Fundusz NHS, Szpitale rejonu Mid Yorkshire Sprawozdanie roczne

Transcription

Fundusz NHS, Szpitale rejonu Mid Yorkshire Sprawozdanie roczne 2012/13
2012/13
2012/13
2
MY ANNUAL REPORT 2012/13
What’s inside
Page
Chairman and Chief Executive statements 4
More about us 6
The highlights of 2012/13 8
Patients 17
Partners and community 24
Staff 29
Board report 35
Looking ahead 45
Annual Governance Statement 47
Financial report 57
Glossary 70
The Mid Yorkshire Hospitals NHS Trust
3
Chairman’s statement
Chairman’s
statement
When I joined the Trust midway through the year, my
expectation was that this was an organisation with limited
prospects and that my role would be to oversee a process to
take the organisation into merger or acquisition by another
organisation.
Since then I have spent a lot of time out and about in the
organisation. I have met some fantastic, dedicated staff and
experienced the passionate loyalty local people have for their
hospitals and community services. It’s therefore no surprise
that six months on – the Trust has a real opportunity to move
forward as a successful organisation.
At the start of 2013/14, we launched a programme
to promote and energise delivery of our Trust values:
Caring, Respect, Improving and High Standards. These values
were developed with our staff, service users and partner
organisations and over the course of the year ahead,
we will be working with teams throughout the organisation
to ensure they underpin everything we do from recruiting
and developing staff to responding to patient concerns.
We have used these values as the headings for sections of
this report to remind people of why they are important to us
and how we can demonstrate them in the way we deliver
care day to day.
I have to thank my predecessor David Stone CBE who
stepped in as acting Chairman in March 2012 and provided
leadership and direction to the Board during a very
challenging period. During the year, we have recruited a
new team of Non-Executive Directors who bring a wealth of
experience to their role and have strengthened the Executive
Director team.
Although we are not a Foundation Trust, the Board has
committed to adopt the standards that apply to Foundation
Trusts – sound systems for ensuring high quality services,
rigorous attention to financial and service performance
and effective engagement with staff and the wider public.
These are the building blocks that will move us to being one
of the best performing organisations – and some examples
of how we are already moving in that direction are described
in this report.
4
Jules Preston MBE
Chairman
Chief Executive’s foreword
Chief
Executive’s
foreword*
It is difficult to sum up in a few words the achievements of
the 12 months from April 2012 to March 2013, which is the
period covered by this report. 2012/13 was an incredible year
for the Trust; a year in which we moved from being amongst
the worst performing Trusts to being recognised for the
positive progress we are making.
At the start of the year, we launched a programme of work
under the banner of Making it Better Together to harness the
energy and initiative of staff to deliver the standards of safe,
high quality care that people in our communities expect and
deserve. There is no doubt that improvement on the scale we
have achieved would not have been possible without a huge
collective effort and everyone in the organisation should be
proud of what we have achieved.
My foreword provides a snapshot of the improvements we
have achieved that are covered in detail throughout the
report.
• Our hospital mortality rate came down so that we
now compare well with similar organisations.
• In 2011/12 the Trust met only half of the national
performance targets. This year we met 89%
• In spite of continued rising demand, we were one
of a very small number of Trusts nationwide who
succeeded in delivering the four hour standard for
treatment in A&E
• The majority of people referred to us for treatment
were seen and treated within 18 weeks and we met
this target as a Trust – although there is still work to
do to get on track in some specialties
• We made major improvements to our outpatient
booking system – which had been a huge frustration
for many people due to inability to book a local
appointment and repeated cancellations
• We have continued to improve our discharge
planning processes so that arrangements are in place
to allow people to go home as soon as they are well
enough
• The number of people who contracted infections
while in our care reduced compared to previous
years.
Throughout the report you will see examples of the excellent
care delivered by our staff and the army of volunteers who
work in our hospitals and in people’s homes. The report also
details how we have invested in improving our services – not
only through investment in equipment and buildings but
also by developing the skills of our staff and by acting on the
feedback we receive from people who use our services.
The report also reflects on some of the challenges we have
faced through the year. Change on the scale we have
delivered has meant tough decisions about how we provide
care, organise our staff and spend public money.
We have also undertaken a major programme of work to
put together proposals for the way hospital services will be
delivered in the future, which were formally consulted upon
between March and May this year.
The Annual Report is an opportunity to celebrate what
we have achieved and thank staff for their hard work and
commitment. I am delighted to say that we have moved a
long way towards our stated aim of being amongst the top
ten Trusts in the country by 2015 and I am confident that we
will continue to build on that success.
Stephen Eames
Chief Executive
Stephen Eames was Interim Chief Executive from 1 March 2012.
* He
was appointed substantively to the post with effect from
2 September 2013.
5
More about us
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Dewsbury and
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More about us
6
Around half a million people living in the
Wakefield and North Kirklees districts of West
Yorkshire use our services in our three main
hospitals – Pinderfields in Wakefield, Dewsbury
and District Hospital and Pontefract - and in
the community as well. People also travel from
other areas to use our services as part of patient
choice.
care to people who have been discharged
from hospital but need extra support, care and
rehabilitation before they go home.
When our Trust was established in April 2002,
we provided mainly hospital services but in
2010 we also started providing community
therapy services and intermediate care services.
These services provide short-term specialist
Our services are provided from three hospital
sites and in a range of community settings such
as health centres, clinics, GP surgeries, family
centres and in people’s own homes.
In April 2011, we expanded to provide
community health services for the Wakefield
district to include Adult Community Nursing
and Children’s and Families’ Health.
More about us
Leeds
Rothwell
Castleford
M62
Normanton
Pinderfields Hospital
(Wakefield)
Featherstone
Pontefract
Hospital
A1(M)
M1
Dewsbury to Pinderfields
8.5 miles
Hemsworth
Pinderfields to Pontefract
10.7 miles
Pontefract to Dewsbury
17.6 miles
Barnsley
South Elmsall
Every day on average during
2012/13…
•
•
•
•
•
•
•
•
More than 600 people attended our emergency departments
About 218 patients were admitted as an emergency
We carried out more than 260 planned procedures, such as operations
We saw around 1,850 people in our outpatient departments
19 babies were delivered in our maternity units
We provided community services to more than 308 patients
Our district nurses made more than 1,060 patient visits
Our health visitors saw more than 17 new babies.
7
The highlights of 2012/13
The
highlights
of 2012/13
This annual report is an opportunity to celebrate some
of the great work, achievements and improvements
delivered by our staff, supporters and partners.
Here’s just a snapshot …
8
Caring
Ensuring quality of care is at
the heart of everything we do.
Arts@Pinders:
A world of new creative opportunities was opened up
to spinal injury patients at a new Arts Club launched
with the help of our Trust. Arts@Pinders gives people
being treated at the Spinal Injuries Centre at Pinderfields
Hospital the chance to use art and crafts as a means of
therapy, self-expression – and fun!
The club was launched by four former patients from
the Spinal injuries Unit - Steven ‘Harry’ Harrison, John
Clayton, Belinda Noda and David Wilders.
National award for support:
Supporting carers
and parents:
A specialist advice line is now supporting parents and
carers across the district to provide the best possible
care for children and young people with diabetes.
The service, operating every day of the year, has been
extended to cover children attending the Dewsbury
diabetes clinic. It puts young people, parents and
carers in direct contact with a team of specialists who
can provide expert advice and support on all aspects of
managing the condition.
Our Childcare and Carers’ Support Service scooped a
national award in May in recognition of its support to
working parents and carers. The team won the ‘Most
effective benefits strategy for working parents and
carers’ award at the national ‘Employee Benefits’ 2012
awards. The service won the award for their work in
developing ways of working for staff with childcare and
carer responsibilities as well as benefits and support
available for all staff.
9
Pledging high quality care:
Nurses from our Trust pledged their commitment to
providing high quality patient care at our first Nursing
and Midwifery conference. It was on the theme of
‘Energise for Excellence’ (E4E), and saw staff come
together to share ideas and best practice.
The conference saw the launch of the Trust’s Nursing
and Midwifery Strategy and provided an opportunity to
showcase the good work and innovative practice that is
being undertaken across both hospital and community
services.
Sharing experiences:
Patients and their families shared their personal
experiences with staff at our Trust in a bid to improve
standards of care. The annual Patient and Family
Experience Summit gave clinical staff a personal
insight into what it’s like to be cared for at our
hospitals.
The event, in its third year, uses real life stories to
help staff see things from the patients’ perspective.
Both positive and negative experiences were talked
about to highlight what things the Trust does well
and what could be done better.
10
Respect
Showing value and respect
for everyone and treating
others as we would wish
to be treated.
Valuing our heroes:
Staff who provide exceptional care at the Trust were
recognised by a national awards scheme. Nine members
of staff from across our three hospitals and community
services were named NHS Heroes. The scheme was set
up as part of the NHS’s 64th birthday celebrations to
honour those who go the extra mile in their work to
make sure that every patient receives the best care.
It’s the first time that both patients and colleagues have
had the chance to celebrate their heroes and recognise
their efforts.
They were: James Carr, Volunteer Guide; Tao Carey,
Midwife; Fran Lofthouse, Health Care Assistant;
Martin West and Helen Chadwick, Design and Print;
Heinz Schulenburg, Consultant Anaesthetist; Heather
Angilley, Senior Specialist Physiotherapist; Lorraine
Hughes, Senior Midwife; and Liz Lynagh, Health Visitor
at Crofton Health Centre.
11
Valuing your voice:
People with a passion for healthcare were invited to
represent their community on our new Stakeholder Forum
which we set up in 2013.The forum enables local people to
have a strong voice in the development of health services
across Wakefield, Pontefract and North Kirklees.
Jules Preston MBE, Chairman of the Trust, said: “Not only do
we need to make sure we provide the right services, we also
need to listen to the public and take on board their views to
identify the most effective ways of delivering them.”
Tackling bad behaviour:
A local Police Community Support Officer (PCSO)
started working with hospital staff to tackle crime
and anti-social behaviour at Pinderfields Hospital.
PCSO Glen Kilduff of West Yorkshire Police started
a dedicated three-month pilot to support Trust staff.
The aim was to ensure the hospital site offers a safe
and pleasant environment for patients, staff and
visitors. His role will include working with security
staff to deal with criminal incidents and anti-social
behaviour.
PCSO Kilduff said: “The Police and the Trust already
have a strong relationship and the hospital has
good facilities and security, but being on the site
means we can work even more closely together to
deal with incidents quickly and effectively.”
12
Satisfaction survey:
Our Physiotherapy Service was highly rated
in a patient satisfaction survey carried out in
2012. The audit showed that 98% of patients
were satisfied or very satisfied with the service,
and 82% of patients had seen a significant
improvement in their condition following
assessment and treatment.
The survey was part of a continued commitment
by us to listen to what patients have to say.
Patients’ views were sought about their
involvement in the planning of their treatment,
whether they were treated with dignity and
respect, how informed they were of their
progress, and whether staff were helpful.
High standards
Taking responsibility for providing the
best services and patient experience.
New hi-tech equipment:
A £500,000 piece of equipment, called a
lithotripter, was installed in the Urology
Investigations Unit at Pinderfields Hospital
in January 2013 and is helping to provide
quicker and better treatment for patients with
kidney stones. It is being used to treat over
20 patients a week using a procedure called
extracorporeal shock wave lithotripsy where
intense high-frequency sound waves are used
to target and crush kidney or gallstones.
It means that emergency patients can be treated
quickly and without the need for invasive surgery
and non-emergency patients require fewer courses
of treatment, meaning fewer trips to the hospital.
Clinics closer to home:
Investing in the future:
Our purpose-built, hospital education centre at
Pinderfields was officially opened in May. The centre
was designed to complement a similar facility at
Dewsbury and District Hospital in providing modern
facilities for staff for learning and study. It houses
clinical skills rooms, mock ward areas, training
rooms for resuscitation, the staff library and a
large lecture theatre. State-of-the-art virtual reality
simulators allow junior doctors to carry out surgical
procedures on virtual reality ‘patients.’
A specialist team of hospital diabetes nurses and
doctors started to hold clinics in GP practices across
the Wakefield District for patients who would
benefit from specialist advice and treatment.
The team works alongside GPs and practice staff.
This means that patients can be seen in their
community by the most skilled person at the right
time, which helps to better manage the patient’s
condition outside of hospital. This also helps patients
avoid long-term complications such as heart, feet
and eye conditions and reduce hospital visits.
13
New screening service:
The first patient in our area to be successfully treated for a
potentially fatal condition discovered by a new screening
programme urged others to go for screening. Mr John
Watson, 65, of Methley, had a successful operation at
Pinderfields Hospital in Wakefield to repair a large abdominal
aortic aneurysm (AAA), which was detected when he
attended for screening at his local GP surgery.
The Abdominal Aortic Aneurysm Screening Programme
was introduced in Wakefield and North Kirklees in
2012 and is being introduced gradually across England.
Screening is offered at local GP surgeries and is free of
charge to all men in the year they turn 65. It is a simple
ultrasound test to detect potential abdominal aortic
aneurysms. Women are much less commonly affected
and are not included in the screening programme.
Eye care changes:
Changes to ophthalmology (eye care) services led
to more patients being seen at Pontefract Hospital.
Glaucoma, medical retina and cataract services at
Pinderfields Hospital moved to Pontefract to make
better use of the space there. Before the move
outpatient clinic rooms at Pontefract were underused and, although theatre sessions were being well
used, there was significant room for improvement
in terms of the number of patients accessing the
theatre unit.
Since the changes in September 2012 there’s been
a significant increase in the number of patients
undergoing planned surgery at Pontefract.
Hitting the standard:
We were delighted to achieve the four-hour
emergency care standard for 2012/13 – especially
against a background of an 8% increase in
activity. Across the year we saw, admitted, treated
or discharged 96.1% of our patients in four
hours against a target of 95%. Chief Operating
Officer Carole Langrick said: “This is a fantastic
accolade and it is all thanks to our staff for their
continued dedication and hard work. It has been
a very demanding year for all of our people, and
particularly those working in emergency care
services.”
14
Improving
We always look for ways to improve
what we do. We encourage involvement,
value contributions and listen to and
positively act on feedback.
More operations at
Pontefract:
Work to improve the way state-of-the-art
facilities at Pontefract Hospital were used for
local residents is reaping results. A project
to improve the way the hospital is used was
launched in December and there have been
increased patients attending fracture clinics
and more operations carried out in the
hospital’s theatres.
Listening to you:
Cancer waits fall:
Waiting times for cancer patients at our Trust had
dramatically improved according to figures we reported
in April 2013. Improvements to the service meant more
patients were receiving their treatment locally than ever
before and we were one of the best trusts in the region
for ensuring that patients with suspected cancer referred
by their GP were seen within two weeks.
Dr Nick Spencer, lead clinician for cancer services, said:
“Thanks to the dedication of all our clinical and support
staff, more patients with suspected cancer are being
assessed and investigated faster than ever before.”
The Friends and Family Test, a national initiative to
gather feedback from patients, was launched at our
hospitals in March 2013. It gives patients the chance
to feed back their views of the care or treatment
they have received in hospital. The feedback helps
us celebrate areas of good practice and target areas
for improvement. On discharge from hospital, each
patient is given a survey form with the question:
“How likely are you to recommend our ward / A&E
Department to friends and family if they needed
similar care or treatment?”
Every patient is invited to respond by choosing one
of six different options, ranging from “extremely
likely” to “extremely unlikely”. They can also add
further comments if they wish to do so.
15
Results on the up:
Improvements in A&E
services:
An annual audit in 2012 showed stroke services
at the Trust were improving. The sentinel stroke
national audit programme measures hospital trusts
against national clinical guidelines for stroke and
gives an indication of how they are doing compared
to other trusts. The audit was carried out by the
lead clinician for stroke at the Trust and the results
showed significant improvements had been made
since the last audit in 2010.
An independent patient survey said our A&E services
had improved significantly. The Picker Institute
conducted the survey on our behalf and patients
were selected at random. They had attended A&E
departments at Pinderfields, Pontefract or Dewsbury
and District Hospitals between January and March
2012.
The 275 people who took part were asked questions
on a range of topics including arrival, waiting, care
and treatment, tests and environment and facilities.
98% of patients said the department was clean
or very clean, 93% praised doctors and nurses for
working well together and 90% rated reception staff
as excellent, very good or good (90%). The results
show the Trust has made significant improvements
in cleanliness and privacy since the last survey which
was in 2008.
Getting IT right:
IT services at our Trust were recognised at the 2012
E-Health insider awards, which reward excellence
in healthcare IT. Our Trust, along with supplier
MongooseIT, beat off stiff competition from four
other finalists to win the Healthcare IT product
innovation category for ‘Healthview’.
Healthview is a search engine which enables staff to
find clinical information from the Trust’s electronic
patient record systems in a very quick and simple
way. The system took 10 months to develop and
was designed with clinicians, for clinicians.
16
Patients
Patients
Every year our staff care for thousands and thousands of people in
our hospitals, in clinics in our community and in patients’ own homes.
Our vision for the future has been shaped by listening to the opinions
and experiences of our patients and those close to them, along
with the views and priorities of our staff and key stakeholders.
We strive to ensure continuous improvement in the quality of our
services for our patients.
Did you know?
were meeting the
The UK food safety regulator confirmed we
safety in March 2013.
very highest standards of food hygiene and
years – the highest
We have held a five star rating for over five
s Agency.
accreditation given out by the Food Standard
17
Patients
What the survey said
Every year the health regulator, the Care Quality Commission,
publishes the results of its inpatient survey, carried out with a
sample of hospital inpatients. More than 800 patients in each
of the 156 Trusts were asked for their views on their hospital
stay in areas such as their experience in A&E, waiting times,
the hospital and ward, doctors, nurses, care and treatment,
operations and procedures and discharge.
In our Trust 397 patients returned their completed survey.
The results showed that in the majority of areas, the Trust
compared well with others across the country. The Trust was
reported as being among the best performers nationally in
key areas such as not re-arranging a patient’s admission date
and in providing support for patients in eating their meals.
The report did however flag up significant areas where
the Trust did not compare favourably including people’s
experience, the perception of enough nurses being on
duty and in providing patients with clear information on
medicines.
Stephen Eames, Chief Executive of The Mid Yorkshire
Hospitals NHS Trust, said: “This survey is one of the ways that
we gather feedback about how our patients feel about our
services. I’m pleased that the majority of patients who took
part in the survey felt that we are doing well in some really
key areas such as not changing their hospital admission date.
“I’m also pleased that in the main, we are also maintaining
our performance on last year and compare well with other
Trusts in the majority of areas.
“However, the survey highlights some really significant areas
that we need to review and act upon. I’m disappointed
that when asked about their overall experience, patients
responded less favourably than in 2011 and this means that
nationally we don’t compare well. This is simply not good
enough.
“Our patients deserve nothing but the best care. While more
recent feedback and performance reports over the last year
are positive, the inpatient survey flags up that we need to do
much more and we will review the results and take action in
response to this feedback from our patients.”
The full CQC inpatient survey results are available at:
www.cqc.org.uk
18
Investing in your care
Nearly £16 million worth of investment in healthcare
equipment and facilities took place in 2012/13. We invested
across our hospitals and community services including buying
new medical and IT equipment and improving buildings.
Below are just some of the investments made during
2012/13:
• The installation of a pharmacy robotic dispensing
system – an automated robotic arm and storage
unit which quickly locates and accesses the correct
medicines for dispensing
• Medical simulation equipment including new
urology simulators, which help in training for surgical
operations
• A new stress echo machine which uses ultrasound to
create images of the heart to help determine whether
any chest pain or associated symptoms are related to
heart disease
• New ophthalmic (specialist eye care) equipment
– a new specialist microscope and a retina imaging
scanner and a specialist camera which can take
detailed photos of the interior of the eye
• A machine which uses a laser to treat patients who
have problems with an enlarged prostate
• A machine which takes x-rays of the upper and lower
jaw and teeth.
In addition, investment has been made across all our hospital
sites including new surgical equipment, a new and improved
patient administration system that will go live in 2013 and an
upgrade to the electronic system which organises staff rotas.
Patients
Listening and helping
When our patients need help, advice or support or need
to raise a concern they can turn to our Patient Advice and
Liaison Service (PALS). PALS operates across our Trust and the
central Patient Liaison Team works with key members of staff
to provide the best possible service for our patients.
We always aim to provide the best possible care for our
patients but occasionally things can go wrong. We take
complaints very seriously and investigate them fully. If there
are issues identified, we work with the patient and their
family to address them and learn from them for the future.
But we are also happy to report that we received many
compliments throughout the year from patients and their
relatives – thanking staff for their care, hard work and
dedication. Just a few are summarised here:
The main role of the PALS team is to:
• Advise and support our patients, their families and
carers
• Provide information on NHS services
• Listen to concerns, suggestions or queries
• Help sort out problems quickly on behalf
of our patients, carers and relatives.
y Clinic,
To Rheumatology Da
Pontefract
a five star
“I felt as if I was in
a taxi was
hotel – help getting
eshment
given, a parting refr
is the best
offered, making th
outing for weeks.”
To the Midwife-led Un
it, Pontefract
“Really relaxed enviro
nment; staff
were attentive, calm
and helpful. I’m
really glad we chose
the midwife-led
unit and would recom
mend it.”
To the Community Nu
rsing team at
Homestead Medical Ce
ntre, Wakefield
“The nurses were exce
llent and my
saviours on more than
one occasion.
They were always th
ere for me,
making me feel safe,
secure and in
good hands.”
ity Nurses,
To Commun
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Medical Cen
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a
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e to thank
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and made
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e experienc
very positiv
To the Colpos
copy Clinic,
Pontefract
“At each vis
it I have
found the ca
re given
to me excepti
onal.
Their dedica
tion and
professionalis
m cannot
be faulted.”
To short stay and thea
tres staff at
Pontefract
“I have just come out
of a short stay
ward at Pontefract an
d I cannot
speak too highly of th
e kindness,
tact and humour of al
l staff on
the ward and in thea
tre to a very
nervous patient.”
19
Patients
To A&E, MAU and SA
U at Dewsbury
“I feel moved to tell yo
u of the
wonderful nursing my
sister received at
Dewsbury. She was ad
mitted to A&E,
then MAU and finally
SAU. Nothing was
too much trouble for
the nursing staff.
She received and I witn
essed, first class
professional caring se
cond to none.”
To staff on ward 20
at Pinderfields and the
Macmillan team
“Can I take the opportunity
to thank all the staff on
ward 20 after looking after
my mother in her final days.
The level of care shown was
above and beyond the call
of duty. May I also thank
the Macmillan team for
their support and empathy.”
To Breast Care nurse and
s
consultants at Pinderfield
d
“When I was diagnose
with breast cancer my
en
world fell apart. But wh
the Breast Care nurses
talked to me I started to
get my head around it.
It was nice to know you
were a phone call away
and that was smashing.”
To PALS (P
atient
Advice an
d Liaison
Service)
“I am very
impressed
with PALS
! What a
great serv
ice you
provide.”
and other
To Ward 12
wsbury
staff at De
five day
“During my
ed what I
stay I receiv
be the best
considered to
m
eatment fro
care and tr
al, nursing
all the medic
y staff.
and ancillar
n
ot have bee
They could n
, helpful and
more caring
friendly.”
To staff in Emergency Department,
CCU and Chaplaincy at Dewsbury
“I am writing to tell you about the
excellent treatment I received from all
the staff who were involved in my care.
Nothing was too much trouble for them
and I just wanted to show my gratitude
and appreciation for the wonderful
work done by staff at Dewsbury
and District Hospital. I would also like
to thank members of the Chaplaincy
team who were also very supportive.”
20
2011/12
2012/13
Number of
compliments
3,090
1,999
Number of formal
complaints received
1,341
1,417
% acknowledged
within three working
days (target 100%)
81%
99%
% responded to within
the agreed timeframe
(target 85%)
63%
66%
10
(1 upheld)
16
(1 upheld)
2,400
2,700
Number of referrals
to the Ombudsman
Number of PALS
enquiries
During 2012/13, as a result of feedback from our
patients, carers and relatives, we made some key
changes including:
• Improvements to the environment and admission
procedures for day surgery patients attending Gate
40 at Pinderfields
• Improvements to the Appointment Centre
at Pinderfields to address problems being
experienced by patients
• The introduction of arrangements within
ophthalmology to offer routine review
appointments for Wakefield district residents at
local health centres.
Our philosophy for
handling complaints
The Trust policy on dealing with formal and informal
complaints was reviewed in September 2011. The Policy
outlines our philosophy for handling complaints and
describes how this is underpinned by the Ombudsman’s
Principles of Good Administration, Principles for Remedy
and Principles of Good Complaint Handling.
A particular focus for our Trust is the application of the
Principles:
•
•
•
•
•
•
Getting it right
Being customer focused
Being open and accountable
Acting fairly and proportionately
Putting things right
Seeking continuous improvement.
Patients
The quality of your care
A Quality Account is an annual report from a provider of NHS healthcare about the quality of
services they deliver. Here is a snapshot of the 2012/13 report but if you would like to find out
more you can find the full document on the NHS Choices website or at www.midyorks.nhs.uk
How we did in 2012/13
Quality priority
Improve systems
and processes to
further reduce
mortality rates
Achieved?
The Hospital Standardised Mortality rate (HSMR) for the Trust in 2011/12 was
108.2 which was significantly higher than the expected rate. We undertook a lot of
work to understand why the HSMR was high and found that the main reason was
that we had under-reported the proportion of patients who were having palliative
care. We were only reporting about 60% of the rates that the average Trust
reported. Dr Foster confirmed that this was the main factor.
Yes
During 2012/13, we did a lot of work to improve our mortality rates by focussing
on the quality of care, on the types of patients coming into hospital and on
ensuring we were coding properly.
During the year we have seen a progressive fall in the HSMR so that the rebased
level is now below the national average at 96.
Improve patient
safety by
implementing
the Safety
Thermometer
The Safety Thermometer focuses on the provision of ‘harm free’ care. The definition
of ‘harm free’ care means that patients are not subjected to the following:
•• Pressure ulcers (hospital acquired)
•• Falls with harm
•• Catheters and urinary tract infection (UTI)
•• Venous thromboembolism (VTE).
Yes
We have seen an increase in “harm-free” care and reductions in falls and
pressure sores/ulcers.
Improve the
diagnosis and
care of patients
with dementia
We have signed up to the national register of Dementia Friendly Hospitals and
committed to be an active member of the multi-agency dementia board, working
with the local authority, mental health trust and other agencies to agree priorities
and action plans.
Yes
We have recently participated fully in the second National Dementia Audit, and
the results show we have made significant progress in developing policies and
developing ward level Dementia Champions. Our training programme on dementia
is in place and staff now have the opportunity to gain additional knowledge and
skills to care for patients with dementia.
We screen patients over the age of 75 years for dementia and have guidance for
staff in place to investigate and support those identified.
Improve compliance
with best practice
guidelines and
prevent healthcare
acquired infection*
The Trust failed to achieve its MRSA bacteraemia target in 2012/13 but achieved a
27% reduction in MRSA bacteraemia on the previous year’s performance. (Target
seven – eight recorded)
No (8 cases
against a
target of 7)
We achieved the C Difficile target by a reduction of 61% in reported infections.
Yes
Improve outpatient
scheduling,
bookings and
communications
with patients
We have developed a performance framework for the management of second
and third time cancellations at specialty level, setting standards about who was
authorised to cancel booked clinics and reminding doctors and specialist nurses
about the rules for booking planned absence.
No (5.7% of
appointments
cancelled
against a
target of 5%)
21
Patients
Quality of care is at the heart of what we do and we are
committed to ensuring the safety of all our services and
providing a consistently first class patient experience. In
support of our quality priorities we will also be developing
and then implementing a quality strategy in 2013/14.
How we performed
in key areas
Compliance monitoring
Our quality priorities for
2013/14 are as follows:
1
2
22
To reduce methicillin sensitive
staphylococcus aureus (MSSA) blood
infections by a third compared with
2012/13
To maintain mortality rates below the
national average
3
To improve patient reported outcome
measures (PROMS) for joint replacements
4
To increase incident reporting rates to
that of the top 25% of Trusts
5
To reduce harm from falls by 25%
compared with 2012/13
Annual
target
2012/13
95%
96.1%
7
8
78
39
Referral to treatment waiting
times - admitted
90%
90.7%
times - non admitted
95%
96.3%
times - patients on an
incomplete pathway
92%
93.1%
Diagnostic test waiting times
<1%
0.7%
Maximum wait of 2 weeks
for urgent cancer referral
93%
97.9%
Two week GP referral to first
outpatient - breast symptoms
93%
97.4%
All cancers - 31 days wait
for second or subsequent
treatment - surgery
94%
99.8%
All cancers - 31 days wait
for second or subsequent
treatment - drugs or
treatment
98%
100%
All cancers - 31 days from
diagnosis to first treatment
96%
99.4%
screening to treatment
90%
94.4%
urgent referral to treatment
85%
86.2%
Delays in transfer of care
3.5%
2.9%
Single sex accommodation
breaches
0
4
Venous thromboembolism
risk assessment
90%
97.9%
Measure
A&E - Total time in A&E
MRSA
Clostridium difficile
Patients
Information Governance
Preventing and controlling
infection
We have a team dedicated to fighting infection across our
hospital wards and departments. They work with staff,
patients and visitors to help reduce the chances of an
infection and keep our hospitals clean and safe.
In 2012/13 there were eight MRSA bacteraemia
(bloodstream infections) cases compared to 11 the previous
year and there were 39 cases of Clostridium difficile
compared to 101 the year before.
While this is movement in the right direction we believe that
every infection is one too many and the work continues to
bring down the numbers by partnership working across our
hospitals and in the community.
The infection prevention and control committee is chaired
by our Chief Executive and over the year we have recruited a
new member of staff to focus on hand hygiene and provided
extra training for staff – all part of our efforts to tackle
infections.
We are committed to ensuring that all paper-based and
electronic patient health and staff records are handled in
accordance with the Data Protection Act 1998 and other
related legislation. In the NHS, the term used to describe
the set of controls for assuring that personal information is
handled in a secure and confidential manner is ‘information
governance’.
Every year we assess our compliance with information
governance standards through the NHS information
governance toolkit and every year we continue to make
sustained positive progress. The information governance
toolkit was updated during 2012/13 and set even higher and
more challenging standards to be achieved by NHS Trusts.
At the end of 2012/13 we achieved a very successful score
of 81% which was classified as satisfactory as we achieved
a level 2 or above score in all the 45 requirements. Plans are
already in place to continue to improve this score for the
2013/14 Version 11 IG Toolkit.
The Trust reported one serious untoward incident related to
an information governance breech.
Every patient, every time
23
Partners and community
Partners
and community
We are a major employer in
Wakefield and North Kirklees,
provide services to hundreds of
thousands of people and have
significant buildings and land
in the districts. We are part
of our community and have a
responsibility to our community.
24
Working together
We work closely with many organisations including our
two local authorities, Kirklees and Wakefield Councils,
Local Involvement Networks (LINks) – which have now been
replaced with local Healthwatch organisations - and our
NHS commissioners (who plan and buy health services for
local people). In 2012/13 our main commissioners were
the primary care trusts in Wakefield and Kirklees. From
April 2013 these have been replaced by the new clinical
commissioning groups for Wakefield and North Kirklees.
We are represented on many local boards and are committed
to working with our partners for the benefit of our
community. These roles are important – we need to work
together to safeguard our community wherever possible and
plan for the future.
The proposals to reorganise hospital services which the
Trust has been consulting on, referred to elsewhere in this
report, have been developed through a partnership group
which includes representatives of commissioners, social care
and community and mental health services. The priority has
been to develop a shared view about how services need to
change and develop to make sure health and social care
organisations develop plans that work together to meet the
needs of the population.
Work to develop integrated health and social care services
is being taken forward through a multi-agency task force
involving partners in social care, community health and
mental health services as well as the Trust.
part in surveys and focus groups. We have also recruited
to a public stakeholder forum to help us develop stronger
links into communities. The forum was recruited through
newspaper advertising and direct contact with existing
user groups. Its role mirrors the role of public members
of a Foundation Trust council of governors and members
will engage with the Trust in a strategic and advisory role
and act as guardians of the public interest, providing a
user perspective to the Trust Board on future plans and
supporting the Trust to engage and communicate with the
public more effectively.
A generous community
The generosity of our local community continues year on
year with individuals, teams and organisations supporting
the work we do with generous gifts to our Trust.
Many people raise funds as a way of saying thank you
for the treatment and care they or a family member has
received. Their efforts make a real difference to both patient
care and staff experience.
We have a dedicated Charitable Funds Committee which
manages the money that is donated to us and makes sure
that it is spent in the best way. You can read the fund’s
financial statement on pages 68 and 69 of this report.
We have also been linking with other providers of acute
hospital services and tertiary services to look at how we
might be able to work more closely to deliver services more
effectively and to explore the potential to save costs by
sharing some non-clinical support services.
In addition to our work with other providers of services, the
Trust has met regularly with the Joint Health Overview and
Scrutiny Committee for Kirklees and Wakefield to discuss the
proposed service changes and has provided regular briefing
information to the chairs of both individual committees.
The proposals for hospital services have been the major
topic of discussion with the LINKs but they have also played
a vital role in helping us to improve services, for example
by supporting a review of the way outpatient services are
organised to address frustrations and concerns expressed by
many people who have used our services.
As part of our plans to develop new approaches to engaging
with the public, we have worked with colleagues in the
clinical commissioning groups to develop a database of
people who are interested in getting more involved by taking
25
Preparing for
emergencies
As a major organisation with a vital role in our local
community we have to make sure we are prepared for the
worst. Our Major Incident Planning is fully compliant with
the requirements of the NHS Emergency Planning Guidance
2005.
We work closely with all our partners and regularly carry out
exercises to test our readiness in the event of an emergency
or major incident. In the last year we have worked with
other organisations, such as the ambulance service and local
authorities, and have been involved in 10 exercises.
The Civil Contingencies Act (2004) sets out very clear
responsibilities for organisations like ours. One of those
is that we have a major incident plan, which sets out our
actions in the event of a major incident. We tested this
plan in an exercise run by the Health Protection Agency in
September 2012.
We also have a winter plan for the Trust, which is approved
annually by the Board. We work closely with other
organisations to ensure we can deal with any problems
caused by winter weather.
Sustainability Report
As with all NHS organisations, we have an energy and
environmental policy in place as part of our ongoing
commitment to minimise our impact on the environment.
During 2012/13 the Trust has continued to progress the
sustainable development agenda and to build on the good
work that has taken place in previous years.
Sustainable Development
action plan
The Trust has further developed a revised Sustainable
Development Plan which will be presented to the Board for
approval in 2013, key highlights of the plan include:
• Establishing a director lead to drive and manage the
sustainability agenda
• Commitment to acting as a Good Corporate Citizen
• Progress towards a sustainable health system
• To comply with all relevant legislation
• To ensure new builds incorporate sustainability
measures
• To further progress the Trust’s Carbon Management
Plan.
The plan will be a living document and will be revised
annually to reflect any impacts which may occur within
the Trust estate.
The Trust has a Carbon Management Plan to support
achievement of carbon reduction targets in line with
the NHS Carbon Reduction Strategy, which requires
the carbon footprint to reduce by 10% between 2007
and 2015. Work that has already taken place include a
new centralised energy efficient boiler, a new site wide
building management system incorporating variable speed
drives and extensive metering arrangements and the
removal of steam plant. These schemes have saved 1,497
tonnes of carbon.
Detailed below are some of the key elements that have
been achieved in the 2012-13 financial year.
26
Summary of Key Achievements
in 2012/13
We are making use of new technology designed to minimise
energy and carbon usage. For example, installing solar panels
on some building roofs which saves energy and reduces
carbon emissions.
During the 2012/13 period the Trust trialled a form of
renewable energy on the estate with the installation
of photovoltaic panels being fitted to the Learning
Development Unit at the Dewsbury site.
The Trust’s Transport Service in 2012/13 has made a further
improvement to our carbon reduction strategy. We have
continued to provide a shuttle bus service which substantially
reduces the amount of carbon produced by individual
journeys for inter site travel between our three hospital sites.
Shuttle bus services supported the journeys of 148 thousand
staff and moved 25,000 items of post, parcels and medical
notes including x-rays and urgent items of medical supplies
for wards and theatres. Using the Carbon Trust calculator for
the 369,000 miles travelled by the Trust’s shuttle service a net Co2 saving of 520 tons has been achieved.
The scheme has reduced the Trust’s carbon
footprint by 6.2 tonnes of carbon/annum
and has provided a reduction in utility cost
of £2,422 a year.
Various lighting projects within the Trust have been
clear winners with the new high energy efficient
lighting being fitted to the Staincliffe Wing corridors
at Dewsbury. The intention is for this type of energy
efficient lighting to be incorporated into all our new
build and refurbishment schemes.
The new energy efficient modules have
given a saving of £5,780 per annum with
a carbon saving of 15 tons a year.
The Trust installed night-watchman, a computer based
system which turns off computers that are not in use.
The electrical savings are monitored on an ongoing basis,
to identify any additional opportunities for further savings,
as computer systems are developed or modified.
We have an ongoing partnership with transport providers
to support our Trust’s Travel and Transport strategy. In a
joint project with the Local Authority and METRO, the local
commissioners of public transport, the Trust was able to
re-establish the dedicated bus service to Pinderfields Hospital
from Wakefield Bus Station in 2012. The new 111 service
operates runs every 20 minutes at peak times and provides
a much needed service for visitors, outpatients and staff.
The new service contributes to the Trust Healthy Travel Plan
by further reducing the organisation’s reliance on car travel.
The Trust has also initiated a cycle scheme where staff can
purchase a reduced cost bicycle to travel to and from work,
cutting the impact on the environment. The cost of the
cycles is spread over three years and a number of staff have
taken up the cycle scheme option with cycle trains starting
up in many areas.
Savings to date, in the first year of operation, have shown
a reduction in carbon of 361 tonnes and revenue saving of
£69,334.
Further development of our Transport and Travel strategy to
reduce carbon emissions and fuel consumption has included:
• Developing our policies for fleet vehicles to
ensure that they are both fuel efficient and have
the lowest carbon emissions for their vehicle size
• Making greater use of our staff shuttle bus
service to transport staff as well as post and
packages between sites, including medical
records and instruments.
27
Becoming greener
Plans and visions for the future:
• An organisational structure that puts sustainability at
the heart of its activities
• A sustainable NHS can only be achieved by all staff
and managers’ efforts
• Localised groups to be set up to identify potential
sustainability initiatives
• Staff to be informed and embrace sustainability issues
• Staff to continue to increase their use of cross site
travel arrangements
• Continue to provide staff with the opprtunity to take
up the salary sacrifice scheme relating to cycle to
work initiative
• Continue to undertake Sustainabilty Promotion Days.
Trust Carbon Footprint
The Trust is committed to continuing to promote the
Sustainability Agenda throughout its business and to keep
the principles of this agenda at the core of all its activities.
The Trust’s base CO2 assessment for reporting year 2007/08
was 23,206 tonnes of carbon. From that period to 2010/11,
the Trust has gone through some significant redevelopments
on two of its main sites which have dramatically improved
its carbon footprint. After completion of the Pinderfields
and Pontefract Hospitals and implementation of the carbon
initiatives undertaken, the Trust’s carbon footprint in 2011/12
was 21,607 tonnes, which is a reduction of 1,655 tonnes
from the 2007/08 base line assessment and equates to 7%.
During 2012/13 adverse weather increased the energy
consumption, resulting in an increased carbon footprint of
23,262 tonnes. Although there has been an in year increase
in the Trust’s carbon footprint, previous initiatives have
continued to limit the extent of this adverse effect.
Partnerships and
working groups
The Trust continues to be an active member within the
following working groups and organisations:
• The Climate Change Management Group Yorkshire
and Humberside
• The Sustainable Development Unit
• Local Authority
• The Wakefield Council Environmental Group
• Royal Institute of Public Health
• Northern Energy Group.
28
Staff
Staff
Buildings, technology and facilities are
all important to your care – but nothing
is more important than the people
who provide it, from the people you
never see – working hard behind the
scenes to keep everything running as
smoothly as possible – to the people
at the frontline delivering your care.
Staff headcount
208 Additional Professional
Scientific and Technical
1,496 Additional Clinical Services
1,465 Administrative and Clerical
533 Allied Health Professionals
964 Estates and Ancillary
The Trust has faced some significant challenges in relation to staff
during the year as it undertakes a major redesign of workforce.
This has manifested in industrial action and staff survey results
which show there are areas of low staff morale. Sickness absence
has also been higher than the national average and work has
been ongoing to address this.
196 Healthcare Scientists
755 Medical and Dental
The Trust has put in place a programme of work to address
workforce challenges. This includes introduction of leadership
development programmes and a Top 100 academy to encourage
and develop people with potential, a comprehensive staff
engagement plan and revised policies for staff management.
30 Students
2,413 Registered Nursing and
Midwifery
8,060Total
29
Staff
Celebrating our staff
We celebrated the dedication and achievements of our staff who have gone
the extra mile to make a difference to local health services at our annual
Celebrating Success event in July.
Delighted winners walked away with coveted awards which mark their
commitment to going beyond the call of duty in areas such as patient
care, new and innovative ways to provide services, leadership and lifetime
achievement. The overall winner of the Chairman’s Award for Outstanding
Achievement and the Excellence in Service Improvement Award were the
urology team for their work to improve the management of prostate cancer.
Consultant plastic surgeon Mr
Oliver Michael Fenton was awarded
an MBE for services to paediatric
plastic surgery in the New Year’s
Honours list. Mr Fenton was
nominated by his anaesthetic
colleague, Keith Judkins, who
accompanies him on his numerous
trips to Romania and India where
they perform operations on children
with cleft lips and palates.
Stephen Eames, our Chief Executive, said: “These awards are a humbling
reminder that our staff have the drive and determination to meet challenges
head on. Our staff go the extra mile, they strive to be better and make a
difference to the lives of our patients and I would like to thank them all.”
Dr Kate Granger was one of the
winners in the Yorkshire Evening
Post’s Best of Health Awards.
Kate was the winner of the Judges’
Award – an award designed to
recognise an individual or team
who has made an outstanding
and inspiring contribution in the
field of health. The awards were
launched by the local paper to
recognise local healthcare workers
who go above and beyond the
call of duty. Midwife Pauline Daley
and MY Rosewood Centre Team at
Dewsbury were also nominated for
awards.
30
Staff
Supporting and
developing our staff
“Ensuring the safety of our patients and our staff through
innovative, yet less time consuming training, is often
a difficult task. However, this year the organisational
development team has focussed heavily on developing
and promoting our e-learning provision so that our staff
have more choice about how and when they complete
their mandatory training.” Ian Ward, Associate Director of
Organisational Development.
Our valued volunteers
Just under 1,000 people volunteer at our Trust and make
a valuable contribution to the day-to-day running of our
hospitals – and bring real benefits to our patients.
Mandatory training is essential to protect our staff and
patients and covers issues such as infection control,
medicines management and fire safety. This year’s new
approach has made a great impact. Through a combined
effort of more choice in the method of training, a more
effective reporting system and through the hard work and
support of all the training leads, the Trust actually doubled its
percentage compliance rate in all of the core subjects during
2012.
Other achievements for 2012/13 included:
Their work varies from helping guide patients and visitors
around our hospitals, running coffee shops, helping out in
our wards and departments and helping to gather important
feedback from our patients.
They come from all walks of life and are all ages. Some give
a few hours each week and some are able to volunteer for
more.
Not only do they give their valuable time, they are also great
fundraisers for our Trust and in 2012/13 raised £101,000.
From this money one of the largest donations was for
the benefit of intensive care patients at Dewsbury and
District Hospital with more than £26,000 for new medical
equipment. The unit was presented with a new ventilator,
fibre optic bronchoscope and a dressings trolley.
Our volunteers do a fantastic job and we would like to say
“thank you” to them all.
• The highly successful Clinical Leadership Development
programme, a series of workshops for our clinical
heads of service, aimed at providing this group with
the skills and knowledge to address the range of
leadership and management situations that arise in
today’s healthcare environment
• We continued with our Institute of Leadership (ILM)
programmes for Band 3-7 leaders, providing them
with a sound start in their leadership careers, in
addition to helping them meet those important
management tasks through our “Licensed to
Manage” programme. During 2012/13 we also
trained over 40 apprentices in roles such as
healthcare assistants and technicians.
As a Trust, we recognised and understood that during
difficult economic times, with the need to meet stringent
targets, staff engagement and motivation can often be put
under serious pressure.
This led to the design of a new Staff Engagement and
Organisational Development framework for 2013, with a
range of development initiatives to engage and empower
our staff. This includes a new appraisal process focussed on
quality, the launch of a coaching scheme to provide support
for our management and the introduction of a behavioural
framework, derived from the Trust’s core values, which will
give confidence to our managers in dealing with behaviours
that work against our desired culture.
31
Staff
Childcare support
Our Childcare and Carers Support Service supports all staff to
help them to balance their work and family commitments.
Affordable childcare is an important issue for many
employees. During 2012/13 we introduced a voluntary salary
sacrifice scheme available to all staff using the onsite nursery
facilities. The scheme enables members of staff to sacrifice
the whole of their annual childcare costs and receive Tax,
National Insurance and pension exemption on the amount
sacrificed.
Our onsite holiday club was awarded the top award by a
national charity in recognition of the high quality service
and continual support for children with additional needs.
The benefit road shows continued to promote a range of
benefits, health and wellbeing services and support offered
by the Trust, our Cyclescheme is now open all year round to
Trust employees and we increased the number of discounts
from local organisations available to staff.
Equality and diversity
We are committed to promoting equality and diversity in
our day to day treatment of all staff, patients and visitors
regardless of race, ethnic origin, gender, gender identity,
marital status, mental or physical disability, religion or belief,
sexual orientation, age or social class.
We have a long-standing Equal Opportunities Policy which
was put together in accordance with the Government Acts
on disability, sex discrimination and age discrimination.
Our policy aims to outline our clear commitment to equal
opportunities and the action we aim to take as an employer.
Together with our Equality and Diversity statement, our Equal
Opportunities Policy outlines the principles and behaviour we
would expect from all our managers and staff.
We carry out Equality Impact Assessments (EIAs) on proposed
policies, service developments or functions to identify any
adverse or positive effect it has on differing groups in the
Trust and communities.
As a major local employer we have been focusing on
addressing recruitment and retention issues. This involves
understanding the make-up of our local population and the
barriers, often multiple, facing potential future employees.
We are involved in both local and national initiatives:
• Get Britain Working: In partnership with Job Centre
Plus we create opportunities under some of the Get
Britain Working measures. We provide voluntary work
experience for unemployed people aged 16-24 to
put themselves forward for work placements lasting
between two and eight weeks and between 25-30
hours per week. Young people who have spent up
to eight weeks in a work experience opportunity
can have their placement extended by four weeks
where an offer of an apprenticeship exists. We are
also involved in Work Together, a nationwide initiative
to encourage all unemployed people to consider
unpaid work placements as a way of improving their
employment prospects while they are looking for
work
• Work Programme: This focuses on the longer-term
unemployed and will support a wide range of people
from Jobseekers Allowance recipients who have been
out of work for some time, to individuals who may
previously have been receiving incapacity benefits for
many years
• Exemplar Employer Framework: This is led by
Wakefield Council and is an agreement amongst
public sector organisations to support those with
severe and enduring learning difficulties and mental
health problems into employment.
32
Staff
During 2012 the Occupational Health Service underwent
a significant review, resulting in changes to the model of
service delivery, staffing structure and skill mix.
We aim to support staff in reaching, maintaining and
sustaining wellness and key stakeholders within the
organisation will have opportunity to assist and play a role in
developing this wellness culture through a new Organisation
Health and Wellbeing Group.
Our staff’s health
and wellbeing
There has been a major focus on managing sickness absence
over the course of the year. This has involved improving
support for staff to tackle some of the underlying causes
of ill health, reviewing staff who have repeated episodes of
absence and supporting staff to return to work after periods
of ill health. Reducing sickness absence saved the Trust
almost £100,000 in cover costs and lost productivity and
also has a major impact on patient care and staff morale by
reducing the frequency with which staff have to cover for
unexpected absence. The chart below shows how we have
improved.
In 2012/13:
• We have introduced workplace health champions
• We launched mental health and resilience training
opportunities for staff
• We provided fast-track access to appropriate
treatment and on-line self assessment forms for staff
with musculoskeletal disorders
• We ran a flu campaign which led to 54% of clinical
staff being vaccinated compared to 42% in the
previous year.
Looking after the health and wellbeing of staff directly
contributes to the delivery of quality patient care.
Poor workforce health has high and far reaching costs
to our organisation and ultimately our patients.
Sickness absence
5.5%
5.0%
4.5%
4.0%
3.5%
3.0%
APR
MAY
JUN
JUL
AUG
SEP
OCT
NOV
DEC
JAN
2011/12 with BBW
2011/12 without BBW
2012/13 with BBW
2012/13 without BBW
FEB
MAR
* Balfour Beatty Workplace (BBW) is the Trust’s PFI partner responsible for provision of
some non-clinical services. These staff are managed by BBW on behalf of the Trust.
33
Staff
Working with our staff
Our staff need to know what is happening across the
organisation, as well as in their own service or department,
and have the chance to influence the future of the Trust.
Keeping our staff informed and opening up routes for them
to communicate with senior managers and other colleagues
is vitally important.
Our staff survey
The results for our Trust in 2012 showed an overall
improvement from 2011 and showed that we are doing
well in areas such as our staff feeling safe at work and the
Trust provision of opportunities for career progression or
promotion.
We use a variety of tools – face to face meetings and team
briefings, traditional newsletters and online versions and
blogs from the Chief Executive. Our directors visit wards and
departments to speak to staff and listen to their views and
concerns.
However, there were some significant findings where
the Trust remains in the bottom 20% for acute trusts.
These included staff recommendation of the Trust as a
place to work or receive treatment; staff motivation at
work; staff reporting errors, near misses or incidents and
agreeing that incident reporting procedures are fair and
effective; and staff having well-structured appraisals.
There are regular opportunities to “Ask Stephen” and gain
the ear of the Chief Executive Stephen Eames. There is also
the “Tell Stephen” email address which provides a failsafe
route by which staff can quickly alert him if they feel they are
encountering blockages to sort a problem out.
Our Chief Executive Stephen Eames said: “While this year’s
results showed that we have improved in some areas it is
very clear that we need to do much more and take wideranging action to build on the improvements that we have
already put in place over the last year.”
We work with our Joint Consultative and Negotiating
Committee (JCNC) and involve the committee in developing
and revising our employment policies and managing change.
The committee is made up of management and union
representatives.
We also carried out our own local survey with staff to find
out what changes and improvements they would like to see,
and have developed an action plan to address the National
Staff Survey results which takes account of this feedback
from staff.
Our Medical Staff Committee provides a forum for our senior
medical staff and also safeguards the terms and conditions
of service of all medical staff employed by our Trust.
Examples of actions taken during 2012/13 as a result of Staff
Survey outcomes:
• Introduction of Employee Assistance Programme,
giving all staff access to professional counselling
advice
• Training delivered to support a mentally healthier
working environment to reduce work related stress
• Working with West Yorkshire Police to provide on-site
Police Community Support Officer to assist staff in
difficult situations
• Series of open staff meetings to engage with staff
regarding future direction of the Trust.
The full results of the national survey are available to view at
www.nhsstaffsurveys.com/cms
34
Board report
Board
report
Our Trust Board is legally responsible for the leadership, direction,
control and risk management of our services. This includes setting
our strategic aims and ensuring that the right financial and
human resources are in place for us to meet our objectives.
The Board meets in public and the meetings are open to anyone
who wants to attend. Details, including agendas and papers,
are available on our website at www.midyorks.nhs.uk
The Board is made up of six Non-Executive Directors,
including the Chairman, and five Executive Directors,
including the Chief Executive, and each member brings a
variety of individual skills and experience. The Trust also
has two associate Non-Executive Directors who do not
have voting rights.
Non-Executive Directors are not employees of the Trust and
are appointed to provide independent support and challenge
to the Board. The independent regulator of Foundation
Trusts, Monitor, requires that Non-Executive directors should
be able to act independently and should not:
• Have been an employee of the NHS [aspirant]
foundation trust within the last five years;
• Have or have had within the last three years, a
material business relationship with the NHS [aspirant]
foundation trust either directly, or as a partner,
shareholder, director or senior employee of a body
that has such a relationship with the NHS [aspirant]
foundation trust;
• Have received or receive additional remuneration
from the NHS [aspirant] foundation trust apart from
a director’s fee, participates in the NHS [aspirant]
foundation trust’s performance-related pay scheme,
or is a member of the NHS [aspirant] foundation
trust’s pension scheme;
• Have close family ties with any of the NHS [aspirant]
foundation trust’s advisers, directors or senior
employees;
• Hold cross-directorships or have significant links
with other directors through involvement in other
companies or bodies;
• Have served on the Board for more than nine years
from the date of their first election;
• Be an appointed representative of the NHS [aspirant]
foundation trust’s university medical or dental school.
All of the Trust’s Non-Executive Directors meet Monitor’s
requirements in terms of independence.
35
Board report
Our Board of Directors
as at March 31, 2013
During 2012/13 there were a number of changes to The Mid Yorkshire Hospitals NHS Trust Board, following the resignation of
the four Non-Executive Directors who were in post in June 2012.
Non Executive Directors
Jules Preston
MBE, Chairman
Mr Preston joined the Trust in October 2012, bringing with him extensive experience in the NHS,
having served as Chairman of the Northumberland, Tyne and Wear NHS Foundation Trust, one
of the largest mental health and learning disability Trusts in the country, since its establishment in
April 2006. He has previously been a Non-Executive Director of other NHS organisations including
the former Sunderland Health Authority and the then Northumberland, Tyne and Wear Strategic
Health Authority.
Terry Carter,
Non-Executive
Director
Mr Carter joined the Trust Board in October 2012 and was previously a Head of Operations for
the Audit Commission and a District Auditor with the Audit Commission for a range of health
and local government bodies. Terry is interested in good governance and service improvements of
health and local government.
Trevor Lake,
Non-Executive
Director
Mr Lake joined the Trust Board in July 2012 and has a background at Senior Executive and
Director level in the Hotel and Hospitality industry and now specialises in consultancy across that
sector. He is also an Independent Member of the West Yorkshire Police Authority (since 2005) and
a Non-Executive Associate with NHS Calderdale, Kirklees and Wakefield District.
Louise Scott,
Non-Executive
Director
Ms Scott joined the Trust Board in March 2013 and brings experience of providing advice and
support to people from a wide range of backgrounds with a career in company and commercial
law spanning more than 25 years. Her latest position was head of the legal department of Croda
International PLC, a FTSE 100 global speciality chemical company with more than 3,000 staff and
a turnover of £1billion. Added to her legal work, Louise is a registered volunteer for ShelterBox,
an international disaster relief charity that provides emergency shelter, warmth and dignity to
people affected by disaster worldwide.
David Hicks
(Associate
Non-Executive
Director)
Dr Hicks joined the Trust Board in March 2013 and has a passion for patient safety and patient
experience, and acts as an Inspector for the Care Quality Commission, giving him an insight into
the importance of how organisations appear from the perspective of the general public. In a
previous role, Dr Hicks has been Medical Director at Barnsley Hospital Foundation Trust, where he
was also Acting Chief Executive for 12 months.
David Sheard
(Associate
Non-Executive
Director)
Councillor Sheard joined the Trust Board in January 2013 and is the Deputy Leader of Kirklees
Council. He was first elected to represent the Heckmondwike Ward in 1982 and has chaired
major committees across the council. He was appointed as a Member of the Dewsbury Bench in
1982 and served until going onto the supplementary list in 2012.
He has a degree in Business Studies and graduated as a member of the IWSP. He worked at BBA
Cleckheaton before joining the RAF. On leaving the RAF he worked for Kirklees Council and the
West Yorkshire Passenger Transport Authority.
Executive Directors
36
Stephen Eames,
Chief Executive
Mr Eames has 20 years’ experience as a Chief Executive. He has substantial experience in
merger and acquisition, PFI and public/private sector partnerships and hospital turnaround.
Stephen is also experienced in top level leadership activities and in partnership working with NHS
institutions, local authorities, the private sector and a variety of other agencies. He is a trained
coach and mentor, and regular contributor to the Health Service Journal. He is a member of the
Editorial Board for the Journal of Marketing and Management in Healthcare.
Richard Jenkins,
Medical Director
Dr Jenkins was appointed as Interim Medical Director in August 2012 and was substantively
appointed in November 2012. He is a Consultant in Diabetes and Endocrinology and has been
with the Trust since 2002 after completing his training in South Yorkshire. He has held a number
of medical leadership roles in the Trust since 2004, most recently as the Divisional Clinical Director
for Medicine. He works clinically at all three Trust sites and in the community. MY ANNUAL REPORT 2012/13
Board report
Helen Thomson,
Interim Chief
Nurse
Mrs Thomson holds an MA in Leading Innovation and Change from York University and a BA
(Hons) in Management from Leeds University. She is a registered nurse and midwife and holds
the Advanced Diploma in Midwifery and the Midwife Teachers Diploma. She became the Director
of Nursing and Midwifery and Deputy General Manager at Huddersfield Royal Infirmary from
1991and in April 2001 was appointed Executive Director of Nursing for the Calderdale and
Huddersfield NHS Trust where she also held the post of deputy chief executive since January
2006. She joined The Mid Yorkshire Hospitals NHS Trust as Interim Part-Time Director of Nursing
and Quality from October 2012 to April 2013 when she returned full time to her substantive
position as Director of Nursing for Calderdale and Huddersfield NHS Foundation Trust.
Robert
Chadwick,
Finance Director
Mr Chadwick joined the Trust in October 2011. He was previously Director of Finance at The
Pennine Acute Hospitals NHS Trust from April 2002 and was Acting Chief Executive at the Trust
from May 2006 to June 2007 and Director of Finance at North Manchester Healthcare NHS Trust.
Carole Langrick,
Chief Operation
Officer and
Deputy Chief
Executive
Mrs Langrick joined the Trust in June 2012 as Chief Operating Officer and Deputy Chief
Executive. She started her health service career as a nurse and since then has held a variety
of clinical, managerial and leadership roles in hospital and community services, as well as in
Commissioning and, more latterly, with Strategic Health Authorities. During his career Bob has provided leadership to large complex organisations, achieving key
financial and performance targets. As QIPP lead for Pennine Acute, Bob designed and lead the
project ‘Transforming for Excellence’ which provided for a sound financial foundation based on
the transformation of service provision.
Prior to joining the Trust, Carole was Director of Strategic Development and Deputy Chief
Executive at North Tees and Hartlepool NHS Foundation Trust.
Directors appointed to the Trust Board since April 2013
Prew Lumley,
Non-Executive
Director
Prew Lumley joined the Trust Board in April 2013. Prew is a partner at the leading law firm Squire
Sanders (formerly Hammonds) which specialises in Commercial Property.
Charlotte
Sweeney,
Non-Executive
Director
Charlotte Sweeney has worked at a strategic human resources and development level for more
than 15 years, reporting to the Boards at a number of global, blue chip financial services firms.
She is a leading expert in equality, diversity and inclusion and has advised a number of
Government bodies on their strategies and focus. She is the founder and Director of Charlotte
Sweeney Associates, a consultancy firm specialising in change management strategy, including
diversity, wellbeing, inclusion and employee engagement.
She is an active member of Leeds Chamber of Commerce. In 2010/11 she sat on the Strategic
Housing and Land Availability Assessment Committee for Leeds and has recently been appointed
to the Leeds Chamber of Commerce Economic and Retail Infrastructure Committee. She is also
involved in the Squire Sanders charitable committee and is a member of the Squire Sanders Social
Committee.
Charlotte is currently Leadership Group Member of Employers for Careers Executive Committee
and President of European Professional Women’s Network in London. In addition, she is an
Equalities Advisory Board Member (external) of the Department of Business, Innovation and
Skills and an Advisory Board Member for Women on Boards UK, a Non-Executive Director with
responsibility for Diversity & Inclusion for the City HR Association and a Co-opted Trustee for the
Equality and Diversity Forum.
Sally Napper,
Chief Nurse
Sally Napper joined the Trust Board in May 2013. She is an experienced director having been Chief
Nurse at Bradford Teaching Hospitals NHS Foundation Trust since 2008 where she was also Chief
Operating Officer. Sally has led on improving patient experience and quality of care at Board level.
She is a Registered Nurse and Registered Nurse for Sick Children and worked at Great Ormond
Street Hospital early in her career.
Directors are required to declare any interests relating to themselves or their spouse which may affect their impartiality.
The Declaration is overleaf.
37
Board report
Declaration of Interests
Directors in post at 31 March 2013
Name and title
Interest
Mr Jules Preston,
Chairman
Chairman/NED, Assessment North East Ltd Sunderland (unpaid)
Chairman/Trustee, Grace House North East Children’s Hospice Appeal (unpaid)
Trustee Pinetree Centre (unpaid)
38
Mr Terry Carter,
Non-Executive Director
Nothing to declare
Mr Trevor Lake,
Director, Six Degrees Consultancy Ltd
Ms Louise Scott,
Nothing to declare
Dr David Hicks,
Associate Non-Executive Director
Chairman, Barnsley Premier Leisure (registered charity)
Councillor Mr David Sheard,
Associate Non-Executive Director
Nothing to declare
Mr Stephen Eames,
Interim Chief Executive
Nothing to declare
Mrs Carole Langrick,
Chief Operating Officer /
Deputy Chief Executive
Nothing to declare
Mr Robert Chadwick,
Director of Finance
Nothing to declare
Dr Richard Jenkins,
Medical Director
Trustee of Diabetes Charity
Ms Helen Thomson,
Interim Chief Nurse
Chief Nurse, Calderdale & Huddersfield NHS Foundation Trust
Mr Graham Briggs,
Director of Human Resources &
Organisational Development
Nothing to declare
Mrs Caroline Griffiths,
Interim Director of Corporate
Planning & Projects
Nothing to declare
Specialist Inspector, Care Quality Commission
Board report
Director who joined the trust since April 2013
Name and title
Interest
Prew Lumley,
Partner, Squire Sanders (UK) LLP
Charlotte Sweeney,
Director, City HR Association
Owner, Charlotte Sweeney Associates Ltd
Leadership Group Member, Employers for Careers
Sally Napper,
Chief Nurse
Spouse: Partner, Wellington House Surgery, Batley/Birstall
Sister: Associate specialising in personal injury/medical negligence,
Irwin Mitchell Solicitors, Leeds
Note: For details of directors throughout 2012/13 and more
information about our Board please see our Governance
Statement from page 47
Arrangements for
performance review
of Board members
The Chairman’s objectives were set on appointment in October
2012 and reviewed at the end of the year by the chairman of
the Strategic Health Authority. This responsibility passed to the
chairman of the national Trust Development Authority in April.
The Chairman conducts a quarterly performance appraisal
of all Non-Executive Directors. The annual objectives of the
Chief Executive reflect the priorities of the organisation
set by the Trust Board and are agreed with the Chairman.
The Chairman reviews the Chief Executive’s performance
against these objectives and provides a formal report
to the Remuneration and Terms of Service Committee.
Each Executive Director agrees objectives with the Chief
Executive which reflect their contribution to delivery of the
organisation’s priorities. The Chief Executive conducts a
quarterly performance appraisal for each director and an
annual appraisal which is reported to the Remuneration and
Terms of Service Committee.
39
Board report
Key
Trust Board Attendance

Attended
û
Apologies
Not applicable
1 April 2012 to 31 March 2013
private
only
Name
David Stone
private
only
private
only
3
May
2012
24
May
2012
31
May
2012
21
June
2012
25
July
2012
14
Sept
2012
27
Sept
2012


û




Jules Preston
25
Oct
2012
29
Nov
2012
31
Jan
2013
28
Feb
2013
Totals
6/7





5/5





12/12
Stephen Eames





Prof Tim Hendra





5/5
Tracey McErlainBurns





5/5
Dr Richard
Jenkins
Robert
Chadwick














7/7







12/12
û




4/5
Helen Thomson
Adrian Griffiths


û
Carole Langrick
2/3








û
8/9







10/12
Graham Briggs


û

û
Ruth Unwin





5/5
Caroline
Griffiths


Kate Harper



û



6/7
2/2
Iain Wilkinson



û
3/4
David Longstaff
û


û
2/4
Jack Kershaw

Dr Margaret
Faull




4/4
Anita Fatchett

û


3/4
1/1
Pat Garbutt



û


Rosie Valerio






Trevor Lake








8/8





5/5

1/1

3/3

1/1
Terry Carter
David Sheard
David Hicks

6/7

6/6
Louise Scott
40
28
March
2013

Board report
Remuneration report
Salary and pension entitlements of senior managers
A) Remuneration
Benefits in
kind
£000
2012/13
Salary
(bands of
£5000)
£000
Other
remuneration
(bands of
£5000)
£000
Benefits in
kind
£000
0
0
0
0
0
0-5
0
0
15-20
0
0
0
0
0
15-20
0
0
Anita Fatchett, Non-Executive Director to
2 July 2012
5-10
0
0
0-5
0
0
Dr Margaret Faull, Non-Executive
Director to 2 July 2012
5-10
0
0
0-5
0
0
David Longstaff, Non-Executive Director
to 2 July 2012
5-10
0
0
0-5
0
0
Iain Wilkinson, Non-Executive Director to
2 July 2012
5-10
0
0
0-5
0
0
Jack Kershaw, Non-Executive Director to
23 May 2012
5-10
0
0
0-5
0
0
Terry Carter, Non-Executive Director from
1 October 2012
0
0
0
0-5
0
0
Trevor Lake, Non-Executive Director from
12 July 2012
0
0
0
0-5
0
0
Patricia Garbutt, Non-Executive Director
from 12 July 2012 to 19 March 2013
0
0
0
0-5
0
0
Rosie Valerio, Non-Executive Director
from 12 July 2012 to 4 February 2013
0
0
0
0-5
0
0
Louise Scott, Non-Executive Director
from 1 March 2013
0
0
0
0-5
0
0
Cllr David Sheard, Associate NonExecutive Director from 1 January 2013
0
0
0
0-5
0
0
Dr David Hicks, Associate Non-Executive
Director from 1 March 2013
0
0
0
0-5
0
0
Name and title
2011/12
Salary
(bands of
£5000)
£000
Other
remuneration
(bands of
£5000)
£000
35-40
Non-executive directors
Ed Anderson, Chairman to 2 March
2012
David Stone, Interim Chairman from
3 March 2012 to 30 September 2012
Jules Preston, Chairman from 1 October
2012
41
Board report
(A) Salary and associated costs are recharged by the organisations which employ
them substantively and it is the total recharge which is reported.
(B) Other remuneration includes Medical Director payment, Clinical Excellence
Award, on-call allowance and Additional Programmed Activity (APA).
(C) Other remuneration includes Medical Director Payment, Clinical Excellence
Award, on-call allowance and Additional Programmed Activity (APA).
(D) Interim executive directors who were not paid via the Trust’s payroll.
A) Remuneration
Name and title
2011/12
Salary
(bands of
£5000)
£000
Other
remuneration
(bands of
£5000)
£000
Executive directors
Julia Squire, Chief Executive to
31 January 2012
Benefits in
kind
£000
2012/13
Salary
(bands of
£5000)
£000
Other
remuneration
(bands of
£5000)
£000
Benefits in
kind
£000
155-160
0
0
0
0
0
Stephen Eames, Interim Chief Executive
from 1 March 2012 (A)
0
25-30
0
0
300-305
0
Professor Tim Hendra, Medical Director
to 5 August 2012 (B)
95-100
110-115
0
30-35
35-40
0
0
0
0
55-60
70-75
0
120-125
0
0
40-45
0
0
Dr Richard Jenkins, Acting Medical
Director 6 August 2012, Substantive
from 23 November 2012 (C)
Tracey McErlain-Burns, Chief Nurse and
Director of Patient Experience to 31
July 2012 (Acting Chief Executive 19
December 2011 to 29 February 2012)
Kate Harper, Acting Chief Nurse and
Director of Patient Experience 6 January
2012 to 29 February 2012 and Acting
Director of Nursing and Quality 1 August
2012 to 14 October 2012
10-15
0
0
15-20
0
0
Helen Thomson, Interim Chief Nurse,
from 15 October 2012 (A)
0
0
0
0
50-55
0
Caroline Griffiths, Interim Director of
Corporate Planning & Projects, from 20
August 2012 (A)
0
0
0
0
90-95
0
Vince Doherty, Interim Finance Director 4
January 2011 to 30 September 2011 (D)
0
90-95
0
0
0
0
Robert Chadwick, Finance Director from
1 October 2011
70-75
0
0
145-150
0
0
John Watts, Interim HR Director until 31
October 2011 (D)
0
140-145
0
0
0
0
Graham Briggs, Director of Human
Resources and Organisational
Development from 1 November 2011
45-50
0
0
115-120
0
0
Angie Watson, Chief Operating Officer
to 30 November 2011
90-95
0
0
0
0
0
Adrian Griffiths, Interim Chief Operating
Officer from 1 December 2011 to 1 June
2012 (D)
0
70-75
0
0
25-30
0
Carole Langrick, Chief Operating Officer/
Deputy Chief Executive from 1 June
2012
105-110
0
0
130-135
0
0
Ruth Unwin, Director of Development,
from 1 October 2010. Director of
Communications and Engagement
from 20 August 2012
105-110
0
0
105-110
0
0
The figure for interim directors reflects the amount reimbursed to their employer organisation rather than actual salary.
42
Board report
Salary and pension entitlements of senior managers
B) Pension
benefits
Name and title
Real
increase
in pension
and related
lump sum
at age 60
Real
increase in
lump sum
at aged 60
Total
accrued
pension
and related
lump sum
at age 60
at 31 March
2013
(bands of
£2500)
(bands of
£2500)
(bands of
£5000)
(bands of
£5000)
£000
£000
£000
Lump sum
at aged 60
related to
accrued
pension at
31 March
2013
Cash
equivalent
transfer
value at 31
March 2013
Cash
equivalent
transfer
value at 31
March 2012
Real
increase
in cash
equivalent
transfer
value
Employers
contribution
to
stakeholder
pension
£000
£000
£000
£000
£000
Executive directors
Professor Tim Hendra,
Medical Director
0
0
285-290
210-215
1,522
1,595
0
Dr Richard Jenkins,
Acting Medical Director
6 August 2012,
Substantive from
23 November 2012
2.5-5
7.5-10
155-160
115-120
628
543
56
Tracey McErlain-Burns,
Chief Nurse and Director
of Patient Experience
to 31 July 2012 (Acting
Chief Executive
19 December 2011 to
29 February 2012)
0
0
190-195
140-145
827
778
9
Kate Harper, Acting
Chief Nurse and Director
of Patient Experience
6 January 2012 to
29 February 2012
and Acting Director of
Nursing and Quality
1 August 2012 to
14 October 2012
2.5-5
10-12.5
150-155
115-120
744
623
89
Robert Chadwick,
Finance Director from
1 October 2011
0-2.5
0-2.5
255-260
190-195
1,337
1,233
40
Graham Briggs, Director
of Human Resources
and Organisational
Development from
1 November 2011
3.5-4
11.5-12
185-190
135-140
933
789
103
Carole Langrick, Chief
Operating Officer/
Deputy Chief Executive
from 1 June 2012
35-37.5
25-27.5
230-235
170-175
1,036
782
176
0
0
110-115
80-85
468
435
11
Ruth Unwin, Director of
Development, from
1 October 2010. Director
of Communications
and Engagement from
20 August 2012
43
Board report
Pay Multiple Statement
Highest paid Director’s total remuneration
Median total remuneration
Ratio
2012/13
2011/12
£245,000 - £250.000
£205,000 - £210.000
£25,000 - £30.000
£20,000 - £25.000
9.6
8.13
All NHS Trusts are required to disclose the relationship
between the remuneration of the highest paid director in
their organisation and the median remuneration of the
organisation’s workforce. Total remuneration includes
salary, non consolidated performance related pay, benefits
in kind as well as severance payments. The median total
remuneration above is the total remuneration of the staff
member lying in the middle of the linear distribution of
the total staff in the Trust, excluding the highest paid
director. This is based on the annualised full time equivalent
remuneration as at the reporting period date.
The increase to the remuneration of the highest paid
director reflects the changes in Trust Board personnel in
2012/13. The remuneration of the highest paid director
excludes the associated charges for pension and other costs
of employment which are required to be included in the
remuneration report.
In 2012/13 one employee received remuneration in excess
of the highest paid director (three in 2011/12) and their
remuneration was in the range of £245,000 to £250,000
(£205,000 to £235,000 in 2011/12).
44
Looking ahead
Looking ahead
The Mid Yorkshire Hospitals NHS Trust is putting together
plans to progress towards becoming a Foundation
Trust following major improvements in service and
financial performance achieved during the last year.
The national Trust Development Authority which regulates
and supports Trusts that are not yet authorised as Foundation
Trusts has categorised The Mid Yorkshire Hospitals as
one of 42 organisations nationally where further work
is needed to achieve sustainability and are expected to
be able to achieve Foundation Trust status within three
to four years. The Trust has put in place a programme of
work with the aim of achieving Foundation Trust status.
45
Looking ahead
Meeting the challenge
A major consultation started in March 2013 on plans
to ensure our hospital services are able to provide
high quality care well into the future, with results for
patients becoming amongst the best in the country.
The decision to go ahead with public consultation was
announced by the Board of NHS Calderdale, Kirklees and
Wakefield District in January.
The decision was made on the basis that the chosen option
would:
•
•
•
•
•
Help save more lives
Improve outcomes of care
Keep as many services local as possible
Provide a first class experience for patients
Contribute to financial improvement.
The decision marked the culmination of an intense period
of engagement work carried out in 2012 to explain the
challenges to our local NHS to our wider communities.
From these conversations, we were made aware of key areas
of concern, such as outpatient appointments and transport.
More details about the consultation, the proposals and the
reasons behind them can be found on our dedicated website
www.meetingthechallenge.co.uk
The proposals in summary:
Emergency care
• Pinderfields will continue to provide consultantdelivered emergency care with full resuscitation
facilities and deal with critically ill and injured patients
• Both Dewsbury and Pontefract Hospitals will deliver
emergency care via a mix of doctors and advanced
nurse practitioners. There would also be consultants
during the day and on-call as well as full resuscitation
facilities available
• The three hospitals will operate as an emergency
care network incorporating accident and emergency
departments and emergency day care services.
Maternity care
• Consultant-led maternity care will be centralised
at Pinderfields Hospital, with midwife-led units at
Dewsbury, Pontefract and Pinderfields
• Antenatal (before the birth) and postnatal care
(after the baby has been born) will still be provided
locally at all three hospitals and in GP practices and
community clinics
• Neo-natal services (for very poorly and premature
babies) will be located with consultant-led maternity
care at Pinderfields.
Paediatric care
• Inpatient services for children will be centralised
at Pinderfields Hospital. This includes surgery for
children, which is already centralised at Pinderfields,
and inpatient medical care
• Dewsbury will have a short stay unit for children who
may need to be observed by a clinical team for a few
hours.
Surgical care
• Complex, emergency and major surgery (generally
requiring the backup of critical care) will take place in
Pinderfields
• Dewsbury Hospital will provide an increased range
of planned inpatient surgery (including orthopaedics
from the Dewsbury area) but there will be no
emergency or complex surgery
• Pontefract Hospital will offer planned orthopaedic
operations, including those requiring an inpatient
stay and some short stay surgery from other surgical
specialties.
46
Annual Governance Statement
Annual
Governance
Statement
All NHS provider organisations are
required to produce a statement
setting out the arrangements that
are in place to ensure the delivery
of safe services and to manage
risks. The Annual Governance
Statement of The Mid Yorkshire
Hospitals NHS Trust is overleaf.
47
Scope of responsibility
The Chief Executive is the Accountable Officer for the Trust
and is responsible for maintaining a sound system of internal
control that supports the achievement of the organisation’s
policies, aims and objectives, whilst safeguarding public
funds.
As Accountable Officer, it is my responsibility to ensure
probity and transparency in the running of the organisation
in accordance with the responsibilities set out in the
Accountable Officer’s Memorandum. I am personally
accountable for ensuring the Trust is administered
economically and that the public funds entrusted in me
are deployed efficiently and effectively.
The section below describes the systems that were in place
during the year from April 2012 to the end of May 2013 to
support decision making and manage risks. The statement
is designed to provide an accurate assessment of the
effectiveness of control systems which have been developed
and enhanced over the course of the 12 month period.
The governance framework of
the organisation
The Trust is governed by a Trust Board comprising six
Non-Executive Directors, including the Chairman, and
five Executive Directors, including the Chief Executive.
In addition, the Director of Human Resources and
Organisational Development attends the Trust Board in a
non-voting capacity and the Director of Communications
and Engagement attends public sessions of the Trust Board.
The Trust Board also has two associate Non-Executive
Directors who attend the Board in a non-voting capacity.
The Trust Board has overall responsibility for determining
the future direction of the Trust and ensuring delivery of
safe and effective services in accordance with legislation and
principles of the NHS. The Trust Board must also ensure the
organisation complies with relevant regulatory standards.
Non-Executive Directors of NHS Trusts were appointed by
the Appointments Commission, which is an independent
body. (This function has now been taken over by the national
trust Development Authority). They are not employees of the
Trust but receive remuneration for their role which is agreed
nationally. Executive Directors are employees of the Trust.
Details of directors’ remuneration is set out on page 42 of
the Annual Report.
48
During the year there were a number of new appointments
to the Trust Board. This includes the appointment of an
experienced NHS Foundation Trust Chairman and Chief
Operating Officer as well as recruitment of Non Executive
Directors with a wide range of experience.
The Trust Board members during 2012/13 were:
• David Stone, Chairman until September 30th 2012
• Jules Preston, Chairman from October 1st 2012
• Terry Carter, Non-Executive Director from October 1st
2012
• Trevor Lake, Non-Executive Director from July 12th
2012
• Patricia Garbutt, Non-Executive Director from July
12th 2012 to March 31st 2013
• Rosie Valerio, Non-Executive Director from July 12th
2012 to February 4th 2013
• David Sheard, Associate Non-Executive Director from
January 1st 2013
• Louise Scott, Non-Executive Director from March 1st
2013
• David Hicks, Associate Non-Executive Director from
March 1st 2013
• Iain Wilkinson, Non-Executive Director to July 2nd
2012
• Jack Kershaw, Non-Executive Director to May 23rd
2012
• David Longstaff, Non-Executive Director to July 2nd
2012
• Anita Fatchett, Non-Executive Director to July 2nd
2012
• Margaret Faull, Non-Executive Director to July 2nd
2012
• Adrian Griffiths, Acting Chief Operating Officer to
May 31st 2012
• Stephen Eames, Interim Chief Executive from March
1st 2012
• Carole Langrick, Chief Operating Officer/Deputy
Chief Executive from June 1st 2012
• Tim Hendra, Medical Director until July 31st 2012
• Richard Jenkins, Interim Medical Director from
August 6th 2012. Substantively appointed as Medical
Director from November 23rd 2012
• Tracey McErlain Burns, Chief Nurse & Director of
Patient Experience to July 31st 2012
• Kate Harper, Acting Director of Nursing and Quality
from August 1st 2012 to October 14th 2012
• Helen Thomson, Acting Director of Nursing from
October 15th 2012
• Caroline Griffiths, Interim Director of Corporate
Planning and Projects from August 20th 2012.
The Trust Board met 12 times during the year.
External review of governance
An external review of governance arrangements
was commissioned by the Trust in March 2012. Its
recommendations included a comprehensive review of
committee structures, Board development – including
changes to the composition of the Board, quality of Board
reports, and administration, review of arrangements for
commissioning internal and clinical audit, refinement of the
serious untoward incident management processes, review of
processes for management of the Assurance Framework and
risk register and the interface with clinical risk registers and
review of policies. A comprehensive action plan was put in
place to address the recommendations. Progress in delivering
these actions is reflected in this statement. A detailed review
of arrangements for quality governance was commissioned
in January 2012 and changes to the processes for delivery,
performance management and Board assurance will be
introduced during 2013.
Trust Board committees
This section describes the committee structure which was
established following the external review of governance.
This structure will be streamlined as a result of the changes
recommended following the review of Quality Governance.
There were six committees in place during 2012/13 which
carried out functions delegated to them by the Trust
Board and seek assurance on behalf of the Board. These
committees report directly to the Trust Board. The role of
the committees and a summary of issues considered by the
committees are detailed below:
The Audit Committee
The Audit Committee reviews and provides assurance on
the systems of internal control, including financial controls.
The Audit Committee membership is made up of NonExecutive Directors. Executive Directors attend the committee
to present information. The Audit Committee met 5 times
during the year. Issues considered by the committee included:
•
•
•
•
•
Internal audit plan and progress reports
Internal audit reports and recommendations
External audit updates
External audit reports and recommendations
Counter Fraud policy and legislation and
investigations
• Accounting procedures and issues
• Governance developments and the system of internal
control
• Process for developing the Assurance Framework and
risk register
• Tender exceptions
• Losses and special payments.
The Finance Committee
The Finance Committee provides assurance on the
development and delivery of the financial plans, including
cost improvements. The Finance Committee is chaired by a
Non-Executive Director and its membership includes NonExecutive and Executive Directors. The Finance Committee
met 10 times during the year.
The major focus of the committee during the year has been
to provide oversight to the development and delivery of
cost improvement plans. In addition the committee also
considered plans for capital investment, property disposal,
performance against contract and delivery of CQUIN
targets and the on-going operational management of the
PFI agreement. The committee has also been involved in
reviewing the development of financial plans for 2013/14.
The Quality and Clinical Governance
Committee
The Quality and Clinical Governance Committee provides
assurance on matters relating to quality, clinical safety and
patient experience as well as the adequacy of systems
for governing quality and risk. The Quality and Clinical
Governance Committee is chaired by a Non-Executive
Director and its membership includes Non-Executive and
Executive Directors and is attended by the divisional clinical
directors and the governance leads of the three clinical
divisions. The frequency of Quality and Clinical Governance
committee meetings was increased in response to the
governance review and the committee met 9 times during
the year. The committee routinely considers matters relating
to quality and patient safety, including performance against
quality account priorities, relevant strategies and policies,
clinical incidents, complaints and patient experience
reports, safeguarding issues, morbidity and mortality rates
and compliance with mandatory training requirements.
In addition, the committee has received assurance in relation
to the following issues:
• Progress in delivering improved hospital mortality
rates
• Medicines safety
• Trust response to risks associated with hip implants
• Improvements in the outpatient booking system to
address risks to patient safety and patient experience.
49
The Remuneration and Terms of Service
Committee
The Remuneration and Terms of Service Committee approves
the appointment of Executive Directors. The committee
also sets remuneration and terms of services for Executive
Directors and agrees the framework for remuneration
of other senior staff and clinicians. Membership of the
Remuneration and Terms of Service Committee is made up
exclusively of Non-Executive Directors and Executive Directors
have no involvement in determining their own remuneration.
The Remuneration and Terms of Service Committee met 6
times during the year and considered the following matters:
•
•
•
•
Directors’ Appraisals and remuneration
Mutually Agreed Resignation Scheme applications
Review of the Executive Director structure
Appointment of Executive Directors.
The Risk Management Committee
The Risk Management Committee was established in July
2012 and is an executive committee chaired by the Chief
Executive. Its principal role is to oversee delivery of the
risk management strategy, to take an overview of the risk
management agenda and ensure a strategic approach to
the management and mitigation of corporate and clinical
risks and ensure effective coordination and performance
management. The Risk Management Committee reviews
the content of the risk register and Assurance Framework
and agrees follow up action.
The committee has reviewed arrangements for updating
the clinical, directorate and corporate risk registers
The Workforce and Organisational
Wellbeing Committee
The Workforce and Organisational Wellbeing committee
was established in December 2012 as a result of review of
internal controls which gaps in control to support delivery
of key objectives in the Assurance Framework.
The Clinical Executive Group
The Clinical Executive Group is the key executive body
responsible for implementing the strategic direction set by
the Trust Board and for ensuring clinical, service and financial
performance in line with local and national standards.
The Clinical Executive Group is chaired by the Chief Executive
and met monthly. Its membership included the Medical
Director, the Chief Nurse, the Chief Operating Officer, the
Finance Director, the Director of Human Resources, the
Director of Corporate Planning and Projects, the Director of
Commissioning, Performance and Informatics, the Director
of Communications, the Divisional Clinical Directors, and
Associate Directors of Operations for the Clinical Service
Groups whose role is set out below.
The Clinical Divisions are responsible for the operational
delivery of services, ensuring service and financial
performance standards specific to their service are delivered.
The Clinical Service Groups are led by a Divisional Clinical
Director, an Associate Director of Operations and an
Associate Director of Nursing. The divisional structure has
been reviewed during 2012/13 and there are now three
Clinical Divisions responsible for integrated care, medicine
and surgery.
A mapping exercise was undertaken with support of Internal
Audit to review the groups which support operational
delivery and performance monitoring and their reporting
arrangements and further work is planned to review
and clarify performance management and assurance
arrangements following the independent review referred to
above.
The Charitable Funds Committee
In addition to the formal committees of the Board referred
to above, the Trust Board acts as Trustee to the Charitable
Funds for the organisation and has established a Charitable
Funds Committee with delegated authority to manage the
charitable funds on its behalf.
The committee is chaired by a Non-Executive Director
and its membership is made up of Executive Directors
and staff with responsibility for workforce development
and wellbeing. The role of the committee is approve key
workforce strategies and policies on behalf of the Trust
Board and provide assurance to the Trust Board in relation
to workforce, organisational wellbeing and organisational
development and the governance of key workforce risks.
50
Compliance with the Code of
Governance
The Board is bound by the Code of Governance which
requires NHS Trust Boards to exercise the same standards
of governance that apply to all private and public sector
organisations.
This means that Trust Board members must work together
and take collective responsibility for the performance of
the organisation, including financial, service and clinical
performance. Not all of the agreed objectives were
fully delivered in-year, indicating a need to improve the
effectiveness of the process for setting deliverable objectives
and the controls that are in place for monitoring delivery.
The Trust Board operates as a unitary Board. This means that
all Board members work as equals to act in the best interests
of the organisation.
Board administration has been reviewed during the
year and new arrangements have been put in place for
preparing and distributing agenda and papers, maintaining
a comprehensive record of meetings and decisions, ensuring
appropriate referral of matters between the Board and
committees and ensuring decisions. The presentation and
content of papers is generally good.
Corporate objectives
The Trust Board agreed that the priorities for the year were:
•
•
•
•
•
The Trust Board has exercised its duty to monitor delivery
against these objectives and the overall performance of the
Trust through the integrated performance reports that it
receives at each meeting.
•
•
•
•
The Trust Board has maintained a strong focus on clinical
governance, ensuring that clinical safety has not been
compromised by the financial pressures facing the
organisation and has applied a range of mechanisms to assess
clinical quality and patient experience, including developing
a patient safety dashboard to supplement other reports on
quality indicators, service performance, patient experience and
introducing director led clinical safety walk rounds.
•
The Trust Board meets the criteria set out in the Code of
Governance in relation to independence of Non-Executive
Directors. Board members have confirmed their commitment
to abide by the Standards of Business Conduct for NHS
Directors.
A Board development programme is in place and has
included induction and orientation of new members,
facilitated workshops on the role of the unitary board,
Quality Governance, development of the Trust’s response
to the Francis report and development of the corporate
objectives and annual plan. Board members have also
attended external events linked to individual development
needs. A 360 degree appraisal process has been undertaken
by all Board members to support the development
programme.
There are clear committee structures and the responsibilities
of individual committees are set out in their terms of
reference and the Scheme of Delegation. The Standing
Orders follow the model standing orders for NHS Trusts and
are complied with.
To improve clinical effectiveness and safety
To improve patient experience
To achieve national and local access targets
To be the employer of choice and maintain a skilled
and motivated workforce
To meet planned financial performance targets and
deliver value for money
To meet regulatory standards
To determine the strategic direction of the Trust
To ensure our communities receive better healthcare
To invest in buildings that meet the best
environmental and sustainability standards
To ensure our culture and practice aligns with public
sector equality legislation.
The risk and control framework
The system for managing and mitigating risk is set out in
the Trust’s risk management policy and strategy which was
refreshed in July 2012. The strategy provides a systematic
approach to the anticipation, prevention, mitigation and
management of risk across all areas of the Trust’s business.
It is based upon the principles laid down in legislation,
government guidance and industry best practice.
The systems of control are designed to offer assurance to the
Trust Board and external bodies that risks are being managed
effectively. Risk is identified through a variety of mechanisms.
A comprehensive system is being rolled out to report, record
and analyse incidents. In addition the Trust uses performance
reports, data analysis and patient feedback to assess and
anticipate risks.
Work has taken place to improve the performance
management regime and the timeliness and quality of
performance data in the Trust during the year.
51
Risk registers are held at clinical service group and corporate
directorate level and work has continued with support
from the Trust’s Internal Auditors to develop arrangements
for feeding risks identified at an operational level into a
Trust wide corporate risk register. The process for ensuring
effective interface between the clinical and divisional risk
registers, the corporate risk register and the Board Assurance
Framework is coordinated through the Risk Management
Committee. The corporate risk register identifying the key
risks to delivery of the Trust’s objectives has been revised
during the year.
The Assurance Framework and Risk Register are reviewed
by the Trust Board at regular intervals throughout the year.
The Assurance Framework identifies potential risks to delivery
of the Trust’s strategic objectives, internal and independent
sources of assurance and gaps in control and assurance.
Throughout the year Internal Audit has liaised closely with
the Trust with regard to its Assurance Framework and has
concluded that the methodology surrounding the design and
operation of the framework is sound and that the process is
well embedded within the organisation.
The Trust Board takes assurance and advice on risk
avoidance from external sources including the Care Quality
Commission, NHS Litigation Authority and the West
Yorkshire Internal Audit Consortium and Counter Fraud
services.
Public stakeholders are able to provide feedback on the
Trust’s services in a variety of ways. The Trust seeks feedback
from service users through surveys, patient involvement
groups and public involvement activities. Representatives of
the Trust also meet regularly with MPs, representatives of
Kirklees and Wakefield Local Involvement Networks (LINKs)
and Overview and Scrutiny Committees (OSC) and with local
authority members. The Trust takes a proactive approach
to communications and holds regular briefings with the
media. There has also been a comprehensive programme
of engagement with the public to support the development
of a strategy for reconfiguration of clinical services as well
as a formal engagement exercise overseen by the joint OSC
to seek views on proposed changes to the organisation of
ophthalmology, orthopaedic surgery and neuro-rehabilitation
services.
Risk assessment
Analysis of risks is carried out using a recognised tool
which assesses the likelihood and potential impact
of a risk manifesting and the key controls in place to
manage and mitigate risk.
A number of risks were identified during the year.
These are recorded on the Trust’s risk register which
reflects the following risks and mitigating action:
52
• The absence of a clearly articulated vision for the
future of the organisation which is being addressed
through a comprehensive approach to financial and
performance recovery, work to determine the future
configuration of services, development of supporting
strategies and regular dialogue with the National
Trust Development Authority. Formal consultation
took place from March to May on proposed changes
to clinical service configuration which will be reflected
in the strategic plan concluded in May 2013
• Maintaining safe services and compliance with
regulatory requirements: action plans have been
developed to ensure compliance with CQC and
NHSLA standards and these are complemented by
routine checks and safety walk rounds, standard
operating procedures and escalation arrangements
• Ability to deliver cost improvements and identify
further cost improvements for 2013/14, mitigated by
a robust financial planning regime including granular,
quality assured CIP plans for 2012/13 which have
been delivered and development of plans using a
similar process for 2013/14
• Competing pressures in the system affecting quality
and patient experience mitigated through review
of the systems and processes to ensure quality
governance, review of arrangements for dealing
with and learning from complaints and robust
arrangements for following up on CQC visits
• Ability to develop a clinically and financially
sustainable model of service which is being addressed
through a comprehensive review of configuration
of hospital services supported by a joint health and
social care programme to strengthen models of care
closer to home
• Fitness of IT systems, which is being addressed
through the implementation of an IM&T strategy,
overseen by a senior level steering group
• Ability to secure public confidence in services, which
is being addressed through a communication strategy
jointly delivered with NHS commissioners, to support
clinical service reconfiguration, communications plans
associated with specific issues, regular media briefing
and through development of a staff engagement
strategy
• Ability to recruit and retain a workforce with the
necessary capacity and capability and to maintain
motivation through a period of significant change.
This is being addressed through a workforce plan,
application of agreed arrangements for managing
change, strengthened monitoring of workforce
targets, action plans to address issues identified
through the staff survey, and policy review
• Absence of a strategic estates plan, mitigated by
a review of estates and facilities functions, review
of arrangements for reviewing and reporting
environmental risks and development of a prioritised
plan for estates development and maintenance.
Review of the effectiveness of
risk management and internal
control
• Discharge Management: Internal Audit was
commissioned to review the Trust’s Discharge
Management processes. The main issue related to the
need to use the expected date of “medically fit for
discharge” as a key driver in the discharge process.
A programme of work is being developed to address this.
The Trust has worked closely with Internal Audit in
developing the risk management framework. The Head of
Internal Audit has concluded that the system of internal
control in place during 2012/13 offered significant
assurance. This is based on the range of work undertaken as
part of the annual Internal Audit plan, including assessment
of the Board Assurance Framework and an assessment of
the range of individual opinions arising from risk-based
audit assignments, contained within Internal Audit reports
throughout the year. This assessment takes account of
the relative materiality of these areas and the improved
performance in terms of addressing identified weaknesses
in control.
• Car Park Follow Up: Internal Audit was commissioned
to follow up previous recommendations made in
relation to ensuring that all staff employed by third
party organisations were paying for their car parking
permits. The audit found that the Trust had taken
steps to identify all third party staff with Trust car
parking permits. Invoices had been sent to third party
organisations to recover back payments. However,
there appeared to have been a lack of agreement
with third party organisations regarding the Trust’s
intention to raise charges for permits and the amounts
to be charged. As a result, a significant proportion of
payments were in dispute.
Internal audit issued 8 limited assurance reports during the
year. These related to:
• Business Continuity: Internal audit acknowledged
that Business Continuity arrangements were being
redeveloped at the Trust but noted that the newly
formed Resilience Forum (RF) had not yet established a
formal work plan and clear reporting lines for reporting
progress against this work plan to the Clinical Executive
Group. Internal audit also recommended that the
Resilience Forum needed to take a robust hold on
Business Continuity matters and ensure that divisional and
directorate plans were developed and were reviewed to
ensure compatibility and consistency.
• Locum Doctors: this was a follow up to a previous
report relating to booking of locum doctors and preappointment checks. Whilst there was evidence of
improvement, issues remained regarding recording
of identity checks and local induction. Weekly checks
to ensure compliance with policy were introduced
in November and Internal Audit have confirmed this
checking process is now embedded.
• Clinical Risk: this audit was undertaken at a time
when the Trust’s risk management processes were
under review. Significant work had been undertaken to
improve corporate and divisional governance structures
and processes were still being refined. The limited
assurance related to the need for the Quality and
Clinical Governance Committee to ensure its assurance
requirements. This has now been actioned.
• Auto Enrolment Pension Scheme: Internal Audit
found that the Trust had developed a project group
and liaised with staff groups to assess the impact
of the Pensions Act 2008 ahead of the April 2013
implementation date. The lmited assurance opinion
was based on the absence of a project plan identifying
the remaining tasks to be done and responsibility for
delivering these. A plan has now been developed.
• Lease Cars: a limited assurance opinion was issued
relating to the need for more robust contract
management arrangements with South West Yorkshire
Partnerships NHS Foundation Trust in relation to the
administration of the car leasing and salary sacrifice
scheme.
• CQC Compliance: Internal audit recommended that the
arrangements for senior management oversight of CQC
related issues at the Trust required greater clarity and that
a formal framework should be put in place to set out the
assurance requirements required by the Board via QCGC
and to assess how the QCGC will obtain these assurances.
The Audit Committee has also sought assurance on
the Trust’s clinical audit arrangements, which are being
reviewed as part of the broader programme to refine Quality
Governance arrangements.
The strategic position of the Trust has been strengthened
through the work done to develop a proposal for service
configuration that is clinically and financially sustainable and
through delivery of recovery plans for financial and service
performance. The improvements in relation to financial and
service performance and Hospital Standardised Mortality
Rates (HSMR) reflect the strengthened controls that have
been put in place and their effectiveness.
96.1% of people attending the Trust’s A&E departments
during the year were seen within four hours. The Trust
also achieved the 18 week for complete pathways (90.7%
against a target of 90% for admitted patients and 96.3%
53
against a target of 95% for non-admitted pathways).
The trust also achieved all targets in relation to referral to
treatment for cancer and incomplete pathways for the year.
The Trust is working towards achievement of level one in
relation to the NHSLA risk management standards.
In the period April 2012 – March 2013 the Care Quality
Commission (CQC) carried out ten inspections at the
Trust.
Dewsbury Hospital 10 April 2012 – follow up visit to
check improvements had been made following previous visits
in 2011 and 2012 in relation to:
• Care and welfare of people who use services – compliance
action required in relation to maternity and midwifery
services
• Staffing – standard being met. CQC confirmed action to
address compliance notice issued in February 2012 had
been taken
• Assessing and monitoring the quality of service provision –
standard being met.
Dewsbury Hospital 3 July 2012 – follow up visit to check
improvements had been made following previous visits in
2011 and 2012 in relation to:
• Respecting and involving people who use services –
enforcement action taken
• Care and welfare of people who use services –
standard being met
• Cooperating with other providers – standard being
met
• Staffing – compliance action required to ensure
sufficient qualified and experienced staff to meet
people’s needs
• Complaints – compliance action required based on
evidence that the standard had not been met over
the year although action to address this was noted.
Dewsbury Hospital 12 November 2012 – confirmed
compliance with all core standards.
54
Pinderfields Hospital 5 September 2012 – inspection of
the day surgical ward when used as extra capacity during
periods of high demand.
compliance action required
standard being met
• Cleanliness and infection control – compliance action
required
• Safety and suitability of premises – enforcement
action taken to ensure compliance with this standard
in relation to.
Pinderfields Hospital 12 and 13 November 2012
standard being met
compliance action required
met
• Cleanliness and infection control – standard being
met
• Safety and suitability of premises – standard being
met
• Staffing – standard being met
• Assessing and monitoring the quality of service
provision – standard being met
• Complaints – standard being met.
Pontefract Hospital 12 November 2012
standard being met
standard being met
met
• Cleanliness and infection control – standard being
met
provision – standard being met
• Complaints – standard being met.
Dewsbury Hospital 21 and 28 February 2013
provision action required. Subsequent visit confirmed
the Trust had taken satisfactory action to address this.
Queen Elizabeth House, Wakefield (intermediate care
service) – fully compliant.
Pinderfields Hospital 4 July 2012
standard being met
standard being met
• Complaints – compliance action required to meet this
standard.
Where issues were identified by the CQC, the Trust has
put in place robust action plans to ensure compliance and
that learning is disseminated to other areas. For each of
the 16 essential outcomes there is a lead who will review
the compliance with the relevant standard and develop
actions if required. An internal CQC self assessment tool
has been developed and this is used to undertake CQC style
inspections on inpatient wards. The CQC internal inspections
are led by the associate directors of nursing and the findings
reported to the divisional boards.
Gaps in assurance identified
in the Assurance Framework
Quality Governance and
Quality Accounts
The Assurance Framework identified some areas where there
were gaps in control or where the Board had not received
adequate assurance. Issues not covered elsewhere in this
statement included:
An independent assessment of Quality Governance
arrangements was commissioned by the Trust and concluded
in April 2013. This has identified potential areas for
improvement and actions have been taken to address the
issues identified. A further assessment has been postponed
and will take place as part of the Trust’s wider programme of
work to develop governance systems that are consistent with
the approach adopted by Foundation Trusts.
• Delays in responding to complaints and lack of focus
on learning lessons
• Issues regarding demand management in
ophthalmology
• Lack of evidence of the positive impact of demand
management initiatives in the wider health and social
care system
• Failure to achieve the national target for MRSA due
to 8 cases being reported against a target of 7. This
was an improvement on the previous year when there
were 11 cases of MRSA.
There have been 8 serious untoward incidents reported to
the Strategic Health Authority compared with 11 in 2011/12
and no ‘never events’. The main categories of serious
incidents during 2012/13 were slips, trips and falls, pressure
ulcers, staffing levels, administration or supply of medication;
and ‘Other’. Incident data, themes and trends are routinely
reviewed by the Quality and Clinical Governance Committee.
A weekly Patient Safety Panel has been established to focus
on avoidance of incidents and review of lessons learned.
There have been 54 data protection incidents compared
with 55 in the previous year. The Trust is achieving level two
compliance with the Information Governance Toolkit.
The Trust identified five priorities in the 2012/13 Quality
Accounts:
• Improve systems and processes to further
reduce mortality rates: nationally validated data
on mortality levels shows that of the three main
measures in use, the Trust is better than average
on two measures and average on the third. The
Trust’s Hospital Standardised Mortality Rate was 96
compared with 108 the previous year
• Improve patient safety by implementing the
safety thermometer: objectives in relation to the
safety thermometer were set in the quality account
for the 2012/13 period. The Trust achieved 85%
harm free care. Falls reduced by 1.07% and pressure
ulcers reduced by 3.18%
• Improve the diagnosis and care of patients
with dementia: the Trust is actively engaged in
multi agency arrangements to develop pathways for
dementia. This includes screening of patients, staff
training, development of patient held records for
use by all agencies and participation in the national
dementia audit. The Trust was able to demonstrate
improvement in the national dementia audits and
dementia care remains a priority for 2013/14
• Improve compliance with best practice
guidelines and prevent hospital acquired
infections: the Trust achieved 100% compliance
with its target to screen all elective patients but failed
to achieve 100% screening of non-elective patients.
The Trust failed to achieve the national target for
hospital acquired MRSA but has maintained above
average performance in relation to management of
C Difficile with 39 cases against a target of 78
• Improve outpatient scheduling, bookings
and communications with patients: as a result
of actions implemented through the Outpatient
Improvement Programme, significant improvements
against an agreed set of indicators. However,
the target was not achieved as the proportion of
cancelled appointments was 5.7% against a target
of 5%.
55
Significant issues
The Trust is driving a major hospital service reconfiguration
programme designed to secure clinically and financially
sustainable services. This will include development of
Pinderfields Hospital as the major acute site with Dewsbury
and Pontefract Hospitals providing a wide range of local
services for people with less acute or complex health needs
and being developed as centres of excellence for planned
care and rehabilitation.
The Trust ended the year with a deficit of £21.8m against
a planned deficit of £26m. This was in line with the Trust’s
agreement with NHS North of England.
During 2012/13 the Trust received £12.5m cash support
from the Department of Health as part of its agreed 2012/13
financial plan. This cash support enabled the Trust to
maintain its payments to staff and suppliers and ensured that
the Trust was able to meet the Department of Health’s target
that at least 95% of all suppliers are paid by the invoice due
date or within 30 days of receipt of an invoice.
The Department of Health set a national target in 2011
that all NHS Trusts must achieve Foundation Trust status by
2014. At the time it was anticipated that those organisations
that were unable to achieve this were likely to be merged
or acquired by existing Foundation Trusts. The Trust has
been working with the Department of Health and latterly
with the national Trust Development Authority to assess the
future direction of the organisation, having confirmed that
Foundation Trust authorisation by 2014 was not achievable.
A decision is expected on whether the Trust can progress to
Foundation Trust within an extended timescale. The Trust
has submitted a comprehensive operating plan to the Trust
Development Authority setting out its priorities for 2013/14.
Internal audit opinion
The Head of Internal Audit has issued an opinion giving
significant assurance in relation to the risk and control
systems in place during 2012/13.
The Trust has experienced three episodes of industrial action
relating to the major workforce re-profiling exercise that is
underway. There is also evidence that this is impacting on
staff morale and motivation as evidenced in the 2012/13
staff opinion survey which placed the Trust in the bottom
20% nationally in relation to staff recommending the Trust
as a place to work or receive treatment, motivation at work,
staff reporting errors, near misses or incidents and agreeing
that incident reporting procedures are fair and effective, staff
having well structured appraisals.
The scale of the challenges facing the Trust require on-going
effort to manage the reputational impact and secure staff
and public confidence. The Trust launched its Making it
Better Together programme in 2012 to encourage staff to
identify opportunities for efficiency improvement. Further
work being developed under the ‘Making it Better’ banner
includes development of a behaviours framework to ensure
staff throughout the organisation promote the Trust’s vision
and values, tackling underlying cultural causes of underperformance and unsatisfactory patient experience. The Trust
also launched the Friends and Family test in March – one
month ahead of the national launch and has established a
public stakeholder forum to act in an advisory capacity to
the Trust Board, providing a direct interface between the
organisation and the communities it serves. A similar forum
is planned for staff representatives.
56
Financial report
Financial
report
57
Financial report
Financial Overview
2012/13
We achieved three of our four Statutory Financial Duties:
• We managed our capital expenditure within approved
limits
• We managed our cash within approved limits
• We achieved a 3.5% on capital employed.
In 2012/13 we agreed a financial plan with the Strategic
Health Authority which provided for a deficit of £26m.
The plan took into account our financial position brought
forward from 2011/12, and the requirements of the 2012/13
NHS Operating Framework.
Within our plan we provided for a cost reduction programme
of £23.2m which covered the 4% national cost efficiency
requirement that all Trusts were required to deliver and
1.4% to cover local pressures and reduce the impact of the
financial challenge brought forward from 2011/12.
Looking forward to 2013/14
We also secured £10m of transitional support from the local
health economy. Our plan also identified a requirement for
cash support from the Department of Health to ensure that
payments to our staff and our suppliers could be maintained.
Our financial challenge will continue into 2013/14 and we
have agreed a financial plan with NHS Trust Development
Authority which provides for a deficit of £20.7m for
2013/14.
At the end of 2012/13
we have:
• Delivered an in year deficit of £21.839m, an improvement
against our plan of £4.161m. The £21.839m is after
agreed Department of Health technical accounting
adjustments charged to our operating expenses and
the impact of a change in accounting treatment for
donated assets. Excluding these adjustments the deficit is
£36.855m. The Department of Health measures the Trust
against the £21.839m. This improved position is due to
the tight financial controls implemented in 2012/13 and
some under spending against additional monies provided
to the Trust in year
• Delivered in year savings of £23.435m, an improvement
against our plan of £0.235m
• Our work force has reduced from 6,823.29 whole time
equivalents on 1st April 2012 to 6,518.40
whole time equivalent staff on 31st March 2013.
The reduction also includes a number of vacancies
some of which will be recruited to during 2013/14
• We received cash support of £12.5m from the
Department of Health and we maintained our
payments, fully achieving the Department of Health’s
target that 95% of our suppliers are paid by the invoice
due date or within 30 days of receipt of the invoice.
58
The impact of our planned deficit was that we failed the
financial duty of breaking even taking one year with another.
In agreeing our financial plan, it was recognised by the
Strategic Health Authority and Department of Health that we
would not achieve this financial duty in 2012/13.
Our forecast deficit takes into account our financial position
brought forward from 2012/13 and the requirements of the
2013/14 NHS Operating Framework. Within our forecast we
have plans to reduce our costs by £25.3m. These plans are
to cover the 4% national cost efficiency requirement that all
Trusts are required to deliver and to reduce the impact of the
financial challenge brought forward from 2012/13. All of our
savings schemes will be assessed for the impact on patient
safety and patient experience by our Medical Director and
Chief Nurse.
In our 2013/14 plan we have identified that we will require
£28m of cash support to from the Department of Health
enable us to maintain our payments to staff and suppliers.
We have also secured £3.9m of transitional support from the
local health economy and NHS England.
Recognising the financial challenge that we have faced in
2012/13 and face again in 2013/14 we are continuing to
work closely with our commissioners and the NHS Trust
Development Authority to develop a financial plan for our
Trust which supports the future provision of sustainable
clinical services.
Financial report
Statement of Comprehensive
Income 2012/13
Capital Expenditure 2012/13
In 2012/13 we invested £15.588m in our healthcare facilities
and equipment.
This can be found on page 62.
Revenue
Total revenue in 2012/13 amounted to £461m, of which,
revenue from patient care activities was £422m with other
operating revenue of £28.5m and £10m in respect of
transitional support.
The majority of our revenue comes from Primary Care Trusts
- £431m (94%). Following the reconfiguration of the NHS
on 1st April 2013, this income in future will be contracted
from Clinical Commissioning Groups, NHS England and Local
Authorities.
Expenses
Our operating expenses excluding financing costs were
£483m and the largest element of this is the pay bill for our
staff of £301m (62%). Also included within the operating
expenses was a charge of £14.9m for the impairment of the
value during the year that Clayton Hospital and Pontefract
Southside were being held in our accounts at. This reflects
the impact of these sites being closed in year and being
accounted for as non operational. The Department of Health
classes impairments as a technical item and adjusts for them
when calculating the Trust’s financial performance for the
year.
Financing costs
We incurred financing costs of £15m, £11m of which
is derived from the PFI unitary payment under the PFI
accounting requirements and £3m is the Public Dividend
Capital Dividend which is paid to the Department of Health.
£4.417m was invested in maintaining and improving our
facilities, £2.621m in replacing our Information Technology
equipment and developing our systems and £8.550m in new
medical equipment. This investment was made across all
three of our hospital sites and our community services.
£0.140m of the investment in new medical equipment was
from charitable sources.
In 2013/14 we plan to spend £13.664m on maintaining,
replacing and developing our healthcare facilities and
equipment. We anticipate that £0.5m of this expenditure
will be funded through donations and the remainder will be
funded internally.
Pages 57 to 69 record the summarised financial statements
for the financial year 2012/13. A full set of the accounts is
available on the Trust’s website at www.midyorks.nhs.uk
or by writing to us at the address on the back page of this
report.
Please note a glossary of terms is included at the end of the
summarised financial statements for ease of reference.
External Auditors
Grant Thornton UK LLP was the Trust’s external auditors
in 2012/13. The cost of the work undertaken by Grant
Thornton UK LLP was £124,763 (net of VAT). This was for
audit services in relation to the statutory audit and the
quality accounts.
Auditing standards require the directors to provide the
external auditors with representations on certain matters
material to their audit opinion. The board has confirmed and
provided assurance via a statement of representation to its
auditors that there is no information relevant to the audit
that they are aware of that has not been made available to
the auditors. Directors have taken all steps necessary to make
themselves aware of any relevant audit information and
established that the auditors are aware of that information.
Robert Chadwick
Director of Finance
24 May 2013
59
Financial report
Statement of Representation
Independent Auditors’ Report
We have examined the summary financial statement for the year ended 31 March 2013 the
Statement of Comprehensive Income, the Statement of Financial Position, the Statement of
Changes in Taxpayers’ Equity and the Statement of Cash Flows.
This report is made solely to the Board of Directors of The Mid Yorkshire Hospitals NHS Trust
in accordance with Part II of the Audit Commission Act 1998 and for no other purpose, as
set out in paragraph 45 of the Statement of Responsibilities of Auditors and Audited Bodies
published by the Audit Commission in March 2010. To the fullest extent permitted by law,
we do not accept or assume responsibility to anyone other than the Trust’s directors and the
Trust as a body, for our audit work, for this report, or for opinions we have formed.
Respective responsibilities of directors and auditor
The directors are responsible for preparing the Annual Report.
Our responsibility is to report to you our opinion on the consistency of the summary financial
statement within the Annual Report with the statutory financial statements.
We also read the other information contained in the Annual Report and consider
the implications for our report if we become aware of any misstatements or material
inconsistencies with the summary financial statement.
We conducted our work in accordance with Bulletin 2008/03 “The auditor’s statement on
the summary financial statement in the United Kingdom” issued by the Auditing Practices
Board. Our report on the statutory financial statements describes the basis of our opinion on
those financial statements.
Opinion
In our opinion the summary financial statement is consistent with the statutory financial
statements of The Mid Yorkshire Hospitals NHS Trust for the year ended 31 March 2013.
We have not considered the effects of any events between the date on which we signed our
report on the statutory financial statements 24 May 2013 and the date of this statement.
Paul Dossett
Senior Statutory Auditor,
for and on behalf of Grant Thornton UK LLP
No 1 Whitehall Riverside
Whitehall Road
Leeds
LS1 4BN
9 September 2013
60
Financial report
Chief Executive’s
responsibilities
The Chief Executive of the NHS has designated that the Chief
Executive should be the Accountable Officer to the Trust.
The relevant responsibilities of Accountable Officers are set
out in the Accountable Officers Memorandum issued by the
Department of Health. These include ensuring that:
• there are effective management systems in place to
safeguard public funds and assets and assist in the
implementation of corporate governance;
• value for money is achieved from the resources
available to the Trust;
• the expenditure and income of the Trust has been
applied to the purposes intended by Parliament and
conform to the authorities which govern them;
• effective and sound financial management systems
are in place; and
• annual statutory accounts are prepared in a format
directed by the Secretary of State with the approval
of the Treasury to give a true and fair view of the
state of affairs as at the end of the financial year and
the income and expenditure, recognised gains and
losses and cash flows for the year.
To the best of my knowledge and belief, I have properly
discharged the responsibilities set out in my letter of
appointment as an Accountable Officer.
Stephen Eames
Chief Executive
24 May 2013
61
Financial report
Statement of Comprehensive Income
for the year ended 31 March 2013
2012/13
£000
2011/12
£000
422,270
412,444
Income in respect of transitional support
10,000
14,000
Other operating revenue
28,522
29,510
0
1,000
Gross employee benefits
(301,145)
(291,802)
Other costs
(166,995)
(168,803)
Impairments
(14,870)
18,816
Operating surplus/(deficit)
(22,218)
15,165
78
88
(27)
(145)
Finance costs
(11,555)
(11,582)
Surplus/(deficit) for the year
(33,722)
3,526
Public dividend capital dividends payable
(3,133)
(3,129)
Retained surplus/(deficit) for the year
(36,855)
397
0
(13,355)
9,273
6,832
(27,582)
(6,126)
(36,855)
397
0
(21,607)
14,870
2,082
146
(89)
(21,839)
(19,217)
66
(220)
Revenue from patient care activities
Income in respect of PFI transitional support
Investment revenue
Other gains and (losses)
Other comprehensive income
Impairments and reversals
Net gain/(loss) on revaluation of property, plant & equipment
Total comprehensive income for the year
Financial performance for the year
2011/12 - IFRIC 12 adjustment including IFRIC12 impairments
Impairments (excluding IFRIC12 in 2011/12)
Adjustments for donated/government grant reserve elimination
Adjusted retained surplus/(deficit)
PDC dividend: balance receivable/(payable) at 31 March
A NHS Trust’s reported NHS financial performance position is derived from its retained surplus/(deficit), but adjusted to take into
account items which the Department of Health do not consider to be part of the organisation’s financial performance.
In 2012/13 the Trust was required to adjust for the impairment of £14.870m and the impact of the donated/government grant
reserve elimination of £0.146m.
In 2011/12 the Trust was also required to adjust for the revenue benefit of accounting for the Trust’s PFI assets on the balance
sheet (required under International Financial Reporting Standards). This adjustment is not required from 2012/13 onwards.
62
Financial report
Statement of Financial Position
as at 31 March 2013
31 March 2013
£000
31 March 2012
£000
442,182
456,743
3,084
1,447
0
226
445,266
458,416
8,717
8,336
16,029
17,300
Non-current assets:
Property, plant and equipment
Intangible assets
Trade and other receivables
Total non-current assets
Current assets
Inventories
Trade and other receivables
2,587
3,506
27,333
29,142
3,233
1,138
30,566
30,280
475,832
488,696
(36,655)
(30,882)
Provisions
(9,208)
(5,304)
Borrowings
(7,452)
(7,192)
Capital loan from Department of Health
(1,000)
(1,000)
Total current assets/(liabilities)
(54,315)
(44,378)
Net current assets/(liabilities)
(23,749)
(14,098)
Non-current assets plus/less net current assets/liabilities
421,517
444,318
0
(237)
(6,305)
(6,499)
(320,488)
(326,776)
(11,500)
(12,500)
(338,293)
(346,012)
83,224
98,306
Cash and cash equivalents
Total current assets
Non-current assets held for sale
Total current assets
Total assets
Current liabilities
Trade and other payables
Non-current liabilities
Trade and other payables
Provisions
Borrowings
Capital loan from Department of Health
Total non-current liabilities
Total Assets Employed:
Financed by taxpayers' equity:
Public Dividend Capital
Retained earnings
Revaluation reserve
Other reserves
Total Taxpayers' Equity:
146,490
133,990
(127,086)
(103,421)
61,135
65,052
2,685
2,685
83,224
98,306
63
Financial report
Statement of changes in taxpayers’ equity
Public
Dividend
Capital
Retained
earnings
Revaluation
reserve
Other
reserves
Total
reserves
£000
£000
£000
£000
£000
133,990
(103,421)
65,052
2,685
98,306
0
(36,855)
0
0
(36,855)
Net gain/(loss) on revaluation of property, plant &
equipment
0
0
9,273
0
9,273
0
0
0
0
0
Transfers between reserves
0
13,190
(13,190)
0
0
New PDC received
19,500
0
0
0
19,500
PDC repaid in year
(7,000)
0
0
0
(7,000)
Net recognised revenue/(expense) for the year
12,500
(23,665)
(3,917)
0
(15,082)
146,490
(127,086)
61,135
2,685
83,224
11,605
(11,605)
133,990
(106,578)
74,335
2,685
104,432
0
397
0
0
397
Net gain/(loss) on revaluation of property, plant &
equipment
0
0
6,832
0
6,832
0
0
(13,355)
0
(13,355)
Movements in other reserves
0
0
0
0
0
Transfers between reserves
0
2,760
(2,760)
0
0
Net recognised revenue/(expense) for the year
0
3,157
(9,283)
0
(6,126)
133,990
(103,421)
65,052
2,685
98,306
0
0
Changes in taxpayers’ equity for the year ended 31 March 2013
Balance at 1 April 2012
Balance at 31 March 2013
Included above: Transfer from revaluation reserve
to retained earnings in repect of impairments
0
Changes in taxpayers’ equity for the year ended 31 March 2012
Balance at 1 April 2011
Balance at 31 March 2012
Included above: Transfer from revaluation reserve
to retained earnings in repect of impairments
64
0
Financial report
Cash Flow Statement
2012/13
£000
2011/12
£000
(22,218)
15,165
Cash flows from operating activities
Operating Surplus/(Deficit)
Depreciation and Amortisation
19,817
19,595
Impairments and Reversals
14,870
(18,816)
0
(235)
(11,559)
(11,562)
(3,419)
(2,788)
(Increase)/Decrease in Inventories
(381)
(401)
(Increase)/Decrease in Trade and Other Receivables
1,563
1,704
Increase/(Decrease) in Trade and Other Payables
4,423
(2,427)
(1,974)
(1,828)
Donated Assets received credited to revenue but non-cash
Interest Paid
Dividend (Paid)/Refunded
Provisions Utilised
Increase/(Decrease) in Provisions
5,534
3,652
Net Cash Inflow/(Outflow) from Operating Activities
6,656
2,059
78
87
(12,008)
(6,303)
(664)
(67)
977
486
(11,617)
(5,797)
(4,961)
(3,738)
Public Dividend Capital Received
19,500
10,400
Public Dividend Capital Repaid
(7,000)
(10,400)
Loans repaid to DH - Capital Investment Loans Repayment of Principal
(1,000)
(1,000)
Capital Element of Payments in Respect of Finance Leases and On-SoFP PFI
(7,458)
(7,157)
0
234
Net Cash Inflow/(Outflow) from Financing Activities
4,042
(7,923)
Net Increase/(Decrease) in Cash and Cash Equivalents
(919)
(11,661)
Cash and Cash Equivalents (and Bank Overdraft) at beginning of the period
3,506
15,167
Cash and Cash Equivalents (and Bank Overdraft) at year end
2,587
3,506
Cash flows from investing activities
Interest Received
(Payments) for Property, Plant and Equipment
(Payments) for Intangible Assets
Proceeds of disposal of assets held for sale (PPE)
Net Cash Inflow/(Outflow) from Investing Activities
Net cash inflow/(outflow) before financing
Cash flows from financing activities
Capital grants and other capital receipts
65
Financial report
Staff Sickness absence
Total days lost
Total staff years
Average working days lost
2012/13
number
2011/12
number
76,683
77,417
7,062
6,450
11
12
Better Payment Practice Code
– Measure of compliance
2012/13
number
2012/13
£000
2011/11
number
2011/12
£000
Total Non-NHS Trade Invoices Paid in the Year
71,547
126,206
76,494
124,400
Total Non-NHS Trade Invoices Paid Within Target
68,003
121,415
72,854
119,363
Percentage of Non-NHS Trade Invoices Paid Within Target
95.0%
96.2%
95.2%
96.0%
Total NHS Trade Invoices Paid in the Year
2,950
38,859
2,921
32,884
Total NHS Trade Invoices Paid Within Target
2,865
38,764
2,826
32,610
97.1%
99.8%
96.7%
99.2%
Non-NHS Payables
NHS Payables
Percentage of NHS Trade Invoices Paid Within Target
The Better Payment Practice Code requires the Trust to aim to pay all valid invoices by the due date or within 30 days of receipt
of a valid invoice, whichever is later.
66
Financial report
Exit Packages agreed in 2012/13
2012/13
2011/12
Number of
compulsory
redundancies
Number
of other
departures
agreed
Total
number
of exit
packages by
cost band
Number
Number
Number
Number of
compulsory
redundancies
Number
of other
departures
agreed
Total
number
of exit
packages by
cost band
Number
Number
Number
Exit package cost band (including any special payment element)
Less than £10,000
1
67
68
2
1
3
£10,001 - £25,000
2
95
97
2
0
2
£25,001 - £50,000
3
45
48
1
0
1
£50,001 - £100,000
7
10
17
0
0
0
£100,001 - £150,000
4
1
5
0
0
0
£150,001 - £200,000
1
0
1
0
0
0
Total number of exit
packages by type
18
218
236
5
1
6
1,402
4,413
5,815
95
3
98
Total resource cost
(£000s)
This note provides an analysis of Exit Packages agreed during the year. Redundancy and other departure costs have been paid in
accordance with the provisions of the NHS Scheme. Where the Trust has agreed early retirements, the additional costs are met
by the Trust and not by the NHS Pensions scheme. Ill-health retirement costs are met by the NHS Pensions scheme and are not
included in the table.
As part of the Workforce Transformation Programme the Trust has run two MARs schemes in 2012/13 which have been fully
approved by the Strategic Health Authority. Of the 236 exit packages agreed, 197 are as a result of these schemes.
This disclosure reports the number and value of exit packages taken by staff leaving in the year. Note: The expense associated
with these departures may have been recognised in part or in full in a previous period.
67
Financial report
Accounts of our Charitable Fund
Statement of financial activities
Unrestricted
funds
£000
Restricted
funds
£000
Endowment
funds
£000
Total funds
2012/13
£000
Total funds
2011/12
£000
153
81
234
18
26
278
24
24
11
35
-
153
105
258
18
37
313
204
561
765
20
50
14
849
1
1
-
-
1
1
-
Charitable activities:
Land and buildings
Purchase of medical equipment
Refurbishment
33
216
-
263
-
-
33
479
-
39
336
51
Staff education and welfare
Patient welfare and Amenities
40
145
4
2
-
44
147
113
109
Sub total direct charitable expenditure
434
269
-
703
648
Governance costs
Total resources expended
13
448
4
273
-
17
721
20
668
(170)
(238)
-
(408)
181
-
-
-
-
(170)
(238)
-
(408)
181
Incoming resources
Incoming resources from generated funds:
Voluntary income:
Donations
Legacies
Sub total voluntary income:
Fundraising events
Investment income
Other incoming resources
Total incoming resources
Resources expended
Costs of generating funds:
Fundraising costs
Sub total costs of generating funds
Sub total: Net (outgoing) / incoming resources
before transfers and other recognised gains and
losses
Transfers:
Gross transfers between funds
Net (outgoing) / incoming resources before
other recognised gains and losses
Other recognised gains and losses:
Realised and unrealised gains/ (losses) on
investment assets
79
30
-
109
132
(91)
(208)
-
(299)
313
Total Funds brought forward
2,040
842
5
2,887
Total Funds carried forward
1,949
634
5
2,588
2,574
2,887
Net Movement in funds
Reconciliation of Funds
68
Financial report
Charitable Fund balance sheet
as at 31 March 2013
Unrestricted
funds
£000
Restricted
funds
£000
Endowment
funds
£000
Total funds
at 31 March
2013
£000
Total funds
at 31 March
2012
£000
Investments
1,012
384
-
1,396
1,287
Total Fixed Assets
1,012
384
-
1,396
1,287
17
3
-
20
55
1,183
461
5
1,649
1,449
97
37
-
134
607
1,297
501
5
1,803
2,111
(37)
(4)
-
(41)
(201)
Net Current assets
1,260
497
5
1,762
1,910
Total assets less current liabilities
2,272
881
5
3,158
3,197
Provisions for liabilities and charges
(323)
(247)
-
(570)
(310)
Net assets
1,949
634
5
2,588
2,887
Permanent Endowment funds
-
-
5
5
5
Restricted income funds
-
634
-
634
842
Unrestricted income funds:
1,949
-
-
1,949
Total charity funds
1,949
634
5
2,588
2,040
2,887
Fixed assets:
Current assets:
Debtors
Short term investments and deposits
Cash at bank and in hand
Total Current Assets
Liabilities:
Creditors falling due within one year
The funds of the charity:
69
Glossary
Glossary
Capital
NHS North of England
Land, premises and equipment.
The regional Strategic Health Authorities are the main link
between the Department of Health and the NHS. They are
responsible for ensuring that all NHS organisations work
together to deliver modern, high quality patient-centred
services.
Capital expenditure
Spending on land, premises and equipment. This includes
works to provide, adapt, renew, replace or demolish
buildings, items or groups of equipment and vehicles. In the
NHS, any spending which is more than £5,000 and where
the item has a life of more than one year is classified as
capital.
Depreciation
The measure of the wearing out, consumption or other
loss of value of property, plant or equipment whether
arising from use, passage of time or obsolescence through
technology and market changes.
External Financial Limit
The External Financing Limit (EFL) is a fundamental element
of the NHS Trust’s financial regime. It is a cash based public
expenditure control set by the Department of Health and
a Trust’s access to all sources of external finance. The EFL
represents the excess of its approved level of capital spending
over the cash that a Trust can generate internally (mainly
surpluses and depreciation).
Private Finance Initiative (PFI)
The use of private finance in capital projects, particularly
in relation to the design, construction and operation of
buildings and support services.
Commissioners
Commissioners is a term used to cover those organisations
who commission services from NHS Trusts or other providers.
Primary Care Trusts (PCTs) were the main commissioners in
the NHS in 2012/13.
Statement of Comprehensive Income
The statement of comprehensive income is the International
Financial Reporting Standards (from 2009/10 all public
bodies including NHS prepare their accounts using these)
equivalent of the income and expenditure account/statement
of total gains and losses (UK GAAP).
Impairments
Statement of Financial Position
Impairments generally relate to property, plant and
equipment and represent the loss of value of these below
that recorded in the accounts of an organisation. Impairment
occurs because something has happened to the property,
plant or equipment itself or to the economic environment in
which it is used.
The statement of financial position is the International
Financial Reporting Standards equivalent of the balance
sheet (UK GAAP).
A previous impairment may reverse when an asset which has
previously fallen in value and been impaired is now valued at
a value higher than that recorded in the accounts.
The Department of Health does not count an impairment
or reversal of impairment against NHS Trust’s financial
performance and classes these as technical in nature.
70
Notes
71
Telephone 0844 811 8110
If you need this annual report in a different language,
large print or braille please contact us on 01924 543635
and we will make arrangements for you.
This report is also available to download at
www.midyorks.nhs.uk
ents
to the pati
Thank you who were
ies
and famil
d or gave
interviewe r their pictures
fo
permission r this Report, as
fo
to be used any members
m
e
th
who
well as
shire staff
rk
o
Y
id
M
uction.
of
g its prod
n
ri
u
d
d
e
help
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Design: MY design – The Mid Yorkshire Hospitals NHS Trust | MYd 78674
Pinderfields Hospital
Aberford Road
Wakefield
WF1 4DG

Fundusz NHS, Szpitale rejonu Mid Yorkshire Sprawozdanie roczne

Transcription

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