Annual Members Meeting

Welcome

Michael Luger Chairman

Anne Medley Lead Governor

Council of Governors Report

Your Governors

Vacant seat

Nurses and

Midwives

Overview of 2014/15 Successful open day

Member events rated ‘excellent’ by our Members

Member and Governor involvement in deciding future services – The Annual Plan

Annual Plan - Council to Board feedback

Membership Strategy

Over 11,000 public members

Representative of local community ENGAGEMENT, RECRUITMENT & RETENTION

….but more work to do!

Governor activities Focus on collecting member and public feedback Attended local neighbourhood forums Membership and involvement in GP Patient Participation Groups

Governor activities

Attending national training events

Recruiting new Members

Involvement with hospital working groups/committees

Fulfilling our governance role

Annual Plan 2015/16

Appointment of Non-Executive Director

Holding Non-Executive Directors to account

Representing interests of members and public

Forward look Governance role –

developing/continuous improvement Membership communication Representative membership

Feedback from members

THANK YOU Members and Governors

Bridget Fletcher Chief Executive

Review of 2014/15 & forward look

Board values & patient centred approach

“…we overtly demonstrate by our actions & behaviours that we understand the impact of our

decisions on patients…”

Airedale NHS FT Board of Directors

Our focus, the patient experience

Right Care Today & Tomorrow

Our key principles

Improving the patient experience

Nothing about me, without me

Making every contact count

Through their eyes

At the heart of everything we do Airedale Patient & Public Experience Strategy

Key priorities for 2014/2015

Last year we set out to…

improve patient experience & enhance the patient environment

engage staff in delivering our Right Care vision

prioritise care of the vulnerable, elderly, patients with dementia & those with nutritional needs

strengthen quality & safety & enhance clinical outcomes

deliver our financial plan, governance & access standards

… do the right thing

Improved care experience for dementia patients

Dementia friendly wards

Dementia garden

Twiddlemuffs

New pictorial menus

Reading well books on prescription

National Dementia Care Awards

Enhancing environment for urgent care patients During 2014/15 we opened a brand new £6.3m Emergency Department with state-of-the-art facilities and equipment

Enhancing the patient environment

New out patients self check in

Refurbished the Friendly Coffee Shop

Transformed pathology reception

Relocated mobility services

New patient information service

New service developments

Created one stop shop for intermediate care In the Vanguard for new models of care Introduced new education service for parents-to-be & sleep overs for new parents Extended Goldline service for patients at end of life

Focus on digital care

Expanded our telemedicine service

Introduced public WiFi

Invested in an automatic dispensing robot

Introduced electronic prescribing

Turned off paper letters to GPs

Focus on our workforce Held our first Pride of Airedale Awards

Hosted our first Long Service Awards

Achieved Investor in People Bronze Award status

Created our first Right Care Champions

Invested in consultant & nurse appointments

During 2014/15 we…..

Our recognition

Named one of top 40 hospitals in England National recognition for emerging model of care for nursing and care home residents

BMJ Palliative Care Team of Year

Yorks in Bloom Award for gardeners

Individual staff recognised for going the extra mile

2014/15 regulatory overview

Our challenges

Demand and capacity Meeting needs of growing, ageing population Doing more with less resource Workforce pressures

Service pressures Stroke Maternity Urgent Care

System pressures System resilience Working in partnership

2014/15 safety record

CHKS Top 5 Hospitals for safety CHKS Top 40 Hospitals CQC Risk Rating of 6

Looking ahead Our Right Care vision

Giving credit

Patients for choosing Airedale

Staff for their dedication, commitment and professionalism

Volunteers, Friends of Airedale & Airedale New Venture who provide support day in, day out

Members and Governors for their continued support and encouragement

Partners who work with us to deliver for our local community

Airedale NHS Foundation Trust Presentation to the Council of Governors Findings of our 2014/15 external audit work – July 2015

www.pwc.co.uk

PwC

1) Broader sector perspective

Airedale NHS FT - Presentation to Governors on 2014/15 Audit Findings 28

July 2015

PwC

2) 2014/15 financial statement audit findings

Our overall view of our audit findings:

Airedale NHS FT - Presentation to Governors on 2014/15 Audit Findings 29

July 2015

2012/13 2013/14 2014/15

Accounts audit opinion Unqualified Unqualified Unqualified

Arrangements for economy, efficiency and effectiveness i.e. VfM

No issues noted No issues noted No issues noted

Annual Governance Statement / Annual Report

No issues noted No issues noted No issues noted

Number of non-IT recommendations 0 3 2

Number of IT recommendations 2 2 (repeated from prior year audit)

2 (of which one repeated from prior

year audit)

Number of audit adjustments Net impact:

3 Net credit to SoCI

£0.1m

4 Net credit to SoCI

£1.2m

1 (disclosure only)

Public Interest Report n/a

n/a n/a

PwC

2) 2014/15 financial statement audit findings (continued)

Behind the headlines:

• All deadlines met – particularly in light of tight timescales set for the sector;

• No material unadjusted errors in final accounts;

• Significant pressures on NHS finances, particularly for acute FTs;

• Trust’s 2014/15 result £2.8m deficit (2013/14: £0.5m surplus) but….

• Longer term financial performance;

• Asset valuations and impact on the accounts - £2.8m net impairment;

• Increase in provisions from £6.4m to £7.0m;

• Performance against national clinical targets; and

• Enhanced audit reporting for 2014/15.

Airedale NHS FT - Presentation to Governors on 2014/15 Audit Findings 30

July 2015

PwC

3) Quality accounts

Airedale NHS FT - Presentation to Governors on 2014/15 Audit Findings 31

July 2015

2012/13 2013/14 2014/15

Content opinion ‘Clean’ audit opinion ‘Clean’ audit opinion ‘Clean’ audit opinion

Consistency opinion

‘Clean’ audit opinion

‘Clean’ audit opinion ‘Clean’ audit opinion

Mandated performance indicators

‘Clean’ audit opinion: 1) 62 day cancer – no issues 2) C.Diff - findings summarised below: • audit identified an additional HCAI reported as community-acquired; • recommendation to update Trust process flowchart, although actual practice was in compliance with Monitor guidance; and • one minor date recording error between HPA system and admission form.

Clean’ audit opinion: 1) 62 day cancer – 3 issues; missing information for 2/25 patients, errors in recorded treatment date for 4/25 patients, and limited discharge notes for 2/25 patients. Extended testing identified no further issues. 2) C.Diff - date recording errors 13/25, although most were by 1 day from new system implementation.

Clean’ audit opinion: 1) 62 day cancer – 3/30 date differences patient file vs Open Exeter system – no impact on KPI 2) 18 week incomplete pathways - 1/30 minor date difference. 3) Recommendation around significant delays responding to requests for patient files and underlying records.

Local indicator Incidents -No issues noted.

Fractured neck of femur length of stay (days) - No issues noted

Emergency re-admissions within 28 days of discharge from hospital - 1/30 discharge date differences – no impact on KPI

Andrew Copley Director of Finance

Annual Report and Accounts 2014/15

Income & expenditure focus

The 2014/15 position is a breakeven position for the Foundation Trust which

includes a technical adjustment for asset Impairments £2,834k. The figure in the accounts not only show Foundation Trusts Financial figures but also include the figures for the Foundation Trusts Charitable Funds which have a deficit of Funds for the year of £1k.

The Trust’s cash balance at 31 March 2015 is £15.9m. Accounts have been fully audited with unqualified opinion

2013/14 £000s

2014/15 £000s

Total Income 146,122 157,406 Total Expenditure (146,122) (160,232) Surplus/ (Deficit) 0 (2,776)

Where does our income come from?

What do we spend our income on?

What do we spend on staff?

What about capital resources?

Capital Plan 2014/15 £10,460,000

Net Capital Expenditure 2014/15 £10,378,000

Underspend £82,000

Major areas of capital expenditure in 2014/15 included:

Pathology £281,000 Information Technology £433,000 Medical equipment £511,000 Emergency Department £4,427,000 Information Technology (Safer Hospital Safer Wards Funding)

£3,259,000

What about capital expenditure?

The Foundation Trust continues to face financial challenges, and is expected to deliver a minimum 4% efficiency each year over the next three years with £7.3m savings in 2015/2016

We have a planned capital investment programme of £13.5m over the next three years

The Board remains committed to deliver efficiency improvements to ensure the long term sustainability of the Foundation Trust

What about capital outlook?

Karl Mainprize Medical Director

Quality Account 2014/15

Patient experience

Patient safety

Clinical effectiveness

Priorities for improvement 2014/15

Ambassador Trust for the Butterfly scheme Butterfly Support Team: 1-2-1 nursing Nutrition Nurse – training on use of nutrition assessment tool Family and carers feedback – Dementia Carers’ Survey Creation of positive therapeutic dementia environments, including the Emergency Department

Patient experience Improving nutritional care for patients with dementia

2012/13 2013/14 2014/15 Falls as percentage of admissions

2.5 2.1 2.0

Falls causing fractures as percentage of admissions

0.03 0.04 0.04

Reported falls/1000 bed days

11.4 11.2 11.0

Reported falls causing fracture/1000 bed days

0.1 0.2 0.2

Patient safety Reduction of slips, trips and falls sustained by Patients admitted to our hospital wards

The use of telemedicine to improve the overall quality of healthcare for people with long-term conditions

Assistive technologies integrated around needs of patients e.g. Craven locality long-term condition patients with iPads The hub staffed 24/7 by highly skilled nurse with access to professional staff SystmOne – shared GP record Across Airedale, Wharfedale and Craven 37 care homes using this technology Intermediate Care Hub – a single point of referral End of Life care – Gold Line Service

Clinical effectiveness:

Summary hospital level mortality indicator [SHMI]

July 2013-Jun 2014 (Published Jan 2015)

National average 1.00

Highest value for any acute trust 1.20 Lowest value for any acute trust 0.54

ANHSFT 0.89

[July 2012 – June 2013 = 0.93]

National Quality Indicators

“…Patients who had been previously discharged talked

about their experiences to us. They described an experience which was “joined up” with admission and

diagnosis being timely. Treatment, even at another hospital, being arranged promptly and after discharge community care being as previously arranged. There

will be of course other contrary experiences, but we could not find patients with an alternative view.”

Based on an interview sample of 40 patients. Healthwatch North Yorkshire (2014), Enter and View Report Airedale NHS Foundation Trust November 2014. Page 2.

Patient experience

CQC Inpatient Survey 2014 – published May 2015

% responsiveness of the provider to the personal needs of patients [access & waiting, safe, high quality co-ordinated care, close relationships, information, choice, clean, friendly, comfortable]

National average % score : 76.6 ANHSFT score: 76.9

CQC Staff Survey 2014 – published April 2015 % of staff who recommended its provider of care to their family or friends

National median % score : 65 ANHSFT score: 69

Patient experience

pressure ulcer annual point prevalence audit

12.3% 12.8%

10.07% 8.9%

2.99% 3.4%

9.6%

7.08%

0.0%

2.0%

4.0%

6.0%

8.0%

10.0%

12.0%

14.0%

2008 2009 2010 2011 2012 2013 2014

Perc

enta

ge o

f pat

ient

s

Overall prevalence [hospital acquired plus community acquired]

Patients with hospital acquired ulcers

Patients with community acquired pressure ulcers outside of FT care domain

Patient safety

Enhanced Recovery (Example – knee replacement)

0.00

1.00

2.00

3.00

4.00

5.00

6.00

7.00

8.00

2011/12 2012/13 2013/14 2014/15

Leng

th o

f sta

y: d

ays

Airedale NHS FT

Airedale NHS FT Linear (Airedale NHS FT)

1st April to 31st March

Clinical effectiveness

Patient Story – “moving and powerful” reflective tool Open culture where the Trust seeks to learn from failures e.g.

communication with patients, Maternity ‘Never Event’ Adherence to the Being Open Policy Patient Safety Walk-rounds Staff Reward and Recognition Scheme Telehealth programme – Enhanced Health in Care Homes Vanguard Continuing high quality work on dementia Acknowledgement of efforts made, including an Estates programmes, to

reduce the number of slips, trips and falls Clinical audit programme and recommendations made and actions taken Data quality, including information governance Safety incident rates for severe harm Hospital acquired infection rates Work to ensure a safe and effective environment Emergency Department - “ improved service to the community” Emphasis on collaboration

Feedback strengths

Falls resulting in fractures & significant harm Stroke services CQUIN 2014/15 programme:

– Friends and Family Test – Safety Thermometer – discharge before 2 pm – dementia diagnostic assessment

Monitoring and assessing the impact of new ways of working, such as telemedicine

Feedback challenges

AWC CCG “…Overall, the ANHSFT Quality Account provides a detailed, open and honest reflection on the activities undertaken throughout 2014/15. It shows clear evidence of continuous improvement in the quality of services delivered. The Account …provides an assurance to the reader that the national drive to improve quality is deeply embedded in the culture and overall direction of travel of ANHSFT.. . …The CCG recognise the commitment of ANHSFT to improving quality and ensuring a safe and effective environment. Overall, the Trust has had a very positive twelve months and there is very clear evidence of the continued commitment to improved quality of care for patients.” Healthwatch Bradford acknowledged the willingness and transparency of Airedale NHS Trust and other health providers to include Healthwatch in their quality work and the production of Quality Accounts. Bradford MDC “…The [Overview and Scrutiny] Committee will …continue to scrutinise the integration of health and social care and I welcome your report recognising the pressing need for continued collaboration with the focus always on delivering the best possible care, treatment and quality of life for people in Bradford District.”

Stakeholder feedback

Patient experience Improving the quality of life for people in the last days of life in Airedale General Hospital

Patient safety Management of pressure area care Clinical effectiveness Management of sepsis

Future quality priorities 2015/16

Any questions?

1. To receive the foundation trust’s annual report and accounts for the year ended 31 March 2015, together with the report of the auditors.

2. To receive the membership report and results of elections and appointments to the Council of Governors.

Resolutions

Thank you