AR for Web.Indd

Gwent Healthcare NHS Trust Annual Report 2004-2005 Gwent Healthcare CONTENTS THE TRUST BOARD The Trust Board 3 Trust delivers quality healthcare to more than 600,000 people Chairman’s/Chief Executive’s Report 4-5 in south-east Wales and is one of the busiest and largest in the United Kingdom. PART ONE It is led by the Trust Board of the chairman and seven non-executive directors, supported by the chief Review of 2004/05 6-10 executive and four executive directors, plus two staff representatives. Patients 11-13 Staff 14-16 The full membership comprises: Nursing 17 Dr Brian Willott CB, Chairman Innovation and Leadership 18-19 Mr Michael Badham, Vice Chairman (until March 2005) Mr Peter Sampson, Vice Chairman (from March 2005) The Future 20-21 Prof Chris Butler Mrs Beryl Melvin OBE Mrs Carol Morgan Mr David Murray PART TWO Ms Patricia Smail Divisional Profiles 22-35 Executive Directors Mr Martin P Turner, Chief Executive Mr Andrew J Cottom, Finance Director Dr Stephen Hunter, Medical Director PART THREE Ms Tracy Myhill, Personnel Director Ms Christine Baxter, Nurse Director (until December 2004) Corporate Governance 36 Mrs Wendy Warren, Nurse Director (from February 2005) Medical Education 37-38 Staff Representatives Mr Chris Jones Research and Development 39 Mr Paul Thomas Audited Accounts 40-49 Key Trust Information 50 Five committees have direct responsibility to the Board Audit Committee Charitable Trust Funds Committee Remuneration Committee Equality and Diversity Committee Quality and Clinical Governance Committee (Key to membership) 2-3 Gwent Healthcare model. A number of capital projects were CHAIRMAN’S / finally approved during the year, including the new cardiology and orthopaedic units at the Royal Gwent CHIEF EXECUTIVE’S REPORT and St Woolos respectively and the integrated health and social care facility in Monmouth which should be completed during the 2005-6 financial year. This year again proved demanding with ever-growing pressure It has been an extremely busy year on the staff front. on our services, increasingly tight performance standards and In addition to handling the day to day pressures, the new Consultants’ contract has been put in place and the continuing development of our longer term clinical strategy. the major task of implementing Agenda for Change has continued. All this, together with changes in the career development of junior doctors, is leading Once again the Trust succeeded in breaking even the year, well over the Wales average, to 104 by the to much restructuring of services, such as the financially after much hard work to manage budgets end of March – well below the Welsh average. It “Hospital at Night”, the development of new roles and reduce costs. We achieved our main waiting has continued to fall after the year end. and expansion of multi-disciplinary team working. time targets – 4 months for cataracts, 6 months for Staff have risen magnificently to the challenge angiography, 18 months outpatients and 12 months The involvement of patients in our activities of making these changes while continuing to for all other treatments. This was a real achievement and service development continues to grow. The provide quality care and we cannot commend given the surge of emergency admissions in January Patients’ Panel goes from strength to strength and them too highly. and February. individual members have been involved in the development of specific services. Patient safety Finally, a word about the longer term clinical A particular challenge, however, was the new is always an overriding priority, addressed strategy which has been developed over the past Dr. Brian Willott, Chairman target of dealing with 95% of all Accident and actively through the Board’s Quality and Clinical two or three years. This is a strategy to provide Emergency attendances within 4 hours. The Governance Sub-Committee. Hospital acquired seamless care and to bring our services closer to the Accident and Emergency Department at the Royal infections, like MRSA, have received a much patient. It involves complete reconfiguration of all Gwent, in particular, was only designed to handle higher profile nationally and have always been a the hospitals across Gwent, of which the plans for half the number of attendances it now gets; major Gwent priority; we have maintained our active Caerphilly and Blaenau Gwent are forerunners. reshaping of the service, the facilities and the programmes which have continued to keep Gwent A successful major public engagement has been processing of patients is being carried out in order below the Welsh and well below the UK average carried out, in partnership with the LHBs and the to achieve the new standard. levels of infection. Community Health Council, on the broad concept Martin P Turner, Chief Executive of the case for change which will now, in the light Major reductions in delayed transfers of care The new Out of Hours Primary Care Service of the comments, be submitted to the Welsh (“bed-blocking”) were achieved during the year in which we introduced with the support of the LHBs Assembly Government for approval. When partnership with the LHBs and Local Authorities. across Gwent following the new GP contract, has implemented this will provide a real 21st Century The total number fell from 227 at the beginning of proved highly successful and is widely seen as a good service to the people of Gwent. 4-5 Gwent Healthcare PART ONE to address the demands placed on the Royal Gwent capacity pressures had a serious impact on treating where severe emergency pressures impacted on its elective patients. ability to meet its target. The Trust set itself an internal target of a maximum This includes separate streaming of minor injury outpatient wait of 15 months, compared to a Welsh patients using experienced nurse practitioners, the target of 18 months and by the end of the year was streamlining of the discharge process to free up beds achieving this in all specialities except orthopaedics, REVIEW OF 2004-05 in the hospital at crucial times and re-designing of which was excluded to enable clinical staff to meet the A&E department to improve flows of patients. the 12 months treatment target. The continued challenges of increasing demand and tougher The appointment of a “navigator”, a qualified nurse The end of year total of patients on Trust waiting to facilitate the transit of patients and overcome lists showed a 25% reduction on those waiting targets, and their impact on key services, were major factors specific blockages and delays, has been important. over 12 months for an outpatient appointment compared with the previous year, but a 2% throughout the year. Elective admissions were particularly badly hit increase in total patients waiting, despite staff during January and February when through- over-performing against activity targets. put was reduced by over 20% because of Given the continuing pressures on both emergency The input of the Medical Assessment Unit (together increased emergency admissions. It also impacted There was a major reduction in patients waiting and elective services, financial constraints and with the new Neonatal Assessment Centre opened on day surgery where units had to be used to over 12 months, the figure falling from 1536 to 131, delays in settling income levels, it was a significant during the year) became clearly visible. Against accommodate emergencies, the latest symptom all of whom had received a second offer of treatment achievement for the Trust to break even on its a total demand of adult medicine referrals and of the increasing pressures. elsewhere but had declined. The number of patients budget for the sixth year in succession and to attendances of 30,510, the MAU was successful waiting for treatment decreased by 15%. meet the SaFF targets established by the Assembly in reducing admissions by 3226. Compared with Key waiting time targets however, were again Government 2003/4, demand increased by 7% from 28,592, achieved. The Trust has been engaged with LHBs in finding whereas admissions only rose by 2.6%. an effective way of sustaining low waiting times But 2004/05 also saw considerable innovation in The six month angiography, four month cataract throughout Gwent. Work is underway jointly to service delivery and progress in new investment. Outpatient attendances increased by 2% to 392,461, and 18 month outpatient targets were met by March reduce emergency medical admissions by 5%, With all services changing and evolving at an of which 115,348 were new outpatients. with the Trust performing consistently against these essential as a major component to ease capacity increasingly rapid rate, the Trust, together with its targets throughout the year. pressure and planned to be phased in from healthcare partners, took forward its long term Mental Health inpatient admissions again fell, by 2% September 2005. However, a review by independent vision for local care and the first steps in introducing to 2,883. Reversing the trend since 2001/2, outpatients The 12 month target for patients waiting for consultants has concluded that at current activity sustainable patterns of clinical services that will be rose by 1% to 21,871, of which 3,458 were new cases. treatment was also met, even though breaching of and performance levels, there is a shortfall of 170 effective, deliverable and affordable. ringfenced beds at both the Royal Gwent and Nevill beds to achieve the 85% occupancy level generally The steady rise in pressure on A&E continued, Hall hospitals during the winter months due to regarded as being optimal. Performance with attendances at A&E/Minor Casualty rising Once again, the consistent pressure of activity to 158,670, 2% higher than the previous year and against a limited number of beds, required 7% more over three years.

Load more