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This Annual Report is available in other languages and in large print. Please contact the Trust Offices for further details. With grateful thanks to PKL Healthcare, leading specialist in fast-track healthcare facilities. Leading the movement in excellence The Robert Jones & Agnes Hunt RESEARCH Orthopaedic & District Hospital NHS TRUST Oswestry, Shropshire SY10 7AG TRAINING Tel: 01691 404000 Fax: 01691 404050 Email: [email protected] CLINICAL EXCELLENCE Website: www.rjah.nhs.uk The Robert Jones and Agnes Hunt Orthopaedic and District Hospital NHS Trust. Best practice.. Annual Report 2004/5 Contents Introduction 3 Our history, background, mission and vision Best placed 4 The Chairman and Chief Executive give their views. Best management structure 6 Board membership; how we are organised. Best achievements 8 Review of another record-breaking year. Best partnerships 10 Working together to make this hospital thrive. Best performance 12 Meeting targets through innovation, excellence and hard work. Best management 14 A tight, efficient framework for running an excellent Trust. Best patient experience 16 How we protect patients’ interest, and how they see us. Best innovation 18 Modernisation and quality initiatives, from the ground up. Best use of investment 20 Targeting funds for maximum effect.. Best employment practice 21 Helping our people fulfil their potential for everyone’s benefit.. Best today, best tomorrow 22 The strategic review confirms a clear vision of the future. Operating and Financial Review An eight-page summary booklet. 16 of the best.. Just a few of the 1,000-plus clinicians, managers, staff and volunteers who work tirelessly to make the RJAH an internationally reknowned centre of excellence. Back, L-R: Judy Lloyd, Matron; Angela Hughes, Health Care Assistant; Pauline Cream, Radiographer; Lee Hayden, Maintenance Team; Ray Salisbury, Gardener; Preston Fletcher, Patient Access Manager; Linda Pugh, Physiotherapist; Richard Spencer-Jones, Consultant; Michelle Watson, Occupational Therapist. Front, L-R: Kate Haining, Registered General Nurse; Helen Hughes, League of Friends; Atty Hemming, Personal Assistant; Brenda Mates, Housekeeper; Pam Campbell, Catering; Sue Pugh, Matron; Chris Austin, Appointments Supervisor. 2 Introduction The Robert Jones and Agnes Hunt Orthopaedic and District Hospital NHS Trust is an NHS hospital specialising primarily in bone and joint disorders, with specific additional areas of expertise including spinal disorders and metabolic disorders affecting muscular development. It was founded by a visionary nurse and an eminent orthopaedic surgeon early in the last century. Dame Agnes and Sir Robert pioneered concepts commonplace today, but unheard-of in the first half of the 20th century. They established traditions of innovative treatment, care, dedication and professionalism which still guide the Trust. Their legacy has been a hospital which continually raises standards, one which pushes boundaries in areas like community-based care, holistic approaches to treatment and multi-disciplinary working between clinicians, physiotherapists and other professionals. The hospital achieved Trust status in 1994. It strives for continual, improving excellence in clinical care, research and training; all three areas are strengthened by a culture of cross-fertilisation and co-operation. The Trust is ideally placed to serve orthopaedic and musculo-skeletal professionals in the UK and abroad. The Trust is well placed near Oswestry in north-west Shropshire to serve Welsh and English patients, also offering care and employment to the local population. Around 1,000 people work on the site. Patients’ written comments and external auditors repeatedly comment on their enthusiasm and dedication. Mission and Vision Statement The RJAH is a specialist elective orthopaedic hospital, committed to providing the best possible clinical care, training and research in its field, benefiting the people of England, Wales and beyond. The Trust manages its business through a culture of continual improvement. Governance and monitoring frameworks are appropriately developed to minimize risk, maximize efficiency and above all, to deliver the best possible outcomes for patients. The Trust seeks to develop partnerships and clinical networks to enhance these objectives. 3 Best placed I arrived at the Trust in January, aware of its excellent reputation. Everything I had heard has been borne out by the professionalism and dedication of the people I have met here. The high-powered National Orthopaedic Project commented that this was a well-run, efficient Trust, and I heartily endorse that. I took over just as the positive benefits of tighter financial control, efficiency initiatives and more effective and open governance arrangements began to show. Continual improvement on all of these fronts is crucial if we are to meet the challenges highlighted in the Strategic Review. Happily, the whole workforce has demonstrated its ability to innovate and change. The willingness of staff to initiate improvements is particularly encouraging. Also vital is the development of new and existing partnerships and alliances. These bring out the best in our organisation, enhance our value and ultimately benefit our patients. Patients are clearly at the centre of all that we do at the RJAH, and that philosophy has led to a fund of goodwill towards our Trust among local people and stakeholders. The scale and generosity of the Trust’s voluntary supporters also bear this out – just look at the new pool, for example! – and we are very grateful for the funding and hard work they provide on a daily basis. All of the factors I have outlined combine to make our hospital a very special and unique institution. Building on them will underpin our future success. David Sear Chairman From left: Consultant Stuart Hay with Chairman David Sear, Chief Executive Jackie Daniel and Pre-operative Assessment Unit Manager Elizabeth Reece. 4 Best placed The watchdog Healthcare Commission awarded the RJAH a maximum three stars in its annual ratings for 2004/05, with our Trust hitting the top performance band in both clinical and patient focus. This was a magnificent achievement, particularly in a year of difficult circumstances. I am delighted to be able to introduce my annual thank-you to everyone at the hospital with such a ringing endorsement of their efforts. We broke even financially, helped by an extraordinary response to requests for continuing cost reductions. As NHS Trusts nationwide wrestle growing deficits, we see real signs that the RJAH has turned the corner. We met all waiting list demands, coping with the phasing-in of the tighter English and Welsh targets. Activity records were smashed again, with absolutely no compromises in patient care. The new modular theatre, with capacity for 1,000 procedures annually, was a key factor. It took around 14 weeks from approval to receiving the first patient – a breathtaking achievement. Meanwhile, we carried out our Strategic Review. Such deep analysis naturally causes anxiety among the workforce and local population. I hope that the results bring confidence and comfort. We now have a rigorously tested, clear picture of where we stand; we recognise our strengths and weaknesses; understand exactly what we really are…and what we really are not. This insight puts us in a much stronger position to negotiate a sound, thriving future for the Trust. The Review’s high estimation of our people’s hard work, skill and dedication came as no surprise. I am proud of everyone here, and grateful for their accomplishments. New challenges keep piling up, but I know they have what it takes to overcome them. Jackie Daniel Chief Executive 5 Best management structure Non-Executive Directors Effective management of risk and performance runs through the Trust’s Board Assurance framework. This integrated approach allows the Trust to monitor, evaluate and enhance performance efficiently. Duplication is avoided, priorities and goals are clearly defined. The Board Assurance Identification of how risk Michael David Sear Jennifer Framework covers every is measured. Bolderstone Chairman Bayliss area of activity within a Chairman (From 1.1.05) Non-executive standardised format which The committee reviews and (Until 31.12.04) Runs a management Director (Until 1.9.04) Chairman for over four consultancy advising local Involved in various training, sets deadlines and identifies manages the Risk Register, years, after eight years as authorities, housing education and staff projects vice-chair of the Princess associations and other in the NHS, including a lead personnel for action. reporting significant risks to Royal in Telford, public sector bodies spell as training manager The framework ensures the Trust Board via the Shropshire’s first NHS nationally. His background at the Royal Shrewsbury Trust. Built up own dairy is in accountancy, mostly Hospital. Member of delivery of objectives. Key Management Board. business and served in the public sector. Spent Shropshire Community groups are: nationally as President of five years as a non- Health Council until the National Dairyman’s executive director on the appointment. Takes a keen Estates and Facilities, Association and Chairman Board of the Shrewsbury interest in local community of the National Dairy Council. and Telford Hospitals Trust. activities. The Trust Board – sets Human Resources, MTBVM ACRCVM MTBVM ACRCVM MTBVM ACRCVM strategic aims and reviews Operations, Research management performance. and Finance Committees