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Lancashire Teaching Hospitals NHS Foundation Trust Annual Report and Accounts 2019–20

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Lancashire Teaching Hospitals NHS Foundation Trust Annual Report and Accounts 2019–20 Lancashire Teaching Hospitals NHS Foundation Trust Annual Report and Accounts 2019–20 @LancsHospitals Lancashire Teaching Hospitals NHS Foundation Trust Annual Report and Accounts 2019-20 Presented to Parliament pursuant to schedule 7, paragraph 25(4) (a) of the National Health Service Act 2006 ©2020 Lancashire Teaching Hospitals NHS Foundation Trust CONTENTS • Overview 1 • Chairman’s and Chief Executive’s Welcome • Performance report 4 • Overview of performance 5 • Performance analysis 11 • Accountability report 20 • Directors’ report 21 • Remuneration report 53 • Staff report 65 • Disclosures set out in the NHS Foundation Trust Code of Governance 82 • NHS Improvement’s Single Oversight Framework 87 • Statement of accounting officer’s responsibilities 88 • Annual governance statement 90 • Council of Governors’ report 114 • Membership report 119 • Audit Committee report 124 • Quality report 131 • Financial review 239 • Independent auditors’ report to the Council of Governors on the financial statements 240 • Foreword to the accounts 250 • Statement of comprehensive income 251 • Statement of financial position 252 • Statement of changes in equity for the year 253 • Statement of cash flows 254 • Notes to the accounts 255 This symbol indicates that more information is available on our website: www.lancsteachinghospitals.nhs.uk Cover photograph: Caroline Watson, Health Care Assistant and Dr Rajesh Kumar, Associate Consultant in Anasethetics CHAIRMAN’S AND CHIEF EXECUTIVE’S WELCOME Welcome to our annual report for the financial year 2019-20, which sets out our achievements, activity and performance. The annual report is also an opportunity to share our vision and priorities at a time of significant pressure and change within the NHS. Well what a year 2020 has been so far! Clearly we are all living in very strange and uncertain times at the moment due to the Coronavirus (Covid-19) pandemic. The commitment and dedication of our staff has always been exceptional, but it is felt now more than ever. Many tell us that they are just doing their jobs but these are uncertain times for everyone, no matter how professional or experienced they are. The kindness and support shown by our local community is going a long way in boosting morale and keeping us positive; seeing so many people join in the Clap for Carers at 8pm every Thursday evening was very much appreciated and puts a smile on our faces. We also want to say a huge thank you for all the kind and generous donations we have received. We have recently set up a new Charity team and they have been inundated with things to help our staff. To find out more about the Lancashire Teaching Hospitals’ Charity you can access the charity website here. You can use the website to make a donation, there is also information about the staff wellbeing appeal and news about all the donations we have received so far and how it makes a real difference. Providing the best care possible for our patients remains our top priority but we also recognise the importance of looking after the health and wellbeing of our staff too. Over the last few years we have introuduced a range of staff health and wellbeing initiatives; from opening health and wellbeing centres, bringing in our own Psychologists and we have even tried laughter yoga! The health and wellbeing of our staff has always been a priority for us but now it is more important than ever. We are doing everything we can to support our teams who are working so incredibly hard and in such difficult circumstances. ‘Wobble rooms’ have been set up in some areas to provide a space for our staff to take a moment out, have a wobble and gather themselves if they need to, we have delivered care packages to them and set up a helpline for our staff who are affected by Covid-19. We want to assure our communities that we are still here for you, if you require urgent treatment, even if it is not Coronavirus-related, you should still seek medical help. Please do not take risks and leave it too late, you should still come to hospital if you need to. Many appointments and procedures are continuing as normal so if you still require treatment and your appointment is still going ahead, please make sure you attend. We have taken precautions to keep you as safe as possible and we have divided our hospitals into zones so that Covid-19 and non-Covid-19 patients are treated separately. We have temporarily reconfigured our services to ensure that we can manage the increasing patient numbers whilst dealing with the pandemic. As part of this reconfiguration we have moved all of our acute respiratory medicine from Chorley and South Ribble Hospital to Royal Preston Hospital; we have temporarily closed the Emergency Department and Critical Care unit at Chorley so that the teams can work on one site. This move allows us to utilise all of our available resources to deal with acutely ill Covid-19 patients on a single site within the larger of our Intensive Care units, in order to better care for our patients. In addition, it reduces the risks associated with transporting infectious patients between locations. Meanwhile, our Chorley 1 site continues to run a 24/7 Urgent Care and Minor Injury service so that patients who fall into this category are treated in a safer environment for them. We want to thank you for staying at home to save lives and protect the NHS and we want to thank you for your patience and your support, we know how hard it is not being able to visit your loved ones who are in our hospitals. Our staff continue to do everything we can to keep loved ones in touch and provide updates for families during this difficult time. Clearly during the coronavirus outbreak all of our teams have been under extreme pressure but one area that has been put in the spotlight is our Critical Care department. Before the pandemic we had already started work on expanding our Critical Care unit at Preston, that work is continuing and we are really excited to open the new multi-million pound, state-of-the-art facility very soon. Aside from Covid-19 we have made some excellent progress in many areas over the past twelve months. Firstly, we welcomed our new Chairman, Dr Ebrahim Adia in December 2019. We are delighted to welcome Ebrahim to our organisation; he joins us at a challenging yet exciting time and brings with him a wealth of knowledge and experience from his leadership roles in higher education, the health economy and local government. The Care Quality Commission (CQC) carried out a planned inspection of our hospitals last summer. Whilst our overall rating remains as ‘Requires Improvement’ we have now achieved a rating of ‘Good’ for being well-led and caring across both Royal Preston and Chorley and South Ribble Hospitals. Four of the six services that were inspected this year are rated as ‘Good’ which is an improvement on the previous inspection. We recognise that we are still not where we want to be and we still have a lot of work to do but these improvements show that we are moving in the right direction. One area which has received an ‘Outstanding’ CQC inspection is our Maternity services, which were rated in the top ten out of all the Trusts across the country who took part in a patient experience survey. We were one of only three Trusts where performance in the survey was significantly better than expected. These results are a reflection of the hard work of our Maternity teams to make the experience as positive as possible for women, babies and their families. The team has also recently launched our new Transitional Care service; a facility to enable babies who need close monitoring or additional support to be cared for alongside their mothers so that we can reduce babies being separated from their mothers. Our Maternity team has recently starred in a television series featured on Channel 5Star called Babies 24/7: The Maternity Ward, which follows the birth journeys of local families and showcases the incredible work of our teams. Nationally, 2020 is the global Year of the Nurse and Midwife. This year has been chosen as it is the 200th Anniversary of Florence Nightingale and we have joined in with the celebrations recognising our fantastic Nurses and Midwives. We continue to work hard to improve the experiences of patients with learning disabilities. They are now able to use state-of-the-art, specialist toilet facilities thanks to £50,000 of Government funding for a ‘Changing Places’ facility. The toilets feature additional equipment for people who are not able to use the toilet independently, including adult-sized changing benches and hoists. Other building work currently taking place is the re-build of the Birth Centre at Chorley. The Maternity services at Chorley were temporarily halted when asbestos was discovered in the 2 building, so we are delighted that work is now underway to reinstate our Birthing Services for people living within Chorley and South Ribble. We are also building a new Ophthalmology Centre at Chorley which will provide extra capacity and dedicated space and is due to open in October 2021. Our commitment to drive innovation through world-class research continues to go from strength to strength with our Clinical Research team regularly winning and being shortlisted for prestigious awards. They are also working hard on a number of Covid-19 research studies to try to find out more about the virus. We are extremely proud to see that our staff continue to be recognised for their outstanding achievements as we continue to win awards across a range of areas.
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