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Warrington and Halton Hospitals NHS Foundation Trust Annual Report and Accounts 2017 / 18

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Warrington and Halton Hospitals NHS Foundation Trust Annual Report and Accounts 2017 / 18 WARRINGTON & HALTON HOSPITALS NHS FOUNDATION TRUST ANNUAL REPORT & ACCOUNTS 2017/18 Page 1 of 284 Page 2 of 284 Warrington and Halton Hospitals NHS Foundation Trust Annual Report and Accounts 2017 / 18 Presented to Parliament pursuant to Schedule 7, Paragraph 25(4)(a) of the National Health Service Act 2006 Page 3 of 284 © 2018 Warrington and Halton Hospitals NHS Foundation Trust Page 4 of 284 ANNUAL REPORT 2017-18 Warrington and Halton Hospitals NHS Foundation Trust's Annual Report for the period 1st April 2017 to 31st March 2018 Table of Contents Page # 1. Performance Report - Performance overview 6 - Performance analysis 17 2. Accountability Report - Directors’ report 25 - The Board of Directors 26 - Remuneration report 36 - Council of Governors 48 - Membership 53 - Staff report 54 - Disclosures set out in the NHS FT Code of Governance 64 - The Accounting Officer’s responsibilities 71 - Annual Governance Statement 72 3. Quality Report 86 4. The Auditor’s Report including certificate 215 5. Foreword to the Accounts 222 Primary Financial Statements 223 Auditors Opinion on Financial Statements 274 CHAPTER 1 Performance Report Overview I present our Annual Report for the 2017-18 year We have pushed forward with our investment in which has been one of the most challenging to technology and the Trust Board approved the date. funding to add an Electronic Medicines Prescribing module to our electronic patient record system. I begin by paying tribute to the compassion, This has significant patient safety benefits which determination and sheer resilience of our will continue after the patient has left our care wonderful staff who, in the face of unprecedented when we join PharmOutcomes, a system that challenge, have continued to work so hard to enables our Pharmacy to inform community deliver the very best care for our patients. I have pharmacist when a patient has been admitted to put on record that the 2017-18 winter pressures hospital and send medication updates at the point have been the worst I have experienced in my 30 of discharge. This is the result of a successful years in the NHS. I also pay tribute to the many collaboration with NHS England and the North thousands of patients who crossed our doors this West Academic Health Science Network. year for their patience and unstinting support of their local hospitals and their praise for the staff Intensive work by our teams and our mortality who have worked so hard to care for them under review group has paid dividends and we are such pressures. pleased to report mortality rates in the ‘as or below expected’ range. For the two indicators we The year has been a game of two halves for WHH have reduced the Hospital Standardised Mortality with some real highs and disappointing lows. Rate (HSMR) from a high of 115 (above expected) Among many highs we celebrated our Maternity in April 2016 down to 101 (as expected) in Service being recognised as Maternity Service of February 2018. For Summary Hospital-level the Year by the Royal College of Midwives. Mortality rate (SHMI) indicator we have reduced Celebrations continue as we prepare for a Royal this from a high of 118 in 2015 (above expected) to visit to commemorate this in May 2018. Our 103 in February 2018 (as expected) – the lowest it Midwifery Led Unit is a best-in-class service for the has been for many years. While never a nice women who chose to deliver their babies in indicator to discuss this provides yet further hospital and we are working on plans to offer even confidence in our patients of the high quality, safe more choice in the future. This is in line with the care being practiced every day in this Trust. Better Births Strategy to which I had the privilege of contributing as part of Baroness Cumberledge’s Similarly, our low infection control rates are the national review. result of sustained focus across both our organisation and partners in the community. There were yet more highs with our teams being There was one reported case of MRSA in the year recognised on the national stage as finalists in the – our first case in nearly two years and 21 hospital prestigious Patient Safety Awards in the Infection onset cases of Clostridium Difficile against the Prevention and Control and Perioperative and annual threshold of 27 cases. Work to significantly Surgical Care categories. We won’t know until the reduce the impact of sepsis through early summer just how successful they are but to be identification and treatment has been exceptional acknowledged among the very best in the country with more than 90% patients in the ED consistently is testament enough. We also sent teams to the screened/given timely antibiotics for this finals of the Health Service Journal’s Value and aggressive, potentially life-threatening condition. Improvement Awards where they were recognised for Community Service Redesign and the British Medical Journal Awards for the same project as well as for Clinical Leadership. Page 6 of 284 Focusing on our patients’ experience we moved development to plan and build healthier places. the national patient survey, the Friends and Family Halton Lea is unique in that it is the only new town Test, to a digital platform which has hugely with a hospital at its heart, offering even more increased feedback through the use of text opportunity to build good health and wellbeing messaging and automated voice calls. More into the community and create a real legacy for importantly, the platform is live and ward/service future generations. specific so we can monitor feedback in real time enabling us to make swift interventions based on The initial design and plans for the Halton Hospital patients’ recent experiences. and Wellbeing Campus were unveiled in March 2018 to a wide range of staff, patients, elected We are extending this excellent system in April members, local residents, members of the public 2018 with a pre-appointment, two-way text and interest groups and their feedback and input reminder service. This will allow our busy patients welcomed. While our bid for £40m capital to NHS to confirm their attendance, cancel or rebook their England was not successful during the spring appointments ‘on the move’. As well as providing round of capital funding we intend to refine and an important reminder service we anticipate that resubmit our bid for the autumn 2018 round. We this will significantly reduce our ‘Did Not Attends’ remain fully committed to building a state-of-the which in 2016-17 cost the Trust over £1m in lost art integrated primary, secondary and mental appointments but more importantly prevented health facility complemented by rehabilitation and other patients from taking up appointment slots. community wellbeing facilities for the benefit of patients, staff and people of Runcorn. Arriving for their Outpatient Appointment patients can now check in digitally rather than waiting in Work on a new hospital for Halton naturally line with the MiCheckIn facility at a number of turned discussions to the ageing facility that is kiosks. This is further supported by the Warrington Hospital, where some parts of the introduction of patient and visitor Wi-Fi across all building are more than 100 years old and where of our hospitals – the result of a £200K grant from annual maintenance costs significantly eat into NHS Digital – and which we know will make a huge scarce budgets. At the end of the financial year a difference to those having to spend even a short large fire in the roof of Kendrick Wing, the oldest time with us. part of the hospital and home of Ophthalmology and many support services, left a considerable part It is worth noting that with increasing global of this wing of the hospital out of action and this reliance on technology there are associated risks will be the case for some months. Once again our and the NHS fell victim to the large cyber-attack in staff rose to the challenge and after an extremely May 2017 where the WannaCry ransomware virus efficient and safe evacuation of all patients and affected a number of organisations around the staff our teams worked around the clock to ensure world. This Trust had applied the patches released we had the Ophthalmology service temporarily by Microsoft earlier in the year and was relocated and up and running just 84 hours later, consequently not infected; but we did take down a with all affected patients rebooked. number of our systems as a precaution over the weekend period. Fortunately our patient care was We are grateful to Warrington Borough Council, not affected and we were able to return to the Overview and Scrutiny Committee our MPs, business as usual with the restoration of email staff and our local community for their continued after the weekend. support of our desire to provide a modern, purpose-built hospital for the people of More widely we have pushed forward with our Warrington. This includes discussions about the partners in the Borough of Halton as part of the potential siting of the new hospital - which may Halton Healthy New Town development, one of indeed include the existing site. While it is very NHS England’s 10 demonstrator sites. Healthy New early days we intend to maintain momentum – Towns intend to shape the health of communities, particularly given the aspirations of the town and and to rethink how health and care services are the planned, significant growth in population, delivered by uniting public health, NHS providers housing and business laid out in the Council’s Local and commissioners, planning and housing Delivery Plan. Page 7 of 284 While these many initiatives and celebrations The process of shaping the future configuration of continue into the new financial year, we are never specialist spinal services across the whole of far away from the pressures and challenges facing Cheshire and Merseyside has already begun, led by today’s health and social care.
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