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Welcome to the

Aintree University Hospital

NHS Foundation Trust

Annual Members’ Meeting Wednesday 27 September 2017

Welcome to the

Aintree University Hospital

NHS Foundation Trust

Annual Members’ Meeting Wednesday 26 September 2018

Today’s programme

What we have done in 2017/18

What we will be doing in 2018/19 and beyond

Dr Neil Goodwin CBE Chairman

Aintree University Hospital

Foundation Trust

Aintree’s Achievements 2017/18 “A highly positive experience; I would recommend the hospital and staff to anyone” - Patient 2018

• Most improved Trust in Cheshire & Merseyside during winter (A&E)

• Best Trust in the country for staff flu vaccinations

• Regional Trauma Centre and Helipad opened

• Diabetes care rated ‘as outstanding’

• Delivery of 3 year + Quality Strategy

• Award winning Volunteers programme

Despite our best efforts….

• Eight never events

• Standards not fully achieved:

– emergency care performance

– 18 week referral to treatment

– Four cancer targets

• Financial performance

• Workforce pressures

Care Quality Commission – Inspection

• Care at Aintree - ‘Good’

• Pharmacy - ‘Outstanding’

• Overall rating - ‘Requires Improvement’

• Areas requiring particular focus:

– Safeguarding

– Quality Governance

– Medicines management systems

Board of Directors

* Non-voting Board member

Aintree’s Strategic Direction

To create sustainable adult hospital services

for the people of Liverpool, the City-region and beyond,

in collaboration with

The Royal Liverpool & Broadgreen University Hospitals NHS Trust,

commissioners and other stakeholders

Trust Priorities

• Quality and Safety

• Staff engagement

• Merger

• Finance and Operations

• Electronic Patient Records

• Represents interests of NHS FT members

• Challenges the Board on its performance

Council of Governors

In conclusion

Council of Governors

Membership 2018

Pamela Peel-Reade - Lead Governor

Foundation Trust Model of Accountability

• Key items of business presented to Governors by Non-Executive Directors at four Council of Governors’ meetings during 2017/18

• These meetings are open to the public

What is the statutory role of Governors?

• To hold the non-executive directors

individually and collectively to account for the

performance of the Board of Directors

• To represent the interests of the members of

the Trust as a whole and the interests of the

public.

Council of Governors

2018/19 governors@aintree.nhs.uk

How we discharged our duties

• Extended Mandy Wearne’s contract, Non-Executive Director (NED)

• Approved the reappointment of Joanne Clague, NED

• Participated in the appraisals of the Chairman and NEDs

• Appointed the external Auditor

• Attended Council meetings and Board of Directors meetings to

observe how NEDs held the Executive Directors to account

• Increased our knowledge and awareness of key issues relating to

quality of care

• Focussed on delivering our Membership Strategy

Governor Involvement at Aintree (1)

• Governor-Led Committees

• Membership

• Quality of Care

• Bespoke Training Sessions

• Safeguarding

• Complaints

• Serious Incidents

• Finance

• Governor Elections

• Meeting with prospective Governors

Governor Involvement at Aintree (2)

• Input into Annual Business Plan & Quality Account

• Patient Led Assessment of the Care Environment (PLACE)

• Director Walk Rounds

• Bowel Cancer Screening Initiative

• Aintree Champions Excellence (ACE) Panels

• World Kidney Day

• Proud of Aintree Awards

• Attendance at DME events

• Multi-disciplinary Accelerated Discharge

• Organ and Tissue Memorial Unveiling

• Fun Day at Westmoreland PPG

• Quality & Improvement Showcase

• Catering Food Quality Group

• NHS 70th anniversary celebratory events

Governor Involvement at Aintree (2)

Membership Report

• Trust Membership is open to anyone who lives in the North West of

England, age 16 or above, and all members of staff

• Our current strategy is to maintain the level at c8,500 public

members, and to focus on increased engagement

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

2015 2016 2017 2018 2015 2016 2017 2018

4208 4202 4697 4916

8154 8313 8543 8711

Staff Public

How do we meet our members

and hear their views?

• Get Involved with Aintree Group

• Membership Stand

• Developed relationships with:

– Local health and community groups

– Patient Participation groups

– Other local and regional hospitals

Membership Engagement

• Staff Governors present at monthly Trust Induction sessions

• Public Governors present at monthly Induction sessions for Volunteers

• Governors raise awareness of the benefits of membership by attending

community and health group events

• Members’ Newsletter

Focus for 2018-2019

• Quality of care, safety and the patient experience

• Merger and service reconfiguration

• Financial position

• Workforce

• Corporate reputation

Steve Warburton - Chief Executive

Review of 2017/18 and

Future Plans

• Highlights of Aintree’s 2017/18 Annual Report & Accounts

• Annual Operational Plan 2018/19

Our Strategy

• To provide excellent services to our local community

• Maintain our specialist services to a wider population

• Work more closely with our local and regional partners to

transform the delivery of all of our services

By strengthening Aintree’s position through:

• remaining committed to achieving financial balance

without compromising the quality of the services we provide

• sustaining improved patient flow throughout the hospital

• greater collaborative working with partners

• investing more in our informatics capability

Aintree University Hospital NHS FT

Our Performance

2017/18 End Q1 2018/19

Standard Actual Actual

RTT incomplete pathways 92% 91.9% 90.1%

A&E 4 hour waits 95% 82.9% 86.9%

Cancer 2 week - all cancers 93% 94.2% 87.7%

Cancer 31 day target - all cancers 96% 96.8% 99.1%

Cancer 62 day target - all cancers 85% 84.1% 78.0%

Cancer 62 day screening 90% 89.7% 55.6%

Diagnostic Access 1% 1.38% 1.10%

C. Difficile (hospital-acquired cases) 46 43 11

Highlights

• Grand Opening of Urgent Care & Trauma

Centre by The Duke of Cambridge

• Helicopter landing pad

• 12 ACE wards under AAA scheme

• Staff flu vaccinations

• £1.5m in grants

• Apprenticeship Programme

• Procurement savings of over £1m

• Develop our workforce to ensure staff have the right skills,

knowledge, attitude and behaviours to deliver high quality

care in the right place, every time

• Promote and develop a safety culture

• Reward our staff by ensuring they feel appreciated and

acknowledged

• Support staff innovation

Developing and supporting our workforce

• Quality Strategy 2018-2020 - we continue to involve staff and patients in

our priorities

• The CQC and Quality Risk Profile action plans combined into a single

overarching ‘Quality Improvement Plan’

• Aim is for continued improvement across all areas of patient care that

improve outcomes and reduce mortality

• Board commitment to the creation of an Explicit Safety Culture as a key

enabler

• Progress to date includes:

– Reducing infection – below the national standard of no more than 46

patients with C.Difficile infection

– Reducing falls causing harm – below target of 36 patients

– 95% of patients diagnosed with Community Acquired Pneumonia (CAP)

receive antibiotics within 4 hours of arrival in the Trust

Our Quality Improvement Journey

Quality

Our

priorities Care that is safe Care that is clinically effective

Care that provides a positive

experience for patients and their

families

Ou

r o

bje

cti

ves

• consistent delivery of harm free care

>98% as Safety Thermometer

• assessing patients for dementia

early in their stay to ensure they

are on the right pathway

• working towards a top 25%

position in the national inpatient

survey

• reducing MSSA bacteraemias by 50%

• reducing the number of C.Difficile

infection cases <=46

• No cases of MRSA

• achieving 95% > in Advancing

Quality care bundle standards

(relating to Acute Kidney Injury,

Alcohol Related Liver Disease,

Hip and Knee Replacement and

Pneumonia.)

• Increase FFT inpatient

recommendations to 96%

• Achieve zero never events

• 100% compliance with WHO Checklist

Care Pathway improvements

• Achieve Cancer 62 day target 85%

of the time

• Achieve RTT and diagnostic over 6

week waiters

• Improve End of Life Care

• Improve Stroke performance

• Complete 75% of complaint

responses in a timely manner

• reducing the number of inpatient falls

with harm

• reducing hospital acquired pressure

ulcers

• reducing harm, measured by

mortality ratings, MUST screening and

patient safety incidents

Activity 2017/18 (1)

Type 1 Emergency Attendances (2.7% up on 2016/17)

Activity 2017/18 (2)

Activity 2017/18 (3)

• We met our planned financial targets in 2017-18 with a Use of

Resource Rating of 4

• Income and expenditure were close to planned levels

• The Quality, Efficiency & Productivity (QEP) Programme of £13.6m

was delivered

• Reported deficit of -£3.5m, inclusive of Sustainability and

Transformation Funding of £10.6m

Finance

We received £351m of

income (before exceptional

items)

This is a £7.7m (2.2%)

increase from the £343.3m

received in 2016/17

Our earnings

£221.4m Pay

£31.5m Drugs

£45.1m Clinical supplies and services

£11.0m General supplies and services

£16.2m Premises costs

£5.3m Depreciation and impairments

£19.0m Other operating costs

£5.0m Cost of capital

Expenditure (millions)

We spent £354.5m (3.9% up on 2016/17)

£221.4m on staff costs, £128.1m on non-pay

and £5.0m servicing loan interest and Public

Dividend Capital

Our spend

Despite a challenging position, we continued to invest in

capital to make improvements throughout the hospital. We

invested £11.6m

including :

• £3.2m on medical equipment

• £3.1m on upgrading our wards

• £2.0m on information technology

• £1.7m on the theatre upgrade programme

• £1.0m on the helipad

Investments in 2017/18

• -£35.7m gap between income and expenditure

• £6.6m Cost Improvement Target

• -£29.1m planned deficit

Board was unanimous in its view that

maintaining safe, responsive and

effective patient care was more important

than achieving a balanced financial position

Finance 2018-19

• Continue to deliver care that is safe, effective and

which provides a positive experience for patients

and their families

• Underpinned by the common purpose of ‘getting

it right for every patient every time’

• Working with Royal Liverpool with the intention of

consolidating our two organisations to improve

the health and well-being of our community

• Demonstrate that we are being as productive and

efficient as possible

• Support innovation and new ways of working

Delivering our Vision

Any Questions?