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Annual Report and Accounts April 2018 to March 2019

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Annual Report and Accounts April 2018 to March 2019 Annual Report and Accounts April 2018 to March 2019 Royal Papworth Hospital NHS Foundation Trust Annual Report and Accounts April 2018 to March 2019 Presented to Parliament pursuant to Schedule 7, paragraph 25(4) (a) of the National Health Service Act 2006 Royal Papworth Hospital NHS Foundation Trust - Annual Report 2018/19 ©2019 Royal Papworth Hospital NHS Foundation Trust Contents 1 Performance Report 4 1.1 Overview of Performance 4 1.2 Performance Analysis 15 2 Accountability Report 21 2.1 Directors’ Report 21 2.2 Remuneration Report 29 2.3 Staff Report 38 2.4 Disclosures set out in the NHS Foundation Trust Code of Governance 47 2.5 NHS Improvement’s Single Oversight Framework 53 2.6 Board of Directors 54 2.7 Audit Committee 61 2.8 Council of Governors 65 2.9 Foundation Trust Membership 75 2.10 Sustainability 77 2.11 Equality and Diversity Report 79 2.12 Statement of Accounting Officer’s Responsibilities 85 2.13 Annual Governance Statement 87 Quality Report See separate contents page Annual Accounts This report is based on guidelines issued by NHS Improvement and was approved by the Board of Directors on the 23 May 2019. Royal Papworth Hospital NHS Foundation Trust - Annual Report 2018/19 3 1. Performance Report 1.1 Overview of Performance Statement from Chief Executive Officer The last year 2018/19 has been an incredibly important one for Royal Papworth Hospital. In the last year, our staff and partners have worked extremely hard to maintain our excellent quality standards whilst remaining on our Papworth Everard site for an extended period following the delay in the move to our new hospital. We had to carefully manage the consequences of the delay in our move whilst continuing to providing an excellent experience for our patients and supporting our staff who had been eager to move to their new site. Despite the huge amount of change we have experienced as an organisation, in the last 12 months we have seen 22,795 inpatients and day cases, and 93,852 outpatients, and we have maintained excellent clinical outcomes and very high scores in our NHS Friends and Family test, with 97% of our inpatients and 98% of our out patients saying they would recommend us as a place to receive treatment (February 2019). Our move is now complete and we treated our first patients at the new hospital on the Cambridge Biomedical Campus in May 2019. We can also be proud of a number of significant achievements made in the last year. In June 2018 we moved over 200 staff to Royal Papworth House. In September we introduced a new pathway for patients suffering from high-risk NSTEMI; a type of heart attack caused by a severely narrowed artery. This new pathway means that patients identified as being high-risk are now transferred directly to Royal Papworth Hospital for treatment within 24 hours, rather than being admitted to an acute hospital first. This offers huge benefits to patients as high-risk patients achieve better outcomes if they receive treatment to unblock the heart’s blood supply within 24 hours. In the six months since the new ‘Rapid NSTEMI’ pathway was launched in September, 134 patients have been accepted onto the pathway (over twice as many as predicted) with 87.3% patients receiving treatment within 24 hours of referral (and 91.8% receiving treatment within 24 hours of arrival at the Trust). As well as helping our patients receive quicker, safer treatment, the pathway has also led to a range of efficiencies in the wider healthcare system saving ambulance transfers; bed days spent in referring hospitals and reduced A&E attendances. The service is a key part of STP plans for pathway reforms and improving the quality of care for patients and has helping to ease pressures on NHS across the region. 2018 marked the centenary of the Trust and the 70th birthday of the NHS and we held a number of events that celebrated our centenary, the wider NHS and our relationship with the village of Papworth Everard since the foundation of the hospital. Over the last 12 months we have improved digital maturity, becoming a Lorenzo Digital Exemplar site. We have introduced new functionality such as ‘Lorenzo on the Wall’ screens in clinical areas. We have achieved interoperability between our electronic patient record and the Epic system used at Cambridge University Hospitals through a two-way interface to record laboratory results Of course, there have been many challenges too, as well as the delay in the move to our new hospital, like other hospital Trusts across England, we have faced many pressures due to staffing, finances and the increasing demand for our services. During the winter period in particular, we experienced a huge increase in demand for our for Extracorporeal Membrane Royal Papworth Hospital NHS Foundation Trust - Annual Report 2018/19 4 Oxygenation (ECMO) service, as well as high levels of transplant activity, which unfortunately led to cancellations for other patients and poor bed occupancy across the hospital. However, while we have faced challenges with regards to staffing throughout the year, I must recognise the huge efforts of staff across the hospital to attract and retain high quality staff to support our patients before, during and after our move to the new hospital. A co-ordinated approach to recruitment campaign has seen for example our critical care nursing now having a waiting list of staff who want to work with our Trust. The consolidated Trust financial position for the year is a reported a deficit of £11.45m (post impairment) and £9.89m (pre-impairment). This deficit is driven by the additional costs associated with the transition costs relating to the management of the move to the new Royal Papworth Hospital and the ongoing running costs of the site. The year ahead will be another important one for the hospital as we move into our new, state- of-the-art hospital on the Cambridge Biomedical Campus. The challenge of moving a hospital safely cannot be underestimated, but I know we can count on the support of our staff, patients and partners to make it a success. I would like to take this opportunity to extend my sincere thanks to all of our stakeholders – from staff and patients to governors, Foundation Trust members and the wider NHS community – for your support of our hospital and our charity throughout the year. Stephen Posey Chief Executive 23 May 2019 Royal Papworth Hospital NHS Foundation Trust - Annual Report 2018/19 5 Overview of Performance The purpose of the Overview is to give the user a short summary that provides them with sufficient information to understand the organisation, its purpose, the key risks to the achievement of its objectives and how it has performed during the year. Hospital History and Statutory Background Royal Papworth Hospital NHS Foundation Trust (“Royal Papworth Hospital” or “the Trust”) is the UK’s largest specialist cardiothoracic hospital and the country’s main heart and lung transplant centre. We have an extraordinary commitment to delivering the highest levels of clinical quality and outcomes and for providing the best possible standards of personalised care to our patients. Royal Papworth Hospital was one of the first foundation trusts to be authorised under the Health and Social Care (Community Health and Standards) Act 2003 and came into existence in July 2004 as Papworth Hospital NHS Foundation Trust. Since then it has been licenced by the Regulator (previously named Monitor, now NHS Improvement). From 2018 we became Royal Papworth Hospital NHS Foundation Trust. Royal Papworth Hospital has an associated charity – Royal Papworth Hospital NHS Foundation Trust Charity (Royal Papworth Hospital Charity) registered Charity number 1049224. From 2013/14, Royal Papworth Hospital has been required to produce group accounts which include the charity. Funds are still retained in the Charity which produces a separate annual report and accounts and continues to be regulated by the Charity Commission. Royal Papworth Hospital is a founder member of Cambridge University Health Partners (CUHP), a partnership between one of the world's leading Universities and three NHS foundation trusts. It is a strategic partnership aiming to improve patient care, patient outcomes and population health through innovation and the integration of service delivery, health research and clinical education across the Cambridgeshire region and beyond. CUHP is a not-for-profit Company Limited by Guarantee, the members of which are the University of Cambridge, Cambridge and Peterborough NHS Foundation Trust, Cambridge University Hospitals NHS Foundation Trust and Royal Papworth Hospital NHS Foundation Trust. Our Services Whilst Royal Papworth Hospital is a regional centre for the diagnosis and treatment of cardiothoracic disease, it is also a national centre for a range of specialist services, including pulmonary endarterectomy (PEA) and Extra Corporeal Membrane Oxygenation (ECMO). Royal Papworth Hospital has the largest respiratory support and sleep centre (RSSC) in the UK. The Hospital treated 22,795 inpatient/day cases and 93,852 outpatient episodes in 2018/19 from across the UK. Royal Papworth Hospital’s services are internationally recognised and include cardiology, respiratory medicine, cardiothoracic surgery and transplantation. New Royal Papworth Hospital In May 2019, we will move into our brand new heart and lung hospital on the Cambridge Biomedical Campus. The state-of-the-art new Royal Papworth Hospital offers cutting-edge facilities for patients requiring heart and lung treatment in a bespoke building. The
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