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ANNUAL REPORT 2013/14

Our Values...To get the basics rightAnnual Report 2013/142

It gives us great pleasure to introduce this annual report which describes the progress Derbyshire Community Health Services NHS Trust has made during 2013/14 towards achieving our vision of being the best provider of local health services and a great place to work. The Trust has had another successful year; delivering against quality, service and financial priorities that we defined for the year and agreed with our commissioners. This report – and our annual quality account – describes our achievements along with the areas where we still have more work to do, and together they are an important way in which we are open and accountable to the communities we serve. Another key way in which we are held accountable is through our Council of Governors, members of the public and staff elected to work with the Board of Directors in shaping the organisation’s future and holding the Trust to account for delivering against its commitments. Our inaugural shadow Council of Governors was elected just before the beginning of the year and we have benefited greatly and appreciated their involvement and engagement with the organisation over the last 12 months. Delivering consistently high quality care to all our patients and service users is our overarching priority and during 2013/14 we have continued to improve the experience, safety and effectiveness of our services. Importantly the quality of our services has also been rigorously and independently inspected by the Care Quality Commission’s (CQC) Chief Inspector of Hospitals this year. Their inspection was very positive, highlighting the overwhelmingly positive feedback that our patients gave about their experiences and the commitment of our staff right across the Trust to delivering excellent care and putting their patients at the centre of what they do. The CQC also identified a number of areas where we need to take action to improve quality and we will working to take these forward during 2014/15. We have continued to work closely with our local commissioners, NHS providers, Derbyshire County Council and Derby City Council this year to develop joined-up out of hospital services and have implemented a wide range of new services to increase the number of people that we can care for and support at home. Key developments include:

• Our innovative Falls Partnership Service which is preventing admissions to hospital for people who have a fall

• Our home-based IV antibiotics services which is enabling people who need long term antibiotics to have these at home rather than having to stay in hospital

• And our care coordinators who are working closely with GPs, community nurses and community therapists to manage people with complex long term conditions as proactively and effectively as possible.

We have also continued to invest in and improve our facilities and equipment and make significant additional investments in nursing and therapy staff ensuring that we remain in a position to continue to develop local, community-based health services that support people to remain as healthy and independent as possible. During the year we worked with Monitor, the independent regulator of NHS Foundation Trusts, who were assessing our application to become a Foundation Trust. Unfortunately although Monitor found the Trust to be well-led and financially sustainable, they were not prepared to authorise us without a full quality assessment by the CQC. Having completed this inspection positively at the end of the year we will be working again with Monitor with the objective of being licensed as a Foundation Trust during 2014/15. The year has also seen some significant changes with us saying goodbye to the 250 colleagues providing planned outpatient and day case care in Leicestershire as they transferred to a new provider in April. We also said goodbye to our inaugural Chairman, Andrew Fry, as he retired to France and would like to take this opportunity to thank him on behalf of the Board and the wider organisation for the contribution he has made during his tenure as Chairman. At the heart of Derbyshire Community Health Services NHS Trust are our incredibly dedicated, caring and professional colleagues. It is a privilege and a proud responsibility to work with them and support them and on behalf of the Trust Board we would like to thank them all for the part they have played in our success this year, and extend these thanks to the many volunteers and our Leagues of Friends whose support makes such a difference to our patients.

Tracy Allen Prem SinghChief Executive Chair

Introduction by the Chair and Chief Executive

Annual Report 2013/14 3Our Values...To act with compassion and respect

Contents

Introduction and background• About us • Delivering excellence through our values • Working the DCHS Way• The Big 9• 2013/14 in brief• DCHS in the news.

Quality service • Services we provide• Care Quality Commission visit to our services• Promoting equality, diversity and inclusion across everything we do• Our commitment to improving quality• Local service developments • Welcoming feedback• Keeping our vulnerable patients safe• Putting quality at the heart of what we do• Commissioning for Quality & Innovation• Zero tolerance to healthcare-associated infections• Data security• Planning for emergencies • Sustainability• Patient stories.

Quality people• Our workforce profile• Staff partnership• Staff ownership, engagement and involvement • Leadership development• Appraisals• Learning and development• Improving skills for all• Core essential learning and staff induction• Clinical essential learning• Continuing professional development • Practice learning• Reflection on practice (clinical supervision) • Preceptorship: nurse training scheme• Sickness absence• NHS Staff Survey results• Patient stories.

Quality business• Striving to become a Foundation Trust• We will all benefit from Foundation Trust status• Are you a member? If not, why not? • Shadow Council of Governors• Council of Governors• Planning ahead• A new commissioning landscape• The Board• DCHS Board members (at 31 March 2014) • Our committees• The Board’s sub-committees• Board Assurance Framework • Learning from action taken• Declarations of interest and register of interest of members of the Trust Board 2013/14• Patient stories.

Reports and finances • Operating and financial review• Remuneration report• Statements and reports• Annual Governance Report 2013/14• Board members’ declaration of interests 2013/14• Notes to the accounts

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Annual Report 2013/144 Our Values...To make a difference

About usHere at Derbyshire Community Health Services NHS Trust (DCHS) our vision is to be the best provider of local healthcare and a great place to work.

We care for patients across a wide range of services, delivered from 133 sites including 13 community hospitals and 28 health centres across 30 towns, dozens of villages and more than 1,000 square miles. We touch the lives of more than 4,000 patients every day.

We employ approximately 4,400 staff, making us one of the largest providers of specialist community health services in the country, serving a patient population of more than one million.

Introduction and Background

On an average day:

• We see 150 people in our minor injury units

• We care for 300 people in our community hospital beds

• More than 1,400 patients are cared for by our community nursing teams

• We treat 530 patients in our community podiatry service

• Our health visitors see 387 children aged 0-5.

To be the community services provider of choice for Derbyshire and beyond

Put people at the centre of what we do and provide

high quality

To ensure that we develop partnerships which support the delivery of innovative

high quality care

To attract and retain the highest quality staff and to ensure that they meet our high standards for the

delivery of care

To be the best provider of local healthcare and to be a great place to work

Our Vision

To deliver high quality and sustainable services that echo

the values and aspirations of the communities that we serve

To build a high performance work environment that engages, involves and supports staff to reach their full

potential

To ensure an effective, efficient and economical organisation which

promotes productive working and which offers good value to its

community and commissioners

• To get the basics right

• To act with compassion and respect

• To make a difference

• To value and develop teamwork

• To value everyone’s contribution ‘everyone matters’

Our Ambitions

Our Objectives

Our Values

We have developed and refined our vision, ambitions and values as an organisation in partnership with our staff.

Delivering excellence through our values

Annual Report 2013/14 5Our Values...To value and develop teamwork

The Big 9 As part of fulfilling our commitment to quality and to achieving our objectives, we have created ‘The Big 9’. Within each element of the DCHS Way (Quality Service, Quality People and Quality Business) three top priorities were identified for 2013/14. The Big 9 is updated monthly and shared with staff across the organisation to enable us to see how we are doing against those priorities.

Achieving them will ultimately mean we provide the best quality care for our patients and make the Trust a great place to work.

Working the DCHS WayThe DCHS Way is a fundamental ‘pledge’ to our staff and patients which promises - in simple terms - how we will govern and manage our organisation.

It has three elements: Quality Service, Quality People and Quality Business; each reflecting our major organisational objectives and highlighting that quality is at the heart of everything we do.

To deliver high quality and sustainable services that echo the values and aspirations of the communities that we serve

To build a high performance work environment that engages, involves and supports staff to reach their full potential

To ensure an effective, efficient and economical organisation that promotes productive working and which offers good value to its community and commissioners

DCHS BIG 9 2013/14

Annual Report 2013/146 Annual Report 2013/14 7

OUR VISION ‘TO BE THE BEST PROVIDER OF LOCAL HEALTHCARE AND BE A GREAT PLACE TO WORK’

Quality Service

Increase the number of patients who are harm free

May 2013Target

Achieved

90 %

90 %

June 2013Target

Achieved

90 %

91 %

July 2013Target

Achieved

90 %

90 %

Aug 2013Target

Achieved

90 %

91 %

Sept 2013Target

Achieved

90 %

92 %

Oct 2013Target

Achieved

90 %

92 %

Nov 2013Target

Achieved

90 %

92 %

Dec 2013Target

Achieved

90 %

92 %

Jan 2014Target

Achieved

90 %

92 %

Feb 2014Target

Achieved

90 %

92 %

Mar 2014Target

Achieved

90 %

92 %

Patients recommend DCHS as a place to have treatment (Friends and Family test score)

May 2013Target

Achieved

71

95

June 2013Target

Achieved

71

90

July 2013Target

Achieved

71

92

Aug 2013Target

Achieved

71

92

Sept 2013Target

Achieved

71

91

Oct 2013Target

Achieved

71

88

Nov 2013Target

Achieved

71

92

Dec 2013Target

Achieved

71

90

Jan 2014Target

Achieved

71

91

Feb 2014Target

Achieved

71

90

Mar 2014Target

Achieved

71

87

95% of identified services achieving monthly clinical records audit standards

May 2013Target

Achieved

95 %

From July

June 2013Target

Achieved

95 %

From July

July 2013Target

Achieved

95 %

94 %

Aug 2013Target

Achieved

95 %

99 %

Sept 2013Target

Achieved

95 %

100 %

Oct 2013Target

Achieved

95 %

100 %

Nov 2013Target

Achieved

95 %

100 %

Dec 2013Target

Achieved

95 %

97 %

Jan 2014Target

Achieved

95 %

95 %

Feb 2014Target

Achieved

95 %

100 %

Mar 2014Target

Achieved

95 %

97 %

Quality

Increase staff

May 2013Target

Achieved

From July

From July

June 2013Target

Achieved

From July

From July

July 2013Target

Achieved

76.5

77

Aug 2013Target

Achieved

76.5

77

Sept 2013Target

Achieved

76.5

77

Oct 2013Target

Achieved

76.5

77

Nov 2013Target

Achieved

76.5

77

Dec 2013Target

Achieved

76.5

77

Jan 2014Target

Achieved

76.5

77

Feb 2014Target

Achieved

76.5

77

Mar 2014Target

Achieved

76.5

77

completion

May 2013Target

Achieved

100 %

87 %

June 2013Target

Achieved

100 %

87 %

July 2013Target

Achieved

100 %

87 %

Aug 2013Target

Achieved

100 %

82 %

Sept 2013Target

Achieved

100 %

81 %

Oct 2013Target

Achieved

100 %

77 %

Nov 2013Target

Achieved

100 %

80 %

Dec 2013Target

Achieved

100 %

87 %

Jan 2014Target

Achieved

100 %

95 %

Feb 2014Target

Achieved

100 %

92 %

Mar 2014Target

Achieved

100 %

93 %

staff attendance

May 2013Target

Achieved

97 %

96 %

June 2013Target

Achieved

97 %

96 %

July 2013Target

Achieved

97 %

96 %

Aug 2013Target

Achieved

97 %

96 %

Sept 2013Target

Achieved

97 %

96 %

Oct 2013Target

Achieved

97 %

96 %

Nov 2013Target

Achieved

97 %

96 %

Dec 2013Target

Achieved

97 %

96 %

Jan 2014Target

Achieved

97 %

96 %

Feb 2014Target

Achieved

97 %

96 %

Mar 2014Target

Achieved

97 %

96 %

Quality Business

£8.1m cost improvement programme

May 2013Target

Achieved

£1.04m

£0.62m

June 2013Target

Achieved

£1.7m

£1.0m

July 2013Target

Achieved

£2.11m

£1.75m

Aug 2013Target

Achieved

£2.79m

£1.87m

Sept 2013Target

Achieved

£3.63m

£2.9m

Oct 2013Target

Achieved

£4.37m

£3.37m

Nov 2013Target

Achieved

£5.11m

£3.91m

Dec 2013Target

Achieved

£5.86m

£4.63m

Jan 2014Target

Achieved

£6.48m

£5.55m

Feb 2014Target

Achieved

£7.29m

£6.22m

Mar 2014Target

Achieved

£8.1m

£7.06m

Income and expenditure surplus of £2.82m

May 2013Target

Achieved

£1.04m

£0.5m

June 2013Target

Achieved

£0.79m

£1.09m

July 2013Target

Achieved

£1.67m

£1.41m

Aug 2013Target

Achieved

£1.71m

£1.83m

Sept 2013Target

Achieved

£2.02m

£2.15m

Oct 2013Target

Achieved

£1.90m

£2.07m

Nov 2013Target

Achieved

£2.48m

£2.16m

Dec 2013Target

Achieved

£2.73m

£2.24m

Jan 2014Target

Achieved

£3.65m

£3.39m

Feb 2014Target

Achieved

£4.48m

£4.06m

Mar 2014Target

Achieved

£2.82m

£2.93m

389 tonnes carbon emissions saving

May 2013Target

Achieved

62t (16%)

56t (15%)

June 2013Target

Achieved

97t (25%)

92t (24%)

July 2013Target

Achieved

136t (35%)

134t (35%)

Aug 2013Target

Achieved

175t (45%)

179t (46%)

Sept 2013Target

Achieved

175t (45%)

217t (56%)

Oct 2013Target

Achieved

245t (63%)

252t (65%)

Nov 2013Target

Achieved

280t (72%)

285t (74%)

Dec 2013Target

Achieved

311t (80%)

317t (82%)

Jan 2014Target

Achieved

342t (88%)

347t(89%)

Feb 2014Target

Achieved

362t (93%)

389t (100%)

Mar 2014Target

Achieved

389t (93%)

389t (100%)

People

engagement

100 % appraisal

Minimum 97 %

Annual Report 2013/14Annual Report 2013/14 98 Our Values...To act with compassion and respectOur Values...To get the basics right

• Ash Green Learning Disability Centre

received a very positive review from the

CQC whose visit in early May focused

primarily on how we support patients

detained under the Mental Health Act.

• Helen Cooper, a nurse who works with

families in the Erewash area, was named

as a Queen’s Nurse – a national title

recognised as a badge of commitment

and dedication to community nursing.

2013/14 in brief

• We promoted equality and diversity in a

series of professional and eye-catching

portraits of transgender people at

Walton Hospital. The exhibition was

called ‘Living my Life’.

• We held free workshops for parents

and carers to help children overcome

communication difficulties by teaching

them to use signs and symbols to

support speech.

• Our Care Home Support Team was

shortlisted for the national Care

Integration Awards 2013 for successfully

reducing falls among elderly people

in care homes in Amber Valley over

the past year with expert support and

therapy.

April

May

We launched an innovative ‘Sustainable

Travel Month’ to give us ideas on how

to make our own travel choices miles

better in the future. Walking Week,

Car Week, Public Transport Week and

Cycling Week gave us all some helpful

tips on how to save money on travel,

be more active and reduce CO2.

• The Care Quality Commission’s (CQC) reports into three areas of our care

were published in April, covering:

• Walton Hospital’s Derwent Ward

• Buxton Hospital’s Minor Injury Unit

• Health visiting, breastfeeding support and community nursing services.

•

• District nurses from Staffa Health Centre in Pilsley

were presented with a new syringe driver following

a donation of £850 from grateful relative Mrs Julie

Easdale, in memory of her late husband, Graham,

who they cared for.

• Our dedicated care of new mothers and young

families across Derbyshire was recognised after

we were awarded UNICEF stage 2 Baby Friendly

accreditation for breastfeeding support provided in

the county’s children’s centres.

Celebrating national NHS Equality and

Diversity Week...

• Local Paralympian,

Andrea Green, gave

staff an inspirational talk

which looked at how

healthcare providers

can better meet the

needs of people with

disabilities.

• We held British Sign

Language and Polish

language taster sessions and put on cultural dancing

displays in the Indian classical styles of Kathak and

Bollywood.

• Staff workshops were delivered by the Derbyshire

Alzheimer’s Society at Newholme and Walton

Hospitals to share good practice in meeting the

needs of patients with dementia.

May

District nurses, based at Baslow Health

Centre, were given the prestigious title of

‘NHS Heroes’ for delivering a gold standard

service and care to their local community.


• We held our first ever meeting of the shadow Council of Governors to set out plans for the shadow Council moving forwards and broadly agreeing how we can work well together. Please refer to page 45 for more details about what the council does.

• Newholme Hospital’s Stanton Day Unit hosted an annual well dressing ceremony with the League of Friends. The art of well dressing has been adopted as part of the therapy for older patients with mental health problems.

June

• Lord Adebowale, Chief Executive of Turning Point, visited Bolsover Hospital’s Welbeck Ward to hear about JONAH, a system which enables staff to plan each patient’s care more smoothly so that delays are avoided, and how it is improving care for patients. • We launched a recruitment campaign under the banner of ‘Caring Never Grows Old’ to help boost our clinical teams delivering inpatient and community services across Derbyshire. Evaluation of the three-month campaign reported that 5,329 people went from our campaign website to view and apply for the positions through NHS Jobs and to date 97 people were appointed.

• We demonstrated out commitment to patients with dementia by signing up to the ‘Dementia Action Alliance’, a new national partnership of over 900 organisations across the country. It aims to tackle the growing problem of dementia in our ageing population and to transform dementia patients’ quality of life.

• Our Stop Smoking Service and Health Promotion Service supported the launch of a ‘Books on Prescription’ scheme, a national initiative to help people manage their mental wellbeing using cognitive behavioural therapy-based self-help books. • Chairman, Andrew Fry, announced his retirement after more than five years at the helm. Tony Okotie, vice chair, took up the role of acting chair following Andrew’s departure and while the recruitment process was carried out for Andrew’s permanent successor. Andrew’s contribution has been significant and the legacy he leaves will be a lasting one.

July

Physiotherapist Ian English and Occupational Therapist Rebecca Spray, from the Erewash Care Team, were recognised nationally as ‘Rising Stars’ in the Advancing Healthcare Awards 2013.

July

Staff at Derwent Suite, Babington Hospital, celebrated a milestone with their 1,000th patient, Moira Hodgkinson, aged 82, from Idridgehay.

Derwent Suite opened in 2004 to provide rehabilitation to patients who are medically fit but need help to reach their maximum level of independence, with the aim of enabling them to return home.

A peaceful new garden for patients opened at St Oswald’s Hospital in Ashbourne to provide a relaxing space for patients, visitors, relatives and staff.


• Our aim to become the country’s first specialist

community NHS foundation trust was deferred

by the independent regulator, Monitor.

Further information on this decision can be

found on page 43.

• The ‘Safety Express’ board game, with the

aim to reduce harm and improve safety and

quality of care for patients, was shortlisted in

the Nursing Times’ Awards 2013. The game

was developed by our Workforce Planning &

Development Team in conjunction with NHS

Innovations East and Focus Games.

• We signed up as a ‘Living Wage

Employer’ - in line with our

commitment to being a great place to

work - making an important difference

to our lowest paid colleagues.

• We were required to relocate almost

all services from Heanor Memorial

Hospital to Ilkeston Community

Hospital following the discovery of

asbestos within the building.

The asbestos was safely contained

within the boiler room area and

experts confirmed that the findings

presented no risk to the health and

safety of our patients or visitors.

August

We officially opened our

Speedwell Development Unit at

Walton Hospital - a brand new

learning centre for staff equipped

with the latest online and

high-tech aids to support effective

learning and development.

September

Labour MP, Natascha Engel, met with staff

and patients when she visited Alton Ward,

a rehabilitation and palliative care ward at

Clay Cross Hospital.

We held our AGM and

Discovery Day at Chesterfield

Football Club which brought

together healthy activities and

a great range of information for

people to help look after their

health and wellbeing.

• Our Chief Executive, Tracy Allen undertook a short ‘job swap’

with Stuart Poyner, Chief Executive of Staffordshire and Stoke

Partnership NHS Trust. It proved to be a great opportunity to

see, with a fresh pair of eyes, how other people approach the

same challenges we encounter.


• Our first Staff Forum took place with a good level of challenge and debate on some really key issues. The forum sees our Frontline Care Council, staff governors and staff partnership representatives join forces to work closely with our executive team to make our Trust a better place to work.

• We were awarded the Royal Society of Public Health and Wellbeing Award for the next three years in recognition of our focus on staff wellbeing and our workplace health champions.

• Our Children and Young People’s Health Promotion Team was awarded the highest level of accreditation by ‘AIM’, the national awarding body for the healthy eating development courses that they run for staff who provide children’s care.

• We marked Black History Month and engaged employees in a quiz to test their knowledge and to raise awareness of the significant contribution that black and other ethnic minority communities have made, and are continuing to make, to UK society.

• The new Sherwood Ward at Bolsover Hospital and Chevin Ward at Babington Hospital received their first patients. The wards were opened to help ease the increase in demand experienced in the NHS over the winter months with more patients needing our care.

• We were pleased to have our Investors in Excellence standard renewed for the next two years following an external review which demonstrated a high standard of our all-round business performance.

October

November

Our health visitors launched a new website offering tips to help parents keep their young children happy and healthy. You can visit the site at: www.dchs.nhs.uk/healthvisiting

• Angela Slater from the Ripley Community Nursing Team won the Lightbulb Award for a simple but effective idea to help combat pressure ulcers.

• Matron Tina Sullivan, was named ‘Healthcare Hero’ for being a role model who nurtures her teams at St Oswald’s Hospital, Ashbourne and Buxton Hospital, to do the very best for patients and families in their care, always putting patients first.

• Alfreton Community Nursing Team was named as Outstanding Team of the Year for their dedication to excellent patient care.

• Janet Griffiths, Podiatry Services Manager for the High Peak and Dales, was chosen for the Outstanding Lifetime Achievement Award for her work in developing podiatry services over 30 years.

• Integrated Community Services Manager, Gill Burrows, based at Babington Hospital, was honoured with the Outstanding Leadership Award for her inspirational leadership and commitment to developing community health services in the Amber Valley area.

• Raffien Azaim from Derby’s Children’s Speech and Language Therapy Team, was named as the winner of the Celebrating Diversity Award 2013 for providing speech and language therapy to children in households where English is often not spoken.

• Steve Ward, estates project manager, based at Newholme Hospital, found himself in the spotlight when he was named “behind the scenes hero” for his 24 hour commitment to ensuring our sites are in good working order for the delivery of patient care.

• Chesterfield-based community podiatrists were named winners in the Excellence in Patient Experience and Making DCHS a Great Place to Work Awards.

• North Derbyshire-based community nurse Joan Pons Laplana was named joint winner of the care and compassion award, as nominated by patients and families for his dedication to providing the best of care.

We celebrated and recognised the outstanding achievements of DCHS’ staff at our Extra Mile Awards 2013…

We launched a new partnership falls service with East Midlands Ambulance Service NHS Trust and Chesterfield Royal Hospital NHS Foundation Trust involving our therapists and paramedics offering a fast response to people who fall at home, to help prevent unnecessary hospital admissions. In its first three months, nearly 60 per cent of patients were successfully treated at home.


• We launched a new ‘Introduction to Equality and

Diversity at DCHS’ video, starring many of our staff,

for new starters to watch at their DCHS induction.

It explains what equality and diversity mean to us,

why it’s important and our expectations of our staff.

• Age UK and DCHS have were successful in a joint

bid to provide falls education services in Derbyshire,

with Age UK operating as the lead provider in

the arrangement. The service provides exercise

programmes to support the prevention of falls.

It is aimed primarily at Derbyshire residents over the

age of 50 and others identified as being at a high risk

of a fall.

• We made “unprecedented progress” in this year’s

Stonewall Workplace Equality Index, the definitive

list of Britain’s most gay-friendly workplaces.

We are now ranked 168th in their index, up from

230th last time.

• We welcomed Prem Singh as our new Chairman on

1 December. Prem said how much he was “looking

forward to leading our Board, working with our

staff, our governors, our patients and our partners

to fulfil the Trust’s ambitions to be the best provider

of local healthcare and to be a great place to work”.

• We marked International Human Rights Day on

the 10th by delivering a presentation to staff and

holding a debate on the theme of ‘understanding

your human rights’.

• Patients on Riverside Ward at Newholme Hospital

burst into song to celebrate the ward’s 20th

anniversary. The patients - who are predominantly

experiencing dementia - have been learning to

find their singing voices again with help from

our therapy staff and the county council’s adult

learners’ team.

January

December

The Duke and Duchess of Devonshire visited Whitworth

Hospital to unveil a plaque marking the reopening

of Oker Ward and the hospital’s physiotherapy

department after a major refurbishment, part-funded

by the Matlock Hospitals League of Friends.


• We held a number of events across the county to celebrate ‘Privacy and Dignity Week’, including a tea party at St Oswald’s Hospital and inviting people to contribute to a dignity tree at Ash Green Learning Disability Centre, by writing their own ideas on a paper leaf about what dignity and respect meant to them.

• We welcomed an inspection team from the Care Quality Commission (CQC) to examine the quality of our services over a two week period. This was a brand new type of inspection for specialist community trusts. Further details on the CQC’s visit can be found on page 23.

• We secured continued registration to the British Standards Institution Quality and Environmental Management Systems, for managing our environmental responsibilities efficiently.

February

• NHS Change Day on 3 March was a huge success with over 1,000 staff signing up to more than 250 pledges with the overall aim of making improvements in quality of care and other ways of working.

• Our Derbyshire County Stop Smoking Service joined forces with Peak FM radio station to encourage smokers to kick the habit as part of No Smoking Day on 12 March.

March

All of our hospital wards arranged special tea parties for patients as part of a Nutrition and Hydration Week 2014, a worldwide awareness campaign to patients receive adequate nutrition and hydration as part of their care.

• We were awarded the contract to extend our mother-to-mother breastfeeding support service across Derbyshire in line with our commitment to help local families who choose to breastfeed their babies.

On the International Day against Homophobia and Transphobia, we launched a video challenging the myths and misconceptions of lesbian, gay, bisexual and transgender young people, produced by our Sexual Health Youth Group, and another video of our employees talking about their experience in non-traditional gender role jobs.

Our children’s community services achieved UNICEF stage three Baby Friendly accreditation for supporting breastfeeding mothers ‘with flying colours’. This is a particular achievement given the swiftness with which we have been able to move from stage two accreditation in just nine months.

Newholme Hospital’s Rowsley Ward was grateful to receive a donation of £850 from the High Peak Livestock Society which represents 650 farmers in Derbyshire, in gratitude for the care received on the ward by its members and their relatives.

Annual Report 2013/1420 Our Values...To get the basics right

Throughout the year, our staff and services hit the headlines for the quality of care they are delivering on a regular basis. Here are some of the highlights:

We welcomed national and regional television crews to our services for some positive stories during the year. ITN National News and ITV Central News filmed with one of our breastfeeding support groups in Chesterfield during November, around new research into breastfeeding. Health visitor Louise Garrod was interviewed and appeared on the national news.

BBC East Midlands Today TV filmed with our new Falls Partnership Service, based at Bolsover Hospital, to report its success in reducing hospital admissions among fall patients in north Derbyshire, broadcast on the main regional news bulletin.

BBC East Midlands Today TV was also due to film the fantastic singing project with dementia patients on Riverside Ward at Newholme Hospital, but breaking news on the day diverted the film crew elsewhere at the last minute – one of the hazards of the media’s ever-changing news agenda.

Regular radio interviews during the year were lined up with various members of staff, usually as a result of our press releases. Dr Stephen Searle was interviewed on BBC Radio Four’s Woman’s Hour in August about male contraception – to highlight the Chesterfield sexual health team’s expertise in carrying out 400 vasectomies each year.

Other radio highlights involving our staff included:

We were featured in various specialist magazines, including a prominent two page piece in the Nursing Standard in February about our NHS Change Day champions and quoting pledges made by our staff. Chairman Prem Singh’s outstanding contribution to healthcare received high profile recognition in the HSJ. And our new environmentally-friendly LED lighting in hospital corridors appeared in Building Better Healthcare. We were also thanked publicly by the Nursing Times on its Twitter feed for supporting its Speak out Safely Campaign.

Local media coverage in newspapers across Derbyshire continued throughout the year with more than 150 positive articles appearing in daily and weekly titles on a whole range of initiatives.

Our inspection by the Care Quality was welcomed by us with a statement to local media highlighting our inclusion because of our advanced foundation trust application.

The Extra Mile Awards gave an ideal opportunity to celebrate the achievements of individuals and teams, with seven papers carrying photos and write-ups: Derby Telegraph, Ripley and Heanor News, Ashbourne News Telegraph, Belper News, Derbyshire Times, Matlock Mercury and Buxton Advertiser, in addition to a live twitter feed. The flu campaign launch was also widely picked up. Our NHS Discovery Day in September received a lengthy pre-event write-up in the Chesterfield Post, and a live Twitter feed during the event ensured our 1,826 followers were kept informed.

DCHS in the NEWS

• Peak FM publicised our Unicef baby-friendly stage two accreditation • BBC Radio Sheffield broadcast the launch of the Falls Partnership Service• Interviews to promote our stop smoking initiatives during the year on Radio Derby, Radio Mansfield 103 FM and Peak FM • High Peak Radio coverage of our Extra Mile Awards, particularly Janet Griffiths’ lifetime achievement award.


Much of our other coverage appeared as a result of press releases shared with local journalists, and via our proactive approach to using Twitter, and also included:

We kept our media contacts updated about necessary changes to services as the year progressed. Our open approach resulted in fair coverage, in line with our press announcements, on a number of topics: change of hours at Whitworth and Ripley minor injury units, transfer of patients out of Derwent Ward at Walton Hospital and Spencer Ward at Cavendish Hospital, and temporary closure of Staveley Clinic for upgrading.

Further finds of asbestos at Heanor Hospital were of big interest to the local media. Explaining the facts carefully was crucial to successful and factual media coverage and to avoiding adverse social media comments.

Spotlight on…• Our Care Home Support Team named finalists in the Care Integration Awards

• Therapists from Erewash community therapy team named as rising stars in the Advancing Healthcare Awards

• The appointment of Queen’s Nurse, Helen Cooper.

New patient facilities…• The opening of St Oswald’s Hospital’s new garden and a local publicity drive around services on site in Ashbourne

• Repton Health Centre’s refurbishment and open day to view plans

• Re-opening of Oker Ward and physiotherapy unit, Whitworth Hospital

• The appointment of additional heart failure nurses in Chesterfield to help patients at home and speed up their discharge from hospital.

The caring environment…• Excellent PLACE scores across our

community hospitals, promoting high standards of cleanliness, hospital food, privacy and dignity

• The success of our Single Point of Access for referrals

• Tackling missed outpatient appointments.

A great place to work…• Early Staff Survey results rated us highly as a place to work

• Our Royal Society of Public Health Award for promoting staff wellbeing

• Our recruitment drive to attract additional nurses and other staff

• The appointment of our fully elected Council of Governors.


Quality Service


Our servicesOur specialist community health services are organised into three major ‘divisions’ shown below. These divisions reflect our aim to promote the health and wellbeing of all, to enhance the life opportunities of many and to promote independence and opportunity wherever possible.

Integrated Community-Based Services• Urgent care

• Rehabilitation

• End of life care

• Community therapy services

• Traumatic brain injury services

• Older people’s mental health services

• Stroke rehabilitation

• Learning disability services

• Community nursing services

• Continence care

• Specialist services

• Pharmacy services

• Long term conditions.

Outpatient & Day Case Services• Consultant outpatient services

• Musculoskeletal (physiotherapy) outpatients

• Occupational therapy outpatients

• Podiatry and podiatric surgery

• Specialist wheelchair service

• Day case surgery across a number of specialties.

Health, Wellbeing & Inclusion• Children and family services

• Speech and language therapy

• Contraception and sexual health promotion

• Health promotion service

• Dental services

• Prison healthcare (for offenders)

• Psychology services.

Our major priorities across all aspects of our service delivery are:• Keeping patients safe

• Enhancing the healing environment and improving outcomes for patients with dementia

• Getting the basics right (clinical effectiveness).

Care Quality Commission visit to our servicesIn November the CQC announced that we would be subject to a new Ofsted-style inspection in February 2014.

We were one of the first community trusts to experience this new-style inspection and we were confident it would be a great opportunity for us to showcase the quality of services we provide.

At the time of announcement, Tracy Allen said: “We welcome this announcement; these inspections are a great opportunity to demonstrate the commitment and pride we have in our services and to take a step back and examine their quality with the huge benefit of a range of external people’s fresh eyes and experience to draw on.”

The new-style inspection sought to answer five questions about our services: are they safe, caring, effective, well-led and responsive to people’s needs? Inspectors then made a judgement about the quality and safety of the care we deliver.

The CQC’s team of inspectors visited 35 sites across the county and accompanied our community-based staff on their visits. In summary they said they received “overwhelmingly positive feedback from patients about the compassion and empathy of staff.”

The inspectors were happy with the actions we’ve taken to address previous issues, but this review found isolated areas in three of our hospitals where we were not seen to be meeting essential standards. Action plans have now been drawn up to make the necessary improvements.

Overall there was lots of very positive feedback as we expected there would be, and that’s a great credit to all of our staff for providing such high quality services for local people. One of the inspectors commented: “Across the Trust’s services, staff demonstrated excellent commitment to providing the best care they could and putting the patient at the centre of their care.” We know this inspection was a really thorough examination of our services and how we provide them and it has been a very positive experience for us all. The feedback didn’t provide us with any surprises, but it did confirm what we already know and that we have some of the best staff in the NHS and we should be especially proud of the work we do.

The inspection reports are now available via our website: www.dchs.nhs.uk.

Annual Report 2013/1424 Our Values...To value everyone’s contribution ‘everyone matters’

Promoting equality, diversity and inclusion across everything we doThis year we have continued to work hard to make equality, diversity and inclusion part of daily routine and the foundation of everything we do.

We have maintained our focus on developing our staff’s understanding and awareness of equality, diversity, inclusion and Human Rights through a range of events and innovative training.

Our ‘Myriad Voices’ staff network group for lesbian, gay, bisexual and transgender employees and their straight allies, continues to develop and we have established groups for our black and ethnic minority employees and for our disabled employees. These groups are helping to make equality a reality, both for employees and our service users.

We have published detailed equalities-related information on our website that shows the progress we are making and how we are meeting our duties under the Equality Act 2010: http://www.dchs.nhs.uk/dchs_equality_diversity

Our commitment to improving quality - responding to the Francis Report Over a year since its publication, the findings in the Francis Report continue to touch us all in the NHS and beyond. The report was published following the inquiry into the failings at Mid-Staffordshire Hospital and made a total of 290 recommendations that the entire health system must continue to learn from. Over the past year Derbyshire’s health organisations have been working side-by-side sharing a collective commitment to providing safe, high quality care for our patients. Locally we discussed the recommendations at length with our staff, and together we grouped our local position into the following areas for development:

• Communication and listening with patients, relatives, carers and staff

• Developing more ‘time to care’ for frontline staff by addressing issues such as record keeping, duplication of effort, appropriate staffing and supportive IT systems

• Reducing bureaucracy and unnecessary processes

• Making an open and transparent culture a reality by: making it easy to raise concerns about quality of care; removing any form of ‘blame culture’; and overhauling our whistleblowing process

• Strengthening clinical leadership at all levels and increasing clinical supervision.

The single overwhelming commitment that came through in all the conversations we’ve had to date was a collective one – a commitment to further improving the high quality care we provide at DCHS.

Good equalities practice is essential to attracting, recruiting and retaining the very best people and in providing high quality and accessible services that meet every patient’s individual needs.

“”

We remain committed to creating a positive and equitable working environment where people feel supported and valued for who they are, and to delivering health services that are inclusive, accessible and focused on quality outcomes for all.

“

”

Annual Report 2013/14 25Our Values...To get the basics right

Communication• In addition to the Friends and Family Test, we’re now

routinely making calls to inpatients following their discharge to speak with them about their experience of using our services. This practice is also being rolled out to community teams.

• We have finalised our Patient Experience and Involvement Strategy which also contains eight ‘ambitions for great patient care’ (see page 27 for more details).

• We have launched a programme of quarterly ‘Pulse Checks’ across the organisation (see page 35 for more details).

• We have refreshed the priorities of our Frontline Care Council.

• Staff engagement has been further enhanced by launching our ‘Staff Forum’ (see page 35 for more details).

Time to Care• Following the significant investment in community hospital

staffing known as ‘Staffing for Quality’, we have established a Staffing for Quality Group, chaired by Carolyn White, Director of Quality/Chief Nurse. The group is looking at national guidance and our local staffing levels across all areas including: inpatient rehabilitation; community nursing; mental health/learning disability facilities; health visiting and healthcare support. We report progress quarterly to the Trust Board.

Reducing bureaucracy• Working closely with relevant teams, we have reviewed

and implemented new inpatient clinical documentation, reducing duplication of effort and any unnecessary bureaucracy.

• Elements of patients’ records now follow the patient out of hospital and into the community setting, streamlining care and removing inefficiencies.

• We have received funding to replace the current Patient Administration System to improve our patient records.

Openness and transparency• We have relaunched our raising concerns campaign

reminding staff how to raise any concerns they may have confidently, confidentially, and in the best interests of high quality patient care.

• We have signed up to the Nursing Times’ Speak Out Safely Campaign which reinforces the fact that we encourage any staff member who has a genuine patient safety concern to raise this within our organisation at the earliest opportunity.

• Our ‘Being Open Policy’ has also been reviewed and updated to ensure we’re doing everything we can to operate as an open, transparent NHS provider. It provides guidance to staff on how to communicate openly and honestly when patients and/or service users are involved in incidents across DCHS.

Clinical leadership• We have refreshed our ‘clinical supervision – reflection on

clinical practice’ policy and have committed to ensuring that all DCHS clinicians receive a minimum of three clinical supervision sessions each year, preferably more.

• Central to enhancing clinical quality, all of our clinical leaders will now receive a new set of personal development priorities and competency frameworks.

• A new developmental programme for our non-registered staff called ‘Fundamentals in Care’ has also been developed and is being delivered across our teams (see page 36 for more details).

• This work is supported by a new ‘Clinical Forum’ for unregistered staff – plus a dedicated code of conduct.

Local service developments Our in-reach teams based at Royal Derby Hospital and Chesterfield Royal Hospital were expanded this year to provide more support to patients to help them leave hospital sooner. The aim is to ensure patients are not spending longer in acute hospital beds than necessary and that they get care in the right place, at the right time, potentially closer to home.

The teams consist of senior, experienced nurses and therapists who identify patients that could have their needs met in one of our community hospital beds, or at home with support from community services. They also work closely with the Medical Assessment Unit at Derby and the Emergency Medical Unit at Chesterfield to ensure patients are not admitted to acute beds in the first place if a more suitable alternative is available, such as a stay on one of our temporary winter wards. These were opened at Bolsover and Babington Hospitals until the end of March to help cope with the expected additional pressure over the winter period.

Advanced nurse practitioners supporting GP hospital admissionsSupport is being provided for GP admissions to community hospitals in the High Peak, Dales and Southern Derbyshire Dales by our advanced nurse practitioners (ANPs).A five-strong team of ANPs provide expertise in admitting patients into community hospitals and support transfers from acute hospitals. The ANPs can also prescribe, order blood tests, x-rays and any other tests which are necessary to assess patients on admission.

This model of care is already working well at Ripley, Babington (Belper), Walton (Chesterfield) and Ilkeston Community Hospitals.

Local developments so far…Below we’ve summarised some of the work that’s happening (or has already happened) following – and thanks to – the local discussions that have taken place.

Annual Report 2013/1426 Our Values...To act with compassion and respect

Welcoming feedbackComplimentsFrom April to October 2013/14 we received a total of 9,701 compliments. Two compliments each week are shared with all staff by email. We stopped collecting compliments from October; for 2014/15 we will have a new way of gathering the full range of patient feedback including compliments and this will be across all our services.

Patient stories Every month both our Board and Quality Service Committee start with a story about a patient using one of our services. It’s a timely reminder to ensure that the business of the meetings is focused around the patient, keeping them at the heart of everything we do. The stories identify strengths of our services and positive patient outcomes as well as highlighting where we need to improve.

The Friends and Family Test From 1 April 2013, we adopted the national Friends and Family Test (FFT) for collecting feedback from patients who use our services. On discharge from our care, patients are asked to complete a simple comment card that asks them to rate (on a scale of 1 to 6) ‘how likely are you to recommend our services to friends and family if they needed similar care or treatment?’

The numerical score for all people completing the test is converted onto a scale from ‘minus 100’ to ‘plus 100’. Scores are reported back to services and to our Board each month in order for us to monitor trends proactively.

Our FFT scores are consistently high with an overall average of 90 for 2013/14, comparing very favourably with other similar NHS Trusts. People completing the comment card are also asked to tell us the reasons for the score they selected, and are asked ‘what could we do better?’ Feedback given on the cards is reported back to services and is reviewed every month by the Patient Experience and Engagement Group. This ensures that we learn from feedback we receive and make improvements as a result.

As well as the Friends and Family Test and learning from complaints, we are actively developing new ways to hear from people who have experience of using our services. We are working with Patient Opinion, an independent feedback platform likened to Trip Advisor for health services, so that patients and their relatives can provide feedback anonymously via a website, and for us to respond online. All feedback and responses are visible to members of the public.

Patients and their families can also provide feedback via our own website, www.dchs.nhs.uk and we continue to develop new ways to help people using our services tell us about their experiences.

Acting on feedbackWe welcome and encourage all feedback, good and bad. We view feedback as valuable information which can help us to improve the experiences of people who use our services. Every complaint or concern is handled by the Patient Experience Team in accordance with local authority social services and NHS Complaints (England) Regulations (2009). The team supports complainants through the process, in line with principles of good practice published by the Parliamentary and Health Service Ombudsman and endorsed by the Local Government Ombudsman.

During 2013/14 we received and responded to 627 enquiries, concerns and complaints compared with 616 in 2012/13. These figures have not been adjusted for any change in our service or activity.

192 complaints required an investigation under the NHS Complaints process. Of these, one accessed the second stage of the complaints process through the Parliamentary and Health Services Ombudsman. This case has been closed and was not upheld. We also received two Ombudsman decisions during 2013/14 from previous years. One was not upheld and one was upheld. We have no cases with the Ombudsman’s office as at 31 March 2014.

Complaints received are categorised. The most common categories of complaint during the year were:

• All aspects of clinical care – 101

• Communication – 25

• Appointments – 23.

Community teams benefiting from the ‘JONAH’ systemThe JONAH system enables staff to plan patient care proactively so that any delays in treatment are avoided for the most efficient and positive patient experience.

This year JONAH was expanded among our community therapy teams for patients being cared for at home, in our day hospitals at Babington and Walton, by the rapid response team at Chesterfield and the community matrons in Chesterfield.

It has helped to reduce waiting times significantly and has enabled clinicians to manage increasing demand. Some early successes by February 2014:

• High Peak – waits for non-urgent appointments reduced to four weeks

• Derbyshire Dales – waits reduced by 40%

• South Derbyshire – waits reduced by 60% within three months

• Amber Valley – an initial reduction of nearly 40% in waits

• Erewash – very low waiting lists.

Annual Report 2013/14 27Our Values...To make a difference

Keeping our vulnerable patients safeThis year the Safeguarding Children & Adults Service has continued to provide specialist advice, training and supervision for all frontline staff on safeguarding.

The key safeguarding children developments this year include:

• The delivery of safeguarding training to over 1,100 staff

• The delivery of supervision to more than 220 health visitors, school nurses, minor injury unit staff and others every four to six months

• Maintenance of a daily advice service for staff, Monday to Friday, 9am to 5pm

• Increased joint working with partner agencies in order to support and protect people who are vulnerable as a result of living in environments where there is domestic violence, substance misuse or neglect

• An audit of child health records to ensure robust information governance is in place.

Patient Experience and Involvement During 2013/14 we have developed a ‘Patient Experience and Involvement Strategy’ which describes how we want to improve the experience of people using our services and how we will develop their active involvement in making decisions about how we are led. The purpose of the strategy is to ensure that:

• The quality of patient experience is at the heart of everything we do

• Our Board is fully aware of any risks around patient experience and receives regular and timely assurance in relation to patient experience

• We provide a range of opportunities for people to be involved in our governance

• We make quality improvements by listening, sharing and acting on feedback

• We engage people in our local communities and ensure that all of our communications are open and honest.

You can find the strategy on our website at: www.dchs.nhs.uk

Underpinning everything we do are our eight ambitions for ‘great patient care’. We worked very closely with patients and staff to develop eight powerful statements which are also known as ‘always events’. These are the basis of our recently published Patient Experience and Involvement Strategy and will be launched widely across DCHS.

1During your time with us you will feel welcomed and valued. You will feel that your care meets your individual needs

2You will have the opportunity to discuss with us what is going to happen at every stage of your care

3You will understand the choices that you can make about your care. You will be supported to make the best choices for you

4You will have all the support you need to feel comfortable and safe

5You will know who is providing your care and what to expect. You will have clear information about how and when they can be contacted

6You will feel confident that you are being looked after by well trained staff who have the time to care

7You will feel able to choose how much we involve your family, friends and carers

8You will feel able to tell us how we could improve

Eight steps to a great patient experience

Annual Report 2013/1428 Our Values...To value and develop teamwork

Dignity in CareWe are part of Derbyshire County Council’s scheme to promote dignity and respect in the services we provide. Since 2011 a total of 56 services have achieved an award. three silver and 39 bronze standard awards were made to our services during 2013/14. All remaining services are working towards achieving a minimum of a bronze award.

Commissioning for Quality & InnovationIn the past year, we agreed ten Commissioning for Quality & Innovation (CQUIN) targets through which we demonstrated a continuous commitment to improving quality.

These targets ensure we support ongoing innovation and improvement across all of our services and in defined areas of clinical care. These ten CQUINs were broken down into four national and six local improvement areas.

The six local targets were:• Dignity in Care: This was a new initiative which challenged

us to demonstrate how we deliver compassion at the heart of the care we provide to all our patients, through achievement of the ‘Dignity in Care’ bronze and silver awards by services across the Trust. This CQUIN also asked us to provide evidence of how we have met the recommendations of the Francis Report

• Breastfeeding: Our health visiting services were asked to demonstrate a programme of training and orientation to support mothers in receiving good information about the benefits of breastfeeding

• Nutrition: Following the work undertaken in 2012/13, we have continued to embed and monitor the use of our nutritional assessment tool across our inpatient and community nursing and therapy services. We delivered a tailored nutritional training programme for our community staff which has supported our frail elderly patients in maintaining good nutrition and long term health

The four national areas were:• Friends and Family Test (FFT): phased expansion,

increased response rate and staff survey performance

• NHS Safety Thermometer (an NHS improvement tool for measuring, monitoring and analysing patient harms and ‘harm free’ care): data collection and continued implementation

• Dementia leadership and supporting carers of patients with dementia

• Venous Thromboembolism (a blood clot that develops within a vein): assessment of risk and root cause analysis of incidents.

• Pressure ulcers: Our commissioners challenged us to reduce further our prevalence of pressure ulcers throughout the year, using the data collected through the Safety Thermometer tool

• Discharge planning and patient flow: The focus of this target was to work with our acute provider colleagues to improve the quality of patient transfers and medical and nursing information coming across into our inpatient wards. A joint working approach was implemented to share best practice and highlight areas requiring improvement

• ‘Making Every Contact Count’: This was a continuation of the initiative to support patients in addressing lifestyle choices that are impacting on their personal health by signposting them to specialist services such as smoking cessation, weight management programmes and substance misuse groups. A training programme for all frontline staff was delivered and an evaluation of last year’s work with our planned care services also formed part of the target.

Annual Report 2013/14 29Our Values...To value everyone’s contribution ‘everyone matters’

In support of the wider quality and improvement agenda, quality leads across all services have continued to work together to maintain a close focus on work required to embed improvements and support change.

Our commissioners were happy that we have demonstrated an ongoing commitment to improving quality across our community services through delivery of the targets. Outcomes have included:

• Improved feedback from our patients through the FFT initiative

• Increased awareness of good nutritional planning across our community services

• Strengthened partnerships with our acute colleagues and as a result, a more seamless transfer of care for patients moving across care pathways

• Positive feedback from carers of people with dementia who were offered support and information on our older people’s mental health wards.

Zero tolerance to healthcare-associated infectionsWe have not had any MRSA blood stream or avoidable clostridium difficile infections for the reporting period for the second year running. By ‘avoidable’ we mean that we have not caused the infection. We can also report that our incidence of unavoidable clostridium difficile has been reduced even further from 12 cases last year to eight in 2013/14.

Hospital cleanlinessWe undertake audits of the cleanliness of our hospitals throughout the year and we are currently scoring 96.5% compliance. Peer reviews have taken place this year which have enabled clinical teams to challenge each other and ensure that the Infection Prevention & Control (IP&C) standards are embedded within services.

This year the national Patient Environment Action Team (PEAT) audits of the hospital environment were replaced with Patient-Led Audits of the Care Environment (PLACE). We were chosen as a pilot organisation to trial these audits and share our experience nationally. Local members of the public make up 50% of the audit team and provide a true ‘patient’s view’ of the environment. These audit scores will be made available later in 2014.

Hand hygiene and champion programmeOur staff continue to demonstrate excellent hand hygiene practices and are currently achieving 99.33% compliance against our hand washing procedure across clinical areas.

Our infection prevention and control champion and tissue viability advocate programmes continue to have a positive impact on the quality of patient care. The close working of the two services has been further strengthened by the appointment of three new integrated staff members whose focus will be ensuring infection prevention and control and tissue viability standards are met across our sites.

Pressure ulcers (tissue viability) The development of pressure damage has a profound and negative effect on all aspects of a person’s life and is very distressing for them, their families and their carers. We have been working very hard to reduce the number of pressure ulcers that develop in our care.

Our clinical teams complete an investigation on every pressure ulcer that develops or deteriorates within our care, supported by our specialist tissue viability team. Our community hospital teams have introduced a ‘bed head’ review for every patient that has pressure damage so that all aspects of their care are reviewed in a timely manner and the patient can be included in the discussions.

This has had a very positive impact so a similar approach is to be used within the community setting. Staff involved in the care of patients within their own home or care homes will meet within 24 hours of the damage occurring and ensure that all measures are in place, such as equipment. The community teams will also ensure that carers and patients are aware of what they can do to help prevent pressure damage.

We have reduced the number of avoidable pressure ulcers by 37.5% and the majority of these now occur within the community setting. It is anticipated that the changes above will help to reduce the incidence further during 2014/15.

Over half of the pressure ulcers that we see have occurred before the patients come into our care. We are working with the wider healthcare community, including social care, to see how we can support carers and care home staff to protect those they care for from experiencing pressure damage. This will continue to be a key area of work during 2014/15.


Data securityWe continue to treat all aspects of information governance extremely seriously. All staff are regularly trained and encouraged to report all incidents and near misses to ensure we can investigate the reasons and take measures to prevent it from happening again. Such incidents might include the loss of person-identifiable data; any breach of confidentiality; the insecure disposal of information and any other incidents where staff or patient information may have been at risk. There were six Serious Incidents Requiring Investigation (SIRI) involving personal data that required reporting to the Information Commissioner in 2013/14. The table below shows a summary of SIRI personal data-related incidents in 2013/14 and separates them by the nature of the incident. Four of the six incidents shown are linked and are being investigated together.

Further information regarding the incidents below is available in the Trust’s Annual Governance Statement, included in this Annual Report.

Total

SUMMARY OF PERSONAL DATA RELATED INCIDENTS IN 2013/14

Category Nature of Incident

A Corruption or inability to recover electronic data 0

B Disclosed in error 0

C Lost in transit 0

D Lost or stolen hardware 0

E Lost or stolen paperwork 4

F Non-secure disposal - hardware 0

G Non-secure disposal - paperwork 1

H Uploaded to website in error 0

I Technical security failing (including hacking) 0

J Unauthorised access/disclosure 0

K Other 1


Emergency Preparedness, Resilience and Response (EPRR)In line with the Civil Contingencies Act 2004 and NHS England’s national programme for Emergency Preparedness, Resilience and Response (EPRR), we are actively engaged in developing and reviewing plans which ensure our ability to respond to incidents, both internally and out in the communities which we serve. As part of this process plans go to the Quality Business Committee, a sub-group of our Board, for review and approval (see page 49 for more information on this committee).

We have a named Accountable Emergency Officer (Director of Operations) who is a member of the Local Health Resilience Partnership (LHRP). The LHRP provides a strategic forum for joint planning across the local health community and supports the local health community’s contribution to wider multi-agency planning.

As part of the continual development cycle for our contingency plans during the last year we participated in a number of training events. This included an urgent care network simulation event to test winter plans (September), and a regional mass casualties exercise put on by NHS England to test arrangements across organisations (November).

We also facilitated our own exercises, including an incident response exercise at Ilkeston Community Hospital to test the local response to an incident at the site (October), and to help promote local partnership working. This particular event was attended by Derbyshire Police and Derbyshire Fire & Rescue Services.

In the last year we have strengthened our relationships with partner agencies, cementing links and progressing multi-agency planning. We have provided mutual aid for partners and supported the local community on several occasions, including the provision of refreshments and equipment to members of the public who were evacuated from their homes following a bomb scare in the Clay Cross area (June), and later in the year we supported Public Health England’s response to a meningitis outbreak in the community. This involved setting up a clinic to provide chemoprophylaxis for those who were in close contact with the meningitis cases (December).

The year has not been without its operational challenges, with an unfortunate run of business continuity disruptions, including: significant water leaks at Ilkeston Health Centre (June), Repton Health Centre (June), and Market Harborough Hospital X-Ray Department (November); and small fires at St Luke’s Hospital Endoscopy Unit (July), and Walton Hospital kitchen (August). During each of these incidents contingency arrangements were put in place and the affected services were either speedily recovered or redirected to alternative facilities until the affected areas and equipment were recovered and declared safe to operate.

We operate a two-tier on-call system (operational and strategic) which is available 24-hours per day, seven days a week, 365 days per year.

The on-call team picks up a range of operational issues but is also there in the event of a major incident.

Planning for emergencies


Patient story -Bryan Metcalf

Sustainable development 2014-2020During January 2014 the NHS Sustainable Development Unit (NHS SDU) launched a new sustainable development strategy to cover the period from 2014 to 2020. This strategy intends to move the focus away from concentration on carbon reduction targets and move it towards a much wider-ranging selection of goals. Every NHS organisation is expected to have its own sustainable development strategy and plan to cover the same period. The areas covered by this new strategy are:

• Adaptation

• Buildings

• Community engagement

• Facilities management

• Models of care

• Procurement

• Travel

• Workforce.

The intention is for organisations and services to look at the wider impacts of, for example, climate change, an ageing population, changing behaviours and expectations of people, availability of suitably qualified staff and changes in technology.

A new ‘toolkit’ provides a series of benchmarking questions, covering each of these areas. We have carried out an initial assessment and have used this as a new baseline for our own Sustainable Development Management Plan (SDMP).

Carbon reduction target 2020

In the past five years we have achieved 25% reductions through improving, managing and reducing carbon emissions from energy, waste, water and travel - saving £578,000 in the process. Although there is still potential to improve efficiencies these improvements and efficiencies are not infinite and further large reductions may be difficult to achieve. This is why our target for the next six years is more modest in aiming for a further 10% reduction against our 2008/09 baseline.

Instead, during the next six years we will increasingly turn our attention to the area of carbon emissions from procurement, such as local sourcing of goods. According to NHS data, approximately 60% of carbon emissions result from this area. During 2014/15 we will aim to identify a suitable process by which to measure a carbon emission baseline for procurement and then we will look to set a 2020 target for a reduction in these emissions.

Over the next five years we expect to reduce our energy, water and waste carbon emissions by 35% compared with baseline year 2008/09, which equates to a saving of approximately £2million. The NHS target is 34% from 1990, but as we do not have reliable data going as far back as 1990 we have to use 2008/09 figures.

Eighty one-year-old heart failure patient Bryan Metcalf, from Holymoorside, had been admitted to hospital four times until he was referred to our specialist heart failure nurses in May 2013.

“I was so breathless at one time that I could do very little but now – although I still get tired – I can turn my hands to all sorts of jobs including gardening and DIY around the house. My wife, Dulcie, is delighted by the progress I’ve made.”

Former motor engineer Bryan is one of a growing number of patients with heart failure who are enjoying a better quality of life with the help of our heart failure nurses, who are successfully reducing hospital admissions and length of stay for patients.

Patients are seen at home or in clinics, up to twice a week, to manage their drug therapy and to be offered psychological support. The team also works in hospital, helping to get patients back home.

“One of our main tasks is to treat symptoms quickly so that acute problems don’t develop and hospital admission isn’t needed,” explained one of the team.

I felt I was on a downward path until I started to be seen by my heart failure nurse who has refined my treatment and is fine tuning my drugs.

“”


Twenty-three-year-old Cathy Booth from Matlock Bath has her sights set on competing in the 2016 Paralympic games in Rio.

Inspired by the London Paralympic Games, Cathy progressed in just 11 months from attending a cerebral palsy sport taster day to competing in national championships and winning two silver medals in discus and javelin.

Last October she was named Derbyshire Dales Disabled Sportsperson of the Year and she is also F37 England Athletics Javelin number one.

So when she developed pain in her unaffected leg there was a lot more at stake than simply mobility.

Her GP referred her to the specialist biomechanics team at Newholme Hospital, where she received expert help from a physiotherapist and podiatrist to work out what was causing the pain and how to resolve it.

Cathy’s mum Anne, herself a community staff nurse at Clifton Road Surgery, Ashbourne, was moved to put her thanks in writing for the support given to Cathy, who has faced many battles for physical health following her premature birth weighing just 1lb 12ozs.

The biomechanics team sees people with a whole range of painful lower limb conditions for specialist assessment, exercises and orthotics tailored to their individual needs.After a full assessment, business studies student Cathy was given some exercises to help overcome the movements which were causing pain - and put her Paralympian ambitions back on track.

Anne added: “It was a set-back for Cathy over the winter but now she is back to training and the boost to her confidence from discovering sport has been immense.

“Since seeing Fiona at biomechanics Cathy has had a great season, increasing her personal best by 2.3 meters.”

Patient story -Cathy Booth

The biomechanics service was wonderful. Cathy was getting awful pain in her leg and we couldn’t understand it. The team she saw was pleasant, prompt and professional. Fiona the physio seemed to have healing hands.

“

”

Anne said:


Quality People


Staff partnershipWe aspire to be a great place to work and an employer of choice. One way to support this is by staff and representatives of trade unions or professional bodies working together at all levels of the organisation.

Within our structure of accredited representatives we have a head of staff partnership who works in an organisation-wide role, and staff partnership leads supported by staff side representatives. Together, the partnership supports the organisation to:

• Enhance and maintain its excellent employee relations

• Improve the working life of employees

• Influence the culture of the organisation so that employees always feel valued and involved.

Staff ownership, engagement and involvement We have made significant progress in increasing employee engagement, recognised nationally for the second time in the Chartered Institute of Personnel and Development Awards for excellence in this area.

Pulse CheckOur new ‘Pulse Check’ survey was launched in July 2013 and provides an indicator throughout the year as to how our staff are feeling. The pulse checks are run on a quarterly basis and allow us to keep track of the engagement levels within teams and provide information to take swift action where results require it. It is also a helpful indicator for our leaders to understand how well they are engaging with their teams to deliver the results we need.

Staff ForumOur Staff Forum was developed to ensure all of our staff have a voice, feel able to make a positive difference, and ultimately, help us to realise a major part of our vision - making DCHS a great place to work.

The Forum meets every other month and includes a total of 33 representatives from our staff partnership/staff side, staff governors and the Frontline Care Council, all of whom work closely with the executive team to make our Trust a better place to work.

Forum members actively encourage all staff to put forward topics for discussion before getting together in the weeks prior to each meeting to consider and agree the final agenda.

Our workforce profileGender Headcount

Female 3847

Male 529

Grand Total 4376

Staff Group Headcount

Administration and estates 1005

Allied health professionals 426

Healthcare assistants and other support staff 1310

Medical and dental 106

Nursing, midwifery and health visiting staff 1128

Scientific, therapeutic and technical staff 322

Grand Total 4376

Ethnic Origin Headcount

BME 144

White 4108

Not Stated 124

Grand Total 4376

Age Band Headcount

Below 25 years 159

26-35 630

36-45 1109

46-55 1617

56-60 568

61-65 231

65+ 62

Grand Total 4376


Learning and development We are committed to developing our workforce through their career progression, providing them with the skills they need to have a direct, positive impact on patient care and patient experience.

We will continue to build our capacity and capability to support the delivery of safe, efficient, responsive and well-led approaches to service delivery.

We continue to offer a wide range of staff training by providing learning in-house and externally, both to meet our mandatory requirements and to provide continuing professional development in line with service needs. We have also invested in a new development centre which provides classroom environments, an IT suite and two high-tech nursing suites which enable staff to practice their nursing and resuscitation skills on fully-computerised talking dummies.

Improving skills for allWe are actively committed to encouraging and supporting staff in bands 1-4 to gain the skills and knowledge required to prepare them to work even more effectively.

More than 300 members of staff have accessed training programmes in areas such as engineering/maintenance, administration and clinical skills/healthcare, including over 60 healthcare support staff who have enrolled on programmes

to undertake either the Diploma in Health/Health and Social Care, or the Foundation Degree offered by the University of Derby. Four members of staff have also completed clinical apprenticeship programmes.

We have also been working on the development of our non-registered clinical support staff as a priority. We have developed a ‘Code of Conduct’ booklet and learning portfolios to support clinical practice and are working on a ‘Fundamentals in Care’ programme, which all new clinically-facing support staff will complete before starting work in a clinical area.

Core essential learning and staff inductionFrom April 2013 we narrowly missed our target of 95% of staff attending the Essential Learning Day, achieving 94.2%. In addition, 97% of new starters completed our corporate induction programme.

Alternative methods of completing mandatory training have also been made available, such as workbooks and e-learning programmes, making training even more flexible, accessible and helping to increase completion rates.

Leadership developmentLeadership is critical to creating a quality-driven, ambitious, engaging culture across our organisation; key traits to succeed in these challenging times. This starts first and foremost with our Board which has in place a challenging development programme to ensure it is high performing and can lead the organisation to Foundation Trust status and beyond. Our senior leaders have access to regional and national development programmes provided by the East Midlands Leadership Academy. We have also developed a range of in-house people management courses to support managers and leaders in key areas such as having ‘courageous conversations’, managing sub-par performance and leading teams and people through periods of change.

AppraisalsThis year we continued to embed our leadership appraisal and launched our revised employee appraisal, which aligns to the NHS Leadership Framework, underpinned by the DCHS Way and individual key performance indicators.

A scoring system has been introduced to the appraisal to allow leaders to understand clearly where their staff are performing and where they need to develop over the next 12 months. All staff have been supported by an in-depth training session to ensure both appraiser and appraisee are able to develop and receive an effective, meaningful appraisal.


Clinical essential learning This training addresses current key issues in healthcare provision for all patient-facing professionals. The programme, which has been delivered to over 900 healthcare professionals in 2013/14, looks at individuals’ responsibilities and accountabilities for keeping patients safe, and expands on the key issues of ‘harm-free care’, a patient safety improvement initiative developed by the NHS.

Continuing professional development Delivering high quality and appropriate services to the population we serve is of paramount importance and we have an ongoing commitment to improve the quality of care for our service users and partners. We are ready to ‘deliver for today and inspire for tomorrow’, supporting the principle of lifelong learning.

Using a range of opportunities available to us, we develop our workforce by ensuring all staff are given the support to attend programmes that will provide them with development opportunities; to equip them with qualities and skills to enhance their roles, thus supporting the delivery of high quality, efficient and effective services.

In addition to over 20,000 places provided on in-house clinical and non-clinical training sessions, our staff have accessed over 200 learning events funded by Health Education East Midlands. We have also funded over 100 additional external learning opportunities for our staff.

Practice learning We continue to support students to access practice placements while undertaking a variety of pre and post-registration clinical courses. This includes delivery of training and support for mentors in clinical areas.

To comply with organisational and professional requirements of the Nursing and Midwifery Council, 95% of our nurse mentors successfully completed their triennial review, a formal review required every three years. This ensures that our current mentors are up to date and competent to support the development of our future workforce.

Work is also being undertaken to help students to access a wider range of practice learning opportunities including working with universities and other healthcare organisations. Placements are based on entire care pathways and ‘the patient journey’, rather than being restricted to a single organisation.

Reflection on practice (clinical supervision) Clinical supervision, sometimes known as ‘reflective practice’ or ‘reflection on practice’, is dedicated time for in-depth and supported reflection on our own clinical practice. The CQC’s assessors have previously recommended we refresh our local approach to clinical supervision; this is to ensure we are able to offer our clinicians focused support and development of their skills outside of their day-to-day clinical duties.

We have recently refreshed our ‘clinical supervision – reflection on clinical practice’ policy and have committed to ensuring that all our clinicians receive a minimum of three clinical supervision sessions each year, preferably more.

Such practice is supported on a national scale by professional bodies, including the Nursing and Midwifery Council (NMC) which says it is “an important part of maintaining and improving standards of patient and client care”. Locally we know it will play a key part in maintaining and improving quality of care – central to our vision and values.

A training session is now delivered in one day to facilitate release of staff to attend and we also intend to develop a DVD as a supporting resource.


Sickness absence We take the health and wellbeing of our employees very seriously and have reviewed our Attendance Matters Policy which we launched last year and the supporting guidance booklets for both staff and leaders.

The policy ensures that all employees have a return to work interview when they return after any period of absence, and wellbeing meetings when they reach a certain level of absence to ensure they are receiving the help and support they need. Managers continue to input absence directly to our Electronic Staff Register (ESR) system with supporting guidance documents and workshops. This enables them to access and analyse real-time information so that any issues can be picked up and dealt with quickly.

Sickness absence continues to be less than last year but is still higher than we would like and we are continually looking at ways we can improve attendance including the introduction of a case management approach; a review to ensure leave and flexible leave are recorded correctly; and a related promotional plan has been delivered internally. We continue to work to understand and resolve any absence-related issues and are committed to reducing the level of absence to 3% over the coming year.

Preceptorship: nurse training schemeWe offer a preceptorship programme to newly-qualified nurses and other allied healthcare professionals (AHPs) such as physiotherapists, in which staff are supported in their area of practice by an experienced preceptor. Preceptees and preceptors can access information and learning resources via a dedicated preceptorship database. The preceptorship period normally lasts for approximately six months, but can be extended if required.

To date, 26 newly-qualified nurses and 29 allied healthcare professionals have undertaken the programme in 2013/14, and have offered very positive feedback about the support it provides. Preceptorship is also offered to staff registered as part of our flexible workforce.

Sickness Absence 2011/12



April 4.02% 4.22% 4.01%

May 3.46% 3.91% 3.59%

June 3.72% 3.66% 3.67%

July 3.43% 4.21% 3.86%

August 3.49% 4.31% 3.40%

September 3.76% 3.80% 4.24%

October 4.38% 4.68% 4.25%

November 4.69% 4.69% 4.40%

December 5.39% 4.80% 4.40%

January 5.19% 5.29% 4.17%

February 4.99% 4.49% 4.21%

March 4.90% 4.32% 4.21%


NHS Staff Survey- how we fared

The annual NHS Staff Survey provides detailed information on the views and experiences of all staff who work in the NHS as a whole. 2,499 of our staff completed the 2013 survey - this represents a response rate of 64.2%, our highest response rate to date. Here are some highlights:

of staff said they would recommend the organisation as a place to work, compared with just 54% nationally

62%

of staff felt that the organisation acts on concerns raised by patients/ service users, compared with 71% nationally

80%of staff agreed that the care of patients/ service users is the organisation’s top priority, compared with an average of 64% for community trusts across the country.

73%

The five key findings where we compare most favourably with other community trusts in England are:

The five key findings where we compare least favourably with other community trusts in England are:

• Percentage of staff feeling satisfied with the quality of work and patient care they are able to deliver

• Percentage of staff saying hand washing materials are always available

• Work pressure felt by staff • Percentage of staff experiencing

harassment, bullying or abuse from staff in the last 12 months

• Staff recommendation of the Trust as a place to work or receive treatment

• Percentage of staff able to contribute towards improvements at work

• Percentage of staff experiencing physical violence from staff in the last 12 months

• Percentage of staff experiencing physical violence from patients, relatives or the public in the last 12 months.

• Effective team working• Support from

immediate managers


Retired solicitor Gerry Slater, aged 79, fell in the street after suffering a black-out while shopping near his home in Bakewell in late October.

Passers-by rushed to his aid and were ready to call an ambulance but he persuaded them it was not necessary.

A short time later his wife took him to Whitworth Hospital Minor Injury Unit where a wound to his head was dressed and he was referred to Chesterfield Royal Hospital’s A & E because his fall had been triggered by a black-out. Initial tests could find nothing wrong to cause him to lose consciousness and he was sent home with advice to see his GP.

A few days later Gerry returned to Whitworth’s Minor Injury Unit to have his head wound dressed and he was told about the Falls Assessment Clinic at Newholme Hospital which it was felt he would benefit from attending.

In mid-November he was called for an appointment by the falls team. His thorough assessment looked into his physical and medical wellbeing to help explain his fall and minimise the risk of a further fall.

It involved an hour with physiotherapist Helen and a further three-quarters-of-an-hour with specialist nurse Sally who felt he might need referral to a cardiologist via his GP.Unfortunately, before his cardiology referral arrived, he blacked out again and fell heavily, breaking his right leg, just before Christmas.

An operation followed to insert a metal plate into his leg and when he was well enough to come home, our community team was ready to provide support to aid his recovery.

An occupational therapist visited his home, ready for his return, to ensure he could cope while his mobility was reduced and sorted out aids such as grab-rails, a zimmer-frame and wheelchair. He has also received regular visits from a physiotherapist, with exercises to help get him back on his feet.

When we spoke to Gerry earlier this year he had “conquered the crutches at long last” and was looking forward to being able to go upstairs again to bed.

Patient story -Gerry Slater

I could not have received better treatment anywhere. They did their job absolutely brilliantly and really cared about what they did. I am most grateful to them both,

“”Gerry wrote to us later.

End of life care We have nearly 60 end-of-life care champions working in our hospitals and community settings.

High quality end of life care is a crucial test of how well we look after patients and their families, not just in the final days of a patient’s life but at any time after a diagnosis of a terminal illness.

Good communication, effective symptom management and personalised, coordinated care are essential for all and a key areas of focus in end of life care.

The end of life care development team organised a champions’ forum for staff working in DCHS and its partnership organisations in November 2013, with guest speakers and workshops. A dedicated public-facing webpage provides access to the latest information and resources.

Four end-of-life facilitators, supported by Macmillan, have been in post with us since March 2013 to liaise with care homes, GPs and other partners in delivering the national and local agendas for end of life care among health and social care providers.


The family of 80-year-old Donald Walkden wrote movingly of the care he received from staff at Oker Ward, Whitworth Hospital during his final days.

His wife Beryl, from Matlock, said: “We cannot thank the staff enough for the outstanding treatment they provided and appreciate everything they did tremendously. Working way above and beyond the call of duty. We will always remember them - and those difficult days - with real gratitude.”

Patient story -Donald Walkden

The Walkden family successfully nominated Oker Ward staff for a DCHS outstanding care and compassion award 2013 for being sensitive, unassuming and hugely professional at a difficult time for the family.

Nina said: “Anna has been on the other end of the phone whenever I needed her. She has even done home visits at the drop of a hat when I was struggling. Her gentle support and encouragement gave me a boost when I was most concerned about Chloe’s weight gain.”

They made sure Dad was just as comfortable as he could be in the circumstances and welcomed us, his family, with enormous but discreet warmth,

“”wrote his daughter Rachel Thomson.

New mum Nina Taylor from Alfreton was bowled over by the support she received from health visitor Elaine and breastfeeding support worker Anna after the birth of her third child Chloe in October 2013. With their help she was able to overcome several difficulties to establish breastfeeding.

Patient story -Nina Taylor I truly feel that the advice and support

Elaine has given was personalised and tailored to my individual circumstances and has far exceeded what I was expecting.

“”

Nina told us:


Quality Business


Striving to become a Foundation TrustAs previously mentioned in this report, our application to become the country’s first specialist community NHS foundation trust was deferred by the independent regulator, Monitor, in August 2013.

We received very positive feedback on our overall application, being recognised as a “well led” and a “financially viable” organisation. However, as part of its programme of unannounced visits, the CQC highlighted a ‘moderate concern’ against defined quality standards that all trusts must adhere to.

We have made good progress against the CQC’s recommendations from the April 2013 reports and underwent the new Ofsted-style CQC inspection in February this year. We hope our progress in the highlighted areas will be reflected in their findings and final report. A positive final report from the CQC will certainly bring great benefit to our overall FT application.

We will all benefit from Foundation Trust (FT) statusWhy? Following the deferral of our FT application in August 2013, we have continued on our bid to gain FT status in 2014. We believe that being a FT will ensure we are better placed to deliver improved health outcomes for our patients. It will also:

• Give us greater financial freedom so we can be more innovative and improve the services we provide more quickly

• Enable us to form new partnerships with service providers to improve our patients’ experience of our services and rapidly develop improved services where they are required.

We launched our membership scheme in 2011 to allow local people to have more of a say in our future by becoming a member. Following a large recruitment push in the summer, we started this year with 11,723 public members. Over the last year, we have attracted a further 558 members taking our public membership figure to 12,281. Together with our staff members, we now have a total of 17,307 members.

This year we have proactively engaged our members in a number of ways:• All members were invited to take part in our Patient-Led

Assessments of the Care Environment (PLACE), to which we had a very positive response

• Members were asked to nominate staff in our new Extra Mile Awards category, the ‘Outstanding Care and Compassion Award’. This award was only open to public nominations

• They were invited to our Discovery Day and Annual General Meeting in September 2013

• We hosted educational sessions for more than 30 of our members on emergency life-saving skills and healthy living workshops in partnership with East Midlands Ambulance Service NHS Trust

• We invited members to our recruitment open days across the county as part of our ‘Caring Never Grows Old’ recruitment campaign

• We invited our members that are also carers to attend focus groups and comment on a new carers’ checklist we had developed

• We hosted our first annual survey to see how we’re doing; what services our members are interested in; and how members would like to get more involved in our services in future

• We held an open day in November for members to visit our Diagnostic and Treatment Centre at Ilkeston Community Hospital

• We shared two editions of ‘The Community’, our members’ newsletter

• We also issued regular email updates on a wide variety of health-related news and events.

This public accountability and remaining a part of the wider NHS family is very important to us. Our staff and patients recognise and understand the NHS as the local provider of healthcare and identify with the benefits of being part of the wider NHS.

Being a FT also allows us to increase our accountability to the local people that we provide services for.


Public % of Membership Base % of Area Index

Amber Valley, Erewash & South Derbyshire 3295 33.64 334077 32.36 104

Bolsover, Chesterfield & North East Derbyshire 2746 28.04 280525 27.18 103

City of Derby 2358 24.08 254184 24.62 98

Derbyshire Dales & High Peak 1395 14.24 163493 15.84 90

Total 9794 100.00 1032279 100.00

Maintaining a representative membershipThis year has focused on building a representative membership. Each constituency is assigned an index showing how representative it is when compared to its population size. An index of 100 is seen to be perfectly representative, but as the population is ever-changing, an index between 80 and 120 is nationally recognised as being acceptable.

Locally we have endeavoured to be more ambitious and maintain an index of between 90-110 for all of our constituencies. The table below demonstrates that we successfully have achieved this aim. We are also proud to have been acknowledged as having one of the most representative bodies of public members nationally in terms of index/numbers per constituency.

This year we have concentrated our efforts on recruiting in the Derbyshire Dales & High Peak constituency, bringing its index up from 84 up to 90.

We are committed to retaining a representative membership but the focus in the coming year will now firmly shift from membership recruitment to actively engaging with our existing members.

Sign up to be a memberWe want to give as many local people as possible the opportunity to work more closely with us in the future. Nearly 12,500 people have already signed up to our public membership scheme and we always welcome new recruits.

You can still sign up to be a member if you are interested in having your say. Membership is free and open to anyone over the age of 12 living in England who has an interest in the services that we provide. It is entirely up to you how much time you wish to give to being a member. It can be as simple as receiving the twice-yearly newsletter to reading about the latest developments within your local NHS; attending member information evenings on a variety of health topics; or as big as applying to become a Governor.

You can register as a member by visiting our website: www.dchs.nhs.uk/become-a-member

Alternatively you can find out more information by ringing our membership office on: 01773 599482 or emailing: [email protected]


Shadow Council of GovernorsIn March 2013, following elections, our first Shadow Council of Governors was formed. The Council plays a key role supporting us to achieve our objectives and being more accountable to the public for the services that we provide.

The council’s main duties are to:

• Hold our non-executive directors to account for the performance of our board of directors

• Represent members and the interests of the public regarding key issues and consult them on important matters

• Help shape our future strategy and the services we provide

• Regularly feedback information to our members

• Share concerns with our Board

• Carry out other statutory duties.

Total 30 Governors

Amber Valley, Erewash & South Derbyshire

Roz ColdicottPeter AshworthValerie Bacon

Ray AsherValerie BroomMichael Perry.

Bolsover, Chesterfield & NE

DerbyshireMaureen Strelley

Linda BarkerSandra Moody

Barry JexPauline Blunt.

Derbyshire Dales & High Peak

Paul KirtleyBrenda Greaves (Lead Governor)

Kathlyn ArthurAndrea Cooke.

City of Derby

Bernard Thorpe.

Rest of EnglandDiana Wood.

Nursing:Sally-ann Coope

Ruth FrancisDenise Sanderson.

Medical & Dental:

Amanda Smith.

Other Registered Professionals:

Sara NashEmma Meakin.

Healthcare Support Staff

Tabitha CrapperHazel Lowe.

Facilities and Estates:

Gavin Sykes.

Admin & Clerical and Managers:

Adam Short.

NHS Commissioners (North Derbyshire Clinical

Commissioning Group)Jackie Pendleton.

HealthwatchKaren Ritchie.

Derbyshire County CouncilVacant seat.

Public Governors

Staff Governors

Our PartnerGovernors

17 10 3

The breakdown diagram (below) shows the names of our Governors and their constituencies:

Since the elections we have supported the Governors to identify and support their development needs in understanding and holding to account a large NHS organisation. Following a formal induction programme, the Governors continue to be supported by an ongoing development programme. We also support them to ensure they are able to communicate with their constituency and to recruit additional members. We utilise their skills and experience of the Governors and ensure they are provided with appropriate information to make informed decisions.


Planning aheadAll NHS Trusts are expected to have a full, Board-approved, annual plan by the end of March each year. Our annual plan links to the forthcoming year of our longer term business plan and focuses on planned developments and risks for the year ahead. It reviews the performance against the previous year’s annual plan and brings together clear and joined-up detail on risks, activity, finance, workforce, quality and strategy. It is also aligned to the plans of commissioners and with regional and national priorities.

A new commissioning landscapeThis year was particularly significant as we entered a new commissioning era with the emergence of clinical commissioning groups (CCGs) and the demise of strategic health authorities and primary care trusts. Our work in forging relationships with Derbyshire’s four CCGs and our local authority commissioners continues, and we have played a strong role in helping them to formulate their plans for the future.

This work continues and we expect to see greater detail about their long term plans emerging in the spring and summer, with the potential for these to have a major impact on our services.

The Council meets formally on a quarterly basis and this is supplemented by Governor involvement in a range of other activities. Governor involvement is shaped around four key areas:

• Quality - patient-facing

• Quality - environment

• Membership

• People (staff) issues.

The Governors were all asked for their interest and preferences regarding involvement in these key areas. Council of Governor sub-groups will be organised to update the Council based around the four areas.

Further Governor involvement will be addressed through participation in key governance committees and sub-groups. We are considering which of the committees and sub-groups are most relevant to invite Governors to join.

During 2014 the Council of Governors met at:• Chesterfield Football Club on 4 March • Postmill Centre, South Normanton on 11 June • The Strutt Centre, Belper on 9 September. It next meets at Belper Town Football Club, DE56 1BA, on 11 December at 2.30pm.

Everybody is welcome to attend these meetings. If you are interested in attending please contact Kirsteen Farrar, Trust Secretary, on: 01773 525065 or email: [email protected]


DCHS Board members: 2013/14

Chair Andrew Fry (1 April – 26 Sept)

Acting Chair Tony Okotie (26 July – 2 Dec)

Chair Prem Singh (1 Dec – 31 Mar 14)

Chief Executive Tracy Allen

Medical Director Dr Ben Lobo

Acting Medical Director Dr Rick Meredith (1 Oct – 31 Mar 14)

Director of People and Organisational Effectiveness

Amanda Rawlings

Chief Nurse and Director of Quality:

Kath Henderson (1 April – 30 June)

Interim Chief Nurse and Director of Quality

Carolyn White (1 April – 4 April)

Interim Chief Nurse Jo Furley (1 July – 1 August)

Chief Nurse Carolyn White (1 Sept – 31 Mar 14)

Director of Finance, Performance and Information

Chris Sands

Non-Executive Director Barbara-Anne Walker (Senior Independent Director)

Non-Executive Director Tony Okotie (Vice Chair)

Non-Executive Director Barry Steans

Non-Executive Director Chris Bentley

Non-Executive Director Nigel Smith

Director of Corporate Strategy: Simon Griffiths

Director of Operations: William Jones

Trust Secretary: Kirsteen Farrar

In addition the following attend and participate in Board meetings in a non-voting and advisory capacity:

The BoardEvery NHS organisation must have a Board comprising of a non-executive chair, non-executive directors and executive directors.The overall management of the Trust is led by our Board of Directors who set our values, direction and objectives. Our Board remains committed to the continued development of good governance principles that reflect the changing needs of the NHS and recognise the developments in broader corporate governance. Our Board will ensure that the organisation remains relevant and responsive in this changing environment.

Our Board operates in accordance with its Terms of Reference – these are reviewed on a regular basis to take account of the appointment of any additional non-executive directors (or similar) and executive directors.

Our Board meetings are held on the last Thursday of the month at a variety of venues across Derbyshire.


Directors who are Members of Committees (at 31 March 2014):

Audit and Assurance Committee

Non-Executive Director: Nigel Smith (Chair)

Non-Executive Director: Barbara-Anne Walker

Non-Executive Director: Barry Steans

Quality Service Committee

Non-Executive Director: Chris Bentley (Chair)

Non-Executive Director: Tony Okotie

Chief Nurse and Director of Quality: Carolyn White

Director of Finance, Performance and Information: Chris Sands

Acting Medical Director: Dr Rick Meredith


Director of People and Organisational Effectiveness: Amanda Rawlings

Trust Secretary Kirsteen Farrar

Quality People Committee

Non-Executive Director: Barbara-Anne Walker (Chair)

Non-Executive Director: Chris Bentley

Director of People and Organisational Effectiveness: Amanda Rawlings




Quality Business Committee

Non-Executive Director: Barry Steans (Chair)

Non-Executive Director: Nigel Smith

Director of Strategy: Simon Griffiths

Director of Finance, Performance and information: Chris Sands


Acting Medical Director: Dr Rick Meredith



Director of People and Organisational Effectiveness: Amanda Rawlings (Joined committee as of its February 2014 meeting)


Is central to the effective governance of the Trust. It works closely with QSC, QPC and QBC to ensure a smooth transition of responsibilities and to ensure that all fulfil their roles effectively.

Audit and Assurance Committee

The Board’s sub-committees

The sub-committees are responsible for reviewing performance, making decisions, agreeing actions, approving policies and making sure we have high standards of behaviour across the organisation. The following diagram shows our Board sub-committee structure and gives a brief description of their remit:

Ensures that the total remuneration of our Chief Executive, Executive Directors and other staff on Very Senior Manager pay and conditions of service and any staff in new, specialist or unique roles is competitive and can be justified as reasonable and fair.

Remuneration and Terms of Service Committee

Ensures we deliver high quality, sustainable and effective services that meet local needs.

Quality Service Committee (QSC)

Ths also a sub-committee of the Board which ensures we adhere to the guidance within the Act. It currently reports through QSC.

The Mental Health Act Committee (MHAC)

Is responsible for ensuring that the People and Organisational Effectiveness Strategy is implemented across the organisation.

Quality People Committee (QPC)

Makes sure the Trust is an effective, efficient and economically-sound organisation.

Quality Business Committee (QBC)

The CFC makes and monitors arrangements for the control and management of our charitable funds.

Charitable Funds Committee (CFC)


Attendance at key meetingsPublic Board

Audit & Assurance Committee Remuneration & Terms of Service Committee

Meetings Held Members attended

April 2013 AF, CB, KF, SG, KH, WJ, BL, TO, AR, CS, BS

May 2013 AF, TA, CB, KF, SG, KH, BL, TO, CS, NS, BS, BAW

June 2013 AF, TA, CB, KF, SG, KH, WJ, BL, AR, CS, NS, BS, BAW

July 2013 AF, TA, CB, KF, SG, WJ, TO, CS, NS, BS, BAW

September 2013 TO, TA, CB, KF, SG, WJ, AR, CS, NS, BS, BAW, CW

October 2013 TO, TA, CB, KF, RM, AR, NS, BS, BAW, CW

November 2013 TO, TA, CB, KF, SG, WJ, RM, AR, CS, NS, BS, CW

December 2013 PS, TA, CB, KF, SG, WJ, RM, TO, AR, CS, NS, BS, CW

January 2014 PS, TA, CB, KF, SG, WJ, RM, TO, AR, CS, BS, BAW, CW

February 2014 PS, TA, CB, KF, SG, WJ, RM, TO, AR, CS, NS, BS, BAW, CW

March 2014 PS, TA, CB, KF, SG, WJ, RM, TO, AR, CS, NS, BS, BAW, CW


April 2013 NS, BS, BAW

June 2013 NS, BS, BAW

July 2013 NS, BS, BAW

October 2013 NS, BS, BAW

January 2014 NS, BS, BAW


April 2013 AF, CB, TO, BS

May 2013 AF, CB, TO, NS, BS, BAW

June 2013 (6) AF, CB, TO, NS, BS, BAW

June 2013 (27) AF, CB, NS, BS, BAW

July 2013 AF, CB, TO, NS, BS, BAW

September 2013 TO, CB, NS, BS, BAW

October 2013 TO, CB, NS, BS, BAW

January 2014 PS, CB, TO, BS, BAW

February 2014 PS, TO, NS, BS, BAW

March 2014 PS, BS, NS, CB


Board Assurance Framework Underpinning the work of our Board and its sub-committees is the role of the Board Assurance Framework (BAF). Any matters presented to the sub-committees for assurance go through a challenge process. The subsequent level of assurance received by the committee is then reflected within the relevant section of the BAF. This allows our Board to map, during the course of the year, the degree of assurance they have received in relation to mitigation of key strategic risks. During 2013/14, the BAF has been strengthened further by the inclusion of an executive lead summary in each of the sub-sections of the BAF. Links to the operational risk register have also been developed, allowing the Board to see how many operational risks directly align to the overarching strategic risks.

Declarations of interest and register of interest of members of the Board 2013/14Declarations of interest for members of our Board are requested at the start of the financial year and are sought at each meeting of the Board and its sub-committees. The register of interests is published each year in our Annual Report and includes those interests recorded during the preceding twelve months for all Board members including those whose appointments have been terminated in-year.

Sub-groupsThe sub-committees all have sub-groups that report to them. The sub-groups oversee specific strategy and are responsible for particular performance and management issues on behalf of the sub-committees. They discuss such issues in greater detail.

Coroner’s inquests and claimsThis year, three Coroner’s inquests have been concluded, two investigations have been closed without proceeding to inquest and we are assisting the Coroner with 15 further cases.

The NHS Litigation Authority (NHSLA) manages negligence (and other) claims against the NHS on behalf of NHS Trusts in England, including DCHS. During the reporting year 29 new claims were registered with them about DCHS. In addition, we have worked with them on 18 claims carried over from the previous year.

Learning from a clinical claimOne claimant underwent a bunion operation and during the surgery a fragment of the drill bit broke off. This was entirely embedded in the bone and so the Consultant Podiatric Surgeon took the decision to leave it in situ, as this would be less damaging to the bone. This fragment subsequently moved to the sole of the claimant’s foot and was surgically removed. This claim has been discussed within the Podiatric Surgical Teams and the following learning was identified:

• Patients to be fully informed prior to surgery with regards to the movement of metal work. This information is in the Patient Information leaflet on risks and complications

• Patients to be advised, under the Being Open Policy, on the day of the operation when something untoward has occurred and appropriate support and advice provided

• All incidents to be logged on Datix on the day they occur and ensure all the team are aware of this

• Ensure that the whole team is involved in the WHO (World Health Organisation) checklist scenario. This should ensure good communication within the surgical team. Also, ensure that all the team, including day ward staff are also aware of types of procedures and complications

• Ensure that any surgical incident/procedure is fully documented both in diagrams and as written narrative within the patient’s notes.


Ice-skating is one of the favourite hobbies of retired science teacher David Grafton. But when he developed arthritis in his big toe and a dorsal bunion swelling on top of his foot, even pulling on a pair of his ordinary shoes became difficult, never mind ice-skates.

David, from Chesterfield, was referred to our podiatric team for treatment and began a series of interventions to try to keep him mobile until it became apparent that surgery would be necessary.

Under the care of podiatric surgeon Stephen Finney, he underwent an operation to carve away some bone on the joint between his foot and big toe to help maintain flexibility in his joint.

During his recovery David, who is also a keen rambler, set himself three goals which he has now achieved: to be able to fit into most of his ordinary shoes, to get back to walking distances of five miles or more in the countryside, and to return to ice-skating.

“In November 2013 I treated myself to a new pair of wider-fitting skates and tentatively took to the ice for the first time in 18 months… How satisfying and reassuring it is to have one’s life handed back,” he said.

Patient story -David Grafton

Now he and his wife – who first took up skating together in their 40s – are once again weekly visitors to the Sutton-in-Ashfield ice rink where they skate and ice-dance just for the fun of it.

In a letter of thanks he praised the whole podiatric team for their skill and expertise and for being caring, professional and good humoured.

It has made such a difference to my life-style. The problem with my foot was threatening to seriously curtail my activities but you have removed that problem, or, at least, delayed it until future years.”

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Financial ReviewThis part of the report provides a commentary on our financial performance. It provides an overview of the accounting process together with an analysis of financial performance.

The Trust’s Primary Financial Statements and supporting notes to the Accounts for the year ended 31st March 2014 are provided at Appendix 1. Our external auditors, KPMG have provided an unqualified opinion on the Accounts. A copy of the full annual report and accounts can be obtained from the Director of Finance, Performance & Information at our Trust Headquarters.

Reports& Finances


Financial StatementsOur annual report and accounts cover the 12-month period from the 1 April 2013 to 31 March 2014. Our accounts have been prepared in accordance with directions given by the Department of Health. They are also prepared to comply with International Financial Reporting Standards (IFRS) and are designed to present a true and fair view of our financial activities.

Going ConcernOur accounts have been prepared on the basis that the Trust is a ‘going concern’. This means that our assets and liabilities reflect the ongoing nature of our activities. Our Directors have considered and declared that:

External AuditOur external auditors are the KPMG. During 2013/14, they have focused on providing an opinion on the financial accounts and providing a Value for Money (VFM) conclusion on arrangements for securing economy, efficiency and effectiveness. In addition, KPMG have also undertaken a review of our Quality Account.

Our Annual Governance Report for the 2013/14 financial year was presented to the Board in June 2014. The total fee for external audit for 2013/14 was £88,140 (plus VAT) in respect of the completion of the statutory audit work, inclusive of Quality Account work.

Counter Fraud ActivitiesWe receive a dedicated Local Counter Fraud Specialist Advice Service from 360 Degree Assurance and have developed a comprehensive counter fraud work plan in accordance with guidance received from the NHS Protect. We also have a counter fraud policy approved by the Board. Anyone suspecting fraudulent activities within our services should report their suspicions to our Local Counter Fraud Specialist by telephoning the confidential hotline on: 0115 883 5323.

Charitable FundsThe Board acts as the Corporate Trustee for our Charitable Trust, which is a charity registered with the Charity Commission under number 1053329.

These charitable funds have resulted from fund-raising activities and donations received over many years by the respective organisations, and are used to purchase equipment and other services in accordance with the purpose for which the funds were either raised or donated.

The charity also has a general purpose fund which is used more widely to the benefit of patients and staff.

Following HM Treasury’s ruling that IAS27, consolidated and separate financial statements, should apply to all NHS bodies for accounting periods from 1 April 2013, we undertook an assessment against the two key criteria of materiality and control. As a result of this assessment we concluded that it was not necessary to consolidate the accounts of the charity with those of the NHS body.

The financial activities of the charity for the 2013/14 financial will continue to be reported within a separate Annual Report and Accounts.

Political and Charitable DonationsWe did not make any political or charitable donations from our exchequer or charitable funds during 2013/14.

Financial PerformanceDespite the current financial difficulties facing the NHS and economy as a whole, we have ultimately performed well during 2013/14.

We have had a number of statutory targets to meet in each financial year. Our performance against these targets is set out below:

Duty Year to Date Performance

Break Even Duty Surplus £2.892m

Maintain within External Financing Limit

£0.799m

Maintain within Capital Resource Limit

£4.971m

Comply with Better Payment Practice Code

Compliance with all 4 measures

After making enquires, the Directors have a reasonable expectation that the NHS Trust has adequate resources to continue in operational existence for the foreseeable future. For this reason, they continue to adopt the ‘going concern’ basis in preparing the accounts.

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CAPITAL EXPENDITURE 2013/14 £000’s

IM&T End User Computer Hardware 768

IM&T PAS replacement 443

IT Business Intelligence System 250

IM&T Systems Procurement 243

IM&T Communications Infrastructure 45

Equipment Podiatry - Buxton and Scarsdale 59

Equipment Replacement across sites 41

Equipment Gaze Interaction - Walton 27

Equipment Ophthalmology - Ripley 23

Equipment Sensory - Ash Green 22

Equipment Elite Equipment - Ilkeston Community Hospital

18

Equipment under £10k 44

Estates - Refurbishment Whitworth 1370

Estates - Upgrades and Refurbishment Repton Clinic

577

Estates - Renovations and Developments Walton

371

Estates - Upgrades and Repairs Clinics 245

Estates - Upgrades and Repairs Ripley 237

Estates - Upgrades and Refurbishment Bolsover

228

Estates - Repair and Refurbishment Ilkeston 143

Estates - Asbestos Removal Heanor, Buxton, Cavendish

91

Estates - Repairs and Replacements across sites

77

Estates - Renovations and Refurbishment Clay Cross

43

Estates - Additional Car Parking Bolsover and Ilkeston

25

Estates items under £10k 90

Gross Capital Expenditure in Year 5480

As an aspirant Community Foundation Trust, we measure ourselves against the governance framework that Monitor uses to assess the financial viability of organisations. The Continuity of Service (COS) rating measures our financial health with the use of two key metrics. Each metric is given equal weighting to derive an overall score. The metrics assess our liquidity or cash position and our ability to service any debt that the Trust holds. Under this rating system in 2013/14 we achieved the maximum score of a four.

Working Capital and LiquidityWe ended 2013/14 with a healthy cash balance of approximately £11.7m which equates to 24 days’ worth of operating expenditure.

We have agreed a set of working capital key performance indicators, and these are routinely reported through to the Quality Business Committee which is chaired by a Non-Executive Director.

We have continued to invest surplus cash in 2013/14 in the National Loans Fund to generate a modest return on investment.

Events after the reporting periodFollowing a tender exercise undertaken by commissioners in Leicestershire during 2013/14, we will no longer be providing elective services in the Leicestershire area. The value of this contract in 2013/14 was £21.4m. Approximately 300 staff will transfer under TUPE legislation to the new provider with effect from 1 April 2014.

Capital ExpenditureThe table below summarises our capital resources and expenditure for 2013/14. Our investment in capital projects has increased significantly during the year following the transfer of a significant portfolio of land and property assets from Derbyshire County PCT on 1 April 2013.

Disclosure: legacy balance transfers.In accordance with the Health and Social Care Act 2012, Strategic Health Authorities and Primary Care Trusts were dissolved on 1 April 2013 and their assets and liabilities transferred to successor bodies in the NHS or to other entities. Under the terms of The Health & Social Care Act 2012, Derbyshire County Primary Care Trust Property Transfer Scheme 2013 and its supporting schedules, a number of assets and liabilities were transferred from Derbyshire County PCT to the Trust on that date. The most significant of these were the community hospitals in Chesterfield (Walton and Ash Green), Bolsover, Clay Cross, Matlock (Whitworth), Ilkeston, Ripley, Heanor, and Buxton (Buxton and Cavendish).The accounting arrangements in respect of these transfers are outlined in note 1.3 to the Annual Accounts.

During the financial year, we invested a total of £5.4 million in capital developments. We successfully bid against a national funding allocation, Nursing Technology Fund. This resulted in the Trust receiving a new allocation of Public Dividend Capital (PDC) of £185,000. The investment in capital expenditure is detailed opposite:


Accounting PoliciesWe have detailed accounting policies approved by the Audit and Assurance Committee which comply with the NHS Manual of Accounts and International Financial Reporting Standards (IFRS). Our accounting policies are detailed in the full set of financial accounts.

NHS Pensions and Directors’ RemunerationThe accounting policy in relation to employee pension and retirement benefits is set out in the full set of the financial accounts for 2013/14. The detail of the directors’ remuneration is contained within the Remuneration Report section of this document.

Policy and Payment of CreditorsThe Non NHS Trade Creditor Payment Policy of the NHS is to comply with both the Confederation of British Industry Prompt Payment Code and Government Accounting Rules. The Government Accounting Rules state:

As a result of this policy, we ensure that a clear consistent policy of paying bills in accordance with contracts exists and that:

• Finance and purchasing divisions are aware of this policy

• Payment terms are agreed at the outset of a contract and are adhered to

• Payment terms are not altered without prior agreement of the supplier

• Suppliers are given clear guidance on payment terms

• A system exists for dealing quickly with disputes and complaints

• Bills are paid within 30 days unless covered by other agreed payment terms.

EfficiencyDuring 2013/14 we generated efficiency savings and contributions from new initiatives of £7.1m part year effect in year, the recurrent full year effect of which equates to £8.4m million against a target of £8.1m. The savings were required to deliver a 4% efficiency requirement for commissioners. This was a national requirement for NHS providers.A summary of our main savings delivered during 2013/14 is shown below:

Cost Allocation and Charging RequirementsWe have complied with the cost allocation and charging requirements set out in HM Treasury and Office of Public Sector Information Guidance.

2013/14 Cost Improvement Programme

Part Year Effect Full Year Effect

Service Area £m £m

Adults 1.3 2.3

Children’s 0.1 0.1

Estates Rationalisation 1.0 1.0

Planned Care 1.0 0.9

Specialist Services 1.0 1.2

Support Services 2.6 2.7

Other 0.1 0.2

Total 7.1 8.4

The timing of payment should normally be stated in the contract. Where there is no contractual provision, departments should pay within 30 days of receipt of goods and services or on the presentation of a valid invoice, whichever is the later.

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Better Payment Practice Code Performance

NHS Non-NHS

Value 98% 97%

Volume 98% 97%


Future Financial PerformanceThe Board has set out a detailed financial plan for the five-year period from 2014/15 to 2018/19. We intend to achieve a surplus of £1.6 million in 2014/15 incrementally rising each year. This will achieve the maximum continuity of service rating of a four from Monitor when we are authorised as a Foundation Trust.

Our five-year financial plan has assumed that the efficiency requirement will continue to be challenging. Over the next five financial years, it is projected that the cumulative impact of national and local cost pressures will require us to deliver additional efficiencies in the region of £33.4 million.

We have taken further measures through 2013/14 to improve our financial governance processes to prepare for the more challenging times ahead. Our Project Management Office, which was set up in 2012, has become embedded across the Trust to ensure that a structured process is in place for the delivery of our major change programmes, which will result in future efficiencies. We also continue to improve our financial reporting to ensure we are more forward looking and have the information to enable us to manage performance proactively.

In our future plans, it is clear that we need to maintain our core business by providing high quality and efficient services to our patients and commissioners. We have produced our Quality Account in 2013/14 and have plans in place to ensure quality improvements in our services are measured and evidenced. We will also be looking for further opportunities to expand our services both within, and outside Derbyshire, where opportunities arise.

The future economic environment continues to become more challenging as public spending on health and social care services slows. There will be increasing pressure on provider organisations to make increased efficiencies and to work in partnership with commissioners to secure effective and efficient care pathways. The scale of the efficiencies required will demand fundamental changes in how services are provided across health and social care communities.

We are well positioned to manage through the more difficult financial environment and work positively with partners to ensure best use of public resources is maintained. In summary, 2013/14 has been another successful year for our Trust. The environment for 2014/15 and beyond is becoming more challenging, however we believe that we are well placed to meet this challenge positively.

We have developed mitigation plans that will be introduced should the need arise.


Directors’ Remuneration

During, 2013/14, Amanda Rawlings, Director of People and Organisational Effectiveness was also employed as an independent Board member for Cross Keys Homes. Remuneration of £4,000 was retained for this office. There were no other executive directors who received remuneration during the year for other directorships.


Notes:As Non-Executive Members do not receive pensionable remuneration, there will be no entries in respect of pensions for Non-Executive Members.

A Cash Equivalent Transfer Value (CETV) is the actuarially assessed capital value of the pension scheme benefits accrued by a member at a particular point in time. The benefits valued are the member’s accrued benefits and any contingent spouse’s pension payable from the scheme. A CETV is a payment made by a pension scheme, or an arrangement to secure pension benefits in another pension scheme, or an arrangement when the member leaves a scheme and chooses to transfer the benefits accrued in their former scheme. The pension figures shown relate to the benefits that the individual has accrued as a consequence of their total membership of the pension scheme, not just their service in a senior capacity to which disclosure applies. The CETV figures and the other pension details include the value of any pension benefits in another scheme or arrangement which

the individual has transferred to the NHS pension scheme. They also include any additional pension benefit accrued by the member as a result of their purchasing additional years of pension service in the scheme at their own cost. CETVs are calculated within the guidelines and framework prescribed by the Institute and Faculty of Actuaries.

The Government Actuary Department factors for the calculation of Cash Equivalent Transfer Values (CETVs) assume that benefits are indexed in line with the Consumer Prices Index which is expected to be lower than the Retail Prices Index which was used previously and hence will tend to produce lower transfer values.

We have used CETVs provided by NHS Pensions. The CETVs have been calculated using different actuarial factors (provided by the Government Actuary’s Department) at the beginning and the end of the period. This is contrary to guidance provided in the NHS Manual for Accounts, which states that common market factors should be used at the beginning and end of the period.

Board of Directors’ Remuneration CommitteeThere is a Remuneration and Terms of Service Committee which is a key sub group committee of the Board of Directors. The Committee has delegated responsibility to review and set the remuneration and terms of service of the Executive Directors. The Committee, which comprises Non-Executive Directors, met on ten occasions during the year. Membership of the committee and the number of times each member met during this period is included in the table (right).

All Executive Directors are employed on substantive contracts with a minimum notice period of three months.

We do not make termination payments to Executive Directors which are in excess of contractual obligations. There have been no such payments during the 2013/14 financial year.


Pay MultiplesReporting bodies are required to disclose the relationship between the remuneration of the highest paid director in their organisation and the median remuneration of the organisation’s workforce.

The banded remuneration of the highest paid director in the financial year 2013/14 was £135-140k. This was 6.4 times the median remuneration of the workforce, which was £21,357.

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.

In 2013/14, two employees received remuneration in excess of the highest paid director, the highest of which was paid £400,650. The highest remuneration related to a self-employed consultant providing medical sessions in one of our hospitals. This arrangement ceased on 31 March 2014.

Comparable figures for 2012/13The banded remuneration of the highest paid director in the financial year 2012/13 was £135k - 140k. This was 6.57 times the median remuneration of the workforce, which was £20,681.

Off-payroll engagementsSee below all off-payroll engagements as of 31 March 2014, costing more than £220 per day and that last longer than 6 months.

For both of the above off-payroll engagements, assurance has been sought and obtained from the individuals concerned that they are responsible for their own tax affairs.

Exit PackagesAs part of the Remuneration Report, the Treasury requires the disclosure of exit package information. The figures disclosed here relate to exit packages agreed in the year. The actual date of departure may be in a subsequent period, and the expense in relation to the departure costs may have been accrued in a previous period. Therefore the figures disclosed here are calculated differently to those included in the expenditure note within the financial accounts.

Redundancy and other departure costs have been paid in accordance with the provisions of the Agenda for Change NHS terms and conditions. Exit costs in this note are accounted for in full on agreement of departure date. 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.

There are no payments included in the above outside the NHS terms and conditions. This disclosure reports the number and value of exit packages taken by staff leaving in the year. Note: The expense associated with these departures may have been recognised in part or in full in a previous period.

Number

Number of existing engagements as of 31 March 2014

2

Of which the number that have existed for:

Less than 1 year at the time of reporting

Between 1 and 2 years at the time of reporting

Between 2 and 3 years at the time of reporting 2

Between 3 and 4 years at the time of reporting

Four or more years at the time of reporting

Number

Number of new engagements, or those that reached six months in duration, between 1 April 2013 and 31 March 2014

1

Number of new engagements which include contractual clauses giving DCHS the right to request assurance in relation to income tax and National Insurance obligations

0

Number for whom assurance has been requested

1

Of which:

assurance has been received 1

assurance has not been received 0

engagements terminated as a result of assurance not being received

0

There were no off-payroll engagements of board members, and/or senior officers with significant financial responsibility, during the year.

For all new off-payroll engagements between 1 April 2013 and 31 March 2014, for more than £220 per day and that last longer than six months:


Appendix 1Annual Accounts and Supporting Schedules


Annual Governance Statement 1 April 2013 - 31 March 2014Organisation Name: Derbyshire Community Health Services NHS Trust

1. Scope of responsibility1.1 The Board is accountable for internal control.

As Accountable Officer, and Chief Executive of this Board, I have responsibility for maintaining a sound system of internal control that supports the achievement of the organisation’s policies, aims and objectives. I also have responsibility for safeguarding the public funds and the organisation’s assets for which I am personally responsible as set out in the Accountable Officer Memorandum.

2. The purpose of the system of internal control2.1 The system of internal control is designed to manage

risk to a reasonable level rather than to eliminate all risk of failure to achieve policies, aims and objectives; it can therefore only provide reasonable and not absolute assurance of effectiveness. The system of internal control is based on an on-going process designed to:

• identify and prioritise the risks to the achievement of the organisation’s policies, aims and objectives,

• evaluate the likelihood of those risks being realised and the impact should they be realised, and to manage them efficiently, effectively and economically.

2.2 The system of internal control has been in place in Derbyshire Community Health Services NHS Trust for the year ended 31 March 2014 and up to the date of approval of the annual report and accounts.

3. Governance Framework3.1 The Trust has established a number of Committees with

delegated authority from the Board. These Committees are chaired by Non-Executive Directors and have a vital role in ensuring the Board receives assurance that the organisation’s strategic objectives are being delivered. The Board Committees are:

• Audit and Assurance Committee

• Remuneration and Terms of Service Committee

• Quality Service Committee

• Quality People Committee

• Quality Business Committee

• Mental Health Act Committee

• Charitable Funds Committee (from March 2014).

3.2 The Quality Service Committee shapes, influences and provides overall assurance in relation to the quality of DCHS’ services. This incorporates the three elements of quality governance i.e. – patient safety, the patient experience and the effectiveness of care in relation to patient outcomes. This is achieved by working on the delivery of:

• DCHS Quality Strategy

• Compliance against regulatory requirements and external scrutiny:

• Performance Framework

• Controls and assurance

• Effectiveness of care.

This committee provides the Board with assurance on the content and publication of the Quality Account, clinical audit, safeguarding adults and children, never events, serious untoward incidents (SUIs) and explanations of follow-up action.

The Mental Health Act Committee reports into the Quality Service Committee. The Mental Health Act Committee (MHAC) will provide assurance to the Board that confirms the experience of all of our patients is fully compliant to the Mental Health Act 1983, the Mental Capacity Act 2005 and the Care Quality Commission’s Essential Standards of Quality and Safety. This committee is chaired by a non-executive director.

3.3 The Quality People Committee oversees the development of the People and Organisational Development Strategy providing assurance to the Board that DCHS has the right staff, in the right place, doing the right things. This includes:

• Ensuring that staff are recruited, trained and qualified to do the roles required

• Monitoring DCHS’ Quality People performance targets

• Ensuring that effective workforce plans and development are in place

• Ensuring effective workforce and development plans are in place

• Ensuring DCHS has effective staff involvement and engagement.

3.4 The Quality People Committee has joint responsibility with the Quality Service Committee for developing and assuring equality and diversity activity.


3.5 The Quality Business Committee shapes, influences and provides overall assurance regarding the delivery of:

• Performance Framework

• Financial strategy and investment

• IM&T Strategy

• Business Development Framework

• Estates Strategy

• Integrated Business Plan (IBP)

• Business partnering arrangements

• Emergency Planning and Business Continuity.

3.6 The Charitable Funds Committee provides assurance that the Trust is discharging its responsibilities as Corporate Trustee to the Derbyshire Community Health Services Charitable Trust.

3.7 The Board and its sub-committees all have a reporting schedule for the year which details the reports which will be presented at each meeting. After each committee meeting, a report is prepared by the Committee Chair and presented to the next Board meeting, ensuring that areas of risk or concern are raised and debated by the full Board. These reports are presented to the public section of the Board meeting and are available on the Trust website. The contents of these reports cover the Trust’s progress against delivering its strategic objectives, and highlights areas of assurance or limited assurance to the Board. The Audit and Assurance Committee report provides the Board with assurance around the governance of the organisation, and the effectiveness of the system of internal control through the Board Assurance Framework.

3.8 The Audit and Assurance Committee undertakes an annual review of Committee membership and reports any concerns to the Board.

3.9 The Trust has developed a Quality Improvement and Assurance Framework. The framework describes the Trust’s approach to quality improvement and assurance. It also describes the process for the escalation of concerns or risks which could threaten delivery of our corporate objectives, service delivery or patient safety.

3.10 The Board has undertaken a review of its Governance Framework, and recommendations for improvement were agreed at the February 2014 Board meeting.

3.11 The Trust has an effective Board, with an appropriate balance of skills and experience and with constructive challenge from the Non-Executive Directors. There is an induction and development programme in place for Board members and a formal and rigorous evaluation of Board effectiveness has been undertaken with external management consultants.

3.12 The Trust deems itself to be compliant with the Corporate Governance Code and has no departures to report. The Board has undertaken a self-assessment against the NHS Foundation Trust Code of Governance and has developed an action plan to ensure the Trust can comply, or explain areas of non-compliance, when foundation trust status is achieved. At this stage a number of the code provisions are not applicable to NHS Trusts.

3.13 The Board has approved a Corporate Governance Manual. This document includes the standing orders, standing financial instructions and scheme of delegation. The Trust Secretary prepares a quarterly report to the Audit and Assurance Committee which reports on compliance with governance arrangements.

3.14 The Board has control systems in place for the discharge of statutory functions. Assurances are provided on these control systems through reports provided by management, and through audit.

3.15 The Board has a development programme in place to ensure the Board continues to learn and develop. This development process involves Board evaluation conducted by an external organisation.

3.16 KPMG are the Trust’s external auditors and 360 Assurance are the internal auditors and providers of Counter Fraud Services.

4. Risk Assessment4.1 The Board has the ultimate responsibility for risk

management and the review and approval of high risk treatment options. The Trust’s risk management framework encompasses a Risk Management Policy which describes DCHS’ approach to risk management including the processes, roles and responsibilities which underpin it. The control mechanisms for prevention of risk are based upon those required by the Department of Health. These control systems have been developed based upon best practice guidance available.

4.2 The Chief Executive has overall responsibility for the management of risk by the Trust. The Director of Quality/Chief Nurse is responsible for the risk management strategy and policy. The Executive Team exercise lead responsibility for specific types of risk.

4.3 The Quality Services Committee takes the lead Committee role for ensuring the risk register is robust. The Committee undertakes monthly reviews of the “Top X” risk register, and quarterly reviews of the full risk register


4.4 The Audit and Assurance Committee takes the lead role in ensuring the risk management control system is robust. The Audit and Assurance Committee reviews the Board Assurance Framework at each meeting to ensure risks to the achievement of strategic objectives are being effectively managed.

4.5 The role of each Executive Director is to ensure that appropriate arrangements are in place for the:

• Identification and assessment of risks and hazards.

• Elimination or reduction of risk to an acceptable level.

• Compliance with internal policies and procedures, and statutory and external requirements.

• Integration of functional risk management systems and development of the assurance framework.

4.6 These responsibilities are managed operationally through corporate managers supporting the Executive Directors and working with designated lead managers within Operational Divisions.

4.7 The Trust has a Risk Management Strategy in place, which is reviewed annually and approved by the Board.

The objectives in the strategy are regularly reviewed during the year to ensure that risk is fully embedded in the day to day management of the organisation and conforms to best practice. The Strategy defines risk and identifies individual and collective responsibility for risk management within the organisation. It also sets out the Trust’s approach to the identification, assessment, scoring, treatment and monitoring of risk.

4.8 Staff are equipped to manage risk in a variety of ways and at different levels of strategic and operational functioning. These include:

• Formal in-house training for staff as a whole in dealing with specific everyday risk, e.g. fire safety, health and safety, moving and handling, infection control, information governance and security.

• Training and induction in incident investigation, including documentation, root cause analysis, steps to prevent or minimise recurrence and reporting requirements.

• Developing shared understanding of broader business, financial, environmental and clinical risks through collegiate clinical, professional and managerial groups.

4.9 The organisation’s key strategic risks are identified in the Board Assurance framework, which is reported to the Public Board quarterly. These risks are categorised as Quality Service, Quality People, Quality Business and Governance risks. The appropriate Committee reviews these risks on a quarterly basis to ensure the risk assessment is current, and to ensure risks are removed when closed, and added when new risks emerge.

5. The risk and control framework5.1 The system of internal control is based upon an

on-going risk management process designed to identify the principal risks to the achievement of the organisation’s objectives; to evaluate the nature and extent of those risks; and to manage them efficiently, effectively and economically.

5.2 The key elements of the Risk Management Strategy are that:

• Risk is a key organisational responsibility.

• All staff must accept the management of risks as one of their fundamental duties.

• Every member of staff must be committed to identifying and reducing risk.

• The management of risk is best achieved through an environment of honesty and openness, where mistakes and untoward incidents are identified quickly and dealt with in a positive and responsive way and lessons learnt are communicated throughout the organisation and best practice adopted.

5.3 The tools used to identify, evaluate and control risks are those outlined in the Australian/New Zealand AS/NZ 4360:1999 using the 5x5 matrix for consequence and likelihood. The use of this tool ensures consistency of risk assessment across the organisation.

5.4 Risks that are assessed as low indicate management by routine procedures. Moderate risks require specific management responsibility and action. High risks require senior management attention. Extreme risks require immediate action, including informing the Board of Directors.

5.5 The key ways in which risk management is embedded in the activity of the organisation is through ensuring staff are aware of their responsibilities and accountabilities as set out in the risk management strategy. Assurances on how effectively the Risk Management System is working is through inspections – such as, environmental, infection control, security, workplace and fire safety – and through the health and safety and clinical governance activities.

5.6 This is supported through the Trust’s induction programme, training updates and individual training as a result of needs assessments. The Trust has introduced a performance management framework which includes the effective management of risk as a key element. The organisation undertakes Equality Impact Assessments on all functions it carries out to ensure that service delivery and employment practices comply with legal requirements.


5.7 The Trust involves key stakeholders in the management of risks. This includes:

• Patients and their carers.

• The general public through consultations.

• Shadow Council of Governors

• Trust Membership

• Staff Partnership Committee

• Staff Forum

• Frontline Care Council

• Mental Health Act Committee (MHAC)

• Health and Safety Committee (HSC)

• Clinical Commissioning Groups (CCG)

• Local Authorities (LAs)

• Improvement and Scrutiny Committee (ISC)

• Care Quality Commission (CQC)

• Trust Development Authority (TDA)

• NHS England

• Monitor

• Healthwatch

5.8 The Trust has developed an Assurance Framework to ensure that there are proper internal and independent assurances given on the soundness and effectiveness of the system and on the processes in place for meeting its objectives and delivering appropriate outcomes.

5.9 The Board of Directors determines the strategic objectives of the Trust. Achievement of these strategic objectives is performance managed through the Board Committee structure. Strategic risks, which threaten the achievement of strategic objectives, are identified and key controls put in place to manage these risks. The Board is provided with reports to enable it to monitor the effectiveness of each element of the Assurance Framework.

5.10 The Board of Directors has considered the key controls that are in place to identify risks, and has assessed whether these controls are adequate. Where gaps in controls have been identified, action plans have been put in place to address the weaknesses.

5.11 The Board of Directors has mapped out how assurances relate to strategic objectives, and identified where gaps exist. Action plans are in place to ensure further assurance is given in these areas. The Trust uses external bodies to provide assurance, where available, and targets the internal audit and clinical audit programmes at specific areas to provide assurance.

5.12 The recommendations from internal audit reports are tracked by the Audit and Assurance Committee to ensure prompt implementation. During the year there were no high risk recommendations identified

5.13 The Trust ensures a strong relationship between the assurance framework and risk register. The two documents are cross referenced, with the assurance framework including strategic risks, and the risk register operational risks.

5.14 Sections of the assurance framework have been assigned to the Board and its Committees to ensure that there is clear oversight of all areas. Where lack of assurance, or gaps in control are identified, these are escalated to the Board of Directors. The Audit and Assurance Committee is responsible for maintaining the overview of the framework.

5.15 The Board of Directors uses the assurance framework to provide assurance when signing declarations to third parties.

5.16 The Directors are required to satisfy themselves that the Trust’s Annual Quality Account is fairly stated. In doing so the Trust is required to put in place a system of internal control to ensure that proper arrangements are in place. The Trust has appointed a member of the Board, the Director of Quality / Chief Nurse, to lead, and advise on all matters relating to the preparation of the Trust’s Annual Quality Account. To ensure that the Trust’s Quality Account presents a properly balanced view of performance over the year, the Quality Services provides scrutiny and challenge over Trust clinical performance. The Trust also has quarterly Quality meetings with its main commissioner, and a monthly performance review with the Trust Development Authority.

5.17 The Quality Service Committee has responsibility for reviewing assurances over clinical quality. The Board Committees have responsibilities for ensuring assurance is obtained routinely on compliance with CQC registration requirements. The Audit and Assurance Committee maintains an overview of compliance. The Trust is reviewing its assurances for CQC compliance in light of the new assessment process being introduced.

5.18 The Trust routinely reports on data quality to the Board of Directors on a monthly basis as part of its performance Dashboard. The Audit and Assurance Committee provides Board oversight of data quality and monitors implementation of the data quality improvement plan on a quarterly basis. The Information Management and Technology (IM&T) Group has lead responsibility for data quality.

5.19 The Trust has systems and processes in place to govern access to confidential data and to ensure certain standards are followed when data and information is in transit. Any new system or process needs to meet these standards as does any hardware (e.g. computers or software). All system developments whether new or existing need to follow a process and be signed off by the IM&T Group to ensure they meet the required criteria and that hardware and software is compatible.


5.20 The Trust monitors its information governance risks through the Information Governance Group. Incidents and risks are managed in accordance with Trust policy and serious risks are escalated through either IM&T Group or more urgent ones through the Executive Team, Quality Services Committee, Board of Directors, and on to the Trust Development Authority if required.

During the financial year, the Trust had 6 data security breaches that were reported to the Information Commissioner. Of these breaches:

• Patient records were damaged following a flood at Repton Health Centre. The Information Commissioner has reviewed the incident and reported that no action will be taken

• Patient records were destroyed when a notes trolley was incorrectly disposed and incinerated. The Information Commissioner has reviewed the incident and reported that no action will be taken

• Patient records went missing from Hinckley Hospital and were found on four separate occasions by members of the public. Investigations are continuing, and the police are supporting the Trust. The Information Commissioner has now closed the incident.

The Caldicott Guardian and Senior Information Risk Owner (SIRO) have both been involved in advising on these incidents, and ensuring that lessons are learnt.

5.21 The Trust has a process in place for the revalidation of medical staff. This process is overseen by the Medical Director.

5.22 The Trust also has a process in place for ensuring that clinical staff renews their professional registration. Where staff’s registration is at risk of lapsing, this is flagged to the Chief Nurse / Director of Quality. This process is overseen by the Director of People and Organisational Effectiveness

5.23 The Trust has a Whistleblowing Policy in place which encourages staff to raise any concerns. The policy sets out how these concerns will be investigated.

5.23 Control measures are in place to ensure that all the organisation’s obligations under equality, diversity and human rights legislation are complied with.

5.24 As an employer with staff entitled to membership of the NHS Pension scheme, control measures are in place to ensure all employer obligations contained within the Scheme regulations are complied with. This includes ensuring that deductions from salary, employer’s contributions and payments in to the Scheme are in accordance with the Scheme rules, and that member Pension Scheme records are accurately updated in accordance with the timescales detailed in the Regulations.

5.25 The Trust has undertaken a climate change risk assessment and developed an Adaptation Plan, to support its emergency preparedness and civil contingency requirements, as based on the UK Climate Projections 2009 (UKCP09), to ensure that this organisation’s obligations under the Climate Change Act are met.

5.26 The Trust has a Major Incident and Business Continuity Plan. This document has been reviewed in-year to reflect the latest guidance from NHS England and the learning from incidents, training and exercises. The Quality Business Committee receives a quarterly assurance report on progress with the plan.

5.27 The Trust was inspected in February and March 2014 by the Care Quality Commission (CQC) under its new inspection model for NHS Trusts. In three hospitals, the CQC found isolated areas where the Trust was not meeting essential standards. These were in respect of the safe disposal of medicines (Regulation 13 at Cavendish Hospital), the safety of equipment (Regulation 16 at Whitworth Hospital), and care planning and consideration of people’s consent on the older people’s mental health wards (Regulations 9 & 18 at Walton Hospital).

Actions plans are in place to address the concerns raised, and progress against the actions will be monitored through the Board governance processes.

5.28 The Trust is fully compliant with the registration requirements of the Care Quality Commission.

6. Review of effectiveness6.1 As Accountable Officer, I have responsibility for

reviewing the effectiveness of the system of risk management and internal control. My review is informed in a number of ways. The Head of Internal Audit provides me with an opinion on the overall arrangements for gaining assurance through the Assurance Framework and on the controls reviewed as part of Internal Audit’s work.

6.2 Executive Directors within the organisation who have responsibility for the development and maintenance of the system of internal control provide me with assurance. The Assurance Framework itself provides me with evidence that the effectiveness of controls that manage the risks to the organisation achieving its principal objectives have been reviewed. My review is also informed by major sources of assurance detailed below.

6.3 I have been advised on the implications of the result of my review of the effectiveness of the system of internal control by the Board of Directors, the Audit and Assurance Committee, the Quality Service Committee, the Quality People Committee and the Quality Business Committee. A plan to address weaknesses and ensure continuous improvement of the system is in place.


6.4 The processes that have been applied in maintaining and reviewing the effectiveness of the system of internal control include the roles of the following:

• The Head of Internal Audit provides me with an opinion on the overall arrangements for gaining assurance through the Assurance Framework and on the controls reviewed as part of the internal audit work. The Head of Internal Audit Opinion for 1 April 2013 to 31 March 2014 is as follows:

• Significant assurance can be provided that there is a generally sound system of internal control, designed to meet the organisations objectives, and that controls are generally being applied consistently.

• The Assurance Framework itself provides me with evidence that the effectiveness of controls that manage the risks to the organisation achieving its principal objectives have been reviewed.

• The work of our external auditors to review the arrangements in place for producing the quality accounts, and to advise us of best practice to inform our development in this area, provides me with assurance.

• The work of our external auditors to review the arrangements in place for producing the financial accounts, and providing an opinion on them, provides me with assurance.

• Internal Audit and other external assessments, provide me with assurance on the effectiveness of controls.

• Clinical audit provides me with assurances of the effectiveness of controls in clinical areas.

• The Care Quality Commission’s Inspection provides me with external assurances over the quality of care provided by the Trust across a range of services.

• The Quality and Risk Profile provided by the Care Quality Commission (CQC) provides external assurance as to the controls in place within the Trust.

• The work of independent reviewers of the Trust around Historical Due Diligence, Quality Governance Framework and the Board Governance Assurance Framework provides external assurance of the controls in place within the Trust.

• The re-certification of the Investors in Excellence standard in year provides assurance that the organisation has continued to develop and make improvements in how the organisation operates.

• The Board of Directors has identified the strategic risks facing the organisation during the period and has monitored the controls in place and the assurances available to ensure that these risks are being appropriately managed.

• The Audit and Assurance Committee provides the Board with an independent and objective view of arrangements for internal control within the Trust and to ensure the Internal Audit service complies with mandatory auditing standards, including the review of all fundamental financial systems.

• The Trust undertook an internal audit against the information governance toolkit, which provided evidence to support the Trust’s view that it was compliant with the standards. The Trust continues to take action to ensure the standards of information governance are improved further in line with best practice.

7. Significant Control Issues7.1 During the year, there have been no significant control

issues.

8. Conclusion8.1 My review confirms that Derbyshire Community Health

Services NHS Trust has a generally sound system of risk management and internal control that supports the achievement of its policies, aims and objectives.

Signed (on behalf of the Board of Directors)

Chief Executive

……………………………………………………….


Board members’ declaration of interests 2013/14

Name Job title Date declared

Interests to declareDate Change made

Tracy Allen Chief Executive 28/03/13 Husband employed by Hardwick CCG

Andrew Fry Chairman 28/02/13 None 26/07/13 Andrew Fry left the organisation

Prem Singh Chairman 20/11/13 Managing Director of PMS ConsultingWife works at TDA as Portfolio Director

1/12/13 Prem Singh commenced in Chair’s role

Chris Bentley Non-Executive Director

28/02/13 Independent Population Health Consultant - Professor Chris Bentley Consulting Ltd

Kirsteen Farrar Trust Secretary 11/03/13 None

Jo Furley Interim Director of Quality & Chief Nurse

01/07/13 None 01/09/13 Interim Chief Nurse post ended upon appointment of the substantive Chief Nurse

Simon Griffiths Director of Strategy

28/02/13 Trustee of Heritage Care - Charity providing supported living services for older people, learning disabilities and mental health

Kathryn Henderson

Director of Quality & Chief Nurse

05/03/13 Trustee of The Richard Foundation (also known as Bluebell Wood Children’s Hospice)

30/6/13 Kathryn Henderson left the organisation

William Jones Director of Operations

04/03/13 Trustee and Board Member - Helen’s Trust

Ben Lobo Medical Director 28/02/13 Development work undertaken in 2012 for Education and Training Website - NHS End of Life Programme.

Richard Meredith

Acting Medical Director

15/01/14 None 01/10/13 Acting Medical Director Post commenced

Tony Okotie Non-Executive Director

13/03/13 Chief Executive - Community and Voluntary Action Tameside

Director - Greater Manchester Centre For Voluntary Organisation (GMCVD)

Chief Executive Healthwatch Tameside

Director - Converge Wellbeing Consortium

Partner is Director of Care - Seashell Trust

Partner is Trustee - Buxton Volunteer Centre

Changes made during the year

74


Name Job title Date declared

Interests to declareDate Change made

Amanda Rawlings

Director of People and Organisational Effectiveness

28/02/13 Independent Board Member - Cross Keys Homes, Peterborough

Chris Sands Director of Finance, Performance & Information

28/02/13 None

Nigel Smith Non-Executive Director

28/02/13 None

Barry Steans Non-Executive Director

10/03/13 Independent Member on Audit and Accounts Committee and Standards Committee - Staffordshire Moorlands District Council.

Treasurer - RS Milner Bequest for Educational Purposes

Barbara-Anne Walker

Non-Executive Director

28/02/13 British Red Cross - Operations Director for Derbyshire, Cheshire and Nottinghamshire.

Husband, Paul Devlin, is Non-Executive Director with NHS Derbyshire Cluster.

Chair of SAIL (Registered Charity) which has Joint SLA with Derbyshire County Council and NHS Derbyshire Cluster

13/11/13 Husband is Chief Executive Officer of Birmingham Healthwatch

Carolyn White Director of Quality & Chief Nurse

01/09/13 None 01/09/13 Carolyn White commenced in post

Carolyn White Interim Director of Quality & Chief Nurse

24/01/13 None 4/4/13 Carolyn White left the organisation as Interim Director of Quality

Changes made during the year


Statement of Comprehensive Income for year ended 31 March 2014 2013/14 2012/13 NOTE £000s £000s Gross employee benefits 10.1 (121,166) (121,403)Other operating costs 8 (60,191) (64,235)Revenue from patient care activities 5 173,904 175,443Other Operating revenue 6 9,807 12,955Operating surplus/(deficit) 2,354 2,760 Investment revenue 12 55 37Other gains and (losses) 13 0 0Finance costs 14 0 0Surplus/(deficit) for the financial year 2,409 2,797Public dividend capital dividends payable 0 0 Transfers by absorption - gains 0 0 Transfers by absorption - (losses) 0 0Net Gain/(loss) on transfers by absorption 0 0Retained surplus/(deficit) for the year 2,409 2,797 Other Comprehensive Income 2013/14 2012/13 £000s £000s Impairments and reversals taken to the Revaluation Reserve (2,617) 0Net gain/(loss) on revaluation of property, plant & equipment 2,508 0Net gain/(loss) on revaluation of intangibles 0 0Net gain/(loss) on revaluation of financial assets 0 0Other gain /(loss) (explain in footnote below) 515 0Net gain/(loss) on revaluation of available for sale financial assets 0 0Net actuarial gain/(loss) on pension schemes 0 0Other Pension Remeasurements 0 0Reclassification Adjustments On disposal of available for sale financial assets 0 0Total Comprehensive Income for the year* 2,815 2,797

Adjusted retained surplus/(deficit)

2,8922013/14 (£000s)

2,8802012/13 (£000s)

Retained surplus/(deficit) for the year 2,409 2,797Prior period adjustment to correct errors and other performance adjustments 0 0IFRIC 12 adjustment (including IFRIC 12 impairments) 0 0Impairments (excluding IFRIC 12 impairments) 880 144Adjustments in respect of donated gov't grant asset reserve elimination (397) (61)Adjustment re Absorption accounting 0 0

Financial performance for the year

Note the other gain relates to write back of former legacy PCT payables which were discharged using DH cash.

31 March 2014 31 March 2013 NOTE £000s £000s


Non-current assets: Property, plant and equipment 15 79,643 3,921Intangible assets 16 1,354 525Investment property 18 0 0Other financial assets 0 0Trade and other receivables 22.1 0 0Total non-current assets 80,997 4,446Current assets: Inventories 21 0 54Trade and other receivables 22.1 10,492 6,257Other financial assets 24.1 0 0Other current assets 25 0 0Cash and cash equivalents 26 11,731 10,932Total current assets 22,223 17,243Non-current assets held for sale 27 0 0Total current assets 22,223 17,243Total assets 103,220 21,689

Current liabilities Trade and other payables 28 (17,085) (15,347)Other liabilities 29 0 0Provisions 35 (967) (250)Borrowings 30 0 0Other financial liabilities 31 0 0Working capital loan from Department 30 0 0Capital loan from Department 30 0 0Total current liabilities (18,052) (15,597)Net current assets/(liabilities) 4,171 1,646Non-current assets plus/less net current assets/liabilities 85,168 6,092

Non-current liabilities Trade and other payables 28 0 0Other Liabilities 31 0 0Provisions 35 0 (27)Borrowings 30 0 0Other financial liabilities 31 0 0Working capital loan from Department 30 0 0Capital loan from Department 30 0 0Total non-current liabilities 0 (27)Total Assets Employed: 85,168 6,065

FINANCED BY: TAXPAYERS’ EQUITY Public Dividend Capital (172) (357)Retained earnings 67,296 6,336Revaluation reserve 18,044 86Other reserves 0 0Total Taxpayers’ Equity: 85,168 6,065 The financial statements were approved by the Board and signed on its behalf by Chief Executive: Date:

31 March 2014 31 March 2013 NOTE £000s £000s

Statement of Financial Position as at 31 March 2014

5 June 2014


£000’s £000’s £000’s £000’s £000’sBalance at 1 April 2013 (357) 6,336 0 86 6,065Changes in taxpayers’ equity for 2013/14 Retained surplus/(deficit) for the year 0 2,409 0 0 2,409Net gain / (loss) on revaluation of property, plant, equipment 0 0 2,508 0 2,508Net gain / (loss) on revaluation of intangible assets 0 0 0 0 0Net gain / (loss) on revaluation of financial assets 0 0 0 0 0Net gain / (loss) on revaluation of available for sale financial assets 0 0 0 0 0Impairments and reversals 0 0 (2,617) 0 (2,617)Other gains/(loss) (provide details below) 0 0 0 515 515Transfers between reserves 0 520 (5) (515) 0Transfers under Modified Absorption Accounting - PCTs & SHAs 0 76,103 0 0 76,103Transfers under Modified Absorption Accounting - Other Bodies 0 0 0 0 0

Reclassification Adjustments Transfers to/(from) Other Bodies within the Resource Account Boundary 0 0 0 0 0Transfers between Revaluation Reserve & Retained Earnings in respect of assets transferred under absorption 0 0 0 0 0On Disposal of Available for Sale financial Assets 0 0 0 0Reserves eliminated on dissolution 0 0 0 0 0Originating capital for Trust established in year 0 0 0 0 0New PDC Received - Cash 185 0 0 0 185New PDC Received/(Repaid) - PCTs and SHAs Legacy items paid for by Department of Health 0 0 0 0 0PDC Repaid In Year 0 0 0 0 0PDC Written Off 0 0 0 0 0Transferred to NHS Foundation Trust 0 0 0 0 0Other Movements 0 0 0 0 0Net Actuarial Gain/(Loss) on Pension 0 0 0 0 0Other Pensions Remeasurement 0 0 0 0 0Net recognised revenue/(expense) for the year 185 79,032 (114) 0 79,103Transfers between reserves in respect of modified absorption - PCTs & SHAs (18,072) 18,072 0 0Transfers between reserves in respect of modified absorption - Other Bodies 0 0 0 0Balance at 31 March 2014 (172) 67,296 18,044 0 85,168 Balance at 1 April 2012 0 3,527 98 0 3,625Changes in taxpayers’ equity for the year ended 31 March 2013 Retained surplus/(deficit) for the year 0 2,797 0 0 2,797Net gain / (loss) on revaluation of property, plant, equipment 0 0 0 0 0Net gain / (loss) on revaluation of intangible assets 0 0 0 0 0Net gain / (loss) on revaluation of financial assets 0 0 0 0 0Net gain / (loss) on revaluation of assets held for sale 0 0 0 0 0Impairments and reversals 0 0 0 0 0Movements in other reserves 0 0 0 0 0Transfers between reserves 0 12 (12) 0 0Release of reserves to Statement of Comprehensive Income 0 0 0 0Reclassification Adjustments Transfers to/(from) Other Bodies within the Resource Account Boundary 0 0 0 0 0Transfers between Revaluation Reserve & Retained Earnings Reserve in respect of assets transferred under absorption 0 0 0 0 0On Disposal of Available for Sale financial Assets 0 0 0 0 0Reserves eliminated on dissolution 0 0 0 0 0Originating capital for Trust established in year 0 0 0 0 0New PDC Received 0 0 0 0 0PDC Repaid In Year (357) 0 0 0 (357)PDC Written Off 0 0 0 0 0Transferred to NHS Foundation Trust 0 0 0 0 0Other Movements in PDC In Year 0 0 0 0 0Net Actuarial Gain/(Loss) on Pension 0 0 0 0 0Net recognised revenue/(expense) for the year (357) 2,809 (12) 0 2,440Balance at 31 March 2013 (357) 6,336 86 0 6,065

Statement of Changes in Taxpayers’ Equity For the year ended 31 March 2014

The movements in Other Reserves relates to the discharge of inherited payables balances following the demise of former SHA and PCT bodies. As part of the Health and Social Care reforms these legacy organisations cease to exist with effect from 31st March 2013. These payables balances were settled using DH cash by the former Derbyshire County PCT legacy team in the period from 1st April 2013 to 31st August 2013. This transaction is reflected as “Other Reserves” and then transferred to Retained Earnings as shown above.

Public Dividend

capital

Retained earnings

Revaluationreserve

Otherreserves

Totalreserves


Cash Flows from Operating Activities Operating Surplus/(Deficit) 2,354 2,760Depreciation and Amortisation 4,452 1,059Impairments and Reversals 880 144Other Gains/(Losses) on foreign exchange 0 0Donated Assets received credited to revenue but non-cash (14) (26)Government Granted Assets received credited to revenue but non-cash (15) 0Interest Paid 0 0Dividend (Paid)/Refunded 0 2,161Release of PFI/deferred credit 0 0(Increase)/Decrease in Inventories 54 4(Increase)/Decrease in Trade and Other Receivables (4,091) 2,541(Increase)/Decrease in Other Current Assets 0 0Increase/(Decrease) in Trade and Other Payables 774 (7,338)(Increase)/Decrease in Other Current Liabilities 0 0Provisions Utilised 0 (3)Increase/(Decrease) in Provisions 690 278Net Cash Inflow/(Outflow) from Operating Activities 5,084 1,580

CASH FLOWS FROM INVESTING ACTIVITIES Interest Received 55 37(Payments) for Property, Plant and Equipment (4,187) (986)(Payments) for Intangible Assets (338) (258)(Payments) for Investments with DH 0 0(Payments) for Other Financial Assets 0 0(Payments) for Financial Assets (LIFT) 0 0Proceeds of disposal of assets held for sale (PPE) 0 351Proceeds of disposal of assets held for sale (Intangible) 0 0Proceeds from Disposal of Investment with DH 0 0Proceeds from Disposal of Other Financial Assets 0 0Proceeds from the disposal of Financial Assets (LIFT) 0 0Loans Made in Respect of LIFT 0 0Loans Repaid in Respect of LIFT 0 0Rental Revenue 0 0Net Cash Inflow/(Outflow) from Investing Activities (4,470) (856)

NET CASH INFLOW/(OUTFLOW) BEFORE FINANCING 614 724

CASH FLOWS FROM FINANCING ACTIVITIES Public Dividend Capital Received 185 0Public Dividend Capital Repaid 0 (357)Loans received from DH - New Capital Investment Loans 0 0Loans received from DH - New Revenue Support Loans 0 0Other Loans Received 0 0Loans repaid to DH - Capital Investment Loans Repayment of Principal 0 0Loans repaid to DH - Revenue Support Loans 0 0Other Loans Repaid 0 0Cash transferred to NHS Foundation Trusts 0 0Capital Element of Payments in Respect of Finance Leases and On-SoFP PFI and LIFT 0 0Capital grants and other capital receipts (excluding donated / government granted cash receipts) 0 0Net Cash Inflow/(Outflow) from Financing Activities 185 (357)

NET INCREASE/(DECREASE) IN CASH AND CASH EQUIVALENTS 799 367

Cash and Cash Equivalents (and Bank Overdraft) at Beginning of the Period 10,932 10,565Effect of Exchange Rate Changes in the Balance of Cash Held in Foreign Currencies 0 0Cash and Cash Equivalents (and Bank Overdraft) at year end 11,731 10,932

2013/14 2012/13 NOTE £000s £000s

Statement of cash flows for the year ended 31 March 2014


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 NHS Trusts Manual for Accounts, which shall be agreed with HM Treasury. Consequently, the following financial statements have been prepared in accordance with the 2013/14 NHS Manual for Accounts 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 NHS Trusts 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.

1.2 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

“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 has agreed that a modified absorption approach should be applied. For these transactions only, gains and losses are recognised in reserves rather than the SOCNE/SOCNI.”

1.4 Charitable Funds

For 2013/14, the divergence from the FReM that NHS Charitable Funds are not consolidated with NHS Trust’s own returns is removed. Under the provisions of IAS 27 Consolidated and Separate Financial Statements, those Charitable Funds that fall under common control with NHS bodies are consolidated within the entity’s financial statements. In accordance with IAS 1 Presentation of Financial Statements, restated prior period accounts are presented where the adoption of the new policy has a material impact.

“For non-consolidated charities:

Following Treasury’s agreement to apply IAS 27 to NHS Charities from 1 April 2013, the Trust has established that as the Trust is the corporate Trustee of the linked NHS Charity The Derbyshire Community Health Services Charitable Trust, it effectively has the power to exercise control so as to obtain economic benefits. However the transactions are immaterial in the context of the group and transactions have not been consolidated. Details of the transactions with the charity are included in the related parties’ notes.”

1.5 Critical accounting judgements and key sources of estimation uncertainty

In the application of the 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.

1.5.1 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 Trust’s accounting policies and that have the most significant effect on the amounts recognised in the financial statements.

Notes to the accounts

Notes To The Accounts


Accounting for property, plant and equipment

On 1st April 2013 the Trust acquired assets from the former Derby County Primary Care Trust which was dissolved as part of the Health and Social Care reforms under which Primary Care Trusts and Strategic Health Authorities. These assets were transferred using modified absorption accounting as agreed by HM Treasury. The main part of these asset are Land and Building assets. The Trust also accounts for other non current assets such as Plant and Machinery and IT equipment. All of these assets with the exception of Land are initially recognised at cost and then depreciated over their useful economic life. Land is not depreciated.

The Trust applies industry recognised indices (provided by a Chartered Surveyor), on an annual basis. Indices are applied to land and property using the DRC method of valuation. A full physical valuation is undertaken when there has been significant expenditure in the year on a particular property to ensure that any impairments are recognised as they are brought into use.

Based on the substance of existing arrangements regarding land and property assets, the Trust has determined that for those assets where there has been a substantial transfer of the risks and rewards of ownership, that those assets should be accounted for as owned assets. These assets would previously have been accounted for by NHS Derbyshire County PCT.

During 2013/14 the Trust has commissioned the District Valuer to undertake a full valuation exercise for all Land and Buildings assets held as at 31st March 2014.

Accounting for leases

Judgements have been made regarding whether risks and rewards of ownership pass to the lessee under lease arrangements.

1.5.2 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.

Estimation of March contract income

The tight reporting deadline for the production of financial statements means that the accounts must be prepared before the final outturn position on the mulitlateral contract is confirmed. Therefore, contract income includes some estimated values based on activity information available at the time.

Compensated absences accrual

In accordance with IAS19, the Trust accrues for untaken leave at the end of the year. The accrual is based on a sample which is then extrapolated across the population.

Accounting for doubtful debts

A general provision is estimated for doubtful debts. This is based on 100% for non-NHS invoices older than 90 days.

1.6 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. Approximately 81% of this revenue is received through a block contract arrangement, with the remaining 19% being contracted on a cost and volume basis. The block income included in the accounts is as per annual contract values. Cost and Volume income included in the accounts is per activity monitoring for 11 months of the year. Due to the fast closure accounting timescales an estimate of March’s activity is included in the accounts due to activity information for March not being available at the time of the production of the accounts. 24% of this Cost and Volume activity relates to inpatient spells. Given that this equates to less than 5% of total contract income no adjustment is made for partially completed spells. Therefore as per previous years the income related to in-patient spells is based on discharged patients, with no work-in-progress adjustment being made.

1.7 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.

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, 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.

1.8 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.

1.9 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 [NHS body];

• 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 setting-up cost of a new building, ward or unit, irrespective of their individual or collective cost.

All IT hardware and software is capitalised on an annual basis.

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

• Specialised buildings – depreciated replacement cost

Until 31 March 2008, the depreciated replacement cost of specialised buildings has been estimated for an exact replacement of the asset in its present location. 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.

Until 31 March 2008, fixtures and equipment were carried at replacement cost, as assessed by indexation and depreciation of historic cost. From 1 April 2008 indexation has ceased. The carrying value of existing assets at that date will be written off over their remaining useful lives and new 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 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 written-out and charged to operating expenses.

1.10 Intangible assets

Recognition

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

• 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 internally-generated 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.

1.11 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 Trust expects to obtain economic benefits or service potential from the asset. This is specific to the 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 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 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.

As IT Hardware is usually routinely replaced every 5 years, the majority of IT equiment is fully depreciated and where greater than 5 years old is disposed of in the accounts. The only exception to this is in respect of IT Servers which are depreciated over a longer term of 8 years and not disposed of until the end of their expected useful life of 8 years.

1.12 Donated assets

Following the accounting policy change outlined in the Treasury FREM 2011/12, a donated asset reserve is no longer maintained. 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.

1.13 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. For donated and government-granted assets, a transfer is made to or from the relevant reserve to the profit/loss on disposal account so that no profit or loss is recognised in income or expenses. The remaining surplus or deficit in the donated asset or government grant reserve is then 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.

1.14 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

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.

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.

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 Trust as lessor

Amounts due from lessees under finance leases are recorded as receivables at the amount of the 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.

1.15 Inventories

Inventories are valued at the lower of cost and net realisable value. This is considered to be a reasonable approximation to fair value due to the high turnover of stocks.

1.16 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 Trust’s cash management.

1.17 Provisions

Provisions are recognised when the Trust has a present legal or constructive obligation as a result of a past event, it is probable that the 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 1.8% for employee early departure obligations).

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.

Present obligations arising under onerous contracts are recognised and measured as a provision. An onerous contract is considered to exist where the Trust has a contract under which the unavoidable costs of meeting the obligations under the contract exceed the economic benefits expected to be received under it.


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. 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.

1.18 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 Trust’. The total value of clinical negligence provisions carried by the NHSLA on behalf of the Trust is disclosed at note 35.

1.19 Non-clinical risk pooling

The Trust participates in the Property Expenses Scheme and the Liabilities to Third Parties Scheme. Both are risk pooling schemes under which the 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.

1.20 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 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 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.

1.21 Financial assets

Financial assets are recognised when the Trust becomes party to the financial instrument contract 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 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 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.

The Trust considers that the fair values of financial assets and liabilities are materially the same as the carrying value so no valuations have been undertaken.

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 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.

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.

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/through a provision for impairment of receivables.

1.22 Financial liabilities

Financial liabilities are recognised on the statement of financial position when the 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 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 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.

1.23 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.

1.24 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.

1.25 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 44 to the accounts.

1.26 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.

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, net assets transferred from NHS bodies dissolved on 1 April 2013 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.

1.27 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 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 [NHS bodies] not been bearing their own risks (with insurance premiums then being included as normal revenue expenditure).

1.28 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 2013/14. The application of the Standards as revised would not have a material impact on the accounts for 2013/14, were they applied in that year:

IAS 27 Separate Financial Statements - subject to consultation

IAS 28 Investments in Associates and Joint Ventures - subject to consultation

IFRS 9 Financial Instruments - subject to consultation - subject to consultation

IFRS 10 Consolidated Financial Statements - subject to consultation

IFRS 11 Joint Arrangements - subject to consultation

IFRS 12 Disclosure of Interests in Other Entities - subject to consultation

IFRS 13 Fair Value Measurement - subject to consultation

IPSAS 32 - Service Concession Arrangement - subject to consultation”

2. Pooled Budgets The Trust does not hold any Pooled Budgets

3. Operating segments No segmental analysis is shown as the sole activity of

Derbyshire Community Health Services NHS Trust in 2013/14 was the provision of specialist community services. The ‘Chief Operating Decision Maker’ is deemed to be the Trust Board. The Board currently receives only high level financial reporting information and does not therefore review information or allocate resources in any way that could be perceived to represent operating segments. This will be reviewed during the course of 2014/15 dependant upon the information received by the Chief Operating Decision Maker.

The Trust has five customers that account for more than 10% of its total revenue derived from providing specialist community services. Customers are defined for this purpose as ‘Clinical Commissiong Groups and NHS England’ and the total income that the Trust received in 2013/14 from Clinical Commissioning Groups and NHS England was £163m for the provision of specialist community services.

4. Income generation activities The Trust does not undertake any income generation activities with an aim of achieving profit, whose full cost exceeded £1m or was otherwise material.

5. Revenue from patient care activities 2013/14 2012/13 £000s £000s

NHS Trusts 94 165

NHS England 19,268 0

Clinical Commissioning Groups 142,057 0

Primary Care Trusts 0 173,261

Strategic Health Authorities 0 0

NHS Foundation Trusts 110 1,318

Department of Health 0 0

NHS Other (including Public Health England and Prop Co) 267 0

Non-NHS:

Local Authorities 11,359 0

Private patients 41 46

Overseas patients (non-reciprocal) 0 0

Injury costs recovery 245 258

Other 463 395

Total Revenue from patient care activities 173,904 175,443


From rendering of services

Income included in non-patient care services to other bodies relates to services provided to other NHS bodies which are not part of the main patient care contracts held with commissioners. The largest single source of non-patient care income is in relation to a number of service level agreements (SLAs) with other NHS bodies for the provision of services to support their patient care activities, e.g. the provision of nursing staff, speech and language services, hotel services. The value of these agreements was approximately £4.5m. In addition to this, for the first quarter of the financial year, the Trust continued to host the Derbyshire Health Informatics Service which generated income of £759,000.

Included in other revenue are fees received in relation to Sunshine Nursery (day care and lunches) £352,000; catering income generated from staff and visitors using community hospital canteens £335,000; estates recharges to GP practices and other bodies (excluding rent) £465,000; sale of continence products at clinics £84,000. Other sources include income from universities to support projects; income received for services provided to private health providers, income received for the administration involved in the provision of health records.

6. Other operating revenue

7. Revenue

2013/14 2012/13 £000s £000s

Recoveries in respect of employee benefits 0 0

Patient transport services 0 0

Education, training and research 994 911

Charitable and other contributions to revenue expenditure - NHS 0 0

Charitable and other contributions to revenue expenditure -non- NHS 0 120

Receipt of donations for capital acquisitions - NHS Charity 509 72

Receipt of Government grants for capital acquisitions 0 0

Non-patient care services to other bodies 6,129 10,039

Income generation 0 0

Rental revenue from finance leases 0 0

Rental revenue from operating leases 148 206

Other revenue 2,027 1,607

Total Other Operating Revenue 9,807 12,955

Total operating revenue 183,711 188,398

183,7112013/14 (£000s)

188,3982012/13 (£000s)

From sale of goods

02013/14 (£000s)

02012/13 (£000s)


2013/14 2012/13

£000s £000s

Services from other NHS Trusts 5,383 5,301

Services from CCGs/NHS England 1,032 0

Services from other NHS bodies 533 123

Services from NHS Foundation Trusts 4,955 5,678

Services from Primary Care Trusts 0 774

Total Services from NHS bodies* 11,903 11,876

Purchase of healthcare from non-NHS bodies 2,562 3,142

Trust Chair and Non-executive Directors 52 53

Supplies and services - clinical 12,876 12,644

Supplies and services - general 1,989 1,833

Consultancy services 1,535 1,091

Establishment 5,042 5,416

Transport 580 681

Premises 16,067 24,538

Hospitality 0 0

Insurance 180 159

Legal Fees 199 100

Impairments and Reversals of Receivables 12 (17)

Inventories write down 0 125

Depreciation 4,292 959

Amortisation 160 100

Impairments and reversals of property, plant and equipment 876 19

Impairments and reversals of intangible assets 4 0

Impairments and reversals of financial assets [by class] 0 0

Impairments and reversals of non current assets held for sale 0 0

Impairments and reversals of investment properties 0 0

Audit fees 84 84

Other auditor’s remuneration [Quality and Accounts] 18 21

Clinical negligence 328 128

Research and development (excluding staff costs) 0 0

Education and Training 499 423

Change in Discount Rate 0 0

Other 933 860

Total Operating expenses (excluding employee benefits) 60,191 64,235

*Services from NHS bodies does not include expenditure which falls into a category below

Employee Benefits

Employee benefits excluding Board members 119,941 120,109

Board members 1,225 1,294

Total Employee Benefits 121,166 121,403

Total Operating Expenses 181,357 185,638

8. Operating expenses


2013/14 2012/13 £000 £000sRecognised as revenue Rental revenue 148 206Contingent rents 0 0Total 148 206

Receivable:No later than one year 0 199Between one and five years 0 0After five years 0 0Total 0 199

Land Buildings Other Total 2012/13 £000s £000s £000s £000s £000sPayments recognised as an expense Minimum lease payments 7 6,027 687 6,721 9,026Contingent rents 0 0 0 0 0Sub-lease payments 0 151 0 151 4,128Total 7 6,178 687 6,872 13,154Payable: No later than one year 7 6,052 687 6,746 7,816Between one and five years 0 3,528 661 4,189 4,827After five years 0 8,821 0 8,821 9,704Total 7 18,401 1,348 19,756 22,347 Total future sublease payments expected to be received: 0 0

9. Operating LeasesThe costs set out below are for payment on leased cars, land, buildings and medical equipment. The terms are standard operating lease terms, with no obligation or incentive to purchase at the end of the lease period and no contingent rents.

9.1 Trust as lessee

9.2 Trust as lessorThe Trust receives rental income from the lease of health buildings.

The terms of these leases are standard operating lease terms, with no obligation or incentive to purchase at the end of the period.


Medical and dental 50 50 0 50 Ambulance staff 0 0 0 0 Administration and estates 894 870 24 954 Healthcare assistants and other support staff 949 946 3 1,023 Nursing, midwifery and health visiting staff 998 907 91 924 Nursing, midwifery and health visiting learners 0 0 0 0 Scientific, therapeutic and technical staff 569 559 10 550 Social Care Staff 0 0 0 0 Other 1 1 0 1 TOTAL 3,461 3,333 128 3,502 Of the above - staff engaged on capital projects 0 0 0 0

2013/14 2012/13 Number NumberTotal Days Lost 31,365 34,836Total Staff Years 3,336 3,457Average working Days Lost 9.40 10.08Number of persons retired early on ill health grounds 8 6 £000s £000sTotal additional pensions liabilities accrued in the year 682 326

2013/14 Permanently

employed£000s

2013/14 Permanently

employed£000s

2013/14 Permanently

employedNumber

Total£000s

Total£000s

TotalNumber

2012/13

TotalNumber

OtherNumber

Other£000s

Other£000s

Employee Benefits - Gross Expenditure Salaries and wages 101,781 97,407 4,374 Social security costs 6,003 5,745 258 Employer Contributions to NHS BSA - Pensions Division 12,417 11,883 534 Other pension costs 5 5 0 Termination benefits 960 960 0 Total employee benefits 121,166 116,000 5,166 Employee costs capitalised 0 0 0 Gross Employee Benefits excluding capitalised costs 121,166 116,000 5,166

10. Employee benefits and staff numbers10.1 Employee benefits

10.2 Staff Numbers

10.3 Staff Sickness absence and ill health retirements

Employee Benefits - Gross Expenditure 2012/13 Salaries and wages 100,432 97,873 2,559 Social security costs 6,036 5,882 154 Employer Contributions to NHS BSA - Pensions Division 12,254 11,942 312 Other pension costs 0 0 0 Termination benefits 2,681 2,681 0 TOTAL - including capitalised costs 121,403 118,378 3,025 Employee costs capitalised 0 0 0 Gross Employee Benefits excluding capitalised costs 121,403 118,378 3,025 In 2012/13 there were categories for ‘other post-employment benefits’ and ‘other employment benefits’. These are now included within the ‘Salaries and wages’ category.


*Number of compulsory

redundanciesNumber

*Number of compulsory

redundanciesNumber

*Number of other

departures agreed

Number

Aggrements Number

Aggrements Number

Total value of agreements

£000s

Total value of agreements

£000s

*Number of other

departures agreed

Number

Total number of exit

packages by cost band

Number

Total number of exit

packages by cost band

Number

10.4 Exit Packages agreed in 2013/14

10.5 Exit packages - Other Departures analysis

Exit package cost band (including any special payment element)

2013/14

2013/14

2012/13

2012/13

Less than £10,000 7 18 25 10 58 68£10,000 - £25,000 26 9 35 9 45 54£25,001 - £50,000 2 3 5 3 35 38£50,001 - £100,000 1 2 3 0 2 2£100,001 - £150,000 0 0 0 0 0 0£150,001 - £200,000 0 0 0 0 0 0>£200,000 0 0 0 0 0 0Total number of exit packages by type (total cost) 36 32 68 22 140 162Total resource cost (£s) 718,188 450,377 1,168,565 313,339 2,367,663 2,681,002

Voluntary redundancies including early retirement contractual costs 0 0 0 0

Mutually agreed resignations (MARS) contractual costs 32 450 140 2,368

Early retirements in the efficiency of the service contractual costs 0 0 0 0

Contractual payments in lieu of notice 0 0 0 0

Exit payments following Employment Tribunals or court orders 0 0 0 0

Non-contractual payments requiring HMT approval* 0 0 0 0

Total 32 450 140 2,368

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.

As a single exit package can be made up of several components each of which will be counted separately in this Note, the total number above will not necessarily match the total numbers in Note 10.4 which will be the number of individuals.

There were 0 non-contractual payments (£0) made to individuals where the payment value was more than 12 months’ of their annual salary.

The Remuneration Report includes disclosure of exit payments payable to individuals named in that Report.

Redundancy and other departure costs have been paid in accordance with the provisions of the Agenda for Change NHS Terms and Conditions. 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.

This disclosure reports the number and value of exit packages taken by staff leaving in the year. Note: The expense associated with these departures may have been recognised in part or in full in a previous period.


10.6 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:

Accounting valuationA 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 2014, is based on valuation data as 31 March 2013, updated to 31 March 2014 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.

Full actuarial (funding) valuationThe 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.

The last published actuarial valuation undertaken for the NHS Pension Scheme was completed for the year ending 31 March 2004. Consequently, a formal actuarial valuation would have been due for the year ending 31 March 2008. However, formal actuarial valuations for unfunded public service schemes were suspended by HM Treasury on value for money grounds while consideration is given to recent changes to public service pensions, and while future scheme terms are developed as part of the reforms to public service pension provision due in 2015.

The Scheme Regulations were changed to 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.

The next formal valuation to be used for funding purposes will be carried out at as at March 2012 and will be used to inform the contribution rates to be used from 1 April 2015.

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.

10.6 Pension costs (continued) 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 the employer. 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.

a)

b)

c)


2013/14 2012/13 £000s £000sAmounts included in finance costs from claims made under this legislation 0 0Compensation paid to cover debt recovery costs under this legislation 0 0Total 0 0

Rental revenue

PFI finance lease revenue (planned) 0 0

PFI finance lease revenue (contingent) 0 0

Other finance lease revenue 0 0

Subtotal 0 0

Interest revenue

LIFT: equity dividends receivable 0 0

LIFT: loan interest receivable 0 0

Bank interest 55 37

Other loans and receivables 0 0

Impaired financial assets 0 0

Other financial assets 0 0

Subtotal 55 37

Total investment revenue 55 37

11 Better Payment Practice Code

2013/14 2013/14 2012/13 2012/13 Number £000s Number £000sNon-NHS Payables Total Non-NHS Trade Invoices Paid in the Year 40,018 40,018 35,838 29,616Total Non-NHS Trade Invoices Paid Within Target 38,966 38,914 34,600 28,764Percentage of NHS Trade Invoices Paid Within Target 97.37% 97.24% 96.55% 97.12% NHS Payables Total NHS Trade Invoices Paid in the Year 1,104 25,311 1,372 43,423Total NHS Trade Invoices Paid Within Target 1,086 24,904 1,347 43,318Percentage of NHS Trade Invoices Paid Within Target 98.37% 98.39% 98.18% 99.76% 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.

11.2 The Late Payment of Commercial Debts (Interest) Act 1998

12. Investment Revenue 2013/14 2012/13 £000s £000s

11.1 Measure of compliance


14. Finance Costs

Gain/(Loss) on disposal of assets other than by sale (PPE) 0 0

Gain/(Loss) on disposal of assets other than by sale (intangibles) 0 0

Gain/(Loss) on disposal of Financial Assets other then held for sale 0 0

Gain (Loss) on disposal of assets held for sale 0 0

Gain/(loss) on foreign exchange 0 0

Change in fair value of financial assets carried at fair value through the SoCI 0 0

Change in fair value of financial liabilities carried at fair value through the SoCI 0 0

Change in fair value of investment property 0 0

Recycling of gain/(loss) from equity on disposal of financial assets held for sale 0 0

Total 0 0

13. Other Gains and Losses 2013/14 2012/13 £000s £000s

2013/14 2012/13 £000 £000s

Interest

Interest on loans and overdrafts 0 0

Interest on obligations under finance leases 0 0

Interest on obligations under PFI contracts:

- main finance cost 0 0

- contingent finance cost 0 0

Interest on obligations under LIFT contracts:

- main finance cost 0 0

- contingent finance cost 0 0

Interest on late payment of commercial debt 0 0

Total interest expense 0 0

Other finance costs 0 0

Provisions - unwinding of discount 0 0

Total 0 0


Cost or valuation: At 1 April 2013 0 0 0 177 5,016 17 1,866 1,745 8,821Transfers under Modified Absorption Accounting - PCTs & SHAs 14,558 59,776 0 708 674 0 487 449 76,652Transfers under Modified Absorption Accounting - Other Bodies 0 0 0 0 0 0 0 0 0Additions of Assets Under Construction 0 0 0 4,971 0 0 0 0 4,971Additions Purchased 0 0 0 0 0 0 0 0 0Additions - Non Cash Donations 0 0 0 0 14 0 0 0 14Additions - Purchases from Cash Donations 0 470 0 0 25 0 0 0 495Additions Leased 0 0 0 0 0 0 0 0 0Reclassifications 0 3,267 0 (5,323) 228 0 797 0 (1,031)Reclassifications as Held for Sale and reversals 0 5 0 0 (121) 0 0 0 (116)Disposals other than for sale 0 0 0 0 (418) 0 (92) (573) (1,083)Upward revaluation/ positive indexation 1,510 998 0 0 0 0 0 0 2,508Impairments/ negative indexation (36) (2,581) 0 0 0 0 0 0 (2,617)Reversal of Impairments 0 0 0 0 0 0 0 0 0Transfers to NHS Foundation Trust 0 0 0 0 0 0 0 0 0Transfers (to)/from Other Public Sector Bodies under Absorption Accounting 0 0 0 0 0 0 0 0 0At 31 March 2014 16,032 61,935 0 533 5,418 17 3,058 1,621 88,614

Land

2013/14 £000s £000s £000s £000s £000s £000s £000s £000s £000s

Buildings excluding dwellings


Dwellings Assets under construction

& payment on account

Plant & machinery

Transport equipment

Informationtechnology

Furniture & fittings

Total

Depreciation At 1 April 2013 0 0 0 1 3,462 13 452 972 4,900Reclassifications 0 0 0 0 0 0 0 0 0Reclassifications as Held for Sale and reversals 0 5 0 0 (19) 0 0 0 (14)Disposals other than for sale 0 0 0 0 (418) 0 (92) (573) (1,083)Upward revaluation/ positive indexation 0 0 0 0 0 0 0 0 0Impairments 0 635 0 24 54 0 10 153 876Reversal of Impairments 0 0 0 0 0 0 0 0 0Charged During the Year 0 2,571 0 0 761 2 754 204 4,292Transfers to NHS Foundation Trust 0 0 0 0 0 0 0 0 0Transfers (to)/from Other Public Sector Bodies under Absorption Accounting 0 0 0 0 0 0 0 0 0At 31 March 2014 0 3,211 0 25 3,840 15 1,124 756 8,971Net Book Value at 31 March 2014 16,032 58,724 0 508 1,578 2 1,934 865 79,643


Asset financing: Owned - Purchased 16,032 55,379 0 508 1,456 2 1,934 865 76,176Owned - Donated 0 3,345 0 0 122 0 0 0 3,467Owned - Government Granted 0 0 0 0 0 0 0 0 0Held on finance lease 0 0 0 0 0 0 0 0 0On-SOFP PFI contracts 0 0 0 0 0 0 0 0 0PFI residual: interests 0 0 0 0 0 0 0 0 0Total at 31 March 2014 16,032 58,724 0 508 1,578 2 1,934 865 79,643

Revaluation Reserve Balance for Property, Plant & Equipment At 1 April 2013Movements (specify) 0 0 0 0 71 0 0 15 86At 31 March 2014 4,806 13,130 0 0 24 0 0 (2) 17,958 4,806 13,130 0 0 95 0 0 13 18,044

Land

2013/14 £000s £000s £000s £000s £000s £000s £000s £000s £000s




Plant & machinery

Transport equipment



Total


Additions to Assets Under Construction in 2013/14 Land 0Buildings excl Dwellings 3,028Dwellings 0Information Technology Hardware & Software 1,749Plant & Machinery 194Balance as at YTD 4,971

£000s

Assets under construction


Expenditure initially charged to Assets Under Construction has on completion of each capital scheme been reclassified to the relevant asset category. In 2013/14 an amount of £1,031,000 has been reclassified to Intangible Assets.


Cost or valuation: At 1 April 2012 0 0 0 71 5,353 17 2,543 1,746 9,730Additions - Assets Under Construction 0 0 0 1,359 0 0 0 0 1,359Additions - purchased 0 0 0 0 0 0 0 0 0Additions - donated 0 0 0 0 72 0 0 0 72Additions - government granted 0 0 0 0 0 0 0 0 0Reclassifications 0 0 0 (1,253) 181 0 763 (1) (310)Reclassifications as Held for Sale and reversals 0 0 0 0 (196) 0 (246) 0 (442)Disposals other than by sale 0 0 0 0 (394) 0 (1,194) 0 (1,588)Revaluation & indexation gains 0 0 0 0 0 0 0 0 0Impairments 0 0 0 0 0 0 0 0 0Reversals of impairments 0 0 0 0 0 0 0 0 0Transfer to NHS Foundation Trust 0 0 0 0 0 0 0 0 0Transfers (to)/from Other Public Sector Bodies under absorption accounting 0 0 0 0 0 0 0 0 0At 31 March 2013 0 0 0 177 5,016 17 1,866 1,745 8,821

Land

2013/14 £000s £000s £000s £000s £000s £000s £000s £000s £000s




Plant & machinery

Transport equipment



Total

Depreciation At 1 April 2012 0 0 0 1 3,250 11 1,510 829 5,601Reclassifications 0 0 0 0 0 0 0 0 0Reclassifications as Held for Sale and reversals 0 0 0 0 (2) 0 (89) 0 (91)Disposals other than for sale 0 0 0 0 (394) 0 (1,194) 0 (1,588)Upward revaluation/ positive indexation 0 0 0 0 0 0 0 0 0Impairments 0 0 0 0 19 0 0 0 19Reversal of Impairments 0 0 0 0 0 0 0 0 0Charged During the Year 0 0 0 0 589 2 225 143 959Transfer to NHS Foundation Trust 0 0 0 0 0 0 0 0 0Transfers (to)/from Other Public Sector Bodies under absorption accounting 0 0 0 0 0 0 0 0 0At 31 March 2013 0 0 0 1 3,462 13 452 972 4,900Net book value at 31 March 2013 0 0 0 176 1,554 4 1,414 773 3,921

15.2 Property, plant and equipment prior-year

Purchased 0 0 0 176 1,554 4 1,414 773 3,921Donated 0 0 0 0 0 0 0 0 0Government Granted 0 0 0 0 0 0 0 0 0Total at 31 March 2013 0 0 0 176 1,554 4 1,414 773 3,921 Asset financing: Owned 0 0 0 176 1,554 4 1,414 773 3,921Held on finance lease 0 0 0 0 0 0 0 0 0On-SOFP PFI contracts 0 0 0 0 0 0 0 0 0PFI residual: interests 0 0 0 0 0 0 0 0 0Total at 31 March 2013 0 0 0 176 1,554 4 1,414 773 3,921


Under the recent Health and Social Care reforms the former Primary Care Trust and Strategic Health Authorities were abolished on 31st March 2013. As part of the closure of the former Derbyshire County Primary Care Trust, Derbyshire Community Health Services NHS Trust was transfered £76.7m of assets that formerly were owned by the Primary Care Trust. This was primarily comprised of Land & Buildings valued at £74.3m. The Trust had donated asset additions in the year totalling £509,000. Whitworth Hospital League of Friends donated £287,000 towards the upgrade of Oker Ward and the Physiotherapy unit. A further £160,000 was donated from the Derbyshire Community Health Services Charitable Fund for the same project.

£18,000 was donated by Ilkeston Hospital League of Friends to purchase Elite equipment for the Diagnostic Treatment Centre. They also donated £7,000 for the purchase of a bladder scanner. The Derbyshire Community Health Services Charitable Fund donated two bladder scanners to the value of £14,000 for use in the Ilkeston and Ashbourne areas. £23,000 was donated by Ripley Hospital League of Friends towards the upgrade of the Ultrasound area in the hospital.

15.3 Property, plant and equipment (continued).

The Trust uses economic lives for buildings as advised by the District Valuer during his periodic reviews

Economic Lives of Plant Property and Equipment

Software Licences

Licences and Trademarks

Patents

Development Expenditure

Buildings excl. Dwellings

Plant and Machinery

Transport Equipment

Information Technology

Furniture and Fittings

Minimum Life (years) Maximum Life (years)

5

0

0

0

16

5

7

5

5

5

0

0

0

100

15

7

8

10


At 1 April 2013 0 780 0 0 0 780Transfers under Modified Absorption Accounting - PCTs & SHAs 4 0 0 0 0 4Transfers under Modified Absorption Accounting - Other Bodies 0 0 0 0 0 0Additions - purchased 0 0 0 0 0 0Additions - internally generated 0 0 0 0 0 0Additions - donated 0 0 0 0 0 0Additions - government granted 0 0 0 0 0 0Additions - leased 0 0 0 0 0 0Reclassifications 0 1,031 0 0 0 1,031Reclassified as Held for Sale and Reversals 0 (70) 0 0 0 (70)Disposals other than by sale (4) (89) 0 0 0 (93)Revaluation & indexation gains 0 0 0 0 0 0Impairments charged to reserves 0 0 0 0 0 0Reversal of impairments charged to reserves 0 0 0 0 0 0Transfer to NHS Foundation Trust 0 0 0 0 0 0Transfer (to)/from Other Public Sector bodies under Absorption Accounting 0 0 0 0 0 0At 31 March 2014 0 1,652 0 0 0 1,652 Amortisation At 1 April 2013 0 255 0 0 0 255Reclassifications 0 0 0 0 0 0Reclassified as Held for Sale and Reversals 0 (28) 0 0 0 (28)Disposals other than by sale (4) (89) 0 0 0 (93)Revaluation or indexation gains 0 0 0 0 0 0Impairments charged to operating expenses 4 0 0 0 0 4Reversal of impairments charged to operating expenses 0 0 0 0 0 0Charged during the year 0 160 0 0 0 160Transfer to NHS Foundation Trust 0 0 0 0 0 0Transfer (to)/from Other Public Sector bodies under Absorption Accounting 0 0 0 0 0 0At 31 March 2014 0 298 0 0 0 298Net Book Value at 31 March 2014 0 1,354 0 0 0 1,354

Asset Financing: Net book value at 31 March 2014 comprises: Purchased 0 1,354 0 0 0 1,354Donated 0 0 0 0 0 0Government Granted 0 0 0 0 0 0Finance Leased 0 0 0 0 0 0On-balance Sheet PFIs 0 0 0 0 0 0Total at 31 March 2014 0 1,354 0 0 0 1,354

Revaluation reserve balance for intangible non-current assets

At 1 April 2013 0 0 0 0 0 0Movements (specify) 0 0 0 0 0 0At 31 March 2014 0 0 0 0 0 0

16.1 Intangible non-current assets

2012/13 £000s £000s £000s £000s £000s £000s

IT - in-house & 3rd party

software

Computer Licenses

Licenses and Trademarks

Patents Development Expenditure

- Internally Generated

Total

£000s £000s £000s £000s £000s £000s


2012/13 £000s £000s £000s £000s £000s £000s

IT - in-house & 3rd party

software

Computer Licenses

Licenses and Trademarks

Patents Development Expenditure

- Internally Generated

Total

16.2 Intangible non-current assets prior year

Cost or valuation: At 1 April 2012 0 515 0 0 0 515Additions - purchased 0 0 0 0 0 0Additions - internally generated 0 0 0 0 0 0Additions - donated 0 0 0 0 0 0Additions - government granted 0 0 0 0 0 0Reclassifications 0 310 0 0 0 310Reclassified as held for sale 0 0 0 0 0 0Disposals other than by sale 0 (45) 0 0 0 (45)Revaluation & indexation gains 0 0 0 0 0 0Impairments 0 0 0 0 0 0Reversal of impairments 0 0 0 0 0 0Transfer to NHS Foundation Trust 0 0 0 0 0 0Transfer (to)/from Other Public Sector bodies under Absorption Accounting 0 0 0 0 0 0At 31 March 2013 0 780 0 0 0 780 Amortisation At 1 April 2012 0 200 0 0 0 200Reclassifications 0 0 0 0 0 0Reclassified as held for sale 0 0 0 0 0 0Disposals other than by sale 0 (45) 0 0 0 (45)Revaluation or indexation gains 0 0 0 0 0 0Impairments charged to operating expenses 0 0 0 0 0 0Reversal of impairments charged to operating expenses 0 0 0 0 0 0Charged during the year 0 100 0 0 0 100Transfer to NHS Foundation Trust 0 0 0 0 0 0Transfer (to)/from Other Public Sector bodies under Absorption Accounting 0 0 0 0 0 0At 31 March 2013 0 255 0 0 0 255Net book value at 31 March 2013 0 525 0 0 0 525 Net book value at 31 March 2013 comprises: Purchased 0 525 0 0 0 525Donated 0 0 0 0 0 0Government Granted 0 0 0 0 0 0Total at 31 March 2013 0 525 0 0 0 525

Following initial recognition, intangible assets are carried at amortised historic cost. Intangible asset values are sufficiently short that amortised historic cost is not considered to be materially different from fair value.

The only class of intangible assets held by the Trust is purchased computer software. These assets are amortised over their useful economic lives of five years.

16.3 Intangible non-current assets


17 Analysis of impairments and reversals recognised in 2013/14

£000s2013/14 Total

Property, Plant and Equipment impairments and reversals taken to SoCI Loss or damage resulting from normal operations 0Over-specification of assets 0Abandonment of assets in the course of construction 0Total charged to Departmental Expenditure Limit 0 Unforeseen obsolescence 217Loss as a result of catastrophe 0Other 19Changes in market price 640Total charged to Annually Managed Expenditure 876 Total Impairments of Property, Plant and Equipment changed to SoCI 876 Intangible assets impairments and reversals charged to SoCI Loss or damage resulting from normal operations 0Over-specification of assets 0Abandonment of assets in the course of construction 0Total charged to Departmental Expenditure Limit 0 Unforeseen obsolescence 0Loss as a result of catastrophe 0Other 4Changes in market price 0Total charged to Annually Managed Expenditure 4 Total Impairments of Intangibles charged to SoCI 4 Financial Assets charged to SoCI Loss or damage resulting from normal operations 0Total charged to Departmental Expenditure Limit 0 Loss as a result of catastrophe 0Other 0Total charged to Annually Managed Expenditure 0 Total Impairments of Financial Assets charged to SoCI 0 Non-current assets held for sale - impairments and reversals charged to SoCI. Loss or damage resulting from normal operations 0Abandonment of assets in the course of construction 0Total charged to Departmental Expenditure Limit 0 Unforeseen obsolescence 0Loss as a result of catastrophe 0Other 0Changes in market price 0Total charged to Annually Managed Expenditure 0 Total impairments of non-current assets held for sale charged to SoCI 0 Total Impairments charged to SoCI - DEL 0Total Impairments charged to SoCI - AME 880Overall Total Impairments 880 Donated and Gov Granted Assets, included above PPE - Donated and Government Granted Asset Impairments: amount charged to SOCI - DEL 0Intangibles - Donated and Government Granted Asset Impairments: amount charged to SOCI - DEL 0


Impairments and reversals taken to SoCI Loss or damage resulting from normal operations 0 0 0 0 0Over-specification of assets 0 0 0 0 0Abandonment of assets in the course of construction 0 0 0 0 0Total charged to Departmental Expenditure Limit 0 0 0 0 0 Unforeseen obsolescence 217 217 0 0 0Loss as a result of catastrophe 0 0 0 0 0Other 23 19 4 0 0Changes in market price 640 640 0 0 0Total charged to Annually Managed Expenditure 880 876 4 0 0 Total Impairments of Property, Plant and Equipment changed to SoCI 880 876 4 0 0

Donated and Gov Granted Assets, included above £000s PPE - Donated and Government Granted Asset Impairments: amount charged to SOCI - DEL 0 Intangibles - Donated and Government Granted Asset Impairments: amount charged to SOCI - DEL 0

17 Analysis of impairments and reversals recognised in 2013/14

£000s £000s £000s £000s £000s

Property Plant and

Equipment

Intangible Assets

Financial Assets

Non-Current Assets Held

for Sale

Total


18 Investment property

19.1 Capital commitmentsContracted capital commitments at 31 March not otherwise included in these financial statements:

Property, plant and equipment 999 0Intangible assets 0 0Total 999 0

Capital commitments relate to Whitworth Hospital (£942k) and Ripley Hospital (£57k)

19 Commitments

£000s £000s31 March 2014 31 March 2013

Balances with other Central Government Bodies 6,363 0 5,907 0Balances with Local Authorities 147 0 1,967 0Balances with NHS bodies outside the Departmental Group 0 0 0 0Balances with NHS Trusts and Foundation Trusts 2,225 0 3,496 0Balances with Public Corporations and Trading Funds 0 0 0 0Balances with bodies external to government 1,757 0 5,715 0At 31 March 2014 10,492 0 17,085 0

prior period: Balances with other Central Government Bodies 3,261 0 6,988 0Balances with Local Authorities 59 0 1,510 0Balances with NHS bodies outside the Departmental Group 0 0 0 0Balances with NHS Trusts and Foundation Trusts 1,225 0 981 0Balances with Public Corporations and Trading Funds 0 0 0 0Balances with bodies external to government 1,712 0 5,868 0At 31 March 2013 6,257 0 15,347 0

20 Intra-Government and other balances

£000s £000s £000s £000s

Current receivables

Non-current receivables

Current payables

Non-current payables

19.2 Other financial commitmentsThe trust has entered into non-cancellable contracts (which are not leases or PFI contracts or other service concession arrangements), for …….... The payments to which the trust is committed are as follows

Not later than one year 0 0Later than one year and not later than five year 0 0Later than five years 0 0Total 0 0

£000s £000s31 March 2014 31 March 2013

£000s £000s31 March 2014 31 March 2013

At fair value Balance at 1 April 2013 0 0

Transfers under Modified Absorption Accounting - PCTs & SHAs 0 0

Transfers under Modified Absorption Accounting - Other Bodies 0 0

Additions Through Subsequent Expenditure 0 0

Other Acquisitions 0 0

Disposals 0 0

Property Reclassified as Held for Sale 0 0

Loss from Fair Value Adjustments - Impairments 0 0

Loss from Fair Value Adjustments - Reversal of Impairments 0 0

Gain from Fair Value Adjustments 0 0

Transfer to other NHS Foundation Trust 0 0

Transfers (to) / from Other Public Sector Bodies under absorption accounting 0 0

Other Changes 0 0

Balance at 31 March 2014 0 0


Balance at 1 April 2013 0 54 0 0 0 0 54 0

Transfers under Modified Absorption Accounting - PCTs & SHAs 0 0 0 0 0 0 0

Transfers under Modified Absorption Accounting - Other Bodies 0 0 0 0 0 0 0

Additions 0 0 0 0 0 0 0 0

Inventories recognised as an expense in the period 0 (54) 0 0 0 0 (54) 0

Write-down of inventories (including losses) 0 0 0 0 0 0 0 0

Reversal of write-down previously taken to SOCI 0 0 0 0 0 0 0 0

Transfers (to) Foundation Trusts 0 0 0 0 0 0 0 0

Transfers (to)/from Other Public Sector Bodies under Absorption Accounting 0 0 0 0 0 0 0 0

Balance at 31 March 2014 0 0 0 0 0 0 0 0

Drugs21 Inventories

Consumables Work in Progress

Energy Loan Equipment

Other Total Of which held at NRV

£000s £000s £000s £000s £000s £000s £000s £000s

NHS receivables - revenue 6,821 4,372 0 0

NHS receivables - capital 144 0 0 0

NHS prepayments and accrued income 762 27 0 0

Non-NHS receivables - revenue 404 431 0 0

Non-NHS receivables - capital 0 0 0 0

Non-NHS prepayments and accrued income 1,354 949 0 0

Provision for the impairment of receivables (133) (133) 0 0

VAT 859 87 0 0

Current/non-current part of PFI and other PPP arrangements prepayments and accrued income 0 0 0 0

Interest receivables 0 0 0 0

Finance lease receivables 0 0 0 0

Operating lease receivables 0 0 0 0

Other receivables 281 524 0 0

Total 10,492 6,257 0 0

Total current and non current 10,492 6,257

Included in NHS receivables are prepaid pension contributions: 0

The great majority of trade is with Clinical Commissioning Groups and NHS England. As Clinical Commissioning Groups and NHS England are funded by Government to buy NHS patient care services, no credit scoring of them is considered necessary.

22.1 Trade and other receivables

£000s £000s31 March 2014 31 March 2013

Non-current

£000s £000s31 March 2014 31 March 2013

Current

106


22.2 Receivables past their due date but not impaired

31 March 2014 31 March 2013 £000s £000s

22.3 Provision for impairment of receivables

Receivables are impaired on review of value, age of debt and likelihood of recovery. This includes an analysis of the value of the receivable versus the cost of recovery measures.

By up to three months 1,891 1,749

By three to six months 58 20

By more than six months 58 19

Total 2,007 1,788

Balance at 1 April 2013 (133) (161)



Amount written off during the year 12 11

Amount recovered during the year 35 179

(Increase)/decrease in receivables impaired (47) (162)

Transfer to NHS Foundation Trust 0 0

Transfers (to)/from Other Public Sector Bodies under Absorption Accounting 0 0

Balance at 31 March 2014 (133) (133)

Annual Report 2013/14108 Our Values...To value everyone’s contribution ‘everyone matters’108

23 NHS LIFT investments

Balance at 1 April 2013 0 0 0

Additions 0 0 0

Disposals 0 0 0

Loan repayments 0 0 0

Revaluations 0 0 0

Loans repayable within 12 months 0 0 0

Balance at 31 March 2014 0 0 0

Balance at 1 April 2012 0 0 0

Additions 0 0 0

Disposals 0 0 0

Loan repayments 0 0 0

Revaluations 0 0 0

Loans repayable within 12 months 0 0 0

Balance at 31 March 2013 0 0 0

£000s £000s £000sLoan Share capital Total

24.1 Other Financial Assets - Current

Opening balance 1 April 0 0Transfers (to)/from Other Public Sector Bodies in year 0 0Other Movements 0 0Closing balance 31 March 0 0

£000s £000s31 March 2014 31 March 2013

Opening balance 1 April 0 0



Additions 0 0

Revaluation 0 0

Impairments/reversals taken to Revaluation Reserve 0 0

Impairment/reversals taken to SoCI 0 0

Change in Fair Value through SoCI 0 0

Transferred to current financial assets 0 0

Disposals 0 0

Transfers (to)/from Other Public Sector Bodies under Absorption Accounting 0 0

Total Other Financial Assets - Non Current 0 0

£000s £000s31 March 2014 31 March 201324.2 Other Financial Assets - Non Current


EU Emissions Trading Scheme Allowance 0 0

Other Assets 0 0

Total 0 0

25 Other current assets

£000s £000s31 March 2014 31 March 2013

Opening balance 10,932 10,565

Net change in year 799 367

Closing balance 11,731 10,932

Made up of Cash with Government Banking Service 11,716 10,907

Commercial banks 0 0

Cash in hand 15 25

Current investments 0 0

Cash and cash equivalents as in statement of financial position 11,731 10,932

Bank overdraft - Government Banking Service 0 0

Bank overdraft - Commercial banks 0 0

Cash and cash equivalents as in statement of cash flows 11,731 10,932

Patients’ money held by the Trust, not included above 6 10

26 Cash and Cash Equivalents

£000s £000s31 March 2014 31 March 2013


Balance at 1 April 2013 0 0 0 0 0 0 0 0 0 0 0Transfers under Modified Absorption Accounting - PCTs & SHAs 0 0 0 0 0 0 0 0 0Transfers under Modified Absorption Accounting - Other Bodies 0 0 0 0 0 0 0 0 0 0 0Plus assets classified as held for sale in the year 0 0 0 0 102 0 0 0 42 0 144Less assets sold in the year 0 0 0 0 (102) 0 0 0 (42) 0 (144)Less impairment of assets held for sale 0 0 0 0 0 0 0 0 0 0 0Plus reversal of impairment of assets held for sale 0 0 0 0 0 0 0 0 0 0 0Less assets no longer classified as held for sale, for reasons other than disposal by sale 0 0 0 0 0 0 0 0 0 0 0Transfers to Foundation Trust 0 0 0 0 0 0 0 0 0 0 0Transfers (to)/from Other Public Sector Bodies under Absorption Accounting 0 0 0 0 0 0 0 0 0 0 0Balance at 31 March 2014 0 0 0 0 0 0 0 0 0 0 0

27 Non-current assets held for sale

Land Buildings excluding dwellings

Dwellings Assets under construction & payments on account

Plant & machinery

Transport equipment



TotalFinancial Assets

Intangible Assets

£000s £000s £000s £000s £000s £000s £000s £000s £000s£000s£000s

Liabilities associated with assets held for sale at 31 March 2014 0 0 0 0 0 0 0 0 0 0 0

Balance at 1 April 2012 0 0 0 0 0 0 0 0 0 0 0Plus assets classified as held for sale in the year 0 0 0 0 194 0 157 0 0 0 351Less assets sold in the year 0 0 0 0 (194) 0 (157) 0 0 0 (351)Less impairment of assets held for sale 0 0 0 0 0 0 0 0 0 0 0Plus reversal of impairment of assets held for sale 0 0 0 0 0 0 0 0 0 0 0Less assets no longer classified as held for sale, for reasons other than disposal by sale 0 0 0 0 0 0 0 0 0 0 0Transfers to Foundation Trust 0 0 0 0 0 0 0 0 0 0 0Transfers (to)/from other public sector bodies 0 0 0 0 0 0 0 0 0 0 0Revaluation 0 0 0 0 0 0 0 0 0 0 0Balance at 31 March 2013 0 0 0 0 0 0 0 0 0 0 0

Liabilities associated with assets held for sale at 31 March 2013 0 0 0 0 0 0 0 0 0 0 0


NHS payables - revenue 5,770 3,419 0 0NHS payables - capital 14 0 0 0NHS accruals and deferred income 33 1,029 0 0Non-NHS payables - revenue 6,374 4,699 0 0Non-NHS payables - capital 1,118 168 0 0Non-NHS accruals and deferred income 1,784 3,987 0 0Social security costs 1,000 993 0 0VAT 0 0 0 0Tax 938 1,011 0 0Payments received on account 21 0 0 0Other 33 41 0 0Total 17,085 15,347 0 0

Total payables (current and non-current) 17,085 15,347

Included above:to Buy Out the Liability for Early Retirements Over 5 Years 0 0 number of Cases Involved (number) 0 0 outstanding Pension Contributions at the year end 1,647 1,517

28 Trade and other payables

£000s £000s31 March 2014 31 March 2013

Non-current

£000s £000s31 March 2014 31 March 2013

Current

PFI/LIFT deferred credit 0 0 0 0Lease incentives 0 0 0 0Other 0 0 0 0Total 0 0 0 0 Total other liabilities (current and non-current) 0 0

29 Other liabilities

£000s £000s31 March 2014 31 March 2013

Non-current

£000s £000s31 March 2014 31 March 2013

Current

Bank overdraft - Government Banking Service 0 0 0 0Bank overdraft - commercial banks 0 0 0 0Loans from Department of Health 0 0 0 0Loans from other entities 0 0 0 0PFI liabilities: Main liability 0 0 0 0 Lifecycle replacement received in advance 0 0 0 0LIFT liabilities: Main liability 0 0 0 0 Lifecycle replacement received in advance 0 0 0 0Finance lease liabilities 0 0 0 0Other (describe) 0 0 0 0Total 0 0 0 0

Total other liabilities (current and non-current) 0 0

30 Borrowings

£000s £000s31 March 2014 31 March 2013

Non-current

£000s £000s31 March 2014 31 March 2013

Current

0 - 1 Years 0 0 01 - 2 Years 0 0 02 - 5 Years 0 0 0Over 5 Years 0 0 0TOTAL 0 0 0

Loans - repayment of principal falling due in:

£000s £000s £000s

31 March 2014 DH Other Total


Embedded Derivatives at Fair Value through SoCI 0 0 0 0Financial liabilities carried at fair value through profit and loss 0 0 0 0Amortised Cost 0 0 0 0Total 0 0 0 0 Total other financial liabilities (current and non-current) 0 0

31 Other financial liabilities

£000s £000s31 March 2014 31 March 2013

Non-current

£000s £000s31 March 2014 31 March 2013

Current

Opening balance at 1 April 2013 290 563 0 131Deferred revenue addition 0 159 0 0Transfer of deferred revenue (241) (432) 0 (131)Current deferred Income at 31 March 2014 49 290 0 0

Total deferred income (current and non-current) 49 290

32 Deferred revenue

£000s £000s31 March 2014 31 March 2013

Non-current

£000s £000s31 March 2014 31 March 2013

Current

Within one year 0 0 0 0Between one and five years 0 0 0 0After five years 0 0 0 0Less future finance charges 0 0 0 0Minimum Lease Payments / Present value of minimum lease payments 0 0 0 0

Included in: Current borrowings 0 0 Non-current borrowings 0 0Total 0 0

33 Finance lease obligations as lessee

£000s £000s31 March 2014 31 March 2013

Present value of minimum lease payments

£000s £000s31 March 2014 31 March 2013

Minimum lease paymentsAmounts payable under finance leases (Buildings)



£000s £000s31 March 2014 31 March 2013


£000s £000s31 March 2014 31 March 2013

Minimum lease paymentsAmounts payable under finance leases (Land)




£000s £000s31 March 2014 31 March 2013


£000s £000s31 March 2014 31 March 2013

Minimum lease paymentsAmounts payable under finance leases (Other)

Finance leases as lesseeFuture Sublease Payments Expected to be received 0 0Contingent Rents Recognised as an Expense 0 0

£000s £000s31 March 2014 31 March 2013

Within one year 0 0 0 0Between one and five years 0 0 0 0After five years 0 0 0 0Less future finance charges 0 0 0 0Gross Investment in Leases / Present Value of Minimum Lease Payments 0 0 0 0 Less allowance for uncollectible lease payments: 0 0 0 0Total finance lease receivable recognised in the statement of financial position 0 0 0 0

Included in: Current finance lease receivables 0 0 Non-current finance lease receivables 0 0 Total 0 0

£000s £000s31 March 2014 31 March 2013


£000s £000s31 March 2014 31 March 2013

Gross investments in leasesAmounts receivable under finance leases (Buildings)Of minimum lease payments

34 Finance lease receivables as lessor



£000s £000s31 March 2014 31 March 2013


£000s £000s31 March 2014 31 March 2013

Gross investments in leasesAmounts receivable under finance leases (Land)Of minimum lease payments




£000s £000s31 March 2014 31 March 2013


£000s £000s31 March 2014 31 March 2013

Gross investments in leasesAmounts receivable under finance leases (Other)Of minimum lease payments

The unguaranteed residual value accruing to the [organisation] 0 0Accumulated allowance for uncollectible minimum lease payments receivable 0 0 Rental revenueContingent rent 0 0Other 0 0Total rental revenue 0 0 Finance lease commitments 0 0

£000s £000s31 March 2014 31 March 2013

31 March 2014 31 March 2013


Balance at 1 April 2013 277 0 27 0 0 0 250 0

Transfers under Modified Absorption Accounting - PCTs & SHAs 0 0 0 0 0 0 0 0

Transfers under Modified Absorption Accounting - Other Bodies 0 0 0 0 0 0 0 0

Arising During the Year 690 0 59 381 0 0 250 0

Utilised During the Year 0 0 0 0 0 0 0 0

Reversed Unused 0 0 0 0 0 0 0 0

Unwinding of Discount 0 0 0 0 0 0 0 0

Change in Discount Rate 0 0 0 0 0 0 0 0

Transfers to NHS Foundation Trusts (for Trusts becoming FTs only) 0 0 0 0 0 0 0 0

Transfers (to)/from Other Public Sector Bodies under Absorption Accounting 0 0 0 0 0 0 0 0

Balance at 31 March 2014 967 0 86 381 0 0 500 0

Expected Timing of Cash Flows: No Later than One Year 967 0 86 381 0 0 500 0

Later than One Year and not later than Five Years 0 0 0 0 0 0 0 0

Later than Five Years 0 0 0 0 0 0 0 0

Amount Included in the Provisions of the NHS Litigation Authority in Respect of Clinical Negligence Liabilities:

As at 31 March 2014 £288,062

As at 31 March 2013 £25,284

The legal provision relates to 14 cases currently with the NHS Litigation Authority.

The restructuring provision relates to the liability from the restructure of a Trust service line.

The other provisions relates to a potential liability for which the value is based upon an estimate from our advisors.

The liability is expected to be settled in the 12 months following 31st March 2014

Total

35 ProvisionsEarly

Departure Costs

Legal Claims

Restructuring Continuing Care

Equal Pay (incl. Agenda for

Change

Other RedundancyComprising:

Contingent liabilities

Equal Pay 0 0

Other - Legal Claims (21) (17)

Amounts Recoverable Against Contingent Liabilities 0 0

Net Value of Contingent Liabilities (21) (17)

Contingent Assets

Contingent Assets 0 0

Net Value of Contingent Assets 0 0

36 Contingencies

£000s £000s31 March 2014 31 March 2013

£000s £000s £000s £000s £000s £000s £000s £000s


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 Total charge to operating expenses in year - OFF SOFP PFI 0 0Service element of on SOFP PFI charged to operating expenses in year 0 0Total 0 0 Payments committed to in respect of off SOFP PFI and the service element of on SOFP PFI No Later than One Year 0 0Later than One Year, No Later than Five Years 0 0Later than Five Years 0 0Total 0 0

The estimated annual payments in future years are expected to be materially different from those which the [organisation] is committed to make materially different from those which the [organisation] is committed to make during the next year. The likely financial effect of this is: Estimated Capital Value of Project - off SOFP PFI 0 0Value of Deferred Assets - off SOFP PFI 0 0Value of Reversionary Interest - off SOFP PFI 0 0 Imputed “finance lease” obligations for on SOFP PFI contracts due

No Later than One Year 0 0Later than One Year, No Later than Five Years 0 0Later than Five Years 0 0Subtotal 0 0Less: Interest Element 0 0Total 0 0

Present Value Imputed “finance lease” obligations for on SOFP PFI contracts due Analysed by when PFI payments are dueNo Later than One Year 0 0Later than One Year, No Later than Five Years 0 0Later than Five Years 0 0Total 0 0

Number of on SOFP PFI Contracts Total Number of on PFI contracts 0 0Number of on PFI contracts which individually have a total commitments value in excess of £500m 0 0

Present Value Imputed “finance lease” obligations for off SOFP PFI contracts due Analysed by when PFI payments are dueNo Later than One Year 0 0Later than One Year, No Later than Five Years 0 0Later than Five Years 0 0Total 0 0

Number of on SOFP PFI ContractsTotal Number of off PFI contracts 0 0Number of off PFI contracts which individually have a total commitments value in excess of £500m 0 0 Charges to operating expenditure and future commitments in respect of on and off SOFP LIFT

Total Charge to Operating Expenses in year - OFF SOFP LIFT 0 0Service element of on SOFP LIFT charged to operating expenses in year 0 0Total 0 0

37 PFI and LIFT - additional information

£000s £000s2013/14 2012/13

£000s £000s2013/14 2012/13

£000s £000s2013/14 2012/13

£000s £000s2013/14 2012/13

£000s £000s2013/14 2012/13


Payments committed to in respect of off SOFP LIFT and the service element of on SOFP LIFT.

LIFT Scheme Expiry Date: No Later than One Year 0 0Later than One Year, No Later than Five Years 0 0Later than Five Years 0 0Total 0 0

The estimated annual payments in future years are expected to be materially different from those which the NHS [organisation] is committed to make during the next year. The likely financial effect of this is: Estimated capital value of project - off SOFP LIFT 0 0Value of Deferred Assets - off SOFP LIFT 0 0Value of Residual Interest - off SOFP LIFT 0 0 Imputed “finance lease” obligations for on SOFP LIFT Contracts due

No Later than One Year 0 0Later than One Year, No Later than Five Years 0 0Later than Five Years 0 0Subtotal 0 0Less: Interest Element 0 0Total 0 0 Present Value Imputed “finance lease” obligations for on SOFP LIFT contracts dueAnalysed by when LIFT payments are due

No Later than One Year 0 0Later than One Year, No Later than Five Years 0 0Later than Five Years 0 0Total 0 0 Number of on SOFP LIFT ContractsTotal Number of LIFT contracts 0 0Number of LIFT contracts which individually have a total commitments value in excess of £500m 0 0

Present Value Imputed “finance lease” obligations for off SOFP LIFT contracts due Analysed by when LIFT payments are due

No Later than One Year 0 0Later than One Year, No Later than Five Years 0 0Later than Five Years 0 0Total 0 0 Number of off SOFP LIFT ContractsTotal Number of LIFT contracts 0 0Number of LIFT contracts which individually have a total commitments value in excess of £500m 0 0

£000s £000s2013/14 2012/13

£000s £000s2013/14 2012/13

£000s £000s2013/14 2012/13

£000s £000s2013/14 2012/13

£000s £000s2013/14 2012/13


The information below is required by the Department of Heath for budget reconciliation purposes

Revenue costs of IFRS: Arrangements reported on SoFP under IFRIC12 (e.g PFI / LIFT)

Depreciation charges 0 0Interest Expense 0 0Impairment charge - AME 0 0Impairment charge - DEL 0 0Other Expenditure 0 0Revenue Receivable from subleasing 0 0Impact on PDC dividend payable 0 0Total IFRS Expenditure (IFRIC12) 0 0Revenue consequences of PFI / LIFT schemes under UK GAAP / ESA95 (net of any sublease revenue) 0 0Net IFRS change (IFRIC12) 0 0 Capital Consequences of IFRS : LIFT/PFI and other items under IFRIC12 Capital expenditure 2013/14 0 0UK GAAP capital expenditure 2013/14 (Reversionary Interest) 0 0

38 Impact of IFRS treatment - current year

£000s £000s31 March 2014 31 March 2013

39 Financial Instruments39.1 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 Trust has with commissioners and the way those commissioners are financed, the 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 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 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. Trust 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 strategic health authority. 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 Trust has low exposure to credit risk. The maximum exposures as at 31 March 2013 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 Clinical Commissioning Groups and NHS England, which are financed from resources voted annually by Parliament. The Trust funds its capital expenditure from funds obtained within its capital resource limit. The Trust is not, therefore, exposed to significant liquidity risks.


Embedded derivatives 0 0 0

NHS payables 0 5,817 5,817

Non-NHS payables 0 9,330 9,330

Other borrowings 0 0 0

PFI & finance lease obligations 0 0 0

Other financial liabilities 0 0 0

Total at 31 March 2014 0 15,147 15,147

Embedded derivatives 0 0 0

NHS payables 0 4,774 4,774

Non-NHS payables 0 8,497 8,497

Other borrowings 0 0 0

PFI & finance lease obligations 0 0 0

Other financial liabilities 0 0 0

Total at 31 March 2013 0 13,271 13,271

£000s £000s

Other Total

£000s

At ‘fair value through profit

and loss’

39.3 Financial Liabilities

£000s £000s

Available for sale

Total

£000s £000s

At ‘fair value through profit

and loss’

Loans and receivables

39.2 Financial Assets

Embedded derivatives 0 0 0 0

Receivables - NHS 0 7,727 0 7,727

Receivables - non-NHS 0 684 0 684

Cash at bank and in hand 0 11,731 0 11,731

Other financial assets 0 0 0 0

Total at 31 March 2014 0 20,142 0 20,142

Embedded derivatives 0 0 0 0

Receivables - NHS 0 4,296 0 4,296

Receivables - non-NHS 0 446 0 446

Cash at bank and in hand 0 10,933 0 10,933

Other financial assets 0 0 0 0

Total at 31 March 2013 0 15,675 0 15,675


40 Events after the end of the reporting periodThe Trust is required to disclose any events occurring after the accounting period but prior to the Accounts being authorised for release. The events are to be deemed so material that non-disclosure would influence the economic decisions of the user of the Accounts.

The Trust is proposing to make the following disclosures in respect of key changes from 1 April 2014:-

During 2013/14, the Commissioners in Leicestershire decided to put the Leicester Elective Services out to tender. The

Board of Derbyshire Community Health Services NHS Trust made the decision that the Trust did not want to tender for this business. As a result, the tender has been awarded to an alliance of Leicester based NHS organisations. As a direct consequence of this and with effect from 1st April 2014, DCHS no longer provides elective care services in the Leicester area. The total value of the contract in 2013/14 was £21.4m and the services were run by approximately 300 staff who have transferred under TUPE legislation to the new provider from 1 April 2014.

41 Related party transactions

During the year 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 Derbyshire Community Health Services NHS Trust other than those listed below.

Barbara-Anne Walker - Employee of the British Red Cross 71 0 0 0

The husband of the Chief Executive is employed by Hardwick Clinical Commissioning Group (CCG) in the capacity as Head of Strategy and Partnerships. DCHS NHS Trust has robust governance processes in place to ensure that any potential conflict of interest in respect of transactions with the CCG is avoided.

Tracy Allen (Spouse) - Employee of Hardwick CCG 0 16,342,000 34,000 900,000

All transactions have been at arms length as part of Derbyshire Community Health Services NHS Trust’s provision of Specialist Community Health services.

The Department of Health is regarded as a related party. During the year Derbyshire Community Health Services NHS 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. For example:

North Derbyshire CCG Chesterfield Royal Hospitals NHS Foundation Trust Southern Derbyshire CCG Derby Hospitals NHS Foundation Trust Erewash CCG Derbyshire Healthcare NHS Foundation Trust Hardwick CCG NHS Litigation Authority West Leicester CCG NHS Business Services Authority East Leicester CCG NHS EnglandLeicestershire Partnership NHS Trust

In addition, the Trust has had a number of material transactions with other government departments and other central and local government bodies. Most of these transactions have been with:

Derbyshire County Council Chesterfield Borough Council Derbyshire City Council HMRC

The Trust has also received revenue and capital payments from a number of charitable funds, certain of the trustees for which are also members of the Trust board. Transactions are as follows:

The Derbyshire Community Health Services Charitable Trust 0 192,000 0 4,000

£ £

Amounts owed to

Related Party

Amounts due from Related

Party£ £

Payments to Related Party

Receipts from Related Party

£ £

Amounts owed to

Related Party


Party£ £



£ £

Amounts owed to

Related Party


Party£ £




Total losses and special payments

Special payments

42 Losses and special payments

£9,163Total Value of Cases

44Total Number of Cases

£4,635 16£13,798 60

Losses

The total number of losses cases in 2013/14 and their total value was as follows:

Total losses and special payments

Special payments

£10,838Total Value of Cases

53Total Number of Cases

£6,123 12£16,961 65

Losses

The total number of losses cases in 2012/13 and their total value was as follows:

Details of cases individually over £250,000There were no cases individually over £250,000


Turnover 0 0 0 0 0 0 184,147 188,398 183,711

Retained surplus/(deficit) for the year 0 0 0 0 0 0 1,447 2,797 2,409

Adjustment for:

Timing/non-cash impacting distortions:

Pre FDL(97)24 Agreements 0 0 0 0 0 0 0 0 0 2006/07 PPA

(relating to 1997/98 to 2005/06) 0 0 0 0 0 0 0 0 0 2007/08 PPA

(relating to 1997/98 to 2006/07) 0 0 0 0 0 0 0 0 0 2008/09 PPA

(relating to 1997/98 to 2007/08) 0 0 0 0 0 0 0 0 0

Adjustments for Impairments 0 0 0 0 0 0 69 144 880

Adjustments for impact of policy change re donated/government grants assets 0 0 0 0 0 0 (97) (61) (397)

Consolidated Budgetary Guidance - Adjustment for Dual Accounting under IFRIC12* 0 0 0 0 0 0 0 0 0

Adsorption Accounting Adjustment 0 0 0 0 0 0 0 0 0

Other agreed adjustments 0 0 0 0 0 0 0 0 0

Break-even in-year position 0 0 0 0 0 0 1,419 2,880 2,892

Break-even cumulative position 0 0 0 0 0 0 1,419 4,299 7,191

*Due to the introduction of International Financial Reporting Standards (IFRS) accounting in 2009/10, 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.

Materiality test (I.e. is it equal to or less than 0.5%):

Break-even in-year position as a percentage of turnover 0.00 0.00 0.00 0.00 0.00 0.00 0.77 1.53 1.57

Break-even cumulative position as a percentage of turnover 0.00 0.00 0.00 0.00 0.00 0.00 0.77 2.28 3.91

2011/12 was the first year of operation for the Trust

43.1 Breakeven performance2006/07

£000s

43. Financial performance targets The figures given for periods prior to 2009/10 are on a UK GAAP basis as that is the basis on which the targets were set for those years.

2007/08£000s

2008/09£000s

2009/10£000s

2010/11£000s

2011/12£000s

2012/13£000s

2013/14£000s

2005/06£000s

2006/07%

2007/08%

2008/09%

2009/10%

2010/11%

2011/12%

2012/13%

2013/14%

2005/06%


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%.

43.2 Capital cost absorption rate

The Trust is given an external financing limit which it is permitted to undershoot.

External financing limit (EFL) 792 1,082Cash flow financing (614) (724)Unwinding of Discount Adjustment 0 0Finance leases taken out in the year 0 0Other capital receipts 0 0External financing requirement (614) (724)Under/(Over) Spend against EFL 1,406 1,806

43.3 External financing

The Trust is given a capital resource limit which it is not permitted to exceed.

Gross capital expenditure 5,480 1,431Less: book value of assets disposed of (144) (351)Less: capital grants 0 0Less: donations towards the acquisition of non-current assets (509) (72)Charge against the capital resource limit 4,827 1,008Capital resource limit 5,147 1,898(Over)/underspend against the capital resource limit 320 890

43.4 Capital resource limit

The Trust held cash and cash equivalents which relate to monies held by the NHS Trust on behalf of patients or other parties. This has been excluded from the cash and cash equivalents figure reported in the accounts.

44 Third party assets

Third party assets held by the Trust.

631 March 2014 (£000s)

1031 March 2013 (£000s)

£000s £000s2013/14 2012/13

£000s £000s2013/14 2012/13

ANNUAL REPORT 2013/14

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