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Annual Report and Accounts 2013-14

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Annual Report and Accounts 2013-14 ANNUAL REPORT AND ACCOUNTS 2013-14 University Hospital of South Manchester NHS Foundation Trust Annual Report and Accounts 2013-14 Presented to Parliament pursuant to Schedule 7, paragraph 25 (4) (a) of the National Health Service Act 2006 Contents 01 About the Foundation Trust and summary of 2013-14 ................................................ 1 02 Chairman’s Statement 2013-14 ..................................................................................... 3 03 Strategic Report ............................................................................................................. 5 3.1 Trust strategy .............................................................................................................. 6 3.2 Business review and management commentary .......................................................... 9 3.3 Operational performance and service developments ................................................. 16 3.4 Financial standing and outlook .................................................................................. 23 3.5 UHSM Academy ........................................................................................................ 28 3.6 Our People ................................................................................................................ 33 3.7 Sustainability report ................................................................................................... 39 04 UHSM’s Quality Account 2013-14 ............................................................................... 43 4.1 Chief Executive’s Statement ...................................................................................... 45 4.2 Performance against the Quality Improvement Priorities in 2013-14 .......................... 47 4.3 Priorities and Proposed Initiatives for 2014-15 ........................................................... 75 4.4 Statements of Assurance from the Board of Directors ............................................... 81 05 Directors’ Report: how we work together and remuneration report ....................... 102 5.1 Biographical details and register of interests ............................................................ 110 06 Council of Governors ................................................................................................ 116 6.1 Composition of the Council of Governors and register of interests ........................... 120 6.2 Trust membership and the public constituency ........................................................ 124 07 Financial Statements ................................................................................................. 126 7.1 Foreword to the accounts ........................................................................................ 126 7.2 Statement of the Chief Executive’s responsibilities as the Accounting Officer of University Hospital of South Manchester NHS FT ......................................................... 129 7.3 Annual Governance Statement ................................................................................ 130 7.4 Independent External Auditor’s report ...................................................................... 140 7.5 Financial Statements……………………………………………………………………....142 01 About the Foundation Trust and summary of 2013-14 The Board of Directors of the University Hospital of South Manchester NHS Foundation Trust (UHSM) presents this, its eighth formal Annual Report, to its Members, Governors and other stakeholders. The Report describes the organisation – and the Board’s stewardship of it – from 1 April 2013 until 31 March 2014. UHSM is a major acute teaching hospital trust providing services for adults and children at Wythenshawe Hospital and Withington Community Hospital, and community services. We are recognised as a centre of clinical excellence and provide district general hospital services and specialist tertiary services to our local community. Our fields of specialist expertise - including cardiology and cardiothoracic surgery, heart and lung transplantation, respiratory conditions, burns and plastics, cancer and breast care services – not only service the people of South Manchester, but help patients from across the North West and beyond. We are also recognised in the region and nationally for the quality of our teaching, research and development. Our major research programmes focus on cancer, lung disease, wound management and medical education. UHSM has 5920 members of staff, including those employed by our Private Finance Initiative partner South Manchester Healthcare Limited. We also have more than 500 valued volunteers, who give up their free time to help our patients and visitors. UHSM’s priority is to be a centre of health and wellbeing for patients and the local population, delivering safe, high quality care. We have a good reputation, and this is reflected in the way that more people are choosing its services than ever before. In 2013/14 there were 94,244 attendances to our A&E department, 88,744 inpatient and day-case spells, and 471,372 attendances to our outpatient clinics. UHSM wants every patient to experience the best quality of care it can offer, and so continues to value and seek out feedback from patients on their experiences. As a self-governing Foundation Trust, the Board of Directors has ultimate responsibility for the management of UHSM but is accountable for its stewardship to the Council of Governors and Members. UHSM performance is also scrutinised by the Foundation Trust regulator, Monitor, and the Care Quality Commission (CQC). UHSM was able to report compliance with almost all key regulatory targets throughout 2013-14 and has maintained a strong performance. The Trust did not meet the emergency four hour waiting time in quarters three and four of the year due to a significant increase in A&E attendances and a significant increase in the volume of emergency admissions. In December 2013, the regulator ‘Monitor’ launched an investigation into the financial position and the short-term finances of the Trust. We have maintained a clear registration with the Care Quality Commission (CQC). During 2013-14, UHSM participated in an inspection by the CQC on dementia, which demonstrated that whilst patients with dementia are being well cared for in the hospital, we have improvements to make, and the Board is committed to this. Page | 1 The relentless fight against infection continues. We have had four cases of hospital acquired MRSA during the year and we reduced the incidence of C. difficile infection from 46 to 36. UHSM continues its commitment to being open and honest with patients and their families / carers, and our staff in line with Duty of Candour requirements. We provide transparent information on our performance and we share this with the public and our key stakeholders. UHSM became the first hospital in the country to publish the results of individual consultants, measured against national standards, and what patients say about them. Beginning with cardiologists and cardiothoracic surgeons, the aim is to publish treatment outcomes and patient feedback about the practice of all 250 consultants. 98.5% of our inpatients were assessed as harm-free during 2013/14, placing UHSM in the top 20% of acute hospital trusts for hospital-acquired harms. If an incident of patient harm takes place, our staff are encouraged to report it, an investigation is launched and upon completion all findings are shared with patients and/or their families. As a teaching hospital with strong affiliations to the University of Manchester we are proud to report that this year we recruited large numbers of patients into research studies and clinical trials again. UHSM is recognised as a centre of excellence for multidisciplinary research and development, and is proud to be a founding member of MAHSC (Manchester Academic Health Science Centre). More than 80 per cent of the staff who work at UHSM live in the immediate community we serve, and so building ever stronger links with the community continues to be a priority. The annual Open Day, held in September again attracted more than 300 visitors to the Wythenshawe Hospital site and was followed by the Annual Members’ Meeting, which attracted positive feedback and lively debate. Governors and volunteers continue to work with the Trust’s engagement team to strengthen communications with local schools and organisations to share best practice on infection prevention and sustainability. In the rest of this Report the Board of Directors will explain how UHSM has performed during 2013- 14 and its wider plans for the next 12 months. Page | 2 02 Chairman’s Statement 2013-14 UHSM has continued to deliver high quality services and treatment to its patients despite a challenging financial situation. The belief that efficient, safe quality care requires an NHS which operates to the same high standards every day of the week, night as well as day, remains at the core of the way we operate. To that end, changes in working practice by medical teams, the recruitment of more full time consultants and nursing staff and the progressive move of managerial responsibility from professional managers to clinicians have continued apace. Infection prevention has improved still further with the virtual elimination of MRSA and a significant reduction in C. difficile. However, the two major challenges referred to in our last annual report, the significant rise in the numbers of very sick people presenting at UHSM’s Accident and Emergency
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