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Welcome to the
Aintree University Hospital
NHS Foundation Trust
Annual Members’ Meeting Wednesday 27 September 2017
Welcome to the
Aintree University Hospital
NHS Foundation Trust
Annual Members’ Meeting Wednesday 26 September 2018
Today’s programme
What we have done in 2017/18
What we will be doing in 2018/19 and beyond
Dr Neil Goodwin CBE Chairman
Aintree University Hospital
Foundation Trust
Aintree’s Achievements 2017/18 “A highly positive experience; I would recommend the hospital and staff to anyone” - Patient 2018
• Most improved Trust in Cheshire & Merseyside during winter (A&E)
• Best Trust in the country for staff flu vaccinations
• Regional Trauma Centre and Helipad opened
• Diabetes care rated ‘as outstanding’
• Delivery of 3 year + Quality Strategy
• Award winning Volunteers programme
Despite our best efforts….
• Eight never events
• Standards not fully achieved:
– emergency care performance
– 18 week referral to treatment
– Four cancer targets
• Financial performance
• Workforce pressures
Care Quality Commission – Inspection
• Care at Aintree - ‘Good’
• Pharmacy - ‘Outstanding’
• Overall rating - ‘Requires Improvement’
• Areas requiring particular focus:
– Safeguarding
– Quality Governance
– Medicines management systems
Board of Directors
* Non-voting Board member
Aintree’s Strategic Direction
To create sustainable adult hospital services
for the people of Liverpool, the City-region and beyond,
in collaboration with
The Royal Liverpool & Broadgreen University Hospitals NHS Trust,
commissioners and other stakeholders
Trust Priorities
• Quality and Safety
• Staff engagement
• Merger
• Finance and Operations
• Electronic Patient Records
• Represents interests of NHS FT members
• Challenges the Board on its performance
Council of Governors
In conclusion
Council of Governors
Membership 2018
Pamela Peel-Reade - Lead Governor
Foundation Trust Model of Accountability
• Key items of business presented to Governors by Non-Executive Directors at four Council of Governors’ meetings during 2017/18
• These meetings are open to the public
What is the statutory role of Governors?
• To hold the non-executive directors
individually and collectively to account for the
performance of the Board of Directors
• To represent the interests of the members of
the Trust as a whole and the interests of the
public.
Council of Governors
2018/19 governors@aintree.nhs.uk
How we discharged our duties
• Extended Mandy Wearne’s contract, Non-Executive Director (NED)
• Approved the reappointment of Joanne Clague, NED
• Participated in the appraisals of the Chairman and NEDs
• Appointed the external Auditor
• Attended Council meetings and Board of Directors meetings to
observe how NEDs held the Executive Directors to account
• Increased our knowledge and awareness of key issues relating to
quality of care
• Focussed on delivering our Membership Strategy
Governor Involvement at Aintree (1)
• Governor-Led Committees
• Membership
• Quality of Care
• Bespoke Training Sessions
• Safeguarding
• Complaints
• Serious Incidents
• Finance
• Governor Elections
• Meeting with prospective Governors
Governor Involvement at Aintree (2)
• Input into Annual Business Plan & Quality Account
• Patient Led Assessment of the Care Environment (PLACE)
• Director Walk Rounds
• Bowel Cancer Screening Initiative
• Aintree Champions Excellence (ACE) Panels
• World Kidney Day
• Proud of Aintree Awards
• Attendance at DME events
• Multi-disciplinary Accelerated Discharge
• Organ and Tissue Memorial Unveiling
• Fun Day at Westmoreland PPG
• Quality & Improvement Showcase
• Catering Food Quality Group
• NHS 70th anniversary celebratory events
Governor Involvement at Aintree (2)
Membership Report
• Trust Membership is open to anyone who lives in the North West of
England, age 16 or above, and all members of staff
• Our current strategy is to maintain the level at c8,500 public
members, and to focus on increased engagement
0
1000
2000
3000
4000
5000
6000
7000
8000
9000
2015 2016 2017 2018 2015 2016 2017 2018
4208 4202 4697 4916
8154 8313 8543 8711
Staff Public
How do we meet our members
and hear their views?
• Get Involved with Aintree Group
• Membership Stand
• Developed relationships with:
– Local health and community groups
– Patient Participation groups
– Other local and regional hospitals
Membership Engagement
• Staff Governors present at monthly Trust Induction sessions
• Public Governors present at monthly Induction sessions for Volunteers
• Governors raise awareness of the benefits of membership by attending
community and health group events
• Members’ Newsletter
Focus for 2018-2019
• Quality of care, safety and the patient experience
• Merger and service reconfiguration
• Financial position
• Workforce
• Corporate reputation
Steve Warburton - Chief Executive
Review of 2017/18 and
Future Plans
• Highlights of Aintree’s 2017/18 Annual Report & Accounts
• Annual Operational Plan 2018/19
Our Strategy
• To provide excellent services to our local community
• Maintain our specialist services to a wider population
• Work more closely with our local and regional partners to
transform the delivery of all of our services
By strengthening Aintree’s position through:
• remaining committed to achieving financial balance
without compromising the quality of the services we provide
• sustaining improved patient flow throughout the hospital
• greater collaborative working with partners
• investing more in our informatics capability
Aintree University Hospital NHS FT
Our Performance
2017/18 End Q1 2018/19
Standard Actual Actual
RTT incomplete pathways 92% 91.9% 90.1%
A&E 4 hour waits 95% 82.9% 86.9%
Cancer 2 week - all cancers 93% 94.2% 87.7%
Cancer 31 day target - all cancers 96% 96.8% 99.1%
Cancer 62 day target - all cancers 85% 84.1% 78.0%
Cancer 62 day screening 90% 89.7% 55.6%
Diagnostic Access 1% 1.38% 1.10%
C. Difficile (hospital-acquired cases) 46 43 11
Highlights
• Grand Opening of Urgent Care & Trauma
Centre by The Duke of Cambridge
• Helicopter landing pad
• 12 ACE wards under AAA scheme
• Staff flu vaccinations
• £1.5m in grants
• Apprenticeship Programme
• Procurement savings of over £1m
• Develop our workforce to ensure staff have the right skills,
knowledge, attitude and behaviours to deliver high quality
care in the right place, every time
• Promote and develop a safety culture
• Reward our staff by ensuring they feel appreciated and
acknowledged
• Support staff innovation
Developing and supporting our workforce
• Quality Strategy 2018-2020 - we continue to involve staff and patients in
our priorities
• The CQC and Quality Risk Profile action plans combined into a single
overarching ‘Quality Improvement Plan’
• Aim is for continued improvement across all areas of patient care that
improve outcomes and reduce mortality
• Board commitment to the creation of an Explicit Safety Culture as a key
enabler
• Progress to date includes:
– Reducing infection – below the national standard of no more than 46
patients with C.Difficile infection
– Reducing falls causing harm – below target of 36 patients
– 95% of patients diagnosed with Community Acquired Pneumonia (CAP)
receive antibiotics within 4 hours of arrival in the Trust
Our Quality Improvement Journey
Quality
Our
priorities Care that is safe Care that is clinically effective
Care that provides a positive
experience for patients and their
families
Ou
r o
bje
cti
ves
• consistent delivery of harm free care
>98% as Safety Thermometer
• assessing patients for dementia
early in their stay to ensure they
are on the right pathway
• working towards a top 25%
position in the national inpatient
survey
• reducing MSSA bacteraemias by 50%
• reducing the number of C.Difficile
infection cases <=46
• No cases of MRSA
• achieving 95% > in Advancing
Quality care bundle standards
(relating to Acute Kidney Injury,
Alcohol Related Liver Disease,
Hip and Knee Replacement and
Pneumonia.)
• Increase FFT inpatient
recommendations to 96%
• Achieve zero never events
• 100% compliance with WHO Checklist
Care Pathway improvements
• Achieve Cancer 62 day target 85%
of the time
• Achieve RTT and diagnostic over 6
week waiters
• Improve End of Life Care
• Improve Stroke performance
• Complete 75% of complaint
responses in a timely manner
• reducing the number of inpatient falls
with harm
• reducing hospital acquired pressure
ulcers
• reducing harm, measured by
mortality ratings, MUST screening and
patient safety incidents
Activity 2017/18 (1)
Type 1 Emergency Attendances (2.7% up on 2016/17)
Activity 2017/18 (2)
Activity 2017/18 (3)
• We met our planned financial targets in 2017-18 with a Use of
Resource Rating of 4
• Income and expenditure were close to planned levels
• The Quality, Efficiency & Productivity (QEP) Programme of £13.6m
was delivered
• Reported deficit of -£3.5m, inclusive of Sustainability and
Transformation Funding of £10.6m
Finance
We received £351m of
income (before exceptional
items)
This is a £7.7m (2.2%)
increase from the £343.3m
received in 2016/17
Our earnings
£221.4m Pay
£31.5m Drugs
£45.1m Clinical supplies and services
£11.0m General supplies and services
£16.2m Premises costs
£5.3m Depreciation and impairments
£19.0m Other operating costs
£5.0m Cost of capital
Expenditure (millions)
We spent £354.5m (3.9% up on 2016/17)
£221.4m on staff costs, £128.1m on non-pay
and £5.0m servicing loan interest and Public
Dividend Capital
Our spend
Despite a challenging position, we continued to invest in
capital to make improvements throughout the hospital. We
invested £11.6m
including :
• £3.2m on medical equipment
• £3.1m on upgrading our wards
• £2.0m on information technology
• £1.7m on the theatre upgrade programme
• £1.0m on the helipad
Investments in 2017/18
• -£35.7m gap between income and expenditure
• £6.6m Cost Improvement Target
• -£29.1m planned deficit
Board was unanimous in its view that
maintaining safe, responsive and
effective patient care was more important
than achieving a balanced financial position
Finance 2018-19
• Continue to deliver care that is safe, effective and
which provides a positive experience for patients
and their families
• Underpinned by the common purpose of ‘getting
it right for every patient every time’
• Working with Royal Liverpool with the intention of
consolidating our two organisations to improve
the health and well-being of our community
• Demonstrate that we are being as productive and
efficient as possible
• Support innovation and new ways of working
Delivering our Vision
Any Questions?
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