Annual Report and Accounts 2016 / 2017 The Annual Report and Accounts are part of the Health Board’s public annual reporting and set out our service delivery, environmental and financial performance for the year and describe our management and governance arrangements. The Annual Governance Statement, which is provided as an Appendix to this document, forms part of the Accountability Report section of this Annual Report, and provides a detailed report on our governance, arrangements for managing risk and systems of internal control. The Annual Quality Statement, published separately, provides information on the quality of care across our services and illustrates the improvements and developments we have taken forward over the last year to continuously improve the quality of the care we provide. Copies of all these documents can be downloaded from the Health Board’s website at www.wales.nhs.uk/sitesplus/861/page/40903 or are available on application to the Health Board’s Communications Team at BCUHB, Block 5, Carlton Court, St Asaph Business Park, St Asaph, LL17 0JG, by telephone on 01248 384776 or by e-mail to [email protected] . 2 “To improve health and provide excellent care” Contents Chairman's Foreword .................................................................................................................. 4 PART ONE - PERFORMANCE REPORT Overview ................................................................................................................................. 5 Chief Executive’s Statement ............................................................................................... 5 Our purpose and activities .................................................................................................. 7 Planning framework ............................................................................................................ 8 Key issues & risks affecting delivery of objectives .............................................................. 9 Performance Analysis .......................................................................................................... 10 Summary........................................................................................................................... 10 Staying healthy ................................................................................................................. 11 Safe care........................................................................................................................... 13 Dignified care .................................................................................................................... 16 Effective care .................................................................................................................... 18 Timely care ....................................................................................................................... 20 Individual care ................................................................................................................... 24 Staff and resources ........................................................................................................... 25 Our activity ........................................................................................................................ 27 Well-being of Future Generations (Wales) Act .................................................................. 28 Sustainability Report ........................................................................................................... 30 Long Term Expenditure Trends .......................................................................................... 41 Annual Quality Statement .................................................................................................... 41 PART TWO - ACCOUNTABILITY REPORT Corporate Governance Report ............................................................................................ 42 Directors’ Report ............................................................................................................... 42 Statement of the Chief Executive’s as Accountable Officer of the LHB ............................ 45 Statement of Directors’ responsibilities in respect of the accounts ................................... 46 Annual Governance Statement ......................................................................................... 46 Remuneration Report ........................................................................................................... 47 Staff Report ........................................................................................................................... 60 National Assembly for Wales Accountability and Audit Report ....................................... 63 Certificate of the Auditor General to the National Assembly for Wales ............................. 64 Report of the Auditor General to the National Assembly for Wales ................................... 66 PART THREE - ANNUAL ACCOUNTS Foreword ............................................................................................................................... 1A Statement of Comprehensive Net Expenditure ................................................................. 2A Other Comprehensive Net Expenditure ............................................................................. 3A Statement of Financial Position .......................................................................................... 4A Statement of Changes in Taxpayers’ Equity ...................................................................... 5A Statement of Cash Flows ..................................................................................................... 7A Notes to the Accounts ......................................................................................................... 8A APPENDIX - Annual Governance Statement ........................................................................... 1B Betsi Cadwaladr University Health Board - Annual Report 2016/17 3 Chairman’s Foreword I am pleased on, behalf of the Board, to present our Annual Report for 2016/17. I am also pleased to report that the Board made good progress in many areas during the year and responded to the improvements that we need to make as part of ‘Special Measures’. However, significant challenges remain, and we need to deliver improvements in a number of areas, including some areas of service/quality performance, and in our financial position. We also continued to progress the investigations into Tawel Fan during the year. The Board continued to engage widely on our developing strategy for the Health and Wellbeing of the people of North Wales over the next few years. This work will come to fruition in the current year and we will publish our Strategy and Three Year Plan before the end of March 2018. Several new Directors joined the Board in 2016 and 2017. In addition to Gary Doherty who started at the end of February 2016, five new Directors joined the Board during the year: Andy Roach (Director of Mental Health and Learning Disability Services), Gill Harris (Executive Director of Nursing and Midwifery), Dr Evan Moore (Executive Medical Director), Teresa Owen (Executive Director of Public Health) and Adrian Thomas (Executive Director of Therapies and Health Sciences). Our Annual Report is also an opportunity to acknowledge and recognise the huge commitment and dedication of our staff and to thank them. The results of our Staff Survey show we have made improvements in every area, but we know we still have much to do to improve further. Dr Peter Higson OBE Chairman 4 “To improve health and provide excellent care” PART ONE – Performance Report Overview Chief Executive’s Statement The last year has seen the Health Board make good progress, but there is much still to do. We have been able to demonstrate substantial progress against the requirements within the Special Measures Framework and have submitted evidence to support this to Welsh Government, Health Inspectorate Wales and the Welsh Audit Office. This includes demonstrating that we are on track to develop a comprehensive three-year Integrated Medium Term Plan by the agreed date of April 2018. It is crucial that we maintain this progress, as moving away from a single year Operational Plan will provide the clarity and stability we need going forward. As part of developing our Integrated Medium Term Plan and as part of our response to the requirements under Special Measures we have established more effective ways of engaging with our public and partners. During the year we held and attended over 300 engagement events across North Wales with local communities, stakeholders and staff, talking and listening to people about or services. We have made a particular effort to base our new Mental Health Strategy on an extensive engagement process. Over the last twelve months there has been a substantial refresh of the Health Board’s leadership team. The new appointments include a Director of Mental Health & Learning Disabilities, a Director of Nursing and Midwifery, a Medical Director, a Director of Therapies and a Director of Public Health. Two new Independent Members were appointed at the start of the year. During 2016/17 the NHS Staff Survey took place across Wales. It was pleasing to see the results for the Health Board showed material improvements across every area, supporting the view that we are moving in the right direction. But