Annual Report and Accounts 2018/19
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University Hospitals Bristol NHS Foundation Trust Annual Report and Accounts 2018/19 University Hospitals Bristol 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 University Hospitals Bristol NHS Foundation Trust 4 | University Hospitals Bristol NHS Foundation Trust | Annual Report and Accounts 2018/19 Contents 1. Chairman’s Statement .............................................................................. 7 2. Chief Executive’s Foreword ..................................................................... 9 3. Performance Report ............................................................................... 13 3.1 Overview ................................................................................................... 13 3.2 Performance Analysis ............................................................................... 20 3.3 Finance Review ........................................................................................ 24 4. Sustainability Report .............................................................................. 30 4.1 Overview ................................................................................................... 30 4.2 Policies ..................................................................................................... 30 4.3 Performance ............................................................................................. 32 4.4 Modelled Carbon Footprint ....................................................................... 35 5. Accountability Report ............................................................................. 38 5.1 Directors’ Report ....................................................................................... 38 5.2 An Overview of Quality ............................................................................. 50 5.3 Remuneration Report................................................................................ 54 5.4 Staff Report ............................................................................................... 63 5.5 NHS Foundation Trust Code of Governance ............................................ 79 5.6 Statement of Accounting Officer’s Responsibilities ................................... 90 5.7 Annual Governance Statement ................................................................. 92 Appendix A – Biographies of Members of the Board of Directors ................. Appendix B – Contact Details ............................................................................ Appendix C – Quality Report 2018/19 ............................................................... Appendix D – Annual Accounts 2018/19 ........................................................... Appendix E – Independent Auditor’s Report to the Board of Governors ...... University Hospitals Bristol NHS Foundation Trust | Annual Report and Accounts 2018/19 | 5 6 | University Hospitals Bristol NHS Foundation Trust | Annual Report and Accounts 2018/19 8 | University Hospitals Bristol NHS Foundation Trust | Annual Report and Accounts 2018/19 2. Chief Executive’s Foreword During 2018/19, University Hospitals Bristol Ensuring we’re an organisation that works NHS Foundation Trust joined the nation in equally for all staff, irrespective of race, celebrating the 70th anniversary of the NHS. gender, sexual orientation or disability, is a It’s a great privilege to be part of an institution major commitment of the Trust Board. During that symbolises a remarkable public the year, we continued our involvement in the consensus about the kind of caring and Bristol Race Equality Manifesto Leadership inclusive society we want to live in. Group but we also sought advice from the race equality implementation team at NHS Caring for the 11,000 staff who work here England about our own potential to make was top of the four priorities I set for senior faster progress, which has fed directly into leaders in the Trust at the start of the year. It our new plan for improving diversity and is a fundamental principle that our staff inclusion inside the Trust. should feel properly engaged and that their wellbeing and development should be The second of the leadership priorities I set supported. There is now plenty of research for the year was about further improvement in evidence confirming what UH Bristol has the quality of care we give to patients. We demonstrated and should be obvious to us all completed our three-year Sign up to Safety – that staff who feel cared for give the best programme with some remarkable care to others. achievements, including a 50 per cent reduction in the number of adverse events in I was pleased therefore that we saw the the Trust. Working with partners through the number of responses to the NHS Staff Survey West of England Academic Health Science rise significantly to 4,500 employees. I was Network, we also contributed to a major even more pleased to see that our staff reduction in the number of deaths attributable engagement score had increased for the fifth to sepsis across the South West of England. year running and that we performed better than the national average against the great We aim not only to keep patients safe while majority of questions in the survey. To stay they are in hospital but to do so while responsive to the needs of our staff, we held demonstrating the highest levels of care and a number of ‘You said, we did’ weeks to compassion. In February, we launched our share how we’d listened to their feedback and new customer service principles, which were we also introduced a new, improved version developed in collaboration with staff and are of our innovative Happy App, which allows designed to ensure that everyone who comes staff to register their mood at any time and into our hospitals has a consistently positive share matters of pride or concern. The new experience. In early 2019, we also started to version of the Happy App allows me and install new, real time feedback points for senior divisional managers to monitor how patients and visitors, as part of a new well and how promptly local leaders are programme called ‘Here to Help’. responding to the issues raised by their My third leadership priority for the year was teams. about planning better and earlier for the It is the quality of local leadership that will challenges that winter always brings and I am make a continuing difference to the pleased to say that, despite unprecedented experience of staff across the Trust. For the levels of urgent and emergency demand on same reason, we introduced new leadership the Trust last winter, our preparations (which and management training, which is included recruiting additional staff, providing a compulsory for all new managers and will small number of extra beds and reviewing the cover all existing managers in time. This way that different clinical teams work builds on the explicit Leadership Behaviours together) meant that we saw fewer medical we launched two years ago, which patients being displaced into inappropriate themselves derive from our Trust values of wards than the previous year and fewer Respecting Everyone, Embracing Change, cancellations of planned surgery. Recognising Success and Working Together. We were supported in this by the new systems we’ve been introducing as a Global 9 | University Hospitals Bristol NHS Foundation Trust | Annual Report and Accounts 2018/19 Digital Exemplar, one of 16 Trusts in England community services to manage the health of leading the way in the use of technology. As the local population as proactively and as a result, we can monitor the status of every close to home as possible, so that scarce inpatient’s care in our hospitals and react to hospital capacity can be used for delivery of any issues or delays we uncover. Around 200 specialised services to the wider region, as teams are also using a new communications well as for exceptional professional education tool, allowing doctors, nurses and other and leading edge clinical research. healthcare staff – wherever they happen to On the subject of clinical research, I would be in the Trust – to message each other like congratulate our Professor of securely about a patient’s care. Rheumatology Nursing, Sarah Hewlett, who Our electronic observations software – which led a clinical trial ending in 2018 which found allows staff to take and share patient that multiple measures of fatigue in patients observations such as blood pressure and with rheumatoid arthritis can be improved by heart rate using mobile devices – has been in cognitive behaviour interventions. I would place for a year and nearly 40 wards and also like to offer congratulations to Dr Karen 6,000 staff are now using the system to help Luyt, Consultant in Neonatal Medicine at St keep their patients as safe as possible. This Michael's Hospital, who was awarded a is just the start, with more exciting digital Health Foundation Scaling-up Improvement innovations planned this year and next. award of £457,000 for a study known as ‘PReCePT2’ – Prevention of Cerebral Palsy My final leadership priority was about working in PreTerm Labour. PReCePT2 builds on smarter, supporting the efforts of local teams work Karen has led since 2014 on the to eliminate waste and delays and deliver benefits of giving magnesium sulphate to even better value for the taxpayer’s expectant mothers during labour to help investment in our services. reduce cerebral palsy