Manchester University NHS Foundation Trust Annual Report and Accounts 1st April 2018 to 31st March 2019 1 2 Manchester University NHS Foundation Trust Annual Report and Summary Accounts - 1st April 2018 to 31st March 2019 Presented to Parliament pursuant to Schedule 7, paragraph 25 (4) (a) of the National Health Service Act 2006. 3 © 2018 Manchester University NHS Foundation Trust 4 Contents Page 1 Welcome from our Group Chairman and Group Chief Executive 6 1.1 Highlights of 2018/19 8 1.2 Service developments 15 1.3 Improving patient and staff experience 15 1.4 Research and Innovation 16 1.5 Our Charity 19 2 Performance Report 2.1 Overview of performance 21 2.2 Performance analysis 34 3 Accountability Report 3.1 Directors’ Report 44 3.2 Remuneration Report 54 3.3 Staff Report 84 3.4 NHS Foundation Trust Code of Governance disclosures 96 3.5 Regulatory ratings 101 3.6 Statement of Accounting Officer’s responsibilities 102 3.7 Annual Governance Statement 104 4 Quality Report 118 5 Auditors’ Reports 272 6 Foreword to the Accounts 278 7 Annual Accounts 279 Note: Throughout this report where comparisons are made with 2017/18 data, these are for the six months from 1st October 2017 (when MFT was formed) to 31st March 2018. 5 1. Welcome and highlights of 2018/19 Welcome from our Chairman and Chief Executive We are very proud to introduce this report for 2018/19, and to share with you the achievements of our first full year in operation. Manchester University NHS Foundation Trust (MFT) was launched on 1st October 2017 bringing together nine hospitals plus community services and providing a once in a lifetime opportunity to deliver even better services for the people of Manchester, Trafford and beyond. The overriding reason for the merger was to make sure every person using our hospitals and community services receives the same excellent experience and quality of care, no matter where they live or where they access care. Over the past 12 months, we have seen many examples of staff working together to improve standards of care for patients and their families. Examples of significant improvements range from lithotripsy (to remove kidney stones) and urgent gynaecology services to the better management of patients suffering a fractured neck of femur (broken hip). Across MFT, staff have been working really hard to develop single services that build on the strengths of our predecessor organisations. Behind the scenes significant work has also taken place to consolidate the systems, policies and processes that support the day-to-day operation of such a major organisation. We are also looking forward to welcoming North Manchester General Hospital to MFT as the final element of delivering a Single Hospital Service for the people of Manchester. The Board aims to complete the transaction in the second half of 2019/20 subject to due diligence, agreement of financial plans and approval of business cases. All this activity has taken place against a challenging backdrop. Like other NHS Trusts, we face increasing demand on our services, workforce challenges and financial pressures. Despite this, our staff have continued to deliver outstanding care whilst also developing single services and delivering service transformation. We would like to thank them for their outstanding efforts and support in establishing MFT, and for their enthusiasm and commitment to maintaining and improving services for our patients. We were delighted to receive our CQC ratings for MFT in March. The inspection was carried out within the first 12 months of our merger and was the largest comprehensive inspection ever carried out in the NHS by the CQC. The CQC’s assessment is that MFT is a Good organisation with a significant number of Outstanding features. In particular: - Manchester Royal Eye Hospital and the University Dental Hospital of Manchester were rated Outstanding. - Critical Care and Child and Adolescent Mental Health Services were rated Outstanding. - There were 24 individual indicators rated Outstanding for individual key lines of enquiry across the Group. 6 In 2018, we also had the privilege of celebrating the 70th anniversary of the NHS, which was inaugurated at Trafford General Hospital on 5th July 1948. Our staff, patients, members, volunteers, fundraisers, partner organisations and many others shared their memories, gratitude and pride in the NHS. It was a truly memorable day, and showed that the founding principles of the NHS remain firmly at the heart of what we do. Building on this tremendous legacy, we look forward to continuing the development of MFT over coming months and years. We are excited about the potential for us to reduce variation in care so that all patients can get the same standard of service no matter where they are in MFT. Together we can achieve an international reputation and exceed all expectations across patient care, education and training, and research and innovation for the benefit of our patients. 7 1.1 Highlights of 2018/19 April 2018 A team at Trafford Hospital is transforming the way shoulder surgery patients receive physiotherapy, by using a series of personalised computer video games to help patients exercise and track their recovery progress at home. The Virtual Physiotherapy (ViP) project aims to improve patient experience while also making physiotherapy programmes more efficient and so increasing the number of patients who can be treated by physiotherapists. https://mft.nhs.uk/2018/05/25/manchester-team-transforms-physiotherapy-through- games-technology/ An MFT and University of Manchester research team has discovered a gene which could hold the key to predicting which liver disease patients are at high risk of further liver damage. It also presents a new target for developing drugs to prevent liver damage, and a potential marker to detect people with undiagnosed liver disease. https://research.cmft.nhs.uk/news-events/gene-discovery-could-help-prevent-liver- disease-deaths May 2018 Phase 1 of the new Emergency Department expansion at Wythenshawe Hospital opened its doors on 16th May, helping to enhance patient experience and care. Improvements in this first phase of the development include 25 new majors cubicles, a new reception and waiting area with improved triage and ambulance bays. https://mft.nhs.uk/wythenshawe/first-stage-of- wythenshawe-hospitals-emergency-department-expansion-opens-to-patients/ Congratulations to Manchester Royal Infirmary’s Emergency Department Team, named ‘Hospital Student Placement of the Year’ at the 2018 national Student Nursing Times Awards. The department sees over 100,000 patients every year and was praised for providing a supportive structured learning environment, giving students the opportunity to work across multi-disciplinary teams and areas. https://mft.nhs.uk/2018/05/03/national-award-win-for-mri-emergency-team/ Specialist sight-saving NHS eye care has been brought to the high street by Manchester Royal Eye Hospital in a new initiative, one of the first of its kind in the UK. Two community eye clinics have been opened, in the Cheetham Hill shopping centre, North Manchester, and in Wythenshawe civic centre in South Manchester. This is part of a ground-breaking approach to deliver high quality hospital expertise for patients closer to where they live. https://mft.nhs.uk/royal-eye/specialist-eye-care-made-more-accessible-for-patients/ 8 We marked the one year anniversary of the Manchester Arena Bomb Attack on 22nd May. There was a minute’s silence at 2.30pm. The Multifaith Centre at MRI and Hospital Chapel at Wythenshawe held a day of reflection. There was also a Cathedral Service and a number of representatives from MFT attended. Michelle Milner, Deputy Director of Nursing for RMCH, read a poem at the service. June 2018 Three MFT colleagues received awards from the Queen in her Birthday Honours List. Gilly Robinson, a Consultant Nurse who specialises in acquired brain injuries, received an MBE for services to children's nursing. Wythenshawe Hospital's Macmillan Information and Support Centre Manager Debbie Smith received a BEM. Former colleague Agimol Pradeep was also awarded a BEM. She led important research into identifying methods to raise awareness of organ donation in the South Asian community during her time with us. The MFT Charity launched its £4m iMRI Scanner Appeal at the end of June to revolutionise brain surgery at Royal Manchester Children’s Hospital (RMCH). Our specialist neurology teams at RMCH treat thousands of patients every year, many of whom require complex brain surgery. Currently scans are taken before surgery and sometimes MRI scans are required during surgery. This Appeal will help to change that by transforming surgical care at the Children’s Hospital. https://mft.nhs.uk/2018/06/20/childrens-hospital-launches-appeal-to-transform-brain- surgery-for-young-patients/ July 2018 We celebrated the NHS 70th anniversary on 5th July with events across MFT. All our Hospitals and Managed Clinical Services had arranged Big7Tea events which included storyboards of each of the hospitals. There was a focus on Trafford as the birthplace of the NHS and a Blue Plaque was unveiled by Greater Manchester Mayor Andy Burnham. MFT was also involved in a number of media activities leading up to the anniversary, including: Songs of Praise featuring Trafford staff, a BBC documentary featuring Renal services at MRI and BBC Radio 5 Live broadcasting from Trafford General Hospital on the morning of 5th July. Representative members of MFT staff attended a service at Westminster Abbey at noon and a choral concert at York Minster in the evening. https://mft.nhs.uk/2018/07/05/nhs70-mayor-commemorates-trafford-general- hospitals-place-in-history/ 9 A ground-breaking partnership between academia, industry and the NHS working with global diagnostics firm QIAGEN was announced. The joint project will create and support up to 1,500 jobs – adding almost £150m to Manchester’s economy over a decade.