Annual Report & Accounts 2018 to 2019
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Annual Report & Accounts 2018 to 2019 Chesterfield Royal Hospital NHS Foundation Trust Annual Report and Accounts 2018/19 Presented to Parliament pursuant to Schedule 7, paragraph 25(4) (a) of the National Health Service Act 2006 ©2019 Chesterfield Royal Hospital NHS Foundation Trust This document contains the following reports: Annual Report and Accounts 2018/19 Including the statement of the chief executive’s responsibilities as accounting officer and the annual governance statement Quality Accounts 2018/19 Financial Accounts and Statements 2018/19 This page is intentionally blank This page is intentionally blank AR5 Annual Report 2018/19 This page is intentionally blank AR6 Annual Report 2018/19 Contents Annual Report AR1 – AR155 Our Vision and Values AR9 Chair and Chief Executive’s Statement AR11 News Round-Up AR13 Performance Report AR25 Overview AR25 About the Trust AR25 Chief Executive’s statement on performance AR25 Key issues and risks affecting delivery of its objectives AR26 Going concern disclosure AR27 Performance analysis AR29 Key performance measures and performance of the Trust over the year AR29 Environmental, social, community and human rights matters AR36 Post financial year-end important events affecting the Trust AR47 Overseas operations AR47 Accountability Report AR49 Directors’ report AR49 Directors of the Trust AR49 Directors’ responsibility for the annual report and accounts AR50 Cost allocation and charging guidance AR50 Political donations AR50 Better payment practice code AR50 Financial disclosures AR51 Annual Report 2018/19 AR7 This page is intentionally blank AR6 Annual Report 2018/19 Quality governance AR54 Other disclosures in the public interest AR54 Governance of the Trust AR57 Board of directors AR57 Council of governors AR75 Membership AR90 Remuneration report AR97 Annual statement on remuneration AR97 Senior managers’ remuneration policy AR98 Annual report on remuneration AR107 Staff report AR111 Staff analysis AR111 Sickness absence data AR113 Staff policies applied during the year AR114 Staff survey results AR117 Expenditure on consultancy AR123 Off-payroll engagements AR123 Exit packages AR125 Code of governance AR129 NHSI Single Operating Framework AR135 Statement of the Chief Executive’s responsibilities as Accounting Officer AR137 Annual Governance Statement AR142 AR8 Annual Report 2018/19 Annual Report 2018/19 AR9 AR10 Annual Report 2018/19 Chair and Chief Executive’s Statement As always, when you reflect on the past year, it soon becomes apparent that an incredible amount of work has happened in a twelve-month period. There are always successes to shout about and achievements to be proud of. There are disappointments to address and challenges to resolve. All of these things make up a typical year for the Trust and the annual financial year of 2018/19 has been no different. This report provides an opportunity to see the journey for yourself - and to appreciate how much further we have come towards our ultimate ambition of being an outstanding organisation for all our patients, alongside creating a great place for all our staff to work. We always offer a candid introduction to our annual reports and it’s the same this year. Somewhat of a roller coaster at times, we have some real highs to share with you, coupled with one of the most difficult decisions our Board of Directors has ever had to make since the Trust was granted its Foundation status in 2004. Before we go into more detail though, we wanted to start by recognising the 4000 staff that make-up #TeamCRH – including those working out at our community bases and in the five GP surgeries of Royal Primary Care. The dedication of our staff is second to none. Their commitment to our patients never ceases to amaze us, matched only by the support they show to each other. We truly value each and every one of them for the incredible work they do every day of the year. This year they have faced unprecedented levels of demand, which has proved to be a real test of resolve. All roles make a difference and we’ve tried really hard to make sure our staff know that they matter. A thank you through our Applause programme and simple gestures like coffee vouchers and afternoon tea may only be small, nevertheless we hope colleagues see them as well-meaning recognition for a job well-done. Without our staff we would certainly not be celebrating as much success as we have done throughout the past twelve-months. On behalf of the Board of Directors we would like to say THANK YOU to the entire team – along with colleagues from partner organisations, our governors and our volunteers - for their invaluable support, encouragement and their roles as ‘critical friends’. The annual report, quality account and the financial position we set out in these pages demonstrates the challenges we’ve been up against this year – within an NHS that itself is facing unprecedented demand. The need for urgent care in particular continues to rise, putting strain on our teams, pressure on services and testing our ability to meet national and locally set targets. In the performance section of the report and in our quality account, you’ll see that we haven’t always made the grade against that backdrop, although in many cases we’ve continued to perform relatively well – despite the circumstances. The commitment of clinical and support colleagues to drive through improvement and give our patients the best possible care has been visible throughout a year of daily challenges to keep services flowing. Working hard to do much more, with only a little more investment, mean the relationships we have with health providers, primary care, social care, the voluntary sector, commissioners and others is increasingly important. We know that real integration and co-operation, working together for the benefit of all our patients, service users and communities is vital and we are pleased to see that the ten-year plan for the NHS builds on a duty of partnership. Our part in the Joined Up Care Derbyshire programme and the South Yorkshire and Bassetlaw Integrated Care System will become increasingly important over the coming year – as an integrated approach to care and service provision becomes the expected ‘norm’. The plan also sets out a desire to give health prevention as much prominence as treatment. We are equally keen to be part of developments that give our patients and communities the opportunity to stay well, prevent hospital admission and to self-manage long-term conditions with appropriate support and assistance. This year has definitely revealed how important this is to enable a sustainable NHS that can continue to meet peoples’ needs as close as possible to where they live. There is so much we feel so proud about this year and we hope that after reading this report you will also feel the same way. Our Royal Primary Care (RPC) division is going from strength to strength, serving 30,000 patients from five GP surgeries. Annual Report 2018/19 AR11 At the time of writing RPC was awaiting reports from the CQC that would indicate services moving forward from ‘requires improvement’ to GOOD. That would mirror the hospital’s own favourable CQC assessment, which was a delight to read in January this year. Not only was the Trust and its divisions rated GOOD overall, it achieved OUTSTANDING commendations in the domain of care for both Child & Adolescent Mental Health and End of Life Services. This is another huge step in our journey to achieve the top CQC accolade across all of its fundamental standards. In addition, we’re just as proud of the investments we’ve made to improve facilities on our main site – with an extension to our Emergency Department and a second MRI scanning facility just two examples in a host of capital schemes amounting to millions of pounds. To achieve this in an economically challenged NHS is testament to our strong financial management. Finally, it’s back to recognising staff and their willingness to contribute to our Trust’s future. As we alluded to earlier, our Board took a difficult decision this year – arguable the hardest it’s ever had to make. In July 2018 we opted to create a wholly-owned subsidiary for our IT, finance, estates & facilities, clinical engineering and procurement services. We firmly believed (and still do) that it would safeguard these vital jobs and services from outsourcing, staffing reductions and potential redundancy. Our decision impacted over 700 staff and led to the biggest staff engagement exercise we’ve seen in our history. We recognise that transferring people out of the NHS - albeit with their terms and conditions protected for at least the lifetime of the 25 year initial contract - was incredibly difficult for our colleagues. We have complete respect for the way they contributed to the process and put forward their ideas and suggestions to develop the business case. They also put forward constructive challenge and questioned every aspect of our proposals. When the subsidiary went live at the end of March 2019 it was with the knowledge that they enabled Derbyshire Support & Facilities Services to get off to a great start – even if the principle of subsidiaries remains a much debated topic. They have already illustrated that their new company is responsive to new ways of working and have pledged to give staff a ‘voice on the Board’ with the introduction of three Employee Associate Director positions. This wish to engage and be involved also translated into our most successful NHS staff survey result to date – with an impressive 71% of our staff contributing to the national fact-finding exercise. The final report demonstrated significant improvement in eight out of ten of the themes. We have the best picture we’ve ever had of how staff feel about working for the Trust and in the NHS.