be delivered bysignificantly reducing management andadministrative clerical staff numbers on the backof the Trust mergers. For the Southern HSC Trust,this means that some 150–200 managerial andadmin posts will have been lost by the end of YearThree. Needless to say, generating savings of thescale required will require the Trust to achievemajor cash-releasing productivity gains throughmajor service redesign, including moving servicesfrom higher (secondary care) to lower (community)cost care settings, lowering ratios of trained tountrained staff where it is appropriate and safe todo, and reducing estates, procurement and othernon-pay costs. The next two years pose a hugefinancial and operational challenge for theSouthern HSC Trust.

Management CostsManagement Costs monitor the proportion of theTrust's income that is spent on a range ofmanagement functions using the following fourcategories:

• Trust Directors and their immediate staff• Corporate functions, such as Performance and

Reform, Human Resources and Finance• Clinical and Operational Services Managers,

including Senior Nurse and Social WorkManagers earning over £30,895

• Managers of Support Services, including thoseprovided by outside contractors.

The summary figures are shown below:

2008/09 2007/08

Management Costs 4.2% 4.0%% of Total Income

SUMMARY FINANCIALPERFORMANCE FOR 2008/09Capital Resource Limit (CRL)

The Trust kept within the CRL of £24.848m by£20k. Expenditure was incurred on a wide variety ofcapital schemes, amongst which were thePortadown Community Treatment and Care Centre,the Trauma Unit Craigavon Area Hospital and aChildren’s Home and Day Centre, Newry.

Public Sector Payment PolicyThe Department requires that Trusts pay their Non-

Health and Personal Social Services tradecreditors in accordance with the CBI PromptPayment Code and Government Accounting Rules.The Trust’s payment policy (a copy of which can beobtained from the Director of Finance) is consistentwith the CBI Prompt Payment Code andGovernment Accounting Rules, and its measure ofcompliance is as follows:

Post Balance Sheet EventsThere are no post balance sheet events having amaterial effect on the accounts.

External AuditorThe Trust's statutory audit was carried out by GrantThornton on behalf of the Northern Ireland AuditOffice. The total cost in 2008/09 was £52,449.

Related Party TransactionsDuring the year the Southern Health and Social Care Trust entered into transactions with the followingrelated parties (as defined by FRS8):

Total Value of the Transactions £

McFarlane Environmental 41,000Enable NI 104,577Northern Ireland Housing Executive 1,246,956RPS Consultancy Engineers 56,629Positive Futures 11,197Edward Street Hostel Ltd 11,396Alzheimers 45,171Belfast Metropolitan College 660

2008/09 2007/08£’000 £’000

Total bills paid in year 136,948 134,593

Total bills paid within 30 days 103,105 112,203

Percentage of bills paid within 30 days 75.3% 83.4%

Pension LiabilitiesThe accounting treatment of pension liabilities isexplained in Note 1.14 of the annual accounts.

The summary financial statements which follow donot contain sufficient information for a fullunderstanding of the activities and performance ofthe Trust. For further information, the full Accounts,Annual Report and Comptroller and AuditorGeneral’s statements for the year ended 31 March2009 should be consulted.

These can be obtained from: Mr M Dillon, Directorof Finance, Southern Trust Headquarters,Craigavon Area Hospital, 68 Lurgan Road,Portadown, BT63 5QQ, tel: 028 3861 3982.


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SUMMARY FINANCIAL STATEMENTSFOR THE YEAR ENDED 31 MARCH 2009Net Expenditure Account for the year ended 31 March 2009

2008/09 Restated 2007/08£’000 £’000

Expenditure:Staff Costs (285,289) (254,735)Depreciation (10,540) (9,944)Other Expenditure (195,517) (175,419)Subtotal (491,346) (440,098)Income:Income from activities 17,445 16,671Other Income 7,075 11,656Reimbursements receivable 9,474 13,462Subtotal 33,994 41,789Net Expenditure (457,352) (398,309)Credit reversal of notional costs:Cost of capital 7,383 6,653Notional costs (audit fees) 52 59Net expenditure for the financial year (449,917) (391,597)Summary Revenue Resource Outturn:Net Expenditure (457,352) (398,309)Adjustments 18,903 18,399Net Resource Outturn (438,449) (379,910)Revenue Resource Limit (RRL) 439,119 379,921Surplus against RRL 670 11

Balance Sheet as at 31 March 20092009 Restated 2008£’000 £’000

Fixed AssetsTangible Assets 249,940 227,398Intangible Assets 107 189Financial Assets 0 0Total Non Current Assets 250,047 227,587Current AssetsStocks and work in progress 3,017 1,830Debtors: Amounts falling due in one year 42,764 36,402Debtors: Amounts falling due after more than one year 13,166 13,300 Short-term investments 0 0Cash at bank and in hand 2,005 5,325 Total Current Assets 60,952 56,857Creditors: Amounts falling due within one year (49,442) (57,620) Net Current Assets/(Liabilities) 11,510 (763) Total Assets less current liabilities 261,557 226,824Creditors: Amounts falling due after more than one year 0 0Provisions for liabilities and charges (31,390) (26,545)Total Assets Employed 230,167 200,279

Financed By:Capital and ReservesRevaluation Reserve 12,494 7,548Donation Reserve 4,180 4,400General Fund 213,493 188,331Total Capital and Reserves 230,167 200,279

I certify that the summary financial statements were approved by the Board of Directors on 28 May 2009.

Mrs Anne Balmer Mr Colm DonaghyChairman Southern Health and Social Care Trust Chief Executive Southern Health and Social Care Trust

STATEMENT OF THE COMPTROLLERAND AUDITOR GENERAL TO THENORTHERN IRELAND ASSEMBLY I have examined the summary financial statement which comprises the SummaryFinancial Performance for 2008/09 set out on pages 28 to 29.

Respective responsibilities of the SouthernHealth and Social Care Trust, Chief Executiveand AuditorThe Southern Health and Social Care Trust and ChiefExecutive are responsible for preparing the summaryfinancial statement.

My responsibility is to report to you my opinion on theconsistency of the summary financial statement within theAnnual Report with the full financial statements, and itscompliance with the relevant requirements of the Healthand Personal Social Services (Northern Ireland) Order1972, as amended, and Department of Health, SocialServices and Public Safety directions made thereunder.

I also read the other information contained in the AnnualReport, and consider the implications for my certificate if Ibecome aware of any apparent misstatements or materialinconsistencies with the summary financial statement.

Basis of audit opinionsI conducted my work in accordance with Bulletin 1999/6“The auditors’ statement on the summary financialstatement” issued by the Auditing Practices Board. Myreport on the Southern Health and Social Care Trust’s fullannual financial statements describes the basis of myaudit opinions on those financial statements and the partof the Remuneration Report to be audited.

OpinionIn my opinion, the summary financial statement isconsistent with the full annual financial statements of theSouthern Health and Social Care Trust for the year ended31 March 2009, and complies with the applicablerequirements of the Health and Personal Social Services(Northern Ireland) Order 1972, as amended, andDepartment of Health, Social Services and Public Safetydirections made thereunder.

JM Dowdall CBComptroller and Auditor GeneralNorthern Ireland Audit Office106 University StreetBelfastBT7 1EU

17th June 2009

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