Annual report 1 October 2014 to 31 March 2015

Transcription

A new beginning
Annual Report
1 October 2014
- 31 March 2015
Contents
2Looking back
Chairman
Peter Worthington
6Looking to the future
Chief Executive
Dame Jacqueline Docherty
8Corporate objectives for 2014/15
10Research and innovation
12Recognising our dedicated staff
16What our staff said about
working here
20Our performance
23 Reducing Infections
24Information governance
28Quality at the heart of what we do
34Listening to what patients tell us
37Being prepared
38Our Trust Board
44Financial Summary
2
London North West Healthcare NHS Trust
brings together hospital and community
services across Brent, Ealing and Harrow.
Our Trust looks after:
• Central Middlesex Hospital
• Community services across Brent,
Ealing and Harrow, including Clayponds
Rehabilitation Hospital,
• Meadow House Hospice, Denham Unit
and Willesden Centre
• Ealing Hospital
• Northwick Park Hospital
• St Mark’s Hospital
Trust headquarters
Northwick Park Hospital,
Watford Road,
Harrow, HA1 3UJ
Telephone: 020 8869 3232
www.lnwh.nhs.uk
www.facebook.com/lnwh.nhs
Twitter: @lnwh_nhs
Looking back
Chairman Peter Worthington
This has been an exciting, if
challenging, six months for our new
organisation with London North
West Healthcare NHS Trust officially
launching on 1 October 2014. Nearly
four years of hard work culminated in
the merger of Ealing Hospital NHS Trust
and The North West London Hospitals
NHS Trust, creating one of the largest
integrated acute and community care
trusts in the country.
With our hospitals and community services
now all under one umbrella we are in a
privileged position to be able to make a real
difference to the quality of our services and
the care we can provide for our patients. The
integration of clinical services will position
us to move finally towards the provision of
specialist services, twenty-four hours a day,
seven days a week, across our hospital and
community services in Brent, Ealing and
Harrow.
It is not just our patients that will benefit from
the merger. We are also creating exciting
new career opportunities for our workforce
and new recruits through the integration and
development of services across the acute and
community setting.
There is no denying that our first six months
have been challenging. This was partly as a
result of the increased pressure experienced
by the whole of the NHS during the winter,
which led to emergency departments
struggling to see and treat patients within
the four hour target. Closing the Central
Middlesex Hospital emergency department
and opening the new £21million emergency
department at Northwick Park in the midst
of this very busy period added additional
pressure.
However, I must take this opportunity to
thank staff for their professionalism and
dedication, ensuring that patients were cared
for safely throughout the winter and during
the transition into the new department. We
worked extremely hard in partnership with
the London Ambulance Service (LAS), local
Clinical Commissioning Groups and other
stakeholders to ensure that the transition
was a success and the teams received
commendations from the LAS, who wrote
that the move was: “the most seamless they
had encountered”.
To address the challenges associated with
reducing our waiting times in A&E, we
established a dedicated emergency pathway
taskforce to review clinical processes
throughout the organisation. Its aim was to
improve the flow of patients through the
emergency department, by removing barriers
that slowed down the safe discharge of
medically fit patients from our services. This
work has achieved real improvements in our
ability to see, treat and admit or discharge
patients within the four hour standard.
3
On average, 90 per cent of patients seen
at Northwick Park are now treated and
discharged within four hours. At Ealing this
figure is above 95 per cent, following a
temporary dip during the winter. However,
there is still work to do and increasing our
capacity remains a priority. This especially
applies at Northwick Park Hospital where a
new 63 bedded modular unit is being added
and is scheduled to open in time for the
coming winter.
It is not just our emergency pathway that
has seen investment, with refurbishment
projects updating Denham Unit and the care
of the elderly ward at Ealing Hospital, plus
the addition of new state of the art surgical
theatres at Northwick Park. We have also
invested in a substantial upgrade to the
electricity supply on the Northwick Park site
to ensure we can react to increasing future
demand.
Our AAA rated stroke team
4
However, our finances do present an ongoing
challenge as the merger and the effects
of winter pressures increased our level of
spending, leaving the new Trust with a deficit
of £24.9 million for the six month period
from 1 October. We are working closely with
the Trust Development Authority and our
commissioners to put the Trust in the best
place going forward.
The reasons for our financial challenge are
varied and longstanding. They include a
rise in patient activity and acuity through
our emergency departments, requiring us
to put in additional capacity and staffing at
short notice. This incurred additional costs in
advance of our planned capacity increase.
In addition, as we go forward, we will be
revisiting how we make best use of Central
Middlesex and Ealing Hospitals to help
address this issue and others specific to those
acute sites. In line with other organisations,
we will also be looking very closely at how
we deliver good quality services within the
financial envelope available and how we hold
ourselves to account for this.
In my round up of the last six months I
must not forget to mention the LNWH staff
excellence awards. This fantastic event only
served to highlight what I already knew: that
we have a highly talented, dedicated and
driven workforce that is focused on delivering
compassionate care to our patients every
day and who are the key to moving this
organisation forward.
Trust on 1 April 2015 and brings a wealth
of clinical and operational experience. She
is moving rapidly to re-focus the Trust’s
efforts on delivering the merger strategy and
benefits, enhancing patient experience and
operational effectiveness, and using the full
potential of the resources now available to
the Trust and our patients.
Peter Worthington
Chairman
Another area of outstanding performance
to note is the stroke team (pictured), who
achieved the top AAA rating for their service,
making it the busiest and best stroke service
in the country. Similarly, our health visitors’
hub saw seven members of its team awarded
prestigious fellowships from the Institute of
Health Visiting – more than any other centre
in London.
The Trust’s research and development team
have excelled in recruiting patients for clinical
trials and St Mark’s Hospital continued to
pioneer world class treatments in the year of
its 180th birthday.
I would like to pay tribute to all our patients,
in addition to our clinical and business
partners, stakeholders such as the Clinical
Commissioning Groups, Health and
Wellbeing Board and local councils.
Also, I would like to thank our outgoing
CEO, David McVittie, for his service. In 2012
he was tasked with completing the merger
and starting the journey towards a more
sustainable future; tasks that he can proudly
count as delivered. In his place, we welcome
Dame Jacqueline Docherty, who joined the
5
Looking to the future
Chief Executive Dame Jacqueline Docherty
I joined the organisation at a busy and
exciting time and look forward to our
first full year as the combined London
North West Healthcare NHS Trust.
There are many challenges ahead as we start
to develop and integrate the organisation
to be a leader in the provision of both acute
and community care. In these early stages
we have a real opportunity to evaluate and
improve the quality of our services and
patient experience for the coming months
and years.
In today’s NHS we do not exist in isolation
and we must understand and react to
challenges that face the NHS as a whole.
Over the coming year, the Trust will continue
to support the Shaping a Healthier Future
programme, which will see the consolidation
of maternity units in North West London.
In supporting this change, we will see
the closure of the maternity unit at Ealing
Hospital, which will be difficult for staff
who have developed such an effective and
efficient service over the years. However, we
know that only by reshaping the maternity
service across the whole of the sector will we
be able to continue providing the safe, high
quality service that the women in our care
deserve and require, both now and in the
future.
6
We will also work closely with North West
London Whole Systems Integrated Care, to
help support patients in their own home and
reduce the need for them to be admitted
to hospital in the first place by delivering
proactive care.
As a major employer within the North
West London sector we have started, and
will continue to prioritise, an ambitious
recruitment and retention programme.
Change cannot be achieved without a wellsupported workforce and our recent staff
survey demonstrates that our staff feel their
roles make a real difference to patients. It is
vitally important for us to invest in our staff so
they can continue to make a difference. The
survey also highlights the areas where staff
do not feel supported and the fact that our
appraisal rates are low – both of which are
areas we will address.
In line with the Government’s direction of
travel, the Trust is positioning itself as a
specialist in the provision of integrated care.
We are also investing in people who will grow
with the organisation, ensuring we provide
training which supports staff development in
their chosen career path. By retaining quality
staff and increasing our recruitment we can
also reduce our expenditure on costly agency
staff, money which can then be reinvested in
clinical services. By supporting our workforce
I hope that we will be regarded as a leading
employer of choice.
While this is an exciting time of change and
development, we must not lose sight of our
finances. We ended the last financial year
as a newly merged Trust with a sizeable
financial deficit. As an organisation, we
must look to develop efficient services that
provide excellent patient care, ensuring we
develop new and innovative care pathways.
By delivering quality, first time, all the time,
we will enhance the experience of patients
whilst reducing expenditure. We can then
redirect resources into areas of growth and
development, bringing us back to financial
stability.
We must also look to make the best use
of resources across all of our community
and hospital sites. There is work to be done
around the Trust’s strategic direction: this will
involve deciding which services we provide,
the contracts we bid for and the specialties
we aim to develop into centres of excellence.
To achieve the right balance, we will continue
to work closely with our commissioners and
local authorities, ensuring the right services
are available for our local community.
I look forward to meeting and working
with you all over the coming months as we
develop London North West Healthcare NHS
Trust together.
Jacqueline Docherty, DBE
Chief Executive
7
Corporate
objectives
for 2014/15
The legacy trusts of Ealing Hospital
NHS Trust and The North West London
Hospitals NHS Trust chose five key
objectives to see the organisations
through their merger on 1 October
2014 and beyond. They were:
1.Improving our focus on safety and quality
• We will work with our patients to ensure that the Trust complies
with the recommendations made by the Francis Inquiry into the
events at Mid Staffordshire NHS Foundation Trust
• We will continue to ensure the safety and wellbeing of all patients
in our care
2.Improving patient experience, satisfaction and
engagement
• We will work with all our stakeholders to develop a culture of
openness, caring and compassion
• We will actively involve patients and carers in all aspects of care
and service delivery and act on their feedback
• We will complete our programme to improve our estate, including
the operating theatres, emergency department and infrastructure
at the Northwick Park site
3.Create a sustainable workforce that is engaged in
developing and improving services
• We aim to become the employer of choice for healthcare staff
• We will ensure our values are understood and embedded
4.Ensure financial sustainability
• We will deliver a financial strategy that supports the merged trusts
but does not undermine our focus on patient safety
5.Plan for our future
• We will support implementation of the Shaping a Healthier Future
programme to enable better standards of care for our patients
8
9
Research and
innovation
The merger and launch of the new Trust
has seen a significant increase in the
numbers of patients participating in
research studies, positioning the Trust as
an important contributor to research in
North West London and beyond.
In March 2015, the Trust launched a
new film to demonstrate the benefits of
research and show patients how they can
get involved. You can watch it online at
www.lnwh.nhs.uk/research
Success stories
The patient research forum –
consisting of more than 40 patients –
has gone from strength to strength,
supporting clinicians with research proposals
and grant applications. The forum has
received positive feedback from researchers
and underpins the Trust’s research strategy by
engaging with patients and service users.
The Trust is a key player in the
Government’s 100,000 Genomes
Project. The aim is for the UK to become the
first country in the world to sequence
100,000 whole human genomes to help
diagnose and treat patients with rare/inherited
diseases and common cancers.
10
The Trust has been identified as the
‘Outer London Hub’ to lead research
on heart failure for the Centre for Leadership
in Applied Health Research and Care
(CLAHRC). It will also lead the ‘Itchy sneezy
wheezy’ programme, looking at allergies in
children.
This year our research excellence
award winners were Dr Ajay Gupta
and Dr Sushen Bhattacharya, for improving
care of elderly patients with hip problems by
putting novel systems in place to ensure they
are operated on more quickly and mobilised
earlier in their recovery.
A study by the Trust demonstrated the
success of SMS texting in recalling to
hospital patients at high risk of sexually
transmitted infections. The study showed a 21
per cent increase in re-attendance amongst
high risk patients, leading to earlier diagnosis
and prevention of complications in HIV.
October 2014
London North West Health Care NHS
Trust was launched, thanks to a lot of
hard work from all our staff. The new
Trust is one of the largest integrated
care organisations in the country,
looking after hospital and community
services in the boroughs of Brent, Ealing
and Harrow. The Executive team spent
their first day out and about meeting as
many staff as possible.
We have developed and tested new
tools to assist patients with cognitive
and communication problems, enabling them
to report their own symptoms and experience
despite their inability to use standard
questionnaires. Many of these tools have
been widely taken up in national clinical
guidelines and are being integrated into
routine clinical practice.
Researchers at Ealing Hospital have
been awarded a European Grant to
investigate the prevention of diabetes in
South Asian patients, both in the UK and
internationally.
Researchers at the Trust published
data showing the impact of the
London Olympics on sexual health. These
data were used in preparations for the
Glasgow Commonwealth Games and provide
an excellent resource for the planning of any
large event.
11
Recognising
our dedicated
staff
We employ almost 8,500 staff, making
us one of the largest local employers.
The success of our Trust in delivering
high standards of patient care can
be attributed to the dedication and
commitment of our staff.
Here we celebrate their outstanding
achievements and share what they think
of our organisation.
Pride in our Staff
LNWH staff
awards
In March a special awards evening was held,
with support from our sponsors, to celebrate
the achievements of our staff. The prestigious
awards received more than 180 nominations
from patients, staff and the public.
The winners were:
Caring Excellence
Team winners Ambulatory Emergency Care
Team Ealing Hospital. “For the service they
provide, which from patient feedback, has
been proven to be excellent.”picture [1]
Individual winner Mahadevan
Thevakanthan, Nurse Practitioner, ENT.
“For his unflinching, hard-working and
patient-centred nursing care.” [2]
Patient Safety
Team winners The Endoscopy
Pre-assessment Team St Mark’s Hospital.
“For helping to reduce complications and
increase patient safety.” [3]
Individual winner Maria Yates, Community
Matron. “Because of her input and passion,
the district nursing team has blossomed.” [4]
Stronger Together
Team winners Clinical Coding Team.
“For their consistent hardworking and
supportive approach during times of extreme
pressure to meet deadlines.” [5]
Individual winner
The judging panel were unable to come to
a decision on one runner up and winner so
there are two this year, and they are:
John Hutchins, Clinical Director, Consultant
Paediatrician. “For his amazing people skills,
quirky style of management and strong work
ethic.” (no picture)
Ginder Nisar, Executive Assistant.
“For being a role model to her peers and an
asset to the organisation - she never takes her
eye off the ball.” [6]
12
1
Pride in our Staff
LNWH staff
awards
2
4
3
6
5
October 2014
Brent Family Nurse Partnership
was launched to support first-time
teenage mums.
13
7
Unsung Hero
Team winners Health visiting teams,
Ealing, Brent and Harrow. “For their
dedication and commitment through a period
of massive change and uncertainty.” [7]
Individual winner Meena Gandhi, Ward
Clerk. “For working above and beyond to
ensure patient safety and giving 110%.” [8]
and Angie Lyon, Telephone Supervisor. “For
her unfailing ability to be professional and
courteous regardless of the situation.” [9]
8
Patient Experience
Team winners Supervisors of Midwives,
Ealing Hospital. “For being recognised for
their excellent work by an external team of
auditors and being used as an example of
good practice for other teams in London.”
[10]
10
Individual winner Debbie Bowry, Paediatric
Physiotherapy Associate Practitioner.
“For delivering an excellent service to her
patients and commitment to her team.” [11]
Innovator of the year
Team winners The Microbiology
Team Northwick Park Hospital. “For the
introduction of the Microbiology ICE referral
system, which has had more than 700
referrals since March 2014.” [12]
Individual winner Andrew Lodge, Endoscopy
Decontamination Manager.
“For demonstrating strength of leadership
and supporting his staff in learning and
development.” (no picture)
Volunteer of the year
Winner Freda Grant. “For her dedication
and commitment to the hospital over the past
24 years.” [13]
14
12
9
Pride in our Staff
Student of the year
From Bucks University Winner
Goretti Dowdican-McAndrew “For her
thesis entitled: The role of multi-professional
healthcare support workers in an intermediate
care team.” [14]
LNWH staff
11
13
14
15
awards
From University of West London Winner
Paul Byrne, Student Midwife “For being an
active and engaged student who is highly
valued by his colleagues.” [15]
Chairman’s Award
The winners are the Emergency Department
Teams from both Ealing and Northwick
Park Hospitals. “For the dedication, hard
work and professionalism they’ve shown
through what has been a very busy year.” [16]
16
Congratulations to everyone shortlisted and thank you to all those who
sponsored the event and those who took the time to nominate. The full list of this
year’s nominations can be found at www.LNWH.nhs.uk/about-us/awards where you
can also make your nominations for next year’s awards.
15
What our staff
said about
working here
Every year, the NHS sends a survey to its
staff to find out what they think about
their working environment. The survey
is undertaken in the autumn and 2014
was the first one for London North West
Healthcare.
The top five areas in which we compared
favourably with other acute trusts were:
staff motivation at work
staff feeling satisfied with the
quality of work and patient care
they are able to deliver
staff agreeing that their roles
make a difference to patients
staff agreeing that feedback from
patients/service users is used to
make informed decisions in their
department/directorate
levels of stress reported by staff
Areas in which we compared less favourably
with other trusts include the number of staff
who have annual appraisals and the number
who experience harassment or abuse. We
are working through action plans to improve
these areas.
16
Embracing equality and diversity
The Trust is committed to ensuring that it
meets and exceeds its obligations under
equality legislation and is in the process of
finalising equality objectives for the new
organisation. Previous equality objectives
from the legacy Trusts will remain in place
until this process is completed.
We are working to become a more inclusive
Trust. Progress includes:
the development of a new Equality &
Inclusion Strategy
engagement with local communities
on how to address health inequalities
the introduction of new technology to
support our staff and service users in
offering a more accessible service
the development of a new bullying
and harassment advisory service to
support staff, something that was flagged up
as a clear priority in the staff survey
mandatory training is supported by
new Trust-wide policies on bullying
and harassment and equality and diversity
policies. These also support staff with
disabilities
the Trust remains a Stonewall Diversity
Champion
Keeping in touch with our staff
The Chief Executive and the Executive team
provide visible leadership by walking-thefloor on a regular basis, visiting wards,
departments and community sites across the
organisation. The visits provide an opportunity
for the team to interact with patients and
staff, whilst also picking up on any potential
issues.
November 2014
Mums-to-be in Brent, Ealing and
Harrow can choose to have their baby at
home, following the launch of our new
homebirth service.
The Chief Executive holds regular open
forums across our sites and regularly writes
to all staff through the ‘This week’ e-bulletin.
Managers are also briefed using the
‘Team talk’ cascade to encourage discussion
of trust-wide issues at local team meetings.
Following the merger, we launched a new
Trust magazine for staff, patients and other
stakeholders. Published quarterly, ‘Our
Trust’ magazine shares news and showcases
17
Workforce performance
Information on a range of key workforce
indicators is reported to the Trust Board each
month. Below are some facts and figures:
8,478
eople are employed by the
p
Trust (8113.21 full- time
equivalents (FTE)).
1,197
people (14.1 per cent) are
employed part time.
• 10.6 per cent of posts were vacant at the
end of the financial year (March 2015).
This was a reduction from the 13.3 per
cent of posts which were vacant when
the Trust was formed in October 2014.
• A small proportion of our workforce left
the organisation voluntarily (5.7 per cent).
highlights from across the organisation.
In October, the Trust launched a new intranet
site which incorporated feedback from staff
to make it more user-friendly. This channel
is frequently used by staff to access news,
information and resources.
Regular health and safety bulletins and fire
safety bulletins are distributed electronically to
all staff and stored on the intranet.
The Trust also has a number of active social
media accounts, including Twitter and
Facebook, which share news and encourage
dialogue with staff and patients.
All communication channels are widely used
to keep staff informed about organisational
changes. Over the last six months, staff have
been updated on a range of important issues,
including post-merger integration across the
Trust, improvements to the performance of
the organisation’s emergency department and
changes to services as a result of the Shaping
a Healthier Future consultation.
18
• On 9 March the Trust launched its new
Education Learning Management System
(ELMS). This online platform enables
staff to book their training, access online
learning and review their training records.
It will improve the uptake and recording of
training in future and will mean that new
staff do not have to duplicate statutory and
mandatory training where they can provide
evidence that they are up to date from a
previous role.
• The reported sickness absence rate was 3.6
per cent. The national average is 4 per cent.
It is disappointing that only 40 per cent of
staff had an up-to-date appraisal recorded
during this period. It has been recognised that
there is an issue around completed appraisals
being recorded centrally and this is being
addressed. The new organisation, London
North West Healthcare NHS Trust, recognises
that appraisals play an important role in staff
development and are crucial in attracting
and retaining high quality staff. Improving
appraisal rates is a key element of the Trust’s
recruitment plan going forwards.
Staff group shown as a percentage
of our workforce
Nursing and midwifery
Administrative and clerical
Additional clinical services
Medical and dental
Allied health professionals
Scientific and technical
Estates and ancillary
Students
Nursing
andscientists
midwifery
Healthcare
Additional clinical services
Medical and dental
Allied health professionals
Scientific and technical
Students
Healthcare scientists
34.9%
19.6%
16.4%
14.5%
9%
3.5%
0.7%
0.7%
34.9%
0.6%
19.6%
16.4%
14.5%
9%
3.5%
0.7%
0.7%
0.6%
Staff ethnicity shown as a percentage
of our workforce
Nursing and midwife
Administrative and c
Additional clinical se
Working in partnership Medical and dental
Allied health profess
We work in partnership with our
recognised
Staff
groups
Scientific
andshown
technia
trade unions. In line with our jointly agreed
Staff
group
LNWH
Estates
change management policy, we
remainand ancillary
Nursing
and midwife
Students
0.7%
committed to consultation when
staff are
Administrative
and c
Healthcare
scientists
affected by changes to the way services are run.
Additional clinical se
Our Joint Negotiating and Consultative
Medical
and dental
Staff ethnicity
shown
Committee (for all staff) and the Local
Allied
health
profess
Ethnic Group LNWH
Negotiating Committee (for medical
Scientific
and techni
Whiteand
35.4%
staff) work together to agree policies
implement staff consultations. Asian 26.3%
Students
Black
16.8% 0.7%
Healthcare
scientists
Chinese/ Other
Mixed 2.4%
Staff
ethnicity shown
Not Stated
10.9%
Ethnic Group LNWH
White
35.4%
More than 240 community and
Our district
trust
provides h
nurses have been given a tablet
Asian 26.3%
computer to support their work.
BlackTablet
16.8%
technology is enabling community
Chinese/ Other
nurses in Ealing, Brent and Harrow
Mixed
2.4%
to review and update patient
records
Not This
Stated
while visiting patients at home.
use 10.9%
November 2014
of technology not only saves time spent
on administration but also allows
nurses
Our trust
provides h
to spend more time supporting and
caring for patients.
Staff ethnicity shown as a percentage
of our workforce
White
35.4%
Asian
26.3%
Black
16.8%
Chinese/Other
8.1%
Mixed
2.4%
Not stated
10.9%
Our trust provides healthcare to a diverse
White
35.4%
population
across north west London.
The
Asian
26.3%
ethnic diversity of our workforce broadly
reflectsBlack
the composition of our local16.8%
Chinese/Other
8.1%
communities.
Mixed
Not stated
2.4%
10.9%
*All figures reported in this section relate to the end of the
period covered by this report, i.e. 31 March 2015.
19
Our
performance
organisations across North West London to
deliver an action plan and resolve the issues
that can sometimes lead to patients not
receiving this treatment within 62 days.
More than 97 out of every
100 women (97.5 per cent)
Here we set out the Trust’s performance
during the period, against national
Department of Health standards that
must be met or exceeded:
Almost 95 out of every
100 patients (94.7 per cent)
who were referred to the Trust by an NHS
cancer screening service received their first
definitive treatment within 62 days, against a
national standard of at least 85 per cent.
Almost 96 out of every 100
patients (95.7 per cent)
who were referred with suspected cancer to
the Trust by their GP or dentist were seen by
a clinician within two weeks. The national
standard is 93 per cent.
Almost 98 out of every 100
were treated for cancer within 31 days of a
decision to treat being taken. This meets the
national standard of at least 96 per cent.
More than 8 out of 10 patients (82.2
per cent) received their treatment
within 62 days following an urgent GP or
dentist referral for suspected cancer. This was
just below the national standard of 85 per
cent. These patients are often on complex
pathways, involving a number of healthcare
providers. We are streamlining our internal
processes and working with other
20
who were referred for a breast surgery
appointment were seen within two weeks.
This met the national standard of at least
93 per cent.
Less than 1 out of every 100
experienced a delay to their discharge once
they were medically fit to go home. This was
within the national standard of less than
3.5 per cent.
94 per cent of patients admitted to the
Trust received an assessment for
Venous Thromboembolism (VTE), narrowly
missing the national standard (95 per cent).
See page 33 for more information about this
important indicator and what we are doing to
ensure we meet the standard in future.
97 out of every 100 patients
admitted with a stroke
spent at least 90 per cent their stay on the
stroke unit. This met the national standard of
at least 80 per cent and is important because
it shows that these patients were in the most
appropriate place to receive specialist
treatment.
receiving palliative care
from London North West Healthcare received
their care in their preferred setting in the
community. This met the national target of at
least 80 per cent.
21
88 per cent of patients who
attended an A&E
or Urgent Care Centre on one of the Trust’s
sites were admitted, discharged or
transferred within four hours, against a
national target of at least 95 per cent. The
Trust, in collaboration with its partners, is
implementing a well developed action plan
to improve this performance over the coming
year. See page 29 for more details of the
work that is taking place.
Since 2013 all NHS Trusts have been
required to eliminate mixed-sex
accommodation, except where it is in the
overall clinical interest of the patient. During
the period covered in this report,
the Trust had no mixed sex
accommodation breaches.
More than 8 out of every 10 patients
(82.3 per cent) admitted for a planned
procedure received their surgery within 18
weeks, against a national standard of 90 per
cent. Over the last 18 months we have
worked hard to ensure that all of our
patients’ waiting times are counted correctly.
Some patients have waited too long for their
treatment and over the coming year we will
be working with our commissioners to fund
additional activity to rectify this.
using the Trust’s podiatry
service reported reduced pain (or no
change). This was better than the national
standard of 85 per cent.
The Trust reported 3.2 falls
per 1,000 patient bed days
within community in-patient units. This met
the standard set by our local commissioners
of no more than 7 falls per 1,000 bed days.
22
December 2014
Northwick Park Hospital’s new
Accident and Emergency department
opened its doors to patients at 4am on
Wednesday 10 December 2014.
The new £21m, state-of-the-art A&E
department incorporates all the main
elements of emergency care and brings
A&E closer to the hospital’s other
emergency services, such as acute
assessment, intensive therapy unit,
operating theatres and wards. More
information about improvements to
our emergency services can be found
on page 29.
Reducing
Infections
During 2014/15, our hospitals and
community services remained committed
to reducing all avoidable healthcare
acquired infections.
Every year NHS England sets each acute hospital
trust a ceiling for the maximum number of
patients with Clostridium difficile infections.
This annual report covers the six month period
immediately following the merger of Ealing
Hospital NHS Trust and North West London
Hospitals NHS Trust (from October 2014 to
March 2015). However, for the purposes of
mandatory reporting of Clostridium difficile,
the two legacy organisations retained their
individual targets for the whole of the
2014/15 financial year.
A ceiling of no more than 26 cases was
set for the combined trusts in 2014/15.
This challenging target represented a reduction
of 17 cases from the previous year. A total of 31
cases were recorded during the full year; a 28
per cent reduction on the previous year’s total.
January 2015
St Mark’s Hospital celebrated its 180th
birthday. In this anniversary year,
Professor Brian Saunders presented a
pioneering surgical technique which
removes polyps without leaving
patients with stoma bags.
Since 2013/14 there has been zero
tolerance to MRSA blood stream
infections for all acute hospital trusts. During
the period covered by this report, the Trust
reported one case of MRSA at Ealing Hospital.
General standards of cleanliness and
hygiene are important factors in
infection control. See page 26 for more
information about how our patients rated the
levels of cleanliness across the Trust’s sites.
23
Information
governance
24
Information governance is the way in
which the Trust ensures it is managing
information ethically and legally, and
that any patient information is used
following strict national guidelines to
ensure confidentiality and integrity.
Incidents relating to information are actively
managed and monitored through the Trust’s
Information Assurance Board and the Audit,
Governance & Risk Committee.
Becoming more sustainable
The Trust is committed to improving its future
sustainability. Over the past six months the
Trust has:
Incidents are rated according to severity
used internal sustainability champions
as defined by the Health and Social Care
to promote cycling and cycle safety,
Information Centre (HSCIC), with 0 being the
lowest and 2 being the highest. All information recycling, energy and water efficiency and to
help maintain local woodland
incidents rated at Level 2 are notified to
the Information Commissioner’s Office (the
reviewed energy and waste
regulator for data protection in England) via
management to explore lower costs
the HSCIC information governance incident
and
more
sustainable alternatives
reporting tool, and also placed on STEIS, the
national incident reporting system.
reduced CO2 emissions by more than
During the period covered by this report, a
300 tonnes (with 270 tonnes saved by
single Level 2 incident was reported.
the installation of LED lighting on large
sections of the Ealing Hospital site)
The following table illustrates reported Level 2
incidents.
built the new emergency department
at Northwick Park to BREEAM 2011
Total
standard. This means it is a very efficient
Nature of incident
reported
building with boilers running on natural gas,
double glazing, LED lighting and solar panels
Loss of inadequately protected
1
reducing CO2 emissions by 30 tonnes a year.
electronic equipment devices
or paper documents from
There are future plans to replace the existing
secured NHS premises
steam boiler system at Northwick Park with
Loss of inadequately protected
electronic equipment devices
or paper documents from
outside secured NHS premises
NONE
Insecure disposal of
inadequately protected
electronic equipment, devices
or paper documents
NONE
Unauthorised disclosure
NONE
Other
NONE
high efficiency package boilers to ensure
emissions remain below the continually
decreasing target levels.
We are also working with the neighbouring
University of Westminster campus to produce
a green travel plan.
25
What our patients say about the
Trust’s environment
2014/15 was the second year that Patient
Led Assessments of the Care Environment
(PLACE) were carried out to assess the
Trust’s environment across the hospital and
community setting. This year’s assessments
were held in April and May 2014, prior to
the merger, but apply to the whole year.
Patient assessors make up 50 per cent of
our assessment teams and the valuable
feedback obtained during this process is
used by the Trust to make ongoing quality
improvements.
Our scores for the four key areas were:
Cleanliness
Food and
hydration
Privacy and
dignity
Condition/
appearance/
maintenance
97.25
88.79
87.73
91.97
97.03
69.58
72.64
92.14
Clayponds%
98.08
95.26
84.93
93.75
Denham Unit
%
94.66
92.63
84.78
85.85
Ealing Hospital
%
97.05
87.17
74.12
86.98
Meadow House
Hospice
%
100.00
90.32
100.00
88.96
Northwick Park & St Mark’s Hospitals%
98.35
72.02
78.05
89.20
Willesden Centre for Health & Care
99.47
97.14
81.15
96.96
National average %
Central Middlesex
Hospital
%
26
%
Following the assessments we have:
implemented a new patient meal
service and menu information booklet
system at Central Middlesex, Northwick Park
and St Mark’s Hospitals
approved a curtain replacement
programme for Ealing, Central
Middlesex, Northwick Park and
St Mark’s Hospitals
improved the appearance and access
route into the main entrance at
Ealing Hospital
reviewed the protected mealtimes
policy and monitoring tools to meet
the requirements of the new Trust
continued to engage patients and
staff in mini-assessments.
The Trust has also invested in the
infrastructure at Northwick Park with the
completion of a new electricity supply to
meet the site’s increasing demands, as well
as improving the main drainage system by
replacing aging infrastructure.
A community estates strategy is being
developed to support the infrastructure of
our community sites. This will be launched
later in 2015/16.
February 2015
Our health visitors lead the way in
tackling postnatal depression. The
development of their assessment
wheel will help to tackle some of the
£8.1bn spent nationally on mental
health problems every year.
Improving our surroundings
The Trust continues to improve its buildings
and services and the second half of the year
saw the anticipated opening of the new £21
million emergency department at Northwick
Park Hospital. The enhanced facility provides
a dedicated X-ray and CT scanner. The
building has been built to modern standards
with enhanced natural light, improved
signage and increased privacy and dignity.
Further refurbishments improved existing
facilities: Ealing Hospital’s care of the elderly
ward was redesigned to be dementia
friendly, cardiology services at Northwick
Park now provide enhanced facilities and
additional beds, the Denham Unit saw
improvements to its facilities and building
commenced on a new 63 bedded unit at
Northwick Park, following the approval of a
£31.5m business case.
27
Quality at the
heart of what
we do
A copy of our quality accounts can be
found at www.nhs.uk
In our 2013/14 Quality Accounts,
pre-merger, we outlined three key
priorities for quality improvement in the
organisation during 2014/15.
These were:
PRIORITY 1
Continued development and improvement of
the patient journey and experience through
our accident and emergency patient pathway
(see page 29)
PRIORITY 2
Improved patient experience (see page 30)
PRIORITY 3
Measures to reduce harm (see page 32)
Throughout the last six months we worked
hard to improve outcomes across these three
priority areas.
28
PRIORITY 1
Continued development and
improvement of the patient journey
and experience through our
emergency patient pathway
The winter was particularly difficult for the
whole of the NHS with significant pressures
created by an increase in the number of
patients who were acutely unwell and in
need of 1:1 care. This created a challenge for
the Trust in attempting to meet the national
emergency department standard to see,
treat and admit or discharge 95 per cent of
patients within four hours.
Since the winter we have taken some
innovative steps to improve clinical processes
across the Trust. We have seen real progress
in reducing the number of patients who wait
more than four hours before being admitted
or discharged from A&E and we remain
committed to meeting the national standard
in future.
We have made a number of changes across
the organisation to improve the experience of
patients who require emergency care at our
hospitals and, in particular, at Northwick Park
Hospital.
Improvements to support our emergency
pathway include:
Capacity
Capacity within the organisation, and
especially at Northwick Park Hospital, played
a part in the failure to meet the emergency
target this winter. Throughout the winter 56
beds were opened across the organisation
and a new modular build is currently under
construction which will provide 63 new beds
to Northwick Park by the winter of 2015/16.
Increasing beds is not the only issue that
needed to be addressed to improve our
performance and give patients attending our
emergency departments the very best care.
In order to make our processes as efficient
as possible across the organisation, we
established a dedicated ‘emergency pathway
taskforce’, led by our Director of Operations
with key lead nurses and clinicians.
Emergency pathway taskforce
To help improve the flow of patients from
the emergency department into the hospital,
a dedicated taskforce was set up to look
at all procedures across the hospital and
community settings.
A major success of the taskforce was the
launch of a new rapid assessment process
and care pathway allowing the emergency
department team to treat stable emergency
patients quickly, without taking up additional
beds.
The taskforce is now looking to improve
access to community beds and care services
so that patients who are ready for discharge
can leave hospital at the appropriate time.
29
Opening the new emergency
department at Northwick Park
Hospital
December 2014 saw the opening of the new
£21million A&E and Urgent Care Centre at
Northwick Park Hospital. The state-of-the-art
department provides a dedicated treatment
area for children and includes 40 individual
bays, giving patients a greater level of privacy.
Following the closure of the A&E at Central
Middlesex Hospital, staff moved to Northwick
Park Hospital to support the new department.
This resulted in the introduction of more
senior clinical staff and consultant cover.
Community beds
To help reduce the pressure on our A&E
departments, our community rehabilitation
hospitals received additional patients over
the course of the winter. These patients still
required care but could be safely looked after
outside our acute hospitals.
STARRS and ICE admissions
avoidance
The Intermediate Care Ealing service (ICE) and
the Short Term Assessment and Rehabilitation
and Reablement Service (STARRS) both
worked to support patients in their own
homes throughout the winter. These services
helped to increase the number of patients
that received their care without being
admitted to hospital.
30
PRIORITY 2
Improved patient experience
Ensuring that our patients have the best
possible experience is a key priority and at the
centre of everything we do.
However, in the last year, the two predecessor
Trusts received feedback from surveys
stating that there were areas of the patient
experience they were not getting right. So,
in 2014/15, the new merged Trust looked at
how we could do better and we have been
working hard to improve training, our culture,
communication and care.
New ward rounds
New ward round standards have been
introduced across the whole Trust by the
Chief Nurse and Medical Director. Under
these new standards, members of the
multidisciplinary team take part in daily ward
rounds, contributing to patient reviews and
receiving important clinical information.
Posters with the new standard are being
displayed across all ward areas.
Tablets in the community
More than 240 community and district
nurses have been provided with a tablet
computer to support their work. Tablet
technology is enabling community nurses in
Ealing, Brent and Harrow to review and
update patient records while visiting patients
at home. This use of technology not only
saves time spent on administration, it also
allows nurses to spend more time supporting
and caring for patients.
The ‘Hello my name is…’
campaign
One of the main issues picked up in feedback
from patients was that they didn’t always
know who was treating them. Acting on this
feedback, the ‘hello my name is…’ campaign
was piloted in our emergency departments
and will be rolled out across our wards in
2015/16. The campaign raises awareness of
the importance of introductions and
encourages staff to build them in to their
routine.
Name boards
New name boards have been placed
above all patient beds to identify each
patient’s lead consultant.
Information boards
New quality boards have been
displayed on all wards to ensure that patients
and visitors can see, at a glance, how the
ward is performing against a range of
measures. Staff use the boards to ensure that
necessary actions are taken to address any
trends before they pose a problem.
Measures displayed on the boards include
items from the NHS Safety Thermometer
(see page 32), staffing levels and patient
experiences, such as responses to the Friends
and Family Test (see page 36).
Foundations of Safety
The Trust signed up to the Foundations
of Safety campaign in conjunction with
Imperial College Health Partners. The
31
PRIORITY 3
Measures to reduce harm
The Trust uses the NHS Safety Thermometer
to measure harm and the proportion of
patients that are ‘harm free’ in four key areas
(see below).
campaign is designed to help change staff
behaviours and clinical practice, based on
evidence. Patient champions have also joined
the campaign and surveys have been sent to
staff and patient groups to help identify areas
of improvement.
Capturing patient feedback
The Trust introduced an electronic,
real-time patient survey system which
facilitates a responsive approach to patient
feedback. There are a number of electronic
kiosks situated in outpatient areas to ensure
patient views are captured.
The ‘100 voices’ programme was held
Trust-wide in February 2015 in order to find
out what patients and staff thought of their
experience with our services. Responses were
received from 705 staff members and 360
patients. Their feedback will help to shape
and improve the outpatient service.
Diabetes Integrated Care
Ealing (DICE)
To support patients with diabetes in the
community, the DICE team held a patient
conference in November. The conference was
designed to support and help people with
diabetes to manage their own condition.
32
To record this data, every third Wednesday of
the month inpatients are surveyed to capture
a snapshot of the situation across the Trust.
During the period covered by this
report, on average the Trust met the
national target to provide ‘all harm free care’
to at least 95 out of every 100 patients.
Reducing harm from
hospital and community
acquired pressure ulcers
The Trust scored well against the NHS
England benchmark of less than 1% of
patients surveyed acquiring a new pressure
ulcer. Just 0.69 per cent of new patients
surveyed acquired a new pressure ulcer while
in our care. This measure has been added to
the wards’ key performance indicators which
are discussed at the monthly meeting of
Matrons and Heads of Nursing. This will help
to reduce the incidence of pressure ulcers by
sharing learning and implementing best
practice across the organisation.
Reducing harm from falls
The Trust performed well against this
target during the period covered by this
report. Just 1 out of every 400 (0.25 per cent)
patients reported harm from falls, meeting
the national standard of less than 0.6 per
cent.
The Trust uses a falls care bundle (checklist)
to identify patients at risk of falling in our
hospital and community settings. We work
hard to reduce the risk of patients coming
to harm in this way by employing a range of
methods, such as ensuring side rails on beds
are used appropriately and low-rise beds are
provided to those patients who find it difficult
to get in and out of bed.
Falls are routinely recorded as part of the
wards’ key performance indicators and the
Trust has a Falls Committee which examines
data and the reasons for patients falling. It
ensures corrective measures are put in place
to reduce the incidence of falls in future.
Ealing Hospital’s care of the elderly ward has
been upgraded with new non-slip floors to
improve safety and colour coded bays to
make it easier to navigate for patients.
Reducing harm from
catheter-associated urinary
tract infections (UTIs)
Fewer than 1 in 500 (0.19 per cent) patients
acquired a catheter-associated UTI, against a
target of less than 0.7 per cent.
The Trust continues to use the catheter
insertion care bundle (checklist) to monitor
and support the care of patients with a new
catheter.
A new patient ‘passport’ was developed to
help reduce urinary catheter infections. The
passport joins up patients’ care across the
hospital and community settings, supporting
them when they are out of hospital. It
enables all clinicians to see when and why
the catheter was inserted, ensuring that it is
changed regularly and ultimately leading to a
reduction in infections.
Reducing the incidence of
venous thromboembolism
(VTE)
VTE is a condition where a blood clot forms
in a vein and may travel in the blood, with
potentially fatal consequences. By assessing
those at risk of acquiring VTE, we are able to
take preventative measures.
On average, the Trust reviewed more than 94
per cent of patients for being at risk of VTE,
narrowly missing the 95 per cent standard.
The Trust closely monitors the completion
of assessments. We will continue to support
and educate staff to ensure appropriate and
timely assessment and reviews take place for
all patients.
To help improve our compliance, the VTE
assessment has been added on to the
clinicians’ electronic white board. This
means that new patients who have not
been reviewed for VTE within six hours of
admission will be clearly flagged up. Similarly,
the system will highlight any patients who
remain in hospital and require a seven day
review.
Data about VTE assessments have also
been added to the wards’ key performance
indicators which are reviewed monthly for
compliance. Where the standard is not met,
wards are set an action plan to improve
compliance.
Staff training
New e-learning training modules have been
introduced, enabling staff to develop their
awareness and skills when caring for patients
with dementia and diabetes.
33
Listening to
what patients
tell us
The Trust welcomes feedback about our
services from patients and their families.
We learn from comments received, using
them to improve patient services and care.
For the period covered by this report,
97 per cent of complaints were responded
to within the date at the Ealing Hospital
NHS Trust legacy organisation. 73 per cent
of complaints were responded to within the
date for the legacy organisation The North
West London Hospitals NHS Trust.
Themes of complaints
Across the Trust the top four themes of
complaints were:
• Clinical treatment
• Verbal communication and information
PALS
Our patient advice and liaison service (PALs)
received 1,995 comments and queries from
patients and visitors between October 2014
and March 2015.
• Staff attitude
• Appointments in the outpatient
department
These reflect the themes identified by the
NHS Information Centre.
Compliments
During this period we received 381 formal
compliments across our hospital and
community sites. These were in addition to the
many cards, letters and tokens of appreciation
received directly by wards and departments.
Complaints
During the period covered by this report,
the Trust received 494 formal complaints.
More than 98 per cent of complaints were
acknowledged within three days of receipt.
The complaint regulations, which were
published in 2009, gave NHS trusts the ability
to negotiate a timeframe for responding
to a complaint with each complainant, and
for a second date to be agreed with the
complainant if the first response date is not
met. These regulations also gave guidance
that all complaints should be responded to
within six months.
34
Principles for remedy
In handling complaints, the Trust adheres
to the Parliamentary and Health Service
Ombudsman’s (PHSO) six principles for
remedy. These highlight best practice for
organisations to ensure complainants are
treated in a fair, open and accountable
manner and that appropriate and
proportionate remedies are offered.
Complainants can ask the PHSO to review
the way in which their complaints have been
handled if they remain dissatisfied with the
investigation and action taken by the Trust in
response to their complaint.
During this period the trust had ten
complaints referred to the PHSO. Of these,
one has not been upheld and the remainder
are still open.
Acting on feedback
As a result of the feedback we received, a
number of improvements and changes to
services have been made:
communication between
multidisciplinary teams, patients and
their families has been improved by
scheduling formal ‘family meetings’ to discuss
care for patients with complex conditions
mobile devices (tablets) have been
given to 240 community and district
nurses, increasing their access to patient
information and ensuring they are better
equipped to meet patient needs
a new Patient Discharge Coordinator
is in place to improve discharge
processes and communication.
35
NHS Choices
Feedback placed on the NHS Choices website
(www.nhs.uk), much of which is anonymous,
is accessed by our patient relations team
and passed on to managers for action as
necessary. Some of this feedback raises
concerns, but an increased number of
postings are positive comments.
Friends and Family Test
NHS hospitals are required to carry out
the ‘Friends and Family Test’, an important
opportunity for patients to provide feedback
on the services that provide their treatment
and care.
The test asks people if they would
recommend the healthcare services used to
their family and friends if they needed similar
care. It was launched in April 2013 and
since then the question has been asked in all
36
NHS inpatient and A&E departments across
England and, since October 2013, in NHS
maternity services.
The Friends and Family Test was offered to
all our patients following their care and was
made available through our website. The
average response rate was 29.7 per cent
(against a target of 30 per cent), with almost
nine out of ten (88.3 per cent) people who
responded saying they would recommend
our inpatient care to their friends and family.
In our A&E department, the average response
rate was 14.9 per cent (against a target of
20 per cent), with almost 8 out of every ten
(77 per cent) people who responded saying
they would recommend our emergency
services. The Trust has an extensive action
plan in place to improve the performance of
its emergency pathway (including A&E), see
page 29.
Being prepared
It is essential for the Trust to prepare for
an emergency and to ensure it would
respond appropriately if a major incident
did occur.
Major incident planning
To ensure the Trust is prepared in case of a
major incident we take part in coordinated
exercises.
Multi-agency table top exercises took
place with health and social care partner
organisations in North West London to test
multi-agency support and mutual aid.
This included Exercise Fadden, a Harrow
Borough resilience forum exercise which
simulated a live command and control
environment.
The Trust participated in an exercise at
Wembley stadium which was designed to test
and validate Brent Council’s procedures for
the opening of public buildings as shelters in
an emergency.
Working with our partners
The Trust works in partnership with
individuals, groups and other organisations to
achieve its aims and objectives and improve
services for patients.
We work closely with our local clinical
commissioning groups (CCGs), local councils
and Healthwatch Brent, Ealing and Harrow.
Our local Healthwatches are made up of
individuals, community groups and social
care services. We regularly meet with them
to discuss potential changes to services and
Healthwatch representatives are welcome
to attend our monthly Trust Board meetings
which are held in public. We work closely
with our partners across the NHS, including
our neighbouring acute trusts in North West
London, the Trust Development Authority,
North West London Commissioning Support
Unit, the Shaping a Healthier Future
programme and NHS England.
March 2015
‘Pride in our Staff’- the LNWH staff
excellence awards. The awards
ceremony was held on 12 March and all
the winners can be found on page 12.
The Trust also took part in a regional Public
Health England Ebola based exercise which
reviewed local preparedness and response
arrangements to a suspected Ebola case.
37
Our Trust Board
Members of the Trust Board during 1 October 2014 to 31 March 2015 were as follows:
Chairman
Chief Executive
Peter Worthington
David McVittie
Non-Executive Directors:
Patricia Williamson, Professor
(Deputy Chairman) David Taube
Caroline Corby
Stella Dutton
Jeanne Spinks
Medical Director
Dr Charles Cayley
(interim)
(from December
2014 ongoing)
Chief Financial
Officer
Simon Crawford
(interim)
Chief Operating
Officer
Christopher
Pocklington (interim)
Martin West
Executive Directors:
Chief Nurse
Carole Flowers
(interim)
Medical Director
Dr Alfa Sa’adu
(Oct 2014 to
December 2014)
(interim)
In attendance
Director
of Human
Resources &
Organisational
Development
Paul Stanton
(interim)
38
Director of
Operations
Tina Benson
Director of
Community
Services
Yvonne Leese
(Appointed
October 2014)
Director of
Commercial
Development
Christopher
Blake (interim)
Director of
Governance
Catherine
Thorne
(Resigned
January 2015)
Director of
Estates and
Facilities
Paul Kingsmore
Chief
Information
Officer
Kevin Connolly
(interim)
Board Sub-Committee Membership
Charitable Funds Committee
Chair: Stella Dutton
Caroline Corby, NED
Jeanne Spinks, NED
Chief Financial Officer
Chief Nurse
Remuneration and Senior Appointments
Committee
Chair: Patricia Williamson
Caroline Corby, NED
Stella Dutton, NED
Professor David Taube, NED
Other members co-opted as required
Audit Governance and Risk Committee
Chair: Martin West
Caroline Corby, NED
Jeanne Spinks, NED
Chief Executive (twice a year)
Chief Operating Officer
Finance, Investment and Estates
Committee
Chair: Caroline Corby
Stella Dutton, NED
Martin West, NED
Director of Estates and Facilities
Clinical Performance and Patient
Experience Committee
Chair: Professor David Taube
Stella Dutton, NED
Caroline Corby, NED
Jeanne Spinks, NED
Medical Director
Chief Nurse
Strategy, Organisational Development,
HR and Communications Committee
Chair: Jeanne Spinks
Professor David Taube, NED
Stella Dutton, NED
Chief Executive Officer
Director of HR & OD
Director of Commercial Development
Integration Board
Chair: Peter Worthington
Deputy Chair: Patricia Williamson, NED
Martin West, NED
Caroline Corby, NED
Chief Executive Officer
Medical Director
Chief Nurse
Director of HR and OD
Chief Information Officer
Director of Operations
Director of Community Services
39
Non-Executive and Executive leads (mandatory requirements)
Role
Executive lead
Accountable Officer
David McVittie
Caldicott Guardian
Delegated by C Cayley
to Simon Gabe
Safeguarding Adults
Carole Flowers
Stella Dutton
Safeguarding Children
Carole Flowers
Stella Dutton
Security
Paul Kingsmore
Counter fraud
Simon Crawford
Martin West
Whistleblowing
Carole Flowers (Clinical) /
Paul Stanton (non-Clinical)
Jeanne Spinks
Health and Safety
Paul Kingsmore
David Taube
SIRO
Kevin Connolly
Responsible Officer
Charles Cayley
Controlled Drugs
Charles Cayley
Patient Safety
Charles Cayley
Allegations against professional
Carole Flowers
Infection Control
David McVittie/
Fiona Coogan
Fire Safety
Paul Kingsmore
Emergency planning
Tina Benson
CQC
Carole Flowers
Doctors in Difficulty
40
Non-Executive lead
David Taube
David Taube
Declaration of interests
Name
Title
Declaration
Peter Worthington Chairman
Director:
LP orgination
Chesilton Consultancy Limited
MRIMC Management Company LLP
Midway Resources International
Patricia
Williamson
Deputy Chairman
Director PMW HR Consulting Ltd
David McVittie
Chief Executive
Director of Imperial College Health Partners
Simon Crawford
Interim Chief
Financial Officer
No Interests declared
Chris Pocklington
Chief Operating
Officer
Director of Imperial College Health Partners
Charles Cayley
Medical Director
No interests declared
Carole Flowers
Chief Nurse
Paul Stanton
Interim HR Director No interests declared
Paul Kingsmore
Director of Estates
& Facilities
Patron of the Association of Healthcare Cleaning
Professionals 2009 – current
Director of Institute of Healthcare Engineering and
Estate Management Ltd February 2015 - current
Christopher Blake
Commercial
Director
David Taube
Non-Executive
Director
Director Imperial College Academic
Healthy Science Centre
Advisor National Kidney Federation
Trustee St Mary’s Kidney Patients Association
41
Name
Title
Declaration
Stella Dutton
Non-Executive
Director
Caroline Corby
Non-Executive
Director
Director of the Probation Association
until July 2014
Chair of the London Probation Trust
(until July 2014)
Board member of JML
since January 2014
Non-Executive Director Criminal Cases Review
Commission (July 2014).
Non-Executive Director of Children and Family
Court Advisory Service (CAFCASS)
(December 2014).
Member; Management Committee
of the Parole Board (January 2015)
Martin West
Non-Executive
Director
Non-Executive Director of
NHS Property Services Ltd
(NHSPS)
Non-Executive Director of
Kent Surrey and Sussex Academic
Health Science Network
Jeanne Spinks
Non-Executive
Director
Member of the Advisory Panel to the
Welsh Ministers about the Public Policy
Institute for Wales
Kevin Connolly
Director of ICT
Catherine Thorne
Director of
Governance
Tina Benson
Director of Operations No interests declared
Yvonne Leese
Director of
Community Services
42
Each director states that, as far as they are aware, there is no relevant audit information
of which the Trust’s auditors are unaware, and that they have taken all steps to ensure
they and the auditors are aware of any relevant audit information.
Service changes to directors
Catherine Thorne’s last day of service: 18 January 2015 (NWLHT/LNWHT)
Yvonne Leese from October 2014 (in her new role LNWHT)
Professor Rory Shaw Medical Director (NWLHT) to 10 December 2014, seconded to
Medical Director Health in the UK with UKTI from 1 November 2013
Dr Alfa Sa’adu Medical Director (LNWHT) from 30 October 2014 to 10 December 2014
Dr Charles Cayley Interim Medical Director from 10 December 2014 to present (LNWHT)
Dr William Lynn until 31 October 2014 (as Deputy CEO EHT)
Don Fairley Director of Human Resources (NWLHT) seconded to Bedford Hospital
NHS Trust from 5 May 2014
Christopher Blake Turnaround Director from November 2013 to 31 October 2014 (EHT)
43
Financial
Summary
was established on 1 October 2014 as
a result of the merger between Ealing
Hospital NHS Trust and North West
London Hospitals NHS Trust.
The initial six month period following
the merger presented increased financial
demands for the new organisation. These
demands were also combined with the
continuingly increasing pressure on NHS
resources and the drive for continued
efficiencies across the NHS, together they
created a series of complex challenges.
Despite this, the Trust delivered a retained
deficit of £24.9m for the six months to 31
March 2015, which was in line with the final
plan agreed with the Trust Development
Authority (TDA). (See ‘statement of
comprehensive income’ of the financial
statements).
From 2009/10 onwards, NHS Trusts have
been required to account and report
financial information in accordance with
International Financial Reporting Standards
(IFRS). This requires Trusts to revalue their
assets periodically and the impact of this
was a charge for impairment and reversal
of impairment of £6m in the six months to
March 2015. Additionally, an International
Financial Reporting Interpretations Committee
Standard, IFRIC 12 (technical reporting
relating to PFI assets) required an adjustment
of £0.3m and a change of accounting
44
treatment for donated and government grant
reserve adjustment of £0.187m.
As a result of the merger between North
West London Hospitals NHS Trust and Ealing
Hospital NHS Trust, a final adjustment of
£294.8m was included within the six month
accounts to reflect the net value of assets that
were transferred into the new organisation.
These four adjustments have been applied
to the reported £263.3m income and
expenditure account surplus, resulting in an
adjusted retained deficit of £24.9m which
is used to measure the Trust’s financial
performance.
The table below shows the financial
performance of the Trust over the last six
months:
Summary of results
Income
Expenditure
Operating surplus/(deficit)
Finance costs and dividends payable
Period ended
31st March
2015
£000s
346,730
(370,220)
(23,490)
(7,947)
Net gain on transfer by absorption
294,802
Surplus/(deficit) for the year
263,365
IFRIC 12, Donated / Government
Grant Reserve and Impairments
6,502
Adjustment for absorption accounting
(294,802)
Adjusted (deficit)/ surplus re statutory
break even duty
(24,935)
The Trust’s deficit in the current year was
achieved after delivering £15.8m of savings
(4.6% of turnover) for the six month period
from October to March 2015. This included
an additional income contribution of £1.8m
relating to over-performance in delivering
patient activity.
Income
The Trust income was £346.7m for the six
months to 31 March 2015.
Where the money comes from
The graph below shows 61% of the
Trusts income is derived from three main
commissioners - Ealing CCG (22%), Brent
CCG (21%) and Harrow CCG (18%).
The Trust continues to provide services to
Hillingdon and Barnet patients, who provide
4% of our income.
NHS England accounts for 14% of the Trust’s
income and is largely related to specialist
patient healthcare. Research and education
makes up 5% of our income.
The Trust continues to be principally a public
sector NHS provider of services, with just 1%
of income derived from private patient activity.
Expenditure
The Trust’s total operating expenditure for the
six month period was £370.2m.
The Trust spent a total of £241.4m on pay in
the period, as shown below, with 69% spent
directly on doctors and nursing staff.
NHS Ealing CCG
22%
NHS Brent CCG
21%
NHS Harrow CCG
18%
NHS England
14%
Other
8%
Other CCG
5%
Education and research
5%
NHS Hillingdon CCG
3%
Local authorities
2%
NHS Barnet CCG
1%
Private patients
1%
How much we spend on staff - £millions
Staff group
Other staff
Professions allied to medicine
Scientific, technical and professional
Medical staff
Nursing staff
0
20
40
60
80
100
120
£million
October - March 2015
45
Our non-pay expenditure
The chart below illustrates our non-pay expenditure for the period. The largest category of nonpay spend was clinical supplies which supports direct patient care on our wards and within our
services.
Impairments in the period were £6m as a result of the revaluation of the Trust’s estate assets.
This is excluded from the Trust’s reported deficit, against which we are performance managed.
Non-pay expenditure - £millions
Non pay type
Other
Impairments
Depreciation
Premises
Establishment and transport
Research, development, education and training
Non-clinical supplies
Clinical supplies
20
40
60
80
October - March 2015
Capital investment
The Trust invested £18.9m in its capital
programme in the period October – March
2015. This significant investment has
allowed us to continue with our substantial
programme to improve facilities and
equipment for patient care. The capital
programme was financed by £6.9m of
internally generated funds and £12.0m public
dividend capital (PDC) from the Department
of Health.
The Trust has maintained capital expenditure
within its agreed Capital Resource Limit from
the Trust Development Authority (TDA).
46
The chart opposite shows how our capital
was spent. Total spend on key projects
amounted to £12.3m, or 65%, and
comprised of:
• A new emergency department opened at
Northwick Park in December 2014
• A new picture archiving and
communication system (PACS) –
A common medical imaging technology
solution that underpins seamless
information exchange across large
geographic areas enabling the Trust to
tailor, deliver and manage in a more
integrated fashion.
• IT costs included spend on projects such as
Community Information Systems.
• Medical equipment programme included
purchases of a MRI scanner, ultrasound
machines and neonatal equipment.
The balance of capital spending, £6.5m,
related to smaller schemes – development
programme Infrastructure, health and safety
and private finance initiative (PFI) (lifecycle
replacement cost).
Capital spent October - March 2015
Cash and liquidity
The Trust received revenue Public Dividend
Capital (PDC) of £21.4m cash in the six
months to March 2015 from the Department
of Health, this supported the financing of the
Trust’s planned deficit as a result of income
not covering the Trust’s in year expenditure.
The Trust retained £1m cash in the bank at
period end.
The Trust has managed its cash within
its external financing limit with a small
undershoot of £0.01m.
The better payment practice code requires
the Trust to aim to pay 95% of undisputed
invoices by the due date or within 30 days of
the receipt of goods and services or a valid
invoice, whichever is later. The Trust paid
58.1% by value of its Non-NHS suppliers
within 30 days. The under achievement of the
target was due to cash management resulting
from the deficit.
Medical equipment
£4.2m
PACS
£3.4m
Development programme
£3.1m
A&E
£2.5m
IT equipment
£2.2m
Infrastructure
£1.9m
Health and safety programme
£1m
PFI lifecycle
£0.5m
Challenging financial environment
The major financial concern for the Trust was
to deliver a challenging savings programme
and maintain financial stability while also
meeting the demands of increased activity and
National operational performance targets.
The Trust has a Project Management Office
(PMO) in place, which monitors and manages
the savings programme. The Trust has
managed to achieve its savings target of
£15.8m for the period October to March 2015
through cost reductions and efficiency savings
as well as a £1.8m efficiency contribution
from the additional income gained by the
Trust from the additional activity. In spite of
the significant progress made in reducing our
costs this year it is expected that the coming
year will be a very challenging one in terms
47
of our finances. The Trust has set a target
of £23.3m of further cost improvements in
2015/16, but this will still not balance the
books and the Trust is forecasting a deficit
of £88.3m against its statutory break-even
duty. The Trust is seeking agreement with
the Department of Health for the necessary
funding to mitigate the cash impact of its
expected deficit position, to be provided
through either PDC support or a working
capital loan. The continuing annual deficit
position is expected to be resolved through
structural change, from realising the service
transformational benefits now that the Trusts
have merged.
In spite of the on-going challenges the
Trust has clear plans to achieve financial
stability through realising the merger
transformational savings and synergies as
well as a fundamental review of its cost base
for delivering services. The Trust has had
confirmation of TDA support to the level of
cash support needed in the next 12 months
to maintain its trading position. The Directors,
therefore, have a reasonable expectation that
the Trust has adequate resources to continue
in operational existence for the foreseeable
future and, consequently, continues to adopt
the ‘going concern’ basis in preparing the
annual accounts.
Financial accountability
Grant Thornton UK LLP is the appointed
external auditor to the Trust. During the six
months to March 2015, the fees payable to
Grant Thornton for its statutory external audit
were £140k. A further payment of £10k was
made in relation to the audit of the Trust’s
Quality Accounts.
48
Counter fraud and corruption
The Trust is committed to promoting and
maintaining an absolute standard of honesty
and integrity, and to eliminating fraud and
illegal acts committed within the Trust.
We undertake rigorous investigation and
disciplinary action where appropriate and
seek recovery of any losses where possible.
The Trust has adopted best practice, as
recommended by the NHS Counter Fraud and
Security Management Service (CFSMS), and is
also involved in the National Fraud Initiative,
which is led by the Audit Commission.
We have widely publicised our procedure for
staff to report any concerns about potential
fraud and corruption. Any concerns raised
are investigated by our local counter-fraud
specialists or the CFSMS as appropriate and
all investigations are reported to the Audit
Committee.
Simon Crawford
Interim Chief Financial Officer
3 June 2015
Independent auditor’s report to the directors
of London North West Healthcare NHS Trust
We have audited the financial statements
of London North West Healthcare NHS
Trust for the period ended 31 March 2015
under the Audit Commission Act 1998. The
financial statements comprise the Statement
of Comprehensive Income, the Statement of
Financial Position, the Statement of Changes
in Taxpayers’ Equity, the Statement of Cash
Flows and the related notes. The financial
reporting framework that has been applied
in their preparation is applicable law and the
accounting policies directed by the Secretary
of State with the consent of the Treasury as
relevant to the National Health Service in
England.
We have also audited the information in the
Remuneration Report that is subject to audit,
being:
• the table of salaries and allowances of
senior managers and related narrative
notes marked subject to audit
• the table of pension benefits of senior
managers and related narrative notes
marked subject to audit
• the table of pay multiples and related
narrative notes marked subject to audit.
This report is made solely to the Board of
Directors of London North West Healthcare
NHS Trust in accordance with Part II of the
Audit Commission Act 1998 and for no other
purpose, as set out in paragraph 44 of the
Statement of Responsibilities of Auditors
and Audited Bodies published by the Audit
Commission in March 2014. 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 the
opinions we have formed.
Respective responsibilities of Directors
and auditor
As explained more fully in the Statement of
Directors’ Responsibilities in respect of the
accounts, the Directors are responsible for
the preparation of the financial statements
and for being satisfied that they give a true
and fair view. Our responsibility is to audit
and express an opinion on the financial
statements in accordance with applicable law
and International Standards on Auditing (UK
and Ireland). Those standards also require us
to comply with the Auditing Practices Board’s
Ethical Standards for Auditors.
Scope of the audit of the financial
statements
An audit involves obtaining evidence about
the amounts and disclosures in the financial
statements sufficient to give reasonable
assurance that the financial statements are
free from material misstatement, whether
caused by fraud or error. This includes an
assessment of: whether the accounting
policies are appropriate to the Trust’s
circumstances and have been consistently
applied and adequately disclosed; the
reasonableness of significant accounting
estimates made by the directors; and
the overall presentation of the financial
statements. In addition, we read all the
financial and non-financial information
in the annual report to identify material
49
inconsistencies with the audited financial
statements and to identify any information
that is apparently materially incorrect based
on, or materially inconsistent with, the
knowledge acquired by us in the course of
performing the audit. If we become aware
of any apparent material misstatements or
inconsistencies we consider the implications
for our report.
Opinion on financial statements
In our opinion the financial statements:
• give a true and fair view of the financial
position of London North West Healthcare
NHS Trust as at 31 March 2015 and of its
expenditure and income for the period
then ended; and
• have been prepared properly in accordance
with the accounting policies directed by
the Secretary of State with the consent
of the Treasury as relevant to the National
Health Service in England.
Opinion on other matters
In our opinion:
• the part of the Remuneration Report
subject to audit has been prepared
properly in accordance with the
requirements directed by the Secretary of
State with the consent of the Treasury as
relevant to the National Health Service in
England; and
• the information given in the annual
report for the financial period for which
the financial statements are prepared is
consistent with the financial statements.
Matters on which we report by
exception
We report to you if:
• in our opinion the governance statement
does not reflect compliance with the NHS
Trust Development Authority’s Guidance
50
• we refer the matter to the Secretary
of State under section 19 of the Audit
Commission Act 1998 because we have
reason to believe that the Trust, or an
officer of the Trust, is about to make, or
has made, a decision involving unlawful
expenditure, or is about to take, or has
taken, unlawful action likely to cause a loss
or deficiency; or
• we issue a report in the public interest
under section 8 of the Audit Commission
Act 1998.
We have nothing to report in these respects.
Conclusion on the Trust’s
arrangements for securing economy,
efficiency and effectiveness in the
use of resources
Respective responsibilities of the Trust
and auditor
The Trust is responsible for putting in place
proper arrangements to secure economy,
efficiency and effectiveness in its use of
resources, to ensure proper stewardship
and governance, and to review regularly
the adequacy and effectiveness of these
arrangements.
We are required under Section 5 of the Audit
Commission Act 1998 to satisfy ourselves that
the Trust has made proper arrangements for
securing economy, efficiency and effectiveness
in its use of resources. The Code of Audit
Practice issued by the Audit Commission
requires us to report to you our conclusion
relating to proper arrangements, having
regard to relevant criteria specified by the
Audit Commission in October 2014.
We report if significant matters have come
to our attention which prevent us from
concluding that the Trust has put in place
proper arrangements for securing economy,
efficiency and effectiveness in its use of
resources. We are not required to consider,
nor have we considered, whether all aspects
of the Trust’s arrangements for securing
economy, efficiency and effectiveness in its
use of resources are operating effectively.
Scope of the review of arrangements
for securing economy, efficiency and
effectiveness in the use of resources
We have undertaken our review in
accordance with the Code of Audit Practice,
having regard to the guidance on the
specified criteria, published by the Audit
Commission in October 2014, as to whether
the Trust has proper arrangements for:
• securing financial resilience
• challenging how it secures economy,
efficiency and effectiveness.
The Audit Commission has determined these
two criteria as those necessary for us to
consider under the Code of Audit Practice
in satisfying ourselves whether the Trust put
in place proper arrangements for securing
economy, efficiency and effectiveness in its
use of resources for the period ended 31
March 2015.
We planned our work in accordance with
the Code of Audit Practice. Based on our
risk assessment, we undertook such work as
we considered necessary to form a view on
whether, in all significant respects, the Trust
had put in place proper arrangements to
secure economy, efficiency and effectiveness
in its use of resources.
Basis for qualified conclusion
In considering the Trust’s arrangements for
securing financial resilience, we identified the
following matter:
• The Trust delivered a deficit of
£24.9 million for the six month period
ended 31 March 2015.The Trust is
currently projecting a full year deficit of
£88.3 million in 2015/16, compared to
the planned deficit of £19.1 million which
was included within the approved merger
business case. Due to this divergence from
the merger business case, the Trust needs
to complete a significant refresh of its
medium term financial plan. The actual
and planned deficits and lack of a realistic
medium term financial plan are evidence
of weaknesses in arrangements in respect
of the Trust’s strategic financial planning.
Adverse conclusion
On the basis of our work, having regard
to the guidance on the specified criteria
published by the Audit Commission in
October 2014, the matters reported in the
basis for adverse conclusion paragraph
above prevent us from being satisfied that
in all significant respects London North West
Healthcare NHS Trust put in place proper
arrangements to secure economy, efficiency
and effectiveness in its use of resources for
the period ending 31 March 2015.
Certificate
We certify that we have completed the
audit of the accounts of London North West
Healthcare NHS Trust in accordance with the
requirements of the Audit Commission Act
1998 and the Code of Audit Practice issued
by the Audit Commission.
Emily Hill
for and on behalf of Grant Thornton UK LLP,
Appointed Auditor
Grant Thornton House
Melton Street
London NW1 2EP
3 June 2015
51
London North West Healthcare NHS Trust - Six Month Accounts
Six month accounts for the period ended 31st March 2015
These accounts are for London North West Healthcare NHS Trust for the six month ended 31st March 2015.
Directors
The following have been Directors of the Trust during the Six Month:
Chairman
- Mr Peter Worthington
Executive Directors:
Chief Executive
-
Interim Chief Operating Officer
-
Interim Medical Director (until December 2014) -
Interim Medical Director (from December 2014)
Interim Chief Financial Officer
-
Interim Chief Nurse
-
Interim Director of Human Resources
and Organisational Development
-
Director of Governance (left January 2015)
-
-
Interim Chief Information Officer
-
Non-Executive Directors
Non-Executive Director and Vice Chairman
-
-
-
-
-
-
Mr David McVittie
Mr Chris Pocklington
Dr Alfa Sa’adu
Dr Charles Cayley
Mr Simon Crawford
Mrs Carole Flowers
Mr Paul Stanton
Ms Catherine Thorne
Mr Paul Kingsmore
Mr Kevin Connolly
Mr Martin West
Professor David Taube
Mrs Stella Dutton
Mrs Caroline Corby
Mrs Jeanne Spinks
Ms Patricia Williamson
BankersAuditors
Lloyds TSB Bank Plc
Grant Thornton UK LLP
286/288 Station Road
Chartered Accountants
Harrow
Grant Thornton House
Middlesex
Melton Street
HA1 2EB
London NW1 2EP
National Wetminster Bank PLC
162 Uxbridge Road
London
W13 8JL
Government Banking Services
West Wing
Somerset House
Strand
London
WC2R 1LB
52
Foreword to the accounts
These accounts for the six month ended 31st March
2015 have been prepared by London North West
Healthcare NHS Trust under section 98(2) of the
National Health Service Act 1977 (as amended by
section 24(2), schedule 2 of the National Health
Service and Community Care Act 1990) in the form
which the Secretary of State has, with the approval of
the Treasury, directed.
London North West Healthcare NHS Trust - six month accounts ended 31 March 2015
53
Statement of comprehensive income for period ended 31 March 2015
NOTE
31 March 2015
£000s
Gross employee benefits
9
(241,463)
Other operating costs
7
(128,757)
Revenue from patient care activities
4
309,522
Other operating revenue
5
37,208
Operating (deficit)
(23,490)
Investment revenue
11
33
Other losses
12
(78)
Finance costs
13
(3,277)
(Deficit) for the financial period
Public dividend capital dividends payable
Transfers by absorption - gains
Transfers by absorption - (losses)
(26,812)
(4,626)
473,443
(178,641)
Net Gain on transfers by absorption
294,802
Retained surplus for the period
263,364
Other Comprehensive Income
Net gain on revaluation of property, plant & equipment
Total comprehensive income for the period
814
264,178
Financial performance for the period
Retained surplus for the year
263,364
IFRIC 12 adjustment (including IFRIC 12 impairments)
3,324
Impairments (excluding IFRIC 12 impairments)
2,992
Adjustments in respect of donated gov’t grant asset reserve elimination
Adjustment re absorption accounting
Adjusted retained (deficit)
PDC dividend balance (payable) at 31 March 2015
54
187
(294,802)
(24,935)
(216)
The Trusts reported NHS financial performance position is
derived from its Retained Surplus (Deficit), but adjusted for
the following:a) London North West Healthcare NHS Trust was
established with originating Public Dividend Capital totalling
£294,802,000, equal to the net assets and liabilities
of Ealing Hospital NHS Trust and North West London
Hospitals NHS Trust transferring over to the newly formed
organisation. Under Absorption accounting, this gain is
taken through the Statement of Comprehensive Income
to arrive at the adjusted retained deficit. It is the adjusted
retained deficit of £24.935m which is measured against the
Department of Health performance target.
b) The revenue cost of bringing PFI assets onto the balance
sheet (due to the introduction of International Financial
Reporting Standards (IFRS) accounting in 2009/10) - NHS
Trusts’ financial performance measurement needs to be
aligned with the guidance issued by HM Treasury measuring
Departmental expenditure. Therefore, the incremental
revenue expenditure resulting from the application of IFRS
to PFI, which has no cash impact and is not chargeable for
overall budgeting purposes, should be reported as technical.
This additional cost £0.29m is not considered part of the
organisation’s operating position.
c) The Trust is required to revalue its Land and Building on a
regular basis as a result of the IFRS implementation and this
has resulted in an impairment of its Building by £6.027m,
of which zero was available to absorbed by the revaluation
reserve. Therefore, an impairment of £6.027m has been
recognised in the I&E account. The impairment for Trust
owned buildings is £2.992m and £3.035m for PFI buildings.
Impairments are specifically excluded from measurement of
the Trust’s financial performance.
d) Due to change in accounting requirement, elimination
of donated and government grant reserve has resulted in
net income of £0.187m.Therefore, the reduction of income
resulting from the application of change to donated
and government grant account treatment, which has no
cash impact and is not chargeable for overall budgeting
purposes, should be reported as technical. This is not
considered part of the organisation’s operating position.
The notes on pages 60 to 100 form part of this account.
55
Statement of financial position as at 31 March 2015
NOTE
31 March 2015
£000s
1 October 2014
£000s
14
419,094
412,160
Intangible assets
15
2,179
2,328
Trade and other receivables
20
0
72
421,273
414,560
Non-current assets:
Property, plant and equipment
Total non-current assets
Current assets:
Inventories
19
8,034
7,910
Trade and other receivables
20
49,154
47,444
Cash and cash equivalents
21
1,043
2,877
Sub-total current assets
58,231
58,231
Total current assets
58,231
58,231
479,504
472,791
Total assets
Current liabilities
Trade and other payables
22
(110,608)
(107,372)
Other liabilities
23
0
(2,128)
Provisions
27
(3,528)
(925)
Borrowings
24
(2,070)
(1,741)
DH capital loan
24
(136)
(136)
Total current liabilities
(116,342)
(112,302)
Net current liabilities
(58,111)
(54,071)
Total assets less current liabilities
363,162
360,489
0
(1,692)
Non-current liabilities
Trade and other payables
22
Provisions
27
(4,116)
(3,919)
Borrowings
24
(57,520)
(58,735)
DH capital loan
24
(1,273)
(1,341)
Total non-current liabilities
(62,909)
(65,687)
Total assets employed:
300,253
294,802
330,877
294,802
31,438
0
FINANCED BY:
Public dividend capital
Retained earnings
Revaluation reserve
Other reserves
Total taxpayers’ equity:
56
814
0
0
0
300,253
294,802
*London North West Healthcare NHS Trust was established with originating Public Dividend
Capital totalling £294,802,000, equal to the net assets and liabilities of Ealing Hospital NHS
Trust and North West London Hospitals NHS Trust, resulting in the Opening Statement of
Financial Performance numbers as at 1st October 2014.
The Retained earnings and Revaluation Reserve balances reflect transactions that have
occurred from 1st October to 31st March 2015 only. All transactions prior to that have
been included in the Opening PDC balance, therefore, prior year comparators are only
meaningful for the Statement of Financial Performance and have been included where
relevant.
The notes on pages 60 to 100 form part of this account.
The financial statements on pages 54 to 59 were approved by the Audit Governance and
Risk Committee and adopted by the Board on 27th May 2015 and signed on its behalf by
Chief Executive:
Interim Chief Financial Officer:
Jacqueline Docherty DBE
Simon Crawford
3 June 2015
3 June 2015
57
Statement of changes in taxpayers’ equity for the period ending 31 March 2015
Public Dividend
capital
£000s
Retained
earnings
£000s
Revaluation
reserve
£000s
Other
reserves
£000s
Total
reserves
£000s
0
0
0
0
0
Retained surplus/(deficit) for the year
0
263,364
0
0
263,364
Net gain on revaluation of property,
plant, equipment
0
0
814
0
814
0
(294,802)
0
0 (294,802)
294,802
0
0
0
294,802
New temporary and permanent PDC
received - cash
36,075
0
0
0
36,075
Net recognised revenue/(expense)
for the period
330,877
(31,438)
814
0
300,253
Balance at 31 March 2015
330,877
(31,438)
814
0
300,253
Balance at 1 October 2014
Changes in taxpayers’ equity for
31 March 2015
Reclassification adjustments
Transfers to/(from) other bodies within
the resource account boundary
Originating capital for Trust
established in year
London North West Healthcare NHS Trust was formed
on 1st October 2014. The assets and liabilities of the
two predecessor organisations (Ealing Hospital NHS
Trust and North West London Hospitals NHS Trust) were
transferred to London North West Healthcare NHS Trust
through the issue of new PDC by the Department of
Health to London North West Healthcare NHS Trust.
The Retained earnings and Revaluation Reserve
balances reflect transactions that have occurred from
1st October to 31st March 2015 only. All transactions
prior to that have been included in the Opening PDC
balance.
58
Statement of cash flows for the period ended 31 March 2015
31 March 2015
£000s
Cash flows from operating activities
(23,490)
Operating (deficit)
6,878
Depreciation and amortisation
6,027
Impairments and reversals
Interest paid
(3,202)
Dividend (paid)
(4,410)
(Increase) in inventories
(124)
(Increase) in trade and other receivables
(986)
(Decrease) in trade and other payables
(5,581)
Provisions utilised
(254)
Increase in movement in non cash provisions
3,000
Net cash (outflow) from operating activities
(22,142)
Cash flows from investing activities
33
Interest received
(Payments) for property, plant and equipment
(17,471)
(Payments) for intangible assets
(526)
Rental revenue
3,159
Net cash (outflow) from investing activities
(14,805)
Net cash (outflow) before financing
(36,947)
Cash flows from financing activities
Gross temporary and permanent PDC received
Loans repaid to DH - capital investment loans
repayment of principal
36,075
(68)
Cash transferred to NHS Foundation Trusts or on
dissolution
2,877
Capital element of payments in respect of finance
Leases and On-SoFP PFI and LIFT
(894)
Net cash inflow from financing activities
37,990
NET INCREASE IN CASH AND CASH
EQUIVALENTS
1,043
Cash and cash equivalents at period end
1,043
59
Notes to the accounts
1. Accounting policies
The Secretary of State for Health has directed that
the financial statements of NHS trusts shall meet
the accounting requirements of the Department
of Health Group Manual for Accounts, which shall
be agreed with HM Treasury. Consequently, the
following financial statements have been prepared in
accordance with the DH Group Manual for Accounts
2014-15 issued by the Department of Health. The
accounting policies contained in that manual follow
International Financial Reporting Standards to the
extent that they are meaningful and appropriate to
the NHS, as determined by HM Treasury, which is
advised by the Financial Reporting Advisory Board.
Where the Manual for Accounts permits a choice
of accounting policy, the accounting policy which
is judged to be most appropriate to the particular
circumstances of the trust for the purpose of giving a
true and fair view has been selected. The particular
policies adopted by the trust are described below.
They have been applied consistently in dealing with
items considered material in relation to the accounts.
1.1 Accounting convention
These accounts have been prepared under the
historical cost convention modified to account for
the revaluation of property, plant and equipment,
intangible assets, inventories and certain financial
assets and financial liabilities.
1.1.1 Going concern
The Trust recorded an adjusted retained deficit of
£24.935m for the six months to March 2015 as
agreed with the Trust Development Authority (TDA)
The financial statements have been prepared on
a going concern basis. In accordance with IAS
1, management has made an assessment of the
Trust’s ability to continue as a going concern. For
the financial year commencing 1 April 2015, the
Trust has forecast a deficit of £88.3 million after a
savings requirement of £23 million. This plan is under
discussion with the TDA and requires additional cash
support through PDC and/or loan funding. The Trust
has received written confirmation from the TDA that
it is reasonable to expect that this cash financing will
be made available such that the organisation is able
to meet its liabilities in the next twelve months.
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The merged Trust will, over the period of Shaping
a Healthier Future (SaHF) implementation, deliver
substantial clinical innovation, efficiencies and
synergies to maintain financial stability. Additionally,
the new organisation will be better placed to
respond swiftly to the rapidly changing healthcare
environment, in effect sustaining long term resilience.
1.2 Acquisitions and discontinued operations
Activities are considered to be ‘acquired’ only if they
are taken on from outside the public sector. Activities
are considered to be ‘discontinued’ only if they cease
entirely. They are not considered to be ‘discontinued’
if they transfer from one public sector body to
another.
1.3 Movement of assets within the DH Group
On 1st October 2014 Ealing Hospital NHS Trust
and North West London Hospitals NHS Trust were
merged to form London North West Healthcare NHS
Trust.Transfers as part of reorganisation fall to be
accounted for by use of absorption accounting in line
with the Treasury FReM. The FReM does not require
retrospective adoption, so prior year transactions
(which have been accounted for under merger
accounting) have not been restated. Absorption
accounting requires that entities account for their
transactions in the period in which they took place,
with no restatement of performance required when
functions transfer within the public sector. Where
assets and liabilities transfer, the gain or loss resulting
is recognised in the SOCNE/SOCNI, and is disclosed
separately from operating costs.
Other transfers of assets and liabilities within the
Group are accounted for in line with IAS20 and
similarly give rise to income and expenditure entries.
For transfers of assets and liabilities from those NHS
bodies that closed on 1 April 2013, Treasury agreed
that a modified absorption approach should be
applied. For these transactions and only in the priorperiod, gains and losses are recognised in reserves
rather than the SOCNE/SOCNI.”
1.4 Charitable funds
For 2014-15, the divergence from the FReM that NHS
Charitable Funds are not considered with the NHS
Trust’s own accounts, is removed. (See note 1.6)
1.5 Critical accounting judgements and key
sources of estimation uncertainty
In the application of the NHS Trust’s accounting
policies, management is required to make
judgements, estimates and assumptions about the
carrying amounts of assets and liabilities that are not
readily apparent from other sources. The estimates
and associated assumptions are based on historical
experience and other factors that are considered
to be relevant. Actual results may differ from
those estimates and the estimates and underlying
assumptions are continually reviewed. Revisions to
accounting estimates are recognised in the period in
which the estimate is revised if the revision affects
only that period or in the period of the revision and
future periods if the revision affects both current and
future periods.
1.6 Critical judgements in applying accounting
policies
The following are the critical judgements, apart
from those involving estimations (see below) that
management has made in the process of applying
the NHS Trust’s accounting policies and that have the
most significant effect on the amounts recognised in
the financial statements.
London North West Healthcare was formed on 1st
October 2014 as a result of merger between Ealing
Hospital NHS Trust and The North West London
Hospitals NHS Trust. All the assets and liabilities of
the former Trusts transferred to London North West
Healthcare NHS Trust.
London North West Healthcare was established under
Statutory Instrument 2524 with originating Public
Dividend Capital totalling £294,802,000, equal to the
net assets/liabilities of the predecessor bodies.
Following Treasury’s agreement to apply IFRS 10 to
NHS Charities from 1 April 2013, London North West
Healthcare has established that as the Trust is the
corporate Trustee of the North West London Hospitals
General Charitable fund, charity number 1083634
and Ealing Hospital Charitable Fund, charity number
1061321, it effectively has the power to exercise
control so as to obtain economic benefits.
Total income received across both charities during
the period 1st October 2014 to 31st March 2015
was £522,000 which is only 0.2% of London North
West Healthcare NHS Trust’s Exchequer Income. There
were no substantive legacies or grant income received
during the six months from October 2014 to March
2015.
IAS 1, Presentation of Financial Statements, says that
specific disclosure requirements set out in individual
standards or interpretations need to be satisfied if the
information is not material and is reiterated in the NHS
Manual for Accounts 2014-15.
Charitable funds are not considered into London
North West Healthcare Trust accounts on grounds of
materiality.
1.6.1 Key sources of estimation uncertainty
The following are the key assumptions concerning the
future and other key sources of estimation uncertainty
at the end of the reporting period, that have a
significant risk of causing a material adjustment to the
carrying amounts of assets and liabilities within the
next financial year.
A model provided by the Department of Health has
been used to calculate the effect of bringing the PFI
scheme on to the Trust balance sheet. This is not
expected to yield a result that is materially different
from other means of calculation.
A full asset valuation and review of remaining lives
of the Trust’s estate was conducted by professional
Chartered Surveyors Debenham Tie Leung, (DTZ)
using data from BCIS (Building Cost Information
Services) and RICS (Royal Institute of Chartered
Surveyors).
The Trust has used the DTZ valuation in its 2014/15
six months accounts. The impact of the assessment
of the Trust’s estate will be an overall decrease in the
valuation as at 31st March 2015 and will result in a
depreciation profile that is a more accurate reflection
of the useful economic life of the land and buildings.
The methodology adopted meets the requirements of
International Accounting Standards (IAS) 16; Property,
Plant and Equipment and does not deviate from the
principles therein.
Provisions for credit notes have been made in order
to ensure that any charges arising from subsequently
cancelling disputed NHS invoices or refunding
SLA contractual and over performance values are
chargeable against the correct financial period and
are included within the amounts disclosed for NHS
payables and receivables.
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Data for the pension provision is provided by NHS
Pensions and uses data tables of expected lives for
males and females provided by the National Statistics
Office. The provision has been discounted at a rate
of 1.3%
1.7 Revenue
Revenue in respect of services provided is recognised
when, and to the extent that, performance occurs,
and is measured at the fair value of the consideration
receivable. The main source of revenue for the
Trust is from commissioners for healthcare services.
Revenue relating to patient care spells that are partcompleted at the year end are apportioned across the
financial years on the basis of costs incurred to date
compared to total expected costs.
Where income is received for a specific activity that is
to be delivered in the following year, that income is
deferred.
The NHS Trust receives income under the NHS Injury
Cost Recovery Scheme, designed to reclaim the cost
of treating injured individuals to whom personal
injury compensation has subsequently been paid e.g.
by an insurer. The NHS Trust recognises the income
when it receives notification from the Department
of Work and Pension’s Compensation Recovery Unit
that the individual has lodged a compensation claim.
The income is measured at the agreed tariff for the
treatments provided to the injured individual, less a
provision for unsuccessful compensation claims and
doubtful debts, currently at 18.9%, an increase from
last years rate of 15.8%
1.8 Employee benefits
Short-term employee benefits
Salaries, wages and employment-related payments
are recognised in the period in which the service is
received from employees. The cost of leave earned
but not taken by employees at the end of the period
is recognised in the financial statements to the extent
that employees are permitted to carry forward leave
into the following period.
Retirement benefit costs
Past and present employees are covered by the
provisions of the NHS Pensions Scheme. The scheme
is an unfunded, defined benefit scheme that covers
NHS employers, General Practices and other bodies,
allowed under the direction of the Secretary of State,
62
in England and Wales. The scheme is not designed
to be run in a way that would enable NHS bodies to
identify their share of the underlying scheme assets
and liabilities. Therefore, the scheme is accounted
for as if it were a defined contribution scheme: the
cost to the NHS body of participating in the scheme
is taken as equal to the contributions payable to the
scheme for the accounting period.
For early retirements other than those due to ill health
the additional pension liabilities are not funded by
the scheme. The full amount of the liability for the
additional costs is charged to expenditure at the time
the Trust commits itself to the retirement, regardless
of the method of payment.
1.9 Other expenses
Other operating expenses are recognised when, and
to the extent that, the goods or services have been
received. They are measured at the fair value of the
consideration payable.
1.10 Property, plant and equipment
Recognition
Property, plant and equipment is capitalised if:
• it is held for use in delivering services or for
administrative purposes;
• it is probable that future economic benefits will
flow to, or service potential will be supplied to the
Trust;
• it is expected to be used for more than one
financial year;
• the cost of the item can be measured reliably; and
• the item has cost of at least £5,000; or
• Collectively, a number of items have a cost of at
least £5,000 and individually have a cost of more
than £250, where the assets are functionally
interdependent, they had broadly simultaneous
purchase dates, are anticipated to have
simultaneous disposal dates and are under single
managerial control; or
• Items form part of the initial equipping and settingup cost of a new building, ward or unit, irrespective
of their individual or collective cost.
Where a large asset, for example a building, includes
a number of components with significantly different
asset lives, the components are treated as separate
assets and depreciated over their own useful
economic lives.
Valuation
All property, plant and equipment are measured
initially at cost, representing the cost directly
attributable to acquiring or constructing the asset and
bringing it to the location and condition necessary
for it to be capable of operating in the manner
intended by management. All assets are measured
subsequently at fair value.
Land and buildings used for the Trust’s services or for
administrative purposes are stated in the statement
of financial position at their revalued amounts, being
the fair value at the date of revaluation less any
impairment.
Revaluations are performed with sufficient regularity
to ensure that carrying amounts are not materially
different from those that would be determined at
the end of the reporting period. Fair values are
determined as follows:
Land and non-specialised buildings – market value for
existing use
expenditure to the extent of the decrease previously
charged there. A revaluation decrease that does
not result from a loss of economic value or service
potential is recognised as an impairment charged
to the revaluation reserve to the extent that there
is a balance on the reserve for the asset and,
thereafter, to expenditure. Impairment losses that
arise from a clear consumption of economic benefit
should be taken to expenditure. Gains and losses
recognised in the revaluation reserve are reported
as other comprehensive income in the Statement of
Comprehensive Income.
Subsequent expenditure
Where subsequent expenditure enhances an
asset beyond its original specification, the directly
attributable cost is capitalised. Where subsequent
expenditure restores the asset to its original
specification, the expenditure is capitalised and any
existing carrying value of the item replaced is writtenout and charged to operating expenses.
Specialised buildings – depreciated replacement cost
1.11 Intangible assets
HM Treasury has adopted a standard approach
to depreciated replacement cost valuations based
on modern equivalent assets and, where it would
meet the location requirements of the service being
provided, an alternative site can be valued.
Recognition
The Trust have engaged with DTZ Limited, an
external independent body, who are RICS qualified
practitioners, to carry out a full valuation of the
Trust’s Land and Buildings including Dwellings. The
calculated value was £364,579,000.
Properties in the course of construction for service
or administration purposes are carried at cost, less
any impairment loss. Cost includes professional
fees but not borrowing costs, which are recognised
as expenses immediately, as allowed by IAS 23 for
assets held at fair value. Assets are revalued and
depreciation commences when they are brought into
use.
Fixtures and equipment are carried at depreciated
historic cost as this is not considered to be materially
different from fair value
An increase arising on revaluation is taken to the
revaluation reserve except when it reverses an
impairment for the same asset previously recognised
in expenditure, in which case it is credited to
Intangible assets are non-monetary assets without
physical substance, which are capable of sale
separately from the rest of the trust’s business or
which arise from contractual or other legal rights.
They are recognised only when it is probable that
future economic benefits will flow to, or service
potential be provided to, the trust; where the cost
of the asset can be measured reliably, and where the
cost is at least £5000.
Intangible assets acquired separately are initially
recognised at fair value. Software that is integral to
the operating of hardware, for example an operating
system, is capitalised as part of the relevant item of
property, plant and equipment. Software that is not
integral to the operation of hardware, for example
application software, is capitalised as an intangible
asset. Expenditure on research is not capitalised: it is
recognised as an operating expense in the period in
which it is incurred. Internally-generated assets are
recognised if, and only if, all of the following have
been demonstrated:
• the technical feasibility of completing the
intangible asset so that it will be available for use
• the intention to complete the intangible asset and
use it
63
• the ability to sell or use the intangible asset
• how the intangible asset will generate probable
future economic benefits or service potential
• the availability of adequate technical, financial and
other resources to complete the intangible asset
and sell or use it
• the ability to measure reliably the expenditure
attributable to the intangible asset during its
development
Measurement
The amount initially recognised for internallygenerated intangible assets is the sum of the
expenditure incurred from the date when the criteria
above are initially met. Where no internally-generated
intangible asset can be recognised, the expenditure is
recognised in the period in which it is incurred.
Following initial recognition, intangible assets are
carried at fair value by reference to an active market,
or, where no active market exists, at amortised
replacement cost (modern equivalent assets basis),
indexed for relevant price increases, as a proxy for fair
value. Internally-developed software is held at historic
cost to reflect the opposing effects of increases in
development costs and technological advances.
1.12 Depreciation, amortisation and impairments
Freehold land, properties under construction, and
assets held for sale are not depreciated.
Otherwise, depreciation and amortisation are charged
to write off the costs or valuation of property, plant
and equipment and intangible non-current assets,
less any residual value, over their estimated useful
lives, in a manner that reflects the consumption of
economic benefits or service potential of the assets.
The estimated useful life of an asset is the period over
which the NHS trust expects to obtain economic
benefits or service potential from the asset. This is
specific to the NHS trust and may be shorter than
the physical life of the asset itself. Estimated useful
lives and residual values are reviewed each year
end, with the effect of any changes recognised on a
prospective basis. Assets held under finance leases are
depreciated over their estimated useful lives
At each reporting period end, the NHS trust checks
whether there is any indication that any of its tangible
or intangible non-current assets have suffered
an impairment loss. If there is indication of an
impairment loss, the recoverable amount of the asset
64
is estimated to determine whether there has been a
loss and, if so, its amount. Intangible assets not yet
available for use are tested for impairment annually.
A revaluation decrease that does not result from a loss
of economic value or service potential is recognised
as an impairment charged to the revaluation reserve
to the extent that there is a balance on the reserve for
the asset and, thereafter, to expenditure. Impairment
losses that arise from a clear consumption of
economic benefit should be taken to expenditure.
Where an impairment loss subsequently reverses, the
carrying amount of the asset is increased to the revised
estimate of the recoverable amount but capped at
the amount that would have been determined had
there been no initial impairment loss. The reversal of
the impairment loss is credited to expenditure to the
extent of the decrease previously charged there and
thereafter to the revaluation reserve.
“Impairments are analysed between Departmental
Expenditure Limits (DEL) and Annually Managed
Expenditure (AME). This is necessary to comply with
Treasury’s budgeting guidance. DEL limits are set
in the Spending Review and Departments may not
exceed the limits that they have been set.
AME budgets are set by the Treasury and may be
reviewed with departments in the run-up to the
Budget. Departments need to monitor AME closely
and inform Treasury if they expect AME spending
to rise above forecast. Whilst Treasury accepts that
in some areas of AME inherent volatility may mean
departments do not have the ability to manage the
spending within budgets in that financial year, any
expected increases in AME require Treasury approval.”
1.13 Donated assets
Donated non-current assets are capitalised at their
fair value on receipt, with a matching credit to
Income. They are valued, depreciated and impaired
as described above for purchased assets. Gains and
losses on revaluations, impairments and sales are
as described above for purchased assets. Deferred
income is recognised only where conditions attached
to the donation preclude immediate recognition of
the gain.
1.14 Government grants
The value of assets received by means of a
government grant are credited directly to income.
Deferred income is recognised only where conditions
attached to the grant preclude immediate recognition
of the gain.
1.15 Non-current assets held for sale
Non-current assets are classified as held for sale if
their carrying amount will be recovered principally
through a sale transaction rather than through
continuing use. This condition is regarded as
met when the sale is highly probable, the asset is
available for immediate sale in its present condition
and management is committed to the sale, which is
expected to qualify for recognition as a completed
sale within one year from the date of classification.
Non-current assets held for sale are measured at
the lower of their previous carrying amount and fair
value less costs to sell. Fair value is open market
value including alternative uses.
The profit or loss arising on disposal of an asset is
the difference between the sale proceeds and the
carrying amount and is recognised in the Statement
of Comprehensive Income. On disposal, the balance
for the asset on the revaluation reserve is transferred
to retained earnings.
Property, plant and equipment that is to be scrapped
or demolished does not qualify for recognition as
held for sale. Instead, it is retained as an operational
asset and its economic life is adjusted. The asset is
de-recognised when it is scrapped or demolished.
1.16 Leases
Leases are classified as finance leases when
substantially all the risks and rewards of ownership
are transferred to the lessee. All other leases are
classified as operating leases.
The Trust as lessee
Contingent rentals are recognised as an expense in
the period in which they are incurred.
Where a lease is for land and buildings, the land and
building components are separated and individually
assessed as to whether they are operating or finance
leases.
The NHS Trust as lessor
Amounts due from lessees under finance leases are
recorded as receivables at the amount of the NHS
Trust’s net investment in the leases. Finance lease
income is allocated to accounting periods so as to
reflect a constant periodic rate of return on the Trust’s
net investment outstanding in respect of the leases.
Rental income from operating leases is recognised on
a straight-line basis over the term of the lease. Initial
direct costs incurred in negotiating and arranging an
operating lease are added to the carrying amount of
the leased asset and recognised on a straight-line basis
over the lease term.
1.17 Private Finance Initiative (PFI) transactions
HM Treasury has determined that government
bodies shall account for infrastructure PFI schemes
where the government body controls the use of
the infrastructure and the residual interest in the
infrastructure at the end of the arrangement as service
concession arrangements, following the principles
of the requirements of IFRIC 12. The Trust therefore
recognises the PFI asset as an item of property, plant
and equipment together with a liability to pay for it.
The services received under the contract are recorded
as operating expenses.
Property, plant and equipment held under finance
leases are initially recognised, at the inception of the
lease, at fair value or, if lower, at the present value
of the minimum lease payments, with a matching
liability for the lease obligation to the lessor. Lease
payments are apportioned between finance charges
and reduction of the lease obligation so as to
achieve a constant rate on interest on the remaining
balance of the liability. Finance charges are
recognised in calculating the Trust’s surplus/deficit.
The annual unitary payment is separated into the
following component parts, using appropriate
estimation techniques where necessary:
Operating lease payments are recognised as an
expense on a straight-line basis over the lease term.
Lease incentives are recognised initially as a liability
and subsequently as a reduction of rentals on a
straight-line basis over the lease term.
Services received
a) Payment for the fair value of services received;
b) Payment for the PFI asset, including finance costs;
and
c) Payment for the replacement of components of the
asset during the contract ‘lifecycle replacement’.
The fair value of services received in the year is
recorded under the relevant expenditure headings
within ‘operating expenses’.
65
PFI asset
The PFI assets are recognised as property, plant and
equipment, when they come into use. The assets are
measured initially at fair value in accordance with
the principles of IAS 17. Subsequently, the assets
are measured at fair value, which is kept up to date
in accordance with the Trust’s approach for each
relevant class of asset in accordance with the principles
of IAS 16.
PFI liability
A PFI liability is recognised at the same time as the
PFI assets are recognised. It is measured initially at the
same amount as the fair value of the PFI assets and is
subsequently measured as a finance lease liability in
accordance with IAS 17.
An annual finance cost is calculated by applying the
implicit interest rate in the lease to the opening lease
liability for the period, and is charged to ‘Finance
Costs’ within the Statement of Comprehensive
Income.
The element of the annual unitary payment that is
allocated as a finance lease rental is applied to meet
the annual finance cost and to repay the lease liability
over the contract term.
An element of the annual unitary payment increase
due to cumulative indexation is allocated to the
finance lease. In accordance with IAS 17, this amount
is not included in the minimum lease payments, but is
instead treated as contingent rent and is expensed as
incurred. In substance, this amount is a finance cost
in respect of the liability and the expense is presented
as a contingent finance cost in the Statement of
Comprehensive Income.
Lifecycle replacement
Components of the asset replaced by the operator
during the contract (‘lifecycle replacement’) are
capitalised where they meet the Trust’s criteria for
capital expenditure. They are capitalised at the time
they are provided by the operator and are measured
initially at their fair value.
The element of the annual unitary payment allocated
to lifecycle replacement is pre-determined for each
year of the contract from the operator’s planned
programme of lifecycle replacement. Where the
lifecycle component is provided earlier or later than
expected, a short-term finance lease liability or
prepayment is recognised respectively.
66
Where the fair value of the lifecycle component is
less than the amount determined in the contract,
the difference is recognised as an expense when the
replacement is provided. If the fair value is greater
than the amount determined in the contract, the
difference is treated as a ‘free’ asset and a deferred
income balance is recognised. The deferred income is
released to the operating income over the shorter of
the remaining contract period or the useful economic
life of the replacement component.
Assets contributed by the NHS Trust to the
operator for use in the scheme
Assets contributed for use in the scheme continue
to be recognised as items of property, plant and
equipment in the NHS Trust’s Statement of Financial
Position.
Other assets contributed by the NHS Trust to the
operator
Assets contributed (e.g. cash payments, surplus
property) by the NHS Trust to the operator before
the asset is brought into use, which are intended to
defray the operator’s capital costs, are recognised
initially as prepayments during the construction phase
of the contract. Subsequently, when the asset is made
available to the NHS Trust, the prepayment is treated
as an initial payment towards the finance lease liability
and is set against the carrying value of the liability.
1.18 Inventories
Inventories are valued at the lower of cost and net
realisable value using the first-in first-out (FIFO)
cost formula. This is considered to be a reasonable
approximation to fair value due to the high turnover
of stocks.
1.19 Cash and cash equivalents
Cash is cash in hand and deposits with any financial
institution repayable without penalty on notice
of not more than 24 hours. Cash equivalents are
investments that mature in 3 months or less from the
date of acquisition and that are readily convertible
to known amounts of cash with insignificant risk of
change in value.
In the Statement of Cash Flows, cash and cash
equivalents are shown net of bank overdrafts that are
repayable on demand and that form an integral part
of the NHS Trust’s cash management.
1.20 Provisions
1.22 Non-clinical risk pooling
Provisions are recognised when the NHS Trust
has a present legal or constructive obligation as a
result of a past event, it is probable that the NHS
Trust will be required to settle the obligation, and a
reliable estimate can be made of the amount of the
obligation. The amount recognised as a provision is
the best estimate of the expenditure required to settle
the obligation at the end of the reporting period,
taking into account the risks and uncertainties.
Where a provision is measured using the cash flows
estimated to settle the obligation, its carrying amount
is the present value of those cash flows using HM
Treasury’s discount rate of 2.2% in real terms, 1.3%
for employee early departure obligations.
The NHS Trust participates in the Property Expenses
Scheme and the Liabilities to Third Parties Scheme.
Both are risk pooling schemes under which the
NHS Trust pays an annual contribution to the
NHS Litigation Authority and, in return, receives
assistance with the costs of claims arising. The
annual membership contributions, and any excesses
payable in respect of particular claims are charged to
operating expenses as and when they become due.
When some or all of the economic benefits required
to settle a provision are expected to be recovered
from a third party, the receivable is recognised as an
asset if it is virtually certain that reimbursements will
be received and the amount of the receivable can be
measured reliably.
A restructuring provision is recognised when the
Trust has developed a detailed formal plan for the
restructuring and has raised a valid expectation in
those affected that it will carry out the restructuring
by starting to implement the plan or announcing
its main features to those affected by it. Whilst the
merger of the two legacy Trust’s, Ealing Hospital NHS
Trust and North West London Hospitals NHS Trust,
was predicated on a business plan which included
restructuring, at the reporting date, these plans
have not been developed in sufficient detail to give
rise to a restructuring provision. The measurement
of a restructuring provision includes only the direct
expenditures arising from the restructuring, which
are those amounts that are both necessarily entailed
by the restructuring and not associated with ongoing
activities of the entity.
1.21 Clinical negligence costs
The NHS Litigation Authority (NHSLA) operates a
risk pooling scheme under which the Trust pays an
annual contribution to the NHSLA which in return
settles all clinical negligence claims. The contribution
is charged to expenditure. Although the NHSLA is
administratively responsible for all clinical negligence
cases the legal liability remains with the NHS Trust.
The total value of clinical negligence provisions carried
by the NHSLA on behalf of the Trust is disclosed at
note 27.
1.23 Carbon reduction commitment scheme
(CRC)
CRC and similar allowances are accounted for as
government grant funded intangible assets if they are
not expected to be realised within twelve months,
and otherwise as other current assets. They are
valued at open market value. As the NHS body makes
emissions, a provision is recognised with an offsetting
transfer from deferred income. The provision is
settled on surrender of the allowances. The asset,
provision and deferred income amounts are valued at
fair value at the end of the reporting period.
1.24 Contingencies
A contingent liability is a possible obligation that
arises from past events and whose existence will be
confirmed only by the occurrence or non-occurrence
of one or more uncertain future events not wholly
within the control of the NHS Trust, or a present
obligation that is not recognised because it is not
probable that a payment will be required to settle the
obligation or the amount of the obligation cannot be
measured sufficiently reliably. A contingent liability
is disclosed unless the possibility of a payment is
remote.
A contingent asset is a possible asset that arises from
past events and whose existence will be confirmed
by the occurrence or non-occurrence of one or more
uncertain future events not wholly within the control
of the NHS trust. A contingent asset is disclosed
where an inflow of economic benefits is probable.
Where the time value of money is material,
contingencies are disclosed at their present value.
1.25 Financial assets
Financial assets are recognised when the NHS trust
becomes party to the financial instrument contract
67
or, in the case of trade receivables, when the goods
or services have been delivered. Financial assets
are derecognised when the contractual rights have
expired or the asset has been transferred.
Financial assets are classified into the following
categories: financial assets at fair value through profit
and loss; held to maturity investments; available for
sale financial assets, and loans and receivables. The
classification depends on the nature and purpose of
the financial assets and is determined at the time of
initial recognition.
Financial assets at fair value through profit and
loss
Embedded derivatives that have different risks and
characteristics to their host contracts, and contracts
with embedded derivatives whose separate value
cannot be ascertained, are treated as financial assets
at fair value through profit and loss. They are held at
fair value, with any resultant gain or loss recognised
in calculating the NHS trust’s surplus or deficit for the
year. The net gain or loss incorporates any interest
earned on the financial asset.
Held to maturity investments
Held to maturity investments are non-derivative
financial assets with fixed or determinable payments
and fixed maturity, and there is a positive intention
and ability to hold to maturity. After initial
recognition, they are held at amortised cost using
the effective interest method, less any impairment.
Interest is recognised using the effective interest
method.
Available for sale financial assets
Available for sale financial assets are non-derivative
financial assets that are designated as available for
sale or that do not fall within any of the other three
financial asset classifications. They are measured
at fair value with changes in value taken to the
revaluation reserve, with the exception of impairment
losses. Accumulated gains or losses are recycled to
surplus/deficit on de-recognition.
Loans and receivables
Loans and receivables are non-derivative financial
assets with fixed or determinable payments which
are not quoted in an active market. After initial
recognition, they are measured at amortised
cost using the effective interest method, less any
68
impairment. Interest is recognised using the effective
interest method.
Fair value is determined by reference to quoted
market prices where possible, otherwise by valuation
techniques such as recent market transactions.
The effective interest rate is the rate that exactly
discounts estimated future cash receipts through the
expected life of the financial asset, to the initial fair
value of the financial asset.
At the end of the reporting period, the NHS trust
assesses whether any financial assets, other than
those held at ‘fair value through profit and loss’
are impaired. Financial assets are impaired and
impairment losses recognised if there is objective
evidence of impairment as a result of one or more
events which occurred after the initial recognition of
the asset and which has an impact on the estimated
future cash flows of the asset.
For financial assets carried at amortised cost, the
amount of the impairment loss is measured as the
difference between the asset’s carrying amount and
the present value of the revised future cash flows
discounted at the asset’s original effective interest
rate. The loss is recognised in expenditure and the
carrying amount of the asset is reduced directly.
If, in a subsequent period, the amount of the
impairment loss decreases and the decrease can
be related objectively to an event occurring after
the impairment was recognised, the previously
recognised impairment loss is reversed through
expenditure to the extent that the carrying amount
of the receivable at the date of the impairment is
reversed does not exceed what the amortised cost
would have been had the impairment not been
recognised.
1.26 Financial liabilities
Financial liabilities are recognised on the statement
of financial position when the NHS Trust becomes
party to the contractual provisions of the financial
instrument or, in the case of trade payables, when
the goods or services have been received. Financial
liabilities are de-recognised when the liability has
been discharged, that is, the liability has been paid or
has expired.
Loans from the Department of Health are recognised
at historical cost. Otherwise, financial liabilities are
initially recognised at fair value.
Financial guarantee contract liabilities
Financial guarantee contract liabilities are
subsequently measured at the higher of:
• The premium received (or imputed) for entering
into the guarantee less cumulative amortisation.
The amount of the obligation under the contract,
as determined in accordance with IAS 37 Provisions,
Contingent Liabilities and Contingent Assets.
Financial liabilities at fair value through profit
and loss
Embedded derivatives that have different risks and
characteristics to their host contracts, and contracts
with embedded derivatives whose separate value
cannot be ascertained, are treated as financial
liabilities at fair value through profit and loss. They
are held at fair value, with any resultant gain or loss
recognised in the NHS Trust’s surplus/deficit. The net
gain or loss incorporates any interest payable on the
financial liability.
Other financial liabilities
After initial recognition, all other financial liabilities
are measured at amortised cost using the effective
interest method, except for loans from Department
of Health, which are carried at historic cost. The
effective interest rate is the rate that exactly discounts
estimated future cash payments through the life of
the asset, to the net carrying amount of the financial
liability. Interest is recognised using the effective
interest method.
1.27 Value added tax
Most of the activities of the Trust are outside the
scope of VAT and, in general, output tax does not
apply and input tax on purchases is not recoverable.
Irrecoverable VAT is charged to the relevant
expenditure category or included in the capitalised
purchase cost of fixed assets. Where output tax is
charged or input VAT is recoverable, the amounts are
stated net of VAT.
1.28 Foreign currencies
The Trust’s functional currency and presentational
currency is sterling. Transactions denominated in a
foreign currency are translated into sterling at the
exchange rate ruling on the dates of the transactions.
At the end of the reporting period, monetary items
denominated in foreign currencies are retranslated
at the spot exchange rate on 31 March. Resulting
exchange gains and losses for either of these are
recognised in the Trust’s surplus/deficit in the period
in which they arise.
1.29 Third party assets
Assets belonging to third parties (such as money
held on behalf of patients) are not recognised in the
accounts since the Trust has no beneficial interest in
them. Details of third party assets are given in Note
36 to the accounts.
1.30 Public dividend capital (PDC) and PDC
dividend
Public dividend capital represents taxpayers’ equity
in the NHS Trust. At any time the Secretary of State
can issue new PDC to, and require repayments of
PDC from, the Trust. PDC is recorded at the value
received. As PDC is issued under legislation rather
than under contract, it is not treated as an equity
financial instrument.
As a consequence of merger of Ealing Hospital NHS
Trust and North West London Hospitals NHS Trust,
The Secretary of State for Health, in exercise of the
powers conferred by sections 27 and 272(7) of,
and paragraph 1(7) of Schedule 5 to, the National
Health Service Act 2006(a) issued London North
West Healthcare NHS Trust Origination Capital of
£294,802,000.
An annual charge, reflecting the cost of capital
utilised by the Trust, is payable to the Department
of Health as public dividend capital dividend. The
charge is calculated at the real rate set by HM
Treasury (currently 3.5%) on the average carrying
amount of all assets less liabilities (except for donated
assets and cash balances with the Government
Banking Service). The average carrying amount of
assets is calculated as a simple average of opening
and closing relevant net assets.
1.31 Losses and special payments
Losses and special payments are items that
Parliament would not have contemplated when
it agreed funds for the health service or passed
legislation. By their nature they are items that
ideally should not arise. They are therefore subject
to special control procedures compared with the
generality of payments. They are divided into
69
different categories, which govern the way that
individual cases are handled.
Losses and special payments are charged to the
relevant functional headings in expenditure on an
accruals basis, including losses which would have
been made good through insurance cover had the
Trust not been bearing their own risks (with insurance
premiums then being included as normal revenue
expenditure).
1.32 Research and development
Research and development expenditure is charged
against income in the year in which it is incurred,
except insofar as development expenditure relates
to a clearly defined project and the benefits of it can
reasonably be regarded as assured. Expenditure so
deferred is limited to the value of future benefits
expected and is amortised through the SOCNE/SOCI
on a systematic basis over the period expected to
benefit from the project. It should be revalued on the
basis of current cost. The amortisation is calculated
on the same basis as depreciation, on a quarterly
basis.
1.33 Accounting standards that have been
issued but have not yet been adopted
The Treasury FReM does not require the following
Standards and Interpretations to be applied in 201415. The application of the Standards as revised
would not have a material impact on the accounts
for 2014-15, were they applied in that year:
IFRS 9 Financial Instruments - subject to consultation
IFRS 13 Fair Value Measurement - subject to
consultation
IFRS 15 Revenue from Contracts with Customers subject to consultation
2. Operating segments
As per NHS guidance, The Trust is considered to have
only one segment i.e. that of healthcare provision.
However, the Board reviews financial performance by
Community and Acute Services.
Some categories of income are not uniformally
credited to individual services, for example some cost
per case activity is credited to ‘central income’ and
other cost per case activity is credited to individual
services. The same is true for some expenditure
categories, for example certain overheads are
charged to ‘corporate’ whereas other overheads are
charged to individual services.
Therefore the operating deficit includes a significant
number of estimates and adjustments and should
be treated as an inidcator of costs only. However, on
a Trust level, the total net deficit of £24.935m is the
same as the Trust’s overall reported adjusted deficit.
Community
Services
31 March 2015
£000s
Income
Expenditure
Operating
deficit
Acute
Services
Total
31 March 2015 31 March 2015
£000s
£000s
66,253
287,012
353,265
(75,838)
(302,362)
(378,200)
(9,585)
(15,350)
(24,935)
Net Assets are not reported by segment.
3. Income generation activities
The Trust undertakes income generation activities
with an aim of achieving profit, which is then used in
patient care. The Trust received income of £11.170m
from income generation activities. This includes
£1.4m from Drug manufacturing scheme and
Pharmacy services provided, £1.0m from recharges to
the Trust’s outsourced pathology provider and £0.9m
from car parking income.
Summary table - drug manufacturing scheme
31 March 2015
£000s
70
Income
902
Full cost
824
Surplus
78
4. R
evenue from patient care
activities
6. Overseas visitors disclosure
31 March 2015
£000s
NHS Trusts
432
NHS England
50,227
Clinical Commissioning Groups
246,009
Foundation Trusts
226
NHS Other (including Public Health
England and Prop Co)
1,041
Non-NHS:
Local Authorities
7,075
Private patients
2,368
Overseas patients (non-reciprocal)
Injury costs recovery
550
1,031
Other
563
Total Revenue from
patient care activities
31 March 2015
£000s
Income recognised during period
ended 31 March 2015
(invoiced amounts and accruals)
550
Cash payments received in-period
(re receivables at 31 March 2014)
625
Cash payments received in-period
(iro invoices issued 2014-15)
368
Amounts added to provision for
impairment of receivables
(re receivables at 31 March 2014)
109
Amounts added to provision for
impairment of receivables
(iro invoices issued 2014-15)
169
Amounts written off in-period
(irrespective of year of recognition)
103
309,522
5. Other operating revenue
31 March 2015
£000s
Education, training and research
16,923
Non-patient care services to other
bodies
605
Income generation
11,170
Rental revenue from operating leases
3,160
Other revenue
5,350
Total other operating revenue
Total operating revenue
37,208
346,730
71
7. Operating expenses
8. Operating leases
31 March 2015
£000s
Trust Chair and Non-executive Directors
Supplies and services - clinical
Supplies and services - general
Consultancy services
Establishment
Transport
Service charges - ON-SOFP PFIs and
other service concession arrangements
Premises
Hospitality
Insurance
Legal Fees
Impairments and reversals of receivables
Depreciation
Amortisation
Impairments and reversals of property,
plant and equipment
Audit fees
Other auditor’s remuneration
Clinical negligence
Research and development (excluding
staff costs)
Education and training
Change in discount rate
Other
Total operating expenses (excluding
employee benefits)
33
71,288
11,059
682
3,587
2,175
1,065
11,245
76
243
541
798
6,544
334
6,027
140
10
7,047
333
1,006
(21)
4,545
128,757
Employee benefits
Employee benefits excluding Board
members
Board members
240,744
Other
£000s
Payments recognised as an
expense
Minimum lease payments
Contingent rents
Sub-lease payments
Total
241,463
Total operating expenses
370,220
31 March
2015
Total
£000s
793
0
0
793
Payable:
No later than one year
Between one and five years
After five years
275
128
0
275
128
0
Total
403
403
Total future sublease payments
expected to be received:
0
8.2 Trust as lessor
31 March
2015
£000
Recognised as revenue
Rental revenue
3,160
Total
3,160
Receivable:
After five years
3,160
0
0
Total
3,160
719
Total employee benefits
72
8.1 Trust as lessee
9 Employee benefits and staff numbers
9.1 Employee benefits
31 March 2015
Total
£000s
Permanently
employed
£000s
Other
£000s
Salaries and wages
Social security costs
Employer contributions to NHS BSA - Pensions division
Termination benefits
207,232
16,063
18,851
105
158,520
14,607
18,014
105
48,712
1,456
837
0
Total employee benefits
242,251
191,246
51,005
788
770
18
241,463
190,476
50,987
31 March 2015
Total
Number
Permanently
employed
Number
Other
Number
Average staff numbers
Medical and dental
Ambulance staff
Administration and estates
Healthcare assistants and other support staff
Nursing, midwifery and health visiting staff
Nursing, midwifery and health visiting learners
Scientific, therapeutic and technical staff
Social care staff
Other
1,393
0
2,061
1,292
3,462
0
1,416
0
0
1,182
0
1,727
983
2,810
0
1,247
0
0
211
0
334
309
652
0
169
0
0
TOTAL
9,624
7,949
1,675
27
25
2
Employee benefits - gross expenditure
Employee costs capitalised
Gross employee benefits excluding capitalised costs
9.2 Staff numbers
Of the above - staff engaged on capital projects
73
9.3 Staff sickness absence and ill health retirements
31 March 2015
Number
Total days lost
63,526
Total staff years
7,862
Average working days lost
8.08
8.08 days represents the average number of days lost per full time equivalent
employee for the calendar year January to December 2014.
31 March 2015
Number
0
£000s
0
Number of persons retired early on ill health grounds
Total additional pensions liabilities accrued in the period
9.4 Exit Packages agreed in period ended 31 March 2015
31 March 2015
Exit package cost band (including
any special payment element)
Number of
compulsory
redundancies
Cost of
compulsory
redundancies
Total number
of exit
packages
Total cost
of exit
packages
Number
£s
Number
£s
Less than £10,000
0
0
0
0
£10,000-£25,000
1
12,463
1
12,463
£25,001-£50,000
0
0
0
0
£50,001-£100,000
1
92,198
1
92,198
£100,001 - £150,000
0
0
0
0
£150,001 - £200,000
0
0
0
0
>£200,000
0
0
0
0
Total number of exit packages
by type (total cost
2
104,661
2
104,661
Redundancy and other departure costs have been paid in accordance with the provisions of the NHS
Scheme. Exit costs in this note are accounted for in full in the year of departure. 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.
74
9.5 Exit packages - Other departures analysis
31 March 2015
Agreements
Number
Total value of
agreements
£000s
Voluntary redundancies including early retirement contractual costs
0
0
Mutually agreed resignations (MARS) contractual costs
0
0
Early retirements in the efficiency of the service contractual costs
0
0
Contractual payments in lieu of notice
0
0
Exit payments following employment tribunals or court orders
0
0
Non-contractual payments requiring HMT approval*
0
0
Total
0
0
This disclosure reports the number and value of exit packages agreed in the year. Note: the expense associated
with these departures may have been recognised in part or in full in a previous period.
9.6 Pension costs
Past and present employees are covered by the
provisions of the NHS Pensions Scheme. Details of
the benefits payable under these provisions can be
found on the NHS Pensions website at www.nhsbsa.
nhs.uk/pensions. The scheme is an unfunded,
defined benefit scheme that covers NHS employers,
GP practices and other bodies, allowed under the
direction of the Secretary of State, in England and
Wales. The scheme is not designed to be run in a
way that would enable NHS bodies to identify their
share of the underlying scheme assets and liabilities.
Therefore, the scheme is accounted for as if it were
a defined contribution scheme: the cost to the NHS
Body of participating in the scheme is taken as equal
to the contributions payable to the scheme for the
accounting period.
In order that the defined benefit obligations
recognised in the financial statements do not differ
materially from those that would be determined at
the reporting date by a formal actuarial valuation,
the FReM requires that “the period between formal
valuations shall be four years, with approximate
assessments in intervening years”. An outline of
these follows:
a) Full actuarial (funding) valuation
A valuation of the scheme liability is carried out
annually by the scheme actuary as at the end of the
reporting period. This utilises an actuarial assessment
for the previous accounting period in conjunction
with updated membership and financial data for
the current reporting period, and are accepted
as providing suitably robust figures for financial
reporting purposes. The valuation of the scheme
liability as at 31 March 2015, is based on valuation
data as 31 March 2014, updated to 31 March 2015
with summary global member and accounting
data. In undertaking this actuarial assessment, the
methodology prescribed in IAS 19, relevant FReM
interpretations, and the discount rate prescribed by
HM Treasury have also been used.
The latest assessment of the liabilities of the scheme
is contained in the scheme actuary report, which
forms part of the annual NHS Pension Scheme
(England and Wales) Pension Accounts, published
annually. These accounts can be viewed on the NHS
Pensions website. Copies can also be obtained from
The Stationery Office.
b) Accounting valuation
The purpose of this valuation is to assess the level
of liability in respect of the benefits due under the
scheme (taking into account its recent demographic
experience), and to recommend the contribution
rates.
75
The last published actuarial valuation undertaken for
the NHS pension scheme was completed for the year
ending 31 March 2012.
The scheme regulations allow contribution rates
to be set by the Secretary of State for Health, with
the consent of HM Treasury, and consideration of
the advice of the Scheme Actuary and appropriate
employee and employer representatives as deemed
appropriate.
c) Scheme provisions
The NHS Pension Scheme provided defined benefits,
which are summarised below. This list is an illustrative
guide only, and is not intended to detail all the benefits
provided by the Scheme or the specific conditions that
must be met before these benefits can be obtained:
The Scheme is a “final salary” scheme. Annual
pensions are normally based on 1/80th for the
1995 section and of the best of the last three years
pensionable pay for each year of service, and 1/60th
for the 2008 section of reckonable pay per year of
membership. Members who are practitioners as
defined by the Scheme Regulations have their annual
pensions based upon total pensionable earnings over
the relevant pensionable service.
With effect from 1 April 2008 members can choose
to give up some of their annual pension for an
additional tax free lump sum, up to a maximum
amount permitted under HMRC rules. This new
provision is known as “pension commutation”.
Annual increases are applied to pension payments
at rates defined by the Pensions (Increase) Act 1971,
and are based on changes in retail prices in the
twelve months ending 30 September in the previous
calendar year. From 2011-12 the Consumer Price
Index (CPI) has been used and replaced the Retail
Prices Index (RPI).
Early payment of a pension, with enhancement,
is available to members of the scheme who are
permanently incapable of fulfilling their duties
effectively through illness or infirmity. A death
gratuity of twice final year’s pensionable pay for
death in service, and five times their annual pension
for death after retirement is payable.
Members can purchase additional service in the NHS
Scheme and contribute to money purchase AVC’s run
by the Scheme’s approved providers or by other Free
Standing Additional Voluntary Contributions (FSAVC)
providers.
10. Better payment practice code
Measure of compliance
31 March 2015
Number
31 March 2015
£000s
Total Non-NHS trade invoices paid in the period
70,581
164,083
Total Non-NHS trade invoices paid within target
26,498
95,349
37.54%
58.11%
Total NHS trade invoices paid in the period
2,081
11,201
Total NHS trade invoices paid within target
489
1,436
23.50%
12.82%
Non-NHS payables
Percentage of NHS trade invoices paid within target
NHS payables
Percentage of NHS trade invoices paid within target
The better payment practice code requires the NHS body to aim to pay all valid invoices
by the due date or within 30 days of receipt of a valid invoice, whichever is later.
76
11. Investment revenue
31 March 2015
£000s
Interest revenue
Bank interest
33
Subtotal
33
Total investment revenue
33
12. Other gains and losses
31 March 2015
£000s
Gain/(Loss) on disposal of assets other than by sale (PPE)
(78)
Total
(78)
13. Finance costs
31 March 2015
£000s
Interest
Interest on loans and overdrafts
24
Interest on obligations under finance leases
77
Interest on obligations under PFI contracts:
- main finance cost
2,086
- contingent finance cost
1,015
Total interest expense
Provisions - unwinding of discount
Total
3,202
75
3,277
77
£000’s
0
0
0
0
0
Additions of assets under
construction
0
0
0 13,958
Additions purchased
0
2,833
Reclassifications
0
20,244
Disposals other than for sale
0
Upward revaluation/positive
indexation
£000’s £000’s
£000’s
£000’s
£000’s
0
0
0
0
0
0
0
0
13,958
0
1,999
0
0
0
4,832
0 (22,810)
2,089
0
56
403
(18)
0
0
0
(330)
0
0
0
(330)
505
(306)
615
0
0
0
0
0
814
Transfers (to)/from other public
sector bodies under absorption
accounting
63,081
351,738
5,630 32,642 89,179
0 46,706 4,050 593,026
At 31 March 2015
63,586
374,509
6,245 23,790 92,937
0 46,762 4,453 612,282
Depreciation
At 1 October 2014
0
0
0
0
0
0
0
0
0
Disposals other than for sale
0
0
0
0
(249)
0
0
0
(249)
Impairments
0
6,027
0
0
0
0
0
0
6,027
Charged during the period
0
2,671
40
0
2,205
0
1,508
120
6,544
Transfers (to)/from other public
sector bodies under absorption
accounting
10,391
60,632
0
0 67,342
0 39,207 3,294 180,866
At 31 March 2015
10,391
69,330
40
0 69,298
0 40,715 3,414 193,188
Net book value at
31 March 2015
53,195
305,179
6,205 23,790 23,639
0
6,047 1,039 419,094
53,195
225,448
6,205 23,790 22,388
0
6,043
Owned - donated
0
7,046
0
0
419
0
4
0
7,469
Owned - government granted
0
3,191
0
0
38
0
0
0
3,229
31 March 2015
Cost or valuation:
At 1 October 2014
0
Plant & machinery
Total
Assets under
construction &
payments on account
£000’s
Furniture & fittings
Dwellings
£000’s
Information
technology
Buildings excluding
dwellings
£000’s
Transport equipment
Land
14. Property, plant and equipment
Asset financing:
Owned - purchased
932 338,001
Held on finance lease
0
0
0
0
794
0
0
107
901
On-SOFP PFI contracts
0
69,494
0
0
0
0
0
0
69,494
53,195
305,179
6,205 23,790 23,639
0
Total at 31 March 2015
78
6,047 1,039 419,094
Land
Buildings excluding
dwellings
Dwellings
Assets under
construction &
payments on account
Plant & machinery
Transport equipment
Information
technology
Total
Revaluation reserve balance for property, plant & equipment
£000’s
£000’s
£000’s
£000’s
£000’s
£000’s
£000’s
£000’s
£000’s
0
0
0
0
0
0
0
0
0
Movements (revaluation)
505
(306)
615
0
0
0
0
0
814
At 31 March 2015
505
(306)
615
0
0
0
0
0
814
31 March 2015
At 1 October 2014
Additions to assets under
construction in 2014-15
£000’s
Land
Buildings excl dwellings
Dwellings
0
5,756
0
Plant and machinery
8,202
Balance as at YTD
13,958
79
Buildings excluding
dwellings
Dwellings
Assets under
construction &
payments on account
Transport equipment
Information technology
Total
£000s
£000s
£000s
£000s
£000s £000s
£000s
£000s
£000s
62,846
327,852
5,375
32,359
88,154 137
45,778
Additions of assets under
0
construction
Additions purchased
0
Additions - non cash donations
0
(i.E. Physical assets)
Reclassifications
0
Revaluation
235
At 30 September 2014
63,081
0
0
14,085
0
0
0
0
14,085
505
0
0
0
0
0
334
142
0
0
914
0
0
45
1,753
187
13,224
10,157
351,738
0
255
5,630
(13,802)
0
32,642
549
0
0
0
89,179 137
14
0
46,706
14
29
0 10,647
4,050 593,163
52,414
(763)
7,765
0
(38)
0
0
0
0
65,306 137
0
0
0
0
37,600
0
0
3,199 169,047
(801)
0
7,765
0
(1,266)
0
0
0
2,482
60,632
291,106
38
0
5,630
52,690
208,026
Owned - Donated
0
Owned - Government granted
31 October 2014
Plant & machinery
Land
14.2 Property, plant and equipment prior-year
Cost or valuation:
At 1 April 2014
Depreciation
At 1 April 2014
10,391
Revaluation
0
Impairments/negative
0
indexation charged to
operating expenses
Reversal of impairments
0
charged to operating expenses
0
10,391
Net book value at 30
52,690
September 2014
3,976 566,477
0
(1,266)
0
0
0
0
32,642
2,036
0
67,342 137
21,837
0
1,607
39,207
7,499
6,258
95
3,294 181,003
756 412,160
5,630
32,642
20,466
0
7,492
632 327,578
7,186
0
0
486
0
4
124
7,800
0
3,373
0
0
41
0
3
0
3,417
Held on finance lease
0
0
0
0
844
0
0
0
844
On-SOFP PFI contracts
0
72,521
0
0
0
0
0
0
72,521
Total at 30 September 2014 52,690
291,106
5,630
32,642
21,837
0
7,499
Asset financing:
Owned - Purchased
80
756 412,160
Of the totals as at 31st March 2015, £53.195m
related to land valued at open market value and
£6.2m related to dwellings valued at open market
value.
The fair value of buildings excluding dwellings is
£305.179m
Land and buildings were revalued as at 31st March
2015 by DTZ, the Trust’s appointed valuers.
The valuation was undertaken by surveyors who were
suitably experienced and qualified members of the
Royal Institute of Chartered Surveyors (RICS).
The valuation was carried out in accordance with the
RICS Appraisal and Valuation Manual insofar as these
terms are consistent with the agreed requirements of
the Department of Health and HM Treasury.
14.3 Details of asset lives
Buildings and dwellings between 22 and 90 years.
Plant and machinery between 5 and 15 years.
Information technology between 5 and 10 years.
Furniture and fittings is between 1 and 10 years.
Software licenses between 3 and 10 years.
81
15. Intangible non-current assets
31 March 2015
Computer Licenses
£000’s
Total
£000’s
At 1 October 2014
0
0
Additions purchased
167
167
18
18
Transfer from other public sector bodies under absorption accounting
Reclassifications
6,185
6,185
At 31 March 2015
6,370
6,370
0
0
Amortisation
At 1 October 2014
334
334
3,857
3,857
At 31 March 2015
4,191
4,191
Net Book Value at 31 March 2015
2,179
2,179
Asset Financing: Net book value at 31 March 2015 comprises:
Purchased
2,179
2,179
2,179
2,179
Computer Licenses
£000’s
Total
£000’s
6,010
6,010
Additions purchased
189
189
Reclassifications
(14)
(14)
15.2 Intangible non-current assets - prior year
2014-15
At 1 April 2014
6,185
6,185
6,185
6,185
Amortisation
At 1 April 2014
3,518
3,518
339
339
3,857
3,857
3,857
3,857
Net book value at 30 September 2014
2,328
2,328
Purchased
2,328
2,328
Total at 30 September 2014
2,328
2,328
Charged during the year
Asset Financing: Net book value at 30 September 2014 comprises:
82
16. Analysis of impairments and reversals recognised in 31 March 2015
31 March 2015
Total £000s
Property, plant and equipment impairments and reversals taken to SoCI
Changes in market price
6,027
Total charged to annually managed expenditure
6,027
Total impairments of property, plant and equipment charged to SoCI
6,027
Total impairments charged to SoCI - AME
6,027
Overall total impairments
6,027
17. Commitments
17.1 Capital commitments
Contracted capital commitments at 31 March not otherwise included in these financial statements:
31 March 2015
Total £000
Property, plant and equipment
21,800
Total
21,800
18. Intra-Government and other balances
Current
receivables
Non-current
receivables
£000s
£000s
£000s
£000s
0
0
9,331
0
1,136
0
69
0
0
0
101
0
Balances with NHS bodies inside the departmental
group
32,452
0
11,124
1,273
Balances with bodies external to government
15,566
0
92,189
57,520
At 31 March 2015
49,154
0
112,814
58,793
Balances with other central government bodies
Balances with local authorities
Balances with NHS bodies outside the
departmental group
Current Non-current
payables
payables
83
19. Inventories
Drugs
£000s
Consumables
£000s
Work in
Progress
£000s
Energy
£000s
Total
£000s
0
0
0
0
0
124
0
0
0
124
Transfers (to)/from other public sector
bodies under absorption accounting
4,279
3,506
0
125
7,910
4,403
3,506
0
125
8,034
Additions
20. Trade and other receivables
Current
Non-current
31 March 2015 1 October 2014
£000s
£000s
31 March 2015 1 October 2014
£000s
£000s
32,452
22,176
0
0
0
877
0
0
16,795
10,702
0
0
0
0
0
0
3,461
12,200
0
0
(6,187)
(5,389)
0
0
2,633
1,353
0
0
0
5,525
0
72
Total
49,154
47,444
0
72
Total current and non current
49,154
47,516
NHS receivables - revenue
NHS prepayments and accrued income
Non-NHS receivables - revenue
Non-NHS receivables - capital
Non-NHS prepayments and accrued income
Provision for the impairment of receivables
VAT
Other receivables
Included in NHS receivables are prepaid
pension contributions:
0
The great majority of trade is with Clinical Commissioning Groups (CCGs) . As CCGs are funded by
Government to buy NHS patient care services, no credit scoring of them is considered necessary.
84
31 March 2015
£000s
1 October 2014
£000s
By up to three months
283
1,462
By three to six months
4,684
1,569
0
0
4,967
3,031
31 March 2015
£000s
1 October 2014
£000s
0
(5,011)
Amount written off during the period
0
168
Amount recovered during the period
0
0
(798)
(546)
Transfers (to)/from other public sector bodies under absorption
accounting
(5,389)
0
(6,187)
(5,389)
20.2 Receivables past their due date but not impaired
By more than six months
Total
20.3 Provision for impairment of receivables
(Increase)/decrease in receivables impaired
Of the £6.187m provision for receivables impaired, £1.5m relates to overseas visitors and private patients and
£1.639m to road traffic accident (RTA) income. The impairment for RTA Income is provided for in line with
Department of Health Policy, currently at 18.9%.
21. Cash and cash equivalents
31 March 2015
£000s
1 October 2014
£000s
2,877
6,574
(1,834)
(3,697)
1,043
2,877
924
2,618
Commercial banks
96
248
Cash in hand
23
11
Cash and cash equivalents as in statement of financial position
1,043
2,877
Cash and cash equivalents as in statement of cash flows
1,043
2,877
4
4
Opening balance
Net change in period
Closing balance
Made up of
Cash with Government Banking Service
Patients’ money held by the Trust, not included above
85
22. Trade and other payables
Current
Non-current
31 March
2015
£000s
1 October
2014
£000s
31 March
2015
£000s
1 October
2014
£000s
10,772
8,907
0
0
0
15,603
0
0
Non-NHS payables - revenue
39,524
29,883
0
0
Non-NHS payables - capital
6,504
5,545
0
0
44,269
32,428
0
1,692
4,493
4,410
0
0
216
0
0
0
0
0
0
0
NHS payables - revenue
NHS accruals and deferred income
Non-NHS accruals and deferred income
Social security costs
PDC dividend payable to DH
VAT
4,830
4,715
0
0
Payments received on account
0
0
0
0
Other
0
5,881
0
0
Total
110,608
107,372
0
1,692
Total payables (current and non-current)
110,608
109,064
5,381
5,341
Tax
Included above:
outstanding pension contributions at the
period end
23. Other liabilities
Current
Non-current
31 March
2015
£000s
1 October
2014
£000s
31 March
2015
£000s
1 October
2014
£000s
Other (research and development)
0
2,128
0
0
Total
0
2,128
0
0
Total other liabilities (current and non-current)
0
2,128
86
24. Borrowings
Current
Loans from Department of Health
Non-current
31 March
2015
£000s
1 October
2014
£000s
31 March
2015
£000s
1 October
2014
£000s
136
136
1,273
1,341
1,698
1,656
56,495
57,387
372
85
1,025
1,348
2,206
1,877
58,793
60,076
60,999
61,953
PFI liabilities:
Main liability
Finance lease liabilities
Total
Total other liabilities (current and non-current)
Borrowings / Loans - repayment of principal falling due in:
31 March
2015
DH
£000s
Other
£000s
Total
£000s
0-1 years
136
1,761
1,897
1 - 2 years
136
1,959
2,095
2 - 5 years
523
5,896
6,419
Over 5 years
614
49,974
50,588
1,409
59,590
60,999
TOTAL
87
25. Deferred revenue
Current
Non-current
31 March
2015
£000s
31 March
2015
£000s
0
0
Deferred revenue addition
3,839
0
Transfer of deferred revenue
4,867
0
Current deferred income at 31 March 2015
8,706
0
Total deferred income (current and non-current)
8,706
Opening balance at 1 October 2014
26. Finance lease obligations as lessee
Amounts payable under finance leases (Other)
Minimum lease
payments
Present value of
minimum lease
payments
31 March 2015
£000s
31 March 2015
£000s
Within one year
704
372
995
774
After five years
268
251
Less future finance charges
(570)
0
Minimum lease payments / present value of minimum lease payments
1,397
1,397
Included in:
Current borrowings
Non-current borrowings
372
1,025
1,397
88
27. Provisions
Arising during the period
Utilised during the period
Reversed unused
Unwinding of discount
Change in discount rate
Transfers to NHS Foundation Trusts
(for Trusts becoming FTs only)
Transfers (to)/from other public sector bodies under
absorption accounting
Expected timing of cash flows:
No Later than One Year
Later than one year and not later than five years
Later than five years
Total
Early
Departure
Costs
Legal
Claims
£000s
£000s
£000s
£000s
£000s
0
3,250
(254)
(250)
75
(21)
0
0
390
(254)
0
75
(21)
0
0
570
0
(250)
0
0
0
0
1,542
0
0
0
0
0
0
748
0
0
0
0
0
4,844
4,163
426
255
0
7,644
4,353
746
1,797
748
3,528
876
3,240
237
876
3,240
746
0
0
1,797
0
0
748
0
0
Other Redundancy
Amount included in the provisions of the NHS Litigation Authority in respect of clinical negligence liabilities:
As at 31 March 2015
£118,144k
The provision of pensions relating to staff refers to pension payments for staff retiring early through ill health.
These figures are provided by NHS Pensions Authority. The discount rate for pensions relating to other staff has
decreased from 1.8% to 1.3% in line with HM Treasury and Department of Health guidelines. Settlements of
these claims are determined using statistics provided by The Office of National Statistics.
Legal claims refer to public and employers liability claims and also provisions in relation to ongoing employment
cases. Value of these claims will be subject to the relevant judgements or subsequent settlements made by the
relevant employment tribunals.
The redundancy provision relates to senior management redundancies as a result of merger between Ealing
Hospital NHS Trust and The North West London Hospitals NHS Trust.
The principal component of “Other” relates to potential liability in relation to the Trust’s managed service for
temporary medical staffing. 28. Contingencies
31 March 2015
£000s
Contingent liabilities
NHS Litigation Authority legal claims
(128)
Employment tribunal and other employee related litigation
(527)
Net value of contingent liabilities
(655)
89
29. PFI and LIFT - additional information
The information below is required by the Department of Heath for inclusion in national statutory accounts
Charges to operating expenditure and future commitments in respect of ON and OFF
SOFP PFI
31 March 2015
£000s
Service element of on SOFP PFI charged to operating expenses in period
1,065
Total
1,065
Payments committed to in respect of off SOFP PFI and the service element of on SOFP
PFI
1,586
Later than one year, no later than five years
6,749
34,662
Total
42,997
The current PFI contract assumed an inflation rate of 2.5% (£42,817k), however if the
assumption that the inflation rate was 0%, then total payments would have been £33,838k.
Additionally, if inflation was 5%, the payment would have been £60,050k.
Imputed “finance lease” obligations for on SOFP PFI contracts due
31 March 2015
£000s
5,711
21,883
84,176
Subtotal
111,770
Less: interest element
(53,577)
Total
Present value imputed “finance lease” obligations for on SOFP PFI contracts due
Analysed by when PFI payments are due
58,193
31 March 2015
£000s
1,657
6,812
49,724
Total
58,193
Number of on SOFP PFI contracts
Total number of on PFI contracts
90
1
30. Impact of IFRS treatment - current period 31 March 2015
The information below is required by the Department of Heath for budget reconciliation purposes
£000s
Revenue costs of IFRS: Arrangements reported on SoFP under IFRIC12 (e.g PFI / LIFT)
Depreciation charges
Interest expense
Impairment charge - AME
Other expenditure
Impact on PDC dividend payable
Total IFRS expenditure (IFRIC12)
Revenue consequences of PFI / LIFT schemes under UK GAAP / ESA95 (net of any sublease revenue)
Net IFRS change (IFRIC12)
476
3,010
3,035
1,065
146
7,732
(4,408)
3,324
Capital consequences of IFRS : LIFT/PFI and other items under IFRIC12
Capital expenditure 2014-15
505
UK GAAP capital expenditure 2014-15 (Reversionary Interest)
505
31. Financial Instruments
31.1 Financial risk management
Financial reporting standard IFRS 7 requires disclosure
of the role that financial instruments have had during
the period in creating or changing the risks a body
faces in undertaking its activities. Because of the
continuing service provider relationship that the NHS
Trust has with Clinical Commissioning Groups (CCGs)
and the way those CCGs are financed, the NHS Trust
is not exposed to the degree of financial risk faced
by business entities. Also financial instruments play a
much more limited role in creating or changing risk
than would be typical of listed companies, to which
the financial reporting standards mainly apply. The
NHS Trust has limited powers to borrow or invest
surplus funds and financial assets and liabilities are
generated by day-to-day operational activities rather
than being held to change the risks facing the NHS
Trust in undertaking its activities.
The Trust’s treasury management operations are
carried out by the finance department, within
parameters defined formally within the Trust’s
standing financial instructions and policies agreed by
the board of directors. The Trust’s treasury activity is
subject to review by the Trust’s internal auditors.
Currency risk
The Trust is principally a domestic organisation with
the great majority of transactions, assets and liabilities
being in the UK and sterling based. The Trust has
no overseas operations. The Trust therefore has low
exposure to currency rate fluctuations.
Interest rate risk
The Trust borrows from government for capital
expenditure, subject to affordability as confirmed
by the Trust Development Authority (TDA). The
borrowings are for 1 – 25 years, in line with the life
of the associated assets, and interest is charged at
the National Loans Fund rate, fixed for the life of the
loan. The Trust therefore has low exposure to interest
rate fluctuations.
Credit risk
Because the majority of the Trust’s revenue comes
from contracts with other public sector bodies, the
London North West Healthcare NHS Trust has low
exposure to credit risk. The maximum exposures as at
31 March 2015 are in receivables from customers, as
disclosed in the trade and other receivables note.
Liquidity risk
The Trust’s operating costs are incurred under
contracts with CCGs, which are financed from
resources voted annually by Parliament. The Trust
funds its capital expenditure from funds obtained
within its prudential borrowing limit. The Trust is not,
therefore, exposed to significant liquidity risks.
91
31.2 Financial assets
At ‘fair value
through profit and
loss’
Loans and
receivables
Available
for sale
£000s
£000s
£000s
Embedded derivatives
0
0
0
Receivables - NHS
0
31,250
0
Receivables - non-NHS
0
12,550
0
Cash at bank and in hand
0
1,043
0
Other financial assets
0
0
0
0
44,843
0
31.3 Financial liabilities
At ‘fair value
through profit and
loss’
Other
Total
£000s
£000s
£000s
Embedded derivatives
0
0
0
NHS payables
0
13,621
13,621
Non-NHS payables
0
73,626
73,626
Other borrowings
0
1,409
1,409
PFI & finance lease
obligations
0
59,590
59,590
Other financial liabilities
0
0
0
0
148,246
148,246
32. Events after the end of the reporting period
There were no adjusting events after the reporting period.
92
33. Related party transactions
During the period none of the Department of Health Ministers, Trust board members or members of the key
management staff, or parties related to any of them, has undertaken any material transactions with the Trust.
The Department of Health is regarded as a related party. During the period the Trust has had a significant
number of material transactions with the Department, and with other entities for which the Department is
regarded as the parent Department.
The most significant (over £100,000) cumulative transactions were as follows:
Amounts owed
to related party
£’000
Amounts due
from related
party
£’000
Barnet CCG
-
351
Brent CCG
-
7,318
Camden CCG
-
152
Central and North West London Mental Health NHS Foundation Trust
287
136
-
232
Chelsea and Westminster Hospital NHS Foundation Trust
146
218
Community Health Partnerships
919
-
Department of Health
216
-
Central London (Westminster CCG)
East and North Herts CCG
Ealing CCG
Enfield CCG
Guy’s and St Thomas’ NHS Foundation Trust
Hammersmith and Fulham CCG
Harrow CCG
145
-
1,061
12,416
-
108
100
-
-
1,145
130
3,997
Health Education England
-
1,141
Herts Valley CCG
-
405
-
1,457
799
-
Hillingdon CCG
Hillingdon Hospitals NHS Foundation Trust
Hounslow CCG
Imperial College Healthcare NHS Trust
Nene CCG
NHS Business Services Authority
NHS England
NHS Property Services
-
228
1,390
1,963
-
110
2,688
-
-
2,651
4,472
-
Public Health England
-
606
Richmond CCG
-
101
Royal National Orthopaedic Hospital NHS Trust
-
133
Slough CCG
-
482
174
174
University College London NHS Foundation Trust
West London CCG
-
298
West London Mental Health NHS Trust
-
297
93
The Trust has also received revenue and capital payments from a number of charitable funds,
of which the trustees are also members of the Trust board. The amounts due or to be paid at
the end of the financial year are;
Amounts owed
to Related Party
Amounts due
from Related
Party
£’000
£’000
8
4
55
-
North West London Hospitals General Charitable Funds
Ealing Hospital Charitable Trust Fund
The Trust has incurred transactions with NHS Property Services. Invoices to the value of
£4.5m have been received. The Trust has on its Board, a Non-Executive Director who is also a
Non-Executive Director at NHS Property Services.
34. Losses and special payments
The total number of losses cases in 31 March 2015 and their total value was as follows:
Losses
Special payments
Total losses and special payments
94
Total Value
of Cases
£s
Total Number
of Cases
278,284
210
3,622
5
281,906
215
35. Financial performance targets
35.1 Breakeven performance
Period ended
31-Mar-15
£000s
Turnover
346,730
Retained surplus/(deficit) for the period
263,364
Adjustment for:
Adjustments for impairments
6,027
Adjustments for impact of policy change re
donated/government grants assets
187
Consolidated budgetary guidance - adjustment
for dual accounting under IFRIC12*
289
Absorption accounting adjustment
Other agreed adjustments
(294,802)
0
Break-even in-period position
(24,935)
Break-even cumulative position
(24,935)
*Due to the introduction of International Financial Reporting Standards (IFRS) accounting in
2009-10, the London North West Healthcare NHS Trust’s financial performance measurement
needs to be aligned with the guidance issued by HM Treasury measuring Departmental
expenditure. Therefore, the incremental revenue expenditure resulting from the application
of IFRS to IFRIC 12 schemes (which would include PFI schemes), which has no cash impact
and is not chargeable for overall budgeting purposes, is excluded when measuring Breakeven
performance. Other adjustments are made in respect of accounting policy changes (impairments
and the removal of the donated asset and government grant reserves) to maintain comparability
year to year.
Period Ended
31-Mar-15
%
Materiality test (I.e. is it equal to or less than 0.5%):
Break-even in-year position as a percentage of turnover
-7.19
Break-even cumulative position as a percentage of turnover
-7.19
95
35.2 Capital cost absorption rate
The dividend payable on public dividend capital is based on the actual (rather than forecast) average relevant
net assets and therefore the actual capital cost absorption rate is automatically 3.5%.
35.3 External financing
The Trust is given an external financing limit which it is permitted to undershoot.
31 March 2015
£000s
External financing limit (EFL)
37,089
Cash flow financing
36,947
External financing requirement
36,947
Under spend against EFL
142
35.4 Capital resource limit
The Trust is given a capital resource limit which it is not permitted to exceed.
31 March 2015
£000s
Gross capital expenditure
Less: book value of assets disposed of
18,957
(81)
Charge against the capital resource limit
18,876
Capital resource limit
19,403
Underspend against the capital resource limit
527
36. Third party assets
The Trust held cash and cash equivalents which relate to monies held on behalf of patients or other parties.
This has been excluded from the cash and cash equivalents figure reported in the accounts.
31 March 2015
£000s
Third party assets held by the Trust
96
4
Remuneration report six months to 31st March 2015 (Subject to Audit)
A
B
C
D
E
Salary
Expense
Performance Long term All pension
payments
pay and
performance - related
(taxable)***
bonuses
pay and
benefits
bonuses
(bands of
(nearest
(bands of
(bands of
(bands of
£5,000)
£100)
£5,000)
£5,000)
£2,500)
£000
£00
£000
£000
£000
F
TOTAL
(bands of
£5,000)
£000
Executive Directors
-
-
-
-
120 - 125
3
-
-
35-37.5
70 - 75
37
-
-
32.5-35
90 - 95
1
-
-
35-37.5
100 - 105
-
-
-
60-62.5
130 - 135
-
-
-
70-72.5
130 - 135
7
-
-
-
80 - 85
60 - 65
55 - 60
-
-
-
32.5-35
27.5-30
95 - 100
85 - 90
90 - 95
-
-
-
75-77.5
170 - 175
Peter
Chairman
Worthington
Patricia
Non-Executive
Williamson** Director &
Deputy Chair
10 - 15
13
-
-
-
10 - 15
5 - 10
-
-
-
-
5 - 10
Caroline
Corby
Stella Dutton
David Taube
Jeanne Spinks
5 - 10
2
-
-
-
5 - 10
5 - 10
5 - 10
5 - 10
4
-
-
-
-
5 - 10
5 - 10
Martin West
5 - 10
3
-
-
-
5 - 10
David
Mcvittie
Catherine
Thorne*
Don
Fairley
Paul
Kingsmore
Chris
Pocklington
Tina
Benson
Arthur Charles
Cayley
Carole Flowers
Kevin
Connolly
Simon
Crawford
Chief
120 - 125
Executive
Governance
30 - 35
Director
HR
55 -60
Director
Director of
60 - 65
Estates
Deputy Chief
70 - 75
Executive Officer
Operational
55 - 60
Director
Medical Director 80 - 85
Nursing Director
Chief
Information
Officer
Interim Chief
Financial Officer
Non-Executive Director
5 - 10
*Left in May 2014
**Chairman Duties P7-9, Non Executive director P10-12
***Expense payments relate to expense allowances that are subject to UK tax
As non-executive members do not receive pensionable renumeration, there will be no entries in respect of pensions.
97
Real increase in
pension at age 60
Real increase in
pension lump sum at
age 60
Total accrued pension
at age 60 at 31st March
2015
Lump sum at age 60
related to accrued
pension at 31st March
2015
Cash Equivalent
Transfer Value at 31st
March 2015
Cash Equivalent
Transfer Value at 31st
March 2014
Real Increase in Cash
Equivalent Transfer
Value
Employer’s
contribution to
stakeholder pension**
Pensions for the year ended 31st March 2015
-
-
-
-
-
-
-
-
Governance
Director
0 - 2.5
2.5 - 5
35 - 40
105 - 110
632
588
33
4
HR Director
0 - 2.5
0 - 2.5
35 - 40
105 - 110
639
595
32
7
Director of
Estates
0 - 2.5
0 - 2.5
50 - 55
155 - 160
1,169
1,101
46
9
Chris
Pocklington
Deputy Chief 0 - 2.5
Executive
Officer
5 - 7.5
40 - 45
125 - 130
718
655
50
10
Tina
Benson
Operational
Director
2.5 - 5
7.5 - 10
25 - 30
85 - 90
422
366
49
8
Arthur
Charles
Cayley
Medical
Director
12.5 15
40 - 42.5 80 - 85
230 - 235
-
-
-
6
Carole
Flowers
Nursing
Director
0 - 2.5
0 - 2.5
55 - 60
165 - 170
1,152
1,088
42
9
Dena
Marshall*
Director of
Transition
0 - 2.5
0 - 2.5
25 - 30
85 - 90
436
432
-
-
Kevin
Connolly
Chief
Information
Officer
0 - 2.5
2.5 - 5
15 - 20
45 - 50
261
234
22
8
Simon
Crawford
Interim
Chief
Financial
Officer
0 - 2.5
5 - 7.5
65 - 70
205 - 210
1,311
1,213
74
13
Executive Directors
David
Mcvittie
Chief
Executive
Catherine
Thorne
Don
Fairley
Paul
Kingsmore
*Left May 2014.
**Employer’s contribution to stakeholder pension takes into account all contributions made by the newly formed
organisation LNWH.
No CETV is available for D Mcvittie & C Cayley as they are over 60.
As non-executive members do not receive pensionable renumeration, there will be no entries in respect of pensions.
98
2014/15
Band of Highest Paid Director Remuneration (£’000)
270-275
Median Total
39,832.50
Ratio
6.90
Reporting bodies are required to disclose the relationship between the salary of the most highly-paid
individual in their organisation and the median earnings of the organisation’s workforce. The banded remuneration of the highest paid director in London North West Healthcare, extrapolated
for full financial year as per guidance stipulated in the 2014-15 Manual for Accounts, in the financial
year 2014-15 was 270-275. This was 6.90 times the median salary of the workforce, which was
£39,832.50
In 2014-15 4 employees received remuneration in excess of the highest paid director.
Total remuneration includes salary, non consolidated performance related pay, benefits in kind as well as
severance payments. It does not include employer pension contributions and the cash equivalent transfer
value of pensions.
Prior year figures would not provide meaningful comparisons against the newly formed organisation,
London North West Healthcare Trust due to 2014/15 being the first part year as an operational entity
and hence have not been disclosed.
99
The information in this report is available in large print by calling 020 8869 3552.
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100
Annual Report - 1 October 2014 to 31 March 2015
How to contact us:
Trust headquarters - Northwick Park Hospital
Watford Road
Harrow, HA1 3UJ
Telephone: 020 8869 3232
www.lnwh.nhs.uk
www.facebook.com/lnwh.nhs
Twitter @lnwh_nhs

Annual report 1 October 2014 to 31 March 2015

Transcription

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