13/07/17

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Welcome!

13July 2017

Annual Public Meeting for

Hinchingbrooke Health

Care NHS Trust

Welcome

Rob Hughes Trust Chairman

13/07/17

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Looking back over the last year

Tonight’s presentation

features the

achievements

of the previous board

of directors, and pays

tribute to the efforts of

staff in 2016/17

Thank you to the board

of Hinchingbrooke

Health Care NHS Trust

for their support as we merged to form North West Anglia

NHS Foundation Trust on 1 April 2017

Agenda for this evening

6.05pm: Review of 2016/17 and merger update

– Caroline Walker, Deputy CEO

6.20pm: Spotlight on Survivorship – Karen Moseley,

Team Leader for Cancer Community

Nurses (Hunts) and Eileen Murphy,

Macmillan Project manager for

Survivorship

6.40pm: Question-and-Answer session

7pm: Close

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Review of 2016/17

Caroline Walker Deputy Chief Executive/

Finance Director

The year in numbers

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The year in numbers

The year’s highlights

Coming out of Special Measures with a rating of ‘Good’

from the Care Quality Commission (Aug 2016)

Winning the national Health Business Award for

Outstanding Achievement in Healthcare

Introducing Schwartz Rounds to support staff in their

wellbeing at work – which has been well received

Expanding our ambulatory care model to see a greater

number of urgent care patients

Making positive changes to the care of patients with

dementia – including having one of the country’s first

Admiral Nurses

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The year’s highlights

CQC National Inpatient survey (published June 2016)

placed Hinchingbrooke in the top 20% of NHS Trusts

nationally for good patient experience

Patient Services Team reached finals of the Health

Estates and Facilities Management Association Awards

(People Development Award category) and our Head of

Facilities (Soft Services) was a finalist in the Leader of

the Year category

Hospital Head Chef was a finalist in the Craft Guild of

Chefs Awards 2017

The year’s highlights

Successful completion of phases 1 and 2 of the

Woodlands Cancer Centre, in conjunction with

Macmillan, which opened in Sept 16

Successful refurbishment of the pathology lab which

completed in Mar 2017

Compliance with Cancer Waiting Times standards is

good – all standards achieved for 11 consecutive months

of the year

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The year’s challenges

Failing the 4 hour waiting time standard for A&E patients

(79.78% against the 95% target)

Lack of bed capacity and issues with the flow of

patients through our hospitals have contributed to this

Deficit of £21.17m against a planned deficit of £9.8m

Increased reliance upon high cost agency staff

(medical and nursing) to meet gaps in rotas and

support increases in activity had driven much of this

increased expenditure

Cost Improvement Plan savings not delivered in full

(£5m savings delivered against a £6.2m target)

The year’s challenges

Recruitment – some hard-to-fill specialty posts, plus hot-

spot areas identified – hence greater reliance upon

agency staff

Quality Surveillance Rating (a quality performance

indicator considered by NHS providers’ regulator and

commissioners) saw Hinchingbrooke Hospital’s risk

profile heightened from ‘regular’ to ‘enhanced’ in final

quarter of the year due to some quality concerns – this

reflected on the risk rating of our new Trust post merger

Managing staff morale – in the light of the merger with

Peterborough and Stamford Hospitals NHS Foundation

Trust

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Formed 1 April 2017

+

Recap – our local health system

Peterborough and Stamford Hospitals NHS FT

clinically and operationally sustainable (with

specific challenges) BUT not financially

sustainable

Hinchingbrooke Health Care NHS Trust neither

clinically nor financially sustainable in current

form

Cambridgeshire and Peterborough is one of the

most financially-challenged health systems in the

country – source: NHS England and NHS Improvement

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Brief history of our hospitals Ongoing regulatory oversight – no solution

Hinchingbrooke Peterborough & Stamford 2005: Trust in financial deficit and

clinically unsustainable 2009: Strategic Health Authority

announces Hinchingbrooke franchise tender

2010: Peterborough in joint bid with Serco to operate Hinchingbrooke

2012: Circle awarded franchise and begins managing Hinchingbrooke

2015: CQC rates it inadequate with lack of clinical sustainability

2015: Circle withdraws early from contract, citing unsustainable losses

2002-2008: In financial surplus 2010: Move to PFI building, Trust

reports a £45m deficit in 2010/11 2012: Monitor-appointed

Contingency Planning Team (CPT) finds Trust clinically/operationally sustainable, but financially unsustainable

2012: National Audit Office and CPT identify approx £20-25m shortfall between PFI cost and tariff

Working together

2015: Regulator-led strategic outline case

recommends closer collaboration between

Hinchingbrooke and Peterborough & Stamford

Nov 2015: Both trusts commence business case

and agree to explore four levels of collaboration:

Option 1 - Do nothing for now

Option 2 - Shared back office function

Option 3 - As per option 2, plus two boards,

one executive team and one operational

organisation

Option 4 - One organisation

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Working Together

May 2016: Outline Business Case approved by

both Trust boards – agreement given to proceed

to Full Business Case

Nov 2016: Both Trust boards agree Full Business

Case and set merger date as 1 April 2017

The clinical case for change

Some services in both organisations deemed

clinically fragile pre-merger - further services at

risk in medium-term

Contributory factors:

Smaller teams compared to teaching trusts/

larger hospitals can make recruitment harder

Agency spending caps

7-day working requirements

Junior Doctors’ contract/provision of rest

For both organisations, collaboration largely

resolves clinical sustainability issues

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Increasingly unsustainable services

As identified in the Business Case:

Hinchingbrooke

Acute Medicine

Cardiology

Diagnostic Imaging

Interventional

Radiology

Haematology

Nephrology

Neurology

Ortho-Gerontology

Palliative care

Stroke

Peterborough & Stamford

Diagnostic Imaging

Gastroenterology - 7 day

bleed service

Interventional radiology

Ortho-Gerontology

Stroke

Clinical benefits of merging

Merging joins all clinical teams under a single

operational management structure:

larger teams

medical staff working equitably across sites

shared workload, rotas, out of hours cover

Merger maximises opportunities for: Single governance arrangements

Greater opportunities for training/sub-specialism

Recruitment/retention and reduce agency use

Clinical consistency through shared best

practice

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Merger benefits in summary

Addresses service vulnerability – particularly for

the population of Huntingdon, which has been

disproportionately disadvantaged

Clinical collaboration strengthens the provision of

a number of services across both sites to ensure

long term, sustainable, high quality health

services for the populations of Peterborough,

South Lincolnshire and Huntingdonshire

Merger saves £9m recurrently

Part of journey to financial sustainability

Our hospitals

Hinchingbrooke Hospital 304 beds, A&E Dept, 23-bed Treatment Centre, The Park

Maternity Unit, private patient ward, outpatient services

Peterborough City Hospital 635 beds, Emergency Dept, Women’s and Children’s Unit

(inc maternity), Cancer Unit, Renal Unit, outpatient

services

Stamford and Rutland Hospital 22 beds, Minor Injuries Unit, day case surgery and

outpatients services

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The area we serve

Serving a

growing

catchment of

700,000 people

Two main clinical

commissioning

groups

6,000 staff

450 volunteers

Executive Team

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Non-Executive Team

Local voices represented

Public governors elected in three constituencies – 6 representing Greater Peterborough

– 6 representing Huntingdonshire

– 5 representing South Lincolnshire

Staff governors elected by colleagues – 3 at Hinchingbrooke Hospital

– 3 at Peterborough City Hospital

– 1 at Stamford Hospital

Council of Governors meetings held quarterly – first meeting took place in May

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Our vision

Working together to be

the best at providing

outstanding care

for local communities

Our goals

Working together to be

the best at providing

outstanding care for local communities

Delivering outstanding

care & experience

Recruiting, developing & retaining

our workforce

Improving & developing our services

& infrastructure

Delivering financial

sustainability

Working together

with local health &

social care providers

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Our shared values

Our shared values are based on suggestions and themes from: 30 staff listening events held across all three hospitals

Public and staff engagement stands at all sites

Staff values survey, which received over 650 responses

We put patients first

We are caring and compassionate

We work positively together

We are actively respectful

We seek to improve and develop

The first day – Saturday 1 April 2017

Trust leadership structure was in place from Day 1

Executive team and senior leaders were present on

all three hospital sites to support teams on duty on

the first weekend and beyond

New North West Anglia NHS FT signage up at all

three hospitals

New website went live (www.nwangliaft.nhs.uk)

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The first month – April 2017

Focus firmly upon continuing delivery of safe services

from Day 1 – detailed plan drawn up to support clinical

and operational teams

No unanticipated issues encountered

Staff briefings and exec walkabouts took place to get to

know Hinchingbrooke teams better

Integration of corporate services began following

consultation process

New patient administration system contract signed -

implementation programme began 3 April

May /June 2017

Corporate service integration well under way

(for example: finance and procurement, HR,

Estates and Facilities, Executive Support team etc)

Operational structure decided following

consultation – move to three divisions:

Emergency and Medicine

Surgery

Family and Integrated Support Services

New divisions in operation from 3 July

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Operational Divisions

management

Looking ahead – widening services

Trust to take over the provision of outpatients and

imaging services at Princess of Wales Hospital, Ely

and Doddington Hospital

We will also provide imaging services at North

Cambs Hospital, Wisbech and dermatology services

at the City Care Centre, Peterborough

These staff will transfer under TUPE to our Trust on

1 Sept 2017

Path lab team at Hinchingbrooke will transfer from

the Pathology Partnership to our Trust on 1 August

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Looking ahead – using our estates HINCHINGBROOKE HOSPITAL

Board of Hinchingbrooke Health Care NHS Trust

announced that Ryhurst Ltd had been chosen as the

preferred partner for the Strategic Estates

Partnership in Summer 2016

No agreement signed – board did not have business

case approval from the regulator, NHS Improvement

This remains the case today

North West Anglia NHS FT board currently looking

at the opportunities within the plan

No decisions made at present

Strategic Estates Partnership recap

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Strategic Estates Partnership plan

Looking ahead – using our estates STAMFORD & RUTLAND HOSPITAL

£2m redevelopment programme due to complete at the end of July

Includes new MRI scanner and imaging dept, new outpatients dept, second ultrasound room, improved physiotherapy gym, new pain management dept, new clinic rooms and waiting areas

Serving more patients closer to home

Open day planned for Autumn to showcase the facilities

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Looking ahead – using our estates

PETERBOROUGH CITY HOSPITAL

New build facility at the front of the Emergency

Department (ED) to provide a GP streaming

service

To be operational in readiness for winter – and

help reduce demand on the busy ED

Trust successfully bid for £650,000 funding to

provide this service at the PCH site - announced

in April

Spotlight on Survivorship

Karen Moseley and

Eileen Murphy

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Next year….

One Annual Public Meeting to review our first full year of

operation as North West Anglia NHS Foundation Trust

Members events to be held at all three hospital sites over

the remainder of this year and next

Focus on subjects that are of the most interest to you

Please feedback to our staff members in the room on

the subjects you want to know more about

Please also tell us what you thought to this event so

we can improve for the future – feedback forms

provided

Your questions?

Please remember to fill out a

feedback form and hand to a

member of staff on your way out