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NHS Foundation Trust Annual Review 2011/12
NHS Foundation Trust
Annual Review 2011/12
QEH 24/7Top Quality Care 24 hours a day
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Our fi rst full year as a Foundation Trust has been one of achievement, focused on our vision to become the preferred hospital for local people.
Over the past 12 months we have been recognised for the high quality of care in orthopaedic, intensive care and stroke services, and the prevention of hospital associated venous thrombo-embolism (deep vein thrombosis).
We are also providing more services closer to people’s homes, such as in St. George’s Medical Centre, Littleport, and will be expanding further during 2012/13 into areas including Fakenham.
None of this could have been achieved without the dedication and hard work of our staff, governors, members and volunteers and we would like to say a big thank you to all for their continued support.
Undoubtedly there have been challenges along the way but our pledge to patients and Foundation Trust members remains strong - to listen to what is needed and tailor services accordingly; work in partnership with GPs and partners to offer a seamless service; invest in our hospital and services to improve effi ciency; and to meet all NHS performance targets. This all adds up to creating a hospital that is a real asset to the West Norfolk community and beyond.
We look forward to the year ahead as we continue on our journey to ensure that commitment to patients and quality care remains at the heart of all we do.
kate Gordon CBChair
Patricia WrightChief Executive
Welcome
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Who we are and what we doThe Queen Elizabeth Hospital King’s Lynn NHS Foundation Trust (QEH) provides healthcare services at The Queen Elizabeth Hospital, a 500-bed acute hospital which opened in 1980 and is located two miles outside King’s Lynn town centre.
We provide healthcare to more than 240,000 people in West Norfolk, north-east Cambridgeshire, South Lincolnshire and part of Breckland via the hospital and a number of outreach services at community hospitals and medical centres in our area.
Being a Foundation TrustThe QEH became a Foundation Trust on 1 February 2011. Although remaining part of the NHS, we have more freedom to develop the type of health services needed for our patients and community.
A Foundation Trust works by:
Accountability – to the local community through the Governors’ Council and Foundation Trust members
Elected representation – members of the Foundation Trust elect public and staff from the membership to the Governors’ Council
Involvement – the Governors’ view is considered by the Board of Directors (responsible for the hospital’s day to day running) in deciding how hospital services are developed
Law – NHS Foundation Trusts have been established under the Health and Social Care (Community Health and Standards) Act 2003 as legally independent organisations. This is not a move towards privatisation
Assets – Foundation Trusts are required to use their assets, such as land and buildings, in support of their main purpose which is to provide NHS services to NHS patients
Regulation – by an organisation called Monitor, the independent regulator of NHS Foundation Trusts.
How does being a Foundation Trust help the QEH?As a Foundation Trust we have financial freedom to raise money from public and private sectors to invest in our capital programme. We are also able to keep any financial ‘surpluses’ we make to reinvest in the services we deliver.
Although we continue to work closely with NHS ‘partner’ organisations in our area, we can also develop new business links with other healthcare providers to develop new and better services.
The Governors’ CouncilThe Governors’ Council represents the interests of the Foundation Trust members and the community served by the Trust. It has a range of statutory, strategic and locally determined functions but this does not include the day-to-day running of the organisation.
There are 32 governors on the Governors’ Council elected from the public, Foundation Trust staff and appointed by local organisations.
You and your family can play an important part in deciding how your hospital services are developed by becoming a public member of the QEH Foundation Trust.
Membership is free and is open to patients and the public. All staff are automatically Foundation Trust members unless they opt out.
We currently have more than 5,000 public members but we need more! You can become as involved as you want to be – the choice is yours.
To find out more or to apply for membership visit www.qehkl.nhs.uk e-mail [email protected] or call 01553 613142.
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BECominG a FoundaTion TrusT mEmBEr
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For a full copy of our Annual Report and Accounts 2011/12 and our Quality Account 2011/12, please visit our website www.qehkl.nhs.uk
NHSNorfolk‐£112m 112178
NHSCambridgeshire‐£26m 25510
NHSLincolnshire‐£10m 10386
SpecialComissioningGroups‐£2m 1960
OtherPCTs‐£2m 2035
StrategicHealthAuthoriJes‐£6m 5640
Othersources‐£7m 7308
Total‐£165m 165017
NHSNorfolk‐£112m
NHSCambridgeshire‐£26m
NHSLincolnshire‐£10m
SpecialComissioningGroups‐£2m
OtherPCTs‐£2m
StrategicHealthAuthoriJes‐£6m
Othersources‐£7m
Facts and FiguresDid you know that during 2011-12, we:
Treated more than 54,200 emergency patients – that’s an average of 148 emergency cases every single day
Saw local people in nearly 269,000 outpatient appointments – on average more than 1,000 people every week day
Carried out more than 16,800 operations (more than 320 each week)
Income and activityDuring the year 1 April 2011 – 31 March 2012 our income was £165 million. We ended the year with a trading surplus of just over £1 million.
NHS Norfolk
NHS Cambridgeshire
NHS Lincolnshire – £10m
Special Commissioning Groups – £2m
Other PCTs – £2m
Strategic Health Authorities – £6m
Other sources – £7m
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Where we fi t in the local health sceneSited near the junction of three counties, with the nearest other acute hospital 40 miles away in any direction, the QEH holds a key strategic position in delivering healthcare to a varied population.
We provide high standard services associated with a general hospital, with highly specialised care such as complex heart and brain surgery, being carried out by partner Trusts offering specialist facilities.
With advances in medical technology and treatment methods, we can now treat more patients as day cases, either in our Day Surgery Unit, or at one of the outreach clinics in Littleport, Wisbech, Wells and Swaffham. During 2012/13 we also plan to expand services into Fakenham and other areas.
This means that many procedures, which could formerly only have been carried out at the main hospital, can now be undertaken closer to people’s homes in the local community.
CasE sTudya surgical outpost
One of the most exciting local healthcare developments of recent years has been the development of ‘outreach’ services at St. George’s Medical Centre in Littleport.
Patients living in the area can face a round trip journey of up to 50 miles to visit their nearest NHS acute hospital.
Our facilities at Littleport, developed in partnership with the resident GP practice, include an operating theatre for day surgery for eye conditions and minor ‘lumps and bumps’ surgery, plus urology services, with plans to extend further into gynaecology.
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Where we have excelledBuilding on the strong performance of previous years, the Trust has excelled in a variety of areas throughout the year including remaining one of the top Trusts in England for day surgery and critical care.
some of our many other achievements include:
april 11A five-bed Enhanced Care Respiratory Bay for seriously ill respiratory patients was established on Marham Ward.
The annual Care Quality Commission inpatient survey names the QEH catering service as one of the best in the NHS.
may 2011The QEH is named in the top 40 performing hospitals by healthcare data benchmarking group CHKS for a third year running.
June 2011Breastfeeding mums welcomed anywhere in the hospital following the award of the UNICEF Certificate of Commitment
The Trust’s Learning Disability Steering Group launches pictorial menus for patients with learning difficulties to choose their meals.
July 2011Work starts on a new £3 million MRI scanner suite for completion during 2012/13.
A £323,000 upgrade is completed of the Arthur Levin Day Centre which deals with minor urology, plastics and pain relief procedures.
august 2011Outreach clinics for respiratory patients launched at GP surgeries in Downham Market and Hunstanton, in association with NHS Norfolk.
september 2011QEH declared one of the best Trusts in the East of England for Orthopaedic care by the National Hip Fracture Database.
The Patient First programme is launched to help increase the amount of time staff spend with patients.
The QEH named the best NHS Trust in the East of England for low rates of hospital acquired pressure ulcers (bed sores).
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october 2011A tissue viability training study by QEH specialist nurses is hailed as a work of major importance by the Royal College of Nursing magazine.
‘Healthy Hearts’ fundraising campaign is launched to raise £200,000 towards new equipment for cardiology, stroke and diabetes patients.
november 2011Secretary of State for Health, the Rt. Hon Andrew Lansley MP, visits the QEH.
The QEH is named joint top organisation in the country for carbon reduction in the Environment Agency’s Carbon Reduction Commitment league table, with 100% compliance to standards.
december 2011The influential Dr Foster Hospital Guide names the QEH as one of the best NHS Trusts in the country for knee replacement surgery and one of the 12 most efficient Trusts for value for money on day-to-day running costs.
January 2012 Terrington Ward becomes a new 34-bed ‘short stay’ unit for patients who can be treated and discharged within 72 hours.
The Ophthalmology department launches a ‘one-stop’ service for glaucoma patients, enabling 500 more patients a year to be treated.
February 2012Work starts on a three month programme to update the obstetric theatre in the Central Delivery Suite to provide one of the most advanced labour facilities in the East of England.
march 2012 The Trust’s Speech and Language Therapy team for stroke services is given an ‘Excellence in Stroke Care’ award by the East of England Stroke Forum.
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Divisional ReportsWe have developed robust plans for our four operating divisions for the coming year. Examples of some of the new service developments in the pipeline include:
Women and Children’s divisionl Improve neonatal and gynaecology ‘outreach’ outpatient and home-based services
l Development of fertility services
l Expansion of midwifery team
surgical and anaesthetic divisionl Improving flexibility in main theatres and day surgery to improve productivity
l Developing ‘outreach’ surgical services
l Improving efficiency and reducing length of stay on the Surgical Assessment Unit
medicine and Emergency Care divisionl Expanding cardiology services
l Improve after-care of respiratory patients to reduce readmissions
l Improving dementia care services still further
l Expanding the acute oncology service and community based palliative care
Clinical support services divisionl Expanding the work of the Aseptic Unit
l Developing ‘outreach’ services
l Reviewing therapy services to improve support for stroke, short stay and orthopaedic patients
l Expanding endoscopy services
l Developing community dietetics
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Service improvementssurgery and anaestheticsImprovements during 2011/12 at the Arthur Levin Day Surgery Centre, rated as one of the ‘top ten’ performing units of its type in England, included:
l A purpose built minor operations theatre/treatment room was created as part of a £323,000 upgrade.
l Installation of a purpose-built auto-disinfector for endoscopes, enabling more procedures to be carried out due to greater efficiency.
Women and Childrenl Development of nurse-led clinics for gynaecology and paediatrics
l Development of fertility services
l Launch of Neonatal Transitional Care service
l Major refurbishment of Castleacre ward and the Central Delivery Suite obstetric theatre
medicine and Emergency Care divisionl Development of a Dementia Care team
l Environmental changes including colour coded signage
CasE sTudyTelephone follow up service
A nurse-led telephone follow up service, offering help and advice to women who have undergone hysterectomy, has dramatically reduced the number of hospital readmissions.
Developed following a workshop with former patients aimed at finding ways of improving aftercare, the project has been commended by the Royal College of Nursing.
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Our StaffThe Staff Opinion Survey results for 2011 returned another excellent set of findings for the Trust. Over 490 staff took part with a response rate of 62%, up 9% on the previous year. The key findings maintain our position in the top 20% of acute trusts overall in England.
The Trust’s four top scoring areas were:l Staff motivation at work
l 94% of respondents believe the Trust provides equal opportunities for career progression
l Perceptions of effective action towards violence and harassment
l 80% of staff have undergone equality and diversity training in the past year (average score 48%)
CasE sTudyshining stars awards
Local people gave an overwhelming vote of support to QEH staff and volunteers at the first ever ‘Shining Stars’ staff awards, culminating in a Hollywood-themed gala awards night.
Staff were encouraged to nominate colleagues who had made an outstanding contribution to local
healthcare and local residents and patients were invited to nominate staff, volunteers or teams.
Each award category was sponsored by the Trust’s suppliers or business partners, with local radio station KLFM sponsoring the Volunteer of the Year Award, and the Lynn News sponsoring the People’s Choice Award.
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Equal OpportunitiesIn July 2011 the Trust Equality Delivery System (EDS) was published to improve equality performance throughout the NHS and support organisations in meeting the requirements of the Equality Act 2010.
Following both a self and independent assessment, the Trust has been rated at a ‘developing’ level in the area of equality. From this promising start we are now working hard towards a number of objectives to further improve equality performance.
occupational Health/ Health and Wellbeing
The health and wellbeing of our staff remains a high priority at the QEH. Throughout the year staff have been encouraged to take part in a number of initiatives aimed at boosting their overall health. These include one to one weight, exercise and alcohol management sessions, fitness classes, a stress busting day and stop smoking advice sessions.
did you knoW? During 2011/12 we employed (full and part-time):
1252 nurses, midwives and healthcare assistants
205 consultants and doctors
153 medical trainees
251 healthcare scientists and technicians
206 allied health professionals – for example, physiotherapists
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Education and Trainingorganisation development/ Learning and developmentAs an organisation, the Trust works towards a yearly strategy to improve operations. In June 2011, we commissioned an independent assessment to examine the impact of this work.
The findings showed that for 2010, the Trust was in the top five acute trusts for engagement of staff. ‘Development’ and ‘Work Environment’ also scored highly and the in-depth focus on leadership at all levels in the Trust is likely to have played a part in this.
The Trust also has a proactive learning, development and education programme to meet the needs of all staff working in all areas.
during 2011/12 we saw a number of advancements including:
l A new supervisory development programme in support services.
l Continuation of the highly successful Leadership and Management programme for team leaders and managers in clinical and non-clinical roles.
l A new clinical leadership development programme for consultants and service line leads and a new Leading Innovation for Clinical Practitioners BA (Hons) MA programme in partnership with UEA.
l System-wide learning for middle and senior managers through the Norfolk Leadership Academy.
l Development of 360 degree feedback based on the new NHS Leadership framework.
l Establishment of an accredited coaching programme.
l Creation of an internal, virtual pool of people offering support to managers and teams as they take their challenging agendas forward.
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our values Our organisational values as determined by the Board are:
Quality patient outcomes, patient safety and patient experience
Efficiencymaking each pound we spend go further
Partnershipwith our staff, clinical networks, commissioners and others
Values and behavioursOur aim is to create a community within which everyone is valued, treated fairly and their voices heard.
Interactive workshops have been held to develop our own unique values and behaviours which are meaningful to our staff and patients.
did you knoW? The QEH’s apprenticeship pilot scheme ‘Growing our own talent’ was recognised at the regional final of the National Apprenticeship Awards and we are now a National Apprenticeship Service Top 100 Employer.
The scheme saw all ten candidates complete their apprenticeship and eight are now employed here at the QEH.
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Our partnersIn line with development of the NHS at national level, we have been focusing on building sound relationships with our healthcare partners at a local level.
We would like to thank all our partners for their continued support in helping us to achieve our aim of ensuring that patients receive the right care, in the right place, at the right time.
In particular we work closely with GP and management colleagues from the West Norfolk Clinical Commissioning Group which will take over responsibility for the majority of buying or commissioning of local health services in 2013. A similar relationship is also developing with the equivalent GP consortium in North Cambridgeshire.
strong links also continue with:l Our current main commissioners, NHS Norfolk, NHS
Cambridgeshire, and NHS Lincolnshire, and with the East of England Ambulance Service.
l Regional centres responsible for the specialist care of some of our cancer, neuro and heart patients such as Addenbrooke’s Hospital and Papworth Hospital in Cambridge.
l Norfolk Community Health and Care, with whom we have partnered on a number of health initiatives during the year.
l Borough Council of King’s Lynn and West Norfolk, liaising over development of the hospital site and public health issues
l Norfolk County Council, particularly through the Social Services team
l Police and fire services
l Local businesses, many of whom have supported the Trust through charitable donations, professional assistance and advice
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VolunteersStaff throughout the hospital are supported by a large body of volunteers who give their time unstintingly and without them, we would be unable to function as efficiently.
Their duties range from staffing the main reception desk and answering visitors’ queries to working alongside nursing staff on some wards, where they play a full and active part in the daily ward routine.
The work of our front-of-house volunteers during the course of the year resulted in them being presented with a Bronze Award at the borough council-backed Disability Forum Opportunity Awards for helping to improve the lives of disabled visitors.
CasE sTudyTribute to a special lady
One of the best loved supporters of the Trust, former League of Friends shop manager Barbara Bush, sadly died last year but will never be forgotten.
Her love of high performance vehicles was legendary and her name lives on in the form of Barbara B – the latest addition to the ‘blood bike’ fleet operated by Norfolk SERV, a charity which delivers blood and tissue samples to NHS Trusts out of hours.
Volunteer riders assembled in January to see the Barbara B blessed and dedicated by the Rev Ian Byrne, Norfolk SERV chaplain and himself a volunteer rider
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Social and Community LinksThe most important of our community links continues to be with the Trust’s League of Friends. They have given support, providing equipment and resources for wards and departments and help to provide NHS services generally not available via NHS funding.
In addition they have brought many thousands of pounds’ worth of equipment now in use around the hospital including the new £15,000 BMW motorcycle as part of the Norfolk SERV ‘blood bike’ fleet, pictorial menus for patients with learning disabilities and red topped water jugs and beakers for patients requiring additional help taking fluids.
CasE sTudy The nHs staff of tomorrow
There’s more to working in the NHS than being a doctor or a nurse – that’s the message being given as part of a community programme to encourage young people to consider a career in the NHS.
Now in its second year, the highly successful ‘Project Search’ is run in association with the College of West
Anglia and Norfolk County Council. The scheme offers students with learning disabilities a one year placement, working and gaining valuable experience in different departments of the hospital.
Primary school pupils as young as ten are also given the opportunity to meet with QEH staff at careers fairs to hear first-hand what it’s like to work in a variety of hospital roles.
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Compliments and complaintsDuring the year, the Trust received 516 complaints (compared to 556 in 2010/11) and dealt with 84% within the target 25 working days. Of those, 98.6% were resolved locally following the first response.
The primary source of complaint continues to be car parking on site. Long term plans have been drawn up to improve the situation.
All complaints are handled in accordance with the Principles of Remedy good practice guidance and the Board of Directors receives regular updates. Where there is room for improvement we take immediate action to ensure performance is corrected.
Our Patient Advice and Liaison Service (PALS) acts on behalf of patients and families when requested and has been able to resolve a large variety of issues leading to positive outcomes.
did you knoW? More than 900 patients or their families wrote letters of thanks to the Trust for the good care received and the high levels of staff professionalism. This more than doubles the number of compliments received last year.
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Risk management and patient safetyImproving patient safety remains one of the three key quality indicators for the Trust and we have built on work undertaken in previous years to further enhance safety and reduce risk.
Measures include specialist staff training, robust risk assessment procedures, a strong incident reporting system and practice reviews at all levels.
The Patient Safety Committee continues to address issues arising from incidents and a Clinical Outcomes Group has supported the Trust in its drive to reduce mortality. This year has seen a further 8% drop in mortality on the previous 12 months.
CasE sTudy safe and secureAs part of the Trust’s commitment to improve safety and security on site for patients, visitors and staff, a team from security specialists Securitas began 24-hour cover of our site for the first time in February.
Previously security issues had been dealt with by our porters who now have more time to concentrate on their principal duties.
CCTV coverage of the site has also been extended as a further security measure.
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Health and SafetyIn May 2011 the Health and Safety Executive carried out a routine inspection. The resultant report included a number of recommendations, 90% of which were addressed within the financial year, but no improvement notices.
securityQEH staff have been encouraged to report all assaults and as a result, the number of reported incidents increased. However, 95% of these ‘assaults’ were carried out by people not deemed to have capacity for understanding their actions such as patients with dementia.
Emergency preparednessOur services and systems are regularly tested throughout the year and our Emergency Preparedness teams took part in a number of real life training scenarios.
Counter FraudCounter Fraud Provision is supplied by CEAC, the NHS consortium that also provides Internal Audit services to the Trust. A Local Counter Fraud Specialist helps to deter and identify fraudulent activity. During the year, no financially significant fraudulent activity has been uncovered.
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Environment and sustainability
Our efforts to maintain a ‘green’ approach to our business activities was recognised in November when we topped the Environment Agency’s Carbon Reduction Commitment league table as joint winner.
The Trust also continues to play a key role in NHS carbon reduction strategy and has retained its Carbon Trust logo.
Recent initiatives include the complete replacement of our onsite ‘street’ lighting with LED lights, saving an estimated £6,000 a year in lighting costs and giving a 20% improvement on lighting levels.
CasE sTudyCar park solution sought
Long term plans for a solution to the on-site parking shortage were put out to public consultation to give local people a say in the final scheme.
Five options were suggested and public opinion was used to draft a strategy for the Board of Directors to consider.
Phase 1 of our improvement programme has seen the
introduction of 250 dedicated spaces for patients and visitors. These are marked with blue lines and staff are no longer allowed to park in them. New fencing has been erected to protect the grass verges and remove the hazards caused by illegal parking. An additional 35 spaces will be created by removing small grassy areas in the car park itself. We will continue to work on improving our car parking provision for our patients and visitors.
Our VisionThe Trust’s three key strategic themes for the future are :
1. Clinical Quality and Patient Care
2. Operational Effectiveness and Efficiency
3. Growth and Service Development
These themes have been used to identify our Corporate Objectives set out as:
1. Clinical Quality and Patient Carel Improved patient experience, safety and outcomes
l Integrated local services
l Integrated patient pathways
2. operational Effectiveness and Efficiencyl Investment in workforce
l Investment in infrastructure
l Improved productivity
3. Growth and service developmentl Capacity development
l Tactical development of business relationships (competitive and collaborative)
l Cost reduction
We will continue to strive to achieve our overall vision to be ‘The Preferred Hospital for Local People’
NHS Foundation Trust
If you would like to receive a copy of this annual review in a different format, eg. Braille, large print, audio or translated, please contact
Richard Humphries on 01553 613216
The Queen Elizabeth HospitalGayton road, king’s Lynn, PE30 4ET
www.qehkl.nhs.uk
