Annual Report and Accounts 2014/15
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Annual Report and Accounts 2014/15 Royal Free London NHS Foundation Trust Pond Street, London NW3 2QG Tel: 020 7794 0500 www.royalfree.nhs.uk Design and photography by UCL Health Creatives Royal Free London NHS Foundation Trust ANNUAL REPORT AND ACCOUNTS 2014/15 Presented to Parliament pursuant to Schedule 7, paragraph 25 (4) (a) of the National Health Service Act 2006 3 Contents 4 8 10 15 A word from our At a glance – Strategic report Financial review chairman and chief the highlights of executive the year 21 28 33 39 Directors’ report Continuous Listening to and Improving our improvements to learning from our environment quality patients 44 45 Meet Andrew A patient praises the ‘brilliant’ treatment, care and communication from the Royal Free Hospital’s kidney cancer team. “The best thing is Andrew Ellis, 48, was referred by UCLH to the Royal Free Hospital at the start of this year after he was diagnosed with a kidney tumour. that there is a CNS He came in to see the team at the Royal Free Hospital in February and discussed who you feel is his treatment with a variety of staff members, including surgeon, Faiz Mumtaz, 46 52 really looking after 62 and clinical nurse specialist (CNS), David Cullen. you. You can call or Mr Ellis said he was delighted with his care from the start. email them if you “The treatment here has been brilliant,” he said. “The staff really took the time have any concerns.” to explain things to me and they let me ask questions,” he said. “I never felt rushed, even though I know they are all very busy. There are also lots of leaflets about the surgery and what I could expect, so that was really helpful. “The best thing is that there is a CNS who you feel is really looking after you. You can call or email them if you have any concerns. I emailed once and David called me back half an hour later. That just puts you at ease.” Playing our part in the Supporting our Mr Ellis had surgery to remove his tumour in March and was able to go home Meet the trust board four days after the operation. Mr Mumtaz carried out the operation with the help of da Vinci, a surgical robot. He explained that the robot enabled him to remove the tumour, and only a small part of the kidney so that the rest of Mr Ellis’s kidney could be retained. He also used the robot to reconstruct the kidney so that it can continue to function. Mr Mumtaz said: “The robot also allows me to see a magnified image of the kidney so I can more easily distinguish between healthy kidney tissue and the tumour. This means the surgery can take place more quickly. “During surgery the blood flow to the kidney needs to be stopped so we clamp the renal artery. If this takes more than 25 minutes the kidney is likely local NHS dedicated staff and our council of to suffer damage. Because the surgical robot allows me to remove the tumour more quickly, this reduces the clamping time and the kidney is less likely to be damaged.” governors Annual Report and Accounts 2014/15 / Patient story Annual Report and Accounts 2014/15 / Patient story 84 85 Meet Michelle One-stop-shop makes complex vascular surgery a smooth journey. After suffering an abdominal aortic aneurism, Michelle Tucknott underwent an operation at a hospital on the south coast to repair the damage. However, due to complications the operation was halted after two-and-a-half hours leaving her in significant discomfort and no closer to recovery. The retired care worker was transferred to the Royal Free Hospital, which 86 78 83 specialises in repairing complex aneurisms, and placed in the care of the aortic team and world-renowned vascular surgeon Tara Mastracci. “Tara recommended I have a fenestrated endovascular graft that would be inserted inside my aorta using keyhole surgery. She was lovely. She took me through all my options and asked me what I wanted to do. After I opted for the graft she took me all the way through what was going to happen next. “The graft was designed especially for me by the Royal Free Hospital’s aortic team before being hand made by a company in Australia. “When I was referred to the Royal Free Hospital I was slightly nervous about all the travelling I would have to do from my home in Worthing. Before I went in Annual governance Remuneration report Statement of for my first operation at the other hospital I was given loads of different dates for each different procedure. It was a pain, especially when I couldn’t drive and I had to get the train up. It was quite tiring.” “But the aortic team at the Royal Free Hospital explained they were trialling a ‘one-stop-shop’ system, which means I go to as many of my pre-op appointments as possible in a single day. In one day I had my bloods taken, my swabs and scans done, and I met with the surgeons to talk through the procedure. It’s a much better system, especially for people like me who have to come from far away.” Michelle had her operation in November 2014 and was discharged a week later. She is now under the care of the vascular team as an out-patient. accounting officer’s “I was so happy with statement the level of care I received at the Royal Free Hospital. Tara is my hero; she has responsibilities saved my life.” Annual Report and Accounts 2014/15 / Patient story Annual Report and Accounts 2014/15 / Patient story 170 171 144 145 “Pioneering wound Meet Gillian treatment by the Meet Derek plastic surgery After a ladder fell on Gillian Mayer’s leg she was left team is ‘amazing’” Joined-up hip fracture service puts patients quickly back on with a wound she feared would never heal on its own. their feet. But a revolutionary skin grafting technique being In February 2015 82-year-old Derek Martin tripped over his front doorstep and trialled at the Royal Free Hospital spared her from fractured his right hip. He was taken to the A&E at Barnet Hospital and within undergoing invasive skin graft surgery and cut her 22 hours was undergoing elective surgery for a full hip replacement. recovery time dramatically. Derek was fast-tracked through the system as part of a joint effort by the Royal 93 Free London’s fractured neck of femur service, which aims to get older patients 146 The Royal Free London’s plastic surgery team is the first in the country to trial suffering hip fractures back on their feet as soon as possible. the new CelluTome procedure, which allows patients to be treated for unhealed wounds as out-patients, without the need for surgery or anaesthetic. The initiative is a collaboration between orthopaedic surgeons, the orthogeriatric team, physiotherapists and occupational therapists, as well as doctors and Gillian said: “When the ladder fell on my leg I had no idea how deep it was. It nurses, from, from A&E, theatres and anaesthetics. The team aims to get was painful, but there wasn’t much blood so I just cleaned it up and put on a elderly patients who arrive at the A&E at Barnet Hospital with a fractured femur dressing. admitted to a ward within four hours and into surgery within 36 hours of “But nearly three weeks later it still wasn’t healing. While I was at an admission. “Thanks to Barnet appointment at the plastic surgery clinic at Mount Vernon Hospital, where I was Derek said: “I was taken to Barnet Hospital A&E and in what felt like no time at Hospital I was able to being treated for skin cancer, a doctor referred me to the Royal Free Hospital to all I was up on Beech ward. A surgeon came down that day to explain that the undergo the CelluTome treatment.” best course of action was to have a total hip replacement on my right side and start cooking for myself Annual accounts Quality report A traditional skin graft involves surgically removing healthy skin from a donor told me that I could have the operation the next day. after about a month site elsewhere on the body before applying it to the affected area, usually while “I was in shock at first. I felt angry at myself for letting this happen. The last and have even started the patient is under general anaesthesia. time I had been in hospital was 1937 when I had my tonsils out, so I was also a taking the dog for a walk. CelluTome, however, uses a combination of suction and warmth to cause the bit apprehensive. But the doctors and nurses were very reassuring. Hopefully I will be able to skin’s surface to blister until it can be removed and captured on silicone gauze, “After the operation I worked with a physiotherapist every day. When I was which is then cut into strips and applied to the wound site. discharged the physiotherapist gave me a recovery plan and the occupational start playing golf again “It was all done in an out-patient clinic in about an hour,” said Gillian. “I therapist made sure I had everything necessary to adapt the house to my needs. soon.” could only feel a slight pin pricking. The heat from the machine was not “When I broke my hip I was afraid that I would suddenly turn into an old man uncomfortable at all and I was able to go home the same day.