Annual Report 2011/12Key Facts
Delivering Outstanding Patient Care
ProfileThe hospital provides a comprehensive range of musculoskeletal services including orthopaedic surgery, spinal injuries, bone disorders and medicine and, as one of the UK’s leading specialist hospitals, provides services on a local, regional and national basis.
Key achievementsContinued high ratings from our patientsResults from both the national inpatients an outpatients surveys showed us to be amongst the best performing hospitals in the country. Feedback from our patients showed the 98% scored the hospital as being excellent or good.
Continued low infection ratesThere have been no cases of MRSA since 2006 and two case of C- Difficile during 2011/12. The hospital also has one of the lowest rates of surgical site infections.
Foundation TrustIn August the Trust became an NHS Foundation Trust. This is a public benefit corporation, and the Trust now has members and elected Governors.
Hospital Re-developmentA project to improve patient parking and a new entrance to provide a focal point for patients was underway during 2011/12. This is now complete and has greatly enhanced the patient experience and will also benefit the environment.
Quality AccountsThe quality accounts show how the Trust has performed against a number of key quality indicators. The full accounts are available on the Trust website at:
www.rjah.nhs.uk/Quality-Account-2011-2012 Some of the significant indicators are shown to the right.
1
Oxford Hip/Knee score increase 6 months after replacement surgery
RJAH National Average
Hip 22.35 19.72
Knee 16.33 14.88
National Inpatient SurveyThis survey is undertaken independently of the Trust. The Care Quality Commission have analysed the responses and produced a combined score representing overall care received. This gave the Trust a score of 9.1 out of ten which places the Trust among the best in the country. Other key scores are shown below.
RJAH National Average
Responsiveness to Patient Needs
80.4 67.4
“Would you recommend this hospital to your family and friends”?
Yes Definitely 92.4% 66.6%
Yes Probably 5.8% 24.6%
Sub Total 98.2% 91.2%
National Outpatient SurveyThis showed the Trust to be performing in the best 20% of Trusts on the key question of “Overall, how would you rate the care you received at the Outpatients Department”
PEAT (Patient Environmental Action Teams)This is an annual inspection of the non clinical aspect of patient care. The scores for the various areas examined are combined to give a summary score over three headings.
Environment
Food and Hydration
Privacy and Dignity
Excellent
Excellent
Excellent
PROMS (Patient Related Outcome Measures)These calculate the improvement following an operation by measuring a patient’s assessment before and after the operation, using the”Oxford Hip and Knee scores”.
ActivityThere was a further increase in the number of surgical patients treated. The Trust has changed the treatment regime for meta-bolic medicine patients, which means that they are treated as outpatients rather than being required to be admitted to hospital. This has been reflected in the overall activity for the medicine division with an increase in outpatient attendance and a decrease in inpatients.
2
FinanceTwo sets of Annual accounts were produced for 2011/12, for the periods pre and post becoming a Foundation Trust. These accounts are included in the Annual Reports, which can be found on the Trust’s website at: www.rjah.nhs.uk/About-Us/Publications/Annual-Reports.aspxThe figures shown in this document are the combined figures for the full financial year.
The Trust achieved a surplus of £1.5m over the 2011/12 financial year. Monitor, the Foundation Trust Regulator, have examined the Trust’s financial ratios in order to assess its financial stability. It has given the Trust a score of 4 (5 being the highest available score)
Waiting TimesFollowing an expert review of the Trust’s waiting list manage-ment polices towards the end of the year, it was found that the national guidelines had not been consistently applied. A re-assessment was subsequently undertaken which showed that the English “Referral to Treatment target” had not been achieved and some patients had waited longer for their treatment than the national standards require.
NHS Trust Foundation Trust Total
1 April 2011- 1 August 2011- 1 April 2011- 31 July 2011 31 March 2012 31 March 2012
£000 £000 £000
Operating income 26,599 57,131 83,730Operating expenses -25,437 -55,585 -81,022Finance costs -421 -770 -1,191
surplus (before impairments) 741 776 1517
Adjust for Impairment 266 266
Net surplus 741 1042 1783
Income and Expenditure Statement
Division 10/11 11/12 % change Surgical 67267 72178 7%
Medical 18898 20905 11%
Total 86165 93083 8% Surgical 11857 11951 1%
Medical 2565 1983 -23%
Total 14422 13934 3% Surgical 704 753 7%
Medical 308 456 48%
Total 1012 1209 19%
The main source of income for the Trust was NHS Contracts for patient care. In common with other Trusts, the highest expenditure is on our staff, expenditure on clinical supplies is high due to the expenditure on implants.
Outpatients
Planned Inpatient Stays
Non Elective Stays
Income
Patient care (excluding Private Patients)
Private Patients
Other
Expenditure
Clinical supplies (including drugs)
Employee expenses
Other non pay
Investing in Patient CareThe Trust invested £4.9m during 2011/12, the majority of which was spent on the hospital redevelopment scheme. This has relocated to patient’s car park adjacent to a new entrance area, which includes state of the art technology to check in patients and guide them to their clinics. Through its backlog maintenance programme the Trust continues to ensure that its estate remains in high quality. We also purchased new medical equipment and made improvements in our operating theatres.
Capital Expenditure 2011/12
Available electronically at:
www.rjah.nhs.uk
design by Medical Photography and Illustration
The Robert Jones and Agnes HuntOrthopaedic Hospital NHS Foundation Trust, Oswestry, Shropshire SY10 7AGTel: 01691 404000 www.rjah.nhs.uk
Scheme
Hospital Redevelopment
Backlog Maintenance
Medical Equipment
Information Technology
Theatre Cooling System
Sheldon Ward Upgrade
Other minor schemes
Total
Expenditure £000
3,025
850
167
192
250
60
350
4,894