Annual Report and Accounts 2018/19

ANNUAL REPORT AND ACCOUNTS 2018/19 Berkshire Healthcare 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 Berkshire Healthcare NHS Foundation Trust Annual Report & Accounts 2018/19 CONTENTS Page SECTION 1 – PERFORMANCE REPORT Joint Foreword by Martin Earwicker, Chair and Julian Emms, Chief Executive’s Report 1 Overview of the Trust 3 Performance Analysis and Review 5 Financial Report 7 Sustainability and Climate Change 9 Emergency Preparedness, Resilience and Response 11 Diversity and Inclusion 12 Stakeholder Relations 20 SECTION 2 - OPERATING REVIEW AND SERVICE DEVELOPMENTS Operational Goals and Priorities 22 Service Review and Developments 22 Patient Experience 33 SECTION 3 – ACCOUNTABILITY REPORT Directors’ Report 37 Board Assessment and Review 38 Focus on Quality 39 NHS Foundation Trust Code of Governance Compliance 39 Modern Day Slavery Statement 39 Governance Framework 41 Board Committees 43 Attendance at Board Meetings and Committees 2018-19 45 Board Members 47 Remuneration Report 52 Staff Report 57 Regulatory Ratings 68 Council of Governors Report 69 Membership Report 73 Public Interest Disclosures 76 SECTION 4 Quality Report 2018-19 77 SECTION 5 Annual Accounts 2018-19 169 CHAIR AND CHIEF EXECUTIVE’S REPORT This year, the Trust has delivered a strong performance, managing the delivery of high quality care whilst maintaining an excellent financial result. This performance is all the more commendable due to the ever increasing demand for our services. We are proud of the commitment of all our staff to delivering high standards of care, whilst maintaining prudent financial management in spite of these challenges. This year we received a full Care Quality Commission inspection of our services. We received another very pleasing result, with the Trust rated as GOOD across all our services and OUTSTANDING in Older Adult, Learning Disability services and Well Led. We are, however, not complacent and we recognise the importance of developing our delivery to ensure everyone receives the same high quality care, irrespective of the service or geography. Our financial performance has been excellent, with the Trust being ranked in the highest category by NHS Improvement. Financial excellence is not, of course, an end in itself, but by ensuring we spend our funding wisely and efficiently enables us to invest in delivering ever better care. Staff satisfaction is good with the NHS staff survey results showing we are highly ranked compared to other Trusts. We have made good progress addressing concerns about equality and diversity with determined efforts to address staff concerns. We are seeing improved proportions of Black, Asian and Minority Ethnic (BAME) staff filling senior posts. Our staff networks for BAME, LGBT and staff with disabilities are active and helping shape our plans. In spite of this progress, we know we have more to do, but the progress to date is pleasing. Staffing, nevertheless remains our highest risk with levels of vacancies and staff turnover too high. In spite of the Trust’s good performance, we know that we have to improve how we deliver services, both to ensure we deliver ever safer and more effective care and to respond to the ever increasing demand. The Trust has adopted the Quality Improvement methodology as the basis for developing its continuous improvement. This empowers front line staff to identify and implement improvements locally, greatly increasing speed of change and increasing staff satisfaction. We are also committed to developing our IT systems so we can take full advantage of digital services. We are already using the connected care system to enable clinicians across the care pathway to access essential clinical information, improving patient care, and our use of social media based applications for mental health is proving highly effective. We are convinced that our commitment to developing a much more comprehensive range of digital services will help in delivering patient centred care, improve the effectiveness of our services, reduce the administrative load on front line staff and help mitigate the increased demand for our services. The Trust is fully committed to working across the health and social care landscape to develop truly integrated services. We are leading players in two Integrated Care Systems ICS): Berkshire West and Frimley Health, both of which are recognised nationally as exemplars. Developing such integrated systems, including social and primary care, community and mental health and acute is complex. We are pleased to report that in both cases, relations are positive and there is a real commitment to integration. This year we said farewell to our Director of Nursing and Governance, Helen Mackenzie. Helen had been a key player in the Executive and on the Board. We would like to express the thanks of the Board for her outstanding contribution. 1 We are pleased to report two of our staff received Honours in the Queen’s New Year’s Honours List 2019: Becky Chester, Consultant Nurse for People with Learning Disabilities and Alison Durrands, Locality Director, Prospect Park Hospital - were both awarded MBEs. The Board and the Governors continue to function well. There has been some difficulty filling all the vacancies on the Council of Governors but the indications are that that is improving. The Trust can report a strong performance with a commitment to continuous improvement in all it does and to playing its full part in the integration of services across Berkshire. None of this would be possible without the commitment of our staff always putting the care of our service users first in spite of the challenges we face. Julian Emms Martin Earwicker Chief Executive Chairman 2 PERFORMANCE REPORT Overview - Brief history and Summary Information The purpose of this section is to provide an overview of the Trust, as well as setting out our performance in 2018-19. Berkshire Healthcare NHS Trust was set up in 2001. The Trust successfully gained NHS Foundation Trust status in May 2007. In line with the Trust’s provider licence, the principal purpose of the Trust is the provision of goods and services for the purposes of the health service in England. The Trust provides specialist mental health and community health services to a population of around 900,000 people in Berkshire. We operate from a number of sites across the county offering community/home based care and inpatient services – with the majority of our services being provided to people within their own homes. The Trust also provides mental health and community health inpatient services. The Trust works with six local unitary authorities (as indicated in the map below) and seven Clinical Commissioning Groups (CCGs) which took on commissioning responsibility from April 2013. The CCGs operate as two “federations” in the East and West of Berkshire. Berkshire Healthcare NHS Foundation Trust – Unitary Authority areas served West Berkshire Windsor & Maidenhead Slough Reading MAIDENHEAD SLOUGH M4 M4 A329(M) WINDSOR M4 READING NEWBURY WOKINGHAM ASCOT BRACKNELL Bracknell Wokingham Forest The Trust’s turnover for 2018-19 was £257m. During 2018-19 the Trust employed approximately 4,300 staff. The Trust was issued with its provider licence by Monitor (the Regulator – now known as NHS Improvement), on 1 April 2013. We have continued our commitment to providing high quality services that meet the requirements of our Care Quality Commission (CQC) registration and in compliance with the conditions of our provider licence. In June 2018, the Trust underwent a comprehensive Inspection by the CQC which resulted in the Trust retaining its overall “Good” rating. The Trust was rated “Good” across the Safety, Effectiveness, Caring and Responsiveness domains and ‘Outstanding’ in the Well Led domain. All of the services inspected were rated as ‘Good’, with the exception of our wards 3 for people with learning disability or autism, and our community based mental health services for older people which were rated as ‘Outstanding’. During the year, we have improved on our original financial forecast, supported by additional Provider Sustainability Funding allocated by NHS Improvement (NHSi) for delivering and exceeding the Trust’s financial control total, and have ended 2018-19 with a surplus of £6.5m (versus plan of £2.3m). This has enabled us to be categorised as a Segment 1 Trust (the maximum level of autonomy) under NHS Improvement’s Single Oversight Framework. We recognise the increasing financial challenge that we are facing – particularly the need to achieve recurrent and sustainable savings in light of increased demand and funding constraints of our partners. A key role for the Trust Board and the Executive Team is to manage and mitigate risks to the delivery of our strategic objectives and we therefore operate a robust risk management process that ensures that all key risks are identified and that mitigation action is taken to address these. Our Board Assurance Framework and Corporate Risk Register are regularly reviewed by both the Trust Board and relevant Executive Groups. Our key risks relate to the safety of and quality of care we provide to our patients, as well as to the Trust’s financial sustainability. We spend considerable time ensuring that financial pressures do not compromise safety and quality. In terms of quality of care and patient safety, we are continually managing the risks that can arise from shortages of particular staff, such as nurses and from increases in demand for services beyond our commissioned activity. More information on our approach to quality can be found in the Quality Report that appears later in this document. The Board of Directors is responsible for preparing this annual report and the annual accounts and the Directors consider the annual report and accounts, taken as a whole, is fair, balanced and understandable and provides the information necessary for patients, regulators and stakeholders to assess the NHS Foundation Trust’s performance, business model and strategy.

Load more