Salford Royal NHS Foundation Trust Annual Report and Accounts 1 April 2018 to 31 March 2019 Salford Royal NHS Foundation Trust Annual Report and Accounts 1 April 2018 to 31 March 2019 Presented to Parliament pursuant to Schedule 7, paragraph 25(4)(a) of the National Health Service Act 2006 © 2019 Salford Royal NHS Foundation Trust Contents 1 Performance report Page 6 Performance overview Page 7 Introduction to Salford Royal NHS Foundation Trust Page 7 Performance overview from the Chairman and Chief Executive Page 10 Performance analysis Page 14 Delivery of the 2018/19 Annual Plan Page 15 Looking forward to 2019/20 Page 42 Quality Report 2018/19 Page 43 2 Accountability report Page 142 Directors report Page 143 Remuneration report Page 151 Staff report Page 166 Compliance with NHS Foundation Trust Code of Governance Page 177 Governance and organisational arrangements Page 179 Membership Page 179 Council of Governors Page 181 Group Committees in Common and Salford Royal Board of Directors Page 186 NHS Improvement’s Single Oversight Framework Page 191 Statement of Accounting Officers responsibilities Page 193 Annual Governance statement Page 194 3 Independent Auditor’s report Page 204 4 Annual accounts for the period 1 April 2018 to 31 March 2019 Page 215 5 Salford Royal NHS Foundation Trust - Annual Report and Accounts 2018/19 1 Performance report 6 Salford Royal NHS Foundation Trust - Annual Report and Accounts 2018/19 1 Performance report Performance report Performance overview The purpose of this Performance overview is to provide a brief introduction to Salford Royal NHS Foundation Trust. This includes a glimpse back at our history and an outline of the purpose and activities of the organisation, including a brief description of the business model and organisational structure. In addition, the Chief Executive and Chairman’s perspective of performance during the year is provided, including the key issues and risks to the delivery of our principal objectives. An introduction to Salford Royal NHS Foundation Trust Salford Royal NHS Foundation Trust (Salford The majority of acute services are provided at Royal) is a statutory body, which became a public the main Salford Royal site and Salford Royal also bene!t corporation on 1 August 2006. We are provides: an Outstanding trust; the only NHS acute and Community healthcare services across Salford community trust to be rated as Outstanding on two consecutive occasions. Specialist services at The Maples Neuro- Rehabilitation Centre in Boothstown Salford Royal is an integrated provider of hospital, community, social and primary care services, Renal dialysis services at satellite units in including the University Teaching Trust. Our team Wigan, Bolton and Rochdale of over 7,000 sta" provide local services to the Elective orthopaedic services at the Manchester City of Salford and specialist services to Greater Elective Orthopaedic Centre (MEOC) on the Manchester and beyond. Through its supply chain Tra"ord General Hospital site partners, Salford Royal provides mental health services to adults and older adults in Salford. We Outpatient neurology and dermatology clinics provide over one million hospital and community across Greater Manchester and into Cheshire contacts for patients and service users across: Mental health inpatient services at the Emergency and elective inpatient services Meadowbrook Unit, on the main Salford Royal Day case services Site, and community mental health services across Salford Outpatient services Diagnostic and therapeutic services Adult Social Care services are delivered in partnership with Salford City Council to maintain Adult and children’s community services a diverse and sustainable market of social care Adult social care assessment and care planning providers who meet the needs of Salford citizens. services This includes Residential Care, Supported Mental health inpatient and community Tenancies and Learning Disability and Home Care services for adults and older adults services all across Salford. 7 Salford Royal NHS Foundation Trust - Annual Report and Accounts 2018/19 1 Performance report Salford Royal has a clinical divisional management Four ‘Care Organisations’ have been established structure to coordinate and deliver high quality within the NCA, including Salford, alongside services for speci!c patient and service user Oldham, Bury & Rochdale and North Manchester, population groups. These include: with responsibility for providing high quality and Division of Greater Manchester Neurosciences reliable care to the local communities they serve. Division of Integrated Care The Care Organisations are supported by an NCA Division of Surgery and Tertiary Medicine Diagnostics and Pharmacy Group Business Unit and Corporate Functions. Each Care Organisation As part of Salford Royal’s vision to provide safe and hospital site has its own Leadership Team and sustainable local health and care services, led by a Chief O#cer and consisting of a Medical Salford Royal committed to developing a Director, Director of Nursing, and Finance Director. healthcare group which would enable the In addition, in recognition of the ongoing delivery of reliable, high quality care around a transformation work across the Salford health large population catchment area. economy, Salford Care Organisation has added a From April 2016, Salford Royal provided Director of Social Care and Director of Integrated leadership and operational support to the Care to its Leadership Team in year. Pennine Acute Hospitals NHS Trust (Pennine) Together they are accountable to the Group following its CQC Inspection in February 2016. CiC for the day to day running of the hospital This arrangement was formalised under a services and, as applicable, primary, community, management agreement in April 2017, and paved mental health and social care services of the Care the way for the establishment of the Northern Organisation. These new local arrangements Care Alliance NHS Group (‘Group’ in this context place the emphasis for operational management does not mean a ‘Group’ as de!ned for accounting where it matters - in each hospital and locality. purposes; separate !nancial statements continue to be prepared for the statutory bodies). From the 1 April 2017, the Northern Care Alliance NHS Group (NCA) was launched, bringing together over 17,000 sta", 2000 beds and serving Rochdale Infirmary and Community Service a population of over 1 million. Whilst Salford Fairfield Royal and Pennine remain statutory bodies, the General Hospital respective Trust Boards delegated the exercise of The Royal their functions to a Group Committees in Common Oldham Hospital (Group CiC), e"ectively managing both Trusts. Salford Royal Hospital and Integrated Services North Manchester General Hospital and Community Services 8 Salford Royal NHS Foundation Trust - Annual Report and Accounts 2018/19 1 Performance report Northern Care Alliance NHS Group vision and objectives Our Mission Statement that binds us all together is: Our Priorities 2018/2019 by delivering highly reliable care and services, at scale, which are trusted, connected and pioneering. Salford Care Organisation Priorities Our Alliance Priorities: 1) We will demonstrate continuous improvement towards our goal of 4) We will support our staff to have rewarding, productive and fulfilling 1. Pursue quality improvement to ensure safe, being the safest health and social care organisation in England careers, enabling us to recruit and retain talented people reliable and compassionate care This means In order to achieve this we will: This means In order to achieve this we will: Reductions in core Implement digital pathways & WHO checklist More people will With the Northern Care Alliance NHS Group 2. Improve care and services through integration, patient and / user harms Develop and implement Local Safety Standards for recommend us as a ‘Place (NCA) teams collaboration and growth each year to work’ and ‘Place for Invasive Procedures (LocSSIPs) Implement the staff engagement strategy Improvements in Care’ each year Improve reliability of compliance with National Develop a talent management strategy mortality indices each We will deliver training, 3. Deliver the financial plan to assure sustainability Early Warning Score (NEWS) and qSOFA (quick Deliver an effective communication strategy year Sepsis related Organ Failure Assessment) coaching and talent development plans. Deliver workforce plans Achieving CQC rating of Improve reliability of intentional rounding Good or Outstanding. Deliver under and post graduate education Deliver reliable mortality reviews. 4. Support our staff to deliver high performance and Deliver compliance with mandatory training standards. continuous improvement 2) We will improve patient and care pathways to deliver improved 5) We will ensure good operational planning & execution to deliver our prevention, earlier diagnosis, earlier treatment and earlier discharge agreed plans & standardise processes across the Northern Care Alliance 5. Deliver operational excellence This means In order to achieve this we will: This means In order to achieve this we will: 6. Develop and implement our Service Development Our patients will access Deliver new models of urgent care Delivering urgent, Deliver national or agreed trajectories for access Strategy and the Northern Care Alliance enabling our hospitals less and go planned and cancer targets including A&E, cancer, Referral To Treatment Deliver the integrated care transformation strategies