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Annual Report and Accounts April 2019 to March 2020

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Annual Report and Accounts April 2019 to March 2020 Annual Report and Accounts April 2019 to March 2020 Royal Papworth Hospital NHS Foundation Trust Annual Report and Accounts April 2019 to March 2020 Presented to Parliament pursuant to Schedule 7, paragraph 25(4) (a) of the National Health Service Act 2006 Royal Papworth Hospital NHS Foundation Trust - Annual Report 2019/20 ©2020 Royal Papworth Hospital NHS Foundation Trust Contents 1 Performance Report 4 1.1 Overview of Performance 4 1.2 Performance Analysis 20 2 Accountability Report 27 2.1 Directors’ Report 27 2.2 Remuneration Report 40 2.3 Staff Report 50 2.4 Disclosures set out in the NHS Foundation Trust Code of Governance 60 2.5 NHS Oversight Framework 66 2.6 Board of Directors 68 2.7 Audit Committee 75 2.8 Council of Governors 79 2.9 Foundation Trust Membership 88 2.10 Sustainability 90 2.11 Equality and Diversity Report 94 2.12 Statement of Accounting Officer’s Responsibilities 100 2.13 Annual Governance Statement 102 The Quality Report for 2019/20 is to be published by 15 December 2020 and will be made available for review on the Trust’s website. Annual Accounts This report is based on guidelines issued by NHS Improvement and was approved by the Board of Directors on the 17 June 2020. Royal Papworth Hospital NHS Foundation Trust - Annual Report 2019/20 3 1. Performance Report 1.1 Overview of Performance Statement from Chief Executive Officer Even before we were confronted with the challenges of a global pandemic, the last 12 month period had been an extremely busy and challenging time for all of us at Royal Papworth Hospital. It was a year in which a series of remarkable milestones were achieved by all that work here and one in which our staff and volunteers, yet again, worked incredibly hard to deliver the best care possible for our patients. In May 2020, we marked the first anniversary of the move to our new hospital on the Cambridge Biomedical Campus. While we could have never predicted the challenges we would face this year, there is no doubt that our experience of moving a hospital and managing an ongoing incident control centre has been extremely valuable in responding to the pandemic. Our purpose-built hospital, with its single patient rooms, enhanced air ventilation system and flexible layout, has proved highly effective in supporting our response to a highly infectious, airborne disease such as COVID19. Following the move to the new site in May 2020 we have focussed significantly on the optimisation of our new facilities to ensure that as many patients as possible can benefit from the excellent care provided at Royal Papworth Hospital. We have so much to be proud of, however, as with all major strategic change programmes, we recognise that there have also been inevitable challenges and so despite our achievements we fully recognise that we have more to do. We have successfully managed a range of issues relating to our Facilities Management mobilisation and our staff helped considerably with this by ensuring that there was timely reporting so that problems could be addressed swiftly through the framework of contracts that support our new building and services. We have received feedback from our staff that has told us that they have felt under significant pressure in this year following the move to our new Hospital and the process of optimisation of our new facilities. In particular we saw pressures in our critical care and put in place remedial actions to support the staff in that area alongside developing plans to deliver a sustainable service model. This work has been overtaken by the steps put in place to respond to the national pandemic. Critical Care remains an area we will continue to support through 2020/21, following the team’s incredible response to Covid-19 and the support and positive outcomes they and their colleagues across the Hospital provided to our patients from across the East of England and nationally. In October 2019 we received our ‘Outstanding’ inspection report and rating from the Care Quality Commission, becoming the first NHS Hospital to achieve an ‘Outstanding’ rating in all 5 CQC domains, Safe, Caring, Effective, Responsive and Well-Led, and the first NHS Hospital to achieve ‘Outstanding’ for the Safe domain. As a Trust we will continue to set high standards and strive to meet all of our performance standards, and this means that we still have work to do to achieve this ambition and to identify opportunities to continuously improve. Through feedback from national and local staff surveys we recognise that we have more work to do to support our staff and create the best possible environment for them to work and develop their careers in. We will be working through our Compassionate and Collective Royal Papworth Hospital NHS Foundation Trust - Annual Report 2019/20 4 leadership programme to ensure that we are enabling our staff to deliver the very best care for their patients. We have included commentary on these matters through our report. The global impact of COVID19 has been profound, and the public health threat it represents is the most serious seen in a respiratory virus since the 1918 H1N1 influenza pandemic. The response to this threat has been managed at national, regional and local tiers of the public sector (including but not limited to the NHS, Local Government, the Police Force and the Army). The response has included unprecedented steps which have impacted on all economic sectors and have restricted civil liberties. Royal Papworth Hospital (RPH), as a nationally recognised centre of excellence for specialist cardiothoracic health care, will continue to play a leading role in the national, regional and local response to this crisis. The Trust has undertaken roles in both an advisory capacity and in our capacity as a direct provider of health care to the population. As we now move in to a new phase of the pandemic response, we are working to restore other clinical services whilst continuing to care for patients with COVID19. At the time of writing, we continue to play an important role in caring for some of the most seriously ill patients across the East of England, including those needing our ECMO service for acute respiratory failure. We have now cared for 119 patients with COVID19 since the start of the pandemic, and thanks to the hard work and dedication of our staff 85 have already been discharged home. Sadly, 22 patients with COVID-19 have died in our hospital and our thoughts remain with their loved ones and our staff who were involved in their care. There is no doubt that responding to a global pandemic has placed huge pressure on our staff. Many have had to work in completely different ways, quickly learning new skills and joining new teams. Some have even moved into our staff accommodation to protect family members in high-risk groups. Many have also been dealing with caring responsibilities, school and nursery closures, financial worries and concerns for loved ones at the same time. We owe them a great deal and must focus on supporting them and giving them a chance to rest in the weeks and months ahead. While it is too early to predict how the easing of ‘lockdown’ measures in the UK will impact on hospital admissions, we can be certain that we will be dealing with COVID19 for the foreseeable future. In May we gradually increased our elective activity across our cardiology, surgery and respiratory services, prioritising patients in most urgent need of treatment. We established our ‘Living with COVID’ Steering Group with representatives from all hospital divisions to develop plans for adapting the hospital environment to reflect new patient pathways and ensure that patients, staff and visitors can observe social distancing and remain safe. We are regularly reviewing new guidance and carrying out risk assessments to ensure that we protect all of our staff who are at higher risk from COVID19 – including those from Black, Asian and Minority Ethnic (BAME) backgrounds, pregnant staff and those with underlying health conditions. We are continuing to work with our system, regional and national partners to ensure that we are in a position to support our patients, our community and the wider population that we serve using our resources effectively and delivering high quality and effective services. Royal Papworth Hospital NHS Foundation Trust - Annual Report 2019/20 5 I am confident, given the remarkable people that work and volunteer at Royal Papworth Hospital and them having delivered so much in 2019/20 and responding so well to the Global Pandemic, that our services will continue to improve as we work together to deliver the best possible care and outcomes to our patients in 2020/21 and beyond. Stephen Posey Chief Executive 17 June 2020 Royal Papworth Hospital NHS Foundation Trust - Annual Report 2019/20 6 Overview of Performance The purpose of the Overview is to give the user a short summary that provides them with sufficient information to understand the organisation, its purpose, the key risks to the achievement of its objectives and how it has performed during the year. Hospital History and Statutory Background Royal Papworth Hospital NHS Foundation Trust (“Royal Papworth Hospital” or “the Trust”) is the UK’s largest specialist cardiothoracic hospital and the country’s main heart and lung transplant centre. We have an extraordinary commitment to delivering the highest levels of clinical quality and outcomes and for providing the best possible standards of personalised care to our patients. Royal Papworth Hospital was one of the first foundation trusts to be authorised under the Health and Social Care (Community Health and Standards) Act 2003 and came into existence in July 2004 as Papworth Hospital NHS Foundation Trust.
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