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Ipswich Hospital Annual Report 2015 / 16
Our Passion, Your Care. Annual Report 2015 / 16
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This report was compiled by the hospital’s Communication team, and designed and printed by our Design and Print Services team. Photography is by our in-house Clinical Photography team and freelance photographers.
2 Annual Report 2015 / 16
Contents
This Annual Report has been Performance Report 4 prepared in accordance with the requirements set out in the Overview 5 Department of Health Group Manual for Accounts 2015 / 2016. Chair’s Foreword 5 Chief Executive’s Overview 6 The Quality Account 2015 / 16 is a companion document to this report About The Ipswich Hospital NHS Trust 8 and is available online at Trust Objectives 11 www.ipswichhospital.nhs.uk Quality 13 Activity 18 Performance Analysis 21 Performance Against Key Indicators 21 Operating Financial Review 23 Our Buildings and Structure 24
Accountability Report 28 Corporate Governance Report 29 Directors’ Report 29 Statement of Accountable Officer’s Responsibilities 39 Governance Statement 40
Remuneration and Staff Report 54 Remuneration Policy 54 Single Total Figure Remuneration Table 55 Pensions Entitlement Table 57 Fair Pay (Ratios) Disclosure 58 Staff Report 60 Glossary 69
3 Annual Report 2015 / 16 Performance Report
4 Performance Report Annual Report 2015 / 16
Overview Chair’s Foreword
I am delighted to introduce this year’s Annual Report, I am immensely proud to be which is my first report to Chair of this hospital. you as Chair of The Ipswich David White Hospital NHS Trust. Chair
Ever since my joining in November 2015 I have been and continue to be impressed by our staff making sure that excellent patient care is their number one priority. Across the Trust, around the clock, our staff are indeed highly dedicated, professional and above all We have also had the biggest ever another wonderful testament to committed to providing safe, high legacy of £1.5million from Mr Peter the support of the community. quality care to people who need Gibbons, a Suffolk resident The support of the 500 volunteers our service. and landowner. After much who give up their time each week careful thought by the Board’s First-hand, as a recent inpatient, I to make life better in hospital for Charitable Funds and Sponsorship have in fact been on the receiving both patients and staff is very Committee we are going to use end of that care and it was much appreciated. this tremendous gift to transform exemplary. four wards in the hospital so that I am immensely proud to be What I am most struck by is how they are of a very high standard Chair of this Trust. I am sure important this Trust is to the and provide a friendly environment the coming months will bring people it serves living in Ipswich, to all our patients including people many opportunities to look at east Suffolk and beyond, and how with dementia. The legacy will also how we can work together much it means to them. Local benefit neonatal and children’s with our partners in other NHS people and communities are so services as well as setting up an organisations, social care and incredibly generous both in the innovation fund to make great voluntary groups. time given to volunteer and indeed ideas from staff to improve care a The title of our report to you is in their financial giving to make a reality. Better Together, which reflects our real difference to life in the Trust. Mr Bryan Sampson, a retired belief that working together with That support is demonstrated in chartered surveyor from Ipswich patients, carers, staff, partners and the amazingly generous support for left his entire estate of over our community, we can be even our £3.7 million appeal for a new £560,000 to the hospital in stronger. cancer centre in partnership with gratitude of the care he received My best regards, national cancer charity Macmillan. from the hospital. These two The new Woolverstone Macmillan legacies amounting to over Cancer Centre opened its doors £2 million is unprecedented. to patients on 16 May 2016. It is Thousands of patients will benefit a tranquil, spacious environment from this generosity. especially designed to give patients Our own Ipswich Hospital Charity David White much greater privacy and the appeal called Sunrise set out to Chair opportunity to have a family raise £100,000 for children and 02 June 2016 member or friend with them when poorly babies in hospital. In April receiving treatment. 2016 the target was reached,
5 Annual Report 2015 / 16 Performance Report
Overview Chief Executive’s Overview
One of the most important standards all hospitals have I continue to be amazed to reach is treating 95% of and humbled by the acts of all patients coming to the kindness I see every day. Emergency Department within Nick Hulme four hours. Chief Executive
Since 2004, when the standard was first introduced, I have been a huge fan. It is for me, the best measurement of a successful health and social emergency care. I feel very proud to be cared for and a place to care system. Everything needs to that thanks to Team Ipswich, we learn? are. work well to deliver success. The latest NHS National Staff More than 84,000 patients, 84,431 We are also one of the best Survey results answer this question. performing hospitals in the to be precise, were treated in The results for us are outstanding. country for stroke services and our emergency department from 76% of staff would be happy with achieved all the national access 1 April 2015 to 31 March 2016, the standard of care provided by standards for cancer services, and we are the only hospital in the this hospital (an increase from referral-to-treatment times, limiting East of England to achieve seeing 65% in 2014). 67% of staff would cancellations and reducing to an 95% of all these patients within recommend this hospital as a place absolute minimum the number of four hours. to work in 2015 (an increase from hospital-acquired infections. When I shared this news with all of 59% in 2014). And overall, 88% our staff, I highlighted how it takes Another innovation in care this of the key findings for us were a whole hospital team effort to year has been the opening of a either in the top 20% of acute achieve this including making sure new Fraility Assessment Base for hospitals, better than average, or the hospital is clean and safe, that older people. The idea behind the average. There is much work still to patients are fed, and working with service is to give frail, older people do in some areas but overall, this is colleagues on the ground from the immediate treatment and care the best staff survey result we have social services who support us in they need to avoid being admitted ever had. to a hospital bed. Clinicians and giving patients their lives back. It is thanks to everyone who works staff working in this service have Our work in emergency care, or volunteers here for all that they also been recognised by the including developing a new ‘trigger do, every day which has helped us Health Service Journal as they are tool’ allowing us to predict very become this ambitious, progressive shortlisted for a national award. busy times has just been shortlisted trust. This is my third year as Chief for a national Health Service Our ambition is to provide safe, Executive and I continue to be Journal award. We have been high quality compassionate care amazed and humbled by the acts asked for our help by almost 50 to the communities we serve. The of kindness I see every day. hospitals throughout the country in economic reality is that we, like all transforming emergency care. My key question to colleagues trusts, have to be sustainable and I made a promise as we entered has been from my first days in the financially viable. Together with all this year that we would be one of role – Would you recommend this our partners in health and social the best performing hospitals for hospital as a place to work, a place care we are going to do things
6 Performance Report Annual Report 2015 / 16
Overview Chief Executive’s Overview
differently so that we achieve this stability in the coming years. Celebrating Our Team Ipswich Colleagues It will be challenging, exacting but also exciting. I will be leading on this work, called the Sustainability Transformation Plan, for North Essex and Suffolk because I believe the NHS is precious to all of us. My thanks,
Nick Hulme Chief Executive The Fracture Liaison Team 02 June 2016 Joint winners: Team of the Year The news that someone may have osteoporosis can be life changing, so caring for them is not only about diagnosing and recommending treatment; but also spending time with people to allay their fears and explain what is happening. The Fracture Liaison team do just this. Every one of the team has seen their workload increase but, by working together, they have kept pace with demand and avoided any breach for investigation or appointment.
The Discharge Coordinators within Medicine Team Joint winners: Team of the Year The Discharge Coordinators in the medical division are a new team, but what a difference they’ve made to helping patients get home. Their work improves patient and staff experience, reduces complaints, releases clinical staff time to care and reduces lengths of stay. But above all, they give patients their lives back.
7 Annual Report 2015 / 16 Performance Report
Overview About The Ipswich Hospital NHS Trust
Ipswich Hospital is an iconic The Trust has 552 beds in general Who the Trust Serves acute, maternity, paediatric and public service with a unique Ipswich Hospital has a catchment neonatal services and had an concentration of specialist population of approximately annual turnover of £266 million in 318,000 people from the districts skills to improve the health of 2015 / 16. Across its 46-acre site, Babergh, Mid Suffolk, Suffolk the communities of Ipswich, we employ just over 3,400 whole Coastal and Ipswich; which Suffolk and north-east Essex. time equivalent NHS staff. represents about 95% of the Every day over 3,000 patients Suffolk’s Local Health Economy overall catchment population. rely on us to improve their currently consists of two local The Trust has a typically older clinical commissioning groups lives. catchment population than the (West Suffolk CCG, Ipswich & East England average, with a greater Suffolk CCG), Norfolk & Suffolk Our services include accident proportion of the population aged NHS Foundation Trust (mental and emergency; critical care; 55 and older. The population is health services) and West Suffolk planned medical and surgical projected to experience a 3.7% NHS Foundation Trust (acute care; consultant and midwifery- increase by 2021. However, there services) and us. All partners work led maternity, and neonatal and is projected to be an overall to serve the Suffolk population paediatric care; diagnostic and 13.6% increase in the catchment and have built strong and cohesive therapy services; and since October population of those 60 and older working arrangements. The Local 2015 community hospitals and by 2021, and a 40% increase by Health Economy partners work specialist community services. 2037. together with Suffolk County We also provide a range of Council at the System Leaders The Trust’s catchment population specialised services including spinal Partnership Board and Health and has a longer life expectancy than surgery, radiotherapy, percutaneous Wellbeing Board. that of England, alongside a lower coronary intervention (PCI) and mortality rate in the main disease 93% of the services provided by gynaecological cancer surgery to areas (cancer, coronary heart the Trust are commissioned by the a wider catchment of more than disease, stroke, circulatory diseases, Ipswich and East Suffolk CCG. 500,000 people. and chronic obstructive pulmonary
Celebrating Our Team Ipswich Colleagues
Sally Knight has worked hard to become the Emergency Department’s first Advanced Clinical Practitioner. Her colleagues describe her as an amazing clinician always looking to improve standards of care in the emergency environment. A fellow nurse nominated Sally and said: “We have an amazing emergency department team and I bet Sally has supported each and every one of us at some point during our careers.”
Sally Knight, Advanced Clinical Practitioner Winner: Living the Values Colleague of the Year Award Nominee: Leader of the Year Award
8 Performance Report Annual Report 2015 / 16
Overview About The Ipswich Hospital NHS Trust
disease). This mortality rate is also Partnerships rating. This highlighted some areas decreasing over time, despite an of outstanding practice alongside The hospital site is the base for increasing – and increasingly elderly areas for improvement. Woodlands, a mental health – population. inpatient centre run by The Norfolk A second milestone was passed In contrast, the catchment and Suffolk NHS Foundation Trust. following the award of the contract population typically has a higher to provide Community Services The Pathology Partnership (TPP) rate of disease prevalence than across Suffolk. This was as part of a also runs services from the site. England, particularly for conditions contractual joint venture with West associated with the elderly; such Suffolk Out of Hours GP service Suffolk NHS Foundation Trust, with as dementia (20% more than uses a large outpatient clinic Norfolk Community Health and England), stroke (14.6%), cancer (rheumatology) on the hospital site Care NHS Trust as a key partner. (14%), and an almost 50% to deliver out of hours care. Performance on access standards greater demand for palliative care. A clinically led and run joint in 2015 / 16 is also positive. Key Combined with reduced mortality, vascular surgery service is in place standards for A&E and 18-week this indicates an increased amount with Ipswich and Colchester referral to treatment have been of comorbities, and more unwell clinicians working together to consistently met, as have cancer people living for longer. deliver this service. standards with the single exception of the 62-day upgrades standard, Stroke specialists at Ipswich and although the overarching 62-day Workforce West Suffolk Hospitals work standard was met. However there together to provide high level 24 At December 2015, there were were breaches of the 1% threshold hour, seven-day-a-week services. 4,075 employees (headcount); with for diagnostic waiting times The latest Sentinel Stroke National a full-time equivalence of 3,477 over the year, with over 90% of Audit Programme (SSNAP) data for employees. breaches occurring due to capacity last quarter shows that we are the constraints in non-obstetric best in the east of England. Along ultrasound. This is being tackled Financial Performance with West Suffolk Hospital, we in the short-term and the Trust is have been awarded the contract Our financial performance has training its own sonographers to to run community services in moved as follows: provide a longer-term solution. Suffolk.We bid for the contract 2013 / 14 £0 m (£7.5m NR income) as a contractual joint venture Progress was made in a number 2014 / 15 £11.9 m deficit and are receiving some support of quality initiatives. The Trust from Norfolk Community Health has implemented ‘NerveCentre’ 2015 / 16 £22.3 m deficit and Care NHS Trust. The contract and electronic whiteboards on During this time period we have covers a range of adult community wards to speed up the process delivered over £40 m of efficiencies services, specialist children’s and monitoring of patient to keep pace with rising activity services and community hospitals. observations and patient flow. and financial pressures and Harm-free care has improved, invested £33 m over the past along with completion rates for three years in estate development Review of 2015 / 16 Mental Capacity assessments and maintenance, information We have made sound progress and support of Do Not Attempt technology (IT) infrastructure and during 2015 / 16. Cardio Pulmonary Resuscitation medical equipment. (DNACPRs), and reductions in The Trust achieved a major length of stay. milestone following a planned CQC inspection in January 2015. The financial position of the The report, released in April 2015, Trust remains the one key area gave the hospital an overall ‘Good’ of focus, which is consistent
9 Annual Report 2015 / 16 Performance Report
Overview About The Ipswich Hospital NHS Trust
with the majority of our peers. Key quality improvements that Significant progress has been made Trusts should also focus on are: in developing a joint working Celebrating Our • Supporting patient choice, relationship with commissioners especially in end-of-life care. Team Ipswich which will ensure system incentives are aligned. This has enabled us • Addressing anti-microbial Colleagues to work together to focus on resistance. cost reduction across the whole • Demonstrating progress towards health economy. Within this new reducing amenable mortality, environment of mutual support especially where lack of seven we have a joint intent to meet the day services is a factor. financial challenge. The Trust actively engaged as Local Health Needs one of the 32 trusts in the Carter Assessment review. We generally benchmarked The 2015 State of Suffolk report well and were consistently in the also outlines priorities for the upper decile. We are using this health of our population: information to focus on areas of Asmah Syed, Trainee Doctor improvement and to improve our • Smoking, alcohol, drug usage, Winner: Trainee of the Year Award financial performance further. obesity and mental health issues in pregnancy, along with uptake Asmah Syed is a foundation of breastfeeding. National Priorities in year 2 trainee doctor and a • Long-term impacts on health medical director of the future. 2016 / 17 of child poverty and low Not only a tremendous patient The Five Year Forward View and attainment in schools. advocate, she always works planning guidance outlines some • Focus on prevention and early hard to support her fellow key objectives for acute trusts in intervention, and supporting junior doctors and medical 2016 / 17: young adults to develop good students. Efforts include • Jointly develop a Sustainability habits. organising teaching workshops Transformation Plan (STP) across • Tacking the causes and impact to help improve prescribing the local health economy. of deprivation on health (also skills and introducing a mentor • Deliver financial balance across highlighted as a key theme support programme for juniors the system, facilitated by in the Health and Wellbeing in their first doctor roles. focusing on the opportunities Board’s Poverty Strategy) and arising from the Model Hospital supporting people to be aware and agency caps. of the early signs of cancer. • Deliver access standards in A&E, • Supporting patients and carers elective waiting times, cancer to be able to stay in their homes and diagnostics. into older age. • Continue to deliver The local health needs set the improvements to quality. context for our developing clinical strategies and our footprint’s The first three elements are Sustainability Transformation Plan. mandatory conditions in accessing sustainability funding.
10 Performance Report Annual Report 2015 / 16
Overview Trust Objectives
Our Objectives
Objective Target Measure
Consistently deliver great healthcare to every patient every day
Deliver care to patients • Consistently deliver access standards for • Performance against NHS constitution standards when they need it Emergency Department (ED), Referral -to- Treatment (RTT), cancer and diagnostics
Develop our teams to • Improve “recommend as a place to work • NHS Staff Survey outcome consistently provide the care or receive treatment” • Improvements in agreed mortality indicators we want for our families • Improve clinical outcomes • Improved patient experience feedback and PLACE • Improve patient and care environment scores experience
Embed accountable • Improve staff engagement • NHS Staff Survey leadership throughout the • Deliver financial plan • Agreed financial plan with NHS Trust Development organisation • Improve Accountability Framework scores Authority (TDA) • Deliver oversight score of 3 across all domains in all divisions
Improve the healthcare we provide to patients when and where you need it
Deliver care to patients in • Increase market share • Volume of referrals from outside core catchment the appropriate setting • Expand our dementia-friendly facilities • Increase the number of dementia-friendly wards • Improve discharge and transfers of care • Reduce discharge delays and improve choice at end process of life
Improve the value of the • Improve organisational efficiency • Deliver Carter milestones Suffolk health £ • Improve system-wide efficiency • Deliver shared Sustainability and Transformation Programme Board (STPB) plan
Flexible and responsive to future demands
Design new pathways • Improve effective use of healthcare • Reduce unnecessary emergency admissions, to improve the overall resource referrals and introduce alternatives to follow-up wellbeing of our population • Move towards a sustainable health visits economy • Deliver agreed milestones
Celebrating Our Team Ipswich Colleagues
The Orthotics admin team make sure all their patients receive a warm welcome and patients say they get an excellent service. Just recently they helped arrange special delivery of a pair of new orthotic shoes so a little girl could take them on holiday. Thanks to this small team, patients are seen on time, orders are followed up, appointments are not cancelled, and patients get their much-needed equipment as soon as possible.
Orthotics Admin Team Highly commended: Team of the Year Award
11 Annual Report 2015 / 16 Performance Report
Overview Trust Objectives
Key Risks and Mitigations
Risk Likely to manifest as: Risk management and mitigation Staff shortages and / or • Excessive agency costs causing deviation • Patient safety recognised as highest priority inability to recruit to key from financial plans • Dedicated workstream to improve recruitment posts • Negative impact on quality of care process and attractiveness as employer • Working across system to address workforce shortages and jointly manage impact
Capacity and capability • Failure to deliver quality improvements • Strengthened governance and oversight by the to deliver scale of change • Delays in delivery of savings STPB required • Slippage on key targets • Joint working with CCG to reduce duplication of assurance processes and align capacity to delivering agreed set of shared objectives
Pressures on services distract • Pressure on ED 4-hour standard • Delivery of access standards a key objective of STPB from delivering change • Breaches of elective, cancer and diagnostic • Redesign workstreams focusing on reducing agenda standards reliance on hospital-based care • Contract incentives aligned between CCG and Trust • Enhanced capacity within operational teams
Key contracts may be subject • Required changes are not delivered in • Joint working with CCG as commissioner to retendering in short to full or are compromised in scope and • Joint working with senior leaders within community medium term ambition services and other providers in local health • Delays in delivery of savings economy • Management resource diverted to • Development of overarching Sustainability servicing tenders Transformation Plan (STP) for the footprint will encompass requirements regardless of organisational and contractual boundaries • Negotiation of longer term community
Demand management plans • Activity not funded to forecast levels • Joint working to develop system cost reduction in final CCG contract opportunities • Trigger and system escalation included in final
New junior doctors contract • Sustained industrial action • Industrial action taskforce established and leading causes disruption to the • Increased number of gaps in junior doctor on Business continuity planning around strike days supply of junior doctors rotas which may require locum cover due to minimise disruption to reduced retention / unable to recruit • Continued focus on being a great place to learn and / or fewer working hours available to and train to attract junior doctors to the Trust cover rotas • New contract task and finish group established with project plan in place – rotas being reviewed as part of plan to identify future gaps • Use of Medical Training Initiative scheme to fill some gaps
12 Performance Report Annual Report 2015 / 16
Overview Quality
Approach to Quality Quality governance comes together Improvement through the Quality Committee, which is supported by: Celebrating Our The Director of Nursing and the • sub-committees covering Team Ipswich Medical Director are joint executive patient and staff safety, clinical leads for quality of care and effectiveness, and patient and Colleagues clinical outcomes, and supported carer experience. These groups by the Director of Governance, oversee a wide range of further and recognising that everyone is groups such as the mortality responsible for quality. The Trust review group; works on a risk and escalation basis for managing quality, and this has • Divisional and Clinical Delivery been built into our structures and Group level governance processes following a governance meetings covering all aspects of review that concluded in March quality; 2016. • dedicated audit days and clinical audit function; • Schwartz rounds and after action reviews (AARs); • Serious Incident Requiring Investigation (SIRI) investigations and reporting; James Pawsey, Analyst • quality priorities reporting to Winner: The Winifred Prize Board through the Integrated Performance Report; • quality metrics embedded James Pawsey is an analytical into the Trust’s Accountability mastermind – a real whizz with Framework; statistics and computing. He works in our transformation • ward-level capture and reporting team to help clinical colleagues on quality and safer staffing; find new ways of working. • quality heat maps reviewed monthly by the Board. Perhaps most notably, he developed a system for the The Trust is in the second year of Emergency Department to its Sign Up to Safety Campaign, predict and cope at busy times. and the five priorities identified through this process are reducing patient falls, reducing pressure ulcers, improving detection of deteriorating patients, seven-day working and clinical outcomes. Quality priorities for 2016 / 17 have been agreed (see table on next The Winifred Prize recognises outstanding page). achievement and is a new award included in our Staff Awards portfolio.
13 Annual Report 2015 / 16 Performance Report
Overview Quality
Quality Priorities for 2016 / 17
Priority Target Key measures To continue to develop • To increase the number of patients using • Monitor the number of patients referred to the services to support patients the Frailty Assessment Base (FAB) service service who are elderly and frail • To reduce the length of stay in both the • Monitor the length of stay of those patients who acute and community hospital setting for require admission following assessment by the those patients who need to be admitted Frailty Assessment Base. following assessment • To increase the percentage of patients who have managed to avoid admission • To expand FAB service to become available seven days a week • To further integrate with community services and social services
To continue to improve our • To deliver high quality, compassionate and • Monitor themes from complaints relating to end of care to those at the end dignified end of life care life care of their life and support • Improve choice and reduce the number of • Monitor results from DNACPR and national end of patients who have limited complaints received relating to end of life life audits to highlight themes for improvement treatment options care • Audit use of individualised care plans to ensure best possible practice • Expand post bereavement follow-up service with families
To avoid delays in transfers • To reduce the number of patients who • Number of patients who have a delayed transfer of of care of a patient from have to stay in our hospitals beyond the care (DToC) hospital or community beds date when they are medically stable for to other care environments discharge
To continue to expand • Creatively re-furbish two further wards • Track progress of works to improve ward our dementia-friendly to provide a shared clinical and social environments to ensure all work is completed environment environment using The Kings Fund’s within the agreed timescale Enhancing the Healing Environment and • Measure the numbers of incidents of violence and other existing research in the design aggression in these areas process • Patient, carer and staff experience findings • To share the learning from creative • Staff sickness and retention in these areas refurbishments with other areas
Celebrating Our Team Ipswich Colleagues
Sarah Smith embodies all the values we expect of our nurses – compassion, kindness, understanding empathy and hard work. She took on the role of Child Health matron at a time when there was plenty to be done. The entire team has come together to make service improvements and if you ask them who has been fundamental in leading them, they will tell you ‘the lovely Sarah’.
Sarah Smith, Child Health Matron Highly commended: Leader of the Year
14 Performance Report Annual Report 2015 / 16
Overview Quality
The Trust will continue to focus on anti-microbial resistance supported by joint working across primary, community and secondary care. Key quality risks identified at this stage are:
Risk Likely to manifest as: Risk management and mitigation Ability to consistently deliver • Excessive agency costs causing deviation • Patient safety recognised as highest priority patient-facing care due from financial plans • Dedicated workstream to improve recruitment to staff shortages and / or • Negative impact on quality of care process and attractiveness as employer inability to recruit to key • Working across system to address workforce posts shortages and jointly manage impact
Continuity of care for • Patients remain on waiting lists without • Robust mobilisation planning patients as service models being seen • Integrated technology to automate flow of are changed and integrated • Patients are not transferred between information with other providers partners following a stage of treatment • Clear advice to patients regarding the changes underway and whom to contact with queries and concerns • PALS kept informed of changes
Delays to care caused • Lack of patient flow eg between ward • Joint planning and coordination by mismatched capacity and community hospitals • Development of interim and longer-term capacity between different services • Backlogs building up in key areas to address bottlenecks • Adoption of ‘red to green’ processes to facilitate early identification and removal of constraints to delivery
Celebrating Our Team Ipswich Colleagues
Nurses Mowena Palmer, Stuart Graham and housekeeper Tracey Cribb arranged a wedding on their ward for a dying patient as his last wish. Flower, make-up, rings – they did it all. And all the time continuing to give fantastic care to the other patients on the ward.
Mowena Palmer, Registered Nurse; Stuart Graham, Registered Nurse and Tracey Cribb, Housekeeper Joint Highly Commended: The Winifred Prize
15 Annual Report 2015 / 16 Performance Report
Overview Quality
Seven-Day Services Celebrating Our The Trust recognises the important link between patient safety, clinical Team Ipswich outcomes, operational efficiency, and seven-day services in key areas. The baseline assessment undertaken in summer 2015 demonstrated that Colleagues the Trust had made good progress in delivering the four priority clinical standards. All diagnostic tests were available and access to clinical decision makers was good, except in a handful of specialties. The gaps are shown in the summary below:
Standard Compliant Non-compliant 2 – Time to • Consultants involved in • 80% of modified early consultant high risk patients within warning system (MEWS) review four hours assessments completed on • 100% of high risk patients admission assessed by a doctor • 100% of patients assessed by consultant within six hours of admission to acute ward
5 – Access to • Fully compliant diagnostics Beverley Rudland, Complaints Manager 6 – Access to • Fully compliant Joint Highly Commended: consultant- The Winifred Prize directed interventions Complaints manager Beverley 8 – On-going • Twice-daily consultant • Except in Acute Medical Rudland is a champion for review review Unit (AMU) patients and carers. With a • Consultant-delivered ward • Not in Care of the Elderly quiet determination and gentle round, once a day, seven • Electronic transfer of records days a week perseverance, she ensures the in development voices of those most in distress are heard and listened to. She The Trust will undertake a refresh of our compliance assessment in is optimistic and always believes accordance with the national programme. ‘we can do it’. The health economy, through the Emergency Care Programme Board, is also reviewing the provision of urgent care and out-of-hours services including NHS 111 and their role in supporting secondary care emergency services. Community reactive responses are also being reviewed through the lens of seven-day services. Providing early intervention and admission avoidance on a seven-day basis will provide a significant benefit to the hospital and the patient population. This project is also being taken forward through the Emergency Care Programme Board, jointly with the CCG, and demonstrates the real benefit that joint working and integrating hospital and community services brings.
16 Performance Report Annual Report 2015 / 16
Overview Quality
Accountability Celebrating Our The Trust has an Accountability special measures include one or Framework (AF) in place which more of the following: Team Ipswich brings together a range of • Financial – Suspension of indicators at a Divisional level. delegated authority; Colleagues These are then grouped into the • Financial – Director approval of Care Quality Commission (CQC) all purchase orders; quality domains and a financial score. Monthly meetings are held • Loss of decision making powers; between the Divisions and the • Divisional Board Capability Executive to review performance. review by Third Party; Escalation reports are also • Division Board to Trust Executive, presented to the Board and special meeting(s); relevant sub-committees. • Improvement plan(s) to be Each Division is given an approved and monitored by oversight category based on their Trust Executive via the AF performance. These are: Oversight meetings or other 1 Special Measures stated forum; 2 Rapid Improvement • Further reviews as needed; • Any other intervention as 3 Intervention Jonathan Douse, determined by the Trust 4 Standard Oversight Respiratory Consultant Executive taking into account Joint Highly Commended: 5 High Performer the specific circumstances The Winifred Prize The examples of intervention under triggering this escalation. Ward-level reports are also Respiratory consultant Jonathan produced for safer staffing and Douse is described as a quality heat map on a monthly motivational leader, particularly basis, and these are reviewed by for the way he helped the the Board. medical division through an extremely busy winter. Dr Douse led by example, supporting colleagues to do their jobs at a time when he too was busy caring for patients.
17 Annual Report 2015 / 16 Performance Report
Overview Activity
Demand During the year the Trust has established detailed population-based Celebrating Our modelling of demand. Using Office for National Statistics forecasts, referral patterns by age band and by specialty, the Trust is able to forecast demand Team Ipswich on a specialty-by-specialty basis driven not just by absolute population Colleagues growth, but also by demographic profile. The contract assumes growth of 1% will present in-year following a range of demand management measures, as detailed below, agreed with Commissioners; this is projected to contain growth below the population model methodology forecast growth of 1.4%.
Programme Comments Musculoskeletal (MSK) Work already well developed with Hospital clinicians. pathway redesign Covers a range of specialties. Trauma & Orthopaedic (T&O) is dominant and we have already seen substantial reductions in referrals and new inpatient activity
Ophthalmology Work is well developed in outpatient pathways being changed to work closer with community services
Referral management General reduction across surgical specialties on basis Marie Fletcher, Senior Midwife of contractual agreement to have primary referral Winner: Leader of the Year management centre
Respiratory Develop of community services to align with findings Senior midwife Marie Fletcher from current work programme to manage prescriptions and community support better. This is forecast to leads the labour wards with a reduce volatility and number of repeat admissions safe and compassionate pair of hands. Outpatient follow-ups Incentives in contract will encourage consultants to find new ways of feeding back results and post-op Her priority is ensuring top monitoring to patients reducing follow-up attendances. quality care for patients and Emergency activity Crisis Activity Team / Fragility Assessment Base schemes she is always there to support being expanded will reduce demand against forecast. and advise her midwives. Capacity constraints in the hospital will incentivise The doctors value Marie for admission compliance with consultants supporting their decisions while Further development work is being undertaken on our demand model never being afraid to challenge. which will inform the STP. This involves greater use of analysis and forecasting techniques, and bringing in complementary data sources to improve the accuracy of forecasting for individual specialties or conditions, to help drive the development of individual clinical strategies and our overarching Trust strategy refresh.
18 Performance Report Annual Report 2015 / 16
Overview Activity
Capacity We have worked extensively with Outsourcing is continuing in on our successful ‘Red to Green’ NHS Interim Management and Orthodontics and there are work. This has now extended Support (IMAS) in the past year no plans to further the scope into the community hospitals in to develop and assure itself of of current outsourced activity. east Suffolk which now come sufficient capacity to deliver NHS Diagnostic Imaging is also using under our management, and early constitution commitments. The outsourced magnetic resonance improvements have been made. latest models were developed imaging (MRI) capacity but is Work is also focusing on how to in autumn 2015, with intensive seeking to reduce reliance on this ensure flow across other discharge support and scrutiny from NHS capacity during 2016 / 17. settings including joint working with Social Services and potentially Interim Management and Support Following a system-wide workshop domiciliary care and care home (IMAS), and are starting to embed held in mid-February, two key providers. as a vital management tool winter resilience schemes are now within the organisation. Work is being permanently established Key milestones in delivering underway in Ophthalmology and alongside reviewing the current transformed services designed to Orthopaedics to repatriate work admissions avoidance schemes deliver productivity improvements following the exiting of the market and bringing them under a and managing demand growth are by an independent sector provider. single umbrella to improve cover, shown below: Plans have been developed which efficiency and resilience. This work allows for the full absorption of is being managed through the this work within current resource Emergency Care Programme Board, levels. This productivity gain is which reports into the STPB. being managed through the Elective Care Programme Board. The Emergency Care Programme This Programme Board will also Board is also managing a range oversee delivery of the elective of joint transformation schemes access standards by focusing which continue to focus on on productivity and demand hospital flow and reducing delays management. across the whole pathway, building
Emergency Care Elective Care Milestone Milestone
25% reduction in community hospital length of stay Generic principles for risk stratified follow-up agreed
Close 1 acute escalation ward (24 beds) New theatres module and scheduling process implemented
Pre-referral guidelines and single point of access developed for all DToC reduction – domiciliary care specialties
DToC reduction – discharge to assess Issue updated admitted pathway Standard Operating Procedures
Further 24 bed reduction from baseline E-outcome forms implemented across all specialties
19 Annual Report 2015 / 16 Performance Report
Overview Activity
Risk Management Our contract with Commissioners is based on a new form of contracting Celebrating Our which incentivises demand management and admission avoidance for both us and the clinical commissioning group. Team Ipswich Alongside a revised contract structure, a joint governance structure and Colleagues shared managerial capacity from the hospital and CCG is focusing on delivering the shared transformation agenda through the Sustainablility Transformation Programme Board with a primary focus on cost reduction delivered by demand management. The Emergency Care Programme Board has overall responsibility for delivery of the ED standard and reducing the level of DToCs to improve flow. The Elective Care Programme Board has responsibility for elective, diagnostic and cancer standards and delivering productivity and capacity to meet patient demands. The Business Development and Integration Programme Board is working on whole pathway transformation – across emergency and elective boundaries – to deliver redesigned services which reduce reliance on the acute sector and focus on supporting early intervention, shared care and self-care for patients. These Programme Boards include senior CCG representation to deliver our shared objective of reducing overall system cost through demand management, efficiency and efficacy.
Brenda Shelley, Volunteer Winner: Supporter of the Year
Brenda Shelley is a volunteer in the hospital’s John Le Vay Cancer Information Centre, where she provides a listening ear and support to cancer patients and their loved ones. Celebrating Our Team Ipswich Colleagues Brenda also helps run courses for the patients, including art Hospital Radio volunteer Gemma Gee is workshops and a book club. a hit on the airwaves. Patients often ask One person said “‘I don’t after her as her upbeat presenting style know how I would have coped lifts their spirits. without the book group, She is described as a ‘volunteer Brenda has given me back my extraordinaire’ who puts patients first and confidence.” gives a great many volunteer hours.
Gemma Gee, Volunteer Nominee: Supporter of the Year Award
20 Performance Report Annual Report 2015 / 16
Performance Analysis Performance Against Key Indicators
The Trust maintained a strong Celebrating Our performance across a range Key facts and figures Team Ipswich of targets, national standards Births: and other key performance 3,821 Colleagues indicators including reducing the number of hospital- Emergency Department attendances: acquired infections. 84,387
Planned admissions: 50,441
Unplanned emergency admissions: 35,278 (excluding maternity) 43,259 (including maternity)
Outpatient attendances: 513,611 (total)
John Decroo, Housekeeper Number of appointments Highly commended: Living the Values people did not attend: Colleague of the Year Award 35,739
Bergholt children’s ward didn’t Diagnostic Imaging know what they were missing examinations: until housekeeper John Decroo 174,805 joined the team. He is the lynch pin that holds them together. Referrals from GPs and dentists: He is generous with his time, his 109,093 actions and his support and all this is reflected in the level of care the team is able to give to children and their families. The ward sister says ‘I would not be the leader that I am without him close behind.’
21 Annual Report 2015 / 16 Performance Report
Performance Analysis Performance Against Key Indicators
Historic Data
Qtr to Qtr to Qtr to Qtr to Indicator Subsections Threshold Jun 15 Sept 15 Dec 15 Mar 16
From point of referral to treatment Maximum time of in aggregate (RTT) 90% YES YES YES NO 18 weeks – admitted
From point of referral to treatment Maximum time of in aggregate (RTT) 95% YES YES YES YES 18 weeks – non-admitted
From point of referral to treatment Maximum time of in aggregate (RTT) – patients on an 92% YES YES YES YES 18 weeks incomplete pathway
Surgery 94%
All cancers: 31-day wait for Anti-cancer drug second or subsequent treatment, 98% YES YES YES NO treatments comprising:
Radiotherapy 94%
From urgent GP referral 85% for suspected cancer All cancers: 62-day wait NO YES YES YES for first treatment: From NHS Cancer 90% Screening Service referral
All cancers: 31-day wait from 96% YES YES YES YES diagnosis to first treatment
All urgent referrals 93% Cancer: 2-week wait from referral to date For symptomatic breast NO YES YES YES first seen, comprising: patients (cancer not 93% initially suspected)
A&E: From arrival to Maximum waiting time 95% YES YES YES NO admission / transfer / discharge of four hours
Is the Trust below the Clostridium difficile 18 YES YES YES YES YTD ceiling
Is the Trust below the MRSA 0 YES YES YES YES YTD ceiling
22 Performance Report Annual Report 2015 / 16
Performance Analysis Operating Financial Review
In 2015 / 16, the Trust returned a deficit of £22.3m; this includes non-recurrent costs associated with impairment of assets and non-recurrent grants and charitable fund income net of depreciation. The underlying deficit before recognising the above was £22.1m.
The Trust ended 2015 / 16 £2.3m and associated costs of temporary • £1.5m on the Aseptic away from a planned deficit of staffing as well as the Community Preparation Unit; £19.8m for the year; the primary Services contract. Non-pay rose • £1.6m backlog maintenance driver of this was the cost of by £14.2m (14%) in 2015 / 16 across the Trust; increased non-elective care and with the increased cost of clinical • £1.5m on enhancing the Trust IT delays to the transfer of care of supplies of £6.0m a primary driver infrastructure; patients identified for discharge of this increase, linked to increases or care in a setting away from in the volume of care. As with the • £1.4m general site the hospital. Despite increases majority of trusts, the contributions improvements; in activity, the Trust was again in to the national Clinical Negligence • £1.2m on replacement MRI 2015 / 16 one of a small number Scheme increased significantly in works. nationally to achieve the 95% A&E 2015 / 16 by £3.8m. The financial outlook for the Trust 4-hour target. As a consequence of the operating remains challenging into 2016 / 17 Continuing improvements to deficit, the Trust was required and beyond; the deficit of £22.1m financial management across the to secure a loan in 2015 / 16 in the past year was delivered organisation helped to identify to underpin cash management with support of a number of non- and deliver £10.1m of Cost across the Trust; this amounted recurrent actions, and the projected Improvement efficiencies in-year, to £17.3m. Cashflow is strongly deficit for 2016 / 17 is a deficit of £9.0m of these are recurrent; the linked to the underlying financial £29.9m. The plan reflects a change focus of these programmes is to position of the organisation in contracting for 2016 / 17 with deliver sustainable improvements and will remain as such for the a guaranteed income agreement in operational and financial medium-term. The financial with our Lead Commissioner body; performance across the Trust. position impacted adversely this is a new arrangement that on the 30-day performance of will reduce contractual risk and In October 2015, the Trust the Trust in 2015 / 16 as careful allow both parties to focus on took over the management of management of scarce cash delivering sustainable change in Community Services in Suffolk resources was required all year; the provision of care through the in partnership with West Suffolk the Trust Executive via the Finance Sustainability and Transformation NHS Foundation Trust; the and Performance Committee networks across a range of care financial impact of this is reflected maintained close scrutiny of this all organisations. The Trust Board has in the Trust accounts with a year. reviewed the financial projection matched increase in revenue and for 2016 / 17 and believes it to be a expenditure. Total income rose The Trust invested £12.6m in credible and appropriate plan. by £15.7m (6%) in 2015 / 16 as a maintaining and developing the result of the Community Services asset base in 2015 / 16, including: contract, Donated Assets income • £2.7m on the Woolverstone and a general increase in the Macmillan Centre; volume of care across the Trust. • £2.0m replacing and upgrading Total Pay increased by £12.7m (8%) Medical Equipment across the through the increases in activity Trust;
23 Annual Report 2015 / 16 Performance Report
Performance Analysis Our Buildings and Structure
Estates Development and funding was agreed at the end of Infrastructure Schemes September 2015 and meant that Celebrating Our the project only started in January Team Ipswich The year of 2015 / 2016 was 2016 on site, with all construction a busy one, with the largest work being undertaken without Colleagues estates development and backlog impacting the existing facility. maintenance programme being undertaken for many years. The The MRI Scanners Replacement Trust initially agreed the Procure commenced in November 2015, 21 Plus (P21+) procurement this saw the start of a very complex route with P21+ partners as the replacement of the two existing mechanism for a large proportion MRI units within a live diagnostic of the programme back in June department at a cost of around 2015, however, due to slower £3m including construction and progress than expected the Estates the scanners themselves. Much Capital Development Team reverted of the existing infrastructure has in September 2015 to delivering had to be replaced and upgraded the projects in a more traditional to allow the new General Electric Ben Hobson, Trainee Doctor format. magnets to be installed. The first Highly Commended: magnet was successfully delivered Trainee of the Year Award As previously mentioned, the and made operational in March largest capital programme for 2016, with the second machine some years was delivered in less Ben Hobson is an exemplary due for delivery in June 2016. The than perfect conditions. Due to trainee doctor and his clinical whole project will be completed in the delays experienced in the P21+ supervisor says he will have September 2016. process, the program started much a very successful career in later than originally planned in The Woolverstone Macmillan whatever specialty he chooses. the financial year which effectively Centre (WMC) and a new Always willing to help out in his allowed only seven months on Aseptic Pharmacy Unit (APU) spare time, Ben has achieved site instead of a more usual 10 to commenced in November 2014 experience far above his 11 months. Some success stories after many years of planning. In training level. however are below: partnership with Macmillan Cancer Support the Trust is very near to He is always willing to go the The New Clinical Investigation completing the WMC oncology extra mile to provide the very Unit was delivered on first floor extension build to create an best clinical care for patients. of the Tower Block in November exemplar centre for cancer care 2015. The project, which cost at a cost of £3.5m. As an added around £400,000, was undertaken bonus the project delivered a from inception to completion in thoroughly modern £1.5m APU in 10 weeks, opening on time for the September 2015 directly on the benefit of patients. floor above. The centre will be Outpatients Entrance 6 was opening to its first patients in May another fast-track project, 2016 and a more formal opening which involved the complete ceremony will take place later in refurbishment of the area and the year. construction works completed in March 2016, and the roll out of new ‘self-check in’ system going live in April. The £390,000
24 Performance Report Annual Report 2015 / 16
Performance Analysis Our Buildings and Structure
Electrical High Voltage which date back some 100 years or hospitals and many community Infrastructure was a critically more. Planning for the use of the healthcare facilities. We are important project to the Trust school is underway with the project committed to reviewing our in providing a resilient high being undertaken within the next buildings and facilities to ensure voltage electrical network to the year. that energy-saving practices and hospital. Through a range of technologies are applied where appropriate. The Ipswich Hospital electrical projects, including the Sustainability replacement and upgrading of NHS Trust also recognises that outpatients generator ‘C’, the The Ipswich Hospital NHS Trust energy and carbon management maternity generator project and has adopted its Sustainable extends beyond our estate to the upgrading of the high voltage Development Management Plan include our suppliers, strategic switchgear for the forthcoming (SDMP) to adapt and mitigate partners and staff. We will work biofuels project, this represented a the impacts of climate change, with leaders, local champions and total overall investment in excess waste to landfill, carbon emissions the public to enable actions that of £2m. Virtually all the Trust’s and uneconomical water usage. further reduce the Trust’s energy electrical switchgear has now been The Ipswich Hospital NHS Trust and carbon impacts. improved and modernised. Along acknowledges the importance of with the new backup generators sustainable development, which Biofuel the hospital is protected for years seeks to protect our world’s natural One particularly innovative project to come and a major significant risk resources while achieving economic will generate electricity to the site to hospital has been dealt with. and professional growth. The using waste vegetable oil as the SDMP (which will be presented fuel source. The fuel is categorized Medical Air and Vacuum Plant to the Trust Board for approval) as zero carbon and will reduce Replacement was another outlines the Trust’s commitment emissions, but it will also mean critically important infrastructure against each workstream and a saving in cost of over £1.283m project which saw the replacement substantiates reasons for the per annum by 2025. The project and upgrading of a number of proposed amendments and was originally intended to be ‘on medical air and vacuum systems ambitions. The workstreams that stream’ during 2015 / 16 but due across the site at a cost of will be addressed include: to unexpected delays will now be £250,000. • Governance commissioned during 2016 / 17. • Organisational and workforce Waste Acquisition of Bridge development School 100% of our clinical waste • Partnerships and networks is incinerated on site and the The Trust purchased the redundant • Energy and carbon management heat recovered is used to heat Bridge School (otherwise known • Procurement of goods and the hospital, saving on gas as Heathside School) from Suffolk services consumption and cost. This reduces County Council as part of its • Transport our carbon emissions by more than strategic estates plan for the 1,100 tonnes. overall redevelopment of the site • Water over the next 10 to 15 years. By • Waste Our non-clinical waste is segregated and the volume sent to acquiring the site at an early stage, • Designing built environment this gives the Trust an opportunity landfill is minimised. • Finance earlier than expected in the redevelopment of the north end The Trust will ensure that our of the hospital with the relocation statutory obligations to reduce of clinical and non-clinical services CO2e are achieved. Our estate from those areas of the hospital is large and varied with four key
25 Annual Report 2015 / 16 Performance Report
Performance Analysis Our Buildings and Structure
Steam Into Garrett Anderson than 1% with a total electricity use sustainable foodstuffs – fewer Centre (GAC) of 15,896,791kWh and at a cost of food miles. As identified earlier in Waste, £1,817,841. • More than 50% of food waste Estates have developed a strategy Our water consumption has risen is now treated in a waste food and engineered solution to use by 12% this year, possibly due to digester, reducing impacts some of the heat recovered from increased footfall and we spent on the drainage system and the incineration of our waste to £323,000 on water and sewerage. reducing landfill. ISS has been in provide as much as 80% of the discussions with Tamar recycling heating and hot water for the CRC Payment with a view to sending all food GAC. This will further reduce The CRC Energy Efficiency Scheme waste off site for anaerobic the overall carbon footprint and is a mandatory scheme aimed at digestion / electricity production. reliance on fossil fuels across this improving energy efficiency and • All waste oil is collected for site and provide direct savings of cutting emissions in large public recycling, which then runs the over £50,000 a year, demonstrating and private sector organisations. delivery vehicles bringing the our commitment to a renewable The cost of CRC has increased chilled and ambient temperature and sustainable future. and our next payment will be food. approximately £166,000. Energy Consumption • Consumable products such as hand towels, toilet tissue, Our total energy consumption Hotel Services Sustainability plastic bags, Vernacare items, has risen by around 6% this year Initiatives disposable curtains, liquid hand overall. The Estates and Facilities soap etc are bought and stored Our gas consumption has risen department works closely with ISS, in bulk – reducing transport by approximately 6% compared its Hotel Services partners, on a costs and emissions. number of sustainability initiatives to last year with a total gas use • All the ISS pathology vans as part of its contract with Ipswich of 10,518,969 kWh at a cost of are the small-engine, energy- Hospital with progress on the £338,314. This is due to a number efficient models with low following areas: of factors including output of emissions. waste steam from the incinerator • ISS retail catering achieved • The on-site ISS security vehicle is and footfall within the Trust. Soil Association Bronze award a full electric model. The Trust’s electricity consumption as part of the ‘Food for Life’, has been kept to an increase of less elements of which pertain to
Celebrating Our Team Ipswich Colleagues
Lyndsey Hessey called the hospital to ask if she could donate some advent calendars to the children’s ward – little did we know she was going to turn up with more than 50, rallied together by friends, family and her work colleagues. Since then she has organised the donation of 230 Easter eggs, 60 duvet sets, boxes full of craft supplies and dozens of Christmas presents. Lyndsey is kind and inspiring.
Lyndsey Hessey, Community Fundraiser Highly commended: Supporter of the Year Award
26 Performance Report Annual Report 2015 / 16
Performance Analysis Our Buildings and Structure
Fire Safety of upgrading cameras. The better developed a Prevent Strategy and quality of recording has assisted in awareness leaflets. The Prevent For the year ending 2015 / 16 improving security and pursuing lead works closely with Local Fire Safety has continued to action to ensure the hospital is a Authority, Suffolk Police and NHS play its part in the day-to-day safe environment. England on WRAP issues, including activities within the Trust, in a any potential referrals. As a Trust, variety of ways. Fire Safety sits The security advisor works closely we haven’t had to make any within the Estates Department with Suffolk Police, and as part referrals under WRAP. under Performance and Statutory of this working partnership he Compliance. has been involved in a couple In October 2015 WRAP training of undercover operations, that was set up and to date 537 Trust Staff training has continued has resulted in individuals being employees have been trained to throughout the year. This has arrested and charged for theft- understand the Government’s included Induction, Mandatory related incidents. Prevent Agenda and to feel Refresher Training, Fire Coordinator confident in raising concerns. This and other bespoke fire safety In the past 12 months there were training has also been delivered to sessions that relate with specific 205 security-related incidents the external contractors working department areas, such as the reported, of which 137 were either on site and 300 employees made Neonatal Unit, Theatres. physical or verbal assaults on staff, up from ISS, Serco and Berryman 28 relate to theft from Trust, staff Personal Emergency Evacuation Contractors have been trained. and patients and 17 fall under Plan (PEEPS) procedure was other incidents, which is a mixture produced. This is a bespoke plan of nuisance behaviour / vagrancy prepared for an individual, eg Accountable Officer: type incidents. Training continues employee, who may require some Nick Hulme to be offered around Conflict form of assistance to a place Resolution and Breakaway training, Organisation: of safety, in the event of a fire but take-up of training progresses The Ipswich Hospital NHS Trust incident. at a modest pace due to the need Signature: to maintain clinical service levels. Security The Government’s Security Strategy Over the past 12 months we have has a requirement for all NHS staff upgraded the CCTV recording to attend a Workshop to Raise the system from analogue to digital Awareness of Prevent (WRAP). The and have installed new monitors Prevent lead in conjunction with Date: and recorders, ready for phase two Adult and Child Safeguarding has 02 June 2016 Celebrating Our Team Ipswich Colleagues
Glynis Berry has a special note on her desk in Occupational Health. It reads ‘Volunteers do not get paid. Not because they are worthless, but because they are priceless.’ And priceless she is – sorting files, checking data, updating spreadsheets, even making cheesecake for the team.
Glynis Berry, Volunteer Nominee: Supporter of the Year Award
27 Annual Report 2015 / 16 Accountability Report
28 Accountability Report Annual Report 2015 / 16
Corporate Governance Report Directors’ Report
Composition of the Board Chair and Non-executives – at 31 March 2016
The overall management of David White Chair (from November 2015) the hospital is the responsibility Alan Bateman Non-executive Director of the Trust Board which comprises a Chair, five Tony Thompson Non-executive Director Non‑executive and seven Andrew George Non-executive Director Executive Directors. Laurence Collins Non-executive Director All Non-executive Director appointments are made through Vacancy Non-executive Director the NHS Trust Development Ann Tate CBE was Chair until September 2015. Authority, which from 01 April Rajan Jethwa was a Non-executive Director until January 2016. 2016 has joined with Monitor to become NHS Improvement. The Chair and all Non-executive The Committee meets six times related assurances that underpin Directors are members of the a year. The role of the Audit the delivery of Trust’s objectives. Trust Board and Remuneration Committee is to ensure effective The Audit Committee receives Committee. The Remuneration control programmes are in place and considers reports from both Committee is attended by the and provide an independent check internal and external auditors and Chief Executive and the HR upon the Executive arm of the reviews the annual accounts and Director as expert advisors to the Board. financial statements. Through this committee. The Audit Committee Committee, actions are put in place Membership of the Audit independently reviews, monitors to ensure that all recommendations Committee comprises three Non- and reports to the Board on the of internal and external audit executives. The Chief Executive attainment of effective control reports are considered, as well as and Director of Finance and systems and financial reporting other assurance functions. Performance usually attend each processes. In particular, the The Chief Executive and Executive meeting as well as external and committee’s work focuses on the Directors were appointed using internal auditors. framework of risk control and open competition and a selection process. They were appointed on a permanent basis. All are subject to Celebrating Our Team Ipswich Colleagues annual performance reviews and all usual Trust policies and procedures. Stella Cobbold has been a volunteer in Other assurance committees of the the Hand Therapy department for more Board are Finance & Performance, than 15 years. The immense support she Healthcare Governance, gives staff with filing and sorting notes Remuneration and Terms of Service is second only to the care, attention and Charitable Funds. and kindness she offers patients and colleagues. Details of directors’ remuneration are given on page 55 of this report. Stella Cobbold, Volunteer Nominee: Supporter of the Year Award
29 Annual Report 2015 / 16 Accountability Report
Corporate Governance Report Directors’ Report
Composition of the Trust Executive Directors – at 31 March 2016 Management Board Nick Hulme Chief Executive We place clinicians at the centre of the hospital’s leadership. There Barbara Buckley Trust Medical Director are three operation divisions each Lisa Nobes Director of Nursing led by a Divisional Clinical Director supported by a Head of Nursing Paul Scott Director of Finance and Performance and a Head of Operations and an HR and Finance Business Partner. Neill Moloney Chief Operating Officer Clinical delivery groups support Clare Edmondson* Director of Human Resources the Board of each division and represent all areas within the Denver Greenhalgh* Director of Governance division. Corporate services provide support to all of the operational * Non-voting Board member areas. Lynne Wigens was Director of Nursing and Quality, Infection Prevention and Control until June 2015. The Executive Directors work Julie Fryatt was Director of Foundation Trust until November 2015. closely with the divisional leadership in developing strategic and operational plans. A Trustwide leadership group (the Executive Management Committee) contributes to and implements Board, Executive and clinical team decisions.
Celebrating Our Team Ipswich Colleagues
The Raedwald Day Surgery Unit team is often singled out for praise by our patients. From the ward, to theatres, to recovery, each area runs efficiently and provides high standards of patient care. It is one of the best day surgery units in the region.
Raedwald Day Surgery Unit Nominee: Team of the Year Award
30 Accountability Report Annual Report 2015 / 16
Corporate Governance Report Directors’ Report
Declaration of Interests
Declaration of Interests 1 April 2015 to 31 March 2016
Ann Tate • Governor – Rattlesden CEVC Primary School Chair (Left Trust September 2015) David White • Non-executive director – Bullen Developments Ltd Chair (Started role November 2015) • Trustee – John Innes Centre • Trustee – Norfolk Community Foundation Alan Bateman • Paid employee – Sailstone Ltd Non-executive Director Laurence Collins • Governor – Rushmere Hall Primary School, Ipswich Non-executive Director Andrew George • Director – Suffolk Mind Non-executive Director • Independent person – Various councils in Suffolk • Interest in a property syndicate (offices in Diss and Eye) Rajan Jethwa • Chief Executive Officer – Microtest Matrices Ltd Non-executive Director (Left Trust January 2016) • Sole Director – Erudite Evolution Ltd Tony Thompson • Trustee – Melton Trust Non-executive Director • Elected Councillor and Chair – Finance, Employment and Risk Management Committee of Melton Parish Council (until 13 / 05 / 15) Nick Hulme • Member – Kettleburgh Parish Council Chief Executive • Wife is a Trustee of Suffolk Family Carers Paul Scott • Nil Director of Finance and Performance Barbara Buckley • Husband is a GP in North London Medical Director
Clare Edmondson • Partner – Badwell Ash Holiday Lodges (until 10 / 09 / 15) Director of Human Resources Julie Fryatt • Motor home rental business trading under the name Foundation Trust Director (Left Trust November 2015) Sunrise Motor Homes Neill Moloney • Part-time lecturer – Surrey University Chief Operating Officer Lynne Wigens • Visiting Senior Fellow – University Campus Suffolk Director of Nursing and Quality (Left Trust June 2015) • Series Editor – Cengage Publishing (Nursing & Healthcare Texts) Lisa Nobes • Nil Director of Nursing and Quality (Started role July 2015) Denver Greenhalgh • Nil Director of Governance
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Research and bringing change, and considering wards, clinics and reception areas Development Strategy clinical developments, service set out how people can make their improvements, risk management views known. The Trust has well developed and internal control issues We aim to respond to complaints policies for research, development throughout the Trust. The within 28 working days from and intellectual property Trust complies with the clinical receiving the complaint. This year which places the Trust in an governance reporting framework 100% of complaints received were excellent position to take part issued in November 2002. in international clinical research responded to in 28 working days studies to improve the quality of or a revised timescale agreed with care provided to our patients. The Emergency Preparedness / the complainant, against a Trust Research and Development team is Major Incident Planning target of 100%. Since November always available to provide support 2014 every effort has been made The Trust has in place a major to staff wishing to take part in to contact each complainant within incident plan which is fully research studies. 24 hours of the complaint being compliant with ‘Handling Major logged by the complaints team. Incidents: An Operational Doctrine’ These calls, known as 24-hour Governance and accompanying NHS guidance courtesy calls, are made by a on major incident / emergency Clinical Governance is about senior manager and are seen as an preparedness and planning. continual improvement in the opportunity to: quality of care provided by NHS • gain insight to understand organisations, and ensuring that Listening and Learning the key issues that need to be improvements, where needed, resolved; We strongly encourage people are made in a climate which is who use the Trust – patients, • take time to understand the supportive, open and learning. their relatives and friends – to tell exact nature of the complaint The hospital has a Healthcare us what they think about their as this will help to ensure a Governance Committee. Each treatment and care. This helps us thorough and meaningful division has a monthly Risk and to continually improve services response; Governance meeting where and to address problems quickly. • explain the 28 working day the groups have a vital role in Information leaflets and posters in timeframe for our response and establish the method in which the complainant would like to receive our feedback, for Celebrating Our Team Ipswich Colleagues example a letter or a face-to- face meeting; Midwife Emily Ruegg is supportive, • help build relationships with reassuring and confident in the care she the complainant, help them provides, empowering women during to feel part of the process and labour and childbirth. She was also demonstrate that we take their nominated for the teaching and support concerns seriously. she gives to students as a mentor. All complaints are assigned to a complaints coordinator who will liaise with the complainant and ensure the department responsible Emily Ruegg, Midwife for investigating and responding Nominee: Living the Values Colleague of the Year to a complaint does so within the time limits set out above. Once
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a complaints investigation has Improvements to PALS offers patients, carers and been completed, it is checked to Complaints Handling visitors: ensure all issues raised have been • advice and signposting – helping A series of recommendations were answered, before being passed to to navigate the hospital and its made in 2014 and we have made the Chief Executive to review and services; sign the letter of response. changes to improve the service. • compliments and comments – The findings from a recent survey PALS can pass on compliments Reopened Complaints of 100 complainants suggests and ideas to improve services; that our service for managing and During the year 2015 / 16, 48 (8%) complaints has improved as a result • PALS can address a non- of the complaints received were of the changes made. reopened. One of the main reasons complex issue informally, often for reopening a complaint has been While information drawn from preventing a formal complaint identified as poor or inaccurate surveys and other forms of patient being raised. feedback is important, every investigation. To address this, Typical matters raised with PALS complaint received indicates that the Trust has developed a more include: for that person or their family, they robust process for ensuring all • patients being unable to contact matters raised within a complaint did not receive the high quality care they rightly expected. clinics by telephone or messages are adequately addressed. The left not being returned; Trust has a process whereby each Complaints and informal concerns • patients chasing test results; reopened complaint is reviewed raised through the Patient Advice and where necessary, a Non- and Liaison Service (PALS) are an • patients chasing appointments; executive Director is involved in the important method by which the • cancelled appointments; and subsequent investigation. Trust assesses the quality of the • families or carers raising service it provides. We take patient concerns regarding elements of complaints very seriously and have inpatient care. Complaints to the responded to them in various ways For more information about the Parliamentary and Health to improve the quality of care we complaints we received during last Service Ombudsman provide. year, please refer to our Quality (PHSO) Account 2015 / 16, which is During the year 2015 / 16, 11 cases PALS available on our website. were referred to the Ombudsman The PALS team handles queries by the complainant as they were and concerns in a practical way, unhappy with the response resolving and addressing issues received from the Trust. Of these, at source to prevent matters six cases are still currently under escalating. This is seen as a really independent investigation by the positive step towards taking more Ombudsman. During the year responsibility for issues as they 2015 / 16 the PHSO completed arise. their investigations into five Ipswich Hospital cases. Four cases were PALS contacts are graded as not upheld; one case was partially either PALS 1 or PALS 2. PALS 1 upheld. are contacts that require straightforward information or signposting. PALS 2 are contacts that relate to a matter which needs to be resolved or addressed.
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Serious Incidents or death is subject to external Regulations 2014 sets out some Requiring Investigation assurance. specific requirements which providers must follow when things The Trust holds Serious Clinical The changes we have made as go wrong with care and treatment, Incident Groups which meet to a result of lessons learnt: including informing people about discuss any untoward incident • Working on an electronic the incident, providing reasonable and determine whether what has solution to flag diagnostic tests support, providing truthful happened is a serious incident that have not been reviewed information and an apology when requiring investigation (SIRI). A SIRI post reporting. things go wrong. is reported to the both Ipswich and • Improve infection control East Suffolk Clinical Commissioning As part of the Trust’s incident procedures in community Group and the Strategic Executive reporting process, patients or their hospitals. Incident system through to the relatives are informed of any such Department of Health. • Updated guidance on Group B incidents. streptococcus prophylaxis. Failure to meet this statutory and • Improved medical handover. Learning from incidents contractual standard results in a • Sepsis identification and financial and regulatory penalties. All reported incidents are management. To date, the Trust has not been investigated and any lessons that • Mandatory consultant presence subject to any penalties relating to can be learnt are shared within at vaginal breech deliveries. Duty of Candour. the clinical area at Divisional Board • Change to visiting times to open meetings, and via the intranet for visiting. hospital areas outside the scope What are we doing to of the Division involved in the • Raised awareness of nutrition make improvements? for all patients and subsequent incident. Lessons learnt are also • Established a Duty of Candour shared at the Trust’s Risk Oversight increased use of Total Parenteral Nutrition. Lead within the central Committee. governance team to provide • Rolled out NerveCentre. It is important that when serious one-to-one advice and training incidents occur, they are reported • Links with regional networks to frontline clinical staff and and investigated in a timely regarding PICC lines for vesicant incident investigators. manner, not only to ensure that drugs. • Improved internal reporting the correct action can be taken, • Improved patient information. system to capture the stages of but also to ensure the Trust learns Duty of Candour both regulatory from the incident to help prevent Duty of candour and contractual. recurrence. • Established monthly reporting of Open and honest communication compliance to the Trust Board. The higher level incidents are with patients is at the heart of categorised as Serious Incidents healthcare. • In 2016 / 17 we have added Duty Requiring Investigation (SIRIs) and of Candour to our internal audit are reported to the Ipswich & East Following the recommendations plan to provide the Trust Board Suffolk Clinical Commissioning from the Francis Inquiry into Mid with independent assurance. Group. These incidents are Staffordshire NHS Foundation investigated, a comprehensive Trust, all incidents deemed to report written and actions be moderate or high severity implemented and the learning or resulting in the death of the shared. patient are reportable to our commissioners. Regulation 20 The percentage of patient safety of the Health and Social Care incidents resulting in severe harm Act 2008 (Regulated Activities)
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Serious Incidents Requiring Investigation (SIRIs) Adverse Events and SIRIs Reported Celebrating Our For the year 2015 / 16, there have been the following adverse events Team Ipswich (categorised as low harm to severe harm) reported on the Datix risk management computer system (includes adverse events occurring at Colleagues community healthcare services managed by The Ipswich Hospital NHS Trust between 1 October 2015 and 31 March 2016).
Number of Type of adverse event adverse events Access, Appointment, Admission, Transfer, Discharge 881 Abusive, violent, disruptive or self-harming behaviour 215 Accident that may result in personal injury 2000 Anaesthesia 16 Clinical assessment (investigations, images and lab tests) 312 Consent, Confidentiality or Communication 193 Diagnosis, failed or delayed 30 John Hartley, Head of Income and Financial loss 17 Contracting Nominee: Living the Values Patient Information (records, documents, test results, scans) 344 Colleague of the Year Award Infrastructure or resources (staffing, facilities, environment) 195 Labour or Delivery 349 Medical device / equipment 267 John Hartley is known as the Medication 1233 ‘fount of knowledge’ among his Implementation of care or ongoing monitoring / review 1772 colleagues in Finance. Other – please specify in description 167 Although not directly involved Security 70 in the delivery of patient care, Treatment, procedure 222 through his supportive role Totals: 8,283 as the head of Income and Contracting he makes sure Of these, 61 were reported as SIRIs: contract decisions are always in Type of adverse event Number of SIRIs the best interest of patients. Allegation against staff 5 John focuses on the Adverse media coverage or public concern 1 opportunities instead of the Apparent / actual / suspected self-inflicted harm meeting SI criteria 1 obstacles. Information Governance breach 2 Diagnostic incident including delay meeting SI criteria 13 Infection control incident meeting SI criteria 3 Maternity / Obstetric incident meeting SI criteria (mother / baby) 7 Medication incident meeting SI criteria 2 Pressure ulcers Grade 3 or 4 3 Slip / trip / fall meeting SI criteria 14 Suboptimal care of the deteriorating patient meeting SI criteria 1 Surgical / Invasive procedure incident meeting SI criteria 7 Treatment delay meeting SI criteria 2 Totals: 61
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Never Events Never Events at The Celebrating Our Never Events are serious, largely Ipswich Hospital NHS preventable patient safety incidents Trust Team Ipswich that should not occur if the Colleagues available preventative measures 2013 / 14 2014 / 15 2015 / 16 have been implemented. 3 3 5 The list of Never Events for 2015 / 16 are: • Wrong site surgery Whilst no patients had long-lasting • Wrong implant / prosthesis or permanent damage, regrettably, five Never Events occurred in • Retained foreign object post 2015 / 16: procedure • Mis-selection of a strong • medication – wrong route; potassium-containing solution • wrong site surgery; • Wrong route administration of • medication – wrong route; medication • retained vaginal swab; and • Overdose of insulin due to • wrong site surgery. abbreviations or incorrect device • Overdose of methotrexate for Safety Thermometer non-cancer treatment The NHS Safety Thermometer Jill Armes, Ward Receptionist • Mis-selection of high strength Nominee: Living the Values is a national improvement tool midazolam during conscious Colleague of the Year Award for measuring, monitoring and sedation analysing patient harms and • Failure to install functional ‘harm-free’ care, which was Ward receptionist Jill Armes has collapsible shower or curtain introduced in April 2012. The many organisational talents – rails safety thermometer survey provides from navigating the complexities • Falls from poorly restricted a snapshot of ‘harm-free care’ on a of organising patients’ transport windows single day each month when every home, to encouraging the current inpatient is assessed for medical teams to complete • Chest or neck entrapment in the presence of any of four harms discharge paperwork on time. bedrails (pressure ulcers, falls, catheter- • Transfusion or transplantation Jill has unrivalled organisational acquired urinary tract infections, of ABO-incompatible blood skills and they rub off on those venous thromboembolism) within components or organs around her. She is also kind and the previous 72 hours. These harms welcoming to patients. • Misplaced naso- or oro-gastric and the results are recorded on a tubes national database which allows • Scalding of patients us to monitor the prevalence of There are exclusions to each Never these harms and to assess our Event. performance in providing harm- free care.
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Surgical Safety Checklist 2 Paper: Recording compliance Charging for Information that all three sections (‘Sign-in’, The World Health Organisation The Ipswich Hospital NHS Trust ‘Time-out’ and ‘Sign-out’) of the (WHO) Surgical Safety Checklist complies with the Treasury’s SSC are completed, for all patients (SSC) was developed by the guidance on setting charges for going through Recovery on one World Health Organisation and information. day per week within East, South, incorporated into the National Blyth, Raedwald and Ophthalmic Patient Safety Agency alert, January Day Care Unit theatres. The 2009 for action by the NHS. The compliance rate for the year is actions included ensuring the 99.8%. checklist is completed for every patient undergoing a surgical The observational audit tool Celebrating Our procedure (including under local feedback concluded that the SSC anaesthesia). is well embedded in the culture at Team Ipswich Ipswich Hospital. Each Division has The SSC is a paper document assessed the use of the checklist. Colleagues comprising three distinct sections ‘Sign-in’, ‘Time-out’ and ‘Sign-out’. In an audit of Datix to review WHO encourages local adaptation whether the SSC has had an of the checklist to ensure it is fit for impact on patient safety incidents, purpose. The SSC aim is to reduce two cases were found which patient harm, improve teamwork identified the WHO SSC as a key and flatten hierarchy. factor in identifying potential major errors prior to surgery. A WHO SSC review group comprising medical, surgical, anaesthetic and allied health Prompt Payment Code professional colleagues was The Prompt Payment Code is a developed with the main aim to payment initiative developed by review the Trust’s existing systems Carolyn Burch, Government with the Chartered Surgical Operational Coordinator and processes in the use and audit Institute of Credit Management Nominee: Leader of the Year Award of the surgical safety checklist. The (CICM) to “tackle the crucial issue group meets twice a year. of late payment and help small Colleagues say working with Compliance at Ipswich Hospital is businesses”. Details of the code surgery operational coordinator measured in two separate ways: can be found at Carolyn Burch is a privilege. 1 Electronically: Theatre staff www.promptpaymentcode.org.uk She never forgets to keep the are required to complete a ‘SSC The code is a series of principles focus on patients and inspires checklist used’ (yes or no) button that all NHS organisations are those working around her to do on iOrmis (theatre computer expected to follow during the the same. Carolyn goes to great system). This button has to be normal course of business. The lengths to support the teams completed before the next screen hospital has signed up to and she works with, no matter how can be accessed. This measures endorsed the code. big the challenges. whether a checklist has been Details of the Trust’s performance used for a particular patient (but against the Better Payments it doesn’t check whether all three Practice code are disclosed in note sections of the checklist have been 7 to the accounts. completed). The compliance rate for the year is 100%.
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Directors’ Statement of Disclosure to Auditors The Directors at Ipswich Hospital trust’s auditor is aware of that the things mentioned above. They NHS Trust are not aware that there information. ‘Relevant audit have made such enquiries of their is any relevant audit information information’ means information fellow Directors and of the Trust’s of which the NHS trust’s auditor needed by the NHS trust’s auditor auditors for that purpose and taken is unaware. The Directors have in connection with preparing their such other steps (if any) for that taken all the steps that they ought report. purpose, as are required by their to have taken as directors in order duties as Directors of the Trust to The Directors have taken all the to make themselves aware of exercise reasonable care, skill and steps that they ought to have any relevant audit information diligence. taken as directors in order to do and to establish that the NHS
Statement of Directors’ responsibilities in respect of the accounts The Directors are required under the National Health Service Act 2006 to prepare accounts for each financial year. The Secretary of State, with the approval of the Treasury, directs that these accounts give a true and fair view of the state of affairs of the Trust and of the income and expenditure, recognised gains and losses and cash flows for the year. In preparing those accounts, Directors are required to: • apply on a consistent basis accounting policies laid down by the Secretary of State with the approval of the Treasury; • make judgements and estimates which are reasonable and prudent; • state whether applicable accounting standards have been followed, subject to any material departures disclosed and explained in the accounts. The Directors are responsible for keeping proper accounting records which disclose with reasonable accuracy at any time the financial position of the Trust and to enable them to ensure that the accounts comply with requirements outlined in the above mentioned direction of the Secretary of State. They are also responsible for safeguarding the assets of the Trust and hence for taking reasonable steps for the prevention and detection of fraud and other irregularities. The Directors confirm to the best of their knowledge and belief they have complied with the above requirements in preparing the accounts. By order of the Board
Date:
Chief Executive:
Date:
Director of Finance:
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Statement of the Chief Executive’s Responsibilities Celebrating Our as the Accountable Officer of the Trust
Team Ipswich The Chief Executive of the NHS To the best of my knowledge and Colleagues Trust Development Authority belief, I have properly discharged has designated that the the responsibilities set out in Chief Executive should be the my letter of appointment as an Accountable Officer to the Trust. Accountable Officer. The relevant responsibilities of I confirm that, as far as I am Accountable Officers are set aware, there is no relevant audit out in the Accountable Officers information of which the Trust’s Memorandum issued by the auditors are unaware, and I have Chief Executive of the NHS Trust taken all the steps that I ought to Development Authority. These have taken to make myself aware include ensuring that: of any relevant audit information Ernie Dawson, Volunteer • there are effective management and to establish that the Trust’s Nominee: Supporter of the Year systems in place to safeguard auditors are aware of that public funds and assets and information. assist in the implementation of Charity stalwart, Ernie Dawson’s I confirm that the annual report corporate governance; immeasurable helpfulness came and accounts as a whole is fair, to light at last year’s Hospital • value for money is achieved from balanced and understandable and Bike Ride. Ernie cheerfully lent the resources available to the that I take personal responsibility his van, time and driving skills Trust; for the annual report and accounts to the event, delivering food, • the expenditure and income of and the judgments required for helping at the pit stops and the Trust has been applied to the determining that it is fair, balanced transporting photographers and purposes intended by Parliament and understandable. medics. Since then he’s helped and conform to the authorities with any project the charity which govern them; Accountable Officer: team has asked for assistance • effective and sound financial Nick Hulme with, and he also volunteers for management systems are in Hospital Radio. place; and Organisation: • annual statutory accounts are The Ipswich Hospital NHS Trust prepared in a format directed by Signature: the Secretary of State with the approval of the Treasury to give a true and fair view of the state of affairs as at the end of the financial year and the income and expenditure, recognised Date: gains and losses and cash flows 02 June 2016 for the year.
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Scope of Responsibility The Governance executive during this period and Framework 12 from Executives. All Board The Trust Board is accountable members completed the annual for governance and internal The Trust has an integrated declaration for Fit and Proper control in The Ipswich Hospital governance approach to ensure Person’s Test, with the 2016 / 17 decision making is informed NHS Trust. As Accountable declaration to be reported to the by a full range of corporate, first Board meeting in public in Officer, and Chief Executive of financial, clinical and information May 2016. The Board’s Register of this Board, I have responsibility governance. Interests was updated in May 2015 for maintaining a sound and it was formally received by the system of internal control that The Board Trust. This will be reviewed and supports the achievement of presented at the May 2016 Board. The Trust Board is comprised the organisation’s policies, of a Chair, five Non-executive From April 2015, the Board has aims and objectives. I also have Director members and five met on a bi-monthly basis to responsibility for safeguarding Executive Director members: the enable more in-depth review of Chief Executive, Medical Director, topics and to develop strategy. The the public funds and the public meeting follows a structured organisation’s assets for which Director of Nursing, Director of Finance and Performance and format, starting with a patient I am personally responsible Chief Operating Officer. Three or carer story to set the tone and as set out in the Accountable other Executive Director members focus of the meeting, followed by Officer Memorandum. without voting rights attend each matters of quality and risk, strategy, Trust Board meeting: the Director performance and corporate The Trust has considered the of Human Resources, Foundation governance, closing and excluding arrangements in place for Trust Director (up to August 2015) press and others as necessary for the discharge of statutory and the Director of Governance a part two confidential session. (from May 2015). The Chair has The private meeting, on alternative functions and they have been months, includes the opportunity checked for any irregularities, a second and casting vote. The Trust Secretary also attends all to review any urgent items on and can confirm the Trust is Board meetings. There was one a monthly basis as required. To legally compliant. Non-executive Director vacancy ensure openness and engagement from December 2015. The Deputy with stakeholders, patients and Chair acts as Senior Independent the wider health economy, the Director. Chief Executive holds open forums in venues across the east of the Recognising the in-year changes county. within the executive team (namely the Director of Nursing; Foundation The Trust Board has undertaken Trust Director and the newly a wide range of development established Director of Governance activities during the year, with positions), the team has continued regular seminar time scheduled to strengthen its visible leadership. into its work programme. This The Board met a total of six times time is used to ensure the Board in public in 2015 / 16 with private is up to date with key issues in Boards in the intervening months. essential areas, for example in Attendance was monitored risk management and seasonal throughout the year and there and resiliance planning, but also were nine absences by a Non- as an opportunity to consider in depth the future strategic issues
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facing the organisation. Experts of reference which describe duties, as independent reviewer of the within their field have been invited responsibilities and accountabilities, internal control environment, the to contribute to the debates, for and describes the process for Audit Committee is the scrutiniser example when looking at the assessing and monitoring of assurance committees including opportunities and challenges effectiveness. There are five the Healthcare Governance of becoming an integrated care formally designated committees of and Finance and Performance organisation; and more recently the Board: Committees and in this capacity considering the changes required • Audit Committee receives highlight reports and to deliver ‘place based care’ and minutes from those committees. • Healthcare Governance how to achieve our objective to be The Audit Committee membership Committee a hospital without walls. comprises three Non-executive • Finance and Performance Directors, one of which is Chair During the year the Trust has Committee of the Committee. The Chief continued to review the • Remuneration and Terms of Executive, Director of Finance effectiveness of the operating Service Committee and Performance, Trust Secretary, model, following the introduction Head of Internal Audit and a of our clinically led divisional • Charitable Funds and representative from the external structure in 2013. Contributions Sponsorship Committee auditors normally attend the from the leadership tiers across The Strategy Steering Board was Audit Committee meetings. Other the organisation, including the suspended in 2015 / 16 with this officers of the Trust are invited Board, are used to identify the work being taken forward through to attend the Audit Committee strengths, weaknesses and further the Board seminars. to report on standing items such opportunities for improved The Audit, Healthcare Governance as the review of risk and also as effectiveness. and Finance and Performance requested on exceptional items. In private sessions during the year, Committees are the main assurance The Audit Committee receives the Board has covered quality and committees reporting to the Board. assurance on fraud deterrent risk topics. Strategic and planning Highlight reports are reported from regular reports from the items have included sessions on the to the next Board meeting. The Trust’s Local Counter Fraud Group development of strategy, market Board may request further work on and from the Local Counter share, estates strategy and actuarial various issues which are raised. Fraud Specialist who attends the approaches and population In 2015 / 16 the Board put in Committee at least once a year and mapping. All Board members place a ‘shadow’ Workforce on request. are actively encouraged to put and Education Committee, in The Healthcare Governance forward topics for discussion in the recognition of the significant Committee meets on a monthly confidential (private) sessions which challenges in human resources basis. It enables the Board to obtain inform the agenda of dedicated in the NHS and to ensure assurance that high standards of seminar sessions. oversight of the clinical workforce care are provided by the Trust and, transformation programme. This in particular, that adequate and Board Committees Committee becomes a substantive appropriate governance structures, There is an established governance board committee from April 2016. processes and controls are in place framework, supported and The Audit Committee meets on to do this. The Committee has a maintained by a framework of a bi-monthly basis and supports number of reporting committees committees. The Board has overall the Board by providing an and provides assurance to the responsibility for the effectiveness independent and objective review Trust Board on all matters relating of the governance framework and of the governance and assurance to quality including patient safety, as such requires that each of its processes upon which the Board clinical effectiveness and patient sub-committees has agreed terms places reliance. In this capacity and carer experience. It focuses on
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overseeing the development of risk at the Board meeting with the Non- management systems through the executive Chair of the Committee Celebrating Our Risk Oversight Committee. commencing the Board discussion Team Ipswich The Healthcare Governance on integrated performance with Colleagues Committee receives assurance on an overview of the Committee’s the quality agenda and clinical discussions.This is followed by governance activities through input from the Executive Director the Patient Safety & Clinical leads for quality, finance, national Effectiveness, and Patient & and contractual standards and Carer Experience Groups which organisation efficiency. report into it. The Healthcare The Audit, Healthcare Governance Governance Committee is chaired and Finance & Performance by a Non-executive Director, and Committees submit an annual two other Non-executive Directors report to the Board to review are members of the Committee the work undertaken during the together with a number of the year and to set out how they Executive Directors including the have performed against their Director of Nursing, the Medical responsibilities as defined in their Ilona Kaminskiene, Volunteer Director, Chief Executive, Chief terms of reference. In addition Nominee: Supporter of the Year Operating Officer, Director of the Audit Committee, Finance Human Resources and the Director & Performance Committee and Ilona Kaminskiene volunteered in of Governance. The Head of Healthcare Governance Committees the Charity Office and her work Internal Audit also attends to undertake an annual self- on the charity’s database has mirror their attendance at the assessment. Audit Committee. The three vastly improved the way we say The Remuneration and Terms of divisional Clinical Directors, the thank you to and communicate Service Committee is chaired by Heads of Nursing and Clinical with hundreds of local people the Chair of the Trust Board and Services, Head of Midwifery, Chief who donate money. the five Non-executive Directors Pharmacist, Associate Director for of the Trust are members. The She demonstrates high levels of Medical Education, Patient Safety Chief Executive and Director of integrity, professionalism and and Quality Lead and Patient Human Resources regularly attend attention to detail. Experience Lead are also members meetings. The Committee makes of the Committee. appropriate recommendations The purpose of the Finance to the Board on the Trust’s & Performance Committee remuneration policy and the specific is to provide the Board with remuneration and terms of service an independent and objective of the Chief Executive, Executive oversight of finance and Directors, Senior Management and performance issues and make employees employed under Ipswich recommendations to support Hospital NHS Trust’s terms and the Board in ensuring the Trust conditions of service, together with maintains cash liquidity and other employees as determined by remains as a going concern, whilst the Board. achieving the key performance Committees terms of reference indicators assigned to it. It is held in were reviewed and approved at the week of the Board each month the end of this year in accordance and a highlight report is reviewed
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with the governance review Internal Audit Sub Contracted Healthcare recommendations. Payments A number of the Of 24 reports finalised by internal contracts reviewed were not The Ipswich Hospital NHS Trust audit, 20 were substantial or authorised in accordance with is the corporate trustee for reasonable assurance and four Standing Financial Instructions. At charitable funds held on trust. were limited. the time of the audit plans were The Trust Board serves as its agent Number in place whereby the use of some and has delegated authority Assurance of contracts would be eliminated or to the Charitable Funds and Assessments reviews significantly reduced. Out of the Sponsorship Committee to Substantial Assurance 3 three contracts in question, two make and monitor arrangements have been terminated and one for the control and management Reasonable 17 has been redrafted and is with our of the Trust’s Charitable Funds in Assurance suppliers. accordance with any statutory or Limited Assurance 4 other legal requirements, or best Ward Assurance – Nutrition practice required by the Charities No Assurance 0 An audit requested by the Director Commission. The Committee of Nursing following triangulation is chaired by a Non-executive The findings of all audit reports of quality information. The audit Director and membership comprises issued to date from the Annual found that the Trust’s Nutrition a further two Non-executive Internal Audit Plan, have been Policy was not being consistently Directors, the Director of Finance reported to the Audit Committee followed. This was disappointing and Performance, Director of during the year. This was the first as local audits had shown high Nursing, Nominated Fund Manager, year that our auditors analysed compliance with nutritional risk Patient Group Representative and their findings / recommendations by assessments being completed. The Head of Communications. The risk area (the four risk areas being Director of Nursing is now working Trust Board meets as the corporate compliance, directed, operational through a plan to ensure future trustee to approve the Ipswich and reputational); and the theme compliance. Hospital charitable funds annual that emerged was inconsistent Workforce – Agency report and accounts, to approve compliance with existing policies Staffing Following the introduction the Letter of Representation and to and procedures. Management of national agency pay cap, the receive the ISA 260 Report from the will use this information to Director of Human Resources external auditors. strengthen our internal assurances had put in a process for the and continue to use the internal authorisation of payments above The Board has Standing Orders, audit process as a positive tool the pay cap. The Director of Human a Schedule of Matters Reserved to measure implementation and Resources requested internal to the Board, Standing Financial progress. audit review of the new process Instructions and a Scheme of to check implementation. Due to Delegation which have been There were four limited assurance a lack of audit trail, no assurance reviewed and amended to reflect reports. These were: could be given that agency returns learning, these changes are subject Payroll – ESR Weaknesses in above cap have been consistently to Board approval in April 2016. authorisation controls had resulted approved in accordance with Trust There were a number of policies in some overpayments to leavers. process all the time. Improvements that had exceeded their review Management actions have been in control, particularly in back-end date which is unsatisfactory. Work in place, such as key performance reconciliation, are now being put in has continued to progress but has indicators included in the place, such as making greater use of been slower than expected This will accountability framework to ensure E-rostering to analyse staff time and ensure policies are up to date and managers complete leavers forms agency use, and to develop a more there is a robust process in place in a timely manner, to strengthen efficient authorisation process. going forward. the process.
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Counter Fraud induction for all staff. This features by an executive function. Each presentations on counter fraud and Division comprises a number of The Trust is required under the on compliance with the UK Bribery clinical sub-groups called Clinical terms of the Standarrd NHS Act 2010. Delivery Groups. In October 2015, Contract (as it was previously the Trust welcomed colleagues required under Secretary of State’s from community services into this Directions) to ensure appropriate Divisional Structure structure as part of the contractual counter fraud measures are in The Trust continues to empower joint venture, where the Trust took place. the divisional accountability on operational responsibility for The Local Counter Fraud structures. The overarching the three community hospitals in Specialist (LCFS) adopts a risk- intention remains one of Ipswich & East Suffolk, services based approach to counter fraud supporting a clinically led for COPD, Continence and Foot work, using the NHS Protect Risk organisation with a single & Ankle Surgery. The operational Assessment Tool and the incidence line of accountability for management of the Trust is of local frauds to identify areas of all aspects of performance structured into three Divisional potential vulnerability. Relevant including patient safety, Boards and a Combined Board local proactive exercises are patient experience, operational which follow a meeting structure consequently built into the Trust’s standards, financial performance comprising the following: annual counter fraud work plan, and staff engagement. This which is overseen by the Audit structure continues to secure the Clinical Governance and Committee. engagement of clinicians including Risk Management Meeting The Audit Committee receives doctors, nurses, midwives and Operations and Performance Meeting assurance on fraud deterrent from allied healthcare professionals in the leadership of the hospital. Divisional Board Development session regular reports from the Trust’s for members (including patient feedback) Local Counter Fraud Group and The structure comprises three from the Local Counter Fraud clinical divisions which reflect how Divisional Oversight Meetings Specialist. patients come into the Trust’s (Accountability framework) services: Medicine & Therapies; The LCFS helps to foster an anti- Combined Board Meeting Surgery; Cancer, and Women & (all Divisions) fraud culture within the Trust Children’s Services, supported through the delivery of training at
Celebrating Our Team Ipswich Colleagues
The Pharmacy Afternoon Team responds promptly to bleeps from ward staff and deals with issues there and then on the wards. The team helps with all aspects of pharmacy work from facilitating discharges and ordering medication to delivering drugs and answering queries. The fact that drug charts no longer have to leave the ward in the afternoon means patients are less likely to have missed or late doses.
The Pharmacy Afternoon Team Nominated: Team of the Year Award
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In addition to the above in-house decision making group of the to ensure this is part of an annual structure there is a partnership Trust with responsibility for the review process. contractual joint venture provider implementation and delivery of the management board for community Trust’s strategic direction, business services. plan and associated objectives, Annual Quality Account standards and policies to ensure Each Divisional Board is chaired The Trust Board under the Health the delivery of safe, high quality, by a Divisional Clinical Director Act 2009 and the National patient-centred care. Terms of who carries responsibility for Health Service (Quality Account) reference for the divisional and the leadership of the Division. Regulations 2010 prepares a combined boards were approved Each Division has nursing and Quality Account for each financial by the Trust Board. The Combined operational leads which make year. Guidance has been issued Board reports to the Trust Board. A a triumervate leadership which to Trusts on the form and content highlight report of the key issues mirrors the Trust Board. The of the Quality Account which discussed and decisions made will Nursing Lead provides senior incorporates the legal requirements be submitted to the next Board nursing and quality of care and requisite external assurance meeting in Public following the expertise and guidance to the arrangements. Combined Board meeting. The Divisional Board. The Operational As part of the external audit of Combined Board reviews the Lead provides expert operational the 2014 / 15 Quality Account accountability framework reports advice to the Divisional Board. our auditors were able to provide from each of the divisions. The The Divisional Boards oversee an unqualified limited assurance Combined Board and the Divisional and monitor the performance report in respect of the content Boards have undertaken a self- of their Clinical Delivery Groups. of the Quality Account 2014 / 15. assessment of their performance Whilst weeks 1 to 3 comprise However, in respect of the over the last twelve months in April separate divisional board mandated specified indicators 2016, with a report to the Board at meetings, the Combined Board issued a qualified ‘except its May / June meeting in line with meets monthly and comprises for’ opinion in respect to the all other committees. The self- the executive team and the percentage of reported patient assessment process will form part senior teams from the three safety incidents resulting in severe of the agenda at the Combined divisional boards. The Combined harm or death. During testing to Board / Divisional Board meetings Board is the senior management assess the completeness of data
Celebrating Our Team Ipswich Colleagues
This team in Cardiology has efficiently and enthusiastically introduced two new services for patients – advanced stress echo testing and TOE scans. Both tests enable clinicians to detect problems and decide whether further treatment or operations are needed. Patients no longer have to travel to other hospitals for the tests. A letter from a patient seen by our judges describes the team as ‘absolutely marvellous’.
Cardiology Stress Echo Service Team Nominated: Team of the Year Award
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Corporate Governance Report Governance Statement
submitted to the national reporting How We Addressed the Issues Celebrating Our and learning system (NRLS), they Raised by the CQC: identified discrepancies between • Reviewed end of life care Team Ipswich the Datix and NRLS figures. In paperwork to improve individual 2015 / 16 the Trust has taken action care planning and provided Colleagues to ensure that all patient safety training to staff. incidents are uploaded to the NRLS. • Increased awareness of mental The Director of Nursing leads on capacity assessment to ensure the Quality Account. For 2015 / 16 that prior to undertaking a the Quality Account priorities procedure, or completing an agreed by the Trust Board were end of life care order, a person’s informed from a number of sources mental capacity is appropriately such as patient surveys, staff assessed and documented. surveys, complaints, compliments • Put procedures in place to and the views of users and user enhance monitoring of cleaning groups. in the outpatient areas including the decontamination rooms. Care Quality Commission • Reviewed medicines Sonya Herbert, Gynaecology Nurse management in our South Nominee: Leader of the Year In 2015 / 16 the CQC did not Theatres, with the installation of conduct any visits, announced or secure access controls. unannounced. Gynaecology colleague Sonya • Worked towards standardised Herbert is an exceptional nurse The CQC conducted a hospital monitoring equipment in our at all times but particularly when inspection between 6 – 9 January South Theatres through capital called upon in an emergency. 2015. They commented that the investment allocation. Under times of stress she acts with Trust had a relatively new Executive • Worked to improve the delivery professionalism and calmness, team, who worked effectively of HDU paediatric care and demonstrating compassion and together to highlight issues and initiated a programme to dignity to all. address challenges within the achieve external accreditation Sonya is a team player as well hospital services. The inspection of our paediatric nurses over as a leader and will do whatever rated the hospital as ‘Good’. the next few years. Further to it takes to ensure the smooth The report, published on 10 April this, continue to work with running of her ward. 2015, detailed eight ‘must do’ and our commissioners to review 12 ‘should do’ recommendations resourcing of this service across for improvement. The Trust the region. developed an action plan to • Enhanced the auditing of ‘do address these recommendations, not attempt cardio pulmonary and progress was monitored resuscitation’ orders which has monthly by the Healthcare improved our compliance with Governance Committee. documentation. • Continued with the Outpatient Transformation programme to keep waiting times for service users to a minimum. • Set up systems to enable pain medication to be provided to
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people attending the fracture to send follow-up letters within 10 Board Effectiveness clinic. days. Review • Reviewed services to identify The Board receives a monthly The Trust commissioned an external staffing and equipment needs report detailing all serious diagnostic of its governance and to inform business planning and incidents, never events, high level quality governance arrangements capital investments for 2016 / 17. complaints and claims which during 2014 / 15. The structure The action plan has been delivered. includes lessons learned from used for this review was the Well- To sustain ongoing training and investigations. Led framework: Guidance for clinical audit outcomes from this NHS Foundation Trusts; with the plan ongoing monitoring by the Clinical Audit final report received in February Healthcare Governance Committee 2015. This made a number of will continue. The Trust has in place a Patient recommendations which were Safety and Clinical Effectiveness discussed at the then Strategy Group which oversees and Serious Incidents Steering Board and an action plan ensures there is a programme of developed. The Trust reports all serious clinical audit activity within the incidents and never events in Trust covering a range of clinical In the context of the NHS line with the national and local standards. The Group oversees that environment in which the Trust frameworks. In March 2016 the the Trust has mechanisms in place faced significant financial and NHS TDA published their learning to implement the latest guidance operational challenges a subset of from mistakes league table which and recommendations from NICE the recommendations was selected draws data from the 2015 NHS and relevant National Confidential to be progressed; in particular: Staff Survey and from the national Enquiries. • refresh the Trust Strategy; reporting and learning service data During 2015 / 16, 32 national • refresh the Risk Management to identify the level of openness clinical audits, six national processes; and transparency of NHS provider confidential enquiries and 159 local organisations. The league table • undertake a Committee review; clinical audits were participated rated the Trust as ‘Good’. • undertake a clinical governance in. A full list of national clinical review; In 2015 / 16 the Trust reported audits and confidential enquiries five never events. In line with and the actions to improve the • review the roles and the requirements of the National quality of healthcare arising from responsibilities of the Executive Framework these incidents were these are provided in the Quality Team; reported to the NTDA and the Account under the section headed • review of Non-executive CQC. The Trust is being supported ‘Participation in Clinical Audit’; Directors with a view to by the quality leads at the NTDA along with a sample of outcomes increasing those with a clinical to ensure its internal systems are from local audits. background; robust. This Patient Safety and Clinical • continue the Improving Together The Trust is able to evidence Effectiveness Group monitors audit programme; that Duty of Candour has been activity to ensure that the overall • establish CIP implementation achieved in respect to being open objectives are met and comply with reviews; and with patients, their families and professional good practice, current • establish a new board carers when things have happened legislation, national policies and development programme. giving rise to a serious incident; guidelines. The review has enabled the Board however further work is being to reflect on its composition, done to deliver this consistently effectiveness, risk management and within the contractual requirement internal control arrangements and
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Likelihood score
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 it is now satisfied that it complies Risks scoring 15 and above migrate • Ageing electrical infrastructure with corporate governance best to the Board Assurance Framework with associated risk of failure practice. The Board is committed (BAF) and thereby inform the causing service interruption. to continuous improvement and Trust Board agenda. The following • Risk of injury to Mortuary staff the further development of the risks were reported in the Board and to dignified handling of Board will be reflected in the Board Assurance Framework in 2015 / 16 deceased due to poor design of Development Plan for 2016 / 18. and were reviewed by the Trust storage areas. Board. • Future funding of training The Risk and Control • Risk of contaminated medical posts could be affected Framework chemotherapy due to poor if training standards and training fabric of the Aseptic Preparation experience is not sustained at Risk Assessment Unit and exceeding capacity. the appropriate level. As Chief Executive, I have overall • The absence of consistent, • A number of policies are out of responsibility and accountability robust and standardised policies date which could compromise for risk management and this is and procedures for managing patient safety. Outpatients could adversely shared with Executive Directors, In March 2016 there were two affect clinical outcomes. who, along with the whole of the high level risks remaining on the Trust Board, are informed on risk • The tightening financial outlook corporate risk register. management and governance may restrict the Trust’s ability to issues through the Healthcare provide services. The Risk Oversight Committee has a role in reviewing, validating Governance Committee, Audit • The inability to meet operational and monitoring all aspects of risk Committee and Finance & standards / key performance reporting. Performance Committee. The indicators in the Emergency Director of Governance is the Department could damage the The Trust’s Risk Management Executive Director with delegated Trust’s Financial and reputational Strategy states that risk responsibility for the coordination, position. management is the responsibility implementation and evaluation • There is a risk to patient care and of all managers and staff, whatever of risk management systems Trust experience if the environment their position within the Trust and wide. of the Oncology Day Unit is not that staff will be provided with The Trust uses the National changed. adequate education, training and support to enable them to Patient Safety Agency 5x5 risk • The inability to recruit meet this responsibility. Managers matrix to assess the likelihood effectively to well-planned are expected to incorporate risk and consequence of all risks on staff establishments will impact management into all aspects of the Trust Risk Register (see table on quality of care and patient their work, from business planning above). experience.
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to local induction and training • Identification and reporting • Assessment of the level of of staff, and to identify the risk of risk residual risk management training needs of all Identification of the risks facing This is the assessment of the their staff, especially as new staff the Trust, working in a way effectiveness of the controls join and are inducted. that spreads the workload that are already in place and and ensures that the initial revised ones that are being The Trust’s approach to risk identification of risk is not too implemented following the management has been made onerous; identification of a perceived risk; available to all staff and risk and management information is • Calculation of the importance included in Trust induction training of each identified risk • Review and challenge and subsequent updates. Staff also Achieved by undertaking an The Trust monitors and reviews undertake mandatory training such assessment of the ‘likelihood’ all reported risks, using the same as manual handling, information of the risk occurring and methodology as outlined above governance, resuscitation, determining the ‘consequences’ to ensure that controls remain infection control, fire safety and, should the event occur, using effective and robust. a matrix based on the National dependent on their role, additional A register of identified risks facing Patient Safety Agency risk competency training in risk the Trust is in place. This details matrix; management. risk issues, severity of risk, controls • Confirmation or introduction The way in which risk is identified, in place and agreed action plans. of controls and mitigating evaluated and controlled within It has been developed by the actions the Trust is based on the following identification and assessment of This stage of the cycle aims to cycle: risks at a local level within the confirm or introduce specific Trust. All principal risks are subject controls to deter and prevent to a continuous process of review the materialisation of identified and validation by Divisions, and the risks. These controls (eg policies Trust’s Risk Oversight Committee. and procedure, controls and Alignment of risks to the three reporting mechanisms, deterrent assurance committees and to the and disciplinary actions) Trust’s strategic objectives has will differ and be prioritised continued in 2015 / 16. according to the severity of the risk involved;
Celebrating Our Team Ipswich Colleagues
Victoria Lloyd and Holly Fudge were shortlisted for their work in the Patient Flow Continuing Care team. Organising continuing care funding for patients could previously take a ward nurse months, but Holly and Victoria work with social workers, patients, families and hospital staff to prevent delays in patients going home. They always make sure patients’ best interests are looked after.
Vicki Lloyd and Holly Fudge, Continuing Care Team Nominee: Team of the Year Award
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Corporate Governance Report Governance Statement
Further work to improve risk Whistleblowing and exception of performance against processes has been undertaken in Speaking Up the breakeven duty for income and 2015 / 16 with the implementation The Trust encourages staff to speak expenditure, the Trust has met all of the output planned from April up about any concerns at work. other duties. 2016 onwards. The new Board The Board considers it to be a vital The Trust had an initial planned reporting will see a greater focus way in which the organisation deficit of £19.8m in 2015 / 16. on assurances received through learns and continues to improve The Trust posted a final deficit of Board Committees. services for our patients and the £22.1m in 2015 / 16. The Trust The Risk Oversight Committee working environment for our staff. operated in a very challenging receives monthly reports detailing In accordance with our duty of environment in 2015 / 16 with all serious incidents, never events, candour, the Board and leadership significant increases in non- high level complaints and claims team are committed to providing elective activity over and above which it reviews and identifies an open and honest culture. To the contracted levels and increases potential risks and highlights these underpin this, a range of processes to delayed transfers of care (or to the appropriate Division for and interventions are in place to people medically fit to leave the risk assessment and escalation as enable staff to report concerns hospital but with no care package appropriate. promptly and to be supported in place). These factors meant the Trust had to open more capacity The Directors of the Trust are in doing so. All staff should be than planned and had to staff it required to satisfy themselves confident that they can raise with locum and agency staff which that the Trust’s annual Quality concerns without fear of reprisal, come at a premium cost. The Trust Account presents a balanced guidance is available within the delivered its cost improvement picture of the Trust’s performance Trust to enable this and external programme for the year. over the period covered and the support is signposted. performance information reported A standard integrated policy The Trust routinely reviews its in the Quality Account is reliable was one of a number of financial reporting and budgetary and accurate. In doing so, we are recommendations of the review controls system via the internal required to put in place a system of by Sir Robert Francis into audit function. This was reviewed internal controls over the collection whistleblowing in the NHS. by internal audit and found to be and reporting of information Following a period of consultation reasonable assurance. Divisional included in the Quality Account. the new policy was published on teams signed up to delivering The Board has been actively 1 April 2016. This policy (produced their budgets at the start of involved in the preparation of the by NHS Improvement and NHS the year after a comprehensive Trust’s annual Quality Account England) will be adopted by our business planning process. These and the proposed improvement Trust and our existing procedures budgets were not delivered due priorities for the coming year. The will be adapted to reflect the best to risks identified at budget Trust has consulted widely on its practice guidance contained within setting not being managed and an quality priorities with internal and it. All of this will help to strengthen unprecedented growth in non- external stakeholders, who have our approach to raising concerns elective activity. These issues were an opportunity to comment on the for the benefit of all patients. spotted early and financial recovery programme. plans were developed to try and address the risks. The Trust believes The 2015 / 16 Quality Account is Review of Economy, that all appropriate actions were currently unaudited; however, the Efficiency and taken to limit the impact of having audit is to be completed in time for to open increased activity. submission of the Quality Account Effectiveness of Resources by 30 June 2016. The Trust has reviewed its statutory The Trust regularly benchmarks financial duties, and with the itself against other trusts and is
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Corporate Governance Report Governance Statement
regularly in the top 10% trusts the national guidance to cease attributable cases and 14 classed when measured on unit cost basis. the use of fax technology for as non-trajectory. The Trust will continue to focus on the transmission of discharge The Trust failed to achieve the 99% delivering realistic levels of internal correspondence with primary care compliance required on diagnostic cost improvement and work with and uses encrypted secure e-mail tests undertaken within six weeks partners in the health system to see exchange to exchange information achieving 98.81%. if there are benefits from sharing in a timely manner. support services, having stronger clinical alliances, working better Review of the Performance Against with colleagues in primary care, Effectiveness of Risk National Priorities Set Out social services and the community Management and Internal to avoid the continued rise in in the NHS Constitution Control attendances at hospital and the 2015 / 16 associated costs to the health and As Accountable Officer, I have During 2015 / 16 the Trust has social care system. responsibility for reviewing the demonstrated good performance effectiveness of the system of against the key performance internal control. My review is Data Security indicators. Key achievements this informed in a number of ways. The year include: In 2015 / 16 the Trust achieved a Head of Internal Audit provides satisfactory ‘green’ assessment • Full year compliance at 95.11% me with an opinion on the at 85% for its information across 2015 / 16 achieving overall arrangements for gaining governance assurance under three of four quarters with the assurance through the Assurance the Information Governance 95% threshold for Accident Framework and on the controls Toolkit. This is an improved score and Emergency four-hour reviewed as part of Internal Audit’s on the previous year. The Trust waits across Type 1 and 3 new work. His opinion is that the overall improved its compliance for staff attendances. arrangements provide reasonable attending mandatory Information • Compliance with the 18-Week assurance. However, there was a Governance training achieving incomplete pathway threshold report of limited assurance. The 95.02%. of 92% across the year at a Trust limited assurance report related The Trust has had no ‘data level at 96.9%. to sub-contracted healthcare payments as discussed earlier in security’ incidents in 2015 / 16 in • The Trust also achieved this report. In addition to the Head relation to loss or interruption of compliance with the of Internal Audit opinion, the IT systems caused by external IT requirement to cancel no more Audit Committee Chair provides security threats. The Trust reported than 1% of patient operations the minutes of each committee two serious incidents associated on the day for non-clinical meeting together with a brief with information breaches to the reasons achieving 0.50%. summary highlighting areas for the Information Commissioner’s Office • Compliance across the 2-Week, in line with national guidance. Full Board’s attention to the next Board 31-Day and 62 Aggregate meeting in public. investigations were undertaken and Cancer Treatment targets across action taken. the 2015 / 16 reporting year. During the year the Trust continued its work to ensure audit The Trust continues to progress its • Achievement of the Trust MRSA recommendations were closed IT ‘paper light’ strategy to reduce trajectory, reporting zero cases in down in a timely manner with the the use of paper within the Trust year. Audit Committee giving specific and undertakes regular reviews of • Achievement of the C.difficile potential risks at its Information focus to this. Every month a trajectory for no more than report is prepared by the Finance and Records Governance Group. 18 cases in 2015 / 16 with 18 The Trust has complied with Department for the Combined
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Corporate Governance Report Governance Statement
Board. The report highlights internal and external reviews of reviews the underlying assurance any recommendations which internal control and from the processes and the effectiveness are past their due date, listed Care Quality Commission. I also of the management of strategic by Division. The report indicates take into consideration reviews by risks. A key role of the Healthcare new recommendations and notes other external bodies including the Governance Committee is to recommendations those which Ipswich Hospital User Group, the review action plans to mitigate have been closed during the Ipswich and East Suffolk Clinical clinical risks identified. It is assisted reporting period. This process is not Commissioning Group, Suffolk in this role by the Risk Oversight yet mature and will be a focus for County Council Health Scrutiny Committee which identifies further improvement by the Audit Committee, HealthWatch Suffolk, operational risks and ensures Committee and the Board. the Trust Development Authority that local controls are in place and the Department of Health, and to manage these. The Executive Executive Directors and managers reviewed by relevant committees. Directors and clinical Divisions within the organisation who have have a key role in managing responsibility for the development I have been advised on the risks, monitoring the control and maintenance of the system of implications of the result of my environment and ensuring that internal control provide me with review of the effectiveness of risks are escalated to produce a assurance. The Board Assurance the system of internal control Board Assurance Framework for Framework itself provides me with by the Board, Combined Board, Board review. The internal auditors evidence that the effectiveness Audit Committee, Healthcare provide independent assurance of controls that manage the risks Governance Committee, Finance on the application of governance, to the organisation achieving and Performance Committee and internal control and risk its principal objectives have Risk Oversight Committee as part management. The external auditors been reviewed. My review is of our approach to integrated provide independent assurance in also informed by comments in governance. In summary, the respect of statutory accounts and reports and other feedback from Board reviews the Board Assurance value for money. Internal Audit, External Audit, Framework and receives minutes NHS Litigation Authority for NHS and highlight reports from the Trusts, NHS Litigation Authority Audit Committee, Healthcare Significant Issues for Maternity Services and internal Governance Committee and Trust updates on progress against Finance and Performance I have considered the factors the action plans from various Committee. The Audit Committee described in the TDA guidance on the 2015 / 16 annual governance statement in respect of significant issues. Celebrating Our Team Ipswich Colleagues Of the matters identified in this statement, the following are judged to be significant: In her work as a blood transfusion practitioner, Sharon Kaznica works closely with our • Financial sustainability and bleeding disorder patients. breakeven duty (in context of pressures from increased Patient safety is Sharon’s top priority and her non-elective activity and efficiency and passion for the job means she is increases in delayed transfers always looking to improve the service. of care)The Trust will continue to focus on delivering realistic
Sharon Kaznica, Blood Transfusion Practitioner levels of savings from sharing Nominee: Living the Values Colleague of the Year Award internal cost improvements and work with partners in the
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health system to see if there working through a plan to Accountable Officer are benefits from sharing ensure future compliance. The Accountable Officer is Nick support service functions, • Workforce – Agency Hulme, who is the signatory to the having stronger clinical alliances, Staffing Following the Annual Governance Statement. working better with colleagues introduction of national in primary care, social services agency pay cap, the Director of and the community to avoid the Human Resources had put in Accountable Officer: continued rise in attendances at a process for the authorisation Nick Hulme, Chief Executive hospital and the associated costs of payments above the pay Organisation: to the health and social care cap. The Director of Human The Ipswich Hospital NHS Trust system. Resources requested internal Signature: • Payroll – ESR Weaknesses audit review of the new process in authorisation controls had to check implementation. resulted in some overpayments Due to a lack of audit trail, no to leavers. Management actions assurance could be given that have been in place, such as key agency returns above cap have Date: performance indicators included been consistently approved in 02 June 2016 in the accountability framework accordance with Trust process to ensure managers complete all the time. Improvements in leavers forms in a timely manner, control, particularly in back-end to strengthen the process. reconciliation, are now being put in place, such as making greater • Sub Contracted Healthcare use of E-rostering to analyse Payments A number of the staff time and agency use, and contracts reviewed were not to develop a more efficient authorised in accordance with authorisation process. Standing Financial Instructions. At the time of the audit plans • CQC ‘must do’ improvements were in place whereby the Detailed plans have been use of some contracts would reported to the Board and be eliminated or significantly its committees to secure reduced. Out of the three improvement in these areas and contracts in question, two have I am satisfied that those issues been terminated and one has have been actively addressed. been redrafted and is with our My review confirms that the Trust suppliers. has a generally sound system of • Ward Assurance – Nutrition internal control that supports the An audit requested by the achievement of its policies, aims Director of Nursing following and objectives. triangulation of quality information. The audit found that the Trust’s Nutrition Policy was not being consistently followed. This was disappointing as local audits had shown high compliance with nutritional risk assessments being completed. The Director of Nursing is now
53 Annual Report 2015 / 16 Accountability Report
Remuneration and Staff Report Remuneration Policy
The Remuneration Committee The Remuneration Committee Pension Contributions comprises the Chair of the Trust acts with the delegated The Trust made contributions Board, who acts as Chair, and the authority from the Trust Board. totalling £15.1 million in the year Non-Executive Directors of the to the NHS Pensions Agency, as (not subject to audit). Board. At the discretion of the per note 6.1 to the accounts. Chair, the Chief Executive and Note 6.2 in the Trust’s accounts The purpose of the Remuneration Director of Human Resources may provide further details as to the Committee is: be present to advise, but not for nature of the pension scheme and any discussions concerning their • to make appropriate accounting practice in relation personal remuneration. recommendations to the Board to associated liabilities. Details of on the Trust’s remuneration A quorum will consist of the the pension benefits of the Trust’s policy and the specific Chair (or his / her nominated senior managers are also given in remuneration and terms of representative) and at least two the Remuneration Report. service of: Non-executive Directors (or their • the Chief Executive; nominated representatives). • the Executive Directors; and Expense Payments The Committee will meet a (excluding benefit in kind • other staff as determined by minimum of twice per year. the Board; Minutes are taken and a report expenses) • determine targets for any submitted to the Board showing The Trust has made expense performance-related pay scheme the basis for any recommendations. payments to 11 Directors totalling contained within the policy; Executives’ pay is annually £10,800 during the 2015 / 16 year • review performance and reviewed by the Remuneration and in the 2014 / 15 year there objectives of the Chief Executive Committee. They are presented were payments made to 8 Directors and other Executive Directors; with benchmarking information to totalling £8,300. • ensure that contractual terms of demonstrate where each Executive termination are fair and adhered Director’s salary sits alongside to; similar posts in the NHS. Decisions to uplift salaries are based on • make recommendations to this information, internal equity, the Board on the level of any affordability, and whether there additional payments contained has been a significant change in within the policy; a Director’s portfolio and thus • ensure that remuneration responsibility. No Executive Director packages enable high quality received a pay rise this year. Notice staff to be recruited, trained and periods apply based on the early motivated and are within levels termination of their contract. The of affordability and are publicly notice periods on resignation are as defensible and amenable to follows: audit; Chief Executive – six months • ensure the terms of reference of the Remuneration Committee Executive Directors – three months. are available, which should set The Trust did not have a bonus out the Committee’s delegated scheme in operation during responsibilities and which should 2015 /16. be reviewed and updated annually.
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Remuneration and Staff Report
Single Total Figure Remuneration Table (Subject to Audit)
Salary and Pension Entitlements of Board Members
Long-term Performance performance All pension- Expense pay and pay and related Salary payments bonuses bonuses benefits TOTAL Salary and Pension Entitlements of (Bands of (taxable) to (Bands of (Bands of (bands of (Bands of £5,000) nearest £100 £5,000) £5,000) £2,500) £5,000) Board Members 2015 /16 £000 £00 £000 £000 £000 £000 Name and title Nick Hulme 165 – 170 4 0 0 50 – 52.5 215 – 220 Chief Executive Paul Scott 135 – 140 3 0 0 45 – 47.5 180 – 185 Director of Finance and Performance Julie Fryatt 55 – 60 3 0 0 20 – 22.5 80 – 85 Foundation Trust Director (01 / 04 / 15 – 01 / 11 / 15) Clare Edmondson 95 – 100 0 0 0 25 – 27.5 125 – 130 Director of Human Resources Denver Greenhalgh 75 – 80 0 0 0 62.5– 65 135 – 140 Director of Governance (16 / 05/ 15 – 31 / 03 / 16) Barbara Buckley 110 – 115 1 0 65 – 70* 32.5 – 35 210 – 215 Trust Medical Director Lynne Wigens 25 – 30 0 0 0 2.5 – 5 30 – 35 Director of Nursing and Quality (01 / 04 / 15 – 30 / 06 / 15) Lisa Nobes 65 – 70 2 0 0 72.5 – 75 135 – 140 Director of Nursing and Quality (01 / 07 / 15 – 31 / 03 / 16) Neill Moloney 125 – 130 0 0 0 – 5 45 – 47.5 170 – 175 Chief Operating Officer Ann Tate 10 – 15 2 0 0 0 10 – 15 Trust Chair (01 / 04 / 15 – 30 / 09 / 15) David White 10 – 15 2 0 0 0 10 – 15 Trust Chair (01 / 11 / 15 – 31 / 03 / 16) Alan Bateman 5 – 10 0 0 0 0 5 – 10 Non-executive Director (Acting Chair 01 / 10 / 15 – 31 / 10 / 15) Tony Thompson 5 – 10 1 0 0 0 5 – 10 Non-executive Director Andrew George 5 – 10 3 0 0 0 5 – 10 Non-executive Director Laurence Collins 5 – 10 0 0 0 0 5 – 10 Non-executive Director Rajan Jethwa 0 – 5 0 0 0 0 0 – 5 Non-executive Director (01 / 04 / 15 – 21 / 01 / 16)
*Element relating to clinical role. The major components of taxable expense payments relate to lease cars (for Executive Directors) and travel expenses (for Non-executive Directors).
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Remuneration and Staff Report Single Total Figure Remuneration Table
Long-term Performance performance Expense pay and pay and All pension- payments bonuses bonuses related Salary (taxable) to Restated*** Restated*** benefits TOTAL Salary and Pension Entitlements of (Bands of nearest £100 (Bands of (Bands of (bands of (Bands of £5,000) Restated** £5,000) £5,000) £2,500) £5,000) Board Members 2014 /15 £000 £00 £000 £000 £000 £000 Name and title Nick Hulme 165 – 170 4 0 0 42.5 – 45 210 – 215 Chief Executive Paul Scott 135 – 140 2 0 0 40 – 42.5 175 – 180 Director of Finance and Performance Julie Fryatt 95 – 100 2 0 0 30 – 32.5 130 – 135 Foundation Trust Director Clare Edmondson 95 – 100 0 0 0 25 – 27.5 125 – 130 Director of Human Resources Barbara Buckley 110 – 115 5 0 65 – 70* 152.5 – 155 330 – 335 Trust Medical Director Lynne Wigens 100 – 105 6 0 0 5 – 7.5 110 – 115 Director of Nursing and Quality Neill Moloney 125 – 130 0 0 0 – 5 17.5 – 20 140 – 145 Chief Operating Officer Ann Tate 20 – 25 2 0 0 0 20 – 25 Trust Chair Alan Bateman 5 – 10 1 0 0 0 5 – 10 Non-executive Director Tony Thompson 5 – 10 0 0 0 0 5 – 10 Non-executive Director Andrew George 5 – 10 2 0 0 0 5 – 10 Non-executive Director Laurence Collins 5 – 10 0 0 0 0 5 – 10 Non-executive Director Rajan Jethwa 5 – 10 0 0 0 0 5 – 10 Non-executive Director
*Element relating to clinical role. ** Non-taxable expense reimbursements were included in prior year’s disclosure, these have now been excluded. *** There have been minor reclassification changes in pay elements for 2015 / 16. The comparative figures have been adjusted to reflect these.
Celebrating Our Team Ipswich Colleagues
Natalie Mucha is a trainee assistant practitioner on Saxmundham Ward, caring for trauma and orthopaedic patients. She is blossoming in her trainee role, demonstrating kindness and compassion for patients which motivates the team around her.
Natalie Mucha, Trainee Assistant Practitioner Nominee: Trainee of the Year Award
56 Accountability Report Annual Report 2015 / 16
Remuneration and Staff Report
Pensions Entitlement Table (Subject to Audit)
Pension benefits of Board members
Pension Benefits – Board Members 2015/16
Real Real increase Lump sum at increase in pension Total accrued pension age related Cash in pension lump sum at pension at to accrued pension Real increase equivalent Employers at pension pension age pension age at at pension age at Cash equivalent in cash transfer contribution age (Bands (Bands of 31 March 2016 31 March 2016 transfer value at equivalent value at to stakeholder of £2,500) £2,500) (Bands of £5,000) (Bands of £5,000) 31 March 2016 transfer value 1 April 2015 pension Name £000 £000 £000 £000 £000 £000 £000 £000
Nick Hulme 0 – 2.5 5 – 7.5 45 – 50 140 – 145 954 52 891 0
Paul Scott 0 – 2.5 0 30 – 35 85 – 90 452 20 427 0
Julie Fryatt 0 – 2.5 N / A 10 – 15 N / A 160 13 137 0
Clare Edmondson 0 – 2.5 2.5 – 5 5 – 10 20 – 25 173 27 144 0 Denver Greenhalgh 2.5 – 5 2.5 – 5 20 – 25 65 – 70 359 43 306 0 Barbara Buckley 0 – 2.5 2.5 – 5 60 – 65 185 – 190 1,276 44 1,217 0 Lynne Wigens 0 – 2.5 0 – 2.5 35 – 40 115 – 120 762 6 730 0 Lisa Nobes 2.5 – 5 N / A 35 – 40 N / A 403 46 338 0 Neill Moloney 0 – 2.5 0 – 2.5 35 – 40 105 – 110 564 24 534 0
Pension Benefits – Board Members 2014 /15
Real Real increase Lump sum at increase in pension Total accrued age 60 related to Cash in pension lump sum at pension at accrued pension Real increase equivalent Employers at pension pension age pension age at at pension age at Cash equivalent in cash transfer contribution age (Bands (Bands of 31 March 2015 31 March 2015 transfer value at equivalent value at to stakeholder of £2,500) £2,500) (Bands of £5,000) (Bands of £5,000) 31 March 2015 transfer value 1 April 2014 pension Name £000 £000 £000 £000 £000 £000 £000 £000
Nick Hulme 0 – 2.5 5 – 7.5 45 – 50 135 – 140 891 63 807 0
Paul Scott 0 – 2.5 2.5 – 5 25 – 30 85 – 90 427 31 379 0
Julie Fryatt 0 – 2.5 N / A 10 – 15 N / A 137 23 111 0
Clare Edmondson 0 – 2.5 0 – 2.5 5 – 10 20 – 25 144 14 114 0
Barbara Buckley 0 – 2.5 2.5 – 5 60 – 65 180 – 185 1,217 26 1,026 0
Lynne Wigens 0 – 2.5 0 – 2.5 35 – 40 115 – 120 730 25 686 0
Neill Moloney 0 – 2.5 0 – 2.5 30 – 35 100 – 105 534 19 494 0
As non-executive members do not receive pensionable remuneration there will be no entries in respect of pensions for non-executive members. On 16 March 2016, the Chancellor of the Exchequer announced a change in the Superannuation Contributions Adjusted for Past Experience (SCAPE) discount rate from 3.0% to 2.8%. This rate affects the calculation of CETV figures in this report. Due to the lead time required to perform calculations and prepare annual reports, the CETV figures quoted in this report for members of the NHS Pension scheme are based on the previous discount rate and have not been recalculated.
Pension Liabilities Directors’ Entitlement for Loss of Office(Subject to Audit) Details of the NHS Pensions Directors are not entitled to any contractual payment for loss of office. No Scheme are disclosed in note 6.2 to such payments were made to departing Directors in 2015 / 16. the accounts.
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Cash Equivalent Transfer Real Increase in CETV Median Staff Pay Values This reflects the increase in CETV Disclosure (Subject to Audit) A Cash Equivalent Transfer Value effectively funded by the employer. Reporting bodies are required to (CETV) is the actuarially assessed It takes account of the increase in disclose the relationship between capital value of the pension scheme accrued pension due to inflation, the remuneration of the highest- benefits accrued by a member contributions paid by the employee paid Director in their organisation at a particular point in time. The (including the value of any benefits and the median remuneration of benefits are the member’s accrued transferred from another scheme the organisation’s workforce. benefits and contingent spouse’s or arrangement) and uses common The midpoint of the banded pension payable from the accrued market valuation factors for the remuneration of the highest paid benefits and any contingent start and end of the period. Director in The Ipswich Hospital spouse’s pension payable from NHS Trust in the financial year the scheme. A CETV is a payment 2015 / 16 was £177,500 (2014 / 15, made by a pension scheme or £177,500). This was 6.6 times arrangement to secure pension Celebrating Our (2014 / 15, 6.6) the median benefits in another pension scheme Team Ipswich remuneration of the workforce, or arrangement when the member which was £27,090 (2014 / 15, leaves a scheme and chooses to Colleagues £26,822). transfer the benefits accrued in their former scheme. The pension In 2015 / 16, two medical figures shown relate to the consultant employees (2014 / 15, benefits that the individual has six) received remuneration in excess accrued as a consequence of their of that of the highest-paid Director. total membership of the pension Remuneration ranged from £6,452 scheme, not just their service in a to £283,733 (2014 / 15 £5,338 to senior capacity to which disclosure £284,111). applies. The CETV figures and the other pension details include the Total remuneration includes salary, value of any pension benefits in non-consolidated performance- another scheme or arrangement related pay, benefits-in-kind as which the individual has transferred Kate Taylor, Matron well as severance payments. Nominee: Leader of the Year to the NHS pension scheme. They It does not include employer also include any additional pension pension contributions and the It’s a sign of mutual respect that benefit accrued to the member as a cash equivalent transfer value of the colleagues matron Kate Taylor result of their purchasing additional pensions. nominated for a Team Ipswich years of pension service in the award have nominated her back scheme at their own cost. CETVs for her leadership. are calculated within the guidelines and framework prescribed by the She provides ongoing Institute and Faculty of Actuaries. encouragement and help through difficulties with both work and personal issues. Kate tells her team ‘whenever you need me, I’m here’ and the team often takes her up on it.
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2014 / 15 2015 / 16 Staff Numbers (Subject to Audit) Restated* Permanently Total Other employed Total number Number number Number Average Staff Numbers Medical and dental 467 447 20 477 Administrative and estates 832 766 66 747 Healthcare assistants and other support staff 755 636 119 654 Nursing, midwifery and health visiting staff 1,223 1,077 146 1,164 Scientific, therapeutic and technical staff 457 445 12 436 Total 3,734 3,371 363 3,478 Of the above – staff engaged on capital projects 44 27 17 51
*Numbers of agency staff have been incorporated in the above figures. The comparative figures shown in the 2014 / 15 annual accounts have been amended to include these. During the year, the Trust has assumed responsibility for certain community services, resulting in increased levels of staffing and associated employee costs.
Staff Gender Breakdown 2015 / 16 2014 / 15 Number Number Female Male Female Male Contracted staff 3,335 861 2,995 808 The Trust maintains a bank of staff 2,319 438 1,850 370 who can be called on as required Total 5,654 1,299 4,845 1,178
Board Gender and 2015 / 16 2014 / 15 Payscale Breakdown Number Number Female Male Female Male Non-executive Director 1 6 1 5 Very Senior Manager (VSM) 6 3 4 3 Total 7 9 5 8
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We have over 3,700 members As part of our cultural change, we The results overall were very of staff and around 500 have an ambition that our staff will encouraging and show that out volunteers all working highly recommend Ipswich Hospital of 32 key findings in the survey as: performance, the Trust improved in together to provide safe and • a place to work; 24 areas and remained neutral in caring services to our patients. three. We were also better than or • a place to receive treatment; and Our clinically led structure equal to average for acute trusts in • a place to be trained. within the hospital, enables 28 key findings. more clinicians to be involved There were no statistically National NHS Staff Survey in the decisions being taken significant negative changes since and provide the direction and The 2015 National NHS staff survey the 2014 survey, however, there took place during quarter 3 and were three statistically significant steer to enable the continued involved 297 NHS organisations. positive changes, as follows: success of the organisation. The survey was sent to a random • recommendation of the selection of 850 staff at Ipswich organisation as a place to work Hospital and a total of 404 or receive treatment; Celebrating Our colleagues responded. This resulted in a local response rate of 49% • motivation at work; and Team Ipswich which was above average for acute • witnessing potentially harmful trusts in England. errors, near misses or incidents Colleagues in the last month. Key Findings In 2015, two key findings were Overall, our staff engagement score in the worst 20% for acute trusts showed a great improvement, – this has improved from 2014 increasing by 3.2% from 3.73 when four key findings were in to 3.85 (1 being poorly engaged this category. The two key findings staff to 5 being highly engaged were: staff). Ipswich Hospital’s staff engagement score was above • effective team working; and (better than) average when • good communication between compared with trusts of a similar senior management and staff. Tracey Wakeling, Matron type. Nominee: Leader of the Year The responses to the two Matron Tracey Wakeling’s component questions within glass is always half full, and the Friends and Family Test (FFT) her enthusiasm is unlimited increased significantly as follows: and infectious. She is always If a friend or relative needed striving to improve quality of treatment, I would be happy with care and patient experience and the standard of care provided by is inspiring to the ward teams this organisation – increased by around her. 11% (from 65% in 2014 to 76% A nurse through and through, in 2015). Tracey is often mentioned in I would recommend my thank you letters from patients organisation as a place to work and relatives. – increased by 8% (from 59% in 2014 to 67% in 2015).
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Workforce Race Equality The NHS Constitution outlines the • giving you and your team the Standard principles and values of the NHS in skills to do a great job; and England including four pledges that • looking after your health and The Workforce Race Equality set out what staff should expect wellbeing. Standard was introduced in 2015 from NHS employers. The pledges and consists of nine metrics, three are part of the commitment of Through national and local staff being workforce data and five the NHS to provide high-quality surveys, colleagues informed us based on data from the national working environments for staff. that they do not feel completely staff survey indicators. The final satisfied they were receiving a well- metric requires organisations What are we doing to provide structured appraisal. As a result, to ensure that their Boards are all staff with clear roles and during 2015 / 16, a new appraisal representative of the communities responsibilities and rewarding jobs process, known as the ‘Improving they serve. for teams and individuals that Together Programme’, was make a difference to patients, developed with our organisational their families and carers, and to values and behavioural standards The full and summary survey communities? in mind. reports for Ipswich Hospital is Our staff experience and This new programme applies to all available at engagement strategy has helped us employees (with the exception of www.nhsstaffsurveys.com focus on eight key areas that our Medical and Dental staff who are colleagues have indicated could be covered by a separate procedure) The workforce race equality further improved: and will ensure that: standard for Ipswich Hospital can • creating #TeamIpswich; be found on the Trust’s website • staff receive an annual and well- under the Equality and Diversity • supporting staff to do the right structured review of how they section. thing; are performing in their current • saying thank you for your role along with a performance efforts; rating grade; • keeping each other informed; • staff receive a rating grade • building our future talent and which is aligned to our values leaders; and behavioural framework; • being valued and supported; • staff and managers are given details of opportunities that are available to ensure they are developed in a way that brings Celebrating Our Team Ipswich Colleagues job satisfaction, but also brings increased quality of care to Saadia Farrakh is an unsung hero who patients and supports the Trust represents the very best a doctor can be: in meeting its objectives; and friendly, professional, competent and • staff receive a clear set of committed. Saadia works in Obstetrics objectives to work towards. and Gynaecology where she helps women safely deliver their babies each day. She also supports her fellow colleagues with educational opportunities and is known and liked for her fairness.
Saadia Farrakh, Obstetrics and Gynaecology Doctor Nominee: Trainee of the Year Award
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This revised appraisal process • the Bed Making team. This review of corporate learning and brings with it a structured new way involves attending ward areas development has concluded this of conducting annual appraisals and making up beds to ensure year which focused on making which is linked to the Trust’s we were able to start caring significant improvements in three business planning cycle. Alignment for our new patients as soon as specific areas; corporate induction, of review dates and individual possible; mandatory and statutory training objectives with the organisation’s • the Portering team. This and refresher training for clinical strategic objectives will ensure that involves transporting our staff. all staff are working towards the patients to either another clinical Our values and behavioural same goal. The new procedure was area (eg a ward or for diagnostic framework is at the heart of this piloted during 2015 / 16 and will tests) or collecting wheelchairs new training approach which will come into effect from 1 April 2016. and returning them to hospital come into effect on 1 April 2016. entrance points; Four leadership conferences were • the Patient Mealtime team. Staff Volunteers held during 2015 / 16; two for This involves attending ward senior leaders in April and October In Quarter 4 we launched an areas and helping patients with 2015 and two for middle managers exciting new initiative for the food and drink at mealtimes; in June and September 2015. All first time – a Staff Volunteering and Programme. This was as a result of four conferences were very well many colleagues suggesting that • the Patient Administration received and were instrumental such a programme would be a very team. This involves supporting in building on our #TeamIpswich visible and practical way of helping our ward clerks and discharge ethos and approach to the way we and supporting frontline staff coordinators with administrative work together. duties. during one of the busiest times of Approximately 150 middle the year. Many of our staff volunteers have managers attended one of the Almost 70 colleagues joined the found their experiences to be two conferences entitled ‘Leading Staff Volunteering Programme very rewarding and senior nursing from the Middle’. Colleagues during quarter 4 and were trained colleagues have been hugely were briefed by members of the appropriately before joining one or grateful for the extra pair of hands. executive team on the Trust’s more of the following teams: As well as conducting a review of strategy, why finance matters and the way we undertake appraisals the leadership challenge ahead. A in the organisation, a major lot of time was also spent focusing
Celebrating Our Team Ipswich Colleagues
Every day between 45 and 80 people contact the John le Vay Cancer Information Centre to ask for help. The team of staff and volunteers are there to support people with cancer, and their loved ones, to get their lives back on track. From exercise classes and social events to counselling at very difficult times – there’s always help when you need it.
Cancer Information Centre Team Nominee: Team of the Year Award
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on the importance of considering standards. Our aim is to achieve reasonable which will ultimately the organisation’s values when excellence, the highest level of benefit the employee and patients. making decisions on a daily basis award. We are also a signatory A Fast Track policy was developed and how middle managers / leaders for the Department of Health’s and implemented in November can make a real difference in OHs Responsibility Deal and have 2015.Suffolk Occupational Health creating a positive culture within action plans in place for a number has the primary responsibility for their teams. of pledges which, along with our the identification of employees commitment to the Workplace who may benefit from a request The Trust’s Health and Wellbeing Wellbeing Charter, support our to expedite a referral made to the Steering Group was formed in priority areas: physical activity, clinician in charge of their case. July 2014 and one of its primary smoking cessation, overweight and The benefits of this initiative are objectives was to develop the obesity, long-term conditions, and being measured. For example, a Trust’s Employee Health and mental and spiritual wellbeing. fast-track surgical referral resulted Wellbeing Strategy (which was in the employee returning to work launched in September 2015) and During the year a number of 42 days earlier. agree the priorities for our five-year wellbeing events were held action plan. including: All staff have access to Suffolk Occupational Health. Trust Our key strategic health and • Dry January; encouraging staff employees have rapid access to wellbeing objectives are: to be alcohol free for a month physiotherapy and counselling and become more aware of the • personal health awareness in line with Simon Stevens’, NHS effects of alcohol on health; and improvement: To help Chief Executive, five-year plan staff to understand their own • the Suffolk Wellbeing Service announced in September 2015 to health status and assist staff to has provided monthly stress improve health in the workplace. improve their own health and management workshops aimed Engage staff in decisions that affect live healthy lives; at giving staff a theoretical understanding of what stress them and the services they provide, • prevention and promotion: is, recognise harmful stress, individually, through representative Wherever we can, to work understand what resilience is, organisations and through local towards staff ill health and know how to use cognitive partnership working arrangements. prevention and promotion of behavioural skills / techniques to All staff will be empowered to put wellness, with a focus on our build resilience; forward ways to deliver better and health and wellbeing priorities; safer services for patients and their • we have worked with LiveWell and families. Suffolk to promote smoking • leadership and support: cessation and a stand was There are a number of ways in To ensure line mangers are placed on 11 March 2016, Non which our staff are involved in the equipped with the knowledge Smoking Day; and decisions which affect them and and skills to support employee the services provided. wellbeing. • on 4 November 2015 we celebrated Stress Awareness Day The Trust has signed up to the The Joint Consultative and with a series of events eg Time Workplace Wellbeing Charter in Negotiating Group (JCNG) is the to Change campaign, yoga, Suffolk as we want to demonstrate hospital’s forum for consultation relaxation and mental health our commitment towards the and negotiation, comprising local advice from Suffolk Wellbeing health and wellbeing of our staff trade union representatives Service. workforce. The Charter provides and management. There is also a clear guidance on how to support The Trust recognises the Local Negotiating Committee health and wellbeing of employees importance of supporting staff (LNC), which meets quarterly. and allows employers to audit and facilitating a return to work The monthly JCNG and quarterly and benchmark against a set of which is as fast as practicable and LNC meetings provide the
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opportunity for the Trust’s staff Schwartz Rounds are held once based on specific job roles which representatives to meet with the a month. During the first part of also meets legal requirements; senior members of the Trust’s the session, a panel of three or and management to enable matters to four colleagues take it in turn to • ensure that statutory and be examined and discussed with a describe a situation which they mandatory training provides a view to reaching agreement. were involved in, which often positive learning experience and relates to an episode of patient Matters for consultation or supports staff to provide safe care. The remaining part of the negotiation include: and effective care. round is opened up to the wider • those affecting the working audience and is guided by the As a result of the work undertaken, environment of employees and facilitators, exploring issues and a new mandatory training their working arrangements; themes raised by the stories. approach and corporate induction programme was agreed with an • policies and procedures for the Studies show that Schwartz implementation date of April 2016. management of the Trust; Rounds lead to an increase in staff • decisions which are likely confidence in handling sensitive Three of our values particularly to affect job security or job issues, empathy with patients as apply to our approach to learning prospects; people and confidence in handling and development: • planning decisions, which non-clinical aspects of care. • Professional – maintaining high have workforce implications, During 2015 / 16 we successfully standards and being reassuringly including in particular potential ran 10 Schwartz Rounds attended professional; redundancies and the effects of by 784 staff. • Efficient – being organised and any proposed re-organisations at efficient in all we do; and the earliest practical opportunity; • Improving Together – and Corporate Learning and improving ourselves, with • relevant matters that the staff Development the support and guidance of group wishes to raise in a formal A complete review of our corporate colleagues. setting. induction and mandatory and Our Trust values are the ‘golden In addition to the formal statutory training programmes was thread’ that runs through meetings, there are many informal undertaken during 2015 / 16. The everything we do, this includes: opportunities for staff to meet objectives of this review were to: with the Trust Directors in clinical • how we train our staff; • provide new starters with high and non-clinical areas across the • how we improve and develop as quality induction and learning hospital. professionals in the workplace; materials which meet and and validate their learning and Schwartz Rounds development needs from pre- • how we keep our patients, our induction up to their 12-month colleagues and ourselves safe. Schwartz Rounds were introduced review; at Ipswich Hospital in February 2015 and are a forum for all • improve the quality of the Trust’s Celebrating Success hospital staff to come together corporate induction programme, Our hospital celebrated the very to talk about the emotional and ensuring alignment with the best of the NHS at an Oscars- social challenges of caring for Trust’s Values and Behaviours; style staff awards ceremony on patients. The aim is to offer staff • develop a system to evaluate the 25 February 2016. The event was a confidential, safe environment effectiveness of induction; funded entirely by sponsorship in which to share their stories and • establish statutory and and staff and patients made offer support to each other. mandatory training requirements the nominations. The judging
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panel included nurses, a doctor, system of revalidation compliant have been contacted and offered therapists, patients and the Chief with the Responsible Officer support. Their identified confirmers Executive, Nick Hulme. Award Regulations. The mandatory audit have been offered training. recipients and nominees are contained within the AOA report Communications have taken place pictured throughout this report. provides a process by which every with the revalidation link for the Responsible Officer, on behalf of community to ensure those staff their designated bodies, provides are offered the same support. Staff Sickness a standardised return to the Approximately 500 registrants have (Not Subject to Audit) higher-level Responsible Officer. been spoken to about revalidation The collated audits then form the The Trust’s rolling 12-month requirements whether through basis of a report to Ministers and sickness rate is at 3.82% (12 drop-in sessions, team meetings, ultimately the public, on the overall months to 31 March 2016). This workshops or one-to-one sessions. compares to 3.76% in March of performance of revalidation 2015. across England. As at 31 March 2016, 37 have undergone the revalidation process The Trust currently has 277 doctors The most recent published data successfully, one had exceptional with a recognised prescribed for the acute medium trusts circumstances granted by the connection and in the last three (November 2015) lists the sickness NMC due to maternity leave and years has successfully revalidated rate as 3.88% which is higher has renewed using the old system 186 doctors. than that recorded for The Ipswich of PREP and one midwife has Hospital NHS Trust at 3.64%. undertaken planned retirement. Nursing Revalidation Every three years nurses and All planned renewals have occurred Appraisal and midwives are required to renew with no one lapsing registration Revalidation their registration with the Nursing unexpectedly. and Midwifery Council (NMC) Revalidation is the process by An intranet site has been set up by demonstrating they have met which a doctor’s licence to practise with example templates, blank certain requirements showing they is renewed and is based on local templates, frequently asked are keeping up to date and actively organisational systems of medical questions, newsletters and links maintaining their ability to practise appraisal and clinical governance. to the NMC website. This will safely and effectively. They are also Licenced doctors are required to continue to be updated as new required to pay an annual fee to have a formal link known as a information emerges. remain on the register. From April prescribed connection with a single 2016, this three-yearly process will Revalidation training will be organisation, identified as the also require them to provide this embedded into the newly qualified designated body, which will provide evidence to a confirmer and will be preceptorship programme. support with their appraisal and known as NMC revalidation. ultimately their revalidation. As at 31 March 2016, Ipswich Volunteers The Trust is required to provide Hospital employs 1,553 NMC assurance to the Board, our More than 500 volunteers work registrants who will need to regulators and commissioners throughout the hospital. They undergo revalidation. This includes that we have effective systems provide their time and commitment central bank staff and community in place to ensure we meet with to improve patients’ experiences staff who joined the Trust in nationally agreed standards for of being in our hospital. Every October 2015. medical appraisal and revalidation. one of our volunteers makes a The Annual Organisational Audit All NMC registrants who are real difference. A Volunteers’ (AOA) Report is a tool used hospital based and have a Conference took place in summer to achieve a robust consistent revalidation date April – June 2016 2015, led by the Chief Executive
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and Director of Human Resources Improved Patient Access and The Trust is commited to: and was attended by approximately Experience • giving full and fair consideration 50 volunteers. • People, carers and communities to applications for employment can readily access hospital, by the Trust made by disabled Equality and Diversity community health or primary persons, having regard to their care services and should not be particular aptitudes and abilities; The Workforce, Development and denied access on unreasonable • continuing the employment Education Committee reviews grounds. those matters pertaining to the of, and arranging appropriate • People are informed and training for, employees of the equality and diversity agenda for supported to be as involved the workforce, and the service Trust who have become disabled as they wish to be in decisions persons during the period when provision elements are considered about their care. by Healthcare Governance they were employed by the • People report positive Committee. Trust; experiences of the NHS. • the training, career development The Equality Delivery System 2 • People’s complaints about and promotion of disabled (EDS2) assists NHS organisations services are handled respectfully persons employed by the Trust. to review and improve their and efficiently. performance for people with Inclusive Leadership characteristics protected by the A Representative and • Boards and senior leaders Equality Act 2010. By using the Supported Workforce routinely demonstrate their Equality Delivery System, NHS • Fair NHS recruitment and commitment to promoting organisations may also be helped selection processes lead to a equality within and beyond their to deliver on the public sector more representative workforce organisations. Equality Duty. The goals and at all levels. • Papers that come before outcomes of EDS2 are: • The NHS is committed to equal the Board and other major Better health outcomes pay for work of equal value and Committees identify equality- • Services are commissioned, expects employers to use equal related impacts including risks, procured, designed and pay audits to help fulfil their and say how these risks are to delivered to meet the health legal obligations. be managed. needs of local communities. • Training and development • Leaders support their staff to • Individual people’s health opportunities are taken up and work in culturally competent needs are assessed and met in positively evaluated by all staff. ways within a work environment appropriate and effective ways. • When at work, staff are free free from discrimination. • Transitions from one service from abuse, harassment, to another, for people on care bullying and violence from any pathways, are made smoothly source. with everyone well-informed. • Flexible working options are • When people use NHS services available to all staff consistent their safety is prioritised and with the needs of the service they are free from mistakes, and the way people lead their mistreatment and abuse. lives. • Screening, vaccination and • Staff report positive experiences other health promotion services of their membership of the reach and benefit all local workforce. communities.
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Staff Sickness Absence and Ill-health Retirements (Not Subject to Audit)
2015 / 16 2014 / 15 Number Number Total days lost 26,389 23,547 Total staff years 3,313 3,140 Average working days lost 8 7 Persons retired early on ill-health grounds 1 ---
Exit Packages and Severance Payments (Subject to Audit) There were no exit packages agreed in 2015 / 16.
2014-15 Number of Cost of Total number Exit package cost band (including any special compulsory compulsory of exit Total cost of payment element) redundancies redundancies packages exit packages Number £s Number £s £25,000 – £50,000 2 75,038 2 75,038 Total 2 75,038 2 75,038
Redundancy and other departure costs have been paid in accordance This disclosure reports the number with the provisions of Section 16 of the Agenda for Change terms and and value of exit packages agreed conditions of service. Exit costs in this note are accounted for in full in in the year. Note: The expense the year of departure. Where the Trust has agreed early retirements, the associated with these departures additional costs are met by the Trust and not by the NHS pensions scheme. may have been recognised in part Ill-health retirement costs are met by the NHS pensions scheme and are not or in full in a previous period. included in the table.
Exit Packages – Other Departures Analysis (Subject to Audit) There were no exit packages for other departures in in this Note, the total number above will not necessarily 2015 / 16 (2014 / 15 None). match the total numbers in Note 10.4 which will be the number of individuals. There were no non-contractual payments made to individuals where the payment value was more than No non-contractual payments were made to individuals 12 months of their annual salary (2014 / 15 None). where the payment value was more than 12 months’ of their annual salary. This disclosure reports the number and value of exit packages agreed in the year. Note: the expense The Remuneration Report includes disclosure of exit associated with these departures may have been payments payable to individuals named in that Report. recognised in part or in full in a previous period. As a single exit packages can be made up of several components each of which will be counted separately
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Off-payroll Engagements (Not Subject to Audit) Consultancy For all off-payroll engagements as of 31 March 2016, for more than £220 The Trust paid £86 k for per day and that last longer than six months: consultantancy services during Number 2015 / 16. Number of existing engagements as of 31 March 2016 20 Of which, the number that have existed: for less than 1 year at the time of reporting 12 for between 1 and 2 years at the time of reporting 4 for between 2 and 3 years at the time of reporting 3 for between 3 and 4 years at the time of reporting 1 for 4 or more years at the time of reporting 0
Most off-payroll engagements are made through established employment agencies and the Trust does not consider that these carry a significant risk of taxes not being properly accounted for. Where payment is not made via such an agency, the Trust conducts checks and seeks assurances regarding employment status. Number Number of new engagements, or those that reached six months in duration, 6 between 1 April 2015 and 31 March 2016 Number of new engagements which include contractual clauses giving The Ipswich Hospital NHS Trust the right to request assurance in relation to 6 income tax and National Insurance obligations Number for whom assurance has been requested 2 Of which: assurance has been received 2 assurance has not been received 0 engagements terminated as a result of assurance not being received 0
Number of off-payroll engagements of board members, and / or senior 0 officers with significant financial responsibility, during the year Number of individuals that have been deemed “board members, and / or senior officers with significant financial responsibility” during the financial 16 year. This figure includes both off-payroll and on-payroll engagements
Accountable Officer: Nick Hulme
Organisation: The Ipswich Hospital NHS Trust
Signature:
Date: 02 June 2016
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Glossary
Glossary of Terms
A&E • Accident and Emergency (Casualty)
Carter Review • Review of Operational Productivity in NHS providers by Lord Carter of Coles
CCG • Clinical Commissioning Group
CRC • Carbon Reduction Commitment
DH • Department of Health
DNACPR • Do Not Attempt Cardio Pulmonary Resuscitation
DToC • Delayed transfer of care
GAC • Garrett Anderson Centre
IHT, the hospital, the Trust, we • The Ipswich Hospital NHS Trust
IMAS • Interim Management and Support
ISS • Provider of facilities services to the Trust
NHS • National Health Service
PHSO • Parliamentary and Health Service Ombudsman
PLACE score • A patient-led assessment of the hospital environment
Prevent • The Government’s Preventing Violent Extremism Strategy
P21+ • Procure 21 Plus is a Department of Health national framework for the development, • construction and refurbishment of NHS buildings
Red to Green • An Ipswich Hospital initiative to give patients back their lives
SSNAP • The Sentinel Stroke National Audit Programme – the single source of stroke data in • England, Wales and Northern Ireland
STP • Sustainability Transformation Plan
STPB • Sustainability Transformation Programme Board
WMC • Woolverstone Macmillan Centre
WRAP • Workshop to Raise Awareness of Prevent
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Celebrating Our Celebrating Our Team Ipswich Colleagues Team Ipswich Colleagues
Stroke / Shotley Ward Team Nominee: Team of the Year Award
Shotley Ward and the wider Stroke Services team are patient-focused, compassionate and well organised. The latest data shows our stroke unit is in fact the best in the region – giving patients fast access to treatment so they have the best possible chance of making a good recovery.
Lyndsey Walker, Paediatric Onclogy Nurse Nominee: Living the Values Colleague of the Year Celebrating Our Team Ipswich Colleagues Paediatric oncology nurse Lyndsey Walker was nominated for the care she gave to a five- year-old cancer patient. The boy’s parents said Lyndsey made sure he received the best treatment, ensuring
appointments, tests, results and Kevin Redshaw, Oncology Doctor medications were always lined Nominated: Trainee of the Year Award up on time. She liaised with other hospitals involved in his Oncology doctor Kevin Redshaw has established a new service for cancer care and always offered warmth patients for the drainage of excess fluid in the chest and abdomen. and friendliness – so much so He is no longer officially a trainee but says ‘we all learn every day’. In his the little boy looked forward to nomination he was described as a natural team player who improves his appointments. morale wherever he brings his clinical and diplomatic skills to bear.
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Celebrating Our Team Ipswich Colleagues The Team Ipswich Awards 2016 From the front cover... Our Hospital’s Oscars
Sam Holloway, Pharmacist Sally Matthews, Ward Sister Debbie Reeve and Esther Pacetti and Nominee: Living the Values Nominee: Leader of the Year Award the Carers’ Cabin Volunteers Colleague of the Year Award Nominees: Supporter of the Year Award There is no hierarchy on Sam Holloway is a pharmacist Saxmundham trauma and Debbie Reeve and Esther Pacitti are working with patients on the orthopaedic ward – just mutual the Suffolk Family Carers support dementia wards and Frailty respect and teamwork led by sister workers in our hospital. They Assessment Base. He uses his skills Sally Matthews. work very closely with the band of from a background in Medicines volunteers in the Carers Cabin. Information to help doctors care Sally is a champion for safe and The team is on hand to ‘care for for patients, particularly those with effective patient care which was the carers’, providing practical and Parkinson’s disease and at risk of demonstrated when the ward emotional support. They really do falls. Sam is dedicated to his role achieved more than 1,000 days of make the hospital a better place. and always ready to improve his pressure ulcer free care. knowledge.
Andrea Craven, Head of Project Jonathan Benmore, Radiographer Vincia Barton, Healthcare Assistant Delivery Nominee: Living the Values Nominee: Living the Values Nominee: Leader of the Year Award Colleague of the Year Award Colleague of the Year Award How would a hospital run without Radiographer Jonathan Benmore’s Martlesham Ward healthcare effective IT systems and colleagues nomination will come as no assistant Vincia Barton has worked like Andrea Craven to manage surprise to his Radiotherapy at the hospital for 38 years and her them? Andrea leads a small team colleagues. He has a wonderful matron says during that time her who between them implement way of explaining treatment positivity, kindness and enthusiasm new and updated technology to and gaining the trust of nervous has never wavered. help all of us provide healthcare. patients – so much so the She looks after patients as if consultant often seeks Jonathan She knows all the hospital’s they were her own family and out to see patients. systems inside out and is always by listening to patients is able to willing to help or advise those who Jonathan has also created an provide a very high standard of don’t. information leaflet to help care. Vincia is a highly valued team patients understand their complex member always with a ready smile. treatment.
Kate Bultitude, Senior Radiographer Outpatient Follow-up Appointments Jo Murphy, Nominee: Leader of the Year Award Team Nominee: Trainee of the Year Award Nominee: Team of the Year Award Senior radiographer Kate Bultitude Needham Ward nurse Joanne is committed to the Diagnostic The Outpatients Appointments Murphy has undertaken specialist Imaging Department and its team, under the leadership of training to care for patients patients. Simon McCarthy, has introduced with spinal cord injuries. These many changes to make booking patients often have very complex It is hard to imagine the inpatient appointments easier for patients. physical and psychological needs imaging department without her The Follow-up Appointments team and Joanne’s commitment to as she selflessly gives so much of has embraced the changes. Every learning and willingness to share her time and energy. team member really cares for each knowledge with her team has patient and the team offers each gone a very long way in helping other friendship and support. our patients.
71 Find out more about the hospital by visiting our website at www.ipswichhospital.nhs.uk or find us on Twitter: @IpswichHosp
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 2016
DPS Ref: 01214-16 © The Ipswich Hospital NHS Trust, 2016. All rights reserved. Not to be reproduced in whole, or in part, without the permission of the copyright owner.