Annual Public Meeting for Hinchingbrooke Health Care NHS Trust - PDF document

13/07/17 13July 2017 Annual Public Meeting for Hinchingbrooke Health Care NHS Trust Welcome! Welcome Rob Hughes Trust Chairman 1

13/07/17 Looking back over the last year  Tonight’s presentation features the achievements of the previous board of directors, and pays tribute to the efforts of staff in 2016/17  Thank you to the board of Hinchingbrooke Health Care NHS Trust for their support as we merged to form North West Anglia NHS Foundation Trust on 1 April 2017 Agenda for this evening 6.05pm: Review of 2016/17 and merger update – Caroline Walker, Deputy CEO Spotlight on Survivorship – Karen Moseley, 6.20pm: Team Leader for Cancer Community Nurses (Hunts) and Eileen Murphy, Macmillan Project manager for Survivorship 6.40pm: Question-and-Answer session 7pm: Close 2

13/07/17 Review of 2016/17 Caroline Walker Deputy Chief Executive/ Finance Director The year in numbers 3

13/07/17 The year in numbers The year’s highlights  Coming out of Special Measures with a rating of ‘Good’ from the Care Quality Commission (Aug 2016)  Winning the national Health Business Award for Outstanding Achievement in Healthcare  Introducing Schwartz Rounds to support staff in their wellbeing at work – which has been well received  Expanding our ambulatory care model to see a greater number of urgent care patients  Making positive changes to the care of patients with dementia – including having one of the country’s first Admiral Nurses 4

13/07/17 The year’s highlights  CQC National Inpatient survey (published June 2016) placed Hinchingbrooke in the top 20% of NHS Trusts nationally for good patient experience  Patient Services Team reached finals of the Health Estates and Facilities Management Association Awards (People Development Award category) and our Head of Facilities (Soft Services) was a finalist in the Leader of the Year category  Hospital Head Chef was a finalist in the Craft Guild of Chefs Awards 2017 The year’s highlights  Successful completion of phases 1 and 2 of the Woodlands Cancer Centre, in conjunction with Macmillan, which opened in Sept 16  Successful refurbishment of the pathology lab which completed in Mar 2017  Compliance with Cancer Waiting Times standards is good – all standards achieved for 11 consecutive months of the year 5

13/07/17 The year’s challenges  Failing the 4 hour waiting time standard for A&E patients (79.78% against the 95% target)  Lack of bed capacity and issues with the flow of patients through our hospitals have contributed to this  Deficit of £21.17m against a planned deficit of £9.8m  Increased reliance upon high cost agency staff (medical and nursing) to meet gaps in rotas and support increases in activity had driven much of this increased expenditure  Cost Improvement Plan savings not delivered in full (£5m savings delivered against a £6.2m target) The year’s challenges  Recruitment – some hard-to-fill specialty posts, plus hot- spot areas identified – hence greater reliance upon agency staff  Quality Surveillance Rating (a quality performance indicator considered by NHS providers’ regulator and commissioners) saw Hinchingbrooke Hospital’s risk profile heightened from ‘regular’ to ‘enhanced’ in final quarter of the year due to some quality concerns – this reflected on the risk rating of our new Trust post merger  Managing staff morale – in the light of the merger with Peterborough and Stamford Hospitals NHS Foundation Trust 6

13/07/17 + Formed 1 April 2017 Recap – our local health system  Peterborough and Stamford Hospitals NHS FT clinically and operationally sustainable (with specific challenges) BUT not financially sustainable  Hinchingbrooke Health Care NHS Trust neither clinically nor financially sustainable in current form  Cambridgeshire and Peterborough is one of the most financially-challenged health systems in the country – source: NHS England and NHS Improvement 7

13/07/17 Brief history of our hospitals Ongoing regulatory oversight – no solution Hinchingbrooke Peterborough & Stamford  2005: Trust in financial deficit and 2002-2008: In financial surplus  2010: Move to PFI building, Trust clinically unsustainable  reports a £45m deficit in 2010/11  2009: Strategic Health Authority 2012: Monitor-appointed announces Hinchingbrooke  Contingency Planning Team (CPT) franchise tender finds Trust clinically/operationally  2010: Peterborough in joint bid with sustainable, but financially Serco to operate Hinchingbrooke unsustainable  2012: Circle awarded franchise and 2012: National Audit Office and CPT begins managing Hinchingbrooke  identify approx £20-25m shortfall  2015: CQC rates it inadequate with between PFI cost and tariff lack of clinical sustainability  2015: Circle withdraws early from contract, citing unsustainable losses Working together  2015: Regulator-led strategic outline case recommends closer collaboration between Hinchingbrooke and Peterborough & Stamford  Nov 2015: Both trusts commence business case and agree to explore four levels of collaboration:  Option 1 - Do nothing for now  Option 2 - Shared back office function  Option 3 - As per option 2, plus two boards, one executive team and one operational organisation  Option 4 - One organisation 8

13/07/17 Working Together  May 2016: Outline Business Case approved by both Trust boards – agreement given to proceed to Full Business Case  Nov 2016: Both Trust boards agree Full Business Case and set merger date as 1 April 2017 The clinical case for change  Some services in both organisations deemed clinically fragile pre-merger - further services at risk in medium-term  Contributory factors:  Smaller teams compared to teaching trusts/ larger hospitals can make recruitment harder  Agency spending caps  7-day working requirements  Junior Doctors’ contract/provision of rest  For both organisations, collaboration largely resolves clinical sustainability issues 9

13/07/17 Increasingly unsustainable services  As identified in the Business Case: Hinchingbrooke Peterborough & Stamford  Acute Medicine  Diagnostic Imaging  Cardiology  Gastroenterology - 7 day  Diagnostic Imaging bleed service  Interventional  Interventional radiology Radiology  Ortho-Gerontology  Haematology  Stroke  Nephrology  Neurology  Ortho-Gerontology  Palliative care  Stroke Clinical benefits of merging  Merging joins all clinical teams under a single operational management structure: larger teams  medical staff working equitably across sites  shared workload, rotas, out of hours cover   Merger maximises opportunities for: Single governance arrangements  Greater opportunities for training/sub-specialism  Recruitment/retention and reduce agency use  Clinical consistency through shared best  practice 10

13/07/17 Merger benefits in summary  Addresses service vulnerability – particularly for the population of Huntingdon, which has been disproportionately disadvantaged  Clinical collaboration strengthens the provision of a number of services across both sites to ensure long term, sustainable, high quality health services for the populations of Peterborough, South Lincolnshire and Huntingdonshire  Merger saves £9m recurrently  Part of journey to financial sustainability Our hospitals  Hinchingbrooke Hospital 304 beds, A&E Dept, 23-bed Treatment Centre, The Park Maternity Unit, private patient ward, outpatient services  Peterborough City Hospital 635 beds, Emergency Dept , Women’s and Children’s Unit (inc maternity), Cancer Unit, Renal Unit, outpatient services  Stamford and Rutland Hospital 22 beds, Minor Injuries Unit, day case surgery and outpatients services 11

13/07/17 The area we serve  Serving a growing catchment of 700,000 people  Two main clinical commissioning groups  6,000 staff  450 volunteers Executive Team 12

13/07/17 Non-Executive Team Local voices represented  Public governors elected in three constituencies – 6 representing Greater Peterborough – 6 representing Huntingdonshire – 5 representing South Lincolnshire  Staff governors elected by colleagues – 3 at Hinchingbrooke Hospital – 3 at Peterborough City Hospital – 1 at Stamford Hospital  Council of Governors meetings held quarterly – first meeting took place in May 13

13/07/17 Our vision Working together to be the best at providing outstanding care for local communities Our goals Delivering outstanding care & experience Working Recruiting, together developing with local & retaining health & Working our social care together to be workforce providers the best at providing outstanding care for local communities Improving Delivering & developing financial our services sustainability & infrastructure 14