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Annual Report and Accounts 2015 – 2016

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Annual Report and Accounts 2015 – 2016 Annual Report and Accounts 2015 – 2016 Annual Report and Accounts 2015 – 2016 North Tees and Hartlepool NHS Foundation Trust Annual Report and Accounts 2015 – 2016 Presented to Parliament pursuant to Schedule 7, paragraph 25 (4) (a) of the National Health Service Act 2006. ©2016 North Tees and Hartlepool NHS Foundation Trust Contents Page 1. Chairman’s Statement 8 2. Performance Report 10 2.1 Overview of Performance 10 2.1.1 Chief Executive’s Statement 10 2.1.2 Overview of the Trust 11 2.1.3 Business Review 13 2.1.4 Trust Strategic Direction 13 2.1.5 Development and Service Improvement 14 2.1.6 Stakeholder Relationships 25 2.1.7 Risks and Uncertainties 25 2.1.8 Going Concern 28 2.2 Performance Analysis 28 2.2.1 Performance and Development of the Trust’s Business 28 2.2.2 Performance Review 30 2.2.3 Business Planning and Linkages to Key Activities 34 2.2.4 Future Challenges to Performance Delivery 36 2.2.5 Corporate and Social Responsibility 37 2.2.6 Environment, Sustainability and Climate Change 39 3. Accountability Report 42 3.1 Directors' Report 43 3.1.1 Organisational Structure 43 3.1.2 Council of Governors 45 5 3.1.3 Board of Directors 52 3.2 Remuneration Report 65 Annual Report and Accounts 2015 – 2016 Page 3.3 Staff Report 70 3.3.1 Commitment to Staff 70 3.3.2 Keeping Staff Informed 76 3.3.3 Supporting Staff 77 3.3.4 Development and Education of Staff 79 3.3.5 Equality and Diversity 88 3.3.6 NHS Staff Survey 91 3.3.7 Staffing Analysis 93 3.4 Code of Governance 95 3.5 Regulatory Ratings 95 3.6 Statement of the Chief Executive’s responsibilities 96 3.7 Annual Governance Statement 98 4. Research and Development 108 5. Quality Report – Our Commitment to Quality 112 6. External Audit Opinion 230 7. Financial Performance 2015-16 238 7.1 Foreword to the Accounts 238 7.2 Financial Performance against Plan 2015-16 239 7.3 Income and Contract Performance 241 7.4 Capital Investment 243 7.5 Financial outlook for 2016-17 243 7.6 Summary 246 7.7 Financial Key Performance Targets 246 7.8 Annual Accounts 2015-16 including Financial Statements and Notes 247 6 8. Contact Information 289 Annual Report and Accounts 2015 – 2016 Welcome North Tees and Hartlepool NHS Foundation Trust provides integrated hospital and community-based healthcare to around 400,000 people living in East Durham, Hartlepool, Stockton-on-Tees and surrounding areas including Sedgefield, Easington and Peterlee. Intensive care unit nurses celebrate a joint 150 years’ service. It provides services from two main hospitals; the University Hospital of North Tees in Stockton-on- Tees and the University Hospital of Hartlepool and provides a number of outpatient and outreach clinics at our smaller community hospital in Peterlee, and in an increasing number of community locations. The breast and bowel screening services extend further, across Teesside and parts of North Yorkshire and County Durham. The Trust also provides community dental services to the whole of Teesside and many of the other community services also reach out beyond its geographical boundaries. The Trust’s skilled staff provides a minor injuries service at One Life Hartlepool and services in other community settings. The Trust is very proud of its staff, who are passionate about providing 7 excellent care for patients and clients. Annual Report and Accounts 2015 – 2016 1 Chairman’s Statement As chairman of North Tees and Hartlepool NHS Foundation Trust I am delighted to introduce this Annual Report which is an opportunity to place on record the enormous amount of work which has been undertaken throughout the year in the interest of patients. The Board of Directors set the direction, strategy and objectives for the Trust, working closely with the Council of Governors and our staff. It is my role as chairman to lead the board and hold the executives accountable for the Trust’s performance. Quality remains our top priority, despite being in a challenging financial climate; we are not prepared as a Trust to compromise the performance and quality our patients have come to expect. While this year has been a really tough time for everyone in the Trust; unprecedented levels of demand for emergency care for prolonged periods of time, financial pressures and challenging operational targets, the Trust has risen to the challenge and we have delivered some fantastic healthcare for our communities over the year. Our accident and emergency performance, our responsiveness and waiting times, and most importantly our patient satisfaction has been good. A great amount of hard work has been put in over the last year from our staff who are constantly making improvements in the interest of our patients, to continuously deliver high quality patient care. The unprecedented pressures we have faced this winter have been seen across the national picture and we have felt the effect just like everywhere else in the country. We plan for these additional pressures every year so that as an organisation we can respond to the increased demand for services. The Trust took part in an initiative called Kick Start January, where we looked at patient flow to ensure patients have a smooth journey through the hospital until they are ready to go home. This initiative put an intense focus on the management of discharge and involved staff at all levels. I was proud to see that it was clearly evident we have strong leadership at all levels and continue to drive the Kick Start January and Perfect Week agenda forward. Despite the increased pressures we have seen across the Trust, performance has remained high. We are not seeing many more patients attending accident and emergency, but we are seeing a higher proportion of those patients being admitted into hospital which shows the levels of frailty and illness across the population. While targets are challenging to achieve, I know the staff are doing their very best for our patients. We had the CQC inspection in July and while we were given an overall rating of ‘requires improvement’, I was very proud of our response to the visit, where we were rated as ‘good’ for safety, caring and responsiveness of our services. A number of areas were identified as good practice, including surgery, critical care, end of life care, the Trust’s simulation suite, community services and the Trust’s services at One Life Hartlepool. Throughout the Trust 65 of the 85 individual ratings were rated as good. It has become incredibly tough to meet the standards, which cannot be compared to those of 20 years ago. We gave a good account of ourselves and it was a positive experience, following which we have already addressed many of the areas 8 mentioned by the CQC, and will continue to improve going forward. We welcome them visiting again for a re-inspection in future. Annual Report and Accounts 2015 – 2016 Thanks to better care, people are surviving illnesses and living with conditions for much longer than we used to. This means that our health service needs to change in order that we can meet patient needs and future proof services for the coming generation in the communities we serve. The Trust is involved in the Better Health Programme, the programme is across County Durham and the Tees Valley and is looking at how services can be improved including changing health needs and how services need to change to meet those needs; how different parts of care services can work together more effectively; ensuring high standards are consistently delivered; having staff with the right skills and training; and making sure we have the right services available, 24 hours a day and seven days a week. Engagement with our patients and the public will be key as this programme progresses. After the disappointment of having to put the new hospital on ‘pause’, we ended 2015 on a more positive note having secured £25m from the government to carry out essential infrastructure work, to give the University Hospital of North Tees a longer life. We really welcome this much needed investment and work is expected to start in April 2016 which will help to secure the longer term future of the hospital. We have continued to invest in services, equipment and our buildings, to keep the environment and equipment up to date so that our staff have the very best facilities to work in and for our patients to receive high quality care. We saw the new electronic patient records system go live in October. There was never going to be an ideal time in the Trust to make such a major change as this, however, for many reasons, it had to be done and despite the enormity of the task, it will bring great benefits in the future. Our staff have done a fantastic job in training, support and implementation of the new system whilst also ensuring continuity of services for patients. It makes me pleased and very proud to be associated with this Trust and all the amazing people who work for us and who keep on giving first class, safe care to local people, in hospital and in the community. I am pleased to place the board’s thanks on record throughout this report, for the work our staff does to ensure the people we serve have a health service they can be proud of. Paul Garvin QPM, DL Chairman Staff in accident and emergency taking part in a huddle. 9 Annual Report and Accounts 2015 – 2016 2 Performance Report 2.1 Overview of Performance 2.1.1 Chief Executive’s Statement Once again this has been a successful year for the Trust.
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