The Hillingdon Hospitals NHS Foundation Trust annual report hillingdonWe still need to get the originals of 2.2. andhospital 7 in non PDF format as well as obtaining original tables etc ... 2018-19 www.thh.nhs.uk The Hillingdon Hospitals 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 The Hillingdon Hospitals NHS Foundation Trust Table of contents 6 SECTION 1 PERFORMANCE REPORT 7 1.1 OVERVIEW OF PERFORMANCE 22 1.2 PERFORMANCE ANALYSIS 37 1.3 ACCOUNTING OFFICER’S APPROVAL OF THE PERFORMANCE REPORT 38 SECTION 2 ACCOUNTABILITY REPORT 39 2.1 DIRECTOR’S REPORT 68 2.2 REMUNERATION REPORT 76 2.3 STAFF REPORT 95 2.4 COMPLIANCE WITH NHS FOUNDATION TRUST CODE OF GOVERNANCE 102 2.5 SINGLE OVERSIGHT FRAMEWORK 103 2.6 STATEMENT OF THE CHIEF EXECUTIVE’S RESPONSIBILITIES AS THE ACCOUNTING OFFICER OF THE HILLINGDON HOSPITALS NHS FOUNDATION TRUST 104 2.7 ANNUAL GOVERNANCE STATEMENT 2018/19 126 2.8 ACCOUNTING OFFICER APPROVAL OF THE ACCOUNTABILITY REPORT 127 SECTION 3 QUALITY REPORT 132 PART 1 STATEMENT ON QUALITY FROM THE CHIEF EXECUTIVE OF THE TRUST 134 PART 2 PRIORITIES FOR IMPROVEMENT AND STATEMENTS OF ASSURANCE FROM THE BOARD 135 2.1 Quality priorities for improvement in 2019/20 149 2.2 Formal statements of assurance from the Board 164 2.3 Performance against Core Quality Indicators 2018/19 181 PART 3 KEY QUALITY INFORMATION AND IMPROVEMENTS WE HAVE MADE IN 2018/19 206 ANNEX 1 STATEMENTS FROM OUR STAKEHOLDERS AND INDEPENDENT AUDITOR’S REPORT TO THE COUNCIL OF GOVERNORS OF THE HILLINGDON HOSPITALS NHS FOUNDATION TRUST ON THE QUALITY REPORT 211 ANNEX 2 STATEMENT OF DIRECTORS’ RESPONSIBILITIES IN RESPECT OF THE QUALITY REPORT 248 SECTION 4 STATEMENT OF DIRECTORS’ RESPONSIBILITIES IN RESPECT OF THE ACCOUNTS 250 SECTION 5 INDEPENDENT AUDITORS REPORT 264 SECTION 6 FOREWORD TO THE ACCOUNTS 266 SECTION 7 THE 2018/19 ACCOUNTS 1 Performance report 1 ANNUAL REPORT AND ACCOUNTS 2018/19 Overview of 1.1 performance Statement on overview of performance from the Chair and Chief Executive Hillingdon Hospitals NHS Foundation Trust has our ward and department accreditation come through a difficult year but with a new programme to share best practice, and a leadership team now has a clear focus for the ‘Themed Friday’ which allows staff to focus future. Lis Paice, Interim Chair and I as the new on a different practice raising staff awareness Chief Executive would like to thank all of our staff and support for Trust staff with the right for their commitment and dedication to the needs knowledge and tools to demonstrate evidence of our patients. We have had the opportunity to of continuous quality improvement. work with so many people who are committed to improving the health of the people we serve We are all aware that both hospitals suffer from through dedication and hard work in these a poor estate with both Hillingdon Hospital and exceptionally challenging circumstances. Mount Vernon needing substantial investment, so we are working with NHS England and We would also like to pay tribute to Richard Improvement to address this. The Trust Board Sumray, the outgoing Chair, for his dedication is focused on the future needs of the people to the patients and staff here at the Trust and we serve and we have identified the need for to our Executive and Non-Executive colleagues, investment, but also the need to work with through what has been a challenging year. partners to develop a longer-term plan. In July 2018 the Care Quality Commission rated the Trust as Requires Improvement and Due to the unprecedented we are committed to improving the care for demand on our services our patients, with the Trust focusing on quality, our financial position has people, performance and value for money. weakened during the year and As part of our responsibility to provide we unfortunately fell short of improvements in care for our patients we have meeting our efficiency savings. introduced a number of initiatives to ensure that our work delivers on quality and safety, working with NSHI and partners to ensure improvements. Our staff are fundamental in ensuring improvement, so we have introduced PAGE 7 ANNUAL REPORT AND ACCOUNTS 2018/19 The future is about working in partnership to improve care of our patients and enabling people to take a more active role in their own health. As a result we want to continue to build strong working relationships with our local MPs, commissioners, local authorities, the Metropolitan Police, and others. We would like to thank the significant contribution of Hillingdon Hospitals Charity, whose involvement enables us to improve areas of the hospital and support staff, for example; with new equipment, painting a day room or helping with additional training. Finally, we would also like to thank the Council Professor Elisabeth Paice OBE FRCP of Governors who continue to support the Interim Chair organisation to meet the needs of patients The Hillingdon Hospitals NHS Foundation Trust and the community and provide support and challenge to the Board. We know there will always be the need for a Sarah Tedford hospital to serve the people of Hillingdon and Chief Executive we are committed to ensuring that it is fit for The Hillingdon Hospitals NHS Foundation Trust the future, delivering the right care, in the right place, at the right time and value for money. 28th May 2019 PAGE 8 ANNUAL REPORT AND ACCOUNTS 2018/19 Purpose, activities and history of the Trust The Hillingdon Hospitals NHS Foundation The Trust provides clinical services to over half Trust was established on 1st April 2011 when a million patients a year, including over 97,000 Monitor authorised the organisation as an NHS Emergency Department attendances. Foundation Trust. The Trust provides health services at two hospitals in North West London: As an NHS Foundation Trust, the Trust has a Hillingdon and Mount Vernon. Hillingdon 25-strong Council of Governors and over 6,300 Hospital is the only acute hospital in the London public members. It employs over 3,500 staff Borough of Hillingdon and offers a wide range making it one of Hillingdon’s largest employers. of services including accident and emergency, The Board of Directors, led by Chairman Richard inpatient care, day surgery, outpatient clinics and Sumray during 2018/19 was comprised of seven maternity services. The Trust’s services at Mount Non – Executive and six Executive Directors. Vernon Hospital include routine day surgery at a The Trust was rated overall as ‘Requires modern treatment centre, a minor injuries unit, improvement’ by the Care Quality Commission and outpatient clinics. The Trust also acts as a (CQC) in 2018 although the Safety and Well Led landlord to a number of other organisations domains for the Hillingdon Hospital site were that provide health services at Mount Vernon, rated as “Inadequate”. including East & North Hertfordshire NHS Trust’s Cancer Centre. As an NHS Foundation Trust, we have a 25-STRONG Council of Governors and over 6,300 public members PAGE 9 ANNUAL REPORT AND ACCOUNTS 2018/19 Overview of the Trust’s strategy and business model The Trust’s focus is to improve Vision health outcomes, and it will adopt the most efficient “To be an outstanding approaches to deliver effective provider of healthcare care – this means extending through leading health and the Trust’s reach beyond the academic partnerships, footprint of the physical transforming services to hospitals, and working with provide best care where community-based partners in needed”. responding to local needs. This statement of purpose is informed by the dual-nature of the Trust’s role. The Trust will continue treating people when they are ill, by providing the best available acute care – as has Purpose been the focus to date. Looking forward, the Trust will be more forthright in helping people “To provide high quality, to stay healthy, so that they do not become safe and compassionate care, ill in the first place – this will represent an improving the health and increased focus on prevention. wellbeing of the people that The Trust strategy for 2018/19 is summarised we serve”. below: PAGE 10 ANNUAL REPORT AND ACCOUNTS 2018/19 CREAting a better future To be an outstanding provider of healthcare through leading health and academic partnerships, transforming services to provide best care where needed. To provide high quality, safe and compassionate care, improving the health and wellbeing of the people we serve. Strengthen emergency care. Improve clinical and Engage people in Help people to Improve end-of- financial productivity. their care. stop smoking. life care. Strengthen crisis Implement core Join-up services Improve the Provide more support services. 7-day service and integrate health of our care closer to standards. care. Ensure better workforce. home. access to mental Develop an Empower people Promote better Better recognise, health services in academic health to self-manage health in the and support, the acute care. partnership their long-term community. role of carers. with Brunel conditions University London and CNWL. Sustainable, Prevention Managing long- Transforming care Improving mental quality, safe, and wellbeing term conditions for older people health acute services OPERATIOnal EXCELLENCE Deliver the NHS Improvement indicators: Comply with the Meet financial Treat people within requirements of performance 18 weeks of referral The Care Quality objectives Fulfil A&E performance standards Commission Achieve targets for cancer care Trust Board and committees: quality, finance and transformation, performance, risk, assurance Divisional performance reviews Balanced Scorecards and key performance indicators IMPROving the preSENT PAGE 11 ANNUAL REPORT AND ACCOUNTS 2018/19 The Trust has articulated its ambitions and Improvement Strategy collated its key strategies in one document.