Chesterfield Royal Hospital NHS Foundation Trust: Annual Report And
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33333333333333333333333333333 Annual Report and Accounts 2019/20 Chesterfield Royal Hospital NHS Foundation Trust Annual Report and Accounts 2019/20 Presented to Parliament pursuant to Schedule 7, paragraph 25(4) (a) of the National Health Service Act 2006 ©2020 Chesterfield Royal Hospital NHS Foundation Trust This document contains the following reports: Annual Report and Accounts 2019/20 Including the statement of the chief executive’s responsibilities as accounting officer and the annual governance statement Financial Accounts and Statements 2019/20 This page is intentionally blank This page is intentionally blank This page is intentionally blank Page |AR 6 Contents Annual Report AR1 – AR159 Our Vision and Values AR9 – AR10 Chair and Chief Executive’s Statement AR11 News Round-Up AR15 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 Derbyshire Support and Facilities Services AR27 Going concern disclosure AR28 Performance analysis AR30 Key performance measures and performance of the Trust over the year AR30 Environmental, social, community and human rights matters AR39 Post financial year-end important events affecting the Trust AR50 Overseas operations AR50 Accountability Report AR51 Directors’ report AR51 Directors of the Trust AR51 Directors’ responsibility for the annual report and accounts AR52 Cost allocation and charging guidance AR52 Political donations AR52 Better payment practice code AR52 Financial disclosures AR53 Page |AR 7 Quality governance AR55 Other disclosures in the public interest AR58 Governance of the Trust AR60 Board of Directors AR60 Council of governors AR78 Membership AR92 Remuneration report AR98 Annual statement on remuneration AR98 Senior managers’ remuneration policy AR98 Annual report on remuneration AR108 Staff report AR111 Staff analysis AR111 Sickness absence data AR114 Staff policies applied during the year AR114 Staff survey results AR117 Expenditure on consultancy AR125 Off-payroll engagements AR125 Exit packages AR126 Code of governance AR131 NHSI Single Operating Framework AR136 Statement of the Chief Executive’s responsibilities as Accounting Officer AR137 Annual Governance Statement AR141 Page |AR 8 Page |AR 9 Page |AR 10 Chair and Chief Executive’s Statement Right now, in the midst of the Coronavirus (COVID-19) pandemic, it almost feels as though the rest of the 2019/20 financial year didn’t happen – or at least we can’t remember much about it. In reality of course, lots happened in the Trust and we mustn’t miss the opportunity to reflect on the last twelve months, which as always have proved to be a mix of successes and achievements, alongside challenges and disappointments. Our annual report provides an honest account of all of these – albeit in a slightly different format to the one you would normally see. COVID-19 has impacted many aspects of the NHS, including some of its usual governance arrangements like the annual report. Even so, we hope the information on these pages provides you with an opportunity to get a feel for this ‘year in our life’ and what it’s been about. We start our statement by commending our 4,200 staff. They do an incredible job across our hospital, community bases and GP surgeries. Throughout the year they have shown true commitment and dedication to duty, providing exceptional care to our patients in circumstances that have not always been easy. Like many other Trusts, we have felt the pressure of demand – caring for a growing number of people in our communities with a range of underlying and long-term health conditions. In addition, COVID-19 has tested us all – throwing up unprecedented challenges. Everything we do here is a collective effort though – with each member of staff contributing something to our end results. We value and appreciate everything they do to provide the best possible care and services, role modelling the values and principles we all aspire to through ‘leading the Chesterfield Way’ and making sure we look after one another, as well as our patients. Thank you never seems to be enough - and can never be said often enough either. Nevertheless, on behalf of the Board of Directors we would like to place our THANK YOU to staff on record. We would also like to thank colleagues from a host of partner organisations, along with our governors and our volunteers. Their invaluable support, encouragement and constructive critique are equally valuable and welcomed. This year we were delighted to be awarded a ‘highly commended’ second place in the Health Service Journal Awards – prestigious recognition in the NHS. What made it special was the fact that it was given in recognition of our staff engagement journey. In just three years we have transformed how we enable every member of staff to get involved in improvement – believing that, with the right tools and support, ‘anyone can bring an idea to life’. We’ve set up an improvement academy – a ‘one-stop shop’ where any colleague can seek - and receive - advice and help. We’ve used the principles of Listening into Action and Quality Service Improvement and Redesign (QSIR) to train, develop and educate. Our programmes and improvement forums are accessible to all. It certainly translated into another successful NHS staff survey result in 2019 – with an impressive 72% of our staff contributing to the national fact-finding exercise* to give us real insight into how people feel about working for the Trust and in the NHS. Our pledge to deliver staff- led change has brought about a real shift in our culture. The Board remains committed to this approach and through our People Strategy – staff engagement, leadership, learning and building our workforce remain key priorities for the coming year. Page |AR 11 As you read through the pages of this report you will see how this approach has paid dividend. The news round-up section reveals a host of stories that illustrate how staff have given our patients an even better experience. Not all ideas have to be large-scale and complex. A new patient menu – created with patients, visitors and colleagues – has really made a difference, catering for all tastes and dietary options. With just a few simple changes there have been big improvements, with positive feedback for both the meals and the choices on offer. On the other side of the coin we have implemented some significant technological improvements – including hand held devices to record patient observations (E-Obs) and virtual out-patient appointments. These had an immediate impact, with E-Obs alerting medical and nursing staff to deteriorating patient conditions; and over the phone consultations a preferred choice for many patients. During the COVID-19 pandemic we have maintained routine out-patient appointments using this new technology – with up to 86% of appointments carried out virtually. We will be looking to harness these sorts of improvements in the coming year – as we recover and restore services to a ‘new normal’ – where the challenge for us will be to provide timely care, whilst meeting social distancing and other government measures designed to keep people safe in the healthcare environment. In the performance section of this year’s report you’ll see that once again finances and operational delivery have provided some challenges for us. At times it’s been difficult to balance these against our desire to strive for high standards of care and an exceptional patient experience - and this year, as a Board, we took decisions to invest in some services to maintain both. As a consequence – and as a result of COVID-19’s impact on our activity in the last quarter of the year – the Trust ended 2019/20 with a £1.7m deficit against its re-forecast to break-even (which the Trust made as part of its Q3 return to NHSI), but due to impairments, showed a £1.5m surplus in our statutory accounts. With a new way of funding the NHS now in place, to support Trusts through COVID-19, we are getting used to a block contract. This financial year we will need to examine how this approach could impact the Trust and if it brings any additional risks to our organisation. Operationally, whilst we’ve not met some of the national performance standards this year – including the four-hour wait in A&E - we are pleased that our patients have still found their experience to be a good one. Whilst there is no Quality Report to share with you at the moment (the deadline for this is extended) our Friends and Family Test results throughout the year have shown high levels of satisfaction. Some areas of the hospital have a 99% recommendation score and we’re pleased that so many of our patients would recommend us to others for the care and treatment we provide. The views of our patients, their family members and our staff are really important to us – and so are the views of our regulators, including the Care Quality Commission (CQC). Last year our Royal Primary Care Services led the way in attaining GOOD ratings. All of them – eight surgeries looking after around 40,000 patients – are rated the same, providing assurance to services users. In August 2019 the CQC also held an unscheduled inspection in our Emergency Department, highlighting a number of issues relating to the environment that required immediate improvement action. Some of these were resolved within 24 hours – and all issues were completed a few short weeks later. A planned inspection of four core services then took place in February 2020 and whilst the well-led element of this could not take place in April (because of COVID-19) we were still awarded a rating. This was revealed in May and we were both pleased – but not surprised – to learn that we had maintained an overall score of GOOD.