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Annual Report and Accounts 2013-14

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Annual Report and Accounts 2013-14 Annual Report and Accounts 2013/14 1 2 Bradford Teaching Hospitals NHS Foundation Trust Annual Report and Accounts 2013/14 Presented to Parliament pursuant to Schedule 7, paragraph 25 (4) (a) of the National Health Service Act 2006. 3 4 Contents 1. Introduction ....................................................................................................................... 6 2. Strategic Report ................................................................................................................ 7 3. Directors’ Report ............................................................................................................. 24 4. Remuneration Report ...................................................................................................... 27 5. NHS Foundation Trust Code of Governance Disclosures................................................ 32 6. Quality Account ............................................................................................................... 52 7. Staff Survey .................................................................................................................. 135 8. Regulatory Ratings ....................................................................................................... 136 9. Income Disclosures ....................................................................................................... 138 10. Other Disclosures in the Public Interest ....................................................................... 138 11. Statement of Accounting Officer’s Responsibilities....................................................... 147 12. Annual Governance Statement 2013/14 ................................................................... 148 5 1. Introduction Bradford Teaching Hospitals NHS Foundation Trust is responsible for providing hospital services for the people of Bradford and, in a growing number of specialties, for communities across Yorkshire. We became a Foundation Trust on 1 April 2004 – among the very first in the NHS to do so - and employ approximately 5,000 staff, serving a population of around 500,000. We also have one of the largest membership bases in the country with almost 50,000 members, equating to 12% of the eligible local population. We currently operate over several sites; the Bradford Royal Infirmary provides the majority of inpatient services, and St Luke's Hospital provides outpatient and rehabilitation services. On 1 April 2011, we welcomed staff from Bradford and Airedale Community Health Services (BACHS) who joined the Foundation Trust as part of the government’s reorganising of the NHS. We also took over the running of four community hospitals: Westwood Park, Westbourne Green, Shipley Hospital and Eccleshill Community Hospital. Bradford Royal Infirmary has over 900 beds and is also home to one of the busiest A&E departments in the country, with more than 120,000 attendances each year. Its maternity unit is also one of the NHS’s busiest, delivering more than 6,000 babies. St Luke’s Hospital has 80 beds and houses a variety of outpatient clinics and daycase facilities. As a teaching hospital, the Foundation Trust is at the forefront of research and development in healthcare. This promotes a culture of learning and professional development that ensures that all doctors, nurses and other healthcare professionals practice the highest clinical standards. The last few years have seen us being named as among the safest hospitals in the NHS. Bryan Millar Chief Executive 6 2. Strategic Report 2.1 National and Local Challenges Shaping Planning Our vision for Bradford Teaching Hospitals NHS Foundation Trust is set out in our strategy for 2013-18 “Together, putting patients first”. In this document we outline our ambitions and vision for the coming years. We have a clear mission to ensure that patients are at the centre of all that we do and that our services support the needs of our population. BTHFT is committed to the safe delivery of these services to the highest standard of quality at all times. We understand that this vision and our ambitions will need to be delivered in the ever more challenging environment that is faced by the NHS both nationally and locally. The NHS overall, faces an ageing population, an increase in long term conditions, rising costs and increased public expectations. Allied to this, there is also an unprecedented financial challenge with the NHS forecast to face a funding gap of £30bn by 2020/21. Locally, the Bradford area faces a range of specific challenges. Amongst these is the fact that it sits within the 10% most deprived local authorities in the country. These higher levels of deprivation have a significant impact on the health needs of the population, with Bradford having higher levels of chronic disease than neighbouring areas. Areas of particular concern are cardiovascular disease, diabetes and respiratory disease. The local population also does not follow national trend with a growing younger population. The Foundation Trust recognises these local factors and is also cognisant of the fact that, in line with the rest of the NHS, we will need to address these issues whilst faced with a significant financial challenge. The estimated funding deficit in the Bradford health and social care economy has been assessed by the Trust and its Local Health Economy (LHE) partners (including adult social care) as being in the region of £357m over the next 5 years. Indeed, the Trust’s high level planning assumptions indicate that the Trust will need to identify £29m of efficiency improvements over the next two years. We are also fully aware that whilst addressing the financial and social challenges outlined above we must also implement the lessons of the Francis, Keogh, Berwick and Clwyd-Hart reports and ensure that our focus on maintaining and improving the quality of our services does not waver. The Foundation Trust has recognised that in order to respond effectively to the unprecedented financial challenge and to maintain our ambitions in terms of quality and patient focussed services, current methods of service delivery will not be sufficient. As a result, it is vital that we work closely with our LHE partners to develop a range of transformational and integrated services. Integration It is clear from our consultation with LHE partners that all parties are aware of the affordability gap affecting health and social care and the challenge of delivering patient focussed, high quality care whilst bridging this gap. The transformation and integration of services and the appropriate use of the Better Care Fund are seen as key drivers in meeting this challenge. Indeed, the Trust and its Local Health Economy (LHE) partners have been aware of the need to transform and integrate 7 services for some time. Consequently, an established (since 2011) and robust Integrated Care Programme (ICP) has been developed involving: • Bradford Teaching Hospitals NHS Foundation Trust • Airedale NHS Foundation Trust • NHS Bradford City Clinical Commissioning Group (CCG) • NHS Bradford Districts CCG • NHS Airedale, Wharfedale and Craven CCG • Bradford District Care Trust • City of Bradford Metropolitan District Council • Bradford Health and Wellbeing Board The ICP is overseen by the Bradford Integration and Change Board (ICB). The ICB liaises with the Health and Wellbeing Board and connects senior leadership from across the NHS with Local Authority Providers and Commissioners. There is also full engagement with the local Healthwatch. Indeed, as a LHE community, we are working with Healthwatch and voluntary sector partners as a pilot site in the Building Health Partnerships programme. The Foundation Trust and its LHE partners have formally committed themselves, through the ICB, to a joint vision for transformation and integration. They have agreed that this joint programme of work must be evidence based and founded on sound data to demonstrate potential improvements in quality and value. Successful actions to date have included; work to develop the Virtual Ward, the development of the Urgent Care Programme and specific areas of service level integration such as multidisciplinary teams in Motor Neurone Disease. Transformation The Trust is aware that it has a responsibility to internally review its services, assess the way in which they are provided, and look to transform delivery wherever possible. Consequently, it has developed a robust process to do this. During 2013, the Trust recognised that it would be appropriate to strengthen its resources with regard to service improvement and service development and appointed an experienced Head of Transformation. The Head of Transformation and the Trust’s Transformation Team are charged with supporting teams to transform the way in which services are provided delivering improvements to the quality, safety and productivity by thinking and working differently. The Head of Transformation and the Service Improvement Team work closely with the Planning department to ensure that opportunities to develop and transform patient centred services are identified at an early stage. During the summer and autumn of 2013, the Trust developed and ran a series of strategy development days for each of its divisions. The purpose of these review days was to encourage clinicians, nurses and service management to identify and have input into the development of services based on key drivers and core principles. These service developments are to apply over the coming 2 year (operational) and 5
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