St George’s Healthcare NHS Trust 2012/13 annual report 2 Contents Foreword from Christopher Smallwood, chairman 5 Introduction from Miles Scott, chief executive 6 Introdduction from Alison Robertson, chief nurse and director of operations 8 Introduction from Ros Given-Wilson 9 About us 10 Becoming a Foundation Trust 11 A brief history 12 2012/13 in review - Children’s and Women’s, Diagnostics, Therapies and Critical Care division 13 2012/13 in review - Medicine and Cardiothoracic division 16 2012/13 in review - Surgery, Theatres, Neurosciences and Cancer 20 2012/13 in review - Community Services 23 Research 26 Living our values 27 Working at St George’s 31 Our Board 42 Our community 51 Charities at St George’s 55 Annual governance statement 58 Our performance 68 Quality account 72 Financial report 153 Independent auditor’s report 169 Contact us 170 3 4 Foreword from Christopher Smallwood chairman I am delighted to welcome you to During 2012/13 we returned a the St George’s Healthcare NHS £6.28 million surplus, which is a Trust annual report 2012/13. significant achievement in the prevailing economic climate. The Since joining St George’s as chair- trust’s prudence in financial terms man in 2011 I have visited wards over the last few years has allowed and departments throughout the us to invest and provide improve- trust, and have always left each ments to our frontline services. area with a sense of pride that staff give their absolute best in During the year we have seen offi- embodying our values and ensur- cial openings of our pre-operative ing that patients receive the best care centre (POCC) and paediatric care possible. intensive care unit (PICU), and are also seeing the benefits of our The past year has seen many suc- emergency department and acute cesses, and I know this is in huge medicine unit (AMU) which were fully refurbished part down to the commitment and strong work and modernised last year. These are significant ethic that staff have shown across all units and services for the significant populations of south departments. west London and south east England, and we must During the year we continued our proud tradi- continue to strive for the best for our patients and tion of providing excellent patient care. The Dr for our staff, ensuring the services we offer are of Foster Hospital Guide has once again identified the highest and safest quality. St George’s as one of only a handful of trusts to The year ahead will bring change, not only for have statistically significant low mortality rates. St George’s but for the NHS as a whole. We are This is a key marker of quality and safety which now working in a much-changed environment. has helped to cement our status as one of the The trust will now work with local clinical commis- country’s leading healthcare institutions. It is also sioning groups (CCGs), Commissioning Support a testament to the dedication of our skilled clinical Units (CSUs) and the wider NHS England to help teams, and the trust’s commitment to research us provide a real difference to those we serve. and innovation. The trust will also have the extra target of becoming Across the trust, teams and services have cel- a Foundation Trust (FT) in the next year. I strongly ebrated success this year. From our cardiology believe that becoming an FT is crucial to the long- and cancer teams through to services in the com- term future of the organisation, and will result in munity, many teams have been recognised on a real benefits for patients, staff and our community. regional, and some on a national level. The strides forward we have made this year will hold Furthermore, the strength and expertise of our us in good stead for the challenges that lie ahead. I clinicians has been evident in the roles to which have every confidence that St George’s Healthcare some of our staff have been appointed. Two of can rise to that challenge. our cancer clinicians have been appointed path- way chairs in the London Cancer Alliance. One of our consultant anaesthetists has become the president of the Royal College of Anaesthetists, whilst an allied health professional has become Christopher Smallwood part of a national clinical expert database, which chairman will provide expert guidance to national health- care policies. 5 Introduction from Miles Scott chief executive St George’s is on the brink of a major trauma and neurorehabili- future that will strengthen our tation services have successfully position as one of the country’s improved patient care. We will leading NHS organisations. Over ensure this achieves the same the last year we have continued to ends, and that the level of care deliver safe, outstanding services continues to be nothing short of for our patients. This has given excellent. us the perfect platform to begin Some of our objectives are ‘behind implementing our recently agreed the scenes’ changes, and may not ten year strategy which will place be instantly obvious. We must quality healthcare at the heart of invest in the facilities, systems and our work. processes our staff use for patients The strategy sets out our goals for to have a better experience. We will the next decade, and outlines our look to make significant invest- vision for delivering outstanding healthcare of ment in our IT systems in order to provide the exceptional quality, underpinned by leading edge consistent service our staff and patients deserve. research and teaching, always ensuring we uphold Our staff initiatives have also been a success, and the highest standards. I was pleased to launch the Listening into Action This coming year we expect to become a programme, putting staff at the centre of change. Foundation Trust (FT). This will bring new oppor- Initiatives like these are essential in telling us tunities for us to really connect with patients, staff where improvement is required from staff on the and local people, and will enable us to develop front line. Our workforce are best placed to point our services and facilities as set out in our strategy. out where we can improve. The discipline and external scrutiny in preparation As well as ‘fine tuning’ the work environment, we for becoming an FT means that local people can want to develop a highly skilled and motivated have even greater confidence in St George’s as an workforce. Our strategy continues to invest in staff, organisation. making certain they are well placed to provide One of our major projects over the next year which excellent care which embodies our values. fits into our strategy is the St George’s Hospital We will also consolidate our work with other edu- helipad, a crucial addition that will allow patients cation providers across south London, including with major trauma injuries from as far as the south our relationship with St George’s, University of of England faster access to life-saving care. Longer- London (SGUL) to provide superb education and term, we will continue developing plans for a ensure the skilled doctors of tomorrow are trained children’s and women’s hospital at St George’s, here today. providing an environment that matches the clini- cal excellence of our staff. Research will become a core part of our business. We will take the lead in improving patient safety, Reconfiguring our services can also improve experience and outcomes through research. We quality of care. Clinical services and patients are an active member of the South London Health can benefit from change, and local healthcare and Innovation Cluster, as well as the South West reviews such as Better Services, Better Value will London Academic Health Science Network (AHSN). undoubtedly have an impact. We are committed We will promote innovation and best practice, to working with local trusts to ensure the most improving health outcomes and strengthening sustainable configuration of hospital and specialist St George’s reputation as a research leader. services in the region. Previous reviews of stroke, 6 Finally, it is important that whilst looking forward to the future, we must not become complacent now. The patient experience must match the excellence of our clinical outcomes. We can best respect the experiences of patients who have been failed by the NHS, including at St George’s, by rooting out poor care where we find it and by always putting patients first. I believe our strategy encompasses all that St George’s can become in the next ten years. We have the tools to build on our position as a leading healthcare provider whilst continuing to uphold the highest standards. By planning well for the years ahead, I know we will be at the forefront of healthcare now and in the future. Miles Scott chief executive 7 Introduction from Alison Robertson chief nurse and director of operations St George’s has many positives to they have been at a level which take from the last year, as well as is not satisfactory either for staff areas to further develop and make or our patients. It is essential to progress. keep patients at St George’s safe, and we will strengthen our focus Patient experience is one area on infection control to raise our where we have continued to performance and provide the best improve. For example, the CQC’s care possible. inpatient survey rated us ‘about the same’ as most other trusts in We need to be proactive in identi- the country. However, specifically fying areas where we can become there were six areas where the safer, better and smarter in our trust improved significantly when work practices; these are the main compared to our results last year, principles of our trust-wide service relating to cleanliness, food choices and the level improvement programme, which we have estab- of involvement patients felt they had in their care.