Annual Members Meeting 27 September 2018 Gillian Norton, Chairman - - PowerPoint PPT Presentation

Annual Members’ Meeting 27 September 2018 Gillian Norton, Chairman

Outstanding Care, Every Time – Annual Members’ Meeting 2018

Council of Governors’ update Kathryn Harrison, Lead Governor

Outstanding Care, Every Time – Annual Members’ Meeting 2018

Celebrating the NHS at 70 A short film

Outstanding Care, Every Time – Annual Members’ Meeting 2018

Patient story Libby Keating

“I’ve had nothing but kindness and compassion.”

Outstanding Care, Every Time – Annual Members’ Meeting 2018

Outstanding Care, Every Time – Annual Members’ Meeting 2018

Outstanding Care, Every Time – Annual Members’ Meeting 2018

Outstanding Care, Every Time – Annual Members’ Meeting 2018

2017/18 – a year of progress Jacqueline Totterdell, Chief Executive

Outstanding Care, Every Time – Annual Members’ Meeting 2018

Overview

• Introduction
• Who we are and what we do/a year of progress
• Cardiac surgery at St George’s
• Outstanding Care, Every Time – delivering on our objectives
• Personal reflections/the future

Outstanding Care, Every Time – Annual Members’ Meeting 2018

St George’s Hospital Queen Mary’s Hospital

Who we are: St George’s cares for a population of 1.3 million across south west London. Two main hospitals, plus a range of community settings.

As well as our two main hospitals, we provide care in the community As well as our two main hospitals, we provide care in the community We share our Tooting campus with St George’s, University of London. We share our Tooting campus with St George’s, University of London.

Outstanding Care, Every Time – Annual Members’ Meeting 2018

What we do Key services, and an organisation to be proud of

• Local, tertiary and specialist services:
• Centre of excellence for neurosciences,

fetal medicine, plus renal transplantation

• Major trauma and heart attack centre
• 24/7 thrombectomy service for stroke
• Growing influence in research
• Trusted services for local people; including

Emergency Department and maternity service

Outstanding Care, Every Time – Annual Members’ Meeting 2018

A year of progress

• Stabilised executive and senior team
• Reduced vacancy rate and spending on

agency staff

• Launched Quality Improvement Plan
• Reduced financial deficit
• Rolling programme of operating theatre and

ward refurbishment

• Friends and Family Test scores improving
• Upgraded to Requires Improvement by CQC
• But…..a huge amount still to do

Outstanding Care, Every Time – Annual Members’ Meeting 2018

Cardiac surgery at St George’s

Taking action to deliver much needed improvements

We commissioned independent external review We are implementing recommendations at pace Taken steps to stabilise the service, including:

• Transferring complex cardiac surgery to other hospitals
• Removing cardiac surgery trainees
• New programme director appointed
• Separate HR review is looking at team behaviours
• External independent panel convened by NHS Improvement

Outstanding Care, Every Time – Annual Members’ Meeting 2018

Outstanding Care, Every Time – Annual Members’ Meeting 2018

• Delivering fundamentals of patient care:
• MRSA/Clostridium difficile rates below national average
• Mortality rates better than many other teaching hospitals
• Dementia carers passport launched
• Ward accreditation scheme introduced
• CQC upgraded Trust from Inadequate to Requires

Improvement in July 2018

• Working with Institute for Healthcare Improvement

and our own Quality Improvement Academy

Treat the patient, treat the person

Outstanding Care, Every Time – Annual Members’ Meeting 2018

Right care, right place, right time

Indicator Target 16/17 17/18 18/19 to date ED 4 hour >= 95% 91.6% 87.56% 91.75% Referral to Treatment (RTT) incomplete pathways >=92% We are not currently reporting our RTT position due to data quality challenges 62 day wait for first treatment for urgent GP cancer referral >=85% 84.9% 82.60% 88.90% Diagnostic waits >=1% 2.9% 0.2% 0.2% MRSA 2 5

Outstanding Care, Every Time – Annual Members’ Meeting 2018

• Finished 2017/18 with deficit of £53.1 million (£78.7 million in 16/17)
• Plan to reduce the deficit to £29 million by March 2019
• We will do this by:
• Increasing the number of patients we treat
• Reducing waste and inefficiencies
• By balancing our books, we can invest in our future
• Benefiting from generosity of St George’s Hospital Charity

Balance the books, invest in our future

Outstanding Care, Every Time – Annual Members’ Meeting 2018

• New strategy in development
• Improving our IT – including the roll-out of

electronic patient administration system

• Renovated theatres at St George’s
• Rolling ward refurbishment programme
• Opened Energy Centre on Tooting site
• Improving response to small-works

requests

Build a better St George’s

DEVELOPMENT OF

TRUST STRATEGY 2019 -2024

Outstanding Care, Every Time – Annual Members’ Meeting 2018

• Reduced vacancy rate from 17% to 10%
• Staff Appreciation Awards with St George’s

Hospital Charity

• New health and wellbeing initiatives for staff
• Improved Staff Friends and Family Test scores
• King’s Fund leadership development
• Appointed Guardian of Safe Working
• Highest staff flu vaccination rate in London

Champion Team St George’s

Outstanding Care, Every Time – Annual Members’ Meeting 2018

What our staff are telling us

Outstanding Care, Every Time – Annual Members’ Meeting 2018

• Surgical firsts, including first robotic hysterectomy
• Highest ever increase in recruitment to clinical trials
• Staff recognised in academic promotions
• Training partnership with Royal College of Surgeons
• Trial of artificial intelligence in fetal medicine
• Part of 100,000 Genomes project

Develop tomorrow’s treatments today

Outstanding Care, Every Time – Annual Members’ Meeting 2018

Celebrating what we do

Outstanding Care, Every Time – Annual Members’ Meeting 2018

Personal reflections

• A year of progress – but more to do
• Some problems are years in the making – and will take

longer to resolve

• Priority is to make life easier for our staff – from the hospital

estate to information technology

• The job is challenging and rewarding – and fun!
• The support we have from local people is tremendous

Outstanding Care, Every Time – Annual Members’ Meeting 2018

The future

• Development of our 2019-2024 strategy
• Return to financial balance and improve key

services

• Exit ‘special measures’ regime for quality and

finance

• Support and champion our 9,500 staff
• Greater focus on patient and public

engagement

Outstanding Care, Every Time – Annual Members’ Meeting 2018

Annual accounts 2017/18 Andrew Grimshaw, Chief Financial Officer

Outstanding Care, Every Time – Annual Members’ Meeting 2018

Audit opinion

• Present the Accounts for year ended 31 March 2018
• Audit undertaken by Grant Thornton
• Conclusions of the Audit;
• Unqualified audit conclusion
• Adverse conclusion in relation to the arrangements for securing

economy, efficiency and effectiveness in the use of resources

• Emphasis of matter opinion due to the Trust’s dependence on

cash support from the NHS

• The Auditors noted that the production of the Financial Statements

had improved again from the previous year

• The Trust continues to be in Financial Special Measures with NHS

Improvement (NHSI)

Outstanding Care, Every Time – Annual Members’ Meeting 2018

Key elements of financial performance

Financial duty 2017/18 2016/17 Comment Deficit £53.1m £78.7m

• Expectation from NHS Improvement is

that Trusts should aim plan to be in financial balance.

• Failure to identify and deliver cost

improvement plans

• Failure to qualify for additional funding

Income £820.3m £799.1m

• Increase of £21.2 million (2.6%)

Expenditure £873.4m £877.8m

• Decrease of £4.6 million (0.5%).

Capital Investment £53.2m £34.0m

• Investment in IT
• New Energy Centre at St George’s
• Medical Equipment

Borrowings £79.7m £86.0m

• Borrowings were to support working

capital, as well as to support finance urgent capital investment.

Outstanding Care, Every Time – Annual Members’ Meeting 2018

Actions to deliver improvements

• Financial performance
• Financial plan agreed with NHSI to reduce 2018/19 deficit to £16.4 million
• This includes £12.6m of Provider Sustainability funding, which is dependent on

delivery of financial and performance metrics

• Process in place to identify and deliver Cost Improvement Plans
• Borrowing
• NHSI have agreed to support working capital in line with the deficit
• Capital investment
• Investing £18.5 million of internally generated capital funding in 2018/19. We will

continue to seek additional resources for further investment

• Systems and processes
• Actions in place to improve the working of the Finance Department, including upgrade
• f the financial system

Outstanding Care, Every Time – Annual Members’ Meeting 2018

Annual audit letter Paul Dossett, Partner, Grant Thornton

Outstanding Care, Every Time – Annual Members’ Meeting 2018

Questions/feedback

Outstanding Care, Every Time – Annual Members’ Meeting 2018