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Annual Report Monitor Monitor 2019 Annual 20 Report Health and high quality care for all, now and for future generations HC 1059 NHS Monitor - Annual Report - 1.Performance Report. v6.indd 1 27/01/2021 10:30 NHS Monitor - Annual Report - 1.Performance Report. v6.indd 2 27/01/2021 10:30 Monitor Annual Report and Accounts 2019/20 Presented to Parliament pursuant pursuant to Schedule 8, paragraphs 17(7)(b) and 21(3)(a), of the Health and Social Care Act 2012. Ordered by the House of Commons to be printed 28 January 2021. HC 1059 NHS Monitor - Annual Report - 1.Performance Report. v6.indd 3 27/01/2021 10:30 © Crown copyright 2020 This publication is licensed under the terms of the Open Government Licence v3.0 except where otherwise stated. To view this licence, visit nationalarchives.gov.uk/doc/open-government-licence/version/3 Where we have identified any third party copyright information you will need to obtain permission from the copyright holders concerned. This publication is available at www.gov.uk/official-documents Any enquiries regarding this publication should be sent to us at: NHS England and NHS Improvement, Quarry House, Quarry Hill, Leeds, LS2 7UE. ISBN 978-1-5286-1897-7 CCS0320331852 01/21 Printed on paper containing 75% recycled fibre content minimum Printed in the UK by the APS Group on behalf of the Controller of Her Majesty’s Stationery Office NHS Monitor - Annual Report - 1.Performance Report. v6.indd 4 27/01/2021 10:30 Contents A view from Baroness Dido Harding, Chair .................................................... 7 About Monitor .................................................................................................. 9 Performance Report .......................................................................................... 11 Chief Executive’s overview ................................................................................. 12 How we measure performance ......................................................................... 14 Performance Overview ...................................................................................... 15 How we supported the wider NHS .................................................................... 23 Chief Financial Officer’s Report .......................................................................... 31 Our priorities for 2020/21 .................................................................................. 33 Accountability Report ....................................................................................... 35 Corporate Governance Report ........................................................................... 37 Board Committees ............................................................................................ 46 Statement of Accounting Officer’s responsibilities .............................................. 60 Governance Statement ..................................................................................... 61 Remuneration and Staff Report ......................................................................... 82 Annual Accounts ............................................................................................... 109 Notes to the financial statements ...................................................................... 114 Appendices ........................................................................................................ 129 Appendix 1: How we have delivered against the Government’s Accountability Framework to the NHS ......................................... 130 Appendix 2: Meeting our Public Sector Equality Duty ......................................... 134 Appendix 3: Reducing health inequalities ........................................................... 137 Appendix 4: Working in partnership with people and communities .................... 141 Appendix 5: Sustainability ................................................................................. 145 Appendix 6: Glossary ....................................................................................... 147 NHS Monitor - Annual Report - 1.Performance Report. v6.indd 5 27/01/2021 10:30 NHS Monitor - Annual Report - 1.Performance Report. v6.indd 6 27/01/2021 10:30 A view from Baroness Dido Harding, Chair Within our NHS Constitution there is one section which is particularly striking. It reads: “[the NHS] works at the limits of science – bringing the highest levels of human knowledge and skill to save lives and improve health. It touches our lives at times of basic human need, when care and compassion are what matter most.” Coronavirus has tested the NHS in ways that were unimaginable last year, when my foreword described the task ahead to deliver our Long Term Plan, but they are perhaps encapsulated by that remarkable constitution. In facing up to COVID-19, I believe we have shown both the strength and value of our NHS as well as the vison we’ve set for its future. It is hard not to become emotional when considering what has happened in the past year as we’ve met this challenge unlike any other in our history. Alongside fear and anxiety for loved ones and the difficulties of new restrictions and rules, have been logistical challenges needing to be met to provide the best possible healthcare we can, on the frontline of the service and as NHS England and NHS Improvement. This is not, of course, just the organisational difficulties in providing safe services in our hospitals, clinics, care homes and communities. It’s also the sacrifices made by staff, in some cases living away from their families or putting themselves in harm’s way to provide compassionate care and to keep people safe. The public too has bolstered our response to COVID-19 in countless ways, but most significantly by understanding what we needed to do and helping us to do it. With us, our patients have learned new technology which has allowed us to provide remote care, kept away while we adapted our buildings and approaches, and changed their lives to help protect the NHS so our staff could treat those most in need. I can assure you that did not go unnoticed and we are enormously grateful. With support from the entire nation, the NHS has transformed how it works, how we support our workforce and colleagues, how we learn, how we innovate. Achievements we thought would take years, have taken, in some cases, mere days. But the cost has been high - colleagues, patients, friends and loved ones have died and their loss is immeasurable. There are no easy ways to express the awe and gratitude I’ve felt from seeing the commitment and sacrifices made at every level across our NHS, from cleaners to chief executives, labs to distribution hubs, clinics to care homes. You continue to be the very best ambassadors of our NHS. Perhaps the reaction from the public says it better – not just the heart-warming clapping at 8pm we saw earlier this year but the numbers who, inspired by your example, have come forward to join, and in some cases rejoin, the ranks of our NHS. ANNUAL REPORT 2019/20 | 7 NHS Monitor - Annual Report - 1.Performance Report. v6.indd 7 27/01/2021 10:30 We head into the next year with trepidation but also determination to continue the restoration of services impacted by COVID-19, while pushing on with the work we’ve committed to in our Long Term Plan. Some of that has accelerated rapidly through our response to the COVID-19 outbreak, such as providing access to online consultation to GPs - 90% of practices now have access to online consultation while 99% offer video consultation capability. Our redesign of outpatient care, to avoid the need 30 million face-to-face hospital outpatient visits by 2023/24, similarly accelerated so that the use of video consultation in secondary care achieved universal coverage in England in just four weeks. In 2019/20, more people than ever before were referred urgently with suspected cancer - 2.4 million compared with 2.2 million in 2018/19, and 1 million in 2010/11. Of them, 167,000 patients started treatment, a 2% increase on the previous year. While this report has been finalised, our efforts to support cancer services affected by COVID-19 to recover and encourage people with possible symptoms who haven’t come forward to do so have gathered pace. A new campaign to bolster these launches shortly. The importance of our work in addressing health inequalities, supporting vulnerable groups, and tackling the common causes of premature mortality, including diabetes and obesity, has also been thrown into a stark light during. An update of what began during 2019/20 is contained within this report and will continue to be a priority. Finally, I’d like to thank everyone at NHS England and NHS Improvement, including our board members and non-executive directors, who have worked tirelessly over the past year. In unprecedented times, your passion and professionalism in leading and supporting the service have been incredible. Baroness Dido Harding, Chair of NHS Improvement 8 ANNUAL REPORT 2019/20 | NHS Monitor - Annual Report - 1.Performance Report. v6.indd 8 27/01/2021 10:30 About Monitor NHS Improvement is responsible for overseeing NHS foundation trusts, NHS trusts and some independent providers. We support them to give patients consistently safe, high quality, and responsive care within local integrated care systems that are financially sustainable. By holding providers to account and, where necessary, intervening, we help the NHS to meet its operational goals and its longer term strategy. NHS Improvement is the operational name for the organisation
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