2009–10 The Whittington Hospital THE NHS Trust ANNUAL REVIEW The Annual Review CONTENTS

2009–10

Editorial 3 4 Investors in people The mail 4 6 Trust board contributors The Critics: Food and drink 8 8 Goings on Achievements 9 9 Fun run preview Talk of the town 12 14 Training for the front line Portfolio 16 17 Patient Experience Ensuring the best treatment 20 22 Fundraising annual report Outside advice: Governors and members 25 25 Developing our staff Environmental impact 27 27 Service statistics Financial report 32 43 Wayfinder

Designed and produced by causeway communications 020 7255 5265 www.causewaycommunications.com Cover illustration by Sam Bevington Photography credits: All photos by Keith Ramsden unless stated www.whittington.nhs.uk

2 THE ANNUAL REVIEW 2009–10 EDITORIAL

The year in review

BY OUR CHAIRMAN AND CHIEF EXECUTIVE

Chairing editor, mean that we must find better and more cost yet highly successful, year for The Joe Liddane effective ways of delivering these services. Whittington. We further enhanced our The Trust Board is determined to maintain reputation for safe, high quality services The Whittington as a leading provider of and achieved all our major operational health services for local people. During and financial targets despite intense the year we have been actively involved pressures on the Trust’s services and with discussions at London regional levels, funding. This has been at a time of with our neighbours at the Royal Free and intense speculation about the future of UCLH hospitals and with NHS Islington The Whittington and its services when and NHS Haringey. We are delighted that we have taken part in important strategic both NHS Islington and NHS Haringey reviews of the future of the organisation. have identified The Whittington as their preferred provider for their community his has been a busy year in other services. We are now developing an ways. In November 2009 BBC organisation that will include hospital and TLondon Radio came here for a live community services across Islington and broadcast of the Vanessa Feltz show and Haringey. we were able to celebrate our successes over the airwaves. We have also had n the earlier part of 2010 the hospital staff participate in fun runs, marathons, he Whittington has had an excellent as has been at the centre of media fashion shows, concerts and much else to well as challenging year. We continue Iand public attention. We have been raise money for the Care of Older people Tto provide high quality and ever improving overwhelmed by the support of our appeal. There is no shortage of things to services to our local population. This is local population and to know that The get involved in. significantly down to the dedicated hard Whittington is held in such esteem. Our services are highly valued in the work of all our staff to whom I pay tribute. Our achievements and more are in community and we highly value the In September 2009 we were fortunate this publication which I hope you enjoy support we receive. The Whittington is a to welcome Rob Larkman as our chief reading. community within a community, we are executive from NHS Camden. Rob proud to serve our local population and is helping ensure we perform to high I look forward to continuing our success standards, whilst his extensive experience EDITING CHIEF EXECUTIVE, together. and strong reputation are invaluable assets ROB LARKMAN as we plan for the future of the hospital. At the same time we bade farewell to David joined The Whittington in September Sloman who moved to be chief executive having spent seven years as chief of the Royal Free Hospital. We thank him Iexecutive of NHS Camden and before for his considerable contribution to The that I was the chief executive of Camden Whittington. and Islington Community Health Services NHS Trust. So for many years I have been ver the last year it has become clear aware of The Whittington’s reputation that continuing exactly as we are is not as a high performing and popular local Oan option, if we are to deliver consistently hospital. Since my arrival I have been high quality services and adapt to the many impressed by the high standards which changes. Rising public expectations, a The Whittington sets for itself and by the growing and aging population and, of skills and dedication of the staff. course, very tough financial conditions This has been a busy and challenging, THE ANNUAL REVIEW 2009–10 3 Investors the maiL in People In January 2010, The Letter of the month NHS also explains how, in 1946, Whittington Hospital Centuries of healing the hospitals on all three sites were achieved the nationally brought together. Two years later recognised Investors in would just like to say how much with the coming of the NHS itself People award. This built on I enjoyed the article in the last in 1948 the hospital became known earlier work and awards to Iedition on the medical history of the as The Whittington. In 1992 The several departments within area and, spurred by the range and Royal Northern Hospital, Holloway, the Trust. The Whittington depth of information provided, have also became part of the group and is one of very few Trusts decided to take on and submit my integrated its services into the site. across London to achieve the own research. Whilst to enter the hospital from organisation wide award. It is a wonderful fact that medical its Magdala Avenue entrance which services have been provided on The opened in 2006, you would never guess This scheme helped The Whittington to measure our progress for the Improving Working Lives objective. Staff from across the organisation were interviewed by an independent assessor who asked them about their experience of working at the hospital. The assessment looked at areas such as:

◗ effective management and support ◗ flexible working ◗ safe working environment ◗ staff involvement & consultation ◗ equality & diversity The unique round ward at the former Royal Northern Hospital, Holloway Road. In 1974, The Royal Northern became part of The Whittington and The assessor’s report and is now commemorated by The Great Northern Building. feedback from this confidential process will help the hospital Whittington site since 1473, originally that the hospital had been there more to continue their progress in as a leper hospital. I never knew that a than a decade, never mind since the improving staff and patient new hospital was built on the St fifteenth century, it’s impressive to think experience. The Whittington Mary’s Wing in 1848 to care for of all the learning and progressions in recognises there is more work smallpox patients. medicine that have stemmed from the to do and is very proud to have Further research also led me to hospital on the hill. achieved this accreditation. discover that independently managed Penri Morgan, hospitals were opened on the Highgate Governor, Whittington South site from 1866 and the Archway site from 1877. In 1900 Highgate We couldn’t agree more Mr Morgan Hill infirmary opened adjacent to thank you for all your work. It really the Smallpox Hospital, these two is remarkable and unique to have hospitals merged shortly after into a such a historic site providing such nurses home contemporary, forward thinking A paper on the history of the services. RL 4 THE ANNUAL REVIEW 2009–10 THE ANNUAL REVIEW 2009–10 5 trust board contributors

Joe Liddane Celia Ingham Clark clinical development from October 2000 Chairman and Chairing Editor Medical Director to December 2009. Deborah trained as a Joe Liddane became chairman of Celia Ingham Clark was appointed as nurse at St Bartholomew’s Hospital, and The Whittington Hospital NHS Trust medical director on 1 November 2004. spent her clinical career in orthopaedic on 1 November 2007. In his early She joined The Whittington Hospital as nursing. career Joe qualified as a chartered a consultant general surgeon in 1996 and accountant and has had a successful took roles as director of medical education, Margaret Boltwood career specialising in performance clinical director and interim director of Director of Human Resources and improvement for financial services and operations before becoming the trust Corporate Affairs private sector businesses, as well as medical director. Her particular interests are Margaret Boltwood joined The Whittington some public sector organisations. He is in service development and in delivering in 1989, as personnel manager for acute presently managing director of a small high quality care. She has a part-time services. She has worked in the NHS in management consulting firm and a non secondment as associate medical director human resources management since 1978, executive director of the NHS Institute for secondary care for NHS London where and is a Fellow of the Institute. She was for Innovation and Improvement. she focuses on medical revalidation and appointed to her present position in 1996. Previously he was a partner in Ernst & improving the quality of healthcare. Young and European managing director Siobhan Harrington for a large American consultancy. Richard Martin Acting Director of Nursing and Clinical Director of Finance Development from December 2010 Joe has lived near The Whittington for Richard Martin joined The Whittington Director of Primary Care 30 years and is a member of St Joseph’s in January 2007 as director of finance, Siobhan Harrington joined The Whittington parish council. having been director of finance at Enfield in September 2006. She trained as a nurse primary care trust since 2001. He has also at St Thomas’s Hospital in the 1980s. She Rob Larkman held a number of public sector finance has worked in a number of nursing and Chief Executive and Editing Chief positions both in local government and management roles across both Primary Executive from September 2009 in other health bodies. He lives with his and Secondary Care and has experience Rob Larkman joined The Whittington family in Enfield. of working at a regional and national level. Hospital NHS Trust as chief executive Siobhan joined The Whittington from on 14 September 2009. He was Bronagh Scott Haringey Teaching Primary Care Trust previously chief executive of Camden Director of Nursing and Clinical where she was director of primary care Primary Care Trust and prior to this was Development commissioning. She was acting director of chief executive of Camden and Islington Bronagh Scott joined The Whittington nursing from January – June 2010. Community Health Services NHS Trust. as director of nursing and clinical In addition to his 11 years as a chief development on 1 June 2010. Bronagh Philip Ient executive Rob has a strong financial comes to The Whittington from Belfast, Director of Facilities background and worked in advertising Northern Ireland where she was director Philip Ient joined The Whittington and management consultancy before of nursing at the Northern Health and Hospital in March 2001. Philip trained joining the NHS in 1993. Social Care Trust for six years. as a marine engineer and served for five years in the Merchant Navy. In 1983 he David Sloman Prior to this Bronagh worked as a joined the NHS as an engineer and has Chief Executive until September 2009 commissioning nurse and patient worked in both primary care and acute David Sloman worked at The advocate across a series of healthcare sectors of the NHS over the past 27 Whittington as chief executive from 1 providers in Northern Ireland. years. Philip is a chartered engineer. November 2004 to September 2009. He was previously chief executive Deborah Wheeler Kate Slemeck of Haringey Teaching Primary Care Director of Nursing and Clinical Director of Operations Trust and prior to this worked as chief Development until December 2009 Kate Slemeck joined The Whittington in executive of the Marylebone Primary Deborah Wheeler worked at The October 2001. Kate has been a general Care Group. Whittington as director of nursing and manager in the NHS for 17 years, and 6 THE ANNUAL REVIEW 2009–10 previously in other acute trusts including Northwick Park and Newham. Prior to moving into management Kate qualified and worked as an occupational therapist.

Fiona Smith Director of Planning and Performance Fiona Smith joined the Whittington in August 1998. Fiona has been a manager in the NHS for nine years. Prior to moving into management, Fiona qualified and worked as a nurse, spending her clinical and policy formulation, business change social care policy analyst, organisational career in accident and emergency and undertaking project and programme development consultant and researcher. nursing. She was appointed to her present health checks. She works on commissioned projects position in 2008. for the Department of Health, numerous Professor Jane Dacre national, regional and local government Non – Executive Director agencies in England and a range of Non – Executive Professor Jane Dacre was appointed as the international and national academic and Directors UCL nominated non-executive Director research institutes and both statutory and for The Whittington Hospital from 1 independent health bodies and agencies. Edward Lord January 2009 to 31 December 2012. Maria lives in Kentish Town. Deputy Chairman and Non-Executive Director Jane took up her first consultant post Anna Merrick Edward Lord is chairman of Local as a rheumatologist in 1990 and was Non- Executive Director Partnerships, a public body that leads a lead clinician in the development of Anna Merrick has lived in the in project support and advisory services the first Clinical Skills Centre in the Highgate area with her family for 20 to all local authorities in England and UK. She has continued to develop years. She spent her career in banking Wales. He is also a member of the Policy expertise in Medical Education and and has extensive commercial and Resources Committee of the City Rheumatology in parallel. Her current experience across a wide range of of London Corporation and serves as a academic interest is in the training corporate banking markets. magistrate and a board member of other and assessment of doctors in general public bodies and charities. He was and rheumatologists in particular. Marisha Ray previously an executive director of two Specialist Advisor universities, prior to setting up his own She was elected Academic Vice Marisha lives with her family in public affairs and governance consultancy President of the Royal College of Clerkenwell. Before becoming a practice in 2002 as well as reading part- Physicians where she served three Liberal Democrat councillor for the time for the Bar. He lives in Bloomsbury. years in this role and has recently London Borough of Islington in 2002 been appointed to the new GMC Marisha was a business analyst with Robert Aitken Council. She is currently director of Marks & Spencer. Non – Executive Director medical education and vice dean at Robert Aitken from Brookfield UCL Medical School, and medical She is on the governing body of Park was a director of Employment director of the MRCP Examination. Elizabeth Garrett Anderson School Commercial and Companies Division and Hugh Myddleton School and was at Treasury Solicitors. Robert has Maria Duggan a trustee of Clerkenwell Charities. She worked for the Department of Health as Non – Executive Director is a member of the Liberal Democrat a lawyer. He was a trustee of the English Maria has an academic background as Party and has been an executive National Opera Benevolent Fund. As a a sociologist. In a lengthy career she has member for community safety local man, Robert was a churchwarden been, amongst other things, a social work and performance, a member of the and is now on the PCC at St Anne’s in practitioner, a director of social services and advisory body of City University, the Highgate. He currently runs his own an academic in the field of social and health management committee of Islington consulting business Brookfield Park policy. Maria currently has an extensive victim Support, London Drug Policy Associates Limited advising on strategy portfolio as an independent health and Forum and Islington Schools Forum. THE ANNUAL REVIEW 2009–10 7 The critics Food and drink goings on N19 

Location, location, location

rchway is an increasingly vibrant To and from and active area of London. The AWhittington is situated on Magdala Via tube: Avenue, north of the famous Holloway Road and within walking distance of rchway tube station is the closest the picturesque Highgate Village. It stop and it is on the Northern line. is accessible on the Northern line and AFrom the tube station it is a five minute has numerous bus routes taking you all walk up Highgate Hill, turning onto around London from various stops close Magdala Avenue for the main entrance. to the hospital. A 15 minute tube ride from Archway brings you to the heart of Via bus: n the foodhall complex on level one of the West End whereas a 15 minute bus The Whittington, there are two cafes journey can take you to Islington’s Upper ighgate Hill is served by the 4, 17, Iand a restaurant; Muffin Break provides Street. Upper Street hosts a large selection 41, 134, 443, 210, 263, 271, 390, cakes, pastries and, of course, a variety of of cafes, bars, restaurants as well as the HC11 and W5 buses. The 4 and C11 then coffees and Café XCLNT provides hot Almeida Theatre, the Business Design turn onto Magdala Avenue and continue food such as lasagna, pasta and rotating Centre. A few minutes walk away from to Dartmouth Park Hill. specials. the hospital is the beautiful Waterlow N19 is the hospital run restaurant that Park and Lauderdale House the former offers a full menu of hot and cold food at home of Nell Gwynn with Hampstead regular prices to the public and subsidised Heath only a short walk away too. prices for staff. N19 is open for breakfast and lunch each week day using fresh produce to provide healthy, staple foods and some indulgent treats for those who fancy one. The N19 is available to staff, patients and visitors alike and has become famous for its themed menus, for occasions such as St Patrick’s day, St George’s day, Diwali and Chinese new year. The restaurant is the heart of the hospital, where staff can discuss work or anything over a vegetable stir fry or plaice fillet with herb butter and potatoes, visitors can indulge in an almond and ginger sponge and medical students can stock up for the day ahead with a special from the grill bar. In good weather N19 has outside seating to make the most of a fresh cappuccino or carrot cake.

8 THE ANNUAL REVIEW 2009–10 achievements Fun run

Popular Chronicles preview The Great Sustaining excellence, they see fit. The registration was assessment accepted without condition. Highgate assessment The Care Quality Commission assessment has delivered a series of inspections 5k Fun Run and surveys over the course of this he NHS is a vast network of year, their annual health check, an Sunday healthcare providers and The outpatient and inpatient survey and a 26 September 2010 TWhittington plays a vital role in staff survey. ensuring the population receives good This year’s Fun Run is the healthcare services when people need it. fourth in Highgate – this Each year hospitals receive a series The annual health great family event for all of inspections and reviews to ensure check ages promises to be fun, they are performing well and can make fun, fun! productive changes if required. This hospital is a living organisation, year, like every other, The Whittington like any thing else, it works best Last year, over 500 people has been subject to assessments from Awhen it is healthy, able to provide took part. independent, external bodies and here good services whilst financially is a brief rundown of the ratings and taking care of itself. This year The This year, we want to accreditations we have received. Whittington received its highest get record numbers of health check score ever, with an people walking, jogging or running all in aid of ‘excellent’ score for its financial the Whittington’s Care of The Care Quality management and a ‘good’ for quality Older People appeal. Commission of services. The quality of services

score is based on an assessment of Get fit, have fun and raise he Care Quality Commission the hospital’s ability to cater to the sponsorship for your local (CQC) has accepted The needs of the local population and hospital. TWhittington’s application to have our its performance against national services formally registered. This is a standards. The financial management compulsory registration that declares score is measured on how well the Register that the services we provide are fit for hospital has met its financial targets Online: purpose and allows the Care Quality over the last two years. This year the Commission to inspect our services trust expects to receive an excellent www.whittington.nhs.uk/ and offer advice on any alterations and excellent score. funrun Telephone : 020 7288 5641 / 5983 Email: [email protected]

THE ANNUAL REVIEW 2009–10 9 achievements

Surveys

The national outpatient The national inpatient The staff survey survey survey

he Whittington performed very his survey took place between taff are the vital energy source of well in the 2009 Care Quality September 2009 and January 2010 any organisation. Their contribution TCommission (CQC) outpatient survey Tand was based on patients who had Smakes The Whittington such an excellent which covers nine broad aspects of been in hospital for more than one night place to be treated. It is therefore very an outpatient visit. The hospital on between June, July and August 2009. important that all staff can speak their the whole improved since the same The Whittington’s performance minds and address their concerns without survey was carried out in 2005. Within improved considerably since the last fear of judgment. the broad topics, particular questions survey in 2008 particularly in the areas There are a series of internal methods where the Trust has notably improved of mixed sex accommodation and results for ensuring staff can communicate in as included: around discharge, care and treatment. many appropriate ways as possible, and The eight areas measured were: on a wider scale the CQC provided a  Flexible patient appointment times staff survey to compile national statistics.  Relaying expected waiting times  Admission All staff were asked to fill in a survey  Outpatient department cleanliness  The hospital and ward between the months of September to  Listening to patients  Doctors December 2009. The CQC then takes a  Patient trust  Nurses sample from all the surveys collected as  Explaining medication  Care and treatment the base for its statistics and collates the  Explaining how to take medication  Operations and procedures information.  Patient inclusion in  Leaving hospital The Whittington always welcomes correspondence with GPs  Overall feedback from staff and we are pleased  Educating patients about their that within the survey we were in the conditions Our results are broadly in keeping best 20 per cent of acute Trusts for with the performance of other Trusts staff recommending us a place to work and the overall patient perception of the and receive treatment as well as for our hospital and their stay here has improved overall staff engagement. on the 2005 results. 10 THE ANNUAL REVIEW 2009–10 The Doctor Foster quality account

he Dr Foster report is an online comparative service that allows Tpatients and the public easy, quick access to compare hospitals and their performance. In a time where the internet is the lead method of communication, the Dr Foster site provides an invaluable tool in impartially helping patients choose the best services for them. This year The Whittington came in the top twenty per cent of Trusts nationally in the Doctor Foster annual quality report. The report measures three aspects of an acute Trust; patient safety, clinical effectiveness and patient experience. The Whittington’s overall score was 86.30 out of 100. This figure was gathered from an assessment of 13 safety measures. Areas in which The Whittington exceeded expectation in patient safety were:

 What is the hospital’s overall death rate?  What is the hospital’s death rate for emergency admissions?  What is the death rate for stroke patients?

Areas in which The Whittington exceeded expectation in clinical effectiveness were:

 How many patients admitted with a broken hip have this repaired within two days?  Are all patients fitted with NICE- approved blood clot prevention devices post-surgery?  What proportion of day-case patients end up staying longer for treatment?

There are a large number of criteria that make up the Dr Foster quality account and The Whittington is delighted to note that for most of the criteria it was in line with expected scores across all the Trusts in England

THE ANNUAL REVIEW 2009–10 11 The Annual Review

the talk of the town

Staff achievements in brief

Nursing Times Awards Hospital Broadcasting Ord f er o the British Award Empire n November 2009 Nursing Times ecurity manager Edward Kent, known endy Martinson, The Whittington’s held its annual award ceremony to as Eddie K to his friends, has broadcast joint clinical nutrition service Icelebrate the hard work and dedication Shis Reggae Rundown show for five years Wmanager, was invited to Buckingham of midwives and nurses across on London Network Radio, the hospital’s Palace in February 2010 to receive an order the country. The Whittington was radio station. In February Eddie’s show of the British Empire in recognition of delighted to have midwives Joy Clarke was nominated for ‘best specialist show’ her services to sport and nutrition. Having and Shamsa Ahmed pick up highly and whilst it did not win, to be nominated helped the British Olympic team and commended awards at the event held at from amongst 226 stations, each West Ham united in fierce competition, the Park Lane Hilton. Joy and Shamsa providing a number of different, diverse Wendy’s reputation is a terrific asset to were recognised for their work with programmes shows just how good Eddie’s The Whittington. women who have undergone genital reggae rundown show is. The Reggae mutilation, a controversial and difficult Rundown broadcasts on channel seven on area of healthcare. Whittington hospital radio.

Photographs: This page – near right – Wendy Martinson receives her OBE. Next page – top right – Eddie K broadcasting on Whittington hospital radio (photograph by Anne Marie). Lower left – Dr Julie Andrews at the British Medical Journal’s annual awards ceremony. Far right – Joy Clarke and Shamsa Ahmed receive their awards at the Nursing Times annual awards ceremony.

12 THE ANNUAL REVIEW 2009–10 British Medical Journal Awards he Whittington hospital’s director of infection prevention and control, TDr Julie Andrews, was short-listed for a clinical leadership award at the British Medical Journal’s annual ceremony. Julie’s leadership has been invaluable in ensuring a safe service during a year with high Norovirus and H1N1 activity across the globe. Whilst Julie did not win the award in this instance, her work has been recognised at the highest level which is an accolade in itself.

Healthcare 100 Award

he Healthcare 100 award is a joint effort between the Heath Service TJournal, the Nursing Times, NHS Employers and the Department of Health. It celebrates the best healthcare employers to work for in England. Hospitals register to enter, they are then given a questionnaire to give to staff. The questionnaire asks staff about the ups, downs and particulars of the place they work. The completed questionnaires are then returned to the Healthcare 100 organisation and the results are collated to determine the top employers. The Whittington was delighted to hear we were in the top 20 this year. A dinner was held in July for the top 100 organisations where the overall winner was announced. The Whittington would like to thank its staff for filling in the survey and helping us achieve a successful application.

THE ANNUAL REVIEW 2009–10 13 training for the front line

The simulation centre

imulation is an ever developing and Excellence in State of the art increasingly vital part of training simulation training facilities Sfor doctors and nurses. For a long time there has been the use of simulation ddressing over 50 professionals he six month project was instigated training in anesthetics, to ensure doses who came to celebrate the and facilitated by a team of dedicated are suitable for the patient type and Aopening of the centre, Rob Larkman, Tclinicians and The Whittington’s lead in accordance with the medical care chief executive of The Whittington resuscitation officer, Mark Madams, needed. However training of other Hospital, said, “This is a great day for together with Dr Nick Harper. Mark doctors and nurses has failed to provide us. For many years, we have had a explained, “Although we have been as full a regime, due largely to the cost reputation for excellence in training. running ward-based simulation for some involved in simulating advance and The new suite, which contains some time, our new high fidelity simulators difficult procedures. impressive equipment, demonstrates will allow us to expose students to many different scenarios that they may hanks to a large investment not have experienced during programme and a training, such as how to assess Tdetermined drive to improve and treat anaphylactic shock or and increase the training meningococcal meningitis, The facilities available to medical AV technology allows us to deliver students, on Tuesday 15 high quality debrief sessions. December 2009 Dr Patricia Well-run scenarios engage Hamilton, Director of Medical participants in a safe, controlled Education for England, was but realistic environment. Only guest of honour at the opening when we see ourselves on footage of The Whittington Hospital’s from the scenario do we realise simulation centre. Funded by how our actions impact on others; the London Deanery, this hi-tech for instance if we have managed training and assessment facility to keep emotion out of our voices will collaborate with nine other or whether we have worked well simulation centres across the within a team. We are looking to capital to meet the growing demand for our commitment to simulation, to standardise all courses so that everyone is scenario-based training. quality and to innovation.” taught the same way. We are all very excited The centre has full audio visual Dr Nick Harper, The Whittington’s about the advanced level of training that the facilities. It has a simulated operating director of simulation, added, new facility will allow us to deliver.” theatre with the capacity to train “Anaesthetists have been using students on adult and infant patient simulation for some time. We are eager he Whittington’s new simulation centre simulators. It also provides a ward to provide better training for doctors, is dedicated to the memory of Dr setting that includes a neonatal area and midwives, nurses and clinicians. With TRaja Jayaweera, an anaesthetist at The emergency department environment, the funding that we have received Whittington Hospital for over 35 years, who a control room and a large conference/ from the London Deanery, we can now died on 6 December 2009. Dr Jayaweera debrief room. embed simulation training within the was a charismatic and inspirational At the opening Dr Hamilton said curriculum to enable teams to practise teacher of national renown and a vigorous that the time had come for simulation common and uncommon procedures advocate of simulation training. His to move forward. It has huge potential such as cardiac arrest, trauma, lumber daughter, Dr Ramanie Jayaweera, herself for improving the confidence and punctures, laparoscopic surgical a Sydney based anaesthetist – kindly competence of trainees and doctors and techniques and so on. Using simulation, attended the launch ceremony. improving patient safety – particularly we can help improve the management Illustration by Maria Megroff in emergency situations of a wide range of complex situations.” Photo by SIRA Studio 14 THE ANNUAL REVIEW 2009–10 The simulation centre provides the opportunities to practice difficult procedures in a safe environment with realistic mannequins, pictured.

THE ANNUAL REVIEW 2009–10 15 portfolio

The NHS Constitution  Access Medical report  Quality of care and environment illness, like medicine, he NHS Constitution was first  Nationally approved treatments and is ever evolving published on 21 January 2009. It was drug programmes Tone of a number of recommendations in  Respect consent and confidentiality ast summer H1N1, also known Lord Darzi’s report ‘High Quality Care  Informed choice as swine flu, gripped the nation, for All’ which was published on the 60th  Involvement in your healthcare and Lvaccines were mass produced as the anniversary of the NHS and set out a 10 in the NHS world prepared for a virus that was an year plan to provide the highest quality of  Complaint and redress unknown entity. care and service for patients in England. The Whittington staff were encouraged The NHS Constitution brings together Within the ‘staff’ section there is to take up the vaccine and led by great in one place for the first time in the a series of rights and pledges, steered example, having had the second highest history of the NHS, what staff, patients by four overriding principles, the four uptake in London with approximately and public can expect from the NHS. principles are: 80 per cent of staff having a vaccination. From 19 January 2010, following There was an intensive campaign asking the successful passage of the Health Act  Having the resources to deliver staff to protect their patients, families and through Parliament, all providers and quality care themselves by taking the vaccine and the commissioners of NHS care are under  Having the support necessary to do seasonal flu vaccine as well. We even a legal obligation to have regard to the a good job held a BBC Radio London broadcast NHS Constitution in all their decisions  Feeling that their job is worthwhile live from the hospital and dedicated and actions. with chances to develop a part of the show to answering calls This means that the Constitution,  The importunity to improve the way from members of the public who were its pledges, principles, values and staff work concerned about the possible side effects responsibilities need to be fully embedded of the vaccine. Our director of nursing and ingrained into everything the NHS and clinical development at the time, does. This duty also covers Monitor and Deborah Wheeler, was on hand to offer the new Care Quality Commission. advice and comfort to those who were The Government has a legal duty to unsure of the vaccine and similarly renew the Constitution every 10 years. No scared about the flu itself. Government will be able to change the As well as managing the swine flu Constitution, without the full involvement outbreak very well, infection control as a of staff, patients and the public. whole has improved this year: The constitution is made of two parts, ‘patients and public’ and ‘staff’. Within  The number of cases of MRSA ‘patients and public’ there are seven bloodstream infections has reduced groups of pledges to uphold, these are by just under 60 per cent, from 23 the following: cases in 2008/09 to eight cases in 2009/10.  Cases of C difficile dropped from 65 cases in 2008/09 to 49 in 2009/10.

16 THE ANNUAL REVIEW 2009–10 patient experience

hen people are sick a hospital has offices into a single centre to make it range of feedback that we receive. This a duty to care for them. Whether easier to respond to patient enquiries about patient feedback is then shared with all Wthe care is short term, an emergency bookings. We have introduced evening the relevant staff. or ongoing, The Whittington wants its bookings where hospital staff telephone patients to have the best experience patients who have been referred for an As we gather this valuable opinion and possible. To this end, the organisation has appointment or a test and agree with them feedback, we can then identify themes a set of pledges called The Whittington a suitable date for this to happen. Similarly and areas for improvement in the year promise, which states: we have linked some special tests with ahead. The patient experience is fed in follow-up appointments. For example if to the Trust Board at their meetings and  We will be clean a patient has been seen in the orthopaedic from patient surveys and we have the  We will be welcoming and caring clinic and requires a MRI scan we can now local LINK representative at every Trust  We will be organised book the scan on a day that suits them and Board meeting so the information goes  We will offer the best possible then ensure that they have an appointment across the entirety of the hospital. The treatment back in the clinic to discuss the result within Whittington is committed to serving our  We will give you information and two weeks of the scan. patients, so filling the electronic surveys listen to what you tell us. provides a quick and easy way for patients Birth centre to influence the services they receive. The feedback received from patients is really important in helping us improve our User feedback has shaped the Surveys services. We listen to formal and informal development of our maternity services feedback including both local and national through direct patient involvement in In 2009 The Whittington carried out patient surveys, complaints and messages our labour ward forum, our antenatal its annual internal patient survey. The via our website and NHS choices. We screening committee and midwifery results were extremely positive and have a number of methods and initiatives liaison committee. User views were key showed 67 per cent of our patients trusted in place to try and make The Whittington in developing our midwifery-led Birthing and had confidence in our nurses and 75 a safe and caring organisation. Unit that opened last year and has proved per cent trusted and had confidence in The public march in support of The very popular. our doctors. Whittington emergency department in Seventy nine per cent of our patients early 2010 showed the value placed Extending the range felt they were treated with dignity and on the hospital’s services by its local of feedback respect and 54 per cent said they were community. involved in decisions about their care. Since 2009 we have turned to patients Overall 78 per cent rated their care as Patient safety for advice and feedback on our services very good or excellent. wherever possible. We have electronic The inpatient survey is of great benefit Patient safety is The Whittington’s kiosks and hand-held screens that enable as it can highlight potential causes for priority. We have made a significant patients on wards, in clinics and in the concern, which we can then address as investment in providing a new electronic emergency department to give feedback quickly as possible. incident reporting system called Datix. to us to help us improve our services. It allows staff to record and report any They can be used in languages other than Patient information incidents or risks in real time so the English and with iconography so they leaflets responses can be instantaneous. This can be used by those with limited literacy system will improve the level of patient such as children. So far more than 5000 In the last year we have extended the safety The Whittington provides. people have completed these short range of information leaflets that we surveys and this has helped us to make provide for patients and updated those Bookings and access changes such as improving cleaning already existing. They are now available schedules in public areas. on our intranet so they can be printed New access centre and linked As well as this, our director of primary off where they are needed and given to appointments: over the last year we have care has held a series of focus groups patients to support the information they joined our admissions and appointments with patients and carers to widen the have been told by the doctor or nurse. THE ANNUAL REVIEW 2009–10 17 Enhanced recovery programme As part of the improved surgical pathway goal, as a priority we aim to expand our enhanced recovery programme for patients having operations at The Whittington. We have already done a lot of work on this for patients having bowel cancer surgery. Using the latest evidence-based techniques we have been able to reduce average length of stay for patients having bowel cancer surgery by five days over the past two years, allowing our patients to leave hospital earlier and fitter. Our length of stay for people having some forms of bowel cancer surgery is now the second lowest in London and in the top 20 NHS Trusts nationally, with no increase in readmission rate. Our enhanced recovery nurse coordinates our multidisciplinary pathway. Elements of the pathway include using minimally invasive surgery wherever possible, and controlling the intravenous fluids administered based on how the patient’s heart is functioning. For some specialist areas such as bariatric 1. We will work to increase the number Over the year ahead we plan to spread surgery and bowel cancer surgery we are of patients who feel involved in the Enhanced Recovery techniques developing DVD or web-based visual decisions about their care. to help people to get better sooner material to improve patient information. following orthopaedic surgery. We have When new clinical guidelines are agreed 2. We plan to implement the dementia just been awarded a grant from the we ask that a patient information leaflet is care pathway recommended by NHS London Innovation fund to lead produced to go with each of these. Healthcare for London. a project promoting enhanced recovery Making difficult decisions: there programmes across North-Central are many potentially difficult decisions 3. We are introducing a more London. that need to be made about the care of systematic approach to learning patients in hospital. We have an active from patient feedback. clinical ethics committee to provide advice and guidance at such times. This Improved surgical committee includes Helena Kanier, a pathways member of the LINKs organisation. For patients who need support to take The Whittington is constantly looking decisions about their own care we have a to improve the patient experience by patient advocacy and liaison service and reducing the amount of unnecessary time where patients do not have the capacity patients remain bed bound around surgery. to decide for themselves we have well- There is already the day treatment centre established links to independent mental for routine and pre-determined procedures capacity advisors. where patients can be operated on in the In the coming year we have three more morning, and be back at home with their priorities to improve our services: loved ones later the same day.

18 THE ANNUAL REVIEW 2009–10 Core services Maternity services

The Whittington’s maternity services have had an excellent year. In a recent survey carried out by Islington primary care trust The Whittington’s maternity services received the highest number of positive ratings for the care of pregnant women provided, with one hundred per cent of surveyed mothers stating the treatment they received was excellent. In particular, the survey points to The Whittington’s strengths in providing choice to patients through alternative antenatal and postnatal care options.

emergency department

This year, statistics produced by NHS London rated The Whittington’s emergency department fourth within London’s 25 emergency departments. Working together These statistics come from various skilled support and motivation from their targets and criteria being monitored, Providing services that can react clinicians and healthcare systems that such as seeing patients in the emergency to the changing needs of people with operate very differently from those we department within a four hour waiting long-term conditions creates enormous have today. target. The Whittington is delighted that challenges for health services, however The programme is an innovative to be placed so highly, in recognition of many people are ready to take a more scheme that joins together both primary the ongoing excellent services provided. active role in their own care. This and secondary care services; and can be gained by patients working clinicians and patients. The children’s in partnership with their clinicians to The focus locally of the co-creating emergency department achieve lasting improvements in their health initiative is type 2 diabetes and health. This is what we mean by ‘co- achievements to date include: Since its opening in 2008, the creating health’. Studies have shown paediatric emergency department has that patient collaboration with clinicians  Measurably significant reductions been a very popular service. In January improves patient outcomes. in HbA1C and LDL cholesterol in 2010 an internal survey was carried out The co-creating health initiative patients participating in the self on the patients treated in the department. aims to transform healthcare for people management programme. The age group was one to 16 year olds with long-term conditions. Through  Eighty nine per cent of clinicians - in relevant cases parents and guardians this initiative, The Health Foundation is who have attended the advanced were asked to help distinguish an answer supporting a partnership between The development programme agree that – and 100 per cent of patients said they Whittington Hospital NHS Trust, NHS they have significantly improved would recommend The Whittington to a Islington and NHS Haringey, along with their knowledge of how to support friend. other ambitious healthcare organisations patient self-management. from across the UK, to create new  Monthly measurements are models of healthcare that promote self- demonstrating improvements in the management across health services. percentages of consultations where a To take a more active role in their care planning consultation is taking health, people need self-management place, with increases of recorded skills and easier access to information collaborative agenda setting, goal about their conditions. They also need setting and follow up goals. THE ANNUAL REVIEW 2009–10 19 Are we there yet? Ensuring the best Waiting times

ithin waiting times there are two treatment principles people really care Wabout. Firstly, if I have an emergency n accordance with much of the friendly and works well, good healthcare and need to be seen in the emergency discussion that has been had in this can be incredibly simple. This article department, how quickly will I be seen? Iyear’s annual review, an ability to work cites a series of core principles that Secondly, if my GP refers me to hospital efficiently and provide a good service is people look to in assessing exactly how for treatment, how long will I have to what people want. If a hospital is clean, good a hospital is. wait to start treatment? his year, The Whittington has fully met its Care Quality Commission Ttargets of treating patients within 18 weeks from their referral from a GP. This year also saw 98 per cent of patients attending our emergency department treated within the four hour target. We work hard to meet our mantra of ‘end waiting, change lives’.

Swift recovery length of stay

hilst in some cases it is necessary to stay in hospital for a prolonged Wperiod, in general, if treatment can be given at home or patients sent home as soon as they feel comfortable and confident enough to do so, they will recover quicker, benefitting from the familiar surroundings a home provides. Obviously not all patients have suitable home support structures and we work hard with our social care department to protect vulnerable patients. However, as in our birthing centre, problem free births can be delivered in a luxury birthing unit and mothers are free to leave merely hours after the birth if they feel up to it. In principle the less time people spend in hospital, the better. We are working hard to reduce the length of stay at our hospital. We are working through an exciting series of opportunities with NHS Islington and Haringey to bring around increasingly preventative approaches. We can work with their primary care providers to create a series of treatment routes, education and integrated care plans that start much earlier, so patients don’t turn up to the emergency department worried 20 THE ANNUAL REVIEW 2009–10 about their health unnecessarily. requiring nutritional intervention is We plan to provide as much healthcare presented with a dietary action plan. outside of the hospital as is reasonably We are very proud that staff from our possible; GP practices will stay open nutrition and dietary team are often later, telephone advice lines will be more asked for comment by the BBC on the widely advertised and urgent care centres relevant stories of the day. introduced to provide initial assessment for patinets with injuries or conditions that Where to turn present severely distressing symptoms. patient advice and The Whittington is eager and excited to liaison services (PALS) bring together a complete, preventative system of healthcare for our community. ALS advisors act as a liaison between patients and healthcare professionals A sense of decency Pand most concerns are dealt with on the privacy and dignity same day that they are raised. In 2009/10 the PALS team dealt with 1,381 clients. atients being treated in hospital feel Pvulnerable enough. Even when Speaking your mind receiving serious treatment, patients are compliments and aware of their environment and those complaints around them. Not feeling like you have all visitors are asked to adhere to the enough privacy can add to the distress infection control messages, washing atients are encouraged to leave of your illness and wherever possible, their hands and using the gel provided. feedback, we are constantly The Whittington enforces single sex Pproviding new ways and campaigns to accommodation. Time to eat gain patient and visitor feedback as we To help fulfil this duty to our patients, protected meal times turn toward a patient led review system. The Whittington has invested a large Compliments and complaints are a large sum of money, £1.2 million, to create ating well, and without distractions, part of our work as they help us develop single sex accommodation (Trust Board improves patient recovery. Our our services. There were a total of 365 declaration). This ensures that, unless it Epatients are assured a set time each day complaints in 2009/10. is clinically unsafe to do so, all patients to enjoy their meals without interruption Our complaints procedures are fully are seen and treated within single sex from other ward activities. compliant with the Principles for Remedy accommodation across the hospital. Patients who are identified as needing guidance published by the Parliamentary The provisions are in place and our staff assistance with feeding at meal times are and Health Service Ombudsmen in well trained to provide for this need. allocated a colour-coded tray to ensure October 2007. Throughout the hospital we are dedicated they receive help with eating their meal. to improving patient privacy and dignity The director of nursing and the director International across all services. of facilities sample patient meals on the relations ward once a month to monitor the standard translation services Rallying the troops of food that is offered at The Whittington. visitors and visiting he Whittington serves a large Eating the right thing Tpopulation of ethnic communities, he presence of family and friends can food and nutrition including Turkish, Chinese and Spanish help provide comfort and support to communities amongst many others. Tpatients. Therefore those wishing to visit atients’ nutritional needs are of the Services are made available for patients their loved ones are welcome to do so. highest priority – nutrition is crucial who would like a translator to accompany Different wards have different visiting Pto our patients’ wellbeing. Catering, them for their appointments. hours and some even have rules on what nutrition and other multi-disciplinary Some Whittington publications are not to bring and how many people may teams work with all ward staff including available to the public in their preferred be present. However, if someone who nurses, doctors and care assistants. language, as well as in Braille. is unwell is thinking of visiting they are Patients are screened within two asked not to come to the hospital and days of their admission and any patient Photos by Maryvonne Arnaud THE ANNUAL REVIEW 2009–10 21 Care of Older People Fundraising Appeal

aunched in April 2009, The annual report Whittington Hospital Care of LOlder People wards appeal was Structure, Governance and Management assigned to raise £100,000 to cover monitoring equipment, rehabilitation The Board of the Whittington The fundraising team has worked resources and social recreation and Hospital NHS Trust as corporate particularly closely with the family facilities. trustee of the charitable funds finance department this year on Our fundraising approaches is accountable to the Charity strengthening the policies and Commission. In 2001 The procedures for fundraising on included wonderful support from the Whittington Hospital Medical and off site. Friends of the Whittington Hospital, Education Charitable Fund, the Kirby Laing Foundation and others which had been a separate entity, In addition to managing general such as the University of London was brought under the same and departmental funds, the Lodge, Tesco Charity Trust and the trustees as the main funds. The fundraising team co-ordinates Inman Charity that have funded medical education funds are a single fundraising appeal for a specific equipment for the wards. primarily for the advancement of specific purpose. These appeals Event fundraising raised more than facilities for medical education, have included over the years the furtherance of medical successful fundraising campaigns £42,000 in all, with people running, education and research, and for the neonatal intensive care singing and even cat-walking in aid of the dissemination of associated unit, imaging equipment, facilities the Care of Older People appeal. The results. for thalassaemia patients, cancer London Marathon in 2009 raised over information services and most £18,000 in sponsorship and this year’s The Trust’s finance department recently the refurbishment and marathon is set for the same success. provides accounting services equipping of Whittington’s elderly The fundraising team organised a and investment management care wards. Whilst this is of benefit fashion show in conjunction with is delegated to professional to the wards and departments advisers. The annual accounts which are focused upon, it has LaLesso clothes and was held at Flutes are audited by the Trust’s meant that the value of the general Bar and Restaurant in Highgate. The external auditors (the Audit fund has diminished as donated event made over £1,000 - we shared Commission) and approved by income has tended to be directed the night with a developmental African the Trust Board. The audited towards the current appeal. charity. Other sporting events such as annual accounts, which are the Highgate Fun Run and the British submitted to the Charity A committee of the Whittington 10k London Run raised the great sum Commission, are available on Postgraduate Medical Education of £11,500 in sponsorship. request. Summaries of income, Centre manages the funds expenditure and movements in relating to postgraduate medical It has achieved the original £100,000 balances are shown at the end education funds separately. target that it set out to raise, but the of this report. appeal will continue to fundraise in order to prepare for the expected move of the elderly day hospital, which is currently on level six and will be moved to the ground floor level opposite the Jenner exit which will be far more accessible for day patients. Dr Barry Hoffbrand is now the chair of the fundraising committee. The local community has welcomed the appeal to care for our local elderly people and we were overwhelmed with the support we have received. We received ‘in memoriam’ gifts from the family and friends of Brendan Nolan, who was a well-known figure in 22 THE ANNUAL REVIEW 2009–10 Other appeals: Highgate. We were bowled over with appeal for the Care of Older People The Oasis Sensory the fantastic £18,000 which was raised Unit raised £95,000, gross, in 2009/10. Garden for the Care of Older People appeal Many other departmental funds have and for Coyle ward. The money will be been active in fundraising during the drawn down over the next few months year, notably the Paediatric Oncology to purchase monitoring equipment Fund which received £22,000 during and furniture which will make the 2009/10. wards feel more comfortable. Other gratefully received donations from Expenditure friends and relatives from deceased patients include donations given in Expenditure on charitable activities memory of Muriel Jean Barwick and and income-generating activities was Margaret Georgiou. £596,000, compared to £610,000 in fter consulting with 120 people, 2008/09. The major items of charitable the idea of creating a new garden Donations above £1,000 were received expenditure this year have been an Ain place of the old tennis courts became from the following: echo machine for the cardiology very popular and Groundwork, the department, funded from the Gladys environmental charity, is now on board Friends of the Embery Bequest, The Whittington with helping us plan, fundraise, develop £10,000 Whittington cat sculpture at the Magdala Avenue and eventually construct the ‘Oasis’ entrance, funded from donations made sensory garden for all to use. Garfield Weston £3,000 to the Art Fund by Jarvis and WFL, The benefits of the green space would Foundation and further equipment purchased for be to create a place of calm for patients, Kirby Laing the neo-natal unit from the Building visitors, staff and the wider public, in £5,000 Foundation for Babies Fund. addition to being an area which can have Governance costs were £58,000, an input from child and adult patients as Tesco Charity Trust £2,128 down from £63,000 in 2008/09. well as from the local community, making Inman Charity £2,240 it into a place which is enjoyed by all. Brendan Nolan Investment losses The fundraising is underway to make £15,312 Memorial the idea a possibility – we need to find Over the course of the year, the £120,000 to cover costs of clearance University of London £1,250 value of the charity’s stocks and and site preparation, resurfacing, garden Lodge equities investments portfolio rose by furniture, plants, trees, artworks and we Pilkington Trust £2,000 £129,000 taking its value back to the hope to be able to show off the garden in equivalent of its March 2009 level. early 2012. M&S Holloway Road £2,733 £105,000 cash has been withdrawn from the investment holdings The Future during the year, to meet cash flow Income and expenditure requirements, predominantly this oth patients and staff are extremely Overview of the relates to the Postgraduate Funds, Bfortunate to have the benefit of the 2009/10 Year which over the past three years have charitable funds to enable the provision incurred £141,000 net outgoing of facilities and benefits that would not resources. otherwise be available. Income Since both our funds and appeals rely Fund balance on the generosity of those wishing to In total, incoming resources were support the hospital it is very much hoped £348,000 in 2009/10 - £86,000 lower At 31 March 2010 the fund balance that those who receive this report will be than in 2008/09. totalled £801,000 at the market value of encouraged with others to donate. This Although the Building for Babies investments. will enable the charitable funds to help Appeal formally closed in December The Whittington to continue to provide 2008, income has continued to be the highest standards of care to its patients received for the neo-natal unit - The statement of financial activities and visitors as well as the best possible £109,000 in 2009/10. The current and balance sheet are shown overleaf. amenities and support for its staff. THE ANNUAL REVIEW 2009–10 23 Summary of unaudited 2009/10 accounts of the Whittington Hospital NHS Trust Charitable Fund

Summary Accounts

2009/10 2009/10 2009/10 2008/09 £’000 £’000 £’000 £’000 Hospital Funds Postgrad Funds Total Funds Total Funds Summary of financial activities Charitable donations 238 11 249 245 Income from activities 39 38 77 135 Investment income 21 1 22 54 Total incoming resources 298 50 348 434 Charitable expenditure 412 26 438 444 Costs of generating income 76 77 153 156 Governance costs 52 6 58 63 Net outgoing resources (242) (59) (301) (239) Gain/(loss) on revaluation of investments 129 0 129 (129) Fund balance brought forward 768 205 973 1,341 Fund balance carried forward 655 146 801 973

BALANCE SHEET

31 March 2010 31 March 2009 £’000 £’000 Fixed Assets : investments 696 675 Debtors 111 111 Stock 4 0 Cash 101 429 Creditors (111) (242) Net current assets 105 298 Net assets 801 973 Fund Balances 801 973

This Statement of Financial Activities and Balance Sheet are subject to audit.

24 THE ANNUAL REVIEW 2009–10 Outside advice governors and Developing our members staff

Workforce Education and training he Whittington was proud to achieve an Investors in People award for the he Whittington has a strong Twhole organisation in January 2010. Our tradition of excellence in education human resources department provides Tand training. We continue to receive training and support to a high standard. positive reports from the Medical he Whittington continues to recruit In the last national staff survey (2009) 72 School regarding the quality of our patients and members of the public per cent of our staff said they had been undergraduate teaching. Tto become Whittington members. appraised during the year. Ninety nine Twenty two Whittington doctors and Governors and members continue to act as per cent of consultants were appraised nurses received top teacher awards and vital intermediaries between the hospital and set personal development plans one received an Excellence in Medical and the community. The Whittington for the year ahead which puts us in a Education Award from UCL Medical membership started as an initiative to good position in preparing for medical School. support our Foundation Trust application. revalidation with the General Medical In postgraduate medical education our Although the application has been Council. reputation for excellence was confirmed withdrawn for the time being, members by external reports in 2009/10 which still play an active part in contributing Number of doctors 396 showed that The Whittington: to the hospital’s development by means employed of focus groups and patient surveys.  was top in London for overall job Number of nursing and 821 Governors and members are kept up to midwifery staff employed satisfaction for foundation year date and informed through the biannual one medicine and year two surgery Link Extra magazine distributed to all Number of healthcare 250 doctors and fourth in London for 4,000 members. and support staff core surgical training. Our Council of Governors continues employed  was top in London for overall job to play a part in providing community Number of estates and 239 satisfaction for paediatric trainees feedback at Trust Board meetings, support staff employed  in the school of surgery visit in council meetings and trust working October 2009 our orthopaedic Number of scientists 292 group meetings such as our Carbon higher training was described as and allied health staff Reduction Strategy Group and our having a “strong learning culture” employed Clinical Governance Committee. and “not only would all the trainees The Council of Governors will Number of 470 recommend their posts, but a high continue to focus its activities on: administration staff proportion has already asked to employed return to the hospital”  improving access to the hospital Number of total staff 2,468  in the MRCP PACES (postgraduate  actively engaging with, and medical exams) in the past two years involving, a full range of the 12 of 13 trainees at The Whittington hospital’s wider community in We are part of the productive ward passed the exam at their first the work of The Whittington, programme in which more nursing time attempt improving the quality and flow of is freed up for direct patient care and our  in the London Deanery quality information between the hospital nurse to bed ratio is 3:1, the fourth best liaison visit in February 2010 the and the community it serves. in London acute hospitals. In the national visiting team was impressed by the  playing a key role in supporting staff survey in 2009 the trust came in enthusiasm and commitment of and developing positive working the top 20 per cent of all trusts for staff the faculty and had no significant cultures, attitudes, and behaviour recommending it as a place to work or concerns about the education amongst the staff. receive treatment. provision at The Whittington THE ANNUAL REVIEW 2009–10 25 Visible leadership Friends of The Internal Whittington communications

t The Whittington clinical he Friends of The Whittington, ommunicating with our staff is management do their upmost a registered charity, has been a important. The Whittington provides Ato be as visible and central to the Tlong established fundraising body for Ca number of ways through which staff can working day as possible. There are the hospital, it has raised significant communicate with each other and share several ongoing campaigns to ensure amounts of money in the last 10 years messages across the hospital. management and staff continuously by running daily stalls in the hospital, The monthly magazine, The Link, work together across all the great collecting boxes around the area is available online and distributed in services that are provided. and wills and legacies. The Friends hard copy around the hospital, staff The Whittington is also now in its work closely with The Whittington’s contributions are always welcome and fourth year of the visible leadership fundraising office and have helped encouraged. practice, where senior nurses and with recent campaigns such as the The chief executive holds a monthly midwives across the hospital spend Care of Older People drive. briefing session that is open to all. The every Monday in clinical practice. The Whittington is always interested chief executive is more than happy to This allows problems, developments in receiving new volunteers and can talk through the pertinent issues of the and achievements to be shared, face be contacted in the first instance at day and actively seeks to get feedback. to face, so any discussions or actions [email protected] or 020 A summary of the briefing is emailed needed can be dealt with as quickly 7288 5641. to all staff and cascaded face to face and as directly as possible. by managers. There is the ‘on the floor’ initiative, Look after yourself In the last year the communications where members of the trust board work department introduced a chairman’s in front line roles, from reception to the orking at a hospital can be forum, where pertinent topics are emergency department. It is a chance stressful, people don’t control posted online, following suggestions for the directors to experience a range Wwhen they get ill so staff can work all from the chairman, and staff can of roles and to have the opportunity to kinds of hours. It’s important to look respond. The chairman then provides talk to staff and patients alike. after yourself. The Whittington has an answer following consultation with The Whittington wants staff to feel arranged an external company that senior staff and wherever possible, comfortable in approaching senior assessed staff health over six months discussions are developed and actions colleagues, and senior staff need to and made reasonable suggestions on put into place. provide an ongoing presence on the how they can improve their health This has gone one step further floor to ensure the hospital is operating by carrying out small, and the chairman to a high standard. daily alterations to their now meets with staff lifestyle. It doesn’t have in informal coffee Volunteers to be running a marathon, mornings, where staff instead getting off the and the chairman can olunteers are the unsung heroes bus one stop early can just get together and of the hospital. They cover roles help bring about an talk over a hot drink. Vsuch as guiding and come from a improvement in health. The communications variety of social, religious and cultural There are toured walks of office is also available backgrounds. You must be 16 or over the area every Tuesday that to work with any to be a volunteer, however there is no are ongoing, providing a department to help upper age limit. great social opportunity them promote a Currently we have 85 volunteers and the chance to discover the green service or event. This year there and some are fast tracked on to the spaces in the area. have been many positive events such temporary staffing register, providing Similarly a stop smoking clinic has as the opening of a new simulation an effective way into work. If you been running from the hospital for a centre, a strong performance in staff are interested in becoming a hospital year now, offering patients and staff receiving the swine flu vaccine and volunteer you can apply via telephone, alike a chance to kick the habit. Run by many worthwhile information days online or in person at the volunteers’ Julie Browne, the clinic has seen 230 such as heart failure awareness day office based in the hospital’s main people in its first year and continues to and international midwives and entrance. offer people a chance to finally give up. nurses day. 26 THE ANNUAL REVIEW 2009–10 Environmental Service statistics impact Number of hospital 357 he environment and green policies Our screensavers show important beds are at the heart of every business, power saving tips and all staff Number of total staff 2,468 Tgovernment, household and public are asked to always turn off their sector organisation globally. As medicine computers when away from their Total emergency 81,557 and technology are advancing, these desk. As part of our cost improvement department patients advances must be tempered with programme we have a team focused Total adult emergency 62,652 responsibility and consideration for the specifically on energy saving ideas department attendances environment. and green energies. Total paediatric 18,905 The Whittington is working hard to The hospital’s waste for the emergency department reduce its carbon footprint. We have year has decreased by six per attendances maintained our recycling rate of 11.5 cent from the previous year, it is per cent and have brought in policies to currently 732 tonnes. From January Total day cases 17,295 improve our carbon reduction practices The Whittington’s clinical waste Total elective inpatients 2,884 such as regulating the heating to reduce contractor has organised contracts to unnecessary energy usage. The carbon use treated clinical waste as fuel in a Total non-elective 29,957 reduction strategy group continues to waste heat recovery plant. We hope to inpatients meet to discuss ways to reduce carbon divert 80 per cent from landfill to use New outpatient 126,991 usage, including a highly successful in waste heat recovery. Unfortunately, attendances green day at the hospital in 2009 where due to an unexpected increase in Follow up outpatient 244,247 carbon saving methods and technologies service demands, clinical waste has attendances were exhibited at the front of the hospital. increased from 361 to 372 tonnes.

THE ANNUAL REVIEW 2009–10 27 From uncertain futures to staff lunches, the range of activities that go in within and around a hospital often get overlooked by most people. All photos on this spread, except top left, by Matthew Stuart.

28 THE ANNUAL REVIEW 2009–10 The recovery process is hard work, but The Whittington is dedicated to working with and for patients.

THE ANNUAL REVIEW 2009–10 29 Small picture: Our partnership with Asteral allows us to pioneer new services, such as scanner that detects iron levels in the liver in ten minutes, a world first.

30 THE ANNUAL REVIEW 2009–10 Large image: Our day treatment centre allows us to see patients for surgery within a day, Teresita Arrieta is one of the many staff who make our day treatment centre such an excellent place to be treated. Photo: Maryvonne Arnaud

THE ANNUAL REVIEW 2009–10 31 Op eRATINg and financial review

Summary Financial Performance Financial Risk 2009/10 was a successful year for In 2009/10, The Whittington achieved The Trust operates within the The Whittington – the Trust achieved a surplus of £139k, achieving its financial regulatory framework determined by the its financial target to deliver a surplus duty to break even during the year. This Department of Health. Risk management against its break-even duty, and met is the sixth successive year that the is monitored through the Trust’s Board all access targets including the four Trust has made a surplus. In addition, Assurance Framework and risk register, hour Emergency Department target the Trust was one of only three London as described in the Statement of Internal (for which the Whittington was the non-Foundation Trusts to achieve an Control. Directors are members or sixth best Trust in London), 18 weeks ‘Excellent’ score for Use of Resources in attendees of the Trust Board and the referral to treatment, and the cancer 14, the Care Quality Commission’s Annual chief executive, as accountable officer, 31 and 62 day referral to diagnosis to Health Check, published in October has put in place systems that provide treatment targets. 2009. information and assurance for the Trust The Whittington continued to make In 2009/10 all NHS organisations Board, including a significant internal progress towards its strategic goals, were required for the first time to prepare audit programme which reports to the aiming to be the hospital of choice accounts on an International Financial Trust’s Audit Committee. for local people and delivering on the Reporting Standards (IFRS) basis, In addition, as confirmed via the ‘Whittington Promise’ to patients. In which require, amongst other changes, annual letter of representation to the order to check our progress towards for the Trust to report the Private Finance Trust’s external auditors, there is no the promise and ensure we encourage Initiative (PFI) hospital on its balance relevant audit information of which the patients to let us know how we are sheet as its own asset. The adverse Trust’s auditors are unaware. This letter performing, we introduced patient impact of this change is excluded from is signed by the chief executive, the survey electronic devices to all the Trust’s duty to break-even under Finance Director and the Non Executive clinic areas and wards to capture Department of Health guidance. chair of the Audit Committee and has real time feedback from our patients Delivery of the surplus will enable the been agreed with other Board members. regarding their care experiences. In Trust to continue to invest significantly to The full Statement of Internal Control the final six months of 2009/10 we improve its buildings and ensure medical and the letter of representation can be captured over 4,000 patient experience equipment and IT systems are of a high obtained from the Press Office, Jenner feedback surveys, and have made standard. This year the Whittington Building, The Whittington Hospital improvements as a result. Results show delivered a capital expenditure NHS Trust, Magdala Avenue, London an improvement in patient experience programme of £6.9m. One of the main N19 5NF. over the last year. projects in 2009/10 was a refurbishment In 2009/10 we opened our new of a number of The Whittington’s wards midwifery led birthing centre, which has to ensure compliance with new single proved to be very popular with women sex accommodation standards, which choosing to birth at The Whittington. has seen significant improvements in the Our dedicated paediatric emergency hospital environment. department was up and running for the Under IFRS the Trust is required year and saw 18,905 children. This has to revalue its assets on a Modern received very positive feedback from Equivalent Asset (MEA) basis. A review our local community. In preparation for of the Whittington’s buildings and land becoming fully single sex compliant as has resulted in an impairment in the an organisation we refurbished six of accounts of £4.6m. This is excluded our wards, to create single sex space, when measuring performance against toilet and bathroom facilities. the Trust’s break-even duty. Illustration by Maria Megroff

32 THE ANNUAL REVIEW 2009–10 Non-Financial Review Future Developments

The Whittington was formed as a Trust This year we continued to work The Whittington plans to deliver in April 1993. Its aim is to be the hospital on the positive relationships we have a break-even position in 2010/11, of choice for local people, and we actively with colleagues in primary care. We although this will be challenging as the encourage patients and members of the have continued to develop innovative national tariff (under which the Trust local public to join the Trust membership pathways across the interface between is paid for the majority of its patient scheme. This allows patients and the primary and secondary care – in activity) is frozen at 2009/10 levels, public to take an active role in the work of particular Co-creating Health, a national with a further two per cent reduction in the hospital and help the hospital develop initiative strengthening self-management The Whittington’s top-up for being in a closer links with local communities and in diabetes which has shown real benefits high cost area. other healthcare providers in the area. in relation to patient outcomes and patient The Trust is planning a significant The Trust’s experience. We cost improvement programme for the clinical activity also continued to coming financial year, totalling £14.5m. continued to grow develop innovative Two of the main emphases of this in 2009/10 mainly services such programme will be a reduction in the due to increasing as community use of agency staffing and improving market share and anti-coagulation, the efficiency and productivity of the lower than c o m m u n i t y existing staff to accommodate the planned effect dermatology in expected increases in patient activity of PCT demand Islington and that Primary Care Trusts (PCTs) have m a n a g e m e n t Hornsey, and the commissioned from The Whittington i n i t i a t i v e s . development of in 2010/11. 2009/10 saw a 6.8 an osteoporosis There are a number of new per cent increase service in performance measures that will in GP referrals Islington. We are affect the Trust in compared to amongst the first 2010/11 – such as the 2008/09, a two per acute Trusts in commitment to single cent increase in London to win a sex accommodation elective (planned) competitive tender and new national care, and a 7.1 per with a GP practice targets on diagnosis cent increase in the number of babies to deliver the urgent care element of their and treatment of delivered – over 4,000 babies were born GP-led health centre in south Islington cancer – that will at The Whittington (including home (from 1 April 2010) in line with the further improve the births) in 2009/10. The growth in these Healthcare for London strategy. service that the Trust areas is reflected in the increase in the The Trust was also successful in its offers its patients. Trust’s operating income above the level application for registration with the of inflation. Care Quality Commission under new The Trust met its targets for reducing regulation requirements, and has been healthcare associated infections, showing registered without conditions for the excellent progress that has attracted other year ahead. The Whittington was rated hospitals to visit The Whittington as a as ‘Good’ for its quality of care, and site showing best practice in reducing continues to be assessed as the highest these infections. The number of cases level three for the maternity element of of clostridium difficile was 49 against a the clinical negligence scheme for Trusts. target of no more than 92 cases, and we We are one of just a few hospitals in the had just eight cases or MRSA (four of country to receive this rating, which which were pre-48 hour cases) against a means that we are considered one of the target of no more than 15. safest places to have a baby.

THE ANNUAL REVIEW 2009–10 33 Income and Expenditure

The Trust’s main sources of income are service level agreements with Primary Care Trusts and education and training income relating to undergraduate medical students, post-graduate medical students and other clinical staff. Total revenue for The Whittington in 2009/10 was £176.9m, up 6.5 per cent on the previous year. The Income and Expenditure statement shows a surplus before interest and dividends of £591k, with net interest payable of £2.6m and dividends payable of £3.2m, resulting in the retained deficit of £5.2m. The higher interest payable figure is due to the reclassification of part of the PFI charge from operating expenses to interest payable as a result of presenting accounts on an IFRS basis. This accounting change for PFI (£718k) and the impact of impairments (£4.6m) are added back to the retained deficit figure to give a surplus against break-even duty of £139k.

The following table summarises key features of the Trust’s Income and Expenditure performance over the last five financial years.

2009/10 2008/09 2007/08 2006/07 2005/06 £’000 £’000 £’000 £’000 £’000 Revenue 176,853 165,983 153,330 142,389 131,498 Operating expenses (including depreciation) (176,262) (160,445) (148,634) (137,480) (128,738) Surplus before interest and dividends 591 5,538 4,696 4,909 2,760 Other gains 0 1 0 0 0 Net interest receivable/(payable) (2,632) 215 302 291 308 Dividends payable (3,156) (3,816) (3,577) (3,215) (3,048) Retained surplus/(deficit) (5,197) 1,938 1,421 1,985 20 Adjustment for impairments included in retained surplus/(deficit) 4,618 107 0 0 0 Adjustment for impact of IFRS accounting on PFI included in retained surplus/(deficit) above 718 0 0 0 0 Position against statutory break-even duty 139 2,045 1,421 1,985 20

34 THE ANNUAL REVIEW 2009–10 Payment of Creditors

The Department of Health requires that Trusts pay creditors in accordance with the Better Payments Practice Code. The target is to pay creditors within 30 days of receipt of goods or a valid invoice, whichever is later, unless other terms have been agreed. The Trust’s performance, which is measured both in terms of volume and value, is tabled below, with a comparison to the prior year in the second table. The deterioration is largely due to the significant increase in patient activity over and above contracted levels – this additional activity is paid in arrears, leading to a delay in receiving enough cash to pay all creditors within the 30-day target period.

2009/10 performance NHS Non-NHS NHS Non-NHS Payables Payables Payables Payables Number Number £’000 £’000 Total bills paid 5,064 50,163 10,439 52,150 Total paid within target 4,320 33,253 6,252 35,096 Percentage paid within target 85% 66% 60% 67%

2008/09 performance NHS Non-NHS NHS Non-NHS Payables Payables Payables Payables Number Number £’000 £’000 Total bills paid 5,030 46,856 7,083 52,353 Total paid within target 4,673 40,848 6,474 46,501 Percentage paid within target 93% 87% 91% 89%

Staff and Management Costs

The Trust recognises the need to contain its management costs at a level appropriate to the achievement of its service and financial objectives. Expressed as a percentage of income, the Trust’s management costs have decreased over the last year to 4.6 per cent. 2009/10 2008/09 £’000 £’000 Salaries and wages 104,334 97,753 Social Security costs 7,959 7,481 Employer contributions to NHS Pension Scheme 10,199 9,501 Total staff costs 122,492 114,735 Of which: Management costs 8,050 7,736 Management costs as a percentage of income 4.6% 4.7%

Medical and Professional Education and Training

In 2009/10 the Trust received education and training funding of £15.2m (£15.9m in 2008/09) from NHS London. Of this, £8.5m related to undergraduate medical teaching, with a further £5.4m relating to postgraduate medical education and the remainder supporting training in other disciplines. THE ANNUAL REVIEW 2009–10 35 Statutory Financial Respective Duties responsibilities of The Trust met all its statutory financial Full sets of the statutory accounts directors and auditor duties in 2009/10. These are described are available from the Press Office, The directors are responsible for below. Jenner Building, The Whittington preparing the Annual Review. Hospital NHS Trust, Magdala Avenue, My responsibility is to report to you  Break-even duty – the Trust is London N19 5NF (Tel: 020 7288 5983). my opinion on the consistency of the required to break even on its No charge will be made for these. summary financial statement within income and expenditure account the Annual Review with the statutory over a rolling three-year period; financial statements.  External financing limit (EFL) Signed I also read the other information – this determines how much contained in the Annual Review and more (or less) cash can be spent consider the implications for my report by the Trust compared to that Date 30 June 2010 if I become aware of any misstatements which is generated from its or material inconsistencies with the operation. The Trust is required Richard Martin summary financial statement. The other by the Department of Health to Director of Finance information comprises only the Operating maintain net external financing and financial review (pages 32 to 43); the within its approved EFL. Editorial; Trust board contributors; and  Capital resource limit (CRL) Signed Ensuring the Best Treatment. – this determines the amount I conducted my work in accordance which can be spent by the with Bulletin 2008/03 “The auditor’s Trust each year on new capital Date 30 June 2010 statement on the summary financial purchases. Rob Larkman statement in the United Kingdom”  Capital cost absorption duty – Chief Executive issued by the Auditing Practices Board. the Trust is required to absorb My report on the statutory financial the cost of capital at a rate of statements describes the basis of my 3.5 per cent. In other words the opinion on those financial statements. total dividends paid on Public Independent Auditor’s Dividend Capital (PDC) must report to the Board Opinion be 3.5 per cent of average net of Directors of The relevant assets. In my opinion the summary financial Whittington Hospital statement is consistent with the statutory Financial Statements NHS Trust financial statements of the Whittington I have examined the summary Hospital NHS Trust for the year ended The statements that follow are drawn financial statement for the year ended 31 March 2010. I have not considered from the audited statutory accounts of 31 March 2010 which comprise the the effects of any events between the the Trust for the financial year ended 31 Statement of Comprehensive Income; date on which I signed my report on the March 2010. The audit was conducted Statement of Financial Position; statutory financial statements (10 June by the Audit Commission, the Trust’s Statement of Changes in Taxpayers’ 2010) and the date of this statement. external auditors. Their audit fee of Equity; and Statement of Cash Flows. £121,523 related to statutory audit This report is made solely to the Andrea White services. Board of Directors of the Whittington Officer of the Audit Commission The financial statements that follow Hospital NHS Trust in accordance with 1st Floor, are in a summarised form, and may not Part II of the Audit Commission Act Millbank Tower contain sufficient information for a full 1998 and for no other purpose, as set Millbank understanding of the Trust’s financial out in paragraph 49 of the Statement London position and performance. of Responsibilities of Auditors and of SW1P 4HQ Audited Bodies prepared by the Audit Commission. 7 July 2010

36 THE ANNUAL REVIEW 2009–10 statement of comprehensive income for the Year to 31 March 2010 revenue

2009/10 2008/09 £’000 £’000 Revenue from patient care activities 152,029 142,130 Other operating revenue 24,824 23,853 Total revenue 176,853 165,983 Operating expenses (including depreciation) (176,262) (160,943) Operating surplus 591 5,040 Other gains 0 1 Investment revenue 11 245 Interest expense (2,598) (2,460) Other finance costs (45) (47) Surplus/(deficit) for the financial year (2,041) 2,779 Public dividend capital dividends payable (3,156) (3,816) Retained deficit for the year (5,197) (1,037) Value of IFRIC12 schemes included in retained deficit 718 0 Value of impairments included in retained deficit 4,618 107 Capital cost absorption rate (target 3.5%) 3.5% 3.7%

Other comprehensive income

2009/10 2008/09 £’000 £’000 Impairments and reversals (17,255) (10,352) Gains on revaluation 7,461 0 Receipt of donated assets 353 32 Transfers from donated asset reserve (130) (114) Total comprehensive income for the year (14,768) (11,471)

THE ANNUAL REVIEW 2009–10 37 Statement of financial position as at 31 March 2010

31 March 2010 31 March 2009 £’000 £’000 Non-current assets Property, plant & equipment 132,801 148,080 Intangible fixed assets 1,186 757 Trade & other receivables 2,346 2,000 Total non-current assets 136,333 150,837 Current assets Inventories 1,122 1,241 Trade & other receivables 7,089 5,293 Cash & cash equivalents 1,146 3,030 Total current assets 9,357 9,564 Current liabilities Trade & other payables (15,542) (15,635) Borrowings (1,964) (1,676) Provisions (1,424) (562) Total current liabilities (18,930) (17,873) Net current liabilities (9,573) (8,309) Total assets less current liabilities 126,760 142,528 Non-current liabilities Borrowings (38,838) (39,801) Provisions (1,946) (2,033) Total assets employed 85,976 100,694 Taxpayers’ equity Public dividend capital 48,134 48,084 Retained earnings 10,658 16,233 Revaluation reserve 25,904 35,267 Donated asset reserve 1,280 1,110 Total taxpayers’ equity 85,976 100,694

38 THE ANNUAL REVIEW 2009–10 statement of changes in taxpayers’ equity

Retained Donated PDC earnings Revaluation assets Total £’000 £’000 £’000 £’000 £’000 Balance at 1 April 2008 47,258 17,131 45,729 1,221 111,339 Retained deficit 0 (1,037) 0 0 (1,037) Transfers 0 139 (139) 0 0 Impairments 0 0 (10,323) (29) (10,352) Receipt of donated assets 0 0 0 32 32 Transfers from donated assets 0 0 0 (114) (114) New PDC 826 0 0 0 826 Balance at 31 March 2009 48,084 16,233 35,267 1,110 100,694

Retained Donated PDC earnings Revaluation assets Total £’000 £’000 £’000 £’000 £’000 Balance at 1 April 2009 48,084 16,233 35,267 1,110 100,694 Retained deficit 0 (5,197) 0 0 (5,197) Transfers 0 (378) 378 0 0 Impairments 0 0 (17,202) (53) (17,255) Net gain on revaluation of property, plant and equipment 0 0 7,461 0 7,461 Receipt of donated assets 0 0 0 353 353 Transfers from donated assets 0 0 0 (130) (130) New PDC 50 0 0 0 50 Balance at 31 March 2010 48,134 10,658 25,904 1,280 85,976

THE ANNUAL REVIEW 2009–10 39 statement of cash flows for the year ended 31 March 2010

2009/10 2008/09 £’000 £’000 Net cash inflow from operating activities 7,201 8,475 Cash flows from investing activities Interest received 13 260 Payments for property, plant & equipment (6,969) (7,374) Proceeds of disposal of assets held for sale 0 4 Payments for intangible fixed assets (369) 0 Net cash outflow from investing activities (7,325) (7,110) Cash flows from financing activities Public dividend capital received 50 826 Capital element of finance leases and PFI (1,810) (1,676) Net cash outflow from financing (1,760) (850) Net increase/(decrease) in cash & cash equivalents (1,884) 515 Cash & cash equivalents held at beginning of period 3,030 2,515 Cash & cash equivalents at end of financial year 1,146 3,030

40 THE ANNUAL REVIEW 2009–10 Remuneration Report

Salary and pension entitlements of senior managers, who held office during the year ended 31 March 2010, are detailed below.

2009/10 2008/09 Salary as Salary as director director Name Job title (bands of £5,000) (bands of £5,000) Non-executives Mr Joe Liddane Chairman 20-25 20-25 Mr Robert Aitken Non-Executive Director 5-10 5-10 Professor Jane Dacre Non-Executive Director from January 2009 5-10 0-5 Mrs Maria Duggan Non-Executive Director 5-10 5-10 Professor Anne Johnson Non-Executive Director to December 2008 0 0-5 Mr Edward Lord Non-Executive Director 5-10 5-10 Ms Anna Merrick Non-Executive Director 5-10 5-10 Ms Marisha Ray Specialist Advisor from October 2009 0-5 0

Executives Mr David Sloman Chief Executive to August 2009 60-65 140-145 Mr Rob Larkman Chief Executive from September 2009 75-80 0 Mrs Margaret Boltwood Director of HR 75-80 75-80 Ms Helen Brown Acting Director of Operations (September 2008-March 2009) 0 40-45 Ms Siobhan Harrington Director of Primary Care and Interim Director of Nursing 85-90 80-85 Mr Philip Ient Director of Facilities 75-80 75-80 Mrs Celia Ingham Clark Medical Director 80-85 80-85 Mr Richard Martin Director of Finance 95-100 90-95 Mrs Kate Slemeck Director of Operations 80-85 70-75 Mrs Fiona Smith (nee Elliott) Director of Planning and Performance 70-75 45-50 Mrs S Sorensen Director of Strategy and Performance (2008/09) 0 45-50 Mrs Deborah Wheeler Director of Nursing and Clinical Development to January 2010 60-65 80-85

Notes The salary figures above represent the 2009/10 financial year and therefore reflect the fact that some directors were only in post for part of the year. The table shows Celia Ingham Clark’s salary as Medical Director. Her total salary in respect of her work for the Whittington was £122,124 in 2009/10 and £145,871 in 2008/09. The prior year figure was restated to correctly account for part-time secondments to other NHS organisations. She undertook a further part-time secondment in 2009/10, thus reducing the element of direct work for the Whittington reflected here. THE ANNUAL REVIEW 2009–10 41 Pension Benefits

Lump Total sum at age accrued 60 related Real Real pension at to accrued Cash Cash Real increase increase in age 60 at pension at Equivalent Equivalent increase Employer’s in pension lump sum 31 March 31 March Transfer Transfer in Cash contribution at age 60 at age 60 2010 2010 Value at Value at Equivalent to (bands of (bands of (bands of (bands of 31 March 31 March Transfer stakeholder Name £2,500) £2,500) £5,000) £5,000) 2010 2009 Value pension and title £000 £000 £000 £000 £000 £000 £000 £000 Mr David Sloman 2.5-5 10-12.5 50-55 150-155 938 714 94 0 Mr Rob Larkman (0-2.5) (2.5-5) 25-30 80-85 574 554 (4) 0 Mrs Margaret Boltwood 0-2.5 0-2.5 30-35 100-105 760 692 34 0 Ms Helen Brown 0 0 0 0 0 227 0 0 Ms Siobhan Harrington 0-2.5 2.5-3 10-15 40-45 253 216 27 0 Mr Philip Ient (0-2.5) (0-2.5) 25-30 85-90 578 524 28 0 Mrs Celia Ingham Clark (0-2.5) (0-2.5) 50-55 155-60 1,040 831 168 0 Mr Richard Martin (0-2.5) (0-2.5) 35-40 105-110 662 604 28 0 Mrs Kate Slemeck 0-2.5 0-2.5 10-15 30-35 178 154 17 0 Mrs Fiona Smith (0-2.5) (2.5-5) 20-25 60-65 327 315 (4) 0 Mrs Deborah Wheeler (0-2.5) (0-2.5) 25-30 85-90 512 471 13 0

Note: The real increase in pension, lump sum (CETV) is the actuarially assessed capital They also include any additional pension and CETV is calculated as the increase value of the pension scheme benefits benefit accrued to the member as a result over and above the five per cent pensions accrued by a member at a particular of their purchasing of additional years index-linked uplift that applied in 2009/10. point in time. The benefits valued are of service in the scheme at their own The reduction in Rob Larkman’s pension the member’s accrued benefits and any cost. CETVs are calculated within the entitlements is due to a correction of prior contingent spouse’s pension payable guidelines and framework prescribed year figures. from the scheme. The pension figures by the Institute and Faculty of Actuaries. The Trust’s accounting policy in shown relate to the benefits that the The real increase in CETV reflects the respect of pensions is described on pages individual has accrued as a consequence increase in the CETV effectively funded nine-eleven of the complete annual of their total membership of the pension by the employer. It takes account of accounts document. As Non-Executive scheme, not just their service in a senior the increase in the accrued pension members do not receive pensionable capacity to which the disclosure applies. due to inflation, contributions paid by remuneration, there are no entries in The CETV figures include the value of the employee (including the value of respect of pensions for Non-Executive any pension benefits in another scheme any benefits transferred from another members. or arrangement which the individual has pension scheme or arrangement) and A Cash Equivalent Transfer Value transferred to the NHS pension scheme. uses common market valuation factors 42 THE ANNUAL REVIEW 2009–10 WAYFINDER for the start and end of the period. The membership of the Remuneration Committee comprises the chairman and all the non-executive directors of The Whittington Hospital NHS Trust. The Committee has agreed a number of key principles to guide remuneration of directors of the Trust.

Signed

Date 30 June 2010

Richard Martin Director of Finance

Signed

Date 30 June 2010

Rob Larkman Chief Executive

The Whittington Hospital welcomes the views of its patients and local community. If you would like to get involved with the hospital or would like further information about this review, please contact:

Deborah Goodhart Head of Communications The Whittington Hospital NHS Trust Highgate Hill London N19 5NF Tel. 020 7288 5983 [email protected] THE ANNUAL REVIEW 2009–10 43 THE WHITTINGTON GIFT COLLECTION

Why not support the Whittington by purchasing an item from our high quality gift collection, some of which is pictured below. All proceeds go towards supporting our invaluable work. Available at our regular stalls at the hospital entrance or via our online shop at www.whittington.nhs.uk/onlineshop

Carrier bag tidy: £5.00 Cat amongst the pigeons mug: £10.00 Copper etching: £180.00

Tote bag: £4.00 Royal Northern Hospital history book: £5.00 Hairbrush: £3.00

Tea towel: £3.50 Fob watch: £10.00 Trolley token: £2.00

For full details and ordering information please visit our online shop at: www.whittington.nhs.uk/onlineshop