Discover Ipswich Hospital... Annual Report and Accounts 2012 / 13
Our Passion, Your Care. Annual Report and Accounts 2012 / 13
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ten priorities • • • Our top ten priorities Our top ten priorities Our top ten priorities • Our top ten priorities Polish język polski 88 CommunicationsCommunications8 8 8Communications CommunicationsCommunications8 Communications and and engagement: engagement: and and and engagement: engagement: andengagement: engagement: Jeśli chcieliby Państwo otrzymać krotkie background background background background background background podsumowanie niniejszego dokumentu lub • • The national context The national context • • • The national context The national context The national context • The national context cały dokument w innym języku, prosimy o • • The local context The local context • • • The local context The local context The local context • The local context skontaktowanie się z Nami przy pomocy • • The NHS Constitution The NHS Constitution • • • The NHS Constitution The NHS Constitution The NHS Constitution • The NHS Constitution osoby anglojęzycznej pod numerem • • The engagement 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Public information and campaigns • Public information and campaigns • • External communications External communications • • • External communications External communications External communications • External communications • • Electronic media Electronic media • • • Electronic media Electronic media Electronic media • Electronic media • • Reputation management Reputation management • • • Reputation management Reputation management Reputation management • Reputation management • • Branding/social marketing Branding/social marketing • • • Branding/social marketing Branding/social marketing Branding/social marketing • Branding/social marketing 01473 704770 • • Emergency preparedness Emergency preparedness • • • Emergency preparedness Emergency preparedness Emergency preparedness • Emergency preparedness • • Community engagement Community engagement • • • Community engagement Community engagement Community engagement • Community engagement • • Equality and Diversity Equality and Diversity • • • Equality and Diversity Equality and Diversity Equality and Diversity • Equality and Diversity
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2 Annual Report and Accounts 2012 / 13 Contents
Welcome ...... 3 Chair’s Foreword ...... 4 Chief Executive’s Overview ...... 5
What We Need To Tell You ...... 6 Background and Context ...... 6 Key Relationships ...... 13 Sustainability Report ...... 17 Structure and Management ...... 19
Performance and Accounts ...... 25 Performance ...... 25 Operating Financial Review ...... 28 Our Accounts ...... 30 Remuneration Report ...... 38 2012 / 13 Governance Statement ...... 42 Declaration of Interests 2012 / 13 ...... 51
Glossary of Terms ...... 53
Thank You To ...... 54
This Annual Report has been prepared in accordance with the requirements set out in the 2012 / 2013 NHS Trust Manual for Accounts. The Quality Account 2012 / 13 is a companion document to this report and is available on line at www.ipswichhospital.nhs.uk
3 Annual Report and Accounts 2012 / 13 Welcome Chair’s Foreword
I am very pleased to top rating was given by Dr Foster, introduce this annual report, an information analyst company at the end of my first year independent from the NHS, who as Chair, and in particular to rated us in the top six in the country for clinical efficiency. highlight just a few of the outstanding achievements And there’s more. We’re working made possible by the hard with national charity The King’s work and dedication of all Fund to improve the care we give to dying patients and their our staff and volunteers families, and are one of the first who make up the Ipswich in the country to sign up for a Hospital NHS Trust. call for action to improve care in hospitals for patients with dementia. We’ve continued to deliver safe, Ann Tate CBE, The past year has been Chair. compassionate care despite much particularly turbulent in the light intense pressure on services of the significant changes being particularly the Emergency introduced across the whole The Care Quality Commission, Department throughout the year. NHS in England and these will who regulate standards in all We are a strong hospital continue to resonate in the health and social organisations, confident of the future, thanks in coming year. In that context it inspected the hospital and gave no small part to the tremendous is therefore doubly gratifying to us a completely clean bill of support we receive from our be able to point to a wide range health – a testament to the hard community, our Members of of success across all our clinical work of staff in improving quality, Parliament, shadow governors, areas. involving patients and family local and regional councillors carers in treatment and care Most notably it has been a year and of course our partners and programmes, and raising the bar in which our maternity services commissioners of care. were awarded the national on patient experience. My thanks to you all. accolade of Maternity Unit of the There was excellent feedback Year 2013 by the Royal College too from patients using the of Midwives. Emergency Department who We have successfully planned, rated the service well above the national average. The Emergency built and delivered a major new Ann Tate CBE Department team’s expertise was heart centre, and a sterile services Chair acknowledged by being given department, on time and on 31 March 2013 budget. These developments Trauma Unit status this year. which cost £10.8 million will Our hospital’s skin cancer care is make a real difference to among the best in the country. patients and allow us to deliver A review of services this year services closer to home for the shows the hospital shares top community we serve. fourth spot in the UK. Another
4 Annual Report and Accounts 2012 / 13
Chief Executive’s Overview
This is my first annual concerned with making genuine report and I am delighted improvements in health and to give this overview. I am social care for people when they really pleased to be part become unwell. By working collaboratively we can make real of what is clearly a team and sustained improvements to of outstanding people people’s health and wellbeing. committed to improving the I want this hospital to be one lives of the community we that everyone can be proud of, serve. the patients we treat, the staff and volunteers who work here and the community we serve. I have inherited a legacy of When we get it wrong, we need exceptional leadership. Nigel to know about it so we can get Beverley was the interim chief it right the next time. I have only executive of the hospital for 11 Nick Hulme, been here a short time but I am Chief Executive. months, taking over from Andrew very proud of the hospital and Reed who had led the hospital for I know that we can become an almost seven years before that. outstanding centre of care. What we are starting to do now We will need to change the way is build on this and really develop the hospital works, including the clinical leadership with clinicians buildings to deliver this. Form at the heart of the organisation follows function so we will need supported by highly skilled to review the hospital site and managers and support staff. potentially change the estate to Nick Hulme deliver this. Chief Executive The NHS faces significant 31 March 2013 challenges and scrutiny that The £10.8 million investment won’t go away as we move programme that we have had this into the next period of our year to build a new cardiology developments. centre and sterile services department will make a fantastic What’s clear is that we need to contribution to the work of the do things differently. Our new hospital. Of course, buildings clinical strategy sets out how don’t by themselves make the we think we can deliver safe, difference it is the people who compassionate care centred work within them. around the patient. This will mean a departure from tradition, The hospital has positive and with more specialist care being good relationships with the delivered in GP surgeries and clinical commissioning groups, health centres and one visit to local authorities and the voluntary hospital for patients for all the sector, together with external tests they need. partners, all of whom are
5 Annual Report and Accounts 2012 / 13 What We Need To Tell You Background and Context
The Ipswich Hospital NHS Trust is a National Health Service Trust providing hospital-based health care to more than 443,000 people who live in and around Ipswich and east Suffolk. The Secretary of State for Health approved Trust status for Ipswich Hospital in April 1993.
The hospital is geographically The hospital has 554 beds (as A changing landscape located in the Suffolk of 31 March 2012) in general The Health and Social Care county town of Ipswich, and acute, maternity, paediatric and Act 2012 is the most extensive administratively within the neonatal services and had an re-organisation of the structure boundaries of Ipswich & East annual turnover of £238 million of the NHS in England to Suffolk Clinical Commissioning in 2011 / 12. Across its 46-acre date. It sets out a new system Group, Suffolk County Council site, we employ just over 3,700 for the NHS and, specifically, and NHS Trust Development whole-time equivalent NHS staff. the establishment of a new Authority Midlands and East. We are proud of the services commissioning system. It is a vibrant single-site, medium- we provide and of our staff Suffolk’s Local Health Economy size acute hospital, renowned who go ‘above and beyond’ currently consists of two local for providing a high standard of to do the very best they can in clinical commissioning groups specialist healthcare services to what can sometimes be difficult (West Suffolk CCG, Ipswich & the residents of Ipswich and east circumstances. East Suffolk CCG), Norfolk & Suffolk, and some specialties such We have a longstanding focus Suffolk NHS Foundation Trust as spinal surgery, radiotherapy on improving the quality of (mental health services) and West and percutaneous coronary our services, and we set high Suffolk NHS Foundation Trust intervention (PCI) from September standards for ourselves. The Trust (acute services) and us. 2013 to a wider population, as offers a comprehensive range of well as outreach services in a All partners work to serve the acute and secondary care patient number of clinical specialties. Suffolk population and have built services. strong and cohesive working We are a safe hospital, with a arrangements. The Local Health low standardised mortality rate. Economy partners work together with Suffolk County Council at the Suffolk NHS QIPP Forum to take forward Suffolk’s healthcare priorities.
Our Maternity Services team won the Royal College of Midwives’ Maternity Service of the Year Award 2013.
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Background and Context
We have had a mission to The Trust has undertaken a review Our Mission and Vision provide care and prevent ill of the healthcare environment The Ipswich Hospital NHS Trust health since we were founded, that it is operating within which has embarked upon an exciting but the environment around us included the following. and challenging journey to has changed enormously, and The impact of rising demand, achieve a new vision and strategy will continue to change. We demographic changes and for the future. Over the next must respond to these changes the costs of new drugs and few years, significant challenges – in the population’s needs and technologies means that the NHS will affect all parts of the NHS. expectations, in technology and will need to deliver efficiency It is our strong belief that many in the economics underpinning savings of up to £20 billion in the acute hospital services will only healthcare. coming years whilst improving be sustainable when provided for Our response will include changes the quality of a comprehensive larger populations than currently, in the way we look after our service on offer to patients. For probably in partnership with patients. We know that because us, this results in the need to other providers. people are living longer, many make productivity gains of at Our mission is: more will need treatment for least 4% each year at least until conditions like cancer and heart the end of 2018. Whilst some “to continue to provide disease. There are great research of this will be achieved through care and prevent ill health developments on the horizon operational efficiencies (and all by moving towards being which mean that we can do such opportunities are being at the centre of a network much more for our patients with pursued), these measures will not of services for the county of cancer and blood disorders, for by themselves be sufficient to Suffolk and parts of north east example. And we know that if address the efficiency gap for the Essex, working with partners, we organise ourselves differently, Trust. Ensuring the sustainability operating from a wider health much of the care our patients of high quality acute services campus, providing co-located need could be provided closer to will require transformational and integrated services and their homes. We must find ways change within acute services and fostering education, teaching of delivering services that will not across the other local healthcare and research.” only satisfy our patients, but will providers. also reduce costs for the health system as a whole.
About 500 babies a year need specialist care in our Neonatal Unit.
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Background and Context
We want to be judged by the • We have a wide range of • Developing multiprofessional quality of care we provide to skilled staff. education, training and those who choose to use our • We promote education and research and achieve services, both now and in the training and foster research University Hospital status by future. locally to support our status working with local higher education providers. Our commitment to high as a teaching hospital quality patient care delivery affiliated to the University of We recognise that delivery of our is encapsulated in a simple Cambridge, the University vision will be challenging, and statement “Our passion, your of East Anglia and University will only be achieved through care”. Campus Suffolk. partnership working, but it is In the shorter term, our plan is to aimed at ensuring high quality Vision for the Future take incremental steps to achieve sustainable healthcare services Our vision for the future is, to the longer term vision by: for the future for our catchment be at the centre of a networked population. • Enhancing the provision of provision of healthcare services healthcare services by creating Our values are: to the population of Suffolk and local specialists centres. north east Essex. Respect and dignity • Delivering integrated models We value each person as The rationale for our vision is of care with Community an individual, respect their outlined below: Providers, and local aspirations and commitments in • Sustainability of small to Commissioners, consistent life and seek to understand their medium sized DGHs will only with Care Closer to Home. priorities, abilities and limits. We be achieved by partnerships • Developing strategic alliances take what others have to say and networked service with other acute provider seriously. We are honest about provision with the move to organisations to promote our point of view and what we 24 / 7 consultant-led services improved quality of care and can and cannot do. and workforce constraints. best value through partnership • Ipswich Hospital provides working. Commitment to quality of care a range of local specialist We earn the trust placed in us by healthcare services. insisting on quality and striving to get the basics right every time: safety, confidentiality, professional and managerial integrity, accountability, dependable service and good communications. We welcome feedback, learn from our mistakes and build on our success.
Our Pathology department includes Haematology, Clinical Biochemistry, Microbiology, Cytology and Histology.
8 Annual Report and Accounts 2012 / 13
Background and Context
Compassion Everyone counts Looking to the future We respond with humanity and We use our resources for the The Trust Board has agreed that kindness to each person’s pain, benefit of the whole community, Patient Safety is paramount in distress, anxiety or need. and make sure nobody is its importance and is therefore excluded or left behind. We integral in everything that we do. Improving lives accept that some people need As such, the Board has agreed We strive to improve health more help, that difficult decisions that nothing we do, in the and wellbeing and people’s have to be taken and that furtherance of the achievement experiences of the NHS. We value when we waste resources we of any of our objectives, must in excellence and professionalism waste others opportunities. We any way compromise the safety wherever we find it – in the recognise that we all have a part of patients. everyday things that make to play in making ourselves and We have developed six over- people’s lives better as much our communities healthier. arching strategic objectives to as in clinical practice, service Our five key objectives are to support realisation of our vision: improvements and innovation. have: 1 Be in the top 10% of • Excellent outcomes: clinical, Working together for patients healthcare providers for and research; We put patients first in providing an excellent • Excellent experience: for everything we do by reaching patient experience, harm- patients, staff and GPs; out to staff, patients, carers, free and with positive clinical families, communities and • Excellent value: improving outcomes. professionals outside the NHS. efficiency and productivity and 2 Be the first-choice provider of We put the needs of patients reducing costs; local healthcare services. and communities before • Full compliance: meeting or 3 Continue to develop organisational boundaries. exceeding all regulatory and local specialist centres (eg outcome standards; and Oncology/ Radiotherapy, and To be: Cardiac Services) and continue • A strong organisation, to foster innovation and effectively investing in our change in all service delivery staff and our infrastructure to to ensure clinical excellence. ensure that we are fit for the future.
Each year, our Pathology service provides 5 million test results.
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Background and Context
4 Develop innovative integrated The hospital has set itself the Ensuring that these are care, so that patients only visit following priorities to improve embedded will be measured the hospital when necessary, quality which are: through; a baseline cultural eg patients suffering long survey comparison to a • To minimise in-hospital harm term conditions. follow-up survey, National to patients from pressure Staff Survey results, patient 5 Be in the top 20% of hospitals ulcers, falls, urinary tract experience data (complaints, assessed against Staff Net infections from catheters and compliments, friends and Promoter Indicators. venous thromboembolism family test – net promoter 6 Achieve a year-on-year surplus (VTE) by working towards score for staff and patients). to reinvest in improving above benchmarked standards services. for ‘harm-free care’; • Improvement in the net promoter score (otherwise We will take into account the • To reduce the numbers of known as the ‘friends and current economic and financial patients readmitted within family test’ who would challenges. 30 days with a condition recommend Ipswich Hospital associated with their previous as a place of treatment to their Quality episode of care, in comparison friends and family) for patients Our approach to quality is to 2012/13 by 31 March receiving care as inpatients, in based on patient safety, clinical 2014; the Emergency Department effectiveness and patient • To reduce amenable mortality and as outpatients. experience. levels in line with benchmark The Quality Report 2012 / 13 is Each year we produce a Quality data (“amenable” mortality is available from late June 2013. Account, which is warmly defined as deaths that were welcomed by staff as it gives potentially preventable by the hospital one central place to direct, timely and appropriate bring together all the different medical care); sorts of information which is • To develop organisational currently collected. It makes values which are understood, the information much more owned and underpin the meaningful and helps staff take behaviours of all Trust staff. immediate action to address issues identified.
Our state-of-the-art Pharmacy robots can sort and store 30,000 packs of drugs.
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Background and Context
Care Quality Commission National policies and priorities CCG was established in April The Care Quality Commission The Department of Health’s 2012 and has responsibility for is the independent regulator Operating Framework approximately 385,000 patients. of health and adult social care 2012 / 13 sets out a number The CCG is expected to have services in England. Every hospital of requirements for all NHS funding of £425m to commission is monitored to make sure they organisations and highlights the healthcare services each year. continue to meet essential need to: The Governing Body of the standards of quality and safety. • maintain and improve the CCG includes seven local GPs Ipswich Hospital was visited by quality of services, building on from across the Ipswich and the CQC in July 2012 and was success to date; east Suffolk area. Additionally, found to be meeting all the the Governing Body includes a • retain financial control essential standards of quality and secondary care doctor (who has and meet the quality and safety inspected. to be from out of the area), a productivity challenge; and ‘patient and public involvement’ NHSLA • to make progress on lay member and an ‘audit and The NHSLA is the litigation the transition to new governance’ lay member. authority which works to improve arrangements. Local GPs understand what their risk management practices in the Local context patients need. Having GPs from NHS. Every NHS hospital is visited Ipswich and east Suffolk in charge by independent assessors once NHS Ipswich and East Suffolk of the local healthcare budget every 2 – 3 years, and this includes Clinical Commissioning Group means they will hold the purse visits to wards, looks at how we (the CCG) is a group of 42 GP strings. This will ensure we make manage clinical risk and informs practices in Ipswich and the the right decisions on buying the premium we pay for clinical eastern part of Suffolk. and managing health services negligence claims. In February From 1 April 2013, the CCG and make a real difference to 2011 we were accredited at became responsible for the community’s health and NHSLA level 2. We had previously commissioning (buying-in) and wellbeing. attained level 1 accreditation managing healthcare services so we are very pleased to have once the local primary care trust, reached this higher status. NHS Suffolk, ceased to exist. The
We carry out over 15,000 operations in theatres a year.
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Background and Context
Ipswich and East Suffolk CCG Specifically the CCG’s priorities (I&ESCCG) overarching aims are are to: to: • improve health and educational • work effectively with patients, attainment for children and carers, communities, clinicians young people; and partners; • improve outcomes for patients • improve the health and with diabetes to above national wellbeing of the people of average; Suffolk; • improve care for frail, elderly • help individuals to take individuals; responsibility for their health; • improve access to mental health • ensure high quality health services; services for all who need • allow patients to die with them; dignity and compassion, and • give patients and their carers choose their place of death; easy access to joined-up • improve the health of those services; and most in need; • maintain financial balance. • ensure high quality local services wherever possible; and • promote self-care.
Over 100 patients a day are treated in our Radiotherapy department.
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Key Relationships
Staff establish for the first time ‘The • To develop a formal support Ipswich Hospital Running Club’, structure and leadership We have over 3,700 members primarily aimed at newcomers programme for middle of staff (3,113 WTE) and around to running, encouraging staff managers within the Trust. 500 volunteers all working to be active, fit and look after together to provide safe and We continue to invest in the themselves. With a sickness caring services to our patients. training and education of all absence rate for 2012 / 13 of There is a new structure within our staff, and have a dedicated 4.5%, we are keen to do all the hospital, enabling more Postgraduate Education Centre we can to provide support and clinicians to be involved in on site, working closely with the guidance to staff on their health the decisions being taken and local universities in East Anglia, and wellbeing. We continue with providing the direction and steer with some of our staff teaching our successful programme of to enable the continued success on programmes of higher health and wellbeing activities of the organisation. education. and promotional events for staff, There are always ways in which which have been warmly received With a new Chief Executive we can improve services for with requests for more! at the helm, this is an exciting patients and quality of life for time for the hospital, to build • To improve access to our staff and we are proud to on the successes and challenges healthcare and health have launched the In Your Shoes of 2012 / 13 and continue to outcomes of older people and and In Our Shoes programmes drive forward a transformation those with learning disabilities. to listen to both staff and programme ensuring that our patients, enabling us to set aside • To improve services for patients and staff are at the heart dedicated time to hear stories protected groups by collecting of the services we provide. from everyone of what their and making use of effective experiences have been when equality data. they have either used or provided • To ensure all protected groups services here. are truly represented and closely engaged with, so that Equality and fairness, and the Trust is able to respond recognising diversity within our appropriately to both the community and staff are always clinical and non-clinical needs at the heart of the services we of patients and carers. provide. Our staff are actively involved in promoting health and wellbeing within the workplace, with some keen promoters of fitness volunteering to be trained as running coaches to
Image from our £2million state-of-the-art Truebeam radiotherapy machine.
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Key Relationships
Patients • Patients receive excellent We have a well-established fundamental care including framework of patient Patients are at the centre of all good food and adequate help representative or user groups we do. We have a strong heritage with basic personal care. within the hospital. The Ipswich of working together with patients Hospital User Group (IHUG) is to make sure their voices are • Patients and the public are the over-arching group with heard; their views shape decisions included in the planning representation from each and they are active partners in and evaluation of service individual group, being full planning services. provision and feedback that they provide (via members with Suffolk Family A Patient Experience Group which user groups, surveys) and Carers and Healthwatch as ex- includes patient representatives PALS & Complaints is used officio members. who voice the views of patients, appropriately. IHUG meets with the Directors their families and visitors, is now • Information is available and Non-Executive Directors well-established and has made for patients and carers of the hospital on a six-weekly several thought-provoking films. throughout their journey and basis allowing issues to be taken The key principles of our Patient support to understand that ‘straight to the top’ as well as Experience work are: information is made available. enabling senior management • All staff have a responsibility • There is adequate access to to engage with patient and for creating an environment spiritual, pastoral and religious carer representatives around where patients receive a good support. operational issues as well as key patient experience. policy and strategy developments. • Family members’ and carers’ • All patients and visitors should needs are considered and There are 14 user groups covering feel welcomed, informed access to support is available. both specific conditions, for and treated with dignity and • Bereaved family and carers example, cancer and diabetes, respect throughout their have access to support. and addressing wider issues patient journey. such as disability and diversity. • Patients and family / carers • The environment is clean, receive high quality ‘end of welcoming and well furnished. life’ care. • Patients feel safe and • Equality and diversity are informed about infection respected at all times. control measures.
During intensive weeks, our Physiotherapy service can see up to 560 patients.
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Key Relationships
Members are patients, carers and Community Key strategic alliances representatives from community We work closely with our As well as working closely with partners such as Age UK. More commissioners and partners Clinical Commissioning Groups, than 150 people are actively both within the NHS and local the National Trust Development involved in these groups and authorities (Suffolk County Agency, Local Area Team, provide insight to enable the Council, Ipswich Borough colleague NHS trusts and local patient and carer perspective Council, Mid Suffolk, Babergh, authorities, we have strategic and experience to influence the and Suffolk Coastal District alliances with universities and development and provision of Councils) to understand and colleges, particularly University services. respond to social and community Campus Suffolk, and medical The hospital already collates issues. These include health schools. patient feedback in a number inequalities, social inclusion, of ways including inhouse and equality of access to health and national patient surveys, services. We have a specific monitoring of complaints and engagement and communications compliments and ‘Your Views programme for communities who Matter’ comment cards on wards. have traditionally not had the iPads (hand-held digital same level of access to health devices) are also capturing services (often referred to as ‘hard patients’ feedback, which is to reach’ groups). collected separately for each area and displayed outside the department’s entrance each month. The hospital was part of the East of England’s pilot for the ‘friends and family’ test survey which has now been rolled out nationally and will provide patients with the opportunity to say whether they would recommend this hospital to their friends and family.
We employ just over 3,400 staff. Some are internationally renown.
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Key Relationships
Sustainability The Trust uses the Premises The sustainable key actions are as Assurance Model when this follows: The Trust is committed to is available as a rigorous self- sustainability of finite resources • The Trust has developed assessment tool to enable the and has developed a proactive a Carbon Reduction Plan Trust to certify that its premises sustainability agenda. The to achieve at least a 20% achieve the required statutory Trust has developed a Carbon reduction in emissions in line and NHS nationally agreed Reduction Plan which has been with government national standards. discussed and adopted by the targets for the NHS. Trust Board. The plan has also The Trust works with our Local • The Trust has calculated its been approved by the Carbon Strategic Partnerships and uses carbon footprint. the Good Corporate Citizen Trust as part of the Trust’s sign-up • An action plan of projects Model to inform our decision to the NHS Carbon Challenge. has been developed to deliver making and support our The Carbon Reduction Plan seeks the required carbon reduction development in Corporate Social to reduce the carbon emissions targets. of the Trust to enable the Responsibility (CSR). • A Sustainable Development Government carbon reduction Management Plan has been targets to be met and addresses introduced. direct energy consumption, procurement, transport and • The Trust has signed up waste. The Trust’s Transport to the Good Corporate Travel Plan has been developed Citizen Assessment Test in conjunction with Ipswich and is developing an action Borough Council and this has programme based upon the been adopted by the Board. results. • The Trust carries out benchmark comparisons against similar Trusts. • The Trust will continue to work with the Carbon Trust and other sustainable organisations. The Trust continues to seek to reduce its estate and carbon footprint where possible.
Nurses around the world – includingCath here Gorman,at Ipswich – are celebrated every year on May 12, the anniversary of FlorenceAssociate Nightingale’s Director of Nursingbirth. – Quality & Compliance.
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Sustainability Report
1% 1202 tonnes of waste recovery The NHS aims to reduce its carbon footprint by 10% between 2009 and 2015. Reducing the amount of We recover or recycle 1202 tonnes of waste, which energy used in our organisation contributes to this is 98% of the total waste we produce. goal. There is also a financial benefit which comes Our expenditure on waste in the last two years was from reducing our energy bill. Major developments incurred as follows: such as the new Cardiology Unit and HSDU and the introduction of new equipment such as in Diagnostic 2011 / 12 Clinical Waste incineration £108,748 Imaging (X-ray) meant a rise of 1% in our overall Domestic Waste £63,815 energy use and carbon emissions. The Trust is still on 2012 / 13 Clinical Waste incineration £106,303 target, however, to achieve the reductions stated. Domestic Waste £62,694
Energy consumption potential savings £1,228,860 Our total energy consumption has risen during the We have put plans in place to reduce carbon year, from 27,727 to 29,369 MWh, however our emissions and improve our environmental relative energy consumption has changed during the sustainability. Over the next 15 years we expect to year, from 0.32 to 0.29 MWh / square metre. save £1,228,860 as a result of these measures. We supply 60% of our space heating from renewable sources; 10% of our supplied electricity is from renewable sources. Our measured greenhouse gas emissions have increased by 480 tonnes this year. Our water consumption has reduced by 1632 cubic meters in the recent financial year. In 2012 / 13 we spent £276,709 on water.
Healthcare assistants play a vital role in patient safety and care.
17 Annual Report and Accounts 2012 / 13
Sustainability Report
CRC payment and infrastructure in the future. It is therefore appropriate that we consider it when planning how The CRC Energy Efficiency Scheme is a mandatory we will best serve patients in the future. scheme aimed at improving energy efficiency and cutting emissions in large public and private Sustainability issues are included in our analysis of sector organisations. During 2012 / 13 our gross risks facing our organisation. expenditure on the CRC Energy Efficiency Scheme NHS organisations have a statutory duty to assess was £129,276 which was slightly lower than the the risks posed by climate change. Risk assessment, initial predicted amount. including the quantification and prioritisation of risk, is an important part of managing complex organisations. Travel costs In addition to our focus on carbon, we are also During 2012 / 13 our total expenditure on business committed to reducing wider environmental and travel was £28,000. social impacts associated with the procurement of goods and services. This is set out within our policies Sustainable Management on sustainable procurement. We plan to start work on calculating the carbon emissions associated Our organisation is continuing to develop its goods and services we procure. sustainable management plan. Having an up-to- date Sustainable Development Management plan The Chief Operating officer is the Board Level is a good way to ensure that an NHS organisation Lead for Sustainability. A Board Level lead for fulfils its commitment to conducting all aspects of Sustainability ensures that sustainability issues have its activities with due consideration to sustainability, visibility and ownership at the highest level of the whilst providing high quality patient care. The NHS organisation. Sustainability issues, such as carbon Carbon Reduction Strategy asks for the boards of all reduction, are included in the job descriptions of NHS organisations to approve such a plan. all staff. “A sustainable NHS can only be delivered through the efforts of all staff.“ We consider the potential need to adapt the organisation’s buildings and estates as a result of Our organisation has a Sustainable Transport climate change, but not the potential need to adapt Plan. The NHS places a substantial burden on the the organisation’s activities. Adaptation to climate transport infrastructure, whether through patient, change will pose a challenge to both service delivery clinician or other business activity. This generates an impact on air quality and greenhouse gas emissions. It is therefore important that we consider what steps are appropriate to reduce or change travel patterns.
Cath Gorman, Associate Director of Nursing – Haughley Ward has special signage and decor to help patients. Quality & Compliance.
18 Annual Report and Accounts 2012 / 13
Structure and Management
The overall management Chair and Non-Executives of the hospital is the responsibility of the Trust Ann Tate CBE Chair (from 02 / 04 / 2012) Board which comprises a Chair, five non-executive Julia Holloway Non-Executive Director and executive directors. Alan Bateman Non-Executive Director
Tony Thompson Non-Executive Director
Andrew George Non-Executive Director
Dave Norval Non-Executive Director (until 31 / 12 / 2012)
Ann Tate CBE, took up her new The Committee meets five times The Chief Executive and Executive appointment as Trust Chair on a year. The role of the Audit Directors were appointed using 2 April 2012. Committee is to ensure effective open competition and a selection control programmes are in place process. They were appointed All non-executive director and provide an independent on a permanent basis and are appointments up to 30th check upon the executive arm of subject to annual performance September 2012 were made the Board. reviews, Trust policies and through the Appointments procedures. During the year Commission. Responsibility The Audit Committee 2012 / 13, three interim directors for non-executive director independently reviews, monitors were appointed, Nigel Beverley appointments transferred to the and reports to the Board on the as interim chief executive from NHS Trust Development Authority attainment of effective control May 2012 until 31 March 2013, from 1st October 2012. systems and financial reporting processes. In particular, the Margaret Blackett as interim The Chair and all non-executive committee’s work focuses on the director of transformation (and directors are members of the framework of risk control and later this included operations) Trust Board, and Remuneration related assurances that underpin from July 2012, and Mary Committee. the delivery of Trust’s objectives. Leadbeater as interim director of finance from 24 September 2012. All the non-executive directors The Audit Committee receives Paul Scott has been appointed are members of the Audit and considers reports from both the substantive director of Committee. Membership does internal and external auditors and finance and joins the Trust on not include the Trust Chair. reviews the annual accounts and 3 June 2013. A substantive chief financial statements. Through The Audit Committee’s operating officer Neill Moloney this Committee, actions are membership is all of the non- has also been appointed and joins put in place to ensure that all executive directors. The Chief the Trust in July 2013. Executive and Director of Finance recommendations of internal and and Performance are attendees at external audit reports are picked Details of directors remuneration each meeting as well as external up, as well as other assurance are given on page 39 of this and internal auditors. functions. report.
19 Annual Report and Accounts 2012 / 13
Structure and Management
Trust Executive Directors
Andrew Reed Chief Executive Left the Trust on 18 / 05 / 2012
Commenced on 21 / 05 / 2012 Nigel Beverley Interim Chief Executive Left the Trust on 31 / 03 / 2013
Peter Donaldson Trust Medical Director Tenure as Medical Director ended on 31 / 03 / 2013
Director of Nursing and Quality, Siobhan Jordan Left the Trust on 17 / 06 / 2012 Infection Prevention and Control Interim Director of Nursing and Quality, Catherine Morgan 18 / 06 / 2012 to 12 / 08 / 2012 Infection Prevention and Control Director of Nursing and Quality, Lynne Wigens Commenced on 13 / 08 / 2012 Infection Prevention and Control Seconded to the SHA from 17 / 09 / 2012 Stephanie Watson Director of Finance and Performance Left the Trust on 31 / 03 / 2013 Interim Director of Finance Mary Leadbeater Commenced on 24 / 09 / 2012 and Performance
Julie Fryatt Director of Human Resources
Margaret Blackett Interim Director of Transformation* Commenced on 02 / 07 / 2012
John Watson Director of Operations * Left the Trust on 18 / 01 / 2013
Andy Burroughs Director of Business Development * Left the Trust on 10 / 04 / 2012
* Non-voting board member.
The executive directors clinically led organisation. There work closely with clinicians are three divisions each with in developing strategic and a Divisional Clinical Director, a operational plans. A senior Head of Nursing and a Head of management team contributes to Operations, together with clinical and implements Board, executive delivery groups leads. and clinical team decisions. For the year covered in this On 1 April 2013, a new way Annual Report, there were seven of leading and managing has business units in place with an been introduced to build a executive support unit.
20 Annual Report and Accounts 2012 / 13
Structure and Management
The business units were: Research and Major incident planning General Acute Services and Development Strategy The Trust has in place a major Pain which included Emergency The Trust’s Research and incident plan which is fully Department, assessment units, Development Strategy (which also compliant with ‘Handling Major theatres and anaesthetics, critical contains a policy and operational Incidents: An Operational care and pain management. procedure for the management Doctrine’ and accompanying General Surgery and of intellectual property), is well NHS guidance on major incident Gastroenterology which established throughout the Trust. preparedness and planning. included gastrointestinal (GI) Staff working in the Research medicine, colorectal surgery, and Development office provide vascular surgery, upper GI surgery support and guidance to all Listening and learning and hepatobiliary surgery. hospital colleagues. We strongly encourage people Specialist and Older People’s who use the Trust – patients, Medicine which included their relatives and friends – to tell Governance cardiology, neurology, care of us what they think about their the elderly, respiratory medicine, Clinical Governance is about treatment and care. This helps us diabetes, renal medicine, thoracic continual improvement in the to continually improve services surgery and dermatology. quality of care provided by NHS and to address problems quickly. organisations, and ensuring Information leaflets and posters Special Surgery which included that improvements, where in wards, clinics and reception ENT, ophthalmology, oral surgery, needed, are made in a climate areas set out how people can orthodontics, audiology, urology which is supportive, open and make their views known. and plastic surgery. learning. The hospital has a Risk The complaints service continues Musculoskeletal Services and Governance Group. Each to manage the complaints which included trauma and business unit had a governance process much more closely than orthopaedics, and rheumatology. group and together they had a in previous years, ensuring the Women and Children’s vital role in bringing change, and process is fair, consistent and Services which included considering clinical developments, timely. Much support is being maternity services, neonatology, service improvements, risk offered to Trust staff responsible gynae-oncology, sexual health, management and internal control for handling complaints which HIV / AIDS, gynaecology, breast issues throughout the Trust. The is welcomed. Feedback from surgery, child health and Trust complies with the clinical staff, patients and relatives has community midwifery. governance reporting framework generally been very good. issued in November 2002. Clinical Support Services and Cancer which included diagnostic imaging, pathology, pharmacy, oncology and haematology, therapy services and central outpatients.
21 Annual Report and Accounts 2012 / 13
Structure and Management
Complaints are recorded in Low level The number of complaints has three ways, depending on their Simple, non-complex issues dropped slightly compared to the severity: including, for example, delayed or previous year (646 in 2011 / 12 cancelled appointments, lack of and 619 in 2012 / 13). This is very High level cleanliness, transport problems. encouraging particularly when Multiple issues relating to a taking into consideration the longer period of care including an Dealt with by the Complaints increased level of activity the Trust event resulting in serious harm. Team or by PALS has experienced. Dealt with by the Complaints The complaints manager leads The PALS service continues to Team. or reviews every medium or high handle queries and concerns in level complaint investigation, Medium level a practical way, resolving and checking responses and Several issues relating to a short addressing issues at source to conclusions for accuracy and period of care including, for prevent issues escalating. This is a bias. The final response is drafted example, failure to meet care really positive step towards taking or checked by the complaints needs, medical errors, incorrect more responsibility for issues as manager (often with further treatment or attitude of staff or they arise. The PALS service is questioning and investigation at communication. now very well established and this point) and then passed on to continues to see an increase in Dealt with by the Complaints Chief Executive for final approval. Team.
800 Annual Complaint Levels
700 646 619 2011/2012 2012/2013 600
500 387 400 350 293 300 223 200
100 3 9 0 Low Medium High All
22 Annual Report and Accounts 2012 / 13
Structure and Management
demand. There has been a 28% If a complainant wishes to take • Plans are in place for a ward- increase in matters raised with their complaint further we advise based midwife to undertake PALS from 1,130 in 2011 / 12 to them they can contact the a secondment to the diabetes 1566 in 2012 / 13. Parliamentary and Health Service team in the Antenatal Clinic. Ombudsman (PHSO). In 2012 / 13 This secondment will form a The PALS team attends wards 11 complaints were taken to the regular rotation to the clinic and departments regularly to PHSO. Of these, ten were closed so that more midwives will support staff in handling negative by the PHSO without investigation be exposed to caring for feedback from patients and and we are currently awaiting the women with diabetes when relatives to encourage local outcome of the one remaining pregnant, with the hope resolution. As mentioned above, case. that this learning will be our PALS service allows us to shared more widely when the monitor issues that may escalate The PALS and complaints service midwives return to the ward into complaints and any issues are aim to not only explain and environment. escalated at the time to relevant apologise when things go wrong, senior managers. but work with departments to • A more appropriate location / make constant improvements and setting is now being sourced The teams welcome feedback adjustments following feedback. for “Teardrop” appointments. and complaints verbally, in Below are some specific examples • A deputy general manager person or in writing and just of actions taken following has been put in place to recently we have overcome concerns raised: help manage the Eye Clinic the issues surrounding email and ensure that patients get correspondence and are therefore • The nursing handover process as timely appointments as now able to accept and respond has now been changed on possible. to issues raised by email. Every Lavenham Ward so that complaint is acknowledged patients are more involved • A multiple sclerosis nurse within 72 hours and a meeting in the process, therefore specialist has been put in place is offered on request within each effective communication can for three days a week. acknowledgment letter. be maintained and patients should be fully aware of their care plan.
Our Critical Care Unit looks after about 75 patients a month.
23 Annual Report and Accounts 2012 / 13
Structure and Management
Serious Incidents Prompt Payments Code Charging for Information Requiring Investigation The Prompt Payment Code is a The Ipswich Hospital NHS Trust The hospital has a Serious Clinical payment initiative developed by complies with the Treasury’s Incident Group which meets to Government with the Institute guidance on setting charges for discuss any untoward incident of Credit Management (ICM) information. and to determine whether what to “tackle the crucial issue of has happened is a serious clinical late payment and help small incident, or a serious incident businesses.” Details of the code requiring investigation (SIRI). can be found at Both incidents are rigorously www.promptpaymentcode.org.uk investigated. A Serious Incident The code does not include any Requiring Investigation is targets but is a series of principles reported to both Ipswich and East that all NHS organisations are Suffolk Clinical Commissioning expected to follow during the Group and the National Trust normal course of business. The Development Agency. hospital has signed up to and endorsed the code.
The Emergency Department has been awarded Trauma Unit status.
24 Annual Report and Accounts 2012 / 13 Performance and Accounts Performance
The Trust maintained a Key facts and figures strong performance across a range of targets, national standards and other key Births: performance indicators 3,790 including achieving 18 weeks maximum wait for Emergency Department patients during the year. The attendances: Trust reduced its number of 75,127 hospital-acquired infections particularly C. difficile very significantly. Planned admissions: 45,438
Unplanned emergency admissions: 29,448
Outpatient attendances: 431,144
Number of appointments people did not attend: 27,407
Diagnostic Imaging examinations: 237,932
Referrals from GPs and dentists: 105,350
25 Annual Report and Accounts 2012 / 13
Performance
Governance Risk Ratings Historic Data
Qtr to Qtr to Qtr to Qtr to Area Ref Indicator Subsections Threshold Weighting Jun 12 Sept 12 Dec 12 Mar 13
2a From point of referral to treatment in aggregate (RTT) – admitted Maximum time of 18 weeks 90% 1.0 YES YES YES NO
2b From point of referral to treatment in aggregate (RTT) – non-admitted Maximum time of 18 weeks 95% 1.0 YES YES YES YES
2c From point of referral to treatment in aggregate (RTT) – patients on an incomplete pathway Maximum time of 18 weeks 92% 1.0 YES YES YES YES Patient
Experience 2d Certification against compliance with requirements regarding access to healthcare for people with a learning disability N / A 0.5 NO YES YES YES
Surgery 94%
3a All cancers: 31-day wait for second or subsequent treatment, comprising: Anti-cancer drug treatments 98% 1.0 YES YES YES YES
Radiotherapy 94%
From urgent GP referral for suspected cancer 85% 3b All cancers: 62-day wait for first treatment: 1.0 NO YES NO YES From NHS Cancer Screening Service referral 90%
3c All cancers: 31-day wait from diagnosis to first treatment 96% 0.5 YES YES YES YES Quality All urgent referrals 93%
3d Cancer: 2-week wait from referral to date first seen, comprising: For symptomatic breast patients 0.5 YES NO YES YES 93% (cancer not initially suspected)
3e A&E: From arrival to admission / transfer / discharge Maximum waiting time of four hours 95% 1.0 YES NO NO NO
Is the Trust below the de minimus 12 YES NO NO NO 4a Clostridium difficile 1.0 Is the Trust below the YTD ceiling 27 YES YES NO YES
Is the Trust below the de minimus 6 YES YES YES YES 4b MRSA 1.0 Is the Trust below the YTD ceiling 1 YES NO NO NO
CQC Registration
Safety A Non-Compliance with CQC Essential Standards resulting in a Major Impact on Patients 0 2.0 NO NO NO NO
B Non-Compliance with CQC Essential Standards resulting in Enforcement Action 0 4.0 NO NO NO NO
NHS Litigation Authority – Failure to maintain, or certify a minimum published CNST level of 1.0 C 0 2.0 NO NO NO NO or have in place appropriate alternative arrangements
TOTAL 1.5 2.5 3.0 3.0 RAG RATING AMBER / AMBER / AMBER / AMBER / GREEN = Score less than 1 GREEN RED RED RED
AMBER / GREEN = Score greater than or equal to 1, but less than 2
AMBER / RED = Score greater than or equal to 2, but less than 4
RED = Score greater than or equal to 4
26 Annual Report and Accounts 2012 / 13
Performance
Governance Risk Ratings Historic Data
Qtr to Qtr to Qtr to Qtr to Area Ref Indicator Subsections Threshold Weighting Jun 12 Sept 12 Dec 12 Mar 13
2a From point of referral to treatment in aggregate (RTT) – admitted Maximum time of 18 weeks 90% 1.0 YES YES YES NO
2b From point of referral to treatment in aggregate (RTT) – non-admitted Maximum time of 18 weeks 95% 1.0 YES YES YES YES
2c From point of referral to treatment in aggregate (RTT) – patients on an incomplete pathway Maximum time of 18 weeks 92% 1.0 YES YES YES YES Patient
Experience 2d Certification against compliance with requirements regarding access to healthcare for people with a learning disability N / A 0.5 NO YES YES YES
Surgery 94%
3a All cancers: 31-day wait for second or subsequent treatment, comprising: Anti-cancer drug treatments 98% 1.0 YES YES YES YES
Radiotherapy 94%
From urgent GP referral for suspected cancer 85% 3b All cancers: 62-day wait for first treatment: 1.0 NO YES NO YES From NHS Cancer Screening Service referral 90%
3c All cancers: 31-day wait from diagnosis to first treatment 96% 0.5 YES YES YES YES Quality All urgent referrals 93%
3d Cancer: 2-week wait from referral to date first seen, comprising: For symptomatic breast patients 0.5 YES NO YES YES 93% (cancer not initially suspected)
3e A&E: From arrival to admission / transfer / discharge Maximum waiting time of four hours 95% 1.0 YES NO NO NO
Is the Trust below the de minimus 12 YES NO NO NO 4a Clostridium difficile 1.0 Is the Trust below the YTD ceiling 27 YES YES NO YES
Is the Trust below the de minimus 6 YES YES YES YES 4b MRSA 1.0 Is the Trust below the YTD ceiling 1 YES NO NO NO
CQC Registration
Safety A Non-Compliance with CQC Essential Standards resulting in a Major Impact on Patients 0 2.0 NO NO NO NO
B Non-Compliance with CQC Essential Standards resulting in Enforcement Action 0 4.0 NO NO NO NO
NHS Litigation Authority – Failure to maintain, or certify a minimum published CNST level of 1.0 C 0 2.0 NO NO NO NO or have in place appropriate alternative arrangements
TOTAL 1.5 2.5 3.0 3.0
AMBER / AMBER / AMBER / AMBER / GREEN RED RED RED
27 Annual Report and Accounts 2012 / 13
Operating Financial Review
2012 / 13 was a year of As a result the hospital met all the key financial targets again: transition for Ipswich Key target Requirement Result Achieved? Hospital, but also the year Income and expenditure £787k surplus which saw the start of Break-even Yes (£205k adjusted*) its transformation into a surplus Capital cost absorption hospital for the future. 3.5% 3.5% Yes rate
The Trust reported a surplus External financing limit Less than £12.9m £9.4m Yes of £787,000 after meeting Capital resource limit Up to £23.0m £14.5m Yes all accounting and technical * Technical accounting reporting requirements mean that the reported income and expenditure surplus has to be reporting requirements. shown with and without the external income received from government grants and charitable funds. (This year the Income and Expenditure (I&E) The Trust’s I&E account included Management Office (PMO) on account included net non- the impact of paying for the Trust delivery of the full Cost Improvement Programme (CIPs). recurrent costs associated contractual consequences of £1.8m and a £1m repayment to with transformation and The Trust had received £3.2m NHS Suffolk (NHSS) that related restructuring services of from NHSS to implement a to a prior year contractual issue, robust strategic transformation £653,000, non-recurrent and the receipt of £2.02m and programme. This included costs of £310,000 related £653,000 to reflect the impact delivering savings of nearly £15m, to incomplete patient spells, on higher than baseline contract £3m higher than last year. A and non-recurrent external costs of treating the volume of number of schemes were part of government grants and actual emergency and outpatient the transformation programme charitable fund income attendances. This recognised that and included: net of depreciation of the application of national tariffs • redesign of patient pathways and NHS ‘business rules’ meant £582,000). The underlying in the Emergency Department that despite the rise in emergency ahead of further work to be surplus before recognising activity of 6%, the financial undertaken in 2013 / 14; the above in year issues was impact to the Trust was effectively • improving the discharge £1,168m. an income reduction of £6m. process to reduce delays so patients can leave on the day The delivery of both The Trust achieved this stronger they expect to; a reported surplus of financial position through £787,000 and an underlying focussing on managing activity • focussing on clinic and theatre against plan on a weekly basis utilisation to minimise waste surplus is an important of expensive clinical resources; milestone for the Trust and by reassessing the position • improving the purchasing of and evidences the positive against the year-end forecast with regular forward monthly medicines and other hospital outcome of the actions financial forecasts at both Trust supplies; taken in 2012 / 13 to and Business Unit level. This work • introducing new job planning respond to issues raised was accompanied by regular processes for clinical staff; and about the Trust’s financial Business Unit financial meetings • delivering an Estates and resilience. with a strong focus by the Project Clinical Services Strategy.
28 Annual Report and Accounts 2012 / 13
Operating Financial Review
Our total income fell by £1.4m ensure all our surgical equipment by strong budget management and our expenditure by £1.7m, is free of any infection risk. These and cost control based on the with non-pay costs rising by schemes were funded by the achievement of CIPs. We must £3.2m and total pay costs Department of Health. A further also recognise the financial falling by £4.9m, reflecting the £1.8m was invested in improving challenge facing all hospitals – reduction in staff numbers of 99 our maternity areas, £2.0m on how to deliver sustainable seven- between this year and last year, new equipment, £1.7m on new day clinical services within an and over £1.3m saved in agency, information technology and a ever tightening financial envelope bank and locum staff. Supplies further £900,000 on other estate – a problem that is particularly and services costs (eg bandages, improvements. pressing for hospitals of our size drugs and medical consumables) and geography. 2012 / 13 was a year of transition fell by over £700,000, despite for the hospital, and the first It is only by working with higher activity, as better step on our journey to deliver our new partners in Clinical procurement was an area our vision of high quality care Commissioning Groups (CCGs) targeted by our transformation in a safe and compassionate that we can deliver this challenge. programme. environment. This vision has to While the core service of our We ended the year with £6.7m be based on a strong financial hospital remains the delivery of in our bank account. However strategy in order to succeed 24 / 7 emergency and maternity our Better Payment Practice Code and the medium term financial care, we need to work together performance improved with the plans show that with gradually to find ways to ensure the number of invoices paid within increasing surpluses, the Trust hospital remains financially and 30 days increasing from 89% aims to move out a cumulative clinically sustainable. to over 93%. We continued deficit position before the end of Demand for care is growing, to prioritise payments to local the five-year planning period. but the money to pay for it is businesses paying over 90% by The Trust has shown that the reducing, and that is a challenge value within 10 days, a major high quality care provided in we must all work on together improvement from 63% last year. 2012 / 13 can be delivered within if we want Ipswich Hospital to The Trust also made its annual tight income streams supported thrive. £3.3m repayment on its working capital loan with the Department of Health, the final repayment on this loan will be made during 2013 / 14. The Trust spent nearly £15m on improving its assets with £4.5m spent on the new Ipswich Heart Centre and over £3.5m on our decontamination service to
Our Emergency Department treats around 60,000 people a year.
29 Annual Report and Accounts 2012 / 13
Our Accounts
This summary financial statement does not contain sufficient information to allow as full an understanding of the results of the Trust and of the policies and arrangements concerning directors’ remuneration as would be provided by the full annual accounts and reports. Where more detailed information is required, a copy of the Trust’s last full accounts and reports are available free of charge.
So far as the directors are aware, The summary below summarises the Independent auditors’ there is no relevant information information contained in the Trust’s statement to the Directors of which the Trust’s auditors are full financial statement for the year of the Board of The Ipswich unaware and the directors have ended 31 March 2013, a copy of taken all the steps that ought to which can be obtained from: Hospital NHS Trust have been taken to make themselves Paul Scott We have examined the summary aware of any relevant audit Director of Finance and Performance financial statement for the year information and to establish that The Ipswich Hospital NHS Trust ended 31 March 2013 which the Trust’s auditors are aware of that Heath Road comprises the Statement of information. Ipswich Comprehensive Income, the IP4 5PD Statement of Financial Position, the Summary Statement of Changes in The Trust’s external auditors are Taxpayers’ Equity, the Statement of PricewaterhouseCoopers LLP. Audit Cash Flows, the related notes, the fees for 2012 / 13 were £115,000 Directors’ Report and the information (2011 / 12 £174,000). in the Remuneration Report that is described as having been audited.
We have some of the best radiotherapy treatment machines in the UK.
30 Annual Report and Accounts 2012 / 13
Our Accounts
Respective responsibilities This statement, including the Opinion opinion, has been prepared for, and of directors and auditors In our opinion the summary financial only for, the Board of The Ipswich statement is consistent with the full The directors are responsible for Hospital NHS Trust in accordance annual statutory financial statements preparing the Annual Report and with Part II of the Audit Commission and the Remuneration Report of summary financial statement, in Act 1998, as set out in paragraph 45 The Ipswich Hospital NHS Trust for accordance with directions issued by of the Statement of Responsibilities the year ended 31 March 2013 the Secretary of State for Health. of Auditors and of Audited Bodies and complies with the relevant Our responsibility is to report to you (Local NHS Bodies) published by the requirements of the directions issued our opinion on the consistency of the Audit Commission in March 2010 by the Secretary of State. summary financial statement within and for no other purpose. We do the Annual Report with the full not, in giving this opinion, accept or annual statutory financial statements assume responsibility for any other and the Remuneration Report and purpose or to any other person to its compliance with the relevant whom this statement is shown or Julian Rickett, requirements of the directions issued into whose hands it may come save Engagement Lead by the Secretary of State. where expressly agreed by our prior consent in writing. We also read the other information For and on behalf of contained in the Annual Report We conducted our work in PricewaterhouseCoopers LLP and consider the implications for accordance with Bulletin 2008/3 Appointed Auditors our statement if we become aware issued by the Auditing Practices The Atrium of any apparent misstatements Board. Our report on the Trust’s St George’s Street or material inconsistencies with full annual statutory financial Norwich the summary financial statement. statements describes the basis of NR3 1AG The other information comprises our audit opinion on those financial Date: 7 June 2013 only the Chair’s Foreword, the statements, the Directors’ Report and Chief Executive’s Overview and the the Directors’ Remuneration Report. Operating Financial Review.
31 Annual Report and Accounts 2012 / 13
Our Accounts
Directors’ statement The auditors have issued unmodified opinions on the full annual financial statements; the part of the directors’ remuneration report that is described as having been audited; and on the consistency of the directors’ report with those annual financial statements. The auditors’ report on the full annual financial statements contained the following modified conclusion: The auditors have qualified their value for money conclusion because in their view, in considering the Trust’s arrangements for securing financial resilience, they identified that the Trust had not met its 5-year rolling cumulative breakeven target and did not have robust plans in place to: • achieve approximately £1.2 million of its target savings of £13 million for 2013 / 14; and • meet its cumulative breakeven target until 2017. The auditors’ report contained no statement on any of the matters on which they are required, by the Code of Audit Practice, to report by exception.
Our £26 million Garrett Anderson treatment centre is home to Emergency Department, day surgery, an elective surgery ward and Critical Care.
32 Annual Report and Accounts 2012 / 13
Our Accounts
Statement of Comprehensive Income for the Year Ended 31 March 2013
2012 / 13 2011 / 12 £000 £000
Employee benefits (139,666) (144,531) Other costs (90,233) (87,199) Revenue from patient care activities 217,407 213,928 Strategic Transformation Funding 0 5,500 Other Operating revenue 19,325 18,722 Operating surplus / (deficit) 6,833 6,420
Investment revenue 29 32 Other gains and (losses) (110) (3) Finance costs (2,138) (2,234) Surplus / (Deficit ) for the financial year 4,614 4,215 Public dividend capital dividends payable (3,827) (3,486) Retained surplus / (deficit) for the year 787 729
Other comprehensive income Impairments and reversals (1,553) (6,099) Net gain / (loss) on revaluation of property, plant & equipment 66 7,842 Total comprehensive income for the year (700) 2,472
Financial performance for the year Retained surplus / (deficit) for the year 787 729 IFRIC 12 adjustment 103 (1,192) Impairments 64 600 Less: Adjustments to donated asset / government grant reserve elimination 749 Adjusted retained surplus / (deficit) 205 137
33 Annual Report and Accounts 2012 / 13
Our Accounts
Statement of Financial Position as at 31 March 2013
31 March 2013 31 March 2012
£000 £000 Non-current assets: Property, plant and equipment 147,424 141,581 Intangible assets 4,063 4,805 Trade and other receivables 803 780 Total non-current assets 152,290 147,166 Current assets: Inventories 3,772 3,764 Trade and other receivables 8,503 5,881 Cash and cash equivalents 6,726 10,330 Total current assets 19,001 19,975 Total assets 171,291 167,141 Current liabilities: Trade and other payables (12,765) (13,300) Provisions (737) (582) Borrowings (1,418) (1,398) Working capital loan from Department (3,348) (3,342) Total current liabilities (18,268) (18,622) Non-current assets plus / less net current assets / liabilities 153,023 148,519 Non-current liabilities: Trade and other payables 0 (481) Provisions (1,312) (1,199) Borrowings (27,506) (29,238) Working capital loan from Department 0 (3,348) Total non-current liabilities (28,818) (34,266) Total Assets Employed: 124,205 114,253 FINANCED BY TAXPAYERS’ EQUITY: Public Dividend Capital 85,185 74,533 Retained earnings (13,841) (16,993) Revaluation reserve 52,861 56,713 Total Taxpayers’ Equity 124,205 114,253
The summary financial statements on pages 33 – 37 have been approved by the Board.
Chief Executive Nick Hulme Date: 6 June 2013
34 Annual Report and Accounts 2012 / 13
Our Accounts
Statement of Changes in Taxpayers’ Equity for the Year Ended 31 March 2013 Public dividend Retained Revaluation Total capital (PDC) earnings reserve reserves £000 £000 £000 £000
Changes in taxpayers’ equity for 2012-13 Balance at 1 April 2012 74,533 (16,993) 56,713 114,253 Retained surplus / (deficit) for the year 787 787 Net gain / (loss) on revaluation of property, plant, equipment 66 66 Impairments and reversals (1,553) (1,553) Transfers between reserves 2,365 (2,365) 0 New PDC received 10,652 10,652 Net recognised revenue / (expense) for the year 10,652 3,152 (3,852) 9,952 Balance at 31 March 2013 85,185 (13,841) 52,861 124,205
Changes in taxpayers’ equity for the year ended 31 March 2012 Balance at 1 April 2011 74,533 (20,987) 58,235 111,781 Retained surplus / (deficit) for the year 729 729 Net gain / (loss) on revaluation of property, plant, equipment 7,842 7,842 Impairments and reversals (6,099) (6,099) Transfers between reserves 3,265 (3,265) 0 Net recognised revenue / (expense) for the year 0 3,994 (1,522) 2,472 Balance at 31 March 2012 74,533 (16,993) 56,713 114,253
Retained earnings relate to the cumulative deficit made by the Trust since its inception. The revaluation reserve reflects movements in the value of property, plant and equipment and intangible assets as set out in the accounting policy. The revaluation reserve balance relating to each asset is released to retained earnings on disposal of that asset and as depreciation is charged on the revalued element.
35 Annual Report and Accounts 2012 / 13
Our Accounts
Statement of Cash Flows for the Year Ended 31 March 2013
2012 / 13 2011 / 12 £000 £000 Cash flows from operating activities Operating surplus / deficit 6,833 6,420 Depreciation and amortisation 8,706 9,471 Impairments and reversals 167 (600) Donated assets received credited to revenue but non-cash 0 (439) Interest paid (2,147) (2,219) Dividend paid (3,799) (3,398) (Increase) in inventories (8) (182) (Increase) / Decrease in trade and other receivables (2,645) 3,986 Increase / (Decrease) in trade and other payables (504) (2,450) Provisions utilised (151) (2,401) Increase in provisions 391 2,770 Net cash inflow / (outflow) from operating activities 6,843 10,958
CASH FLOWS FROM INVESTING ACTIVITIES Interest received 29 32 (Payments) for property, plant and equipment (16,074) (8,503) (Payments) for intangible assets 0 (247) Net cash inflow / (outflow) from investing activities (16,045) (8,718)
NET CASH INFLOW / (OUTFLOW) BEFORE FINANCING (9,202) 2,240
CASH FLOWS FROM FINANCIAL ACTIVITIES Public dividend capital received 10,652 0 Loans repaid to DH – Working Capital Loans Repayment of Principal (3,342) (3,342) Capital element of payments in respect of finance leases and On-SoFP PFI and LIFT (1,712) (1,562) Capital grants and other capital receipts 0 439 Net cash inflow / (outflow) from financing activities (5,598) (4,465)
NET (DECREASE) / INCREASE IN CASH AND CASH EQUIVALENTS (3,604) (2,225)
Cash and cash equivalents (and bank overdraft) at the beginning of the period 10,330 12,555 Cash and cash equivalents (and bank overdraft) at year end 6,726 10,330
36 Annual Report and Accounts 2012 / 13
Our Accounts
Better Payment Practice Code
2012 / 13 2011 / 12
Measure of compliance Number £000 Number £000
Non-NHS Payables Total non-NHS trade invoices paid in the year 59,463 94,377 58,924 89,577 Total non-NHS trade invoices paid within target 53,731 81,901 49,559 72,317 Percentage of non-NHS trade invoices paid within target 93.30% 86.78% 84.11% 80.73%
NHS Payables Total NHS trade invoices paid in the year 1,713 9,439 1,649 11,111 Total NHS trade invoices paid within target 1,501 8,060 1,366 9,655 Percentage of NHS trade invoices paid within target 87.62% 85.39% 82.84% 86.90%
The Better Payment Practice Code requires the Trust to aim to pay all valid invoices by the due date or within 30 days of receipt of goods of a valid invoice, whichever is later. The current year analysis is calculated differently from past year which was based on 34 days.
37 Annual Report and Accounts 2012 / 13
Remuneration Report
The purpose of the Remuneration • ensure the terms of reference of this information, internal equity, Committee is: the Remuneration Committee affordability, whether there has been • to make appropriate are available, which should set a significant change in a director’s recommendations to the Board out the Committee’s delegated portfolio and thus responsibility. No on the Trust’s remuneration responsibilities and be reviewed executive director received a pay rise policy and the specific and updated annually; this year. remuneration and terms of • report the frequency and Notice periods apply based on the service of: members of the Remuneration early termination of their contract. • the Chief Executive; Committee in the report. The notice periods are as follows: • the Executive Directors; and The Remuneration Committee Chief Executive – six months comprises the Chair of the Trust • other staff as determined by the Executive directors – three months. Board, who acts as Chair, and the Board. Non-executive Directors of the The Trust did not have a bonus The objectives of the Committee are Board. At the discretion of the scheme in operation during to: Chair, the Chief Executive and 2012 / 13. • make recommendations to the Director of Human Resources may One executive director who is non- Board on the remuneration and be present to advise, but not for any voting, has a performance-related terms of service of the Chief discussions concerning their personal component to their pay, which is Executive, the Executive Directors remuneration. determined and overseen by the and other staff as determined by A quorum will consist of the Chair Remuneration Committee. The the Board; (or his / her nominated representative) performance-related component of this director’s pay was agreed • determine targets for any and at least two Non-executive by the Remuneration Committee. performance-related pay scheme Directors (or their nominated Performance against each of a contained within the policy; representatives). range of defined objectives was • review performance and All nominated representatives for reviewed and the award ratified objectives, and agree a policy the quorum must be Non-executive by the committee based upon that for the remuneration of Chief Directors. performance. The employment Executive, Executive Directors The Committee acts with the package was designed at the start to and other staff as determined by delegated authority from the Trust have a variable element. the Board; Board. The Trust made contributions • ensure that contractual terms of The Committee will meet as a totalling £13.1million needed to termination are fair and adhered minimum half yearly. Minutes are the Pensions Agency in the year. to; taken and a report submitted to the Note 10.5 in the Trust’s full accounts • make recommendations to Board showing the basis for any provides further details as to the the Board on the level of any recommendations. nature of the pension scheme and additional payments contained Executive’s pay is annually accounting proactive in relation within the policy; reviewed by the Remuneration to associated liabilities. Details of the pension benefits of the Trust’s • ensure that remuneration Committee. They are presented senior managers are also given in the packages enable high quality with benchmarking information to Remuneration Report. staff to be recruited, trained and demonstrate where each executive motivated and are within levels director’s salary sits alongside of affordability and are publicly similar posts in the NHS. Decisions defensible and amenable to staff; to uplift salaries are based on
38 Annual Report and Accounts 2012 / 13
Remuneration Report
Other Bonus Salary remuneration Payments Benefits in Kind (Bands of (Bands of (Bands of (Rounded to Salary and Pension Entitlements of £5,000) £5,000) £5,000) nearest £100) Board Members 2012 /13 £000 £000 £000 £00 Name and title
Andrew Reed Chief Executive (01/04/2012 to 18/05/2012) 140 – 145 0 0 0 Julie Fryatt Director of Human Resources 95 – 100 0 0 0
Peter Donaldson Trust Medical Director (Tenure ended 31/03/2013) 20 – 25 140 – 145 0 – 5* 0 Stephanie Watson Director of Finance and Performance 125 – 130 60 – 65# 0 2
Siobhan Jordan Director of Nursing and Quality (01/04/2012 to 17/06/2012) 20 – 25 0 0 0
Lynne Wigens Director of Nursing and Quality (13/08/2012 onwards) 60 – 65 0 0 0
Andy Burroughs Director of Business Development (01/04/2012 to 10/04/2012) 0 – 5 10 – 15** 0 0
John Watson Director of Operations (01/04/2012 to 18/01/2013) 80 – 85 0 0 0 Catherine Morgan Interim Director of Nursing and Quality (18/06/2012 to 12/08/2012) 10 – 15 0 0 0
Nigel Beverley Interim Chief Executive (21/05/2012 to 31/03/2013) (Paid via Ltd company and includes VAT) 195 – 200 0 0 0 Margaret Blackett Interim Director of Transformation and Operations (02/07/2012 onwards) (Paid via Ltd company and includes VAT) 170 – 175 0 0 0
Mary Leadbeater Director of Finance and Performance (24/09/2012 onwards) (Paid through an agency and includes agency fees and VAT) 150 – 155 0 0 0
Ann Tate Chair (02/04/2012 onwards) 20 – 25 0 0 2
Dave Norval Non-Executive Director (01/04/2012 to 31/12/2012) 0 – 5 0 0 0 Julia Holloway Non-Executive Director 5 – 10 0 0 1 Alan Bateman Non-Executive Director 5 – 10 0 0 0 Anthony Thompson Non-Executive Director 5 – 10 0 0 0 Andrew George Non-Executive Director 5 – 10 0 0 2
*Clinical Excellence Award **Redundancy payment # Mutually Agreed Resignation Scheme (MARS) payment Andrew Reed was seconded to NHS Midlands and East Strategic Health Authority and his salary was recharged to NHS Midlands and East SHA. Stephanie Watson was seconded to NHS Midlands and East Strategic Health Authority from 17 September 2012 until 31 March 2013. MARS: In brief, the national scheme has been commissioned by the Department of Health and developed in partnership with the Social Partnership Forum. It does not constitute a collective agreement. It is anticipated that those non-Foundation Trust employers in England that wish to run a MARS will work in partnership with their local staff-side representatives to implement this scheme.
Pension Benefits – Board Members2012 /13 Real Lump sum at Real increase Total accrued age 60 related to Cash Real increase in pension pension at age accrued pension Cash equivalent increase Employers in pension lump sum 60 at at age 60 at equivalent transfer in cash contribution at age 60 at age 60 31 March 2013 31 March 2013 transfer value value at equivalent to (Bands of (Bands of (Bands of (Bands of at 31 March 31 March transfer stakeholder £2,500) £2,500) £5,000) £5,000) 2013 2012 value pension Name £000 £000 £000 £000 £000 £000 £000 £000 Andrew Reed -2.5 – 0 -5 – -2.5 55 – 60 165 – 170 1,150 1,082 12 0 Julie Fryatt 0 – 2.5 N / A 5 – 10 N / A 87 66 17 0 Peter Donaldson -2.5 – 0 -5 – -2.5 55 – 60 170 – 175 1,325 1,248 11 0 Stephanie Watson -2.5 – 0 -2.5 – 0 35 – 40 105 – 110 674 626 15 0 Andy Burroughs -2.5 – 0 N / A 0 – 5 N / A 46 44 -1 0 John Watson 2.5 – 5 12.5 – 15 30 – 35 95 – 100 521 414 86 0 Siobhan Jordan -2.5 – 0 -7.5 – -5 15 – 20 50 – 55 252 256 -18 0 Lynne Wigens 2.5 – 5 7.5 – 10 30 – 35 100 – 105 622 525 70 0 As non-executive members do not receive pensionable remuneration there will be no entries in respect of pensions for non-executive members.
39 Annual Report and Accounts 2012 / 13
Remuneration Report
Cash Equivalent Transfer Real Increase in CETV Median staff pay disclosure Values This reflects the increase in CETV Reporting bodies are required to A Cash Equivalent Transfer Value effectively funded by the employer. disclose the relationship between (CETV) is the actuarially assessed It takes account of the increase in the remuneration of the highest- capital value of the pension scheme accrued pension due to inflation, paid director in their organisation benefits accrued by a member contributions paid by the employee and the median remuneration of the at a particular point in time. The (including the value of any benefits organisation’s workforce. benefits are the member’s accrued transferred from another scheme Total remuneration includes salary, benefits and contingent spouse’s or arrangement) and uses common non-consolidated performance- pension payable from the accrued market valuation factors for the start related pay, benefits-in-kind as benefits and any contingent spouse’s and end of the period. well as severance payments. pension payable from the scheme. It does not include employer A CETV is a payment made by a pension contributions and the cash pension scheme or arrangement to equivalent transfer value of pensions. secure pension benefits in another As one director at the Trust received pension scheme or arrangement a termination payment in addition when the member leaves a scheme to salary, this meant that the and chooses to transfer the benefits median pay disclosure shows a accrued in their former scheme. significant increase in 2012 / 13. The pension figures shown relate to The banded remuneration received the benefits that the individual has by the highest paid director in The accrued as a consequence of their Ipswich Hospital NHS Trust in the total membership of the pension financial year 2012 / 13 including scheme, not just their service in a this payment was £191,577.38 senior capacity to which disclosure (2011/ 12, £139,116.58). This was applies. The CETV figures and the 6.39 (4.22 excl termination payment) other pension details include the times (2011 /12, 4.27) the median value of any pension benefits in remuneration of the workforce, another scheme or arrangement which was £29,991 (2011 / 12, which the individual has transferred £32,532). The size of change in this to the NHS pension scheme. They multiplier in 2012 / 13 was therefore also include any additional pension an exceptional change. benefit accrued to the member as a result of their purchasing additional In 2012 / 13, 4 (2011 / 12, 27) years of pension service in the employees received remuneration scheme at their own cost. CETVs are in excess of the highest paid calculated within the guidelines and director. Remuneration ranged framework prescribed by the Institute from £188,884.87 to £214,103.00 and Faculty of Actuaries. (2011 / 12, £142,778.10 – £213,642.80).
40 Annual Report and Accounts 2012 / 13
Remuneration Report
Other Bonus Salary remuneration Payments Benefits in Kind (Bands of (Bands of (Bands of (Rounded to Salary and Pension Entitlements of £5,000) £5,000) £5,000) nearest £100) Board Members 2011 /12 (Audited) £000 £000 £000 £00 Name and title Andrew Reed Chief Executive 140 – 145 0 Julie Fryatt Director of Human Resources 95 – 100 0 Peter Donaldson Trust Medical Director 20 – 25 140 – 145 0 – 5* 0 Stephanie Watson Director of Finance and Performance 125 – 130 0 Siobhan Jordan Director of Nursing and Quality 90 – 95 0 Andy Burroughs Director of Business Development 80 – 85 0 John Watson Director of Operations 95 – 100 0 Mike Brookes Chair 15 – 20 6 Dave Norval Non-Executive Director / Acting Chair from 1 January 2012 5 – 10 1 Julia Holloway Non-Executive Director 5 – 10 0 Alan Bateman Non-Executive Director 5 – 10 0 Anthony Thompson Non-Executive Director 5 – 10 0 Andrew George Non-Executive Director 5 – 10 1
*Clinical Excellence Award
Pension Benefits – Board Members2011 /12 (Audited) Real Lump sum at Real increase Total accrued age 60 related to Cash Real increase in pension pension at age accrued pension Cash equivalent increase Employers in pension lump sum 60 at at age 60 at equivalent transfer in cash contribution at age 60 at age 60 31 March 2012 31 March 2012 transfer value value at equivalent to (Bands of (Bands of (Bands of (Bands of at 31 March 31 March transfer stakeholder £2,500) £2,500) £5,000) £5,000) 2012 2011 value pension Name £000 £000 £000 £000 £000 £000 £000 £000 Andrew Reed 0 – 2.5 0 – 2.5 50 – 55 160 – 165 1,082 980 70 0 Julie Fryatt 0 – 2.5 N / A 5 – 10 N / A 66 38 26 0 Peter Donaldson 2.5 – 5 12.5 – 15 55 – 60 165 – 170 1,248 1,071 143 0 Stephanie Watson 0 – 2.5 2.5 – 5 30 – 35 100 – 105 626 539 70 0 Andy Burroughs 0 – 2.5 N / A 0 – 5 N / A 44 23 20 0 John Watson 0 – 2.5 0 – 2.5 25 – 30 75 – 80 414 334 68 0 Siobhan Jordan 0 – 2.5 2.5 – 5 15 – 20 55 – 60 256 190 60 0
As non-executive members do not receive pensionable remuneration there will be no entries in respect of pensions for non-executive members.
Revised guidance was issued by HM Treasury on 26 October 2011 regarding the calculation of CETVs in public service pension schemes. Based on this guidance the NHS Pensions Agency, with effect from 8 December 2011, has used revised and updated actuarial factors produced by GAD when calculating CETVs within the NHS Pensions Scheme.
41 Annual Report and Accounts 2012 / 13
2012 / 13 Governance Statement
Scope of responsibility The governance framework The Trust Board is accountable for governance and internal of the organisation control in Ipswich Hospital NHS Trust. As Accountable Officer, The Trust has an integrated and Chief Executive of this Board, I have responsibility for governance approach to ensure maintaining a sound system of internal control that supports the decision making is informed by a full range of corporate, financial, clinical achievement of the organisation’s policies, aims and objectives. I and information governance. also have responsibility for safeguarding the public funds and the The Trust Board is comprised of a organisation’s assets for which I am personally responsible as set Chair, five Non-executive Director out in the Accountable Officer Memorandum. members and five Executive Director members with one other executive director member without voting rights attending each meeting: the Interim Director of Transformation. The Chair has a second and casting vote. The Trust Secretary also attends all Board meetings. The Chair commenced a four-year tenure on 2 April 2012 following appointment through the Appointments Commission process. In addition, the Deputy Chair decided to step down at the end of December 2012 because their second term of office was due to end in October 2013 and they wanted to enable a new Non-executive Director to be appointed who would be able to remain with the Trust for the entire process to Foundation Trust Status. A new Non-executive Director was appointed through the Appointments Commission process and commenced their four-year tenure on 1 April 2013. A new Deputy Chair was appointed from the existing Non-executive Directors. There has been substantial change in the executive team during the year with five of the six executive directors having changed. The Chief Executive left the Trust in May 2012 and an Interim Chief Executive (acting as Accountable Officer) was appointed in May 2012 for a period of up to one year. A substantive Chief Executive was recruited and
42 Annual Report and Accounts 2012 / 13
2012 / 13 Governance Statement
commenced employment on 1 April during the year when business has • Charitable Funds and 2013. The Director of Nursing necessitated this and the Board is Sponsorship Committee and Quality left the Trust in June mid-cycle: specifically meetings have • Conflicts of Interest Committee 2012 with the post being covered been held on the Annual Plan and internally until August 2012 by Trust Strategy and the Transforming • Foundation Trust Steering Board the Associate Director of Nursing Pathology Partnership. (time limited) when a new substantive Director The Audit, Healthcare Governance In addition the Board holds of Nursing and Quality commenced and Finance and Performance seminar sessions which provide an employment. The Director of Finance Committees are the main assurance opportunity for the Board to be and Performance left the Trust in committees reporting to the Board. briefed on a number of issues of September 2012 and an Interim During the year, the Chair undertook interest or to focus on in-depth work Director of Finance and Performance a review of Non-executive Director required for strategic matters. During was appointed in the same month. membership of committees and as the year the Board has covered A substantive Director of Finance a result changes were made to the the following topics in its seminar and Performance was recruited allocation of committee membership. sessions: The Health Act 2012, and commenced employment on The major change was that the Care of Older People Strategy, Local 3 June 2013. The Medical Director’s Audit and Healthcare Governance Education Training Boards, Quality term of office came to an end in Committees moved from having Governance Framework, Board March 2013 and a new Medical all five Non-executive Directors as Governance Assurance Framework, Director appointed from within the members to having three Non- Trust Strategy, Long Term Financial organisation commenced in role at executive Director members each. Model and Cost Improvement Plans. the beginning of April 2013. The All Board members are actively The Audit Committee supports Director of Operations left the Trust encouraged to suggest topics for the the Board by providing an in January 2013 to take up a career seminar sessions. independent and objective review opportunity at another Trust and the of the governance and assurance Interim Director of Transformation There is an established and robust processes upon which the Board covered the role in the interim. A governance framework, supported places reliance. In this capacity as decision was made to establish the and maintained by a framework independent reviewer of the internal role of Chief Operating Officer and of committees. The Board has control environment the Audit an appointment was made with a overall responsibility for the Committee is the scrutiniser of all commencement date of July 2013. effectiveness of the governance committees including the Healthcare framework and as such requires The Board undertook a review of Governance Committee. The Audit that each of its sub-committees has its meeting practice during the year Committee membership comprises agreed terms of reference which and from October 2012 moved from three Non-executive Directors and is describe duties, responsibilities and holding a Board meeting in public chaired by a Non-executive Director. accountabilities, and describes the bi-monthly to monthly, with the The Chief Executive, Interim Director process for assessing and monitoring first part of each meeting open to of Finance and Performance, Trust effectiveness. There are seven the public and closing as necessary Secretary, Head of Internal Audit formally designated committees of for a part two confidential session. and a representative from the Both sections of the meeting follow the Board: external auditors attend the Audit a structured format with each public • Audit Committee Committee meetings. Officers of the Trust are invited to attend the Audit meeting starting with a patient • Healthcare Governance Committee to report on standing or carer story to set the tone and Committee focus of the meeting. The patient / items such as the review of the Board carer story is followed by matters of • Finance and Performance Assurance Framework (BAF) and also strategy, performance and corporate Committee as requested on exceptional items. governance. The Board has also held • Remuneration and Terms of The Healthcare Governance a number of additional meetings Service Committee Committee oversees the
43 Annual Report and Accounts 2012 / 13
2012 / 13 Governance Statement
development of risk and clinical at their confirmation are reported to an annual report to the Board governance activities and ensures the next Board Meeting. The Board to review the work undertaken their effective management in may request further work on various during the year and to set out how order to improve the quality of issues which are raised. they have performed against their care throughout the hospital. During the first two quarters responsibilities as defined in their The Committee has a number of of the year the Finance and terms of reference. In addition both reporting committees and provides Performance Committee operated committees undertake an annual self assessment which informs the annual assurance to the Trust Board on as an executive-led Committee report. The Audit Committee’s self all matters relating to quality chaired by the Chief Executive including patient safety, clinical assessment results are discussed at with membership comprising the effectiveness and patient experience the June Audit Committee meeting Executive Directors and Clinical and engagement. It focuses on and the Healthcare Governance Directors of the Trust. At the end overseeing the development of risk Committee self assessment results of September 2012 the Committee management activities through the are discussed at the May committee was reconstituted as a Non-executive Risk Management Committee. meeting. Director-led committee chaired The Healthcare Governance by a Non-executive Director and The Remuneration and Terms of Committee receives assurance on with membership comprising two Service Committee is chaired by the quality agenda and clinical other Non-executive Directors, the the Chair of the Trust Board and governance activities through Chief Executive, Interim Director of the five Non-executive Directors of the Patient Safety and Clinical Finance and Performance, Director of the Trust are members. The Chief Effectiveness and Patient Experience Operations, Director of Nursing and Executive and Director of Human Groups which report into it. The Quality, Director of Human Resources Resources regularly attend meetings. Healthcare Governance Committee and Trust Secretary. The committee makes appropriate is chaired by a Non-executive recommendations to the Board of The Committee’s purpose is Director, and two other Non- Directors on the Trust’s remuneration to provide the Board with an executive Directors are members policy and the specific remuneration independent and objective oversight of the committee together with a and terms of service of the Chief of finance and performance issues number of the executive directors Executive, Executive Directors, to assure, suggest and make including the Director of Nursing Senior Management and employees recommendations to support the and Quality, the Medical Director employed under Ipswich Hospital’s Board in ensuring the Trust maintains and the Interim Director of terms and conditions of service, cash liquidity and remains as a going Transformation. The Trust Secretary together with other employees concern whilst achieving the key attends the Healthcare Governance as determined by the Board of performance indicators assigned to Committee meetings. The Head Directors. it. It is held the week of the Board of Internal Audit also attends to The Ipswich Hospital NHS Trust is each month and its draft minutes mirror their attendance at the Audit the corporate trustee for charitable are reviewed at the Board Meeting Committee. The Audit Committee funds held on trust and the Trust with the Non-executive Chair of and Healthcare Governance Board serves as its agent and has the Committee commencing the Committees receive each other’s delegated authority to the Charitable Board discussion on finance and minutes to ensure that there is no Funds and Sponsorship Committee performance with an overview of overlap or inadvertent omission. The to make and monitor arrangements the Committee’s discussions. This is Board receives a highlight report and for the control and management followed by input from the executive unconfirmed minutes of both the of the Trust’s Charitable Funds in director leads for quality, finance, Audit Committee and Healthcare accordance with any statutory or national and contractual standards Governance Committee at its next other legal requirements or best and organisation efficiency. meeting following the committee practice required by the Charities meetings. Any amendments Both the Audit and Healthcare Commission. The Committee is subsequently made to the minutes Governance Committees submit chaired by a Non-executive Director
44 Annual Report and Accounts 2012 / 13
2012 / 13 Governance Statement
and membership comprises a further clinicians including doctors, nurses, senior nursing and quality of care Non-executive Director, the Interim midwives and allied healthcare expertise and guidance to the Director of Finance and Performance, professionals in the leadership of the Divisional Board. The Operations Director of Nursing and Quality, hospital. As a result, a number of Lead will provide expert operational Nominated Fund Manager, Patient changes were made to the existing advice to the Divisional Board. Group Representative and Head of governance arrangements. The Divisional Boards oversee and monitor the performance of their Communications. Following consultation a revised Clinical Delivery Groups. Whilst The Trust Board met as corporate structure became operational from weeks 1 to 3 comprise separate trustee to approve the Ipswich 1 April 2013 which comprised three divisional board meetings, the Hospital charitable funds annual clinical divisions which better reflect Combined Board meets monthly report and accounts for the year how patients come into hospital: and comprises the executive team ended 31 March 2012, to approve Medicine and Therapies; Surgery; and the senior teams from the three the Letter of Representation and to Cancer, Women and Children, and divisional boards. The Combined receive the ISA2260 Report from the which are supported by an executive Board is the senior management external auditors. function. Each Division comprises a decision-making group of the number of clinical sub-groups called The Conflicts of Interest Committee hospital with responsibility for the Clinical Delivery Groups. Whilst the was established to evaluate, monitor implementation and delivery of the restructure did not significantly affect and supervise real and potential Hospital’s strategic direction, business the composition or remit of the conflicts of interest to ensure plan and associated objectives, compliance with legislation and Trust Board’s assurance committees, it did standards and policies to ensure the policies. This is done by working with result in changes to the operational delivery of safe, high quality, patient- employees to eliminate, minimise management of the hospital with the centred care. Terms of reference and manage any actual or potential cessation of the Trust Management for the divisional and combined conflicts of interest to protect the Team and the creation of three boards were approved by the Trust reputation and tangible assets of Divisional Boards and a Combined Board. The Combined Board reports the Trust as well as the reputation of Board which follow a four-weekly to the Trust Board on a monthly individual employees. meeting structure as follows: basis through a highlight report The Board has Standing Orders, a • Week 1: and through the executive directors Schedule of Matters Reserved to the Divisional Board Clinical raising key issues as required. The Board, Standing Financial Instructions Governance and Risk Combined Board receives highlight reports from the Divisional Boards on and a Scheme of Delegation which Management Meeting. key issues covered at their meetings were reviewed twice in 2012 / 2013: • Week 2: and covers items which require at the beginning of the year and at Divisional Board Operations and escalation or further consideration by the end of the year in advance of the Performance Meeting. the combined group. introduction of the new organisation • Week 3: structure. The Trust undertook Formal evaluation of the Board Divisional Board Development a review of the organisation in during its public and confidential session for members (including 2012 /2013 to develop a clinically board meeting was undertaken in patient feedback). led organisation. The overarching September 2012 by the Strategic intention was to create a single line • Week 4: Health Authority as part of the Trust’s of accountability for all aspects of Combined Board Meeting. Foundation Trust application process. performance including patient safety, Each Divisional Board is chaired There were no significant issues patient experience, operational by a Divisional Clinical Director arising through this observation standards, financial performance and who carries responsibility for the process and following the feedback staff engagement. Importantly the leadership of the Division. Each received a review of Board practice introduction of the new structure Division has nursing and operational was undertaken by the Trust sought to secure the engagement of leads. The Nursing Lead provides Secretary and a number of proposals
45 Annual Report and Accounts 2012 / 13
2012 / 13 Governance Statement
made which were considered by The risk and control The Director of Nursing and Quality is the Board in November 2012. A framework the Executive Director with delegated progress report on the changes was responsibility for the coordination, received by the Board in February implementation and evaluation of Risk assessment 2013. The Board undertook an risk management systems Trust wide. initial assessment against the As Chief Executive, I have overall The Trust’s Risk Management Board Governance Assurance responsibility and accountability for Strategy states that risk management Framework in October 2012 and risk management and this is shared is the responsibility of all managers identified the requirement for a with Executive Directors, who along and staff, whatever their position formal evaluation of the Board and with the whole of the Trust Board within the Trust and that staff will be are informed on risk management subsequent establishment of a board provided with adequate education, and governance issues through the development programme. Due to training and support to enable them Healthcare Governance Committee, the number of interim directors to meet this responsibility. Managers Audit Committee, and Finance and and the changes at board level the are expected to incorporate risk Performance Committee. formal evaluation has not yet been management into all aspects of their undertaken and it is planned that The Trust uses the National Patient work, from business planning to this will be undertaken once the new Safety Agency 5 X 5 risk matrix local induction and training of staff, Board has begun to embed. to assess the likelihood and and to identify the risk management The Care Quality Commission made consequence of all risks on the Trust training needs of all their staff, Risk Register (see Table 1). an unannounced visit to the Trust especially as new staff join and are on 26 July 2012 as part of their Risks scoring 15 and above (strategic) inducted. planned routine of scheduled migrate to the Board Assurance The Trust’s approach to risk reviews. The inspection team focused Framework and thereby inform the management has been made on the following outcomes: Trust Board agenda. The following available to all staff and risk risks were identified and added to • privacy and dignity; management information is included the Board Assurance Framework in in Trust induction training and • care and welfare of people who 2012 / 13: subsequent updates. Staff also use our services; • Failure to deliver the planned undertake mandatory training such • nutrition; financial plan for 2012 / 13 and as manual handling, resuscitation, • cleanliness and infection control; financial duties. infection control, and fire safety and, depending on their role, • supporting workers; and • Successful Foundation Trust application. additional competency training in • quality. risk management as required by the • Financial risk of Strategic NHS Litigation Authority. The CQC determined that the Trust Health Authority delay in was compliant with all outcomes awarding community contract The way in which risk is identified, inspected. to Transforming Pathology evaluated and controlled within the Partnership. Trust is based on the following cycle: • Failure to meet 18-week RTT • Identification and reporting Service Standard for Trauma and of risk – Identification of the Orthopaedics. risks facing the Trust, working in a way that spreads the workload The Risk Management Committee reviews, validates and monitors and ensures that the initial all aspects of risk reporting and identification of risk is not too assurance, and reports to the onerous; Healthcare Governance Committee.
46 Annual Report and Accounts 2012 / 13
2012 / 13 Governance Statement
Likelihood score Table 1: 5X5 Risk Matrix 1: 2: 3: 4: 5: Rare Unlikely Possible Likely Almost Certain
5: Catastrophic 5 10 15 20 25 4: Major 4 8 12 16 20 3: Moderate 3 6 9 12 15 score 2: Minor 2 4 6 8 10 Consequence 1: Negligible 1 2 3 4 5
• Calculation of the importance • Review and challenge – The committees to monitor their risks. of each identified risk – Trust monitors and reviews all The Trust formally investigates all Achieved by undertaking an reported risks, using the same serious clinical incidents (Serious assessment of the ‘likelihood’ methodology as outlined above Incidents Requiring Investigation – of the risk occurring and to ensure that controls remain SIRIs), reports their findings via the determining the ‘consequences’ effective and robust. Risk Management Committee and should the event occur, using A register of identified risks facing follows up on all actions agreed as a matrix based on the National the Trust is in place. This details risk part of the outcome of the report. Patient Safety Agency risk matrix; issues, severity of risk, controls in The Directors of the Trust are • Confirmation or introduction place and agreed action plans. It has of controls and mitigating been developed by the identification required to satisfy themselves that actions – This stage of the cycle and assessment of risks at a local the Trust’s annual Quality Account aims to confirm or introduce level within the Trust. All principal presents a balanced picture of the specific controls to deter and risks are subject to a continuous Trust’s performance over the period prevent the materialisation of process of review and validation by covered and the performance identified risks. These controls (eg Divisions (business units until end information reported in the Quality policies and procedures, controls of March 2013), and the Trust’s Account is reliable and accurate. In and reporting mechanisms, Risk Management Committee. The doing so, we are required to put in deterrent and disciplinary actions) Healthcare Governance Committee place a system of internal controls will differ and be prioritised and Combined Divisional Board over the collection and reporting of according to the severity of the (Trust Management Team up until information included in the Quality risk involved; end of March 2013), are informed Account. The Board has been actively of all principal (extreme) risks on • Assessment of the level involved in the preparation of the of residual risk – This is the a bi-monthly and monthly basis respectively, or earlier if deemed Trust’s annual Quality Account assessment of the effectiveness and the proposed improvement of the controls that are already in necessary. In addition, during the priorities for the coming year. The place and revised ones that are year a piece of work has been Trust has consulted widely on its being implemented following the undertaken to align risks to the three quality priorities with internal and identification of a perceived risk; assurance committees via the NPSA and domains and to the Trust’s strategic external stakeholders, who have objectives. Dashboards are being an opportunity to comment on the developed to enable the assurance programme.
47 Annual Report and Accounts 2012 / 13
2012 / 13 Governance Statement
Data security Actions taken to mitigate future Performance against incidents include all information In 2012 / 2013 the Trust achieved a national priorities set out security incidents being graded satisfactory assessment at 82% for in the NHS Operating and reported according to the its information governance assurance Framework 2012 / 2013 Trust’s Serious Incidents Requiring under the Information Governance Investigation Policy. This enables During 2012 / 2013 the Trust has Toolkit. learning to result from any incidents. demonstrated good performance The Trust had two data security In addition mandatory annual against the key performance breaches that were reported to the training and education of staff indicators. Key achievements this Information Commissioner’s Office for information governance is year include: during 2012 /2013. Both breaches undertaken. The Trust’s Information • Full year compliance at 95.35% related to paper-based data loss. Management and Technology across 2012 / 13 with the They were: strategy is focused on a paper-light 95% threshold for Accident & In April 2012 the Trust identified organisation and includes the use Emergency 4-Hour waits. a level 4 information governance of Lorenzo Regional Care, Evolve • Compliance across both the breach which was reported as Mobile, scan-on-demand medical 18-Week admitted and non- a Serious Incident Requiring records service and managed print admitted thresholds across the Investigation and reported to the services. The Chief Information 2012 / 13 reporting year. Information Commissioner’s Office Officer has attended the Audit on 12 April 2012 (ICO reference Committee to provide an overview • Compliance across the 2-Week, number: ENF0444086). A summary of information and information 31-Day and 62-Day Cancer sheet with details of five patients was technology assurance. Treatment targets across removed from a patient’s bedside 2012 / 13 as a reporting year. table. A patient’s relative picked up • The Trust also achieved its the summary sheet and removed it C.difficile trajectory for no more from the ward. The details of the five than 27 cases in 2012 / 13. patients included medical summary, The Trust did not achieve its MRSA name, date of birth, next of kin trajectory of no more than one case and care summary. The record was in year, recording two cases across returned by the patient’s relative. 2012 / 13. The Trust also failed In December 2012 the Trust identified to achieve the 99% compliance a level 3 data breach which was required on diagnostic tests reported as a Serious Incident undertaken within six weeks due to Requiring Investigation and reported problems across the first six months to the Information Commissioner’s of 2012 / 13 achieving 98.34%. Office on 11 December 2012 (ICO reference number ENF0477072). A patient attended Washbrook Ward and brought with their appointment letter another piece of paper that was attached to the appointment letter. The attached piece of paper was a theatre list for ODCU (Ophthalmic Day Care Unit) for a specific date in November 2012. The theatre list contained details of four patients including names, date of birth, hospital number and procedure.
48 Annual Report and Accounts 2012 / 13
2012 / 13 Governance Statement
Review of the effectiveness updates on progress against the As a result of my review I of risk management and action plans from various internal consider the following items internal control and external reviews of internal to be significant issues and control and the core standards self therefore warrant further As Accountable Officer, I have assessment declaration. I also take disclosure: responsibility for reviewing the into consideration reviews by other The external auditors have issued an effectiveness of the system of external bodies including the Ipswich unqualified opinion on the annual internal control. My review is Hospital Users Group, Suffolk County financial statements and a modified informed in a number of ways. The Council Overview and Scrutiny value for money conclusion. The Head of Internal Audit provides Committee, Midlands and East of qualified conclusion is by exception me with an opinion on the overall England Strategic Health Authority and relates to securing financial arrangements for gaining assurance and Department of Health. resilience and economy, efficiency through the Assurance Framework I have been advised on the and effectiveness. There were and on the controls reviewed as part implications of the result of my two reasons for this conclusion. of Internal Audit’s work. His opinion review of the effectiveness of the In respect to the 2013 / 14 cost is that the overall arrangements system of internal control by the improvement plans (CIP) – at the provide good assurance. However, Board, Trust Management Team, time of the audit, CIP schemes had only limited assurance could be Audit Committee, Healthcare been identified for 2013 / 14 to provided on the controls in certain Governance Committee and Risk the level of £11.6m / 90%. These areas including consultant job plans Management Committee as part had been identified and financially and car park income. In addition to of our approach to integrated risk rated, leaving £1.2m still to the Head of Internal Audit opinion, governance. In summary, the Board be identified, costed and quality the Audit Committee Chair provides reviews the BAF and receives minutes assured. In addition, the Trust has the minutes together with a brief and brief highlight summaries from not met its statutory target to break summary highlighting areas for the both the Audit Committee and even over a five-year period, with Board’s attention following each Healthcare Governance Committee. a cumulative deficit remaining of committee meeting to the next The Audit Committee reviews the £3.4m. Board Meeting in public. underlying assurance processes and During 2012 the Hospital completed During the year the Trust also the effectiveness of the management actions to the satisfaction of the took positive steps to ensure audit of strategic risks. A key role of the Royal College of Surgeons and NHS recommendations were also closed Healthcare Governance Committee Suffolk addressing issues raised as a down in a timely manner. Executive is to review action plans to mitigate result of a Royal College of Surgeons managers within the organisation risks identified. It is assisted in invited review of colorectal surgery who have responsibility for the this role by the Risk Management at the hospital in September 2011 development and maintenance of Committee which identifies in response to concerns raised the system of internal control provide operational risks and ensures that by individuals relating to safety, me with assurance. The Assurance local controls are in place to manage effectiveness and experience in Framework itself provides me with these. The Executive Directors have the colorectal surgical service. The evidence that the effectiveness of the key role in managing risks, main issues addressed included controls that manage the risks to the monitoring the control environment referral pathways from Primary organisation achieving its principal and ensuring that a BAF is produced Care, the appointment of a nurse objectives have been reviewed. My for Board review. The internal auditors specialist to support patients, review review is also informed by comments provide independent assurance on the of arrangements for analysis of in reports and other feedback from application of governance, internal pathology specimens, organisation, Internal Audit, External Audit, control and risk management. The support and attendance of NHS Litigation Authority for NHS external auditors provide independent multidisciplinary teams, additional Trusts, NHS Litigation Authority for assurance in respect of statutory colorectal surgeon post agreed, and Maternity Services and internal Trust accounts and value for money. review and revision of arrangements
49 Annual Report and Accounts 2012 / 13
2012 / 13 Governance Statement
for the management of patients with Regrettably one Never Event recommendations including one high liver metastases. occurred at the hospital in 2012 / 13. priority recommendation that the During 2012 the Hospital received Never Events are adverse events that job planning process for 2012 / 13 a final report of an investigation are unambiguous (clearly identifiable should have been fully completed undertaken independently into and measurable), serious (resulting by December 2012. In reviewing the contractual arrangements entered in death or significant disability), and job planning process it became clear into by the Trust with an external usually preventable if the available that the proposed dates were not healthcare provider in 2010 / 11 and measures have been implemented consistent with the scale of review, 2011 / 12. The final report confirmed by healthcare. An investigation capacity planned approach and team that the Hospital’s standing financial took place following this incident job plan approach. The medical instructions had been breached. and areas where improvement staffing steering group will set Work was then completed during could be made were identified revised timescales to complete job 2012 / 13 to address issues raised in and implemented. The changes planning, in conjunction with clinical the final report including a review implemented are regularly audited leaders. Job planning guidance has and re-launch of the standing to ensure they are sustained and been drafted. A detailed action plan financial instructions and scheme of become embedded. will be overseen by the medical delegation and a review of the Trust’s In March 2013 the Midlands and staffing steering group and reported Standards of Business Conduct. East Multiprofessional Deanery to the Combined Board. In April 2012, NHS Suffolk undertook a performance and quality undertook a quality review of the assurance visit to the Trust as part Accountable Officer: Hospital, making a number of of a scheduled two-yearly cycle. The Nick Hulme recommendations. The main issues decision of the Deanery in relation Organisation: addressed included: strengthening to medical education and training The Ipswich Hospital NHS Trust of clinical engagement within the had been met with conditions. The conditions related to patient organisation; increased awareness Signature: of day-to-day working and front-line safety issues in the Emergency staff views by Board members; robust Department and their relationship and planned approach to escalation to training, supervision and support bed increases and reporting on the for Foundation trainees at night in impact of escalation bed activity Medicines and Surgery. The Trust has established an action plan in Date: decisions to Trust Board; review 06 June 2013 of nurse staffing and agreement response to the findings which was from the Board to increase nurse reviewed at the Trust Board in April staffing levels; implementation of 2013. Confirmation of completion e-rostering; and a comprehensive of actions on immediate concerns review of non‑nursing staffing has been sent to the Deanery with requirements, including medical a formal update to the Deanery due staffing, undertaken. The progress of by 6 September 2013. In addition, the resulting Quality Review action an interim follow-up meeting with plan was regularly monitored by the the Deanery is scheduled for 18 July Healthcare Governance Committee, 2013. Completion of the action and regular feedback on progress plan is being monitored through the was given to the Commissioners. Healthcare Governance Committee. The Trust confirmed and the An internal audit report on the Commissioners agreed that all quality of consultant job plan (weekly actions were completed in March diary plans) records resulted in 2013. limited assurance and a number of
50 Annual Report and Accounts 2012 / 13
Declaration of Interests
Declaration of Interests 1 April 2012 to 31 March 2013
Ann Tate • Governor of Rattlesden CEVC Primary School Chair (From 02 / 04 / 2012) Alan Bateman • Paid Employee / Director / Substantial financial interest in Sailotone Ltd Non-executive Director Andrew George • Director of Suffolk Mind Non-executive Director • Standards Committee Member for Suffolk Councils Julia Holloway • Employee of Geoff Holloway, Independent Financial Advisor Non-executive Director • Trustee – Age UK Suffolk Dave Norval • Paid Employee / Director / Substantial financial interest in URSA Limited Non-executive Director Co No 4197496 (Until 31 /12 / 2012) • Paid Employee / Director / Substantial financial interest in Team Business Ltd Co No 6269715 • Director / Substantial financial interest in URSA Ghana Limited • Chairman – Ipswich Beira Health Initiative Tony Thompson • Paid employee in Parasol Ltd Non-executive Director • Trustee for the Melton Trust • Elected councillor Melton Parish Council Andrew Reed • Governor of Little Bealings School Chief Executive (Until 18 / 05 / 2012) • Married to Dr PJ Newman, salaried GP, Barrack Lane Medical Centre, Ipswich, and Consultant in Public Health, NHS Suffolk (currently seconded to NHS Midlands and East) Nigel Beverley • Paid employee of NB Health Consulting Ltd Interim Chief Executive • Non-executive Director of Fortrus Ltd from 01 / 02 / 2013 (From 21 / 05 / 2012) • Married to Ruth May, Chief Nurse for NHS Midlands and East Margaret Blackett • Paid employee / partner in Blackett Sharp Ltd Interim Director of Transformation • Director of Britannia Sailing School Ltd (From 02 / 07 / 2012) Peter Donaldson • Partner in Ipswich Urology Partnership until 31 / 10 / 2012 Medical Director (Until 31 / 03 / 2013) • Married to Rosemary Donaldson, Matron / Senior Manager at Ipswich Nuffield Hospital Julie Fryatt • Motor home rental business trading under the name Sunrise Motor Homes Director of Human Resources Stephanie Watson • Office holder Friends of Withersfield Director of Finance and Performance • Office holder PCC St Marys Withersfield (Seconded to SHA 17 / 09 / 2012. • Office holder Village Hall Management Committee Withersfield Left Trust 31 / 03 / 2013) Mary Leadbeater • Director of Esther Troy Ltd Interim Director of Finance and • Trustee of Asthma UK Performance (From 24 / 09 / 2012) • Member of Asthma UK Finance and Audit Committee • Director of the Caxton Foundation • Chair of the Caxton Foundation Audit Committee Siobhan Jordan • Nil Director of Nursing and Quality / Director of Infection Prevention and Control (Until 17 / 06 / 2012)
Continued overleaf...
51 Annual Report and Accounts 2012 / 13
Declaration of Interests
Continued from previous page
Catherine Morgan • Nil Interim Director of Nursing and Quality / Director of Infection Prevention and Control (From 18 / 06 / 2012 until 12 / 08 / 2012) Lynne Wigens • Visiting Senior Fellow – University Campus Suffolk Director of Nursing and Quality / Director of Infection Prevention and Control (From 13 / 08 / 2012) Andy Burroughs • Nil Director of Business Development (Until 10 / 04 / 2012) John Watson • Nil Director of Operations (Until 18 / 01 / 2013)
52 Annual Report and Accounts 2012 / 13
Glossary of Terms
Glossary of Terms
The Ipswich Hospital NHS Trust • Referred to as ‘the Trust’, ‘the hospital’ or ‘we’ throughout this report.
NHS Suffolk • The Primary Care Trust for Suffolk
NHS • National Health Service
GP • General Practitioner
DH • Department of Health
53 Annual Report and Accounts 2012 / 13 Thank You To...
• All the staff of The Ipswich Hospital NHS Trust • All our volunteers • All our Council of Shadow Governors and Members • All our patients and visitors • Fundraisers throughout the community – individuals, families and organisations • The Ipswich Hospital Band • Hospital Radio Ipswich • The media – Evening Star, East Anglian Daily Times, BBC Radio Suffolk, Heart, Town 102, BBC Look East, ITV Anglia • Health colleagues in the east of England
This report was compiled by the hospital’s Communication team and designed by the Design and Print team.
In 2012, local film-maker Nick Wainwright gave his services free of charge to make a video that showcases just some of the people and places that make up our Trust. We have used images from his film throughout this report. You can watch the whole film at www.ipswichhospital.nhs.uk/aboutourhospital or, if you are viewing this document as a PDF, simply click the image on the left to watch it via YouTube.
54 Annual Report and Accounts 2012 / 13 Section Title
55 Find out more about the hospital by visiting our website at www.ipswichhospital.nhs.uk
Further copies of this report are available from: The Press Office (N057) The Ipswich Hospital NHS Trust Heath Road Ipswich Suffolk IP4 5PD Tel: 01473 704770 Email: [email protected]
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Published: Summer 2013
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