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2017-18 Annual Report and Accounts

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2017-18 Annual Report and Accounts Annual Report and Accounts 2017-18 Forewords 3 Contents | Performance Report Overview | 5 Performance Analysis | 7 Performance Tables | 16 Key Financial Information | 19 Sustainable Development | 23 Statement of Disclosure | 23 Accountability Report Corporate Governance Report | 24 Governance Statement | 27 Remuneration and Staff Report | 37 Financial Statement and Notes to the Accounts | 48 2 FOREWORDS Chief Executive’s foreword Looking back over the last 12 months there had our Perfect Week (and weekend), are many milestones which illustrate our Red2Green, Hospital at Night and Silver commitment to improving our services as Week to help us test different ways of we seek to provide the quality of care we’d working to improve patient fl ow. want for our family and friends. In May we ran our Hospital@OutofHours Encouragingly, these milestones indicate a programme which adopted a multi- direction of travel which puts us in a great professional and multi-speciality approach position to build on the changes we’ve to deliver care at night and out of hours made, many of which have been embedded During the summer last year we agreed a in our processes and routines and which memorandum of understanding with our are, above all, sustainable in the long term. commissioners, the Herefordshire Clinical Whilst it’s the Board’s responsibility to Commissioning Group. This paved the way set the Trust strategy and to facilitate and for the move towards the principles of an monitor its delivery, successful healthcare Accountable Care System for Herefordshire. organisations devolve responsibility to This was signifi cant as it ushered in a clinical teams and support them to operate new relationship between the Trust and and innovate. So an important action for HCCG and puts patients and the needs of us at the start of the year was to establish individual communities at the heart of our a clear ’10 Point’ plan and to review our service planning. delivery structure. This review concluded that we needed to devolve more and Our formal partnership with South support our leaders at all levels more. This Warwickshire NHSFT was further cemented approach saw the creation of two new when we announced in the summer last replace our old hutted wards with state-of- Divisions. year that we would become a “Foundation the-art wards fi t for 21st century nursing Group” to help both Trusts tackle the is due for approval within the next few We also held a number of staff sustainability challenges faced within the months. We now await the green light engagement and consultant engagement NHS. from NHSI which will signal the start of sessions and have created an action work in earnest on the site. plan from these which will underpin our As part of this process, a joint board continued organisational turnaround committee with Board directors from Of course, all this must be seen in the light project including quality and performance WVT and SWFT has been established to of the diffi cult fi nancial situation the NHS improvement. A key element of this has look at areas such as service improvement fi nds itself in. Despite the national trend been a desire to improve our standing as an and ways to formalise the sharing of best of deteriorating fi nances, locally we have employer so that we can recruit and retain practice across both Trusts. achieved signifi cant turnaround. Our cost more staff and reduce our dependency and productivity improvement programmes A major transformational project which on temporary labour. The end of the year have signifi cantly reduced our operating had an impact right across the Trust was saw some encouraging signs on this front defi cit without impacting on the volume the eagerly anticipated Electronic Patient including marked improvements in nursing and quality of care. It will be important Record system – phase one went live in the retention. for us to use this success as a platform for summer. further improvement and to help to secure Our Ten Point Plan served us well last This was the culmination of many months a long-term fi nancial settlement for the year and as a consequence the plan for of hard work and will help us deliver Trust, and for the NHS in Herefordshire. the coming year retains many consistent real benefi ts as it supports patient care We ended the year setting out a clear and themes. Having stabilised the Trust we need pathways. compelling statement of our organisational to start to put in place changes that our strategy demonstrating our commitment clinical teams, patients and service users In tandem with this, we were named as to continuous focus on quality and helping want to see. Over the year we created the one of 18 NHS Trusts to benefi t from a our communities to live healthier lives. ‘Flow Academy’ through which we have £160 million fund to progress the use of championed many improvements which we new technology to improve patient care. will increasingly implement and embed. In This effectively puts the Trust in the digital doing so we will improve our performance fast lane under the scheme which will see in urgent and elective care, something the Trust work closely with Taunton and which is now a real priority for us. Somerset NHS FT to develop technology Glen Burley solutions with the aim of replacing paper A number of key initiatives stand out as Chief Executive record and printed orders where possible. testament to our ability to try new ways of working, and during 2017/18 we have More recently our planning application to 3 Chairman’s foreword 2017 was another demanding year for There are many heroic tales of staff who our Trust. The combined challenges of battled in to work despite several feet of limited funding, a very tough winter and snow. I would like to thank members of driving the necessary changes to ensure the Herefordshire 4X4 group who willingly we remain a Trust our community can be carried out more than 400 journeys ferrying proud of should not be underestimated. staff to and from work when the snow Wye Valley Trust has a number of almost arrived in abundance. unique issues but at their core are two I would also like to pay tribute to our Health central challenges. The fi rst is a fi nancial at Work team – our staff fl u vaccination one. This mainly relates to the requirement campaign has drawn national attention for us to offer the comprehensive range of after we were named the second best Trust clinical and medical services of a District in the country with a total of 91.16 per General Hospital but with a relatively cent of clinical staff having received their low population base with a higher than vaccination. average age profi le. To do this in the way we are currently funded is unsustainable. We also achieved another national success This makes our fi nancial situation more when we passed the fi ve year mark without diffi cult than almost any other NHS Trust. a case of hospital-acquired MRSA. This is a Our second challenge is staff recruitment magnifi cent achievement and puts the Trust and we have struggled for a number of in the number one slot among NHS Trusts years to recruit as many staff as we need in the UK. and therefore are far too reliant on agency There have been a number of other staff. Glen Burley outlines in his Chief signifi cant achievements during the last Executive Summary how we have begun Nonetheless we still have much to do. Our year; we have recently signed a new to respond to these challenges. Given this waiting times are too long, our fi nancial Managed Equipment Services contract with backdrop I believe our Trust performed well defi cit too large and our staff vacancies are Phillips, which will mean new radiology in 2017/18. too great. All of these are being addressed equipment, and the extension to our A&E as a priority and I am very confi dent we will This has been the fi rst full year of the department has opened, creating three make good progress in the year ahead. collaboration with the South Warwickshire new consulting rooms and increasing the NHS Trust (SWFT) and this has led to capacity of the waiting area. shared learnings and benefi ts to both The major appeal we launched this year – ourselves and SWFT as the year developed. our Born Sleeping appeal for a maternity Importantly both organisations share similar bereavement suite – has taken off with challenges and a shared view on how many local groups, organisations and Russell Hardy to respond to them. Our strategy going individuals raising money through a host of Chairman forwards is focused on engaging our staff different activities. better than historically we have done so they can help us improve the safety and Our grateful thanks go out to all those effectiveness of our care. who go the extra mile to support the Trust in so many ways – and I would like to Working with our partners in the thank, once again, the team of volunteers Herefordshire Healthcare system to who devote so much time to improve the improve our collective productivity and the experience of patients and visitors to our experience of our patients. hospitals. Helping all of us to help ourselves to live Finally I want to thank the senior leaders longer and happier lives. Each of us can, and Board of the Trust for their hard work and needs to, do more to stay healthy and as we have driven change through the to look after members of our community organisation.
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