Annual General Meeting 26th July 2018

Agenda

Chairman’s Report and Welcome

Andy Meehan Chairman

A look back over the year 2017/18 Andy Hardy Chief Executive Officer

Summary of the Financial Accounts

Susan Rollason Director of Finance and Strategy

Summary of the Quality Account Meghana Pandit Chief Medical Officer

Sleep Study Michelle Goodlad Lead Sleep Physiologist

Questions from the public

Chairman Andy Meehan Chairman’s Report

Chairman’s Report

• Welcome

• Changes to the Board 2017/18 • Welcome to:

o Lisa Kelly, Chief Operating Officer replacing David Eltringham

o Su Rollason, Chief Finance Officer replacing David Moon

Chief Executive Officer Andy Hardy A look back over the year 2017/18

Achievements in the last 12 months

Vital Statistics

2017/18 2016/17 2015/16 2014/15 2013/14 2012/13

Number of people attending an outpatient appointment

665,209 656,191 628,452 608,288 574,242 534,718

The number of people attending Accident & Emergency (A&E) including those in specialist Children’s A&E

190,549 187,792 184,979 183,440 176,485 175,349

The number of inpatients and day cases (based on admissions)

169,028 163,834 158,189 149,949 142,389 138,588

Number of Births 6,174 6,217 6,332 6,223 5,991 5,092

Patients operated in theatres 42,609 42,709 42,786 41,095 41,157 40,564

2017/18 Highlights

• State of the art radiotherapy equipment at the Arden Centre

• Transformation of the Children’s Outpatient Unit at Hospital of St Cross

• A new mobile cardiac catheterisation lab now in place at Hospital of St

Cross

• Identification of the functions of natural killer cells in the womb by

researchers at UHCW and University of Warwick

• Maternity Team named the best in country by the Royal College of

Midwives

The New Trust Strategy for 2018 - 2021

2018/19 Key Objectives

• Safest care and excellent experience

• Model employer

• Leader in operational performance

• Lead the integration of pathways

• Front runner in research, innovation and education

• Achieve financial sustainability

Chief Finance Officer Su Rollason Summary of Financial Accounts

Financial Performance Overview

• The Trust’s total turnover for 2017/18 amounted to £630.6 million.

• In year we formally changed our forecast position to a £22.4 million

deficit.

• In the year 2017/18 the Trust:

– Fully delivered a Cost Improvement Programme of £29.1 million,

– Delivered a £18.3 million deficit after receipt of sustainability

monies. This was £4.1 million better than the agreed forecast,

– Further reduced our reliance on agency ensuing we were under

the agreed agency ceiling.

Financial Responsibilities

• As a public body there are certain obligations we must fulfil in order to demonstrate we are being responsible with taxpayers’ money including:

– Break even (so expenditure does not exceed income):

(target not achieved)

– Remaining within the borrowing and capital expenditure limits set by the Department of Health:

• Borrowing: £0.286 million undershoot (target achieved)

• Capital: £1.652 million under spend (target achieved)

– Paying suppliers on time: 91% of invoices paid on time (target achieved)

– Final Accounts audit (clean audit opinion)

Where did the money come from?

How was the money spent?

Financial Outlook

• The 2018/19 position continues to be challenging. A

range of efficiency programmes have ben identified to

support the delivery of the cost improvement target.

• The trust is an active participant within Coventry and

Warwickshire Sustainability and Transformation Plan.

Chief Medical Officer and Deputy CEO Meghana Pandit Quality Account 2017/18

What is the Quality Account?

• It is an annual report about the quality of services

at UHCW

• The quality of the services is measured by looking

at patient safety

• The effectiveness of treatments that patients

receive

• Patient feedback about the care provided

Clinical Effectiveness- Reviewing Mortality

ACHIEVED

Patient Experience - Customer Care Course

ACHIEVED

Patient Safety A) Reducing pressure ulcers

PARTIALLY ACHIEVED

A multi-professional pressure ulcer forum was established in July 2017

to improve governance.

All patients that have a grade 3 or 4 pressure ulcer have a visit from the

Patient Safety Response Team.

Weekly production board/huddle established with the Tissue Viability

Team and is attended by the Associate Director of Nursing for Quality

and Patient Safety.

Part of the NHSI pressure ulcer collaborative

Patient Safety B) Falls ACHIEVED

Brilliant Basics forms part

of Trust induction for all

new starters.

1300 people have been

trained through the initial

training programme. 480

people through staff

induction.

1780 in total!

Continued development of

care bundles.

Understanding patient deaths

within 30 days of discharge.

777 staff members have

taken part in informal

education and awareness

as part of the Keep on

ASKIN campaign.

The threshold for falls January 2018 is

2394 the actual number of falls is

1748.

Falls with moderate harm the threshold

of 56 the actual number was 36

Repeat fallers and number of repeat

falls continues to meet projected 50%

reduction.

Quality Account Priorities 2017-18

Quality Account 2017/18 Highlights

• New training package for

incident investigators has been

developed and introduced

• Seven Day Patient and Advice

Liaison Service

• New Friends and Family Test

questionnaire

• QUESTT tool in use across the

Trust

Quality Achievements- Patient Safety • Winner HSJ National Patient

Safety Team of the Year 2018

• Improved Incident Reporting

• PSR respond to all moderate

harm and above incidents

• Increase in use of Datix for

recording of actions

• Human Factors Training

• Learning teams in place

• Baywatch

• Root Cause Analysis and

Refresher Training for

Investigators

• 100% of eligible doctors

revalidated in first cycle

(2013-2018)

• Mortality Training

Programme

• Improvements in clinical

guideline compliance

• Morbidity Scorecard

Quality Achievements-Clinical Effectiveness

• Published the Care Bundle

Policy

• Online Mortality Review

forms updated

• Consultant Peer Review for

Mortality Reviews

• Mortality Dashboard

Quality Achievements-Patient Experience • Patient Information leaflets - 97% leaflets

in date

• New Friends and Family Test

• Patient Experience and Engagement

Delivery Plan 2018-21 published

• Involvement Hub

• Complaints action module implemented

• New Action log for responding to patient

feedback

• Bedside booklets with “How may I help you?”

Quality Priorities 2018/19

Patient Safety: Year on year improvement against

baseline (55%) for WHO 5 moments for hand hygiene

and reduce avoidable infections

Clinical Effectiveness: To provide care in line with

national and local evidence based guidance

Patient Experience: Establish a process for reviewing

the patient environment and acting upon issues

effectively with support from the process of PLACE

A Co-development approach to Quality Account 2018/19

An engagement event will take place in the Autumn to engage

with staff, patients and stakeholders about what’s important from

their perspective and how we celebrate quality achievements

made through the year.

Where can the Quality Account 2017/18 be accessed?

• UHCW NHS Trust’s NHS Choices page

• UHCW website: www.uhcw.nhs.uk/about-

us/quality

• Hard copies of the full document are available on

request by calling the Patient Insight Team on

02476965196.

Principal Sleep Physiologist Michelle Goodlad The New Complex Sleep Service At UHCW NHS Trust

History Of The Sleep Service At UHCW NHS Trust

• Since 1997 there has been a respiratory sleep

service at UHCW NHS trust

• In the beginning there was just a diagnostic

service with patients going to Stoke-on-Trent &

Oxford hospitals for treatment

• In 1999 we commenced a CPAP treatment service

allowing patients to be treated in their local area

The Current Sleep Service

• The Trust has an well established sleep disordered breathing service diagnosing and treating patients from both in the local area and the surrounding counties

• We perform approx. 400 home sleep studies/year.

• We now have over 3,000 patients on CPAP and in the last 3 years expanded the service to include:

Clinics at St Cross Hospital

Fast track sleep service for occupational drivers

Hold clinics at local prisons

Annual patient support meetings

We are now ready to take the next step towards…

A Complex Sleep Service.

What Is A Complex Sleep Service?

Specialises in diagnosing and treating sleep

conditions such as:

• Excessive daytime sleepiness e.g. narcolepsy or

idiopathic hypersomnia

• Parasomnia e.g. Sleep walking, night terrors and

sleep behaviour disorders

• Nocturnal epilepsy

• Restless leg syndrome and other movement

disorders of sleep

• Insomnia

• Traumatic stress disorders (PTSD)

Why Do We Need A Complex Sleep Service?

• To become a tertiary centre, delivering a

comprehensive, neurological and respiratory sleep

medicine service

• Have the ability to investigate & treat a wide range

of sleep disorders

• Be involved in research both as a team and to

collaborate with other disciplines

• Increase the profile of the sleep service and

hospital

Why Do We Need A Complex Sleep Service?

We can:

• Shorten waiting times for complex sleep tests and

provide a service for local patients closer to home

and offer tests to patients outside the area

• Currently patients are referred to Heartlands and

Leicester General Hospitals for more complex sleep

studies

• Resulting in patients travelling outside the area for

diagnosis and treatment of their sleep conditions &

these hospitals have long waiting times for tests

Potential Patient Area

St Cross UHCW Heartlands

Birmingham

Glenfield Leicester

John Radcliffe

Oxford

Papworth

Cambridgeshire Bristol Royal

Infirmary

Bristol

The New Sleep Unit

• As part of the PFI hospital, a room on Ward 30

(UHCW) and PSG was provided and a pilot

service was launched. Room not really suitable for

sleep studies

• By moving to the St Cross site, has enabled a

bespoke 2 bedded sleep unit to be built with

potential to expand

• Always been a point of principle for the

Respiratory Physiology & Sleep Dept. to have

comparable services at St Cross

• Support and funding from the Friends Of St Cross

New Sleep Unit Plans….. From this……

New Sleep Unit Plans….. To This……………

Fitted With Up To Date Equipment

Coming soon…………

• Hoping to see the first patients in August 2018

• Already Coventry & Rugby GPs are aware of the

service

• Specialist Sleep staff have been employed

• Equipment familiarisation has gone well

• A few technical issues which hopefully are being

sorted

Thank you………….

• Juliet Starkey General Manager St Cross

• Dr Asad Ali – Clinical Lead for Sleep

• Joanna Shakespeare. Service Manager

• Sara Lee & Team. Group Manger Cardio-Respiratory

• Friends Of St Cross Charity and the Rugby Group

Benevolent Fund

• Senior Sleep Physiologists

• Vinci

• ICT

Questions