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A N N U Al R Ep Ort an D Accou N Ts 2 019/2 0 Annual Report and Accounts 2013/14 The Royal Marsden NHS Foundation Trust Annual 2019/20 Report and Accounts The Royal Marsden 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 Annual Report and Accounts 2019/20 C The Royal Marsden NHS Foundation Trust At The Royal Marsden, we deal with cancer every day, so we understand how valuable life is. And when people entrust their lives to us, they have the right to demand the very best. That’s why the pursuit of excellence lies at the heart of everything we do. Life demands excellence D The Royal Marsden NHS Foundation Trust Annual Report and Accounts 2019/20 At The Royal Marsden, we deal with Contents cancer every day, so we understand how valuable life is. And when people entrust their lives to us, they have the right to demand the very best. That’s 1. Performance report 2 why the pursuit of excellence lies at the heart of everything we do. Overview of performance 2 Summary of performance 7 Life demands excellence 2. Accountability report 15 Directors’ report 15 Remuneration report 26 Staff report 34 NHS Foundation Trust Code of Governance 44 NHS Improvement’s Single Oversight Framework 49 Statement of Accounting Officer’s responsibility 50 Annual Governance Statement 51 3. Annual Accounts for the year ended 31 March 2020 60 Foreword to the Accounts 60 Auditor’s Report 61 Four primary financial statements 70 Notes to the Accounts 74 D 1 The Royal Marsden NHS Foundation Trust 1. Performance report Overview of performance Introduction Chairman and Chief Executive joint statement The Royal Marsden opened in 1851 as the world’s first hospital dedicated to cancer This year The Royal Marsden NHS Foundation diagnosis, treatment, research and education. Trust continued to ensure cancer patients at Today it operates as a specialist cancer the hospital, across the UK and around the hospital and National Institute for Health world can benefit from the advances being Research (NIHR) Biomedical Research Centre made in cancer research, treatment and care. for Cancer, working closely with its principal The Trust was delighted to retain its academic partner, the Institute of Cancer ‘outstanding’ rating from the Care Quality Research (ICR). Commission (CQC) in January 2020, following Together, The Royal Marsden and the ICR an inspection in September and the well are ranked in the top five cancer centres in led inspection in November 2019. The Chief the world for the impact of their research. Inspector of Hospitals said: “The Royal Marsden The Royal Marsden operates from two centres, NHS Foundation Trust is a beacon of in Chelsea and Sutton, and is the founder Outstanding practice. It was Outstanding and host of RM Partners, the Cancer Alliance overall before but has improved by achieving for west London, which includes St George’s outstanding in four of the five main categories Healthcare NHS Foundation Trust, Imperial CQC rate. It is a well‑run centre of excellence in Healthcare NHS Trust, and other Trust and the study and treatment of cancer and is known clinical commissioning group (CCG) partners worldwide for the work that it does.” across north west and south west London. CQC inspectors commented on staff going above and beyond for patients, viewing people’s emotional and social needs with the same level of importance as their physical needs, and taking a holistic approach to care, of which patients spoke very highly. The CQC also commented on the Trust’s innovative and pioneering approach to treatment and care, particularly referencing its “national and international reputation for research”. Research is at the heart of so much of the work at The Royal Marsden, and the past 12 months has been another exceptional year. With over 900 trials open, the Trust offers the largest number of cancer research trials to patients in England. The Royal Marsden celebrated a year of treating patients on the MR Linac across six tumour types as part of an international consortium trialling this new technology, and it was commissioned to provide chimeric antigen receptor T (CAR‑T) cell therapies, an exciting new area of research and treatment. A new class of cancer drug trialled in the Oak Paediatric and Adolescent Drug Development Unit at The Royal Marsden was also approved for use in Europe. Larotrectinib is a tumour‑agnostic drug that targets a specific genetic abnormality. 2 Annual Report and Accounts 2019/20 Partnerships are vital to the delivery of the The coronavirus pandemic of 2020 presented very best treatment and care, and this year us with major challenges in the delivery of The Royal Marsden has continued to work with treatment and care, and we had to make partners across north west and south west significant changes to business as usual at London as the host of RM Partners, the Cancer The Royal Marsden. We are proud of how our Alliance for west London. The Alliance was staff rose to the challenge and worked tirelessly awarded a further £10 million funding by NHS to ensure we could continue to deliver cancer England and NHS Improvement for a range of services while protecting our patients. Flexible initiatives in early diagnosis and innovative working has included a much greater use of treatment to ensure earlier detection of cancer telemedicine and expert helplines, delivering and improved survival, in line with the priorities care differently to keep patients and staff safe, in the NHS Long Term Plan. and a new cancer surgical hub which was the first in the country to designate safe capacity During the year, The Royal Marsden continued to treat cancer patients, led by RM Partners. its work with partners in the North London A clinical priority group was established at Genomics Laboratory Hub to enhance cancer the outset to bring together cancer experts genomic testing across north and south to ensure clinical teams could continue to west London. This work involves both the operate throughout the pandemic, and this consolidation of testing to ensure equity of model will continue in the months ahead access for patients, and the development of to ensure all cancer surgery can be restored new, larger gene testing panels which will allow to pre‑pandemic levels. the Trust to test for a greater number of gene abnormalities across a wider patient population. The Trust recorded a surplus for the year of £39.7 million which was £17.5 million higher It is also important that the hospital works than initially planned. This was achieved with its regulators to maintain a safe and by both NHS and private patient revenues effective service across the Trust. This year exceeding the original plan approved by the the Trust received accreditation from JACIE Board, with minimal additional costs. All of (Joint Accreditation Committee International the surplus has been allocated for improving Society for Cellular Therapy‑Europe & European the infrastructure in the Trust on equipment Society for Blood and Marrow Transplantation) and IT and patient environments, ensuring the for both its adult and children’s services in Trust can deliver on its strategic objectives. stem cell transplantation and cellular therapy. It also retained certification from ISAS The Trust continues to maintain a strong (Imaging Services Accreditation Scheme) for balance sheet and cash position. At 31 its radiography delivery, the MHRA (Medicines March 2020 the Trust held cash deposits of and Healthcare products Regulatory Agency) £121.5 million; an increase of £43.3 million from for medicines safety, British ISO (International the previous year. The Trust has continued to Organisation for Standardisation) standards invest in estate and infrastructure, spending for radiotherapy and chemotherapy, and the £37.9 million on buildings, equipment and Customer Services Excellence Standard for IT during the year. £14.3 million of this all its services. capital expenditure was funded through charitable donations. 3 The Royal Marsden NHS Foundation Trust During March 2020 the Trust incurred The Royal Marsden would not be the hospital £0.5 million of additional costs responding to it is without its outstanding staff. Their the coronavirus pandemic, whilst also losing exceptional commitment, professionalism and around £1.5 million in expected income. The compassion is commented on by so many of Trust was reimbursed by NHS England for this our patients. We would like to thank every amount. However, the challenging operating single one for their outstanding contribution conditions present a risk to the Trust’s planned to cancer research, education, treatment and surplus for 2020/21, with the NHS financial care which helps us to improve survival and architecture for the year still under review. quality of life for all those affected by cancer locally and globally through our programmes Looking to the future, we will be working of research and education. with our partners and stakeholders on the provision of children’s cancer services following a decision by the NHS England and NHS Improvement Board in January 2020 that children’s cancer services should be co‑located on the same site as paediatric intensive care. Dame Cally Palmer There is currently no hospital in south London Chief Executive which provides both specialist children’s cancer 12 June 2020 services and paediatric intensive care on the same site. We know that the Oak Centre for Children and Young People ensures our patients receive the very best treatment and care, including access to clinical trials to improve Charles Alexander survival, expertise in oncology, and modern, Chairman age‑appropriate facilities. Patients and families 12 June 2020 consistently rate us as one of the best centres in the country for patient experience.
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