Annual General Meeting14 September 2011

Agenda18:00 Introduction and Welcome Brian Stables,

Chairman

18:10 Financial Position of the Trust Catherine Phillips, Director of Finance

18:20 Chief Executive’s Report James Scott, Chief Executive

18:35 ‘Caring For You’ – The Quality Improvement Journey Tim Craft, Medical Director & Francesca Thompson, Director of Nursing

18:45 Putting the patient at the centre of the service, and how patient experience and outcomes are paramount

Angela Rippon OBE, Vice President of the Patients Association

19:15 Member Talk Back Brian Stables, Chairman

19:30 Summary & Close Brian Stables,Chairman

Financial Position of the Trust

Catherine PhillipsDirector of Finance

Reporting requirements

� Annual Report

� Full Set of Accounts

� Audit Committee and Trust Board

� External Audit Opinion

Independent Auditor’s Opinion

The financial statements give a true and fair view

The financial statements have been properly prepared

Financial information in the annual report is consistent with the finance statements

Grant Thornton LLP8th June 2011

Financial performance in context

Target Performance

Income and expenditure (before impairments of land and buildings)

£4.2m £4.2m

To not exceed the Capital Resource Limit

£12.6m £12.6m

To deliver the External Financing Limit

-£8.4m -£8.4m

Financial performance in contextIn Year

Surplus / (Deficits)£’000

Breakeven Duty £’000

Deficits pre-2002 -8,145 -

2002/03 -24,784 -24,784

2003/04 -1,968 -1,968

2004/05 -946 1,022

2005/06 -7,339 -6,393

2006/07 144 144

2007/08 1,900 1,900

2008/09 5,600 7,405

2009/10 1,398 5,800

2010/11 4,143 4,195

Changes in accounting policies -10,285

Accumulated Deficit -40,282 -Breakeven duty - -12,679

Future financial plans� Surplus on Income & Expenditure

� NHS Foundation Trust status

� Loan Repayment - 2012/13

� Capital Investment Strategy

� Maintain the progress

Chief Executive's Report

James ScottChief Executive

Overall Performance

2009/10 2010/11

Q1 Performing Q1 Performanceunder review

Q2 Performing Q2 Performing

Q3 Performing Q3 Performing

Q4 Performanceunder review

Q4 Performing

NHS Foundation Trust Application

� Expected authorisation date - Spring 2012;

� Trust is performing well and is ready to be authorised;

� Opportunity to develop an organisation with a strong membership base and deliver services in line with local needs.

inReview� inReview is a new publication for the RUH;� Includes a look back at the events and

successes of the past year;� Also includes Corporate Social

responsibility reporting;� Complements the more detailed corporate

Annual Report and Quality Accounts;� Feedback on the new format welcome;

Patient Safety Award� And the winner is:

Lisa Brown, Tissue Viability Nurse, Forrester Brown Ward

Patient Safety Award� Lisa Brown developed the “think Pink” - all

documentation related to pressure ulcers is coloured pink;

� Due to Lisa’s enthusiasm, creativity and drive leading the team in reducing pressure ulcers there has been a significant reduction in patients developing pressure sores on the Forrester Brown;

� Since commencing the pressure ulcer collaborative in January 2011 the incidence of pressure ulcers on Forrester Brown has reduced by more than 50%, with no incidence of grades 3 or 4 pressure ulcers (4 being the worst)

Note: * Estimate. Expenditures shown in $US PPP (purchasing power parity).Source: Calculated by The Commonwealth Fund based on 2007 International Health Policy Survey; 2008 International Health Policy Survey of Sicker Adults; 2009 International Health Policy Survey of Primary Care Physicians; Commonwealth Fund Commission on a High Performance Health System National Scorecard; and Organization for Economic Cooperation and Development, OECD Health Data, 2009 (Paris: OECD, Nov. 2009).

AUS CAN GER NETH NZ UK US

OVERALL RANKING (2010) 3 6 4 1 5 2 7

Quality Care 4 7 5 2 1 3 6

Effective Care 2 7 6 3 5 1 4

Safe Care 6 5 3 1 4 2 7

Coordinated Care 4 5 7 2 1 3 6

Patient-Centered Care 2 5 3 6 1 7 4

Access 6.5 5 3 1 4 2 6.5

Cost-Related Problem 6 3.5 3.5 2 5 1 7

Timeliness of Care 6 7 2 1 3 4 5

Efficiency 2 6 5 3 4 1 7

Equity 4 5 3 1 6 2 7

Long, Healthy, Productive Lives 1 2 3 4 5 6 7

Health Expenditures/Capita, 2007 $3,357 $3,895 $3,588 $3,837* $2,454 $2,992 $7,290

Country Rankings

1.00–2.33

2.34–4.66

4.67–7.00

Exhibit ES-1. Overall Ranking

‘Caring For You’ – The Quality Improvement Journey

Tim Craft, Medical Director & Francesca Thompson, Director of Nursing

The ‘Caring for you’ series� Series of events led by experts in the

Trust determined by member interests;� Sharing changes and new developments

in clinical and non-clinical services;� Bimonthly at venues across the

constituencies;� Programme to be communicated in

October 2011;

Caring for you topics� Building a sustainable hospital for

the future (Estates Strategy);

� The rise and fall of the superbug (Infection control);

� Children and blue lights (Baby and Children’s emergency care);

� Growing old gracefully (Care of older people);

How do you improve quality?

� Keep it simple –”less is more”� Measure – often and with relevant

indicators� Build will� Have ideas� Know how to carry them out

Will, ideas, execution

0

50

100

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0 10000 20000 30000 40000 50000 60000 70000 80000 90000 100000

Cas

es

Inpatient Admissions

Royal United Bath

Great Western

South Devon

Poole

Taunton

Royal Bournemouth

Incidence of Clostridium difficile2008/9

0

50

100

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250

300

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0 10000 20000 30000 40000 50000 60000 70000 80000 90000 100000

Cas

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Inpatient Admissions

Royal United Bath

Great Western

South Devon

Poole

Taunton

Royal Bournemouth

Incidence of Clostridium difficile2008/9

Collaborative Working� Close the “gap” (variation of delivery and outcome)

� Set measurable targets� Face to face – reports, reflection, discussion� Share data, ways of working, protocols etc.� Thinking differently, steal shamelessly� Senior Leader engagement� “The Breakthrough Series Collaborative”

IHI White Paper 2003 www.ihi.org

The Qulturum

25

7 months before 7 months after

C. Diff on 5 wards before and after

HSMR at RUH has fallen (ie improved)

� Faster than the national average� Faster then the SHA average� Despite the expected mortality rate

increasing

Quality of care improvements 2010/11

Last year alone an additional 256 patients had their life saved

than had they been admitted with the same condition just two years earlier

(2008/9)

The patient’s perspective

� See It My Way

� Dementia - July� 141 attendees

Feedback

� Routine is everything for people with dementia

� Listen and ask� Involve carers more� Role of carers is important� Speak to those who know patients

best

Quality Improvement

� Continuous� Outcomes are important� Patients and their carers must be at

the heart of all we do

Putting the patient at the centre of the service, and how patient experience and outcomes are paramountAngela Rippon OBE, Vice President of the Patients Association

Member Talk Back� Your opportunity to raise questions

to the Trust Board;� To be held every 6 months;� Will in future include Public and Staff

Governors;� Questions and answers to be posted

on the Trust website;

Summary & Close

Brian Stables, Chairman

3D View 1

Laboratory