south tyneside nhs foundation trust · pdf filesouth tyneside nhs foundation trust 2015/16...

Annual Members Meeting

5th December 2016

South Tyneside NHS

Foundation Trust

Welcome and Introduction

Reports for the Year

2015/16

Review of the Year

Chief Executive

Ken Bremner

Key Performance for 2015/16 • Emergency Care 4 hour standard

– 93.4% for all types of A & E attendances including our Urgent Care Hub were seen and treated within 4 hours. National performance was 91.91%.

– 92.87% of Hospital A & E attendances were seen and treated within 4 hours. Nationally, for Type 1 units, the figure was 87.88%.

• Cancer targets met

• 18 week Referral To Treatment targets met

• No cases of MRSA bacteraemia 6 cases of C. Difficile (against a target of 8)

2015/16 Patient Safety Priorities

1. To develop and publish a 3 year Safety Improvement

Plan as part of a 5-year Quality Strategy

2. To create and roll out quality improvement training

3. To further develop our culture of learning from

experience

4. To provide assurance to the Board and patients that we

are continually focused on demonstrating safe staffing

levels

CQC inspection headlines • Overall assessment ‘Requires Improvement’

• 70% all individual assessments ‘good’ or ‘outstanding’

• ‘Outstanding’ for ‘Are services caring?’

• ‘Good’ or ‘Outstanding’ for every community services assessment

• Areas for improvement and include the following - Safety, Quality, Staffing, Environment, Corporate

Annual Report 2015/16

2015/16 Annual Report &

Summary Financial Statements

• Accountability Report

• Governance & Disclosures

• Key Performance Figures

• Annual Governance Statement

• Remuneration Report

• Quality Report

• Assurance Statements from Commissioners, Healthwatch

and Local Authority Oversight and Scrutiny Committee

• Financial Performance

Financial Performance

April 2015 - March 2016 STATEMENT OF COMPREHENSIVE 2015/16 2014/15

INCOME

£000 £000

Income from continuing operations 200,899 208,235

Operating expenses (212,081) (209,063)

Operating deficit (11,182) (828)

Net Finance Costs* (1,782) (2,395)

Transfer by Absorption (St. Benedict’s Hospice) 9,811 -

DEFICIT FOR THE YEAR (3,153) (3,223)

Net revaluations/ (impairments) 10,733 (29,109)

TOTAL COMPREHENSIVE INCOME/(EXPENSES) 7,580 (32,332) * Includes Public Dividend Capital Dividends (1,703) (2,411)

Financial Performance

April 2015 - March 2016 • Underlying Deficit £8,295k after:

• Transfer of St. Benedict’s Hospice £9,811k

• Restructuring costs of (£3,500k)

• Impairments of (£767k)

• Equal pay costs (£402k)

• Achievement of a £10.7m cost improvement

• Closing Cash £15.5m. This includes approximately £12m of loans drawn

down in advance of capital expenditure

• Capital investments £10.3m

• Revised Risk assessment Framework from August 2015. Assessed by

NHS Improvement as ‘2’ for Financial Sustainability Risk Rating and

‘Under Review’ for the Governance Risk Rating

Auditors Report 2015/16

South Tyneside NHS Foundation Trust

2015/16 Audit

Presentation to the Annual Members Meeting

5 December 2016

Deloitte-LBG UK screen 4:3 (19.05 cm x 25.40 cm)

© 2015 Deloitte LLP. Private and confidential.

Scope of our work Accounts, Quality Report and Annual Report Consolidation Schedules

Identification and testing of the key risk areas.

Performance of sample testing and analytical review.

Testing of the auditable sections of the Remuneration

Report.

Review of the work of relevant regulatory bodies.

Review and testing of the Quality Report.

Review of:

The Annual Report for consistency with the

content of the Financial Statements.

The Annual Governance Statement.

Comparison of the Consolidation Schedules to the

audited Annual Report and Accounts.

‘True and Fair’ Opinion

on Accounts

Value for Money & Going

Concern

Consistency of the Consolidation

Schedules

Confirmation to National Audit

Office over content

of WGA schedules

The opinion on the Quality Report was qualified on the A&E 4 hour waits & 18 week RTT indicator.

All other opinions were unmodified.

Standard ‘Limited Assurance’

opinion on

Quality Report

External Audit presentation to Council of Governors

Deloitte PowerPoint timesaver – March 2011

Key Findings

©2015 Deloitte LLP. Private and Confidential

Audit Findings -

Accounting Performance

The Trust submitted its draft and

audited Annual Report and

Accounts ahead of the Monitor

timetable.

Regular meetings have been held

with management through the year.

Early discussions were held to

improve the efficacy and efficiency

of the audit process in certain

areas.

The working papers produced to

support the draft accounts were of

a very high standard and we

received full co-operation from

management throughout the audit

visit.

Annual Governance Statement

The review of the Trust’s Annual

Governance Statement identified no

significant issues.

Accounting policies and

financial reporting

As part of our audit, we

consider the quality and

acceptability of the Trust’s

accounting policies and

financial reporting. We

provided comments to the

Trust on presentational

matters which have been

reflected in the financial

statements.

Annual Report

The Trust provided a largely complete

draft of the Annual Report during the

audit process, and management were

keen to reflect recommendations made.

Controls Findings

We did not identify any significant deficiencies in the financial reporting

systems.

Three recommendations were raised during the audit in relation to the IT

environment. We raised four recommendations with regard to the District Valuer

Service in relation to property valuations.

External Audit presentation to Annual Members Meeting



Value for Money & Going Concern

The Trust faces a number of significant financial challenges in both the short and medium

term that will require careful management going forwards.

Nature of

Risk

The Trust operates in an increasingly financially constrained environment, with significant

ongoing cost pressures.

Work

performed

In order to gain assurance over the Trust’s financial sustainability in relation to value for

money, we completed additional focussed work in this area which included:

• review of the Trust’s financial performance during the year and outturn position and

challenge of management’s assessment of going concern.

• review of correspondence with Monitor in relation to the Trust’s FSRR rating.

• review of Board papers and other documentation in respect of the Trust’s

deficit/variance to plan.

• review of CIP performance in 2015/16.

• review Trust plans for 2016/17 including strategy and mitigating actions to achieve

financial sustainability.

• review of the cash position of the Trust and its future cashflow forecast including

mitigating options agreed to ensure the Trust has sufficient cash headroom to meet its

future liabilities as they fall due.

Based upon the evidence provided to us by management we have accepted the Trust’s

ability to continue as a going concern for the 12 month period to May 2017. We gave a clean

opinion on VfM for the year ended 31st March 2016.




Significant Audit Risks

3 significant risks were identified as part of the 2015/16 audit:

• Risk identified in relation to contract income which may not recognised in the correct period at year end.

• Tested income on a sample basis with no issues to report

Revenue recognition

• Risk required by auditing standards in relation to the potential misstatement of the financial statements as a result of management override of controls.

• No issues noted from our testing.

Management Override of

Controls

• Valuations of Trust properties are by nature significant estimates which are based on specialist and management assumptions.

• We are satisfied that key assumptions are appropriate.

• We raised four recommendations regarding commentary in the valuation report received from the valuer, the inclusion of St Benedict’s Hospice and Haven Court, as well as providing more detail on reasons for changes in the asset portfolio.

Property Valuations




Quality Report Audit

• The scope of our work is to support a “limited assurance” opinion, which is

based upon procedures specified by Monitor in their “Detailed Guidance for

External Assurance on Quality Reports 2015/16”.

• Our audit responsibilities are to review the content and consistency of the quality

report and to undertake testing of three performance indicators, two of which are

mandated and one of which is selected by the Council of Governors.

• In response to the growth of performance indicators across the NHS, we have

developed a framework of considerations for evaluating data quality. We have

used this framework in evaluating our findings and the recommendations we

have raised.

• We have completed our review, including validation of the selected indicators, of

the 2015/16 quality report and documentation.

• We issued a modified opinion in relation to the A&E 4 Hour waits and 18 weeks

RTT indicators.


Chief Executives Update

Ken Bremner

• Single Oversight Framework

• Group Update

• Sustainability and Transformation Plan

(STP)

Forward planning – our draft STP

The Northumberland Tyne and Wear

and North Durham (NTWND) STP

footprint is a new collaboration

covering a total population of 1.7

million residents across three

Localities:

• Newcastle Gateshead

• Northumberland and North

Tyneside

• South Tyneside, Sunderland and

North Durham

STP: Our 3 key gaps

Our STP local plans • ‘Path to Excellence’ Programme of clinical service reviews

• Developing our Out of Hospital services including building on the success of our Sunderland Vanguard Programme and our South Tyneside Pioneer Self Care Programme

• Increasingly working with partners across health and social care to enable greater prevention and earlier intervention

• Developing our Single Executive and Management Team and the South Tyneside and Sunderland Healthcare Group to support both Foundation Trusts

• In the longer term, develop further collaborative opportunities with North Durham

Council of Governors

Reports

Neil Mundy

Chairman

Re-appointment of Non

Executive Director

• Re-appointment of Mrs Pat Harle for a

further 3 years

• Robust appraisal process

• Approved by Council of Governors at

meeting of 22 September 2016

Membership as at end November 2016

Public Members 5518

Gateshead 175

South Tyneside 5109

Sunderland 234

Staff Members 3854

Clinical 2707

Non Clinical 1147

Broad Aims

•To achieve a year on year increase in the Trust’s

membership to ensure an appropriate representation of

the diversity of the community

•Using a range of methods to engage with our members

about the Trust’s vision, mission and objectives

Membership Strategy

Trust Membership

Election Results 2016

Public Constituencies

• Gateshead (elected unopposed)

– Tom Scott

• South Tyneside

– Alan Cormack

– Mo Abuzahra

– David Herbert

– Margaret Eaglesham

• Sunderland

– Hemendra Gandhi

– Chris Morgan

Staff Constituencies

• Staff – Non Clinical (elected unopposed)

– Marion Langley

• Staff – Clinical (elected unopposed)

– Simon Ayre

– Susan Goldsbrough

Congratulations to all our

new and returning Governors

Thank you and Goodbye Dr Rob Bolton, Clinical Staff Governor

Tom Defty, South Tyneside Public Governor

Graeme Hunt, South Tyneside Public Governor

Sophie Marchal, Gateshead Public Governor

Michael McDonnell, Sunderland Public Governor

Elaine Richards, South Tyneside Public Governor

South Tyneside NHS

Foundation Trust

• Thank you

• Annual Members Meeting

• 2016

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