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Royal United Hospital BathNHS Trust

Annual Report 2001 - 2002

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Annual Report2001/2002

Contents Page

Trust Profile and Commitment to the NHS Plan . . . . . . 3

Chairman’s Statement . . . . . . . . . 4

Chief Executive’s Statement . . . . . . . . . 5

Patient Care . . . . . . . . . . . 6

Performance . . . . . . . . . . . 8

People . . . . . . . . . . . . 10

Prevention . . . . . . . . . . . 14

Partnership . . . . . . . . . . . 16

Key Objectives 2002/2003 . . . . . . . . . 18

Summary Financial Statements 2001/2002 . . . . . . (i)-(x)

The Board of Directors . . . . . . . . . 19

Directors’ Interests . . . . . . . . . . 20

If You Want to Know More . . . . . . . . . 21

The Royal United Hospital Bath NHS Trust Annual Report is publishedby the communications office, telephone 01225 825849.

Photographs are courtesy of Robin Allison Smith and Oliver Lyon.

T W O

T H R E E

Profile of the Trust

The Royal United Hospital BathNHS Trust provides acutetreatment and care for acatchment population of around500,000 people in Bath, and thesurrounding towns and villages inNorth East Somerset, and WesternWiltshire. The Trust provides 577beds and a comprehensive rangeof acute services includingmedicine and surgery, services forwomen and children, accident andemergency services, and diagnosticand clinical support services.

The Trust employs 3,439 staff,some of whom also provideoutpatient, diagnostic and someday case surgery services atcommunity hospitals in Bradford-on-Avon, Chippenham, Devizes,Frome, Malmesbury, Melksham,Paulton, Shepton Mallet,Trowbridge, Warminster and

pathway from prevention totreatment in order to promote theindividual’s responsibility for goodhealth.

Our Commitment to Meetingthe Aims of the NHS Plan

The Trust is fully committed toworking with its partners in theBath health community to meetthe aims of the NHS Plan. This hasmeant focussing on patient care –the quality of service we give, andperformance – the quantity of careprovided and the speed at which itis made accessible to the public.Neither of these aims could beachieved without the contributionof the whole range of staff whoaim to provide a high level ofservice.

Westbury. This fulfils part of theTrust’s aim to provide high qualitycare to people in their localcommunities.

The hospital provides health careto the population served by fourprimary care trusts (PCTs), Bathand North East Somerset PCT,West Wiltshire PCT, Mendip PCTand Kennet and North WiltshirePCT.

Our vision for the Royal UnitedHospital is that of a hospital‘without walls’ which recognisesthat it is an organisation with akey role to play in thedevelopment of medicine in avariety of settings. In doing this itsees itself not simply as a providerof healthcare, but one whichconcerns itself with education,facilitation and the delivery ofeffective health outcomesthroughout the whole care

Trust Profile and Commitment to the NHS Plan

The Royal United Hospital Catchment Area

Bath & N.E. Somerset PCT

Mendip PCT

Kennet andNorth Wiltshire PCT

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F O U R

As the Royal United Hospital (RUH)interim chairman, I am verypleased to be presenting thisannual report to you. I would firstwant to thank Mr Gerald Chownwho was chairman of the RUHfrom 1997 - 2002 until my arrival.Mr Chown led the Board througha significant re-buildingprogramme and also through anumber of major clinicaldevelopments so that the clinicalservice currently offered by theRUH is nationally recognised asbeing of a very high quality.

The year covered by this annualreport will not be rememberedhistorically as one of the ‘goodyears’ for the RUH. The issuesleading to our status as a zero starhospital are well known, andseveral months into this financialyear, following the publication ofthe star rating, some progress isbeing made to improve ourposition in relation to waiting lists,waiting times and finance. Thereare major management challengesfacing the Trust, but I amconfident that these will beovercome.

The Board is made up ofexecutives and non-executives whoare individually and corporatelydetermined to ensure thateverything that can be done willbe done. They will ensure that thepeople who require our servicesnow and in the future, are assuredof effective and efficient systemsof care delivery and working to thebest standards of clinical andcorporate governance.

Patients of the RUH are generallyvery supportive of the care offered,and there has been good use ofthe Patient Advice and LiaisonService (PALS) since it opened inApril. We all have much to learnfrom the patients who use ourservices and as a Board we need

which we work, but alsoacknowledging that the artsencourage healing of the spirit.

Staff of the RUH are supported bymany people who volunteer theirservices, either by giving up theirtime to enhance the patientexperience, or by involvingthemselves in fund raising andsupporting staff in many differentparts of the hospital.

I want to end by recording mythanks to the many staff andvolunteers who are committed tomaking the RUH a place where allwho need our services receive careand treatment to the higheststandards. The future of theservice we offer depends on eachand every one of them.

to be looking at ways that we caninvolve patients more directly inour strategic development.Although considerable energymust be invested in dealing withthe problems created by the past –we cannot afford to stand still,and need to reaffirm the strategicvision for the RUH - involving staffand the general public.

The RUH is very proud of itsheritage. Implicit in the nameRoyal United Hospital is a historyof change and developmentculminating in the current rebuildon this site. Although there is stillbuilding work going on, manypeople who work as part of thehealth care team take pride inkeeping the building clean and ingood repair and it is as a result oftheir efforts that we were able toreceive a ‘4’, the top mark,following the recent PatientEnvironment Assessment Team(PEAT) visit. The Board would liketo express its thanks to all involvedin the work leading to thisachievement.

I am personally very impressed bythe arts project making such adifference to the environment in

Chairman’s Statement

Clinical manager sister Gill Caponinvolves her patient in his care

Housekeeper Helen Pearce adds ashine to the endocrinology anddiabetes centre

F I V E

As someone who only took uppost at the end of June 2002, it ishard to comment on the Trust’sprogress in the financial year justgone. It was undoubtedly a verydifficult year for the Trust withserious financial issues and majorproblems on waiting lists and ingetting emergencies into thehospital. Despite this, the Trustdid continue to provide excellentservices to its patients asevidenced by good reports andgood ratings of the clinical qualityof its services, and indications inpatients’ surveys and othercomments that patients aregenerally well satisfied with thecare they receive.

I believe that in future years, theyear just past will be seen as theyear in which the Trustacknowledged its problems andstarted to work on them andstarted to do what it needed toreally improve them. I am pleasedto say that work has beengathering momentum over the lastfew months and it is probable thatthe Trust would no longer warranta ‘no star’ rating if a snapshot ofits performance was taken today.

Inpatient and outpatient waitinglists, which had beenunderestimated and then emergedas the worst in England are nowradically reduced. A few monthsago there were quite significantnumbers of patients waiting over ayear and a half for their operationsand over 6 months for outpatientappointments. By the time of thisyear’s Annual General Meetingthere will be none in eithercategory: indeed no patient will bewaiting as long as 15 months foran operation by then. We are alsoon track to reduce those waits still

they should have for admissionand treatment. The good news isthat these problems are now beingtackled and patient waits aredropping fast and will continue todrop. In many other respects theRoyal United Hospital continues toprovide outstanding service andthis is much appreciated by itspatients.

The coming year will be a vital onein ensuring that the progress issoundly based and that confidenceis fully restored in the hospital.

further so that by March 2003 nopatients will wait as long as a yearfor an operation and themaximum outpatient wait will beunder five months.

During the last financial year theTrust also experienced majorproblems with emergencyadmissions and a number ofpatients were waiting on trolleysfor over 12 hours. I am pleased toreport that this too has improvedand that there have been no longtrolley waits for patients awaitingemergency admission since shortlyafter I joined the Trust. We areworking flat out to consolidatethese gains and to ensure ourperformance in other areasmatches what the people of Bathwant.

To sum up, the last year was a veryhard one for the organisation andit failed to meet a number oftargets, essentially meaning thatpatients were waiting longer than

Chief Executive’s Statement

Dr Elizabeth Lyon examines a patient onRobin Smith Ward

Clinical director of the breast unit Dr Dorothy Goddard

S I X

During 2001/2002, progress hascontinued towards improvingpatient care in all areas throughoutthe Trust.

Emergency Department

The emergency staff have workedextremely hard this year underexceptional pressures treating50,000 ‘walk-in’ attendances and16,500 emergency admissions. The department has introduced anumber of new initiatives toaddress this increase in demand:

● The successful recruitment of anumber of emergency nursepractitioners to assess and treatminor injury patients and inaddition, support staff to ensurethat patients are transferredquickly and safely to theappropriate specialty area.

● The appointment of twoassociate specialist doctors whoprovide medical care andtreatment of patients within themedical admissions unit.

● The operation of a dedicatedambulance for patientsrequiring transport from thehospital to a communityhospital, or a nursing orresidential home.

Ophthalmology

This year, the ophthalmologydepartment celebrated the firstanniversary of high volume cataractsurgery at Westbury, which hasdelivered operations to more than500 patients within the locality.Since the New Year, three membersof nursing staff have completedtraining in performing follow-upclinics post cataract surgery. A postfor a nurse practitioner is alsoplanned to commence initialassessment and treatment of eye

ensured high quality care isdelivered in cancer services.

As part of the Avon, Wiltshire andSomerset Cancer CollaborativeProject, the Trust has establishedseven service improvementinitiatives to provide patientfocused care. These includeproposals to create a user group,adding power to the patient’s voicein decision making about cancerservices.

The strength of our cancer serviceswas demonstrated through anindependent review last year. 98%of our patients with suspectedcancer were seen within twoweeks of referral and all patientswith breast cancer receivedtreatment within eight weeks oforiginal referral.

During 2001/2002, all patientswith suspected colon cancer orstomach and oesophageal cancerreceived a direct appointment forendoscopy and accurate diagnosiswithin two weeks of referral.

casualties, in addition toperforming other diagnosticinvestigations and treatments.

Gynaecology

The gynaecology directorate hascontinued its work throughout2001/2002 leading a regional studyin the management of womenwho miscarry and offering newoutpatient treatments for themanagement of a range ofgynaecological disorders whilstmeeting all Government waitinglist targets.

The directorate also remains aworld pioneer in outpatientmicrowave endometrial ablation, anovel treatment for themanagement of women withheavy periods and post menopausebleeding.

Cancer Services

The continuing commitment of ourclinical teams and the dedication ofstaff across the hospital have

Patient Care

Dr Venkatesha Babu and Dr Fazal Akbar, associate specialists on the medicaladmissions unit

S E V E N

Patient Advice and LiaisonService

In 2001, the Trust made asuccessful bid for Pathfinderfunding to establish the PatientAdvice and Liaison Service (PALS)and a head of service wasappointed. PALS aims to advise andsupport patients, and their familiesand carers, to provide informationon NHS services, to listen toconcerns, suggestions or queriesand help sort out problems quickly.

Locally, PALS networking withother trusts in the Bath healthcommunity has been establishedwith the aim of providing acomprehensive service to patientsand the public regardless of wherethey live.

Improving the Environment

Last year, the Trust spent £10.5mimproving the hospitalenvironment: the emergencydepartment moved into temporaryaccommodation whilst work gotunderway to build the newdepartment; the older people’s unitwas also completed, significantlyimproving the facilities andenvironment for older people beingtreated in the Bath area; diabeticand endocrinology services as wellas many wards also benefited fromupgrades.

The Trust has responded extremelywell to the NHS Clean Hospitalsinitiative to improve cleanliness andthe patient environment. At thebeginning of this year, it receivedGreen Hospital Status following acomprehensive inspection of thehospital. To ensure that thesestandards are maintained andfurther improved, the Trust has setup a Patient Environment ActionTeam to regularly monitor progress.

NHS Menu

Work has begun on a national levelto develop a new NHS Menu as

The ForeverFriends Appeal

The Forever Friends Appealis raising £10 million toprovide state-of-the-artdiagnostic and treatmentequipment to match theRUH’s new hospitalbuildings, and thereby savemore lives.

The Appeal is achieving . . .

. . . improveddiagnosis andtreatments for variousforms of cancer.

“The early diagnosis ofuterine cancer can savelives - the equipment TheForever Friends Appeal hasfunded will enable morewomen to be diagnosedand treated more quickly”.

Dr David Walker, ClinicalDirector Obstetrics andGynaecology

part of the NHS plan. LloydGrossman together with several ofthe country’s leading chefs hasdeveloped a range of exciting newdishes for hospital catering. Ourcatering manager has nowintroduced over 40 of these dishesto the hospital’s menus. Patientsatisfaction surveys have shownthat the new dishes are verypopular and have much improvedthe variety of foods on offer.

Patient Complaints

The Trust is committed toimproving the handling ofcomplaints and ensuring thatpatients, relatives and visitors knowhow to complain if they aredissatisfied with the service theyreceive.

Staff are trained in handlingcomplaints, through formal trainingsessions and opportunities toreflect on lessons learnt.

During 2001/2002, the Trustreceived 630 complaints, a smallreduction from the previous year.96% of complaints wereacknowledged promptly and 66%of complainants received a fullresponse within 20 working days. This is an improvement over theprevious year but efforts continuein order to make further progresson this important standard.

There were 12 requests forindependent review during theyear, two of which have proceededto panel and a further panel is stillto be convened. All other requestswere returned to the Trust for localresolution.

Lessons learned from complaintshave led directly to changes inservice provision and improvementsin patient care. A popular themeof complaints has been waitingtimes issues and enormous effortshave been devoted to tacklingthese problems.

CANCER PATIENTS

E I G H T

Despite a lot of hard work, theTrust fell short of certain keyGovernment targets. This resultedin a ‘no star’ status in the NHSPerformance Ratings, which werepublished in July 2002 but relate toour performance in 2001/2002.

During this year we treated:

● 66,500 patients in A&E ofwhom 16,500 were emergencyadmissions – the equivalent of180 patients per day.

● 30,000 patients who wereadmitted for elective surgicalprocedures.

● 240,000 patients were seen inour outpatient departments.

The Trust failed to meet thefollowing key targets:

● No patient waiting over 15months for an operation.

● No patient waiting over 26weeks for first GP referredoutpatient appointment.

● Financial balance.● Commission for Health

Improvement assessment.

Clinical Governance

The past year has brought bothsuccesses and disappointments inthe development of quality.

The Commission for HealthImprovement (CHI) inspected theTrust in July 2001. This was anopportunity for staff to give theirown view of how the Trust wasdeveloping clinical governance andimproving the quality of itsservices.

The review concentrated on threeservices: emergency, orthopaedicsand neurology services. The Trustwas praised for its work ondeveloping integrated carepathways and for the way in whichpatients have been involved indeveloping services. In particular,staff were commended for the lifesupport training provided and forthe succession planning for thenurse consultant posts. However,the report highlighted the lack ofmanagement systems andprocesses in place to ensure boththe care and protection of patientsand staff. This is a priority for theTrust management in the comingyear.

Nursing Documentation

From April 2002, new standardisednursing documentation will beimplemented across all medicalareas and all other specialities. Thenew documentation includes apatient profile - a multidisciplinarytool using colour codes to indicatethe degree of nursing interventionnecessary - and a standardisedformat for core care plans whichwill be available to all areas via theTrust Intranet.

Although there was recognitionduring the year that these targetswere unlikely to be achieved, anumber of initiatives were put inplace to minimise the impact:

● The national Winter EmergencyServices Team worked with theTrust and its primary carepartners to speed up theadmission of the emergencypatient and reduce waiting inthe A&E department.

● An external review ofmanagement of waiting listswas undertaken and validationof the entire inpatients waitinglist was put in hand.

● Additional capacity for bothinpatient and outpatienttreatment was put in placeenabling significant reductionsin numbers waiting by the yearend.

In the coming year, the Trust willcontinue to work with its partnersin primary care to improve thespeed of access for care in order toachieve the maximum waitingtimes outlined in the NHS Plan.

Performance

Accident & EmergencyAttendances

Outpatient Attendances

1999

/00

2000

/01

2001

/02

NU

MB

ER O

F PA

TIEN

TS

45000

46000

47000

48000

49000

50000

51000

NO

. OF

ATT

END

AN

CES

(N

ew a

nd

Fo

llow

up

)

215000

220000

225000

230000

235000

240000

245000

1996

/97

1997

/98

1998

/99

1999

/00

2000

/01

2001

/02

1996

/97

1997

/98

1998

/99

N I N E

The Essence of Care ClinicalBenchmarking Project

Continues to implement improvedstandards of care for patients inthe Trust. These improvementsinclude supplying toiletries, andincreasing patient privacy. Inaddition, ongoing work is focusingon nutrition, pressure soremanagement and patient records.

CRITICAL CARE PATIENTS

Day Cases Elective InpatientAdmissions

FIN

ISH

ED C

ON

SULT

AN

T EP

ISO

DES

(FC

E’S)

12000

14000

16000

18000

20000

22000

24000

NU

MB

ER O

F PA

TIEN

TS

7000

8000

9000

10000

11000

12000

13000

1999

/00

2000

/01

2001

/02

1996

/97

1997

/98

1998

/99

1999

/00

2000

/01

2001

/02

1996

/97

1997

/98

1998

/99

Emergency nurse practitioner Emma Barber assesses a patient

Head of patient access Jo Box



. . . enhanced facilitiesfor acutely unwellpatients, including anew state-of-the-artA&E department.

“We are trained to expectthe unexpected 24 hours aday. The high techequipment supplied byRotary through the appealfor our new state-of-the-artdepartment will help us toprovide care to the higheststandard - saving lives”.

Dr David Watson, Accident & EmergencyConsultant

T E N

Successful bids reported in lastyear’s annual report have turnedinto reality with plans to open anew building in August 2002, tohouse the Trust extended nurseryprovision. A further 50 places willbe available to our staff over time.Opening hours have beenextended to reflect the flexibility inhours our staff work.

The Trust’s achievements over thelast year have only been possiblebecause of the hard work andcommitment of its dedicatedworkforce. Our staff have workedhard to deliver patient care to ourlocal population.

Our Workforce

At the end of March 2002 RUHemployed 3439 staff, or 2680.2WTE. The make-up of ourworkforce is illustrated by the charton page 12.

Over the last year the Trust hasundertaken a number of initiativesto improve retention andrecruitment of key staff.

Recruitment and Retention

Our new recruitment website -alifestylechoice.com - developed atthe end of 2001 had by March2002 received over 5,000 visits.Interested staff can find out aboutthe benefits of working within thehospital using the web site. Suchtechnological advances help tospeed up the recruitment process,which is essential in today’scompetitive labour market.

In July 2001, representatives fromthe hospital visited Dubai andrecruited 51 nurses. Most nurseswere from the Philippines, but hadworked within English speakinghospitals in Dubai or Oman for twoyears or more. Although the nursesarrived on a cold, wet Octoberevening, the welcome theyreceived from hospital staff couldnot have been warmer. All nursesattended a comprehensiveinduction/adaptation programmeand have made a significant impacton the wards working alongsideour existing staff.

Improving Working Lives

Since the launch of thegovernment’s Improving WorkingLives (IWL) initiative, much workhas been undertaken to developpolicy and practice to create aflexible and fair workingenvironment. The initiative is anintegral part of the NHS Plan andthe Trust aims to achieve this by

People

Student nurse Charlotte Hickery works on day surgery

E L E V E N

Board on the number of staffemployed from ethnic minoritiesand is working to develop bettermonitoring mechanisms to ensureit meets its objectives in this area.The coming year will see a focuson tackling harassment and theTrust is committed to ensuringstaff are treated with dignity andrespect by all service users. AnHuman Resources (HR) Committeehas been formed to lead onequality and diversity issues. TheTrust has already achieved the ‘twoticks’ disability symbol andwelcomes applications frompeople with disabilities.

meeting the educational anddevelopmental needs of staff andproviding flexible workingarrangements. The Trustrecognises that our staff havemany commitments and need tohave a healthy balance betweentheir working and personal lives.

Success to date has included anumber of job share posts, termtime hours’ contracts andagreement on flexible contractswhich determine the number ofhours to be worked over a comingyear.

Diversity

The Trust is committed to ensuringthat it recruits a diverse workforcereflective of the local communityand meets the targets contained in‘Working Together’ and the ‘VitalConnection’. Part of its commitmentto equal opportunities is to ensurethat staff receive training indiversity issues. A senior universitylecturer successfully ran a diversityawareness programme over thepast year. All staff are encouragedto attend and share views on theneed to celebrate differences andto express how they think thismight impact upon workingpractice. The Trust reports to the

News Ways of Working

As part of the NHS Plan, the Trustcontinues to investigate, developand implement new ways ofworking and new roles. One suchexample is that of the doctor’sassistant post. The Trust hasrecruited and trained doctor’sassistants to perform tasks that donot need to be undertaken bymedical staff. This has provided akey development opportunity forsome of our staff and is designedto provide more efficient clinicalcare.

Staff Development

This year has also seen the launchof a full programme of appraisalsfor all staff. For the very first time,all consultant medical staffparticipated in a 360-degreeappraisal process, which takes intoaccount feedback from theircolleagues. This has proved verysuccessful. The Trust is committedto ensuring all staff receive anappraisal and further work will beundertaken next year to achievethis. Trust staff participated in awide range of education anddevelopment activities over theyear.

Ward clerk Sandra Graham on medical admissions unit

Our international nurses have made a significant impact on the wards alongsideour existing staff

T W E L V E

Staff Involvement

The Trust continues tocommunicate and consult with itsstaff and staff-side representativesthrough the established bi-monthlyTrust Consultative and NegotiatingCommittee (TCNC). Trust staffhave developed and agreed arange of new and updatedpolicies, including the Trust’songoing commitment to theemployment of people withdisabilities. The Trust also has anewsletter and a range of openstaff meetings to promote betterstaff involvement.

Our Healthier Staff

The Trust recognises theimportance of promoting a healthyworkplace. During 2001/2002,

This chart shows the make-up of our workforce withinthe Trust

Nur

sing

42%

Adm

inis

trat

ive

and

Cle

rical

17%

Med

ical

and

Den

tal 1

2%

Anc

illar

y 12

%

Sci

entif

ic a

nd P

rofe

ssio

nal 1

1%

Pro

fess

ions

alli

ed t

o m

edic

ine

6%

The RUH Bath Half Marathon team raises money for The Forever Friends Appeal

T H I R T E E N



. . . improveddiagnosis andtreatment facilities.

“The equipment andfacilities in the new cardiac‘village’ have greatlyimproved patient care - itis a new beginning for ourdepartment”.

Dr William Hubbard,Consultant Cardiologist

CARDIAC PATIENTS

the occupational health teamfurther expanded to include afourth doctor and an additionalnurse with specialist training inpsychiatric nursing. This teamprovides an important service tostaff with health problems.

Exercise facilities at the RUH havebeen further improved with thereplacement of the old tenniscourts with a new one.

The RUH Bath Half Marathon teamgrew to over a hundred yet againthis year with staff meeting up forregular training sessions during thethree months prior to the event.Yoga classes, and the cycling andswimming facilities have alsoremained popular.

Research and Development

Throughout the year the Trustcontinued to contribute towardsraising clinical standards byparticipating in researchprogrammes at a local, nationaland international level.

During the year eighty-threeprojects involving RUH patients

were approved by the localresearch ethics committee. Someof these involved collaborationswith the Avon, Somerset andWiltshire Cancer Services Networkwhich contributed financially toenable the RUH to fully participatein improving and maintainingcancer services at a local level.

The Trust also participated innational trials sponsored byresearch councils, charities and theDepartment of Health. Some ofthe clinicians at the RUH not onlyparticipated in research, but alsolead their own projects. The topicsranged from studying anaestheticairway devices to post-mastectomysensations and pain. The researchactivity is reflected in researchoutputs - during the year clinicianspublished 72 articles in peerreviewed journals as well asattending and presenting tonumerous conferences around theworld. An exciting developmenthas been the filing of a patentapplication for an automatedbreast scanner, developed by themedical physics department andthe Bath Institute of MedicalEngineering.

Main receptionist Janet Hough and Gill Cole are two of our front of house staff

F O U R T E E N

Adverse Incident Reporting

The risk management teamsupported by practicedevelopment colleagues hassuccessfully redeveloped theadverse incident reporting system.A new form for incident reportinghas been implemented taking intoaccount all the latest guidancefrom a National level. Adverseclinical incident reporting hasincreased significantly leading tosafer care.

Flu Vaccine

Last winter occupational healthgave over 1000 flu jabs to RUHstaff (and to staff of other NHStrusts in our area). Flu vaccine willagain be available for staff - asfrom September.

Health and Safety Award

The Trust recently received theGold Award for best practice inHealth and Safety from the RoyalSociety for the Prevention ofAccidents (RoSPA), jumping frombronze to gold levels in one year.This significant achievementreflects the excellent systems thatare in place to prevent accident orinjury to staff and patients, as wellas the regular monitoring thattakes place. The hospital also wonan award for recycling cardboard,which saves £4,000 a month indisposal costs.

Prevention

Senior radiographer Katherine Knightcarries out a mammogramme

Environmental porters Joe Espositoand Shaun Boswell recycle cardboardhelping to reduce Trust disposal costs

The risk management team Kay King, Kym Wright, Simon Smith, Sharon Bradleyand Sharon Urch receive the Gold Award for best practice in Health and Safety

F I F T E E N

Directors’ Statements on InternalControl

The Board is accountable for internalcontrol. As accountable officer, andchief executive officer of this Board, Ihave responsibility for maintaining asound system of internal control thatsupports the achievement of theorganisation’s objectives, and forregularly reviewing its effectiveness.The system of internal control isdesigned to manage rather thaneliminate the risk of failure toachieve these objectives; it cantherefore only provide reasonableand not absolute assurance ofeffectiveness.

The system of internal control isbased on an ongoing riskmanagement process designed toidentify the principal risks to theachievement of the organisation’sobjectives; to evaluate the natureand extent of those risks; and tomanage them efficiently, effectivelyand economically. The system ofinternal control is underpinned bycompliance with the requirements ofthe core controls assurancestandards:● Governance● Financial management● Risk management (risk

management system standard for2001/2002)

I plan to have the necessaryprocedures in place by the beginningof the financial year 2003/2004necessary to meet the Treasuryguidance. This takes into account thetime needed to fully embed theprocesses that the Board has agreedshould be implemented.

The actions taken so far include:● The organisation has undertaken

a self-assessment exercise againstthe core controls assurancestandards (governance, financialmanagement and riskmanagement). An action plan isbeing developed and will beimplemented to meet any gaps.

● The organisation has in placearrangements to monitor, as partof its risk identification andmanagement processes,compliance with other keystandards, including relevantcontrols assurance standards

covering areas of potentiallysignificant organisational risk.Developing the Board’s awarenessof their responsibility towards thecore assurance standards.

In addition to the actions outlinedabove, in the coming year it isplanned to:● Further develop the Trust’s risk

register to capture all significantrisks identified through financial,clinical and non-clinical riskassessment processes.

● Firmly establish a revised sub-committee structure,incorporating improved lines ofaccountability between theBoard, the risk managementcommittee, audit and riskmanagement and quality reviewfunctions.

● Further develop the financialcontrols framework in theorganisation.

● Develop and strengthen a goodsolid risk management cultureand structure.

● Continue to participate andcontribute to benchmarkingacross the local health communityand nationally.

● Develop and implement a robustperformance managementframework.

As accountable officer, I also haveresponsibility for reviewing theeffectiveness of the system ofinternal control. My review of theeffectiveness of the system ofinternal control has taken account ofthe work of the executivemanagement team within theorganisation which haveresponsibility for the developmentand maintenance of the internalcontrol framework, and of theinternal auditors. I have also takenaccount of comments made byexternal auditors and other reviewbodies in their reports.

Signed (Chief Executive Officer)

3rd September 2002(on behalf of the Board)



. . . a new integratedchildren’s centre.

“The new Centre is reallybenefiting from theparent’s accommodationand all the medical andtherapeutic equipmentreceived through TheForever Friends Appeal - itis transforming our work”.

Dr Jennifer Tyrrell, Consultant Paediatrician

CHILDREN

S I X T E E N

Discharge Planning

Since January 2002, the primarycare trust liaison nurses and socialwork teams have met on a dailybasis in order to plan and discusstransfers and complex discharges.This has allowed more timely andappropriate discharges andtransfers, freeing up valuable beds.

The implementation of thedischarge lounge has also had asignificant impact on theavailability of beds earlier in theday. The lounge caters for patientswho are being transferred to acommunity hospital or nursinghome, or being discharged homethat day. In addition, patientleaflets have been produced whichexplain what to expect when beingadmitted into the hospital.

Accessing Information

The RUH adopts a Code ofOpenness and is committed toproviding public access toinformation.

The hospital holds monthly boardmeetings and encourages membersof the public and press to attend.When appropriate, the Trust

with an invitation to take a lookbehind the scenes. The day wasvery well attended with severalhundred people visiting and takingpart in a variety of events. Nearlyall the departments in the hospitalwere represented, giving tours,demonstrating services or offeringhealth checks; there were evenopportunities to have limbsplastered!

Voluntary Support

League of Friends

The Friends have enjoyed anexceptionally busy year with theirnew shop premises and numerousvolunteer teams.

The coffee shop continues to thriveand now benefits from a recentlyopened ‘quiet garden’ overlookedby the new older people’s unit. Itoffers a pleasant area for patientsto enjoy, but the peace and quietcan be enjoyed by everyone.

This year, amongst otherdonations, the League of Friendsgave £40,000 to the fracture andorthopaedic clinic and £38,000 tothe diabetic clinic. The clinicsremain exceptionally busy but theirsurroundings have now beentransformed vastly improving thepatient experience.

The Friends have showntremendous support andappreciation to the hospitalthroughout its difficulties duringthe past year. This will bereaffirmed later in the year with athanksgiving service for thehospital and re-dedication for theFriends.

provides the national and localpress and broadcast media withaccess to the hospital and to someof its staff when issues of publicinterest arise. The local media alsoreport on many of theachievements of our staff.

Regular staff open meetingscommenced in November 2001enabling our staff to keep up todate on issues and achievementsand to share accurate informationwith the public. A communicationsstrategy group has also beenformed to encourage directoratesto take a more active role incommunications. Staff areencouraged to contribute to thehospital magazine Grapevine whichprovides a useful way of keepingup to date with more positivedevelopments within the Trust.

The Trust web site has becomemore user friendly and workcontinues to provide up to date,useful and relevant information forstaff, patients and visitors.

Trust Open Day

In November last year, the RUHopened its doors to severalhundred members of the public

Partnership

Charge nurse Daniel Messom talks to apatient in discharge lounge

S E V E N T E E N

Bath Cancer Unit SupportGroup

The Bath Cancer Unit SupportGroup was founded in 1985 andcontinues to raise funds toimprove the facilities for patientsof the cancer unit.

The group has agreed to financeat a cost of £280,000 a new daytreatment unit, which willsignificantly increase the numberof patients treated and is currentlyfundraising for this purpose. Thenew unit is expected to open inJanuary 2003.

Bath Hospital Radio

The hospital’s volunteer-run radiostation, celebrated earlier in theyear when it was named theNational Hospital Radio Station ofthe Year. Competing with 300other hospital radio stations acrossthe UK, this was a fantasticachievement made possible by the30 plus volunteers who supportthe radio station by collectingrequests, fund-raising andproducing programmes.

The service broadcasts to bedsideradios and day room loud speakersacross the site and provides a 24hour-a-day mix of popular music,news and hospital information.Radio station volunteers regularlyvisit the wards to collect requests,which are played every evening bythe team of presenters.

League of Friends volunteer ClaireBrodie provides refreshments forpatients on Robin Smith ward


The Forever Friends Appealis raising £10 million toprovide state-of-the-artdiagnostic and treatmentequipment to match theRUH’s new hospitalbuildings, and thereby savemore lives.

Nearly £4 million has beensecured since the Appeal’slaunch in October 1999.Ted’s Big Day Out! – ourvery own region-widefundraising day that takesplace each October - hasbeen established as a greatsuccess. In 2001, it raisednearly £80,000 in just oneday and this event has now

become an integral partof our fundraising

calendar.

The work of theAppeal has begun to

make a tremendousdifference to many

departments – cancer,cardiology, critical care &children are the main areasbeing provided with newequipment. Without thehard work of many people– none of this would bepossible. The ForeverFriends Appeal would liketo thank all those donors,sponsors, RUH staff andvolunteers for theirconsiderable effort inachieving the Appeal’ssuccess to date.

E I G H T E E N

The RUH is in the process ofdeveloping a comprehensiveoperational plan to ensure that theTrust meets the targets set out inthe NHS plan in the coming year.This will require a review of howservices are delivered and in someareas a review of the way work iscarried out.

Patient Care● For all of our services, we will

continue to improve thepatient’s experience in terms ofspeed of access and quality ofcare, whilst respecting patientchoice.

● The use of new technologieswill enhance patient care.

● We will continue to improvethe quality of the environmentand services for patients.

● We will continue to developservices in line with nationalguidance (e.g. cancer services,coronary heart disease, care forolder people).

Performance● Continue to drive towards

reducing the waiting times forpatients.

● Continue to monitor andimprove the standard of caregiven.

human resources strategy - ‘HRin the NHS’.

Prevention● The Trust will work with other

partners to improve the healthof the local population.

● We will aim to develop andprovide health promotionliterature and informationwherever possible.

Partnership● The Trust will maintain and

develop services in conjunctionwith partners in primary care,social services and otherhealthcare organisations.

● Staff will work to ensure thatpatients are fully involved indecisions regarding their careand receive relevantinformation relating to theircondition and treatment.

● The organisation will work withpatients and theirrepresentatives to shapeservices. This will includesystematically measuringsatisfaction. Results of thismonitoring, together with theaction taken to resolve anyproblems identified, will bepublished in a patientprospectus.

● Develop a plan in partnershipwith primary care colleagues toreturn the Trust to a position offinancial balance.

People - Our WorkforceThe Trust will work towards theachievement of practice stage ofthe Improving Working Livesstandard by March 2003, by:● Increasing its focus on diversity

issues, particularly harassmentagainst staff.

● Improving and encouragegreater levels of staffinvolvement.

● Commencing work on theintroduction of the national

Key Objectives 2002/2003

Senior sister Ruth Godfrey accompanies a patient on older people’s unit

The older people’s unit will significantly improve the facilities and environment forolder people in the Bath area

SUMMARY FINANCIAL STATEMENTS

Introduction

Financial management at the RUH Bath was extremely challenging during the year 2001/02.

The Trust achieved the statutory break even duty after receiving £17.9m of non-recurring revenue support.

The financial targets set for Management Costs, Capital Cost Absorption Rate and Capital Resource Limit were allachieved within the permitted parameters.

The core External Financing Limit of £1,912,000 was delivered to within £3,000.

The Trust’s Public Sector Payment Policy achievement for 2001/02 was 75% by number and 86% by value of billspaid within 30 days.

Further details of the mandatory financial targets are shown on page (vi).

Looking ahead, 2002/03 will be another difficult year as the Trust strives to deliver high quality patient care andimproved waiting times against a background of rising financial pressures.

The year started with a planned financial deficit of £17,033m for the Bath Health Community. Mid year incomeand expenditure forecasts and financial risk-assessments indicate an additional year end forecast deficit of £5mrelating to services provided by the RUH Bath for the local community.

Plans to investigate the risks and deliver the original financial targets are being developed in conjunction with localPrimary Care Trusts (PCTs) and Avon, Gloucestershire and Wiltshire Health Authority (AGW HA).

I would like to thank staff throughout the Trust and related agencies for their hard work in striving to deliver thefinancial targets and provide value for money services for our patients.

Stephen CassDirector of FinanceSeptember 2002

The accounts for the year ended 31 March 2002 have been prepared by the Royal United Hospital, Bath NHS Trustunder section 98 (2) of the National Health Service Act 1977 (as amended by section 24 (2), schedule 2 of theNational Health Service and Community Care Act 1990) in the form which the Secretary of State has, with theapproval of the Treasury, directed.

The summary financial statements that follow are a summary of the information in the full accounts which areavailable from the Trust’s Finance Department. Please write to James Ellis, Head of Financial Services, Royal UnitedHospital, Bath NHS Trust, Combe Park, Bath BA1 3NG.

(i)

DIRECTORS’ STATEMENTS

Statement of the Chief Executive’s responsibilities as the Accountable Officer of the Trust

The Secretary of State has directed that the Chief Executive should be the Accountable Officer to the Trust. Therelevant responsibilities of Accountable Officers, including their responsibility for the propriety and regularity of thepublic finances for which they are answerable, and for the keeping of proper records, are set out in theAccountable Officers’ Memorandum issued by the Department of Health.

Jan Filochowski, Chief ExecutiveSeptember 2002

Statement of Directors’ responsibilities in respect of the accounts

The Directors are required under the National Health Services Act 1977 to prepare accounts for each financial year.The Secretary of State, with the approval of the Treasury, directs that these accounts give a true and fair view ofthe state of affairs of the Trust and of the income and expenditure of the Trust for that period. In preparing thoseaccounts, the Directors are required to:

- apply on a consistent basis accounting policies laid down by the Secretary of State with the approval of the Treasury.

- make judgements and estimates which are reasonable and prudent.- state whether applicable accounting standards have been followed, subject to any material departures

disclosed and explained in the accounts.

The Directors confirm they have complied with the above requirements in preparing the accounts. The Directorsare responsible for keeping proper accounting records which disclose with reasonable accuracy at any time thefinancial position of the Trust and to enable them to ensure that the accounts comply with requirements outlinedin the above mentioned direction of the Secretary of State. They are also responsible for safeguarding the assets ofthe Trust and hence for taking reasonable steps for the prevention and detection of fraud and other irregularities.

By order of the Board

Jan Filochowski, Chief ExecutiveSeptember 2002

Stephen Cass, Director of FinanceSeptember 2002

(ii)

Independent Auditors’ Report to the Directors ofRoyal United Hospital, Bath NHS Truston the Summary Financial Statements

I have examined the summary financial statements set out on pages (iv) to (x).

Respective responsibilities of Directors and Auditors

The Directors are responsible for preparing the Annual Report. My responsibility is to report to you my opinion onthe consistency of the summary financial statements with the statutory financial statements. I also read the otherinformation contained in the Annual Report and consider the implications for my report if I become aware of anymisstatements or material inconsistencies with the summary financial statements.

Basis of opinion

I conducted my work in accordance with Bulletin 1999/6 ‘The auditor’s statement on the summary financialstatements’ issued by the Auditing Practices Board for use in the United Kingdom.

Financial Standing

In forming my opinion I have considered the adequacy of the disclosures made on pages (viii) and (ix) regardingthe proposals for achieving financial balance both within the Trust and in the wider local health economy. By thenature of such plans there are inherent uncertainties in their delivery and I will continue to keep these underreview, but my opinion is not qualified in this respect.

Opinion

In my opinion the summary financial statements are consistent with the statutory financial statements of the RoyalUnited Hospital, Bath NHS Trust for the year ended 31st March 2002 on which I have issued an unqualifiedopinion.

Richard LottSeptember 2002

District Audit32 South CourtThe CourtyardWoodlandsBradley StokeBS32 4NH

(iii)


Income and Expenditure for the Year Ended 31 March 2002

2000/01 2001/02£000 £000

Income from activities 90,042 113,807Other operating income 14,567 15,599Operating expenses (99,521) (121,433)Operating Surplus 5,088 7,973

Exceptional gain: write-out of clinical negligence provisions 0 3,761Exceptional loss: write-out of clinical negligence debtors 0 (3,761)Loss on disposal of fixed assets (167) (6)Surplus before Interest 4,921 7,967

Interest receivable 110 96Interest payable (2) 0Surplus for the financial year 5,029 8,063

Public Dividend Capital - dividends payable (5,365) (5,984)

Retained Surplus for the year (336) 2,079

Balance Sheet as at 31 March 2002

2000/01 2001/02£000 £000

Fixed AssetsTangible Fixed Assets 105,507 116,578

Current AssetsStocks 2,708 2,324Debtors: amounts failing due after one year 3,026 428Debtors: amounts failing due within one year 7,046 15,633Cash at bank and in hand 6 2,072

Creditors: Amounts failing due within one year (4,850) (19,293)

Net Current Assets 7,936 1,164

Total Assets less Current Liabilities 113,443 117,742

Creditors: Amounts failing due after more than one year 0 0Provision for liabilities and charges (3,538) 0Total Assets Employed 109,905 117,742

Financed byPublic dividend capital 122,297 124,485Revaluation reserve (5,152) (2,412)Donation reserve 4,080 4,240Other reserves 0 0Income and expenditure reserve (11,320) (8,571)

Total Capital and Reserves 109,905 117,742

(iv)


Cash Flow Statement

2000/01 2001/02£000 £000

Operating ActivitiesNet cash inflow from activities 2,230 16,139Returns on investments and servicing of financeInterest received 110 96Interest paid (2) 0Net cash inflow (outflow) from returns on investments and servicing of finance 108 96

Capital ExpenditurePayments to acquire tangible fixed assets (12,076) (12,184)Receipts from sale of tangible fixed assets (54) 24Net cash inflow (outflow) from capital expenditure (12,130) (12,160)

Dividends paid (5,365) (5,984)Net cash inflow (outflow) before management of liquid resources and financing (15,157) (1,909)Management of liquid resources 0 0Net cash inflow (outflow) before financing (15,157) (1,909)

FinancingPublic dividend capital received 22,767 15,315Public dividend capital repaid - not previously accrued (7,610) (13,127)Public dividend capital repaid - accrued in prior period 0 (276)Net cash inflow (outflow) from financing 15,157 1,912

Increase (decrease) in Cash 0 3

Statement of Recognised Gains and Losses

2000/01 2001/02£000 £000

Surplus for the financial year before dividend payments 5,029 8,063Fixed asset impairment losses (13,351) (450)Unrealised surplus on fixed asset revaluations/indexation 1,582 3,920Increase in the donation reserve due to receipt of donated assets 1,571 450Reduction in the donation reserve due to depreciation, impairment(loss of economic benefits), and/or disposal of donated assets (252) (350)Additions/(reductions) in “other reserves” 0 0

Total Recognised Gains and Losses for the financial year (5,421) 11,633Prior period adjustment* (3,677) 0

Total Gains and Losses Recognised in the financial year (9,098) 11,633

* The prior period adjustment relates to the reversal of the loss arising from the impairment of fixed assets (FRS11).

(v)


Key Financial Targets

Breakeven PerformanceNHS Trusts are normally required to break-even financially over a three-year period. An agreement was reachedthat this period would be extended to five years for the RUH linked to a financial recovery plan and capitalrebuilding programme. Timescales agreed in the plan have subsequently slipped and additional costs have beenincurred meeting NHS Plan targets. The financial target has been achieved with the help of non recurring incomeof £17,922K from Avon Health Authority. The Trust is developing a plan that should delivera recurring expenditure balance within the next five years.Financial Year 1998/1999 1999/2000 2000/01 2001/02Breakeven in year position (478) (543) (336) 2,079Breakeven cumulative position (1,200) (1,743) (2,079) 0

External Financing LimitSpending on the acquisition of land and buildings is financed by borrowing from the Government. The ExternalFinancing Limit (EFL) is a limit on the amount of cash that may be borrowed in any one financial year and, atnational level, is an important component in the control of public expenditure. Managing the EFL is a key financialduty of the Trust. The Trust missed its EFL as set by the NHS Executive for the Trust in 2001/02 of £1,912K by £3K.

Capital Resource LimitThe Capital Resource Limit (CRL) is a new target set by the Department of Health for 2001/02. The limit is thefunding available to the Trust for capital expenditure. The Trust is required to stay within its CRL but is permitted toundershoot (underspend). The undershoot for the year was £88K.

2001/02Gross capital expenditure 12,902Less book value of assets disposed of (30)Less donations (450)Charge against CRL 12,422Capital Resource Limit 12,510

Public Sector Payment Policy Trusts are required to pay their non-NHS trade creditors in accordance with the CBI prompt payment code andGovernment Accounting Rules. Government Accounting Rules state that ‘the timing of payment should normallybe stated in the contract .... where there is no contractual provision the Trust should pay within 30 days of receiptof goods and services or the presentation of a valid invoice, whichever is the later’. The Trust’s payment policy isconsistent with both of these and its measurement of compliance is:

2000/01 2001/02Total number of bills paid 44,851 55,281Total number of bills paid within target 24,021 41,476Percentage of bills paid within target 54% 75%

Total value of bills paid (£’000) 63,448 82,102Total value of bills paid within target (£’000) 46,793 70,770Percentage of bills paid within target 74% 86%

Under the Late Payment of Commercial Debts (Interest) Act 1998 companies can charge interest on overdueaccounts. During the year 2001/2002 the Trust paid no interest from claims made under this legislation.

Management Costs 2000/01 2001/02Income (excluding FRS11 income) 104,609 129,406Management costs in year 3,834 5,416Management costs expressed as a percentage of income 4% 4%

In accordance with the Permanent Secretary/Chief Executive of the Department of Health letter of 9th April 2001on NHS Managers’ pay, the Trust has taken all practical steps to ensure that pay rises for senior managers did notexceed 3.7% of the managerial pay bill for 2001/02.

Capital Cost Absorption RateThe Trust is required to absorb the cost of capital at a rate of 6% of average relevant net assets. In 2001/02the Trust achieved a rate of 5.8% which is within the NHS Executive’s materiality range of 5.5% to 6.5%

(vi)


The Avon Health Community deficit position in 2001/02

NHS Body Reported Reported Planned Unplanned Deficit(deficit) Surplus Financial Financial Before

Assistance Assistance FinancialAssistance

£’m £’m £’m £’m £’mRoyal United Hospital, Bath NHS Trust 0.00 2.10 (5.50) (12.42) (15.82)Other NHS Bodies in Avon (unaudited) (13.11) 0.00 (6.00) (7.03) (26.14)Totals (13.11) 2.10 (11.50) (19.45) (41.96)

The “financial assistance” above was met by:Transfer from capital monies 7.40 7.40Dept of Health “virement” 4.10 19.45 23.55Totals 11.50 19.45 30.95

“Other NHS bodies in Avon” is made up of the following organisations:Avon and Wiltshire Mental Health Partnership TrustUnited Bristol Healthcare TrustWeston Area Health TrustNorth Bristol TrustRoyal National Hospital for Rheumatic DiseasesAvon AmbulanceAvon Health AuthoritySouth Gloucestershire PCTBath and North East Somerset PCT

The above table identifies the planned and unplanned financial assistance provided to NHS Bodies in theAvon Health community in 2001/02. Avon Health Authority received increased resource limit of £23.55 millionfrom the Department of Health, which was effectively the virement of funding from 2002/03. In 2002/03, thisamount will be funded by the use of short term financial support in the form of either a grant or loan from theDepartment of Health. The new Avon, Gloucestershire and Wiltshire Health Authority will seek permission totransfer capital monies to offset the deficits of £13.11 million reported in 2001/02.

Health Community 2002/03 Financial Position

The projected deficit for Avon, Gloucestershire and Wiltshire Health Authority (AGW HA) in 2002/03, beforeexternal support, is £46 million. This assumes that savings plans are delivered and in-year spending is managed toreduce costs by 1%, equivalent to £17 million. It also reflects the use of new performance fund monies to improveeffectiveness equivalent to £3 million. In total, this represents an underlying deficit of £66 million.

Additional short term financial support from the Department of Health will reduce deficits by £21.45 millionleaving £24.55 million to be addressed. AGW HA is seeking approval to transfer capital monies to meet theremaining gap. In addition it will consider other options, including resource limit virement as a last resort, in orderto breakeven in 2002/03.

A financial recovery plan is being developed as part of the updated AGW HA Franchise Plan for October 2002 inorder to demonstrate how AGW HA will achieve financial balance over the next three years. NHS Trusts and PCTsare working together locally to develop their plans.

(vii)


Royal United Hospital, Bath NHS Trust (RUH) 2002/03 Financial Position

In 2002/03 the RUH portion of the AGW HA projected deficit (£46 million) is £17.033 million. The RUH deficit is,however based on the following significant assumptions and projections:

£mRecurring deficit 14.028Cost pressures 5.240Total 19.268

Achieving savings (2.235)

Planned deficit 17.033

Since plan submission, the RUH has been notified that it is unlikely, at this time, to receive any funds from theDepartment of Health (part of the £21.45 million referred to on page (vii)). Without a further injection of fundingor recovery action during 2002/03, RUH is likely to record a deficit of £17.033 million. AGW Health Authority istherefore seeking approval to transfer capital monies to meet the remaining gap and considering otheroptions, including recovery plans, in order to achieve financial balance. The Trust Board is satisfied that theplans developed to date, whilst challenging are achievable. Processes have been established within the localhealth community to develop a plan covering the next three years to achieve financial balance on a recurringbasis. We have been assured by the Avon, Gloucester and Wiltshire Health Authority that any additional cost ofmeeting the access targets will be met by Primary Care Trusts. Whilst the financial deficit sits with the Royal UnitedHospital, Bath NHS Trust, responsibility rests with the Bath Health Community to tackle the problems collectively.There is no implication that the financial difficulties rest wholly with the Royal United Hospital, Bath NHS Trust.

(viii)


Board Directors’ Remuneration

This note reflects the Greenbury requirements for senior employees. Senior employees are those persons in seniorpositions having authority or responsibility for directing or controlling the major activities of the Trust. The ChiefExecutive has confirmed that this definition relates to the Executive and Non-Executive Directors of the Trust. Thedisclosures in this note have only been made with the prior consent of the individuals concerned. Stated salariesrelate to the proportion of the year during which the individual was employed.

2001/2002

Name and Title Age Salary Other Benefits in Real increase Total accruedremuneration kind in pension at pension at age

£000 £000 £000 age 60 60 at 31.3.02

Mr Gerald Chown, Chair * 24 0 0 ** **

Executive DirectorsMr John Stephenson, Director of Corporate Affairs * * * * * *Mr Martin Dove, Director of Finance * * * * * *Mr David Gilburt, Acting Director of Finance * * * * * *Dr Graham Smith, Medical Director 49 126 29 0 ** **Mrs Jane Cummings, Director of Nursing 40 87 0 7 ** **Mr David Tappin, Director of Planning/Acting Chief Executive 35 90 0 7 ** **Mr Stephen Holt, Director of Facilities 44 69 0 5 ** **Mr Richard Gleave, Chief Executive 38 59 0 0 ** **Ms Jenny Barker, Programme Director 42 43 0 0 ** **Dr James Playfair, Director of Primary Care 48 39 0 0 ** **Ms Alex O’Grady, Director of HR 46 43 0 2 ** **Ms Barbara Harris, Chief Executive 41 37 0 3 ** **Mr Steven Simmons, Acting Director of Finance 52 25 0 0 ** **Ms Sally Fox, Director of H R 36 12 0 0 ** **

Non-Executive DirectorsMr Jeff Manning 57 6 0 0 ** **Mr Thomas Shepperd 49 6 0 0 ** **Mrs Prudence Skene 58 6 0 0 ** **Mr Barry Stevenson 63 6 0 0 ** **Ms Millie Carter 63 4 0 0 ** **

*Consent to disclose withheld.

** Pension is managed by the NHS Pensions Agency

No senior employees received golden hellos or compensation for loss of office during 2001/02.

(ix)


CHARITABLE FUNDS

Charitable funds arise from donations, subscriptions and bequests and must be accounted for independently ofmonies received from purchasers for the provision of health care. Charitable funds are very important to the Trustand provide additional benefits to patients and staff which could not otherwise be provided.

The Royal United Hospital, Bath NHS Trust is the Trustee for the Charitable fund, registered charity number1058323. The Trust Board is therefore fully accountable for the funds but has delegated some responsibilities tothe Charitable Funds Committee. The Charitable Funds Committee is supported by the Audit Committee and afinance department representative.

The main duties of the Charitable Funds Committee are to ensure that the funds are collected, spent andmanaged legally, ethically and in accordance with all relevant legislation. The Committee also recommends policyand procedural changes to the Trust Board in relation to Charitable Funds to ensure compliance with statutorychanges. This includes fundraising, investment, expenditure and operational policies.

The Trust wishes to thank all those who have generously donated funds during the year.

Statement of Financial activities for the year ended 31 March 2002

2000/01 2001/02£000 £000

Incoming resourcesDonations 1,011 777Legacies 417 302Operating Activities 27 57Investment income 38 43Other income 0 0Total incoming resources 1,493 1,179

Resources expendedCosts of generating funds 151 148Grants payable to other NHS bodies 655 505Activities in furtherance of charity’s objectives 394 275Management and administration 52 60Total resources expended 1,252 988

Gains/(losses) on disposal of investment assets (219) (80)

Fund balances brought forward 1,358 1,380

Fund balances carried forward 1,380 1,491

Balance sheet as at 31 March 20022000/01 2001/02

£000 £000

Investment Assets 1,030 975Current Assets 383 534Creditors (33) (18)Total Net Assets 1,380 1,491

Funds of the CharityRestricted income funds 1,075 1,094Unrestricted income funds 305 397Total Funds 1,380 1,491

(x)

Non-Executive Members

Gerald Chown became chairman in 1997 and waspreviously chairman of Bath & West CommunityNHS Trust for five and a half years. Prior to this, hewas managing director of UBM, the Bristol basedbuilding supplies company and has extensivegeneral management experience. He is a memberof the Council of the University of Bath and waschairman of the Audit Committee. Mr Chownretired as chairman in May 2002. Professor RuthHawker was appointed as interim chairman fromMay 2002 pending the appointment of a new chair.

Barry Stevenson has an extensive financialbackground and is a Fellow of the Institute ofChartered Accountants and a Fellow of the Instituteof Corporate Treasurers. He was group chiefexecutive of Canadian Overseas PackagingIndustries Ltd and is currently chairman of BrunelHoldings Plc. Mr Stevenson resigned from the RUHTrust Board in June 2002.

Mildred Carter has a health service and policybackground. As a nurse she had 34 years clinicalexperience in the NHS as well as management andcapital, and service planning experience. Mildredworked in London, Glasgow, Bristol, Oxford,Manchester and Bath before joining theDepartment of Health for five and a half years in1991. She is currently honorary treasurer of theBath Branch of the Parkinson’s Disease Society andshe helps to organise and run medical/legal trainingseminars. Ms Carter retired from the RUH TrustBoard in November 2001.

Jeff Manning is a member of Bath & North EastSomerset Council representing Combe Down. Hewas elected to the former city council in 1985 andwas Mayor of Bath and chairman of the Councilfrom 1995 to 1996. He trained as a mechanicalengineer in the aerospace industry. He worked forRotork, a Bath-based company, between 1969 -1974 and in the late 1970s formed his own dentalequipment and supplies business, which hesubsequently sold. He currently managesinvestment property. Jeff is also chairman of thehospital’s Forever Friends Appeal raising £10 millionfor the hospital.

Prudence Skene CBE works as a freelance artsconsultant and chairs the Rambert Dance Companyand the Arvon Foundation. As an experienced artsadministrator, from 1975-1986, she was theadministrator for Ballet Rambert and in her finalseason as executive director - in celebration of thecompany’s 60th anniversary - won the LaurenceOlivier Award for Outstanding Achievement inDance. Prudence then became executive producer ofthe English Shakespeare Company (1987-1990 andagain in 1992) and produced the successful ‘TheWars of the Roses’ world tour. From 1993-1998,she was director of the Arts Foundation and is currentlythe chair of the hospital’s arts steering group.

Thomas Sheppard joined the Trust as a non-executive director in December 2000. He is a Bathsolicitor who has been a director and trustee ofDorothy House since 1991 and was chairman untilDecember 2000. In the past, he has also been adirector and company secretary of Bath Rugby Ltd,managing director of the Bath Priory Ltd, the BathFestivals Trust and Bath FM.

Rev Jonathan Lloyd joined the Trust as a non-executive director in April 2002.

Executive Members

Barbara Harris, the chief executive until June 2001,joined the NHS as a management trainee in 1981.Following work in the Middlesex and Westminsterhospitals, she moved to Bristol to commission theBristol Eye Hospital, before moving on to theGloucestershire Royal Hospital where she becamedirector of operations. She was appointed chiefexecutive of the Trust in 1993, leaving in June 2001to take up the post of director of the NHSLeadership Centre.

Martin Dove, the director of finance until July2001, is a chartered accountant. He joined the Trustin 1994 from the South and West Regional HealthAuthority, where he was the deputy director offinance. He joined the NHS in 1991, havingpreviously worked in Thailand for theCommonwealth Development Corporation, theBritish Government’s overseas development bank.He trained with Coopers and Lybrand. Martin leftthe Trust in July 2001 to take up the post of chieffinancial officer of the NHS Estates Trading Fund.

The Board of Directors

N I N E T E E N

The Trust is required to maintain a register ofdirectorships and other significant interests of all Boardmembers and to publish them in the annual report.

Those directors to whom this applies are listed below:

Gerald ChownMember of the Council of the University of Bath

Mildred CarterTreasurer, Bath Branch of the Parkinson’s DiseaseSociety

Jeff ManningMember of Bath & North East Somerset Council

Prudence SkeneDirector of the Ballet Rambert Limited and RambertTrust

Director of The Arvon Foundation Limited

Director of the Theatre Royal Bath Limited

Trustee of Stephen Spender Memorial Trust

Graham SmithDirector of the Prior Walk Management Company

Barry StevensonDirector of Brunel Holdings plc

David Tappin, the director of planning, joined theNHS as a management trainee following a degree inpolitics, philosophy and economics. He worked at theRoyal Gwent Hospital in Newport before moving to theRoyal United Hospital in 1993. David joined the Boardin May 1997 and became acting chief executive in June2001. Mr Tappin left the Trust in November 2001 totake up the post of director of planning at North BristolNHS Trust.

Professor Graham Smith, held the post of medicaldirector from 1 April 1999 to 23 May 2002. He is aconsultant haematologist specialising in haemato-oncology. He is a Fellow of the Royal College ofPhysicians and the Royal College of Pathologists and aProfessor of Haematology at the University of West ofEngland. He was director of the Prior WalkManagement Company, of which he was the chairmanfrom 1996 to 1999. In 2001, he was appointeddirector of Research into Care of the Elderly (RICE)based at St Martin’s Hospital.

Jane Cummings became the director of nursing andcommissioning in August 1999. A registered nurse,she joined the NHS in 1979 and has worked in Bristoland Gloucestershire in a wide range of clinical and

managerial roles. She joined the RUH in 1996 as theproject director for the hospital redevelopment. MsCummings is currently on secondment to theDepartment of Health and Social Care (South) asnursing officer for acute services.

Richard Gleave joined the Trust as chief executive inOctober 2001 having previously been the executivedirector of service development & review for UnitedBristol Health Care NHS Trust. Previously, Richard heldsenior operational management positions in acutehospitals both in the North East and London. He is agraduate of Oxford University, where he gained a firstclass degree in Geography. Mr Gleave stood down aschief executive in June 2002 and is currently onsecondment to the Department of Health.

Steve Simmons held the post of acting director offinance from August 2001 to March 2002.

David Gilburt held the post of acting director offinance from January 2002 to July 2002.

Stephen Cass joined the Trust as director of finance inSeptember 2002.

The Board of Directors (cont.)

Directors’ Interests

T W E N T Y

If you would like to know more, or to comment on our plans or services, please write to our chief executive Jan Filochowski at:

Royal United Hospital NHS TrustCombe ParkBATHBA1 3NG

Telephone: 01225 824033Fax: 01225 824304

E-mail: [email protected]

Website: www.ruh-bath.swest.nhs.uk

If You Want to Know More

T W E N T Y - O N E

Royal United Hospital, Combe Park, Bath BA1 3NGTelephone: 01225 428331

email: [email protected]: www.ruh-bath.swest.nhs.uk

Royal United Hospital BathNHS Trust

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