Annual General Meeting 2020 An Associated University Hospital of - - PowerPoint PPT Presentation

Annual General Meeting 2020

An Associated University Hospital of Brighton and Sussex Medical School

Welcome and

• verview

Richard Shaw Chair

4.30pm Welcome Richard Shaw Chair 4.35pm Our year Michael Wilson CBE Chief executive 4.45pm COVID-19: our response and looking ahead Mr Ian Maheswaran Chief of surgery 4.55pm Annual accounts Paul Simpson Chief finance officer 5.00pm The best dementia-friendly hospital in the UK Jane Dickson Chief of nursing and midwifery 5.10pm Building for the future: our new neonatal unit Dr Avinash Aravamudhan Lead consultant paediatrician 5.20pm Questions Chaired by Gillian Francis-Musanu 5.55pm Close and thank you Richard Shaw Chair

Agenda

Our year

Michael Wilson CBE Chief executive

Overview

• 5,000 SASH staff
• 10,000+ members
• 200+ volunteers
• 100+ Friends of East Surrey Hospital
• Radio Redhill volunteers
• Macmillan staff and volunteers
• Buster and our other therapy dogs
• Jasmine our therapy cat

One Team

• Directors
• Non executive directors
• Governors from the public and

partner organisations

Working together

Our year

We launched a major recruitment drive, and reduced our nursing vacancy rate to virtually 0.

Each year our staff are invited to complete the national NHS Staff Survey. We were delighted that our staff ranked SASH the best nationally when asked if they would recommend it as a place to work and if patient care was the top priority. We ended 2019/20 with a surplus of £7.1million.

We were named best dementia friendly hospital in the country.

Our year

We were one of the first trusts in the country to launch a dedicated system for video appointments for patients. We have already provided 5500 video appointments.

And built a brand new neonatal unit for some of our smallest patients.

Our year

We opened state of the art facilities for women and children and dental patients.

Safety Pin Trust wide safety messages written by clinicians and sent to all staff each week

Quality safe care

Falls remain under the national average Mortality is lower than expected for

• ur patient group

Consistent delivery

• f 98% harm free

care One of the top performers in the country on the emergency department waiting time standard Building on our Outstanding rating with a real focus on Safe and Effective care

Our SASH+ transformation work and Lean for Leaders course continued to develop. We give staff from across SASH the

• pportunity to learn the tools and

techniques to make change; reduce variation and improve patient care.

Working with our partners

Developing SASH Charity

• New three year strategy developed and launched
• New fundraising campaign (Olive’s Appeal) raised over £100,000
• 37 runners raised over £12,000 at Run Reigate
• Successful in our bid to become Gatwick Airport’s next Charity Partner
• We funded thousands of pounds of schemes, including a refurbishment
• f the multi-faith chapel, the NHS Rainbow Badges, heat pads for

patients having chemotherapy, artwork and much more.

COVID-19

Thank you to our incredible staff.

COVID-19

• Enormous effort to

reorganise our services to prepare our response

• We quadrupled our

ventilated beds

• Staff across the Trust

worked in new and unfamiliar roles

• 160 people moved to

support intensive care directly

COVID-19

As of 27 July:

• Total patients treated following a positive test: 1102
• 868 discharged home
• At its peak we had around 150 positive inpatients in East

Surrey Hospital

• The speed, skill and dedication of our staff has been

remarkable throughout.

COVID-19

We remember all those who have lost their lives to this terrible virus.

• Our risk assessment was rolled out for all staff
• Peer-to-peer support through critical incident stress management, chaplaincy

support and our confidential care employee assistance programme

• We’re investing in additional psychological support
• Free wellbeing apps and support line provided by the NHS
• Since April we’ve held regular peer-to-peer sessions for staff from black, Asian

and minority ethnic backgrounds due to the emerging evidence of increased risk.

Supporting our staff

COVID-19

Thank you to our community

• We appreciate your support,

your donations, your clapping and your good wishes.

• We are hugely grateful for

your continued efforts to follow the national guidance.

Mr Ian Maheswaran Chief of surgery

• We expanded our intensive

care footprint and capacity very quickly

• This enabled us to care for

more patients who needed critical care support

• Whole wards moved

locations and new teams were formed.

Never before has our One Team value been so evident:

We’ve found other ways to see patients:

• All hospitals suspended non-urgent appointments and procedures
• We increased video consultations from 10 a week before COVID-19 to

up to 500 per week in June.

And helped patients keep in touch with loved-ones too

• We implemented visiting

restrictions to reduce the spread of infection

• We continued facilitating

visits in exceptional circumstances

• We used technology more

than ever to help

• We introduced a message

service

• Lots of staff telephoned

loved-ones every day

We recruited over 100 people to the RECOVERY research trial

• Thank you to those taking part to help us learn more about the virus
• We are taking part in a number of other important national studies too.

Over 800 people have recovered following treatment for coronavirus at East Surrey Hospital

Next steps

• We have resumed all surgical specialties
• We have rigorous processes to safely see patients face-to-face
• We are continuing to use video and phone appointments where clinically

appropriate

Thank you to our community

Please continue to follow the guidance and help us prevent the spread of infection.

2019/20 Annual accounts

Paul Simpson Chief finance officer

Audit and approval

Slide 31

• Annual accounts 2019-20:

Approved by Trust’s Audit and Assurance Committee in June 2020 - on behalf of the Board

• Accounts received an unqualified

external audit opinion from PricewaterhouseCoopers LLP on 24 June 2020

• No material issues
• Audit completed remotely

*note: this diagram shows a schematic (this one is AMU) used to validate the valuation of the hospital site remotely by the auditors. Neil Pritchard (CAD Technician from the Estates Office & unsung hero) had to shade the schematics according to value per m2. He had to do this for the entire site.

1998/99 1999/00 2000/01 2001/02 2002/03 2003/04 2004/05 2005/06 2006/07 2007/08 2008/09 2009/10 2010/11 2011/12 2012/13 2013/14 2014/15 2015/16 2016/17 2017/18 2018/19 2019/20 Underlying surp/(def) 0.9 (5.0) (4.6) (0.2) (0.0) (12.8) (26.4) (27.8) (12.2) (2.6) (2.7) (0.2) (2.2) (11.9) (9.2) (4.3) (5.2) (7.2)

• 4.3

5.3 1.3 4.2 Net surp/(def) 0.9 (5.0) (4.6) (0.2) 6.7 (4.1) (26.4) (10.8) (12.2) 0.0 7.0 7.6 1.0 (6.1) 0.3 0.3 (2.4) (6.5) 3.7 13.6 11.2 7.1

(35.0) (25.0) (15.0) (5.0) 5.0 15.0 25.0

(£m)

Underlying surp/(def) Net surp/(def)

Financial surplus:

1998/99 1999/00 2000/01 2001/02 2002/03 2003/04 2004/05 2005/06 2006/07 2007/08 2008/09 2009/10 2010/11 2011/12 2012/13 2013/14 2014/15 2015/16 2016/17 2017/18 2018/19 2019/20

• SASH ended 2019/20 with an income and

expenditure surplus of £7.1m [after technical adjustments]

• £4.3m of this financial surplus is from additional

Provider Sustainability Funding awarded to the Trust for effectively managing its financial position

1998/99 1999/00 2000/01 2001/02 2002/03 2003/04 2004/05 2005/06 2006/07 2007/08 2008/09 2009/10 2010/11 2011/12 2012/13 2013/14 2014/15 2015/16 2016/17 2017/18 2018/19 2019/20 Underlying surp/(def) 0.9 (5.0) (4.6) (0.2) (0.0) (12.8) (26.4) (27.8) (12.2) (2.6) (2.7) (0.2) (2.2) (11.9) (9.2) (4.3) (5.2) (7.2)

• 4.3

5.3 1.3 4.2 Net surp/(def) 0.9 (5.0) (4.6) (0.2) 6.7 (4.1) (26.4) (10.8) (12.2) 0.0 7.0 7.6 1.0 (6.1) 0.3 0.3 (2.4) (6.5) 3.7 13.6 11.2 7.1

(35.0) (25.0) (15.0) (5.0) 5.0 15.0 25.0

(£m)

Underlying surp/(def) Net surp/(def)

Financial surplus:

1998/99 1999/00 2000/01 2001/02 2002/03 2003/04 2004/05 2005/06 2006/07 2007/08 2008/09 2009/10 2010/11 2011/12 2012/13 2013/14 2014/15 2015/16 2016/17 2017/18 2018/19 2019/20

• This is our fourth consecutive year of surplus…

..allowing us to properly recover the cash deficit from our past and halve

• ur borrowing

Value for money:

• PwC gave an unmodified

[favourable] opinion on value for money

• In 2019/20 SASH continued to treat

more patients and make significant investments in services while improving our productivity

• …this keeps our reference cost low

– among acute trusts SASH has the lowest reference cost and 2nd lowest cost per [weighted activity] unit in England

Reference cost/national cost collection index Cost (£) per weighted activity unit

2006/07 116 2007/08 95 2008/09 86 2009/10 94 2010/11 97 2011/12 89 2012/13 92 2013/14 92 2014/15 88 2015/16 86 £3,010 2016/17 83 £2,930 2017/18 83 £2,903 2018/19 82 £2,791

Nursing agency costs

986 936 943 830 707 697 622 660 557 464 367 328 267 322 313 200 400 600 800 1,000 1,200 Jan-19 Feb-19 Mar-19 Apr-19 May-19 Jun-19 Jul-19 Aug-19 Sep-19 Oct-19 Nov-19 Dec-19 Jan-20 Feb-20 Mar-20 Apr-20 May-20 Jun-20

£000's

Nursing (Registered and Unregistered) Agency (£000's)

Please note that the trend assumes a reduction in specialist nursing vacancies i.e. Theatres, Paediatrics, RMN's etc.

In January 2019 we spent nearly £1.0m in that month on agency nurses …

*note: this is through the work of the Chief Nurse, Director of OD & People, and their teams. They have: a) recruited staff from overseas and in the UK to reduce our nursing vacancy rate to nearly zero; b) have improved how we manage our bank [paying a bit more], and; c) introduced a different contract structure for agency companies. Our temporary staffing audit provided ‘substantial assurance’ for the first time in our history.

…in January 2020 we spent £0.3m.

SaSH

Cost and quality

Chart shows CQC ratings, cost per unit and surplus on one chart (in Model Hospital) Chart suggests trusts that are rated high quality have lower costs.

Homerton University Hospital FT

SASH

• £14.6m was spent on improving our facilities,

medical equipment and IT infrastructure

Slide 37

Infrastructure spend:

Capital spend £m

2012/13 10.9 2013/14 16.8 2014/15 19.6 2015/16 17.8 2016/17 11.4 2017/18 13.5 2018/19 18.0 2019/20 14.6

Olive’s appeal raises funds for SASH Charity to pay for additional equipment in the new neonatal unit

..our new neonatal unit was opened in 2020, and was opened early to help a difficult birth of triplets – mum and the babies are all very well

Financial plan 2020-21

• Previous NHS financial processes have halted with COVID-

19 (we are paid on a block contract/’top-up’ basis). Within that SASH plans to deliver breakeven in 2020-21, and will use its cash reserves to finance its remaining loan repayments

• We are working with Surrey Heartlands and Sussex CCGs

(and integrated care systems) to fund and plan the restoration of services to manage the winter and any 2nd surge

Slide 38

Jane Dickson

Chief nurse with Chris O’Connor

Consultant Admiral Nurse

Dr Iain Wilkinson

Consultant ortho-geriatrician

The best dementia-friendly hospital in the country

• We developed an ambitious strategy,

set up an action plan and regular team meetings

• Joint clinical leadership:
• Dr Iain Wilkinson, Consultant Orthogeriatrician
• Chris O’Connor, Consultant Admiral nurse
• Dementia care needs a team and this

required a team effort across the Trust to develop and deliver the strategy across four key themes:

• 1. Training and governance
• We designed and provided training across the
• rganisation
• We strengthened governance and data so staff

are now better able to ensure people with dementia have the right support when they need it and are cared for in the most appropriate environment

• As a result, in the last National Audit of Dementia

in General Hospitals we ranked joint highest for governance.

• 2. Engagement
• Through listening to people living with

dementia and their carers we have made lot of improvements, for example in nutrition.

• We have also engaged with partners

across the community including carers organisations, charities, and schools.

Improvements in nutrition

• snack boxes with high-

calorie finger food

• meal times reviewed
• alternative crockery such as

blue plates on some wards to help people see their food more easily

• Ranked joint highest for

nutrition in latest National Audit of Dementia in General Hospitals.

• 3. Environment
• Camomile Courtyard
• Focus on flooring, signage and art

work

• Distinct colours and images aid

recognition

• Important principles throughout our

hospital; not just wards dedicated to

• lder people.

• 4. Experience
• Regular dementia café held
• Wards made pledges and own improvements in

experience for their patients

• We’ve provided ‘movies for memories’, plant

potting, pamper sessions, tea parties and more

Conclusions and next steps

• Strategy being re-written to focus on
• ur future challenges
• Expanding the team and dementia

champions

• Working in line with the next national

strategy and being a pilot site for the next national audit of dementia care

• Looking to engage in research
• pportunities

Dr Avinash Aravamudhan Lead consultant paediatrician

Building for the future: Our new neonatal unit

Neonatal care at SASH

• In 2000 we were delivering

2,000 babies a year, now it’s more than doubled to 4,500.

• Around 500 of these need

care in our neonatal unit each year.

Our new unit

• Over £8.5m investment.
• Transformed our small

facilities into a modern spacious environment with the latest advances in safety and technology.

• Work started in July 2019

and was completed in three stages.

Maintaining care

• Babies continued to be cared

for in the unit throughout the development (including the triplets who were three of our first patients after phase one completed in December).

• Their safety and care and
• ur stringent infection control

standards were our highest priority.

Increased capacity

• We previously had 20 cots,

this has now increased to 25.

• We previously had two HDU

and two ITU cots; we now have eight cots that can safely accommodate both groups of babies.

More space

• Space around our incubators

has quadrupled

• Dedicated space for both

parents to sit by their baby with a clearly defined personal space marked by different floor colouring

A better environment

• Comfortable expressing

room for parents

• A quiet room
• Two side rooms with en-suite

facilities

• Bespoke décor throughout,
• ffering a friendlier and less

daunting environment

• Clinical staff and parents had

a significant input into the design and facilities

State-of-the-art equipment

• State-of-the-art incubators

allow parents to record their voice, heartbeat or a story for their baby.

• Lights can be controlled to

ensure babies gradually gain an awareness of day and night which aids development.

Next steps

• Our community’s donations

to SASH Charity’s Olive’s Appeal have already funded the décor, and are now helping us to build an additional family room and purchase more state-of-the- art incubators and reclining chairs – we are very grateful!

Our people – making a difference

• Dignity and

respect

• One team
• Compassion
• Safety and

quality

Questions

Gillian Francis-Musanu Director of corporate affairs

Thank you

Richard Shaw Chair