Welcome to our AGM Sue Jacques, Chief Executive 11 th September 2019 - - PowerPoint PPT Presentation
Welcome to our AGM Sue Jacques, Chief Executive 11 th September 2019 www.cddft.nhs.net About our Trust We are the largest Trust in the North East, serving a population of over 650,000 Number of sites = 55 (including 2 acute sites, 1 planned
Sue Jacques, Chief Executive 11th September 2019
www.cddft.nhs.net
About our Trust
www.cddft.nhs.net
We are the largest Trust in the North East, serving a population of over 650,000 Number of sites = 55 (including 2 acute sites, 1 planned care site, 5 community hospitals) Number of #TeamCDDFT colleagues = 7,605 We provide acute & planned hospital care, community services and health and wellbeing services Total Operating Revenue = £487.8m (2018/19 Accounts)
Vision and Strategy
www.cddft.nhs.net
Our Vision sets our what we want to be known for – what we are here to achieve - which is providing care that is Right First Time, Every Time. Our mission sets out ‘why we exist’ – our purpose – which is to provide safe, compassionate and joined-up care to the populations of County Durham and Darlington.
‘Our Patients Matter’ – the Trust’s strategy gives us a framework for the future which sets out our short-and long- term goals and how we will achieve these. It helps us focus
mission - providing the safest, most compassionate and joined-up care for the populations we serve.
www.cddft.nhs.net
www.cddft.nhs.net
www.cddft.nhs.net
A diverse and talented workforce of over 7,000 colleagues #LivingtheValues
www.cddft.nhs.net
Investments & Developments 2018/19
www.cddft.nhs.net
www.cddft.nhs.net
£30 million development – new operating theatres and bereavement suite at Darlington Memorial Hospital
www.cddft.nhs.net
We’re a research- led Trust. In 2018/19, we took part in over 90 studies, involving more than 2,000 patients.
www.cddft.nhs.net
Our #NextStepHome campaign is promoting less time in hospital helping people return to independence in their place of residences sooner – meaning better outcomes and experience.
www.cddft.nhs.net
Building work to transform access to emergency and urgent care was completed at Darlington in April 2019.
www.cddft.nhs.net
We were successful in
community services. Working more closely with our health and social care partners.
www.cddft.nhs.net
NHS70 was an
recognise and celebrate the efforts of
advancements in care and technology across the NHS.
www.cddft.nhs.net
Performance
www.cddft.nhs.net
2018-19 Position Target not achieved A&E attendances – up 2.6% Non-elective admissions – up 2.4% The Trust was unable to meet the NHSI 4-hour wait standard every month, but we did make significant improvements…
Unscheduled Care
www.cddft.nhs.net
A&E and non-elective admissions continued to grow
Unscheduled Care
www.cddft.nhs.net
A&E and non-elective admissions continued to grow
Reduction in ambulance delays More patients assessed within 15 minutes More ambulance handovers within an hour More patients discharged home sooner Reduced trolley wait times Increased use of discharge lounges
2018-19 Position Target achieved CDDFT ahead of target
Diagnostics
www.cddft.nhs.net
99% of diagnostics should be completed within 6 weeks of referral
2018-19 Position Target not achieved
Performance above national average but slightly below NHSI targets
Referral to Treatment
www.cddft.nhs.net
Referral to treatment within 18 weeks
Pressures on some specialties due to increasing demand and staffing challenges
2018-19 Position
Some targets achieved
2-week wait: good but with some variable performance due to increasing referrals 31-day waiting standard: continue to perform strongly 62-day wait for treatment: good performance but managing some areas of pressure
Cancer performance
www.cddft.nhs.net
Consistently better than national average, although not all NHSI targets were achieved
The Year Ahead 2019/20…
www.cddft.nhs.net
Priority areas
www.cddft.nhs.net
Unscheduled Care Demand Maximising staff engagement Achieving long-term financial sustainability Maintaining a high quality patient environment IS strategy
Our Plans 2019/20
www.cddft.nhs.net
Continue our transformation of integrated community services Remain committed to plans for a new Emergency Care Centre at UHND Continue to build role of BAH and further enhance orthopaedic centre of excellence
Improving our emergency and urgent care performance
Our plans and strategy are aligned to the NHS Long Term Plan and we positioned well We are also part of the North Cumbria and North East Integrated Care System and two Integrated Care Partnerships
Roll out of CDDFT ‘Improvement Matters’ Programme to empower service improvement
www.cddft.nhs.net
Noel Scanlon, Executive Director of Nursing
www.cddft.nhs.net
www.cddft.nhs.net
Quality Matters – our plan to support the achievement of our vision, Right First Time, Every Time, and is underpinned by our core values. Quality priorities set out for the next three years, to improve patient safety, clinical outcomes and the experience of those who use our care. We review and refresh with stakeholders annually through the Quality Accounts. This is an overview...
Quality Accounts
www.cddft.nhs.net
How we agree our priorities
Quality Accounts
Quality Accounts
In 2018/2019
quality targets to improve patient safety, clinical
experience of those who need our care
Quality Accounts
In 2018/2019
Consistent focus on our priority areas has been rewarded with improved performance and positive movement forwards in terms of meeting our targets
Highlights & Continued focus:
Quality Accounts
We set ourselves ambitious targets for our patients. Although not all goals met – improvements made and part of continuous journey.
2018-19 Position Ambition not met/achieved The reporting of pressure ulcer incidents resulted in an increase in incidents being reported by community services that were actually attributable to other care providers and patient’s choice. 2019/18 – Rapid Review Process implemented to address
Quality Accounts – Safety
www.cddft.nhs.net
Reduction of Avoidable Pressure Ulcers To have no avoidable grade 3
within acute and community services. Ambition 0 Achievement 10 Pressure Ulcers
2018-19 Position
Goal not met but improvements made MRSA Ambition: 0 Achieved: 2 Clostridium Difficile Ambition: 18 Achieved: 19
Quality Accounts – Safety
www.cddft.nhs.net
We continue to perform consistently well We are one of the best performers nationally in relation to our rate of Clostridium Difficile infections per 100,000 bed-days. Infection Control
2018-19 Position Ambition: met/achieved Mortality indicators remain within expected levels
Quality Accounts – Safety
www.cddft.nhs.net
Reduction in Risk Adjusted Mortality Indices to within ‘as expected’ range (Hospital Standardised Mortality Ratio [HSMR] and Standardised Hospital Mortality Indicator [SHMI]) Mortality
Quality Accounts – Safety
www.cddft.nhs.net
Patient Falls (reduction in incidence per 1,000 bed days community hospitals)
Ambition: met/achieved
= Ambition: 8.0 Achieved: 6.0 Patient Falls (reduction in incidence per 1,000 bed days acute hospitals)
Ambition: met/achieved
= Ambition: 5.6 Achieved: 5.5 Follow Up Patients with Fragility Fracture
Position in 2018/19 41.2%
Trust Ambition not met/achieved but improvements made
Ambition 50% Falls
2018-19 Position
Goal not met but improvements made = Ambition: 95% = Achieved: 92.2% Quality Accounts – Safety
www.cddft.nhs.net
Percentage GP discharge summaries arriving within 24 hours
Discharge Summaries
Rate of patient safety incidents resulting in severe injury or death from the National Reporting and Learning System (NRLS) Goal not met but improvements made Within national average for rates resulting in severe injury or death however number
Ambition: 75th Achieved: 50th (April to September 2018 data)
Quality Accounts – Safety
www.cddft.nhs.net
64.1 34.6 1.1 0.1 0.1 78.5 19.4 1.8 0.2 0.1 10 20 30 40 50 60 70 80 90 No Harm (inc.near miss) Low (Minor) Moderate Severe Death
Incident Reported to NRLS by degree of harm
County Durham and Darlington Foundation All Acute (non specialist) trusts
Incident Reporting
Ambition: met/achieved Improvement demonstrated Quality Accounts - Safety
www.cddft.nhs.net
Improve management of patients identified with sepsis ensuring patients are screened appropriately Sepsis
Ambition: met/achieved Embedded Practice
Quality Accounts – Safety
www.cddft.nhs.net
To comply with the legal duty to be open and honest when things go wrong Demonstrate compliance and monitoring Duty of Candour
www.cddft.nhs.net
Quality Accounts – Safety
We know we also have challenges. As we reported four Never Events in 2018/19 but we have further to go. Continue working to embed safety protocols and learning. Target
Becoming a highly reliable
Never Events
2018-19 Position Ambition: met/achieved To audit against new indicators
Monitoring and refinement introduced
Quality Accounts – Experience
www.cddft.nhs.net
To move nutrition assessment to Nervecentre 2017/18
Nutrition and Hydration
Ambition: met/achieved
Preferred
place of death audit demonstrates improvement Quality Accounts - Experience
www.cddft.nhs.net
We want our workforce to be equipped to provide high quality end of life care and patients approaching the end
receiving high quality care in accordance with their wishes End of Life Care
Quality Accounts – Experience
www.cddft.nhs.net
Responsiveness to patients personal needs
Responding to Patients’ Personal Needs
Position in 2018/19 69.3
Ambition: met/achieved
Ambition 68.6%
Quality Accounts – Clinical Effectiveness
www.cddft.nhs.net
Reduction in re-admission rate to hospital within 28 days
Position in 2018/19 13.2%
Ambition 7% Improvement not demonstrated Readmission to Hospital
Left without being seen Ambition met/achieved Ambition: <5% Achieved: 2.3% Quality Accounts – Clinical Effectiveness
www.cddft.nhs.net
Unplanned re-attendance Ambition met/achieved Ambition: <5% Achieved: 1.8%
Quality Accounts – Clinical Effectiveness
www.cddft.nhs.net
Time to initial assessment Ambition not met/achieved Ambition: 15 mins max. Achieved: 42 mins Time to treatment decision Ambition met/achieved Ambition: 60 mins Achieved: 42 mins
To be treated/admitted/discharged within 4 hours Position in 2018/19 91.5%
Ambition 95%
Ambition not met/achieved To reduce length of time to assess/treat patients in A&E
Quality Accounts – Clinical Effectiveness
www.cddft.nhs.net
Breastfeeding
Position in 2018/19 59.4%
Ambition 60%
Smoking in Pregnancy
Position in 2018/19 16.6%
Ambition 22.4%
12 week Booking
Position in 2018/19 90.3%
Ambition 90%
Complete gap analysis against @Saving Babies Live Implementation Underway Ambition met/achieved
Maternity Standards
2018-19 Position Ambition: met/achieved
Quality Accounts – Clinical Effectiveness
www.cddft.nhs.net
Improved paediatric pathways for urgent/emergency care
Paediatric Care
stretch ourselves further
areas of monitoring within the strategy
improvements in order to improve patient care, safety and experience #TeamCDDFT ready for the challenges and
In Summary
www.cddft.nhs.net
www.cddft.nhs.net
David Brown, FCCA Executive Director of Finance
www.cddft.nhs.net
Financial Reporting and Performance
www.cddft.nhs.net
Challenging Financial Environment
£571m deficit in NHS Providers £177m worse than plan 107 of 230 trusts finished the year in deficit Two thirds of acute trusts are in deficit £2.2 billion of recurrent CIPs delivered £924m non-pay overspend Agency staffing costs reduced to £2.4 billion
www.cddft.nhs.net
Opinions
the Group and the Trusts affairs as at 31st March 2019
prepared in accordance with the published directions
www.cddft.nhs.net
Financial Performance in 2018/19
Financial Performance vs NHSI Plan £000’s Headline Group Financial Deficit
Impairment in Land & Buildings removed 13,918 Charitable Funds net movement removed 755 Less: Capital Donations / Grant Funding
Regulatory Financial Surplus – Actual 52
Capital Investments of £20.6m Cash Balance of £7.86m Cost Improvements of £24.6m
www.cddft.nhs.net
NHSI Assessment
Use of Resources Metric Rating (1 to 4) Capital Service Cover 4 Liquidity 3 I&E Margin 2 I&E Variance from Plan 3 Agency 1 Use of Resources Overall Rating 3 Ratings 1 = Best / 4 = Worst (Planned level = 3)
www.cddft.nhs.net
Questions
www.cddft.nhs.net
Governors and Membership
Warren Edge Senior Associate Director, Assurance and Compliance Richard Scothon Lead Governor
www.cddft.nhs.net
Membership
Public Membership 2017/18 Number of Members Start of year 11,504 New members 290 Members leaving (see below) 435 At year end 11,225
area, choose to end their membership or sadly pass away.
www.cddft.nhs.net
Public constituencies….
Constituency Membership at 31 March 2019:
The geographic profile of the members remained largely static with slight increases in
www.cddft.nhs.net
Membership goals
What do we want?
engagement
inform our plans and services
(more important than numbers)
How are we seeking to achieve it?
www.cddft.nhs.net
Governor Elections
We have 39 Governor seats: 20 public governors, 9 staff governors and 10 governors appointed to represent our stakeholders.
Constituency Turnout Darlington 13.79% Derwentside 11.75% Durham City 12.80% Easington 12.35% Wear Valley and Teesdale 12.77% Staff – Nursing and Midwifery 2.79% Staff – Admin, Clerical and Managers 7.73% Staff – AHPs, Professional and Technical 3.45% Chester-le Street Elected unopposed
Vacant seats carried forward:
Tyneside and Sunderland
and Richmondshire
www.cddft.nhs.net
Governor activities and achievements
As your elected / appointed representatives here are just some of the things our Governors have done on your behalf: Recommended priorities to the Board for short and long-term planning including: (a)
Making best use of Bishop Auckland Hospital (b) Integration of care / community services transformation (c) Improving communication and engagement around service change (d) Further strengthening the Trust’s safety culture (e) Improving the Trust’s CQC rating
Meeting with Non-Executive Directors to understand how they seek assurance and challenge the Executive on important matters such as A&E performance, finance, recruitment and retention and CQC action plans
www.cddft.nhs.net
Governor activities and achievements
Reviewing, providing views, and seeking assurance on sustainability of specific services. Holding the Board to account, in a very open and honest discussion, on learning with respect to staff and public consultation on service change (Ward 6, Bishop Auckland). Providing feedback which is / has been taken account re: specific services including access to out of hours Ophthalmology services, improving the Maternity Bereavement Service and provision of Pharmacy Support to Community Hospitals. Contributing through the Trust’s Patient Experience Forum to the development of initiatives to ensuring patients valuables are not lost and to reduce noise at night
www.cddft.nhs.net
Governor activities and achievements
Representing Governors, and providing a Governor voice, in the Trust’s Charitable Funds Committee, influencing where and how charitable funds are used to improve patient care Reviewing the Council of Governors’ own effectiveness, making the case for increased access to training (internal and external), greater access to NEDs and increased member engagement Providing views on Governor and member engagement via the Trust’s website, to inform the design of the new site which is currently under construction Reviewing and recommending improvements in the patient environment on PLACE visits Reviewing plans for the Cumbria and North East ICS, and highlighting the need for strong representation from Governors
www.cddft.nhs.net
Governor activities and achievements
And there is much more….