Royal Berkshire NHS Foundation Trust Annual Report and ...

1 Royal Berkshire NHS Foundation Trust Annual Report and Accounts 2016 to 2017 Royal Berkshire NHS Foundation Trust Annual Report and Accounts 2016 to 2017 Presented to Parliament pursuant to Schedule 7, paragraph 25(4) (a) of the National Health Service Act 2006 2017 Royal Berkshire NHS Foundation Trust Annual Report 2016/17 Contents Page No Chairman s and Chief Executive s Introduction 7 Performance Report Overview of performance Performance analysis 10 11 Accountability Report Directors Report Statement as to disclosure to auditors Income disclosures Enhanced quality governance reporting Governance arrangements Remuneration Report Annual statement on remuneration Senior managers remuneration policy Annual Report on remuneration Staff Report Introductory paragraph Staff survey Expenditure of consultancy/off payroll NHS Code of Governance Finance and Use of Resources Statement of Accounting Officer s Responsibilities Annual Governance Statement Quality account Annual Accounts 17 38 47 52 56 58 59 68 124 7 CHAIRMAN S Report I am sure you will be aware that the NHS has come under considerable pressure from demand

2 In the community and from media reporting. The Royal Berkshire has not escaped this. I have to say though that I am immensely proud to Report that due to the professionalism, dedication and wonderful nature of our teams here at the Royal Berkshire , we have performed well in 2016/17. We were able to deliver our financial targets, were in the top 25% of NHS Trusts for our Emergency Department access standard and have maintained good performance in routine access standards and a significant improvement in our core cancer standards which are now being achieved for the first time in a number of years. During late 2016, I put in place a plan to secure a new CEO for the Trust . I am very pleased to say that at the beginning of January, I was able to welcome Steve McManus to the Royal Berkshire as our new CEO. His appointment signals my plan for the Trust to move to the next significant phase in its evolution and the scaling up of the wider improvements in our operational performance and strategic plans to meet the challenges that the NHS faces.

3 A fundamental part of this is working more closely with our local partners to change the way we deliver health needs and social care services for the people in our community and they can be met within the resources available. So, this year, we have continued to make significant and sustainable progress in so many areas across the Trust . Whilst we still have much to do, I am confident that under a strong executive leadership and solid governance we will achieve this. The year ahead will see continued pressure on our resources which we will need to manage carefully. We have new strategies that are well developed and a vision for the Trust which will underpin our day to day successes. In addition, we are striving to work more closely with partners within and outside the NHS. This notwithstanding, we will still need to face the external challenges and make tough decisions to ensure we continue to provide high quality healthcare to our entire community. I have three sincere and humble thank you s to offer: Firstly, we have some of the best professionals anywhere in the country, working throughout our Trust .

4 Their commitment to and tireless work for our patients has been outstanding this year. Thank you each and every one of you for all you do. Secondly, our volunteers and the charities that support us have worked seamlessly and made a tremendous contribution to the Trust this year. Thank you deeply. We could not do what we do without you. Finally, I would like to acknowledge and offer my personal thanks to the Non-Executive and Executive Directors and the Governors of the Royal Berkshire , all of whom have made a significant contribution in supporting the Board, and me, in improving the robustness in governance and management of the Board to make it the success it is becoming. I am proud to lead a Board that has never had the needs of our patients and staff more in their mind as it does today and that relishes the challenges to make the Trust the best it can possibly be and to drive forward our future plans and strategies. 8 CHIEF EXECUTIVE S Report I am delighted to have joined the team at the Royal Berkshire NHS Foundation Trust .

5 I started with the organisation in January 2017 and would like to thank Mary Sherry, Chief Operating Officer who acted as Chief Executive from November 2016. I am pleased to Report that the past year has seen the Trust improve its performance in a number of areas for the benefit of our patients. During 2016/17 we have continued our focus to improve safety for our patients and have successfully reduced the number of Clostridium Difficile ( ) cases during the year. In 2016/17 the number of cases reported was 17 against a full year target of 27, and only 5 of these 17 cases were deemed to be as a result of lapses in care. We are consistently well above the national average for harm free care as assessed using the patient safety thermometer. We have also continued our focus to improve access to our services for patients. 2016/17 has been a really positive year for our cancer services as we are now delivering all core cancer standards for the first time in a number of years. We have seen 4197 more patients within 14 days and we have treated 232 more cancer patients within 62 days of being referred to us when compared with the previous year.

6 This is a significant improvement for patients and is due to the hard work and commitment of our staff. I am extremely proud of this achievement. Through the year we have continued to achieve the 18 Week Referral to Treatment (RTT) Incomplete Standard. We have been focusing on making efficiencies in the way we capture and manage the information used to support our RTT delivery. Over the year we have achieved just under 94% (against a target of 92%) of patients waiting less than 18 weeks. Although the Accident and Emergency Department (A&E) 4 hour standard has been a challenge we remained above 91% throughout the year. The Trust performs well when compared across the South Central region and we are in the top 25% in the country for emergency access against the 4 hour standard. Our teams have worked exceptionally hard over the year to ensure we are working safely and as effectively as possible for our patients needing emergency care. Our patients continue to give us positive feedback and I am proud to Report that we have consistently achieved 99% for inpatient Friends and Family recommendation which is amongst the best nationally.

7 We are committed to continually learn from patient feedback and patient complaints have significantly reduced with much improved response times during the year. The Trust maintained its NHS Choices rating. This measure is one way that NHS England gauges patient satisfaction. The star rating is one we are proud of, and feedback received on NHS choices includes a number of 5 star ratings. Where we receive less favourable feedback, we act on it and seek to improve our patients experience. We returned to financial surplus this year following receipt of from the national Sustainability and Transformation Fund ( STF ). We became eligible for these extra monies having achieved the financial target we set at the start of the financial year. All these extra monies are being reinvested back into equipment and facilities to support improving delivery of patient care. Our focus over the next two years is to improve our financial performance, such that we are able to achieve a surplus without the need for additional central NHS funding.

8 9 I am pleased to Report that a number of our services have been recognised at a national level. The Trust Hip Fracture Unit won the Health Service Journal (HSJ) Value in Healthcare Award in the Trauma and Orthopaedic category. Following an unannounced inspection by the General Pharmaceutical Council on 15 April 2016 the Trust s pharmacy team received Good ratings in five out of the six areas judged with the other being deemed Satisfactory . In addition to providing quality healthcare services, our role in education and research is really important to us. The Trust continues to perform well on research and in 2016 was ranked 19th out of 156 acute trusts by the National Institute for Health Research for our level of research activity. We have been working with the University of Reading and Berkshire Healthcare NHS Foundation Trust to develop the Thames Valley Clinical Trials Unit (TVCTU) which will be officially launched on 18 May 2017. All three organisations have a history of working together to deliver high quality research to improve patient care.

9 The creation of the TVCTU is central to our research strategy and the collaborative approach makes the most of the research resources across all three organisations. The Trust continued to invest in and improve our services throughout the year. In November 2016, the Trust invested in a new extension for the A&E department, to support new ways of working, and help ease pressure on the department. The extension provided eight additional cubicles where patients brought into the A&E by ambulance can be seen and assessed before being transferred to the most appropriate area for the continuation of their care. In 2016 we completed a successful upgrade of the Trust s Electronic Patient Record (EPR) system. This was an important part of our future plan to deliver paperless records and provided a platform for new ways of working and further systems development as part of becoming a digital hospital. We are committed to becoming a digital hospital and making our Electronic Patient Record available to both clinicians and patients.

10 The Board approved the decision for the Trust to join the Surrey Pathology Service (SPS) to form the Berkshire Surrey Pathology Service (BSPS) in 2015. A number of services integrated during 2016/17 and are becoming established with further services to follow during 2017/18. BSPS is a collaboration of four NHS Foundation trusts (RBFT, Frimley Health, Royal Surrey County and Ashford and St. Peter s) providing pathology services across Berkshire and Surrey. On 17 November 2016 the Trust was advised by NHS Improvement (NHSI) that we were no longer in breach of our licence and certificates of compliance were issued on all non-financial undertakings. This demonstrates positive progress at every level of the organisation and provides further reassurance to our patients and staff. Our focus for the year ahead is to develop our services to be more responsive for patients across Berkshire and beyond. We are investing in our satellite sites in Bracknell, Newbury, Windsor and Henley and will work with our acute and specialist partners to make services more accessible for patients.