Annual Report 2011/12, Including the Quarter, Quarter 4 2011/12

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Quarter 4 2011/12 NHS Chief Executive’s annual report 2011/12 theyear. 2011/12 Enter DH INFORMATION READER BOX Policy Clinical Estates HR/Workforce Commissioner Development IM&T Management Provider Development Finance Planning/Performance Improvement and Efficiency Social Care/Partnership Working Document purpose For information Gateway reference 17802 Title The Year: NHS Chief Executive’s annual report 2011/12, including The Quarter, Quarter 4 2011/12 Author Sir David Nicholson Publication date 21 June 2012 Target audience PCT Cluster CEs, NHS Trust CEs, SHA Cluster CEs, Care Trust CEs, Foundation Trust CEs, PCT Cluster Chairs, NHS Trust Board Chairs, Special HA CEs, Directors of Finance Circulation list Medical Directors, Directors of PH, Directors of Nursing, Local Authority CEs, Directors of Adult SSs, GPs, Communications Leads, Directors of Children’s SSs, Voluntary Organisations/NDPBs Description Sir David Nicholson’s annual report highlights progress and achievements across the NHS during the last 12 months, and challenges that remain as the NHS continues through transition. Cross references The Year: NHS Chief Executive’s annual report 2008/2009 Superseded documents N/A Action required N/A Timing N/A Contact details Office of the NHS Chief Executive Room 428 Richmond House London SW1A 2NS For recipient’s use theyear. 04 Introduction s ntentoC 06 Quality 06 Our ambition 06 What we have delivered 06 Infection control 08 Waiting times 08 Dentistry 09 Ambulance services 09 A&E performance 09 Cancer 10 Mixed sex accommodation 11 Stroke 11 Patient experience 12 Challenges for the future 13 Innovation 13 Our ambition 14 What we have delivered 14 Early successes 14 Rewarding innovation 15 Challenges for the future 16 Productivity 16 Our ambition 17 What we have delivered 17 Efficiency savings 18 Activity levels 18 Workforce numbers 18 Staff wellbeing 18 Staff satisfaction 19 Agency spend 19 Finance 19 Challenges for the future 20 Prevention 20 Our ambition 21 What we have delivered 21 Venous thromboembolism (VTE) 21 Health visitors 22 Maternity 22 Smoking prevention 23 Challenges for the future 24 Transition to the new 24 Our ambition 24 What we have delivered 24 Ensuring resilience 25 Designing the NHS Commissioning Board 25 Developing clinical commissioning groups 26 Creating a robust provider sector 27 Re-designing and improving services 29 NHS Constitution 29 Empowering patients 30 Challenges going forward 31 Conclusion 3 Contents. 2011/12 theyear. 2011/2012 was a remarkable year for the NHS. I certainly can’t remember another time in my three decades as an NHS manager when we have faced so many complex challenges on so many fronts at once. Not only was the service required to start delivering the Quality, Innovation, Productivity and Prevention (QIPP) efficiency savings – releasing up to £20 billion to re-invest in quality – we did this against a backdrop of intense political and public debate about reform, and as we began to lay the foundations for an entirely new system of need and need alone, regardless of ability of delivery, that necessitated a great deal of to pay. It is our shared purpose that continues change and uncertainty for our staff. to sustain and motivate us throughout these challenging times, and this creates the In the NHS Operating Framework 2011/12, I said conditions for the success that I set out in this that our overarching goal in this period would annual report. be to build strong foundations for the new system by maintaining and improving quality, But although there is much to be proud of, there by keeping tight financial control and delivering is also much more to be done to make sure that on the quality and productivity challenge, and all of our patients get the very best quality care creating energy and momentum for transition currently available in the NHS, so that our very and reform. best practice becomes standard practice, and we root out and end unacceptable practices Despite the huge challenges we have faced in wherever we find them. The journey to high this extraordinary year, we have achieved the quality care for all is a never ending one, and ambitions we set during 2011/12: we must continue to learn from our failures, Introduction 3 Infection rates at their lowest since as well as our successes, if we are to harvest mandatory surveillance was introduced developments in knowledge and technology for the benefit of all our patients. The report on 3 Lowest ever level of patients waiting more the public inquiry into Mid Staffordshire NHS than 18 weeks for their treatment and both Foundation Trust will be published later this standards met each month year. This will provide a salutary moment for 3 All ambulance trusts meeting their category the NHS to reflect on the learning that emerges A8 performance measure for the first time from Robert Francis’s report. We must use it since Call Connect was introduced as a catalyst to raise our ambitions and drive further service improvement. 3 Performance measures on A&E, cancer care, dentistry, waiting times – all met Because that’s what we do when we are at our best: we take the resources we’re granted by 3 And all in a year where we worked smarter Parliament, the reforms and tools for delivery, and more effectively, delivering £5.8 billion and drawing on our experience and judgement of QIPP savings to the system. deploy them to meet the current needs of These achievements did not happen by accident patients and drive the transformation required or default: they are the result of the heroic for the future. And that’s what I’m starting to efforts made by the 1.2 million staff who see when I go round the country. work for our patients in the NHS, and I want I’ve seen GPs starting to use the powers they to take this opportunity to thank you all for have as doctors, and as members of clinical keeping focused on what matters during this commissioning groups (CCGs) beginning to extraordinary time of change. I know that what drive clinically-led commissioning, working motivates you – what motivates me – are the with providers so services can be wrapped values of the NHS: the opportunity to work for around the needs of patients. I’ve seen the NHS a system that provides care to all on the basis 4 Introduction. 2011/12 theyear. really engage with local authorities around the a long time to come. QIPP is therefore no longer new public health agenda and the creation of a strategy for managing the NHS up to 2015, it the health and wellbeing boards, so services is going to have to become the way we manage can reflect the wider needs of all of our the service for the foreseeable future. communities. Some think now the Health and Social Care Bill And every time I go out to a new area, or visit has passed through Parliament that somehow, a particular service, I am struck, and indeed the reforms are ‘done’. Well unfortunately, they moved by, the response of our staff to the couldn’t be more wrong. This next year is when challenges they face. How despite the fact the the reforms actually have to be implemented. reforms will have a direct impact on the Together we need to implement the transition job that they (may no longer) have, most NHS from the old system to the new, while doing staff are simply rolling up their sleeves and all we can to reduce risk in the system and asking themselves, as we always do: right, continue to deliver and improve upon the how can I use these reforms to get a better quality of care we provide to the one million deal for patients? patients the NHS treats every 36 hours. It is We will need to maintain this level of a daunting challenge, but this annual report commitment to our shared purpose, because demonstrates the efforts of our staff today have the environment in which we work is about to put in place strong foundations for our staff get tougher, not easier. This is the year when and patients of tomorrow. we will need to start working out how we are going to respond to the Chancellor’s Autumn Statement, which confirmed that restrictions on public spending are likely to remain in place for I want to take this opportunity to thank you all for keeping focused ‘‘ on what matters: making sure that all of our patients get the very best quality care. 5 Introduction. 2011/12 theyear. • To begin to create the environment for Our ambition greater devolution in 2012/13, and the y litauQ We have worked hard in recent years to put conditions for a health care system designed quality at the heart of the health care system, to deliver quality outcomes. so that our shared purpose increasingly drives The National Quality Board has led a major everything we do. The passage of the Health programme of work to ensure we maintain and Social Care Act 2012 provides a radical set quality during transition, and this work is of reforms aimed at creating an NHS with a detailed on page 24. Below we set out the relentless focus on outcomes for patients. Our achievements the NHS has made in the areas ambitions for 2011/12 with regard to quality that we know matter most to patients in terms were threefold: of the quality of care that they receive. • To maintain the quality of care provided during a time of transition • To ensure a tight grip on those quality issues that matter most to our patients to maintain and improve performance 1.

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