Annual Report and Accounts 2012/13

Annual Report and Accounts 2012/13 Chesterfield Royal Hospital NHS Foundation Trust Annual Report and Accounts 2012/13 Presented to Parliament pursuant to Schedule 7, paragraph 25(4) (a) of the National Health Service Act 2006 CONTENTS PAGE ANNUAL REPORT 1 Introducing Chesterfield Royal Hospital 3 Chairman and Chief Executive’s Statement 8 Directors’ report 11 The directors of the Trust 11 The principal activities of the year 13 Operating and financial review 24 Environmental, social and community issues 44 Patient care and stakeholder relations 48 Management/governance of the Trust 54 Board of Directors 54 Council of Governors 73 Membership 91 Remuneration report 106 Quality Accounts 115 Part 1 – Statement from the Chief Executive 116 Part 2 – Priorities for improvement 117 Part 3 – Review of quality performance 128 Statement of directors’ responsibilities in respect of the 147 quality report External auditor’s limited assurance statement 150 Statement of the Chief Executive’s responsibilities as accounting officer 153 Annual governance statement 157 Annual accounts and financial statements 171 Foreword to the accounts i Auditors report iii Statement of comprehensive income Page 1 Statement of financial position Page 2 Statement of changes in taxpayers’ equity Page 3 Statement of cash flows Page 5 Notes to the accounts Page 6 Blank Page Chesterfield Royal Hospital NHS Foundation Trust Annual Report 2012/13 1 Blank Page 2 INTRODUCING CHESTERFIELD ROYAL HOSPITAL A ‘potted history’ As the only district general hospital serving the 400,000 people who now live in Chesterfield and North Derbyshire, we have come a long way since our humble beginnings in 1854. Even then, nearly 160 years ago, the hospital pledged to ‘do its best for local people’ and demand for its services grew quickly. Just five years later foundations for a new hospital in the town were laid, with two wards and a dispensary included in the plans. Thanks to the generosity of local benefactors and businesses, five more wards were added over the next 60 years; and their legacies remain today in some of our ward names. In 1919, HRH King George V gave his permission for the hospital to use the word ‘Royal’ in its title – adding a seal of approval to its standing in the community Fast-forward through World War I, the hard times of the 1920s and World War II; and the Royal’s reputation as an excellent local hospital grew apace. So much so that by the time the NHS was ‘born’ in 1948, its once convenient base in the town-centre became a detriment – preventing expansion and development from taking place. Finally, by the early 1970s, a hilltop site in Calow was sanctioned for a new build - and in 1977 work began on the project. At a cost of £29 million, Chesterfield & North Derbyshire Royal Hospital (as it was known then) finally opened its doors to patients on April 29 1984…. Building on success Looking back at this ‘potted history’, it’s clear that our hospital has always had tremendous support from the local community; as well as staff who want to provide the very best care for their patients. It’s always been a forward-thinking and progressive hospital – becoming one of the first NHS Trust hospitals in 1993; and later, in 2005, one of what was then only a handful of NHS Foundation Trusts. This status – firmly based within the NHS but allowing some freedoms and autonomy – has enabled us to determine our own future, our own investments and decide what services we provide. In the last eight years, thanks to a stable position and good clinical performance we’ve been able to build on our success and have used financial gains to our benefit, with more than £80 million of development taking place on the Royal’s site. A £12 million three-ward build has provided more capacity, more than £4 million has seen women’s services and maternity care transformed, and last year (2012) the Chesterfield Eye Centre opened, with £2 million worth of investment bringing ophthalmology specialities under one roof. Millions of pounds have been ploughed into ward refurbishments – to create more single rooms, and en-suite facilities - plus we’ve created new pathology laboratories and a modern main entrance; as well as upgrading medical and diagnostic equipment. These are just a few examples of what’s changed for the hundreds of thousands of patients who come through the doors each year… Our challenge now Over the last few years we’ve seen rapid development, especially in terms of the physical environment we provide to our patients. Our challenge now, for 2013/14, in the midst of a tough economic climate and a new NHS commissioning structure, is to improve the quality of the services we provide; deliver services effectively; and make sure we become efficient, saving money as a result. This 3 approach is reflected in the new objectives and commitments we’ve set ourselves in Our Journey (see below). Four principles are at the heart of how we run the hospital. First, just as we started out in that terraced house in 1854, is that in whatever we do we must remember that we only exist to serve our patients and our community. Second, we have to respect each other as colleagues. Third, we realise that we are not an ‘island’ and we have a duty to work in partnership with others to improve services for our patients. Fourth, we should be a clinically-led hospital, giving our clinicians a much greater say in the important choices that affect our future. We’re working like never before to make our hospital a great place to be a patient and a great place to work. Our Journey Over the past year we’ve refined our ‘strategic statements’ and our ‘values’ with the input of staff, patients, our members and our Governors. ‘Our Journey’ explains what sort of hospital we want to be, what our challenges are; and what we need to do to achieve our aim. We also need to be clear about what our future success will look like – and how we will know when we’ve ‘got there’... “I would like to thank staff for the excellent care and compassion shown to my Mum over the past week. She has Alzheimer’s and the difference in care, skill, understanding and compassion shown by your staff, compared to other recent experiences is astounding. Thank goodness for the NHS and thank you for having such high standards – it is so reassuring to know you are there.” Mrs W, December 2012 What sort of hospital do we want to be? A first-class district general hospital (DGH) – the model for what a DGH can be in the service of its community – delivering sustainable high quality clinical care; offering an exceptional experience for our patients; and creating a great place for our staff to work. How will we do this? We have six objectives to achieve our aim. For our patients and our community we will: 1. Provide high-quality, safe and person-centred care; 2. Deliver sustainable, appropriate and high-performing services; and 3. Build on existing partnerships and create new ones to deliver better care. For our hospital and our staff we will: 4. Support and develop our staff; 5. Manage our money wisely, foster innovation and become more efficient to improve quality of care 6. Provide an infrastructure to support delivery. 4 What are our challenges? The NHS is changing rapidly and we need to respond to the challenges this presents, including: The new architecture for the NHS with clinically-led commissioning at its heart; A challenging economic environment with NHS providers required to make a minimum of 4% savings annually for the foreseeable future; Rising public expectations and a new system which encourages greater choice for patients and competition between public and private providers; Increasing demand for long-term care and treatment for complex chronic conditions, particularly amongst an increasingly elderly population; How will we meet these challenges? Our six objectives provide a framework for the practical steps we will take to meet these challenges and deliver our aims for the hospital. Building on the success of our past by transforming our approach to service delivery through partnership working and staff engagement. Using service and quality improvement to drive efficiency and meet the financial challenge. We will ensure our hospital is led by our clinicians, with support from our managers – to make sure that everything we do has the needs of our patients at heart. Front-line staff will be encouraged to have more freedom to decide how they deliver their services, to give our patients the best possible care. How do we show that we are Proud to CARE? At Chesterfield Royal our Proud to CARE ethos is at the heart of how we run the hospital – looking after our patients and taking care of our staff: Compassion Compassionate care delivered with professionalism and a positive, friendly attitude; Care that preserves dignity and respects the person; putting patients at the heart of all we do; Respecting the unique and individual contribution that each of our staff makes – fair, positive and inclusive, recognising diversity and using it to enrich our organisation. Achievement Excellent care, safe services and a positive experience every time; Exceeding expectations by delivering first-class performance, bettering national standards through innovation and ingenuity. Relationships An open and honest relationship with patients, staff, partners and our communities; Working in partnership in the interests of our patients; Acting in a socially responsible way and meeting our commitments to the local community. 5 Environment Providing a hospital environment that is modern, clean and safe – conducive to care and recovery, and a good place to work.

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