Agenda 2pm Welcome and introductions Angela Schofield, chairman - - PowerPoint PPT Presentation

Agenda

2pm Welcome and introductions – Angela Schofield, chairman 2.10pm Presentation of annual report – Debbie Fleming, chief executive 2.25pm Presentation of annual accounts – Paul Miller, finance director 2.35pm Membership and governor update – Sandra Yeoman, governor 2.45pm Q&A chaired by Angela Schofield 2.55pm Group discussions on priorities for improving services 3.05pm Feedback on priorities for improving services 3.15pm Clinical presentation on developments in maternity care – Mr Daniel Webster, clinical director for obstetrics & gynaecology 3.35pm Q&A on clinical presentation 3.45pm Close of presentations

Poole Hospital Annual Members’ Meeting ● 25 September 2014

Presentation of annual report

Debbie Fleming, chief executive

Poole Hospital Annual Members’ Meeting ● 25 September 2014

Contents

• Our vision and philosophy of care
• Highlights of the year
• Performance in 2013/14
• Feedback:

– Care Quality Commission – Patients – Staff

• Proposed merger
• Looking to the future

– Redefining our strategy – Transformation programme

Poole Hospital Annual Members’ Meeting ● 25 September 2014

Presentation of annual report

Our vision

• Our vision:

To provide excellent, patient-centred emergency and planned care to the people we serve

• Our unique philosophy
• f care – The Poole

Approach:

Friendly, professional, patient-centred care with dignity and respect for all

Poole Hospital Annual Members’ Meeting ● 25 September 2014

Presentation of annual report

Highlights of the year

• May 2013: Health minister praises innovative

nursing care at Poole

Health Minister Dr Dan Poulter visited the medical investigations unit and older people’s unit, and praised their ‘patient-focused approach’

• August 2013: ‘Fantastic’ matrons receive

Mayor of Poole’s first ever recognition award

Award recognised matrons’ role in improving local health services and changing the way the hospital cares for patients

Poole Hospital Annual Members’ Meeting ● 25 September 2014

Presentation of annual report

Highlights of the year

• November 2013: Older people’s unit

recognised by NHS medical director

Rapid assessment and consultant evaluation (RACE) unit handed a seven-day care award by Sir Bruce Keogh at national conference

• December 2013: Innovative joint

research project wins prestigious award

Joint project with Bournemouth University to develop an ‘epidural simulator’ training tool won at Institution of Engineering & Technology Awards

Poole Hospital Annual Members’ Meeting ● 25 September 2014

Presentation of annual report

Highlights of the year

• January 2014: Maternity staff recognised for
• utstanding contribution to midwifery

Three maternity staff were awarded prestigious Royal College of Midwives awards for achievements in midwifery care and support

• March 2014: Medical

investigations unit (MIU) receives national acclaim

MIU is named runner-up at Nursing Times awards in recognition of its innovative and unique approach to nurse-led care

Poole Hospital Annual Members’ Meeting ● 25 September 2014

Presentation of annual report

Performance and progress

• Strong performance against national standards

set by the health regulator, Monitor:

– All cancer targets relating to surgery, radiotherapy and chemotherapy achieved – 18-week referral-to-treatment achieved for admitted and non-admitted patients – Low rates of hospital-acquired infections such as C-difficile and MRSA – A&E four-hour wait achieved in all but final quarter – significant pressures experienced from Dec 2013

Poole Hospital Annual Members’ Meeting ● 25 September 2014

Presentation of annual report

Performance and progress

• Good performance against local targets

designed to ensure we are delivering effective and appropriate care:

– Achieved standard for ensuring patients who have suffered a stroke receive the right specialist care – Over 95% of fractured neck of femur (broken hips)

• perations carried out within 48 hours

– Challenges during busy months in performing all diagnostic tests within required timeframes, but ended year achieving key targets – Worked with partners to keep delayed discharges to a minimum – further work needed

Poole Hospital Annual Members’ Meeting ● 25 September 2014

Presentation of annual report

Feedback from the CQC

• Care Quality Commission (CQC) visited for two routine

inspections during 2013/14:

– May 2013 – three-day unannounced inspection

• Range of patient feedback - every comment was positive
• Inspectors identified the need for a review of some internal

processes

– January 2014 – one-day unannounced inspection

• Inspectors were satisfied that action had been taken in all key areas

identified in May review

• Ended the year fully compliant with all CQC standards for acute

hospitals

• New intelligent monitoring reports introduced in

October 2013:

– Reports assess trusts on a range of key risk factors and award bandings – from band 1 (high risk) to band 6 (low risk) – Poole rated band 5 in October; band 4 in March

Poole Hospital Annual Members’ Meeting ● 25 September 2014

Presentation of annual report

What our patients said

• Positive feedback in surveys:

– 2013 National Cancer Patient Experience Survey 93% of patients rated care as excellent or very good – 2013 National Maternity Services Survey Services satisfactory in vast majority of areas – improvements to time midwives spend with patients – 2014 National Inpatient Survey ‘Better performing’ in key areas including food and pain control – improvements to mixed sex bathrooms – Friends & Family Test 77.5% of patients ‘extremely likely’ to recommend Poole; 88% of comments positive

Poole Hospital Annual Members’ Meeting ● 25 September 2014

Presentation of annual report

What our staff said

• Staff survey 2013:

– 2013 survey saw a significant improvement in results, with an excellent response rate – Trust featured in the top 20% in seven key areas including:

• Staff motivation
• Staff engagement, including communication between senior

management and staff

• Ability to contribute to improvements at work

– Areas for improvement included:

• Staff experiencing physical violence or harassment from

patients, relatives or the public

• Pressure to attend work when feeling unwell

Poole Hospital Annual Members’ Meeting ● 25 September 2014

Presentation of annual report

Proposed merger

• Proposed merger with the Royal Bournemouth & Christchurch

Hospitals NHS Foundation Trust:

• Boards agreed to pursue a merger in 2012 as a means of securing

clinical and financial sustainability

• Review carried out by competition authorities (Competition

Commission) in 2013

• October 2013 - authorities completed review and made a

decision to prohibit merger on grounds it would result in a substantial lessening of competition which could impact on patient choice

• Poole board took immediate steps to refocus on future as a

standalone trust, ensuring priority remained the delivery of high-quality patient-centred care

Poole Hospital Annual Members’ Meeting ● 25 September 2014

Presentation of annual report

Looking to the future: redefining our strategy

• Appointment of new chief executive and key

board members

• Three key areas of strategic focus:

– Implementation of a robust and sustainable transformation programme to increase efficiency and improve the way we deliver care – Involve staff, stakeholders, patients and the public in the development of a future strategy to meet the needs of the local community – Participation in the Dorset-wide review of clinical services, led by Dorset Clinical Commissioning Group

Poole Hospital Annual Members’ Meeting ● 25 September 2014

Presentation of annual report

Looking to the future: Transformation programme

• Transformation programme designed to return the organisation

to financial and operational health

• Programme will deliver savings of £13.6m over the next 2 years
• Effective implementation is critical – short-term savings must be

achieved whilst longer terms plans are developed

• Need to challenge ourselves to think and work differently, and

transform how we operate

• Initiatives to improve the way we work include:

– Better theatre utilisation – Reductions to unnecessary length of stay – Shaping our workforce around the needs of patients as healthcare changes

• Programme is underpinned by robust governance to ensure quality of

care is maintained

Poole Hospital Annual Members’ Meeting ● 25 September 2014

Presentation of annual report

Presentation of annual accounts

Paul Miller, finance director

Poole Hospital Annual Members’ Meeting ● 25 September 2014

Financial performance summary

• The Trust has achieved its key financial objectives in

the year to March 2014

• This was achieved in the year when the planned

merger with the Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust did not proceed (October 2013) and the associated Monitor investigation into future financial sustainability was positively concluded in March 2014

Poole Hospital Annual Members’ Meeting ● 25 September 2014

Presentation of annual accounts

Sustained good financial performance

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£m 2010/11 2011/12 2012/13 2013/14 Income 188.9 195.1 201.0 210.4 Total Costs (193.1) (194.1) (199.7) (209.5) Estate Revaluation 5.2 (0.9) (9.7) (0.8) Surplus/(Deficit) per Accounts 1.0 0.1 (8.4) 0.1 Add back Revaluation Impact (5.2) 0.9 9.7 0.8 ‘Real’ Surplus / (Deficit) (4.2) 1.0 1.3 0.9 Cash Balance 9.0 15.4 15.0 10.1

Poole Hospital Annual Members’ Meeting ● 25 September 2014

Presentation of annual accounts

2013/14 operating expenses £207,514

Poole Hospital Annual Members’ Meeting ● 25 September 2014

Presentation of annual accounts

2013/14 total staff numbers (2,942)

Poole Hospital Annual Members’ Meeting ● 25 September 2014

Presentation of annual accounts

2013/14 capital £13,241

Poole Hospital Annual Members’ Meeting ● 25 September 2014

Presentation of annual accounts

The trust is an efficient, low-cost provider of high-quality services and has established a sound financial position based on current tariff levels:

• Operating surplus of c.£1m for last 3 years
• Has delivered agreed financial plans
• Healthy liquidity with cash balance of £10m
• No long term debt
• Reference cost index 93

23

Assessment of current financial position

Poole Hospital Annual Members’ Meeting ● 25 September 2014

Presentation of annual accounts

The trust has to successfully operate in a future NHS of:

• very limited real growth in funding
• ageing population
• increased clinical advances
• need to improve clinical outcomes and quality
• improve the integration of care
• rganise services around patients
• increased competition and challenging

commissioning

24

Future financial challenges

Poole Hospital Annual Members’ Meeting ● 25 September 2014

Presentation of annual accounts

Membership and governor update

Sandra Yeoman

Public governor for Poole Chairman of membership, engagement and recruitment group

Poole Hospital Annual Members’ Meeting ● 25 September 2014

26

Membership facts and figures (31 March 2014)

• 5,647 public members
• 3,858 staff and volunteer members
• Target to maintain a total public membership of

5,872 was not met

• 2014/15 target is 6,260

Poole Hospital Annual Members’ Meeting ● 25 September 2014

Membership and governor update

27

Representative membership

• Membership broadly reflects the populations we serve

in terms of gender and diversity with proportionally slightly more members in the female and older age groups

• We have open access to those eligible to become a

member as detailed within the Constitution

• Applications to become a member are available

electronically or in paper format

Poole Hospital Annual Members’ Meeting ● 25 September 2014

Membership and governor update

28

Progress on the membership strategy

Governors used the following opportunities for recruiting and engaging with members:

• Talking with patients and visitors in hospital areas
• Through the governor column in Foundation Talkback
• Through promotion of the Big Ask local survey
• Attendance at local events such as Bournemouth

University Fresher’s Week, residents associations, church coffee mornings and Lewis Manning conference Opportunities to encourage younger members were explored

Poole Hospital Annual Members’ Meeting ● 25 September 2014

Membership and governor update

29

Progress on the membership strategy

It is now easier for individuals to sign up to be a member:

• New website with an online membership form and

members can live anywhere in England!

Poole Hospital Annual Members’ Meeting ● 25 September 2014

Membership and governor update

Successful elections were held in line with the trust’s election rules for the following:

• 1 seat in the Purbeck, East Dorset and Christchurch

constituency

• 2 seats in the staff constituency (clinical and non

clinical class)

• 4 seats in the Poole constituency
• 1 seat in the Bournemouth constituency

30

Elections 2013/14

Poole Hospital Annual Members’ Meeting ● 25 September 2014

Membership and governor update

31

Council of governor activities

On the recommendation of the nominations, remuneration and evaluation committee, the council of governors approved:

• The chairman and non-executive directors appraisal

process

• Remuneration and allowances for chairman and non-

executive directors

• Outcome of the chairman and non-executive directors

appraisals

• Re-appointment of non-executive directors

Poole Hospital Annual Members’ Meeting ● 25 September 2014

Membership and governor update

32

Council of governor activities

• Approved the appointment of a new chief executive
• Produced a revised governor development plan
• Approved changes to the Constitution
• Attendance at training and networking events
• rganised by the hospital or local/national groups

Poole Hospital Annual Members’ Meeting ● 25 September 2014

Membership and governor update

33

Looking to the future 2014/15

• Hold a number of clinical presentations with

members invited to attend with governors

• Establish a governor training and development

reference group

• Increase recruitment activity to achieve agreed

target

• Continue the focus to recruit younger members
• No proposed changes to the structure of the

council of governors and board of directors

Poole Hospital Annual Members’ Meeting ● 25 September 2014

Membership and governor update

34

How to contact a governor Members can contact the council of governors through the membership office by:

01202 448723 Members.contact@poole.nhs.uk Poole Hospital NHS Foundation Trust Longfleet Road Poole Dorset BH15 2JB

Poole Hospital Annual Members’ Meeting ● 25 September 2014

Membership and governor update

Q&A

Led by Angela Schofield, chairman

Poole Hospital Annual Members’ Meeting ● 25 September 2014

Over to you! Group discussion

• Share your thoughts and help us to shape

future services around the needs of our local community

• Please discuss:

– What should our priorities be if we are to improve the way we deliver care at Poole Hospital? (10 minutes)

• Please nominate a member of the group to

provide feedback

Poole Hospital Annual Members’ Meeting ● 25 September 2014

Developments in maternity care

Daniel Webster

Consultant obstetrician and gynaecologist Clinical director for maternity

Poole Hospital Annual Members’ Meeting ● 25 September 2014

Background

• Consultant since 2011
• Clinical director since April 2014
• No conflict of interests

Poole Hospital Annual Members’ Meeting ● 25 September 2014

Developments in maternity care

Maternity care at Poole

• High risk maternity centre

for East Dorset

• Central Delivery Suite
• Low risk birthing unit –

Haven Birthing Centre

• Home birth team – Eden team
• Bournemouth – have low risk midwife led unit
• All high-risk patients from Bournemouth deliver

at Poole

Poole Hospital Annual Members’ Meeting ● 25 September 2014

Developments in maternity care

Statistics

2013-14 2012-13 Deliveries at PHT 4536 4653 Deliveries at RBH 386 441 Caesarean Section Rate 26.2% 24.8% Normal Delivery rate 61.2% 63.2% Home births 132 58

Poole Hospital Annual Members’ Meeting ● 25 September 2014

Developments in maternity care

What’s new

• New Haven Birth Centre
• pened 2014
• Fantastic modern low

risk unit

Poole Hospital Annual Members’ Meeting ● 25 September 2014

Developments in maternity care

What’s new

• Refurbished neonatal

unit

• Two extra rooms on

Central Delivery Suite including a pool room

• This enables high-risk

women to have a water birth

Poole Hospital Annual Members’ Meeting ● 25 September 2014

Developments in maternity care

What’s new

• Eden Homebirth

team

• Created April 2013
• Designed to offer

better support for women wishing homebirth

• Aim to increase

homebirth numbers

Poole Hospital Annual Members’ Meeting ● 25 September 2014

Developments in maternity care

Clinical excellence

• Award-winning midwives at RCM 2013

national awards

Poole Hospital Annual Members’ Meeting ● 25 September 2014

Developments in maternity care

Quality standards

• 2013 National Maternity Survey
• Friends and Family Test – 73% ‘extremely likely’
• Monthly scorecard looking at quality indicators

– 3rd degree tear – Postpartum haemorrhage – Shoulder dystocia – Stillbirth

• 60hr consultant cover
• 1:31 midwife: woman ratio

Poole Hospital Annual Members’ Meeting ● 25 September 2014

Developments in maternity care

Obesity

• Over 20% book in pregnancy with BMI>30
• Risks of obesity

– Hypertensive disorders of pregnancy – Growth restriction – Gestational diabetes – Increased risk of instrumental delivery/ caesarean section – Increased anaesthetic risks – Deep vein thrombosis

Poole Hospital Annual Members’ Meeting ● 25 September 2014

Developments in maternity care

Caesarean section

• Increasing caesarean section rate
• Problem if multiple sections

– Risk of morbidly adherent placenta

• No. of previous

caesarean sections No of women with placenta accreta Chance of placenta accreta with low lying placenta 0.24% 3% 1 0.31% 11% 2 0.57% 40% 3 2.11% 61% 4 2.33% 67% 5 6.74% 67%

Poole Hospital Annual Members’ Meeting ● 25 September 2014

Developments in maternity care

Medical problems

• Increasing maternal age
• Increasing ethnicity
• Diabetes more prevalent

Poole Hospital Annual Members’ Meeting ● 25 September 2014

Developments in maternity care

Smoking

• National target to ensure that <12% of

pregnant women are smoking at booking

• Risks of smoking

– Stillbirth – Premature delivery – Low birthweight

Poole Hospital Annual Members’ Meeting ● 25 September 2014

Developments in maternity care

Where next?

A new maternity unit! Why?

• Vast majority of our patients are high-risk

women

• Proposed for at least 25 years
• Remains as high priority now

Poole Hospital Annual Members’ Meeting ● 25 September 2014

Developments in maternity care

How?

• This is not just a Poole problem
• Affects pregnant women in Bournemouth,

Christchurch, East Dorset, Swanage and the Purbecks

• Affects residents of all three of our local

authorities

• Need to work together with our local partners

to achieve this goal

Poole Hospital Annual Members’ Meeting ● 25 September 2014

Developments in maternity care

Q&A on developments in maternity care

Daniel Webster

Consultant obstetrician and gynaecologist Clinical director for maternity

Sandra Chitty

Head of midwifery

Poole Hospital Annual Members’ Meeting ● 25 September 2014