Annual Review 2008-09 by The Clatterbridge Cancer Centre

Clatterbridge Centre for Oncology NHS Foundation Trust

Annual Review 2008 - 09

Annual Review 2008-09

Welcome

Welcome Our total focus on giving patients the highest possible quality of care has made us into one of the most advanced centres for providing chemotherapy and radiotherapy in the world. We strive to achieve excellence in all the things we do and thanks to the hard work and dedication of staff, Governors and Members, 2008/09 was another tremendously successful year. This review highlights key achievements against the Trust’s core values... standards which ensure that we: • put people first • achieve excellence • are passionate about what we do • always improve our care • are committed to our future

We are pleased to report that Clatterbridge Centre for Oncology continues to provide the highest quality clinical care possible and in recognition of this the Healthcare Commission awarded the Trust its ‘excellent’ rating for both the quality of services and for the use of resources for 2007/08 and we are confident that we will receive a similarly high rating for 2008/09. In addition, the Foundation Trust Regulator has awarded the organisation the highest ratings possible for the two key issues it monitors; governance and finance.

Contents Putting people first Achieving excellence Passionate about what we do Always improving our care Committed to our future Our plans for the future Financial Report Board of Directors Board Committees Council of Governors

The Trust has achieved a strong balance sheet with a surplus of £4.45m. This has enabled us to develop a £3m investment programme to upgrade facilities and services at the Centre, which you will read about in this review.

Chairman’s and Chief Executive’s statement

Chairman’s and Chief Executive’s statement Reaching the end of the financial year 2008/09 is an opportune time to reflect on the work of the Trust during the course of the year.

Thank you for your continued interest in our work.

02 08 14 20 26 35 40 49 50 51

Annual Review 2008-09

We pride ourselves on leading the way when it comes to technological advances in modern radiotherapy treatments. A core value of the Trust is ‘putting people first’. In December we became the first cancer facility in the UK to offer patients access to a revolutionary radiotherapy treatment technology known as Rapidarc™. The treatment significantly reduces patient treatment times.

We are also the only Trust in the UK to provide low energy proton treatments for eye cancers. New forms of proton treatment are now available to deal with other types of tumours and we are currently looking to build on our expertise to secure Department of Health support to establish a high energy proton facility in Merseyside. This will enable Clatterbridge Centre for Oncology to be the first Centre in the UK to provide these types of treatment. Proton therapy has significant benefits particularly for young people. One of the key drivers for the Board has been to try and deliver our services as near as possible to the patient. We already have seven chemotherapy clinics located in acute hospitals throughout the region but all our radiotherapy is undertaken at the Clatterbridge site. With this in mind we are building a satellite radiotherapy centre adjacent to The Walton Centre NHS Foundation Trust. Clearly 2008/09 has been a productive year for the Trust. The Board has worked with the Governors on the future strategic development of the Centre to ensure their views are understood and supported and we are confident that with the continued support of our Governors and Members and the commitment and hard work of our staff, 2009/10 will prove to be equally demanding and successful.

Alan White – Chairman Andrew Cannell – Acting Chief Executive Clatterbridge Centre for Oncology NHS Foundation Trust

Annual Review 2008-09

Putting people first

“The staff are here to help the patients, but the spirit and courage of our patients help us through our job too. It’s a two way process.” Barbara Hodgkinson MRI Deputy Superintendent Radiographer Barbara Hodgkinson has worked in the Diagnostic Imaging Department at the Centre for the last 14 years.

Annual Review 2008-09

Putting people first

Annual Review 2008-09

Putting people first

Top marks in staff and patient surveys

Director of Nursing & Quality Helen Porter said: “We are committed to delivering excellent patient care. Over the last year we’ve taken steps to make further service improvements and maintain a high standard of cleanliness and it is encouraging to see this reflected in the results.

Values led organisation

In addition fun, interactive and practical seminars gave staff a deeper understanding of how to increase their own personal wellbeing by eating the right ‘mood’ food and knowing how to fight the signs of stress.

The Centre scored amongst the best performing NHS organisations across England according to the Healthcare Commission’s staff and in-patient surveys for 2008. In the staff survey the Centre scored in the top 20% of all acute hospitals in 22 of the 36 categories. Areas where staff scored the Centre high included job satisfaction, feeling valued by colleagues, Trust commitment to work-life balance, good communication between senior managers and staff and personal development and training. Dawn Jennings, Director of Human Resources said: “It is hugely reassuring to receive such a high level of positive feedback from our people. However, we are never complacent and have once again used the survey results to implement further improvements; we have already reviewed the Performance & Development Review process, developed a number of initiatives to help combat and avoid stress and introduced trained support workers to help staff with a range of issues that could crop up in the workplace.” For the in-patient survey the Centre was rated within the country’s 20% best performing trusts in 85% of the questions and in 10 areas scored the top score achieved by any Trust, recognising the cleanliness of the wards and confidence in staff. Responses also showed the Trust to be extremely effective in its admission procedures – with experiences of waiting times for admission to hospital and onto wards being very positive.

“We believe the professionalism and expertise of our staff is second to none – so it is extremely rewarding to see this recognised by the cancer patients that receive treatment at our Centre.” Following the survey results we have: • I mproved the environment in relation to privacy and dignity for radiotherapy patients. • I mproved our processes for ensuring patients and their GPs receive appropriate discharge information. • I ncreased the availability of our complimentary hand sand foot massage service to patients. • P rovided free tea and coffee for patients through our volunteer service.

achieving excellence

17,500 More than 17,500 diagnostic imaging requests carried out for CT, MRI, X-Ray, Ultra Sound and Nuclear Medicine

Our vision is to deliver world-class cancer care and the Trust’s leadership recognised that a path to achieving this is through our people. Our people are committed to the future of the Trust and developing values from the ground up with staff involvement at every phase has helped fuse together strategic direction and ambition. Work has continued on embedding the values and they now play a core part in Trust processes, informing decisions made in areas such as recruitment, induction, staff awards and internal communication channels. Following the successful implemention and embedding of our values the Centre was one of only five Trusts from across the country to be chosen to feature in a Department of Health DVD.

Staff see benefits of some healthy me time The health and wellbeing of staff is a priority for the Trust and by giving them the opportunity to take time out of their daily tasks they were able to see how small changes can make a real difference to their health and wellbeing. The Centre teamed up with Vitality Healthcare, a company who specialise in healthcare advice and information, to bring their expertise to staff in the workplace. During the three-day event staff were encouraged to take part in a number of activities such as a ‘know your numbers’ health screening to check cholesterol and blood pressure readings, a desk side breakfast and snack bar providing healthy food and drink sampling, plus qualified therapy practitioners offered lifestyle and postural advice; treating staff to complementary therapies such as back and shoulder and Indian head massages.

Dawn Jennings, Director of Human Resources said: “It seems we all know what we should be doing to maintain our health and wellbeing but the reality is that we find it difficult to put it into practice. With evidence that healthy and satisfied staff provide better care for patients, it makes sense for us to help our people to make healthy choices.”

Centre ranked in top 100! In March 2009 members of the Clatterbridge team travelled to London to accept their place in the Health Service Journal’s Top 100 Healthcare companies list. The list was compiled to identify the top healthcare providers to work for in the UK. Out of the 100 companies short-listed for the awards Clatterbridge Centre for Oncology ranked 40th in the overall list. A fantastic achievement for the Centre quoted as being ‘a friendly and close-knit place’ and ‘small is beautiful’. The influential list conducted on behalf of Health Service Journal and Nursing Times, and supported by NHS Employers, is open to both NHS and independent healthcare providers in the acute, primary care, mental health and ambulance sectors. The results are based on an exclusive poll of the employees of registering organisations.

Annual Review 2008-09

Putting people first

“I would say I have always been a ‘glass is half empty’ person, but coming out the other side of this illness I think I’m now a ‘3/4 glass full’ person! And that’s definitely due to my experience and the way I was dealt with by everyone at the Centre.” Stan Edwards 51-year-old Stan Edwards, who recently retired from the Merseyside Police force after 30 years of service, was diagnosed with cancer of the tonsils which had spread into his carotid artery.

Annual Review 2008-09

Achieving excellence

“The nature of this job calls for people who have certain qualities and skills. What you end up with is a group of people all of the same mind-set and manner, working towards the same goal, and that’s pretty special.” Mark Ballard Mark Ballard is 26-years-old. As a Therapy Radiographer Mark works within a team to deliver radiotherapy treatments.

Annual Review 2008-09

Achieving excellence

Highest rating for quality and resources

The Foundation Trust Regulator, Monitor, awarded the organisation the highest ratings possible for the two key areas it monitors. The independent regulator awarded green for governance and provision of mandatory services and five for financial viability.

The Healthcare Commission rated the Centre as ‘excellent’ for its quality of services and ‘excellent’ for its use of resources. Out of 391 trusts only 42 in the country achieved an ‘excellent’ rating in both areas.

The Centre continues to achieve all the required NHS targets including 62 day waiting time target (urgent referral to treatment for all cancers) and the 18 week waiting time target (point of initial referral up to the start of any treatment).

The Commission’s annual health check is the most comprehensive assessment of performance ever undertaken in the NHS.

During the year there was no waiting time for the chemotherapy service and, where possible, treatment was provided in one of our off-site clinics. Currently over 16,000 of our chemotherapy treatments are delivered in one of our seven off-site clinics across the region, the highest proportion in the country.

The ratings go from ‘excellent’, ‘good’, ‘fair’ or ‘weak’. One rating covers the quality of services, measured against the government’s core standards and national targets; the other relates to the use of resources, measured against how well finances are managed.

The Trust received 100% for its standard of care, waiting to be seen, dignity and respect, keeping the public healthy and good management. Chairman Alan White said: “This is a challenging assessment and we are absolutely delighted to achieve the highest rating. We take our responsibilities for providing the highest possible standards of patient care extremely seriously and thanks to the work that is going on at all levels within the organisation this rating reflects the commitment we put into delivering an excellent service for our patients.”

Achieving excellence

Achieving all targets

The Centre received the highest rating in an independent assessment carried out by the then Healthcare Commission in October 2008 for its performance in 2007/08.

The Healthcare Commission report stated: “Based on our assessment for 2007/08, Clatterbridge Centre for Oncology NHS Foundation Trust provided an excellent quality of service to patients. Its performance has continued to improve over the last three years. This Trust gained Foundation status during 2006/07. It has continued to be excellent at managing its finances.”

Annual Review 2008-09

In radiotherapy, our waiting times have been consistently below 20 days, including treatment planning times. We are committed to ensuring all of our patients can access their treatment within 45 minutes travelling time from their home and to help us achieve this target we are currently building a new satellite radiotherapy centre in Liverpool. achieving excellence

90,000 More than 90,000 radiotherapy and proton therapy treatments

Infection control continues to present particular challenges because nearly all of our patients are referred from other hospitals but the Centre has consistently achieved its target for the reduction in MRSA and in December 2008 the regional performance report indicated that the Trust is one of only two hospitals out of 29 surveyed to report no cases of MRSA Bacteraemia for the year. The Centre is also well within its target for C-Difficule infections.

achieving excellence

29,000 More than 29,000 chemotherapy treatments

Annual Review 2008-09

Achieving excellence

“Every element of a patient’s cancer journey affects their experience and that extends to the administration staff - to know you’ve helped them in some way while they are being treated for cancer, no matter how small, is rewarding.” Jeni Bradshaw 27-year-old Jeni Bradshaw is a Medical Records Officer at the Trust and has worked here for 10 years.

Annual Review 2008-09

Passionate about what we do

“The patients appreciate what we do so much and it’s just wonderful to see them relaxing in front of you. It’s their reaction to the therapy that spurs us on and keeps us coming back.” Moira & Jenny Moira Nicoll and Jenny Cruickshank have been hand and foot massage volunteers at the Centre for four years. They trained together and have worked as a duo ever since.

Annual Review 2008-09

Passionate about what we do

Annual Review 2008-09

Passionate about what we do

First to offer revolutionary radiotherapy treatment

Chemotherapy delivered closer to home

Scanner improves service for patients

Advice, support and education

Clatterbridge Centre for Oncology is the first cancer facility in the UK to offer patients a revolutionary radiotherapy treatment that significantly shortens treatment times.

In 2007 the national Cancer Reform Strategy recommended services be taken closer to patients’ homes. As a result, the Centre looked at how delivery of the chemotherapy service could be further improved.

Since April 2008 patients have benefited from improved access to a cutting edge mobile scanning unit.

Radiotherapy involves the use of high-energy X-rays and electrons to treat cancer. This noninvasive treatment is delivered by a rotating machine called a linear accelerator. A single treatment can sometimes take up to 30 minutes as the machine needs to circle the patient - stopping periodically to deliver the beam. This new treatment technique, called RapidArc™, allows the machine to deliver cancer treatments in one continuous rotation around the patient, making it possible for clinicians to deliver advanced image-guided, intensitymodulated radiation therapy (IMRT) treatments in less than two minutes – up to eight times faster than existing technology. Because RapidArc™ offers increased precision and delivers treatments faster, consultants at Clatterbridge Centre for Oncology are now in the opportune position to treat more patients who will benefit in reduced length of treatment and comfort. Dr. Brian Haylock, Clinical Director at Clatterbridge Centre for Oncology said: “We pride ourselves as leading the way when it comes to technological advances in modern radiotherapy treatments and it is a core value of the Trust to put people first.” 65-year-old grandfather of six Graham McCormack from Warrington was the first UK patient to be treated using the technique. Graham was diagnosed with prostate cancer in June 2008 and has been undergoing hormone therapy prior to his radiotherapy treatment. Graham’s radiotherapy treatment time using RapidArc™ has been reduced by almost 25%. Graham said: “It’s exciting to be the first patient in the UK to benefit from this treatment. Everyone at Clatterbridge has been great; they are clearly experts in their field so I was comfortable with their guidance. The treatment itself is over in minutes – I’m just grateful to be in such good hands.”

Before 2007 the Centre delivered treatment at some off-site clinics, but today Clatterbridge Centre for Oncology staff deliver cancer treatment at 11 weekly clinics in seven locations across the region, the scale of this makes Clatterbridge unique.

The PET/CT (Positron Emission Tomography/ Computed Tomography) scanner is a mobile facility which visits the Centre on a weekly basis. The service was set up under a national contract between the Department of Health and Alliance Medical as part of the Department’s strategy to increase access to diagnostic services.

The nurse-led clinics are held in hospitals throughout the region and allow patients to go to their local hospital for treatment rather than travelling to Clatterbridge Centre for Oncology.

Prior to this PET/CT scans were not widely available in the North West; a few patients were able to have scans but had to travel to Preston, Birmingham or London.

In January 2009 the latest clinic opened at Halton General Hospital. Part funded through CANtreat – a cancer charity that specialises in funding improved environments for chemotherapy patients in the North West region, the unit is run by a mix of nurses and consultants from Clatterbridge Centre for Oncology. The drugs are prepared in advance at Clatterbridge and taken over to Halton for each clinic. The unit has a large open area with reclining seats for providing the treatment as well as a comfortable waiting area, nurse’s station, clinic room, drug preparation area and a relatives’ room.

The introduction of the facility has meant an increased number of patients are being scanned quicker, bringing benefits to many patients. The scan also provides information that was not previously available by showing areas of active disease as well as the associated anatomy.

In 2008/09 staff from Clatterbridge Centre for Oncology delivered over 29,000 outpatient chemotherapy treatments. Of these 16,351 were delivered at off-site clinics. This number looks set to increase in the future as plans are in place to increase the number of clinics even further with one planned at the Liverpool Women’s Hospital and Liverpool Heart and Chest Hospital. Kim Barrow, Chemotherapy Clinical Services Manager said: “Our patient satisfaction results are excellent because what we are doing helps to reduce patients’ symptoms and improves the patient experience. By working in partnership with our colleagues across the region we are able to treat patients locally to where they live whilst ensuring they receive their treatments from chemotherapy experts.”

The scans are carried out and reported on by experts in medical imaging, with specialists and radiographers providing the service. One of our Consultant Radiologists, Dr. Christopher Romaniuk is a member of the local reporting team. Consultant Radiologist and Clinical Director of Imaging at Clatterbridge Centre for Oncology, Dr. Keith Grant said: “It is essential for cancer treatment centres to be able to offer this service. Medical professionals recognise PET/CT scanning as the way forward. It has made a lot of difference to our ability to diagnose, plan and monitor responses to cancer treatment in patients.” Since the unit was introduced at the Centre the frequency of visits has been increased to meet demand and it is now at the Centre every Wednesday and alternate Fridays.

The Centre is committed to creating an environment where patients want to ask for advice and discuss any issues. This is achieved by continuing to provide an extensive range of specialist rehabilitation and support to patients. During the year the Cancer Rehabilitation and Support Services (CReST) department launched two new clinics to enable staff to deliver positive support to patients. One of these is a nurse-led management of menopausal symptoms clinic. The clinic takes a holistic approach and equips patients to deal with symptoms more effectively. The clinic is currently aimed at patients with breast and gynaecological cancers but it has been recognised that this is an issue in all treatment groups and the service will be offered to all groups in the future. Education is also a priority for the team and the Specialist Lung Cancer Nurses have been going into the community to educate on the dangers of smoking. Primary carcinoma of the lung is the leading cause of cancer deaths in both men and women with current or former cigarette smokers making up approximately 90% of patients with lung cancer. Education from an early age is therefore key to try and prevent children from falling prey to tobacco consumption. The team has set up a regular program of attendance at local schools in the region to raise awareness of the dangers of tobacco. The Trust has also signed up to the national survivorship project which addresses the long term effects of pelvic treatments. An education programme is being set up for patients to help them improve their physical, psychological and social functioning after cancer. The programme is based on a social needs holistic model, driven by patient and carer involvement, led by an expert resource of multi-disciplinary professionals and support staff.

Annual Review 2008-09

Passionate about what we do

“The sessions are very light hearted so we often have a really good laugh with the patients so I suppose having a good sense of humour helps but we cope with tears as well.” Mary Roberts 62-year-old Mary Roberts is a ‘HeadStrong’ volunteer at the Centre. The HeadStrong service helps give advice to any cancer patient who has lost their hair as a side effect of cancer treatment.

Annual Review 2008-09

Always improving our care

“I’m not the world’s greatest worrier, I’m an eternal optimist - and Clatterbridge has given me every reason to be optimistic, the staff have been simply fantastic and I’ve responded to my treatment really well.” Patrick Toosey Retired Patrick Toosey is a father of five and grandfather of ten who was diagnosed with prostate cancer in 2007.

Annual Review 2008-09

Always improving our care

Annual Review 2008-09

Always improving our care

Cherie Blair opens new out-patients

Everton supports new teen unit

In-patient wards re-modelled

Everton defender Tony Hibbert assisted a different team to reach their goal - when he visited Clatterbridge.

The Centre’s three in-patient wards are being re-modelled and refurbished as part of the Trust’s £3 million investment plan.

New processes improve patient experience

Construction work got underway to build a dedicated teen and young adult unit, and Everton FC showed their full support of the development for young cancer patients in the region. Tony dropped in to have a look over the plans and meet with a few of the teenage cancer patients who will benefit from this new investment.

The Trust is committed to delivering excellent patient care and providing a clean, safe and welcoming environment and in February 2009 work started on re-modelling Sulby ward, the inpatient chemotherapy ward.

In December the Centre welcomed Cherie Blair to officially open a new facility at the hospital. The wife of the former Prime Minister officially opened the new out-patient department as the first completed phase of a £3m investment plan to upgrade facilities and services at the Centre. The project will eventually see all in-patient wards re-modelled and a dedicated four-bedded teen and young adult facility built. The new department includes state-of-theart clinic rooms and patient waiting areas, and a new conservatory has been built into a landscaped water garden at the Centre as an extension to the patient waiting area. Local fundraising partner, The Melanie Beattie Appeal, donated essential funds to help build and furnish the conservatory. Cherie Blair said: “Due to my close links with the area I am all too aware of Clatterbridge’s excellent reputation for cancer care. The hospital provides an invaluable service to the people of Merseyside and I was thrilled to open this fantastic facility.” Following the visit Cherie Blair became a patron of the Centre’s charity, Clatterbridge, your cancer centre. achieving excellence

4,700

The four-bedded facility, which is due for completion at the end of the summer 2009, will accommodate patients aged 16-24 years, offering privacy and independence - as well as additional space for overnight stays by family members. The unit will benefit from all the latest computer gaming and home entertainment equipment. Plans also include space for a common room so young patients can interact with each other and welcome friends to visit them in a much more relaxed and comfortable environment. Clatterbridge Centre for Oncology is working with Royal Liverpool University Hospitals and Aldey Hey Children’s Hospital on the project and the national charity, The Teenage Cancer Trust is supporting the unit by donating £100,000. The Teenage Cancer Trust builds specialist units in NHS hospitals where teenagers and young adults can be treated with others their own age. Teenage Cancer Trust units are not like ordinary hospital wards. Instead, they provide teenagers with an environment where they can get on with being teenagers. At the same time, patients are provided with the best possible medical treatment in a recognised centre of excellence.

The new ward will consist of six threebedded units with en-suite facilities. There will be two extra single rooms all with en-suite facilities and all of the bathroom facilities will be DDA (Disability Discrimination Act) compliant. The ward will be refurbished and the colour scheme will be consistent with the corporate design in the new out-patient department. Work on Sulby ward is set to be completed by the end of the summer, work will then start on re-modelling the other in-patient wards.

E-prescribing launched on wards A successful pilot scheme to introduce ‘electronic prescribing’ in the Trust has been carried out on two of the patient wards. The implementation of electronic prescribing is a key element of the Trust’s Information Management &Technology strategy and vision to operate a fully functional Electronic Patient Record. The Project Team firstly introduced the system as a pilot on Sulby ward and then rolled it out onto Delamere; our chemotherapy day case unit. Following its success, the innovative system will be implemented across all off-site chemotherapy clinics that are run by Clatterbridge staff at different hospitals across the region.

More than 4,700 patient admissions as an elective or emergency patient

The system has been developed to improve patient medication records, clarity of prescriptions and audit trails - and will provide a complete record of each prescription/regimen through to clinical screening, patient assessment and all records.

The Centre is always looking at ways to improve the patient experience and during the past year has been involved in two new initiatives. From September 2008 a new Practice Development and Research Unit (PDRU) has been piloted on one of the in-patient wards. Led by the Research Nurse, Head of Clinical Governance & Practice Development and the Macmillan Lecturer, the unit’s focus is on the need to modernise and continually improve the organisation of systems and delivery of care. In partnership with the University of Chester, key representatives from the Trust have worked collaboratively with members of staff to facilitate evidence based projects to benefit the organisation, improving patient care and professional practice. In addition the Centre also introduced the NHS Institute for Innovation and Improvement’s ‘Productive Ward - Releasing Time to Care’ initiative. The initiative focuses on improving ward processes and environments to help nurses and therapists spend more time on direct patient care. Conway ward was chosen to showcase the initiative and for the past year has been applying the effective processes. The pilot ended in March and the ward continues to apply the processes thanks to its success. The initiative will now be extended to include other clinical areas. Helen Porter, Director of Nursing & Quality said: “The Productive Ward initiative has resulted in a number of benefits, the main one being that the amount of time nurses spend on direct patient care has significantly increased. The medicine rounds, ward rounds and nursing procedures have also been reviewed and revised and we are now providing a more effective delivery of care.”

Annual Review 2008-09

Always improving our care

“There are different support groups available for people my age with cancer, but I just wanted to deal with it my own way. I’d rather be with my mates playing football because that’s what I’d be doing if I didn’t have cancer.” Ryan O’Callaghan 19-year-old Ryan O’Callaghan underwent an operation to remove a tumour followed by chemotherapy treatment at Clatterbridge Centre for Oncology.

Annual Review 2008-09

Committed to our future

Committed to our future Liverpool is a step closer to getting its first radiotherapy treatment centre Liverpool city council’s planning committee gave full planning permission for the new satellite radiotherapy centre in March and building work started in the summer. The new £17M purpose-built facility will be situated next to The Walton Centre for Neurology and Neurosurgery and is scheduled to be completed by the end of 2010.

Committed to our future “For me it’s simple – we have the opportunity to improve the treatment of patients with cancer, and I enjoy being active in bringing developments in cancer treatment forward.”

Clatterbridge Cancer Centre – Liverpool will be staffed and operated by Clatterbridge’s own specialist radiographers and doctors and will house three state-of-the-art radiotherapy treatment machines as well as expert cancer rehabilitation and support services. It is a national recommendation that patients should not travel more than 45 minutes for radiotherapy. This is not the case at the moment as two thirds of cancer patients in Merseyside and Cheshire live north of the River Mersey and there is no other radiotherapy provision outside the Clatterbridge site on the Wirral. The new radiotherapy facility will help improve access to cancer services for Merseyside residents. The expansion plans will see cancer patients across Merseyside benefiting from traveling shorter distances for radiotherapy treatments. Funding for the project is being actively supported by local charity ‘The Marina Dalglish Appeal’ who has pledged to raise £5M towards the development. Throughout the year they have organised a number of fundraising events including a Valentine’s Ball and the Hillsborough memorial match. Needless to say the Trust is most grateful for all their continued support. Marina said: “The work done at Clatterbridge is second to none, but a long uncomfortable car journey when you are trying to deal with the effects of cancer can be very hard. This new cancer centre in Liverpool will benefit from the expertise of Clatterbridge staff and a location that will ease the burden of the journey through the tunnel. We are so excited to be involved in what will be a magnificent facility.”

Philip Mayles Dr Philip Mayles is Head of Physics at Clatterbridge Centre for Oncology. He started his career in cancer radiotherapy treatment over 40 years ago.

Annual Review 2008-09

Committed to our future

Annual Review 2008-09

Liverpool is a step closer to getting its first radiotherapy treatment centre

Partnership working in the name of research

Jenny Almond, Research and Development Project Director, Clatterbridge Centre for Oncology, said: “Cancer Research UK’s Liverpool Centre will provide medical experts with the facility to carry out pioneering research that will enable them to increase their understanding of cancers and research better treatments with fewer side effects.

Liverpool city council’s planning committee gave full planning permission for the new satellite radiotherapy centre in March 2009 and building work started in the summer. The new £17M purpose-built facility will be situated next to The Walton Centre NHS Foundation Trust and is scheduled to be completed by the end of 2010. The radiotherapy centre will be staffed and operated by Clatterbridge’s own specialist radiographers and doctors and will house three stateof-the-art radiotherapy treatment machines as well as expert cancer rehabilitation and support services. It is a national recommendation that patients should not travel more than 45 minutes for radiotherapy. This is not the case at the moment as two thirds of cancer patients in Merseyside and Cheshire live north of the River Mersey and there is no other radiotherapy provision outside the Clatterbridge site on the Wirral. The new radiotherapy facility will help improve access to cancer services for Merseyside residents. The expansion plans will see cancer patients across Merseyside benefiting from travelling shorter distances for radiotherapy treatments. Funding for the project is being actively supported by local charity ‘The Marina Dalglish Appeal’ which has pledged to raise £5M towards the development. Throughout the year they have organised a number of fundraising events including a Valentine’s Ball and the Hillsborough memorial match. Needless to say the Trust is most grateful for all their continued support. Marina said: “The work done at Clatterbridge is second to none, but a long uncomfortable car journey when you are trying to deal with the effects of cancer can be very hard. This new cancer centre in Liverpool will benefit from the expertise of Clatterbridge staff and a location that will ease the burden of the journey through the tunnel. We are so excited to be involved in what will be a magnificent facility.”

Clatterbridge Centre for Oncology is committed to the development of worldclass cancer services and we believe working in partnership will enable us to provide the best possible results for cancer patients. In February 2009 Liverpool became one of the first links in a unique chain of Cancer Research UK Centres to be launched round the country. The cancer centres will draw together world-class research and areas of medical expertise to provide the best possible results for cancer patients nationwide. As one of the first Cancer Research UK Centres, Liverpool will set the pace for national and international progress in cancer of the pancreas, head and neck and blood. It will also concentrate on pioneering the latest techniques in surgery, radiotherapy and the treatment of children’s cancers. Collaboration is the key to the success of the Centre which will focus on a better understanding of how cancers start and behave, how to develop better treatments with fewer side effects and how to tackle cancer in lowincome communities where survival is lowest. Cancer Research UK already supports research in Liverpool but is set to increase its contribution to around £3m a year to help develop the Centre. The Centre aims to be a world leader in developing treatments tailored to individual cancer patients based on understanding the biology of the disease and how that varies among patients. It brings together Clatterbridge Centre for Oncology, Royal Liverpool University Hospitals, the University of Liverpool, the City Council and the Merseyside and Cheshire Cancer Network.

Committed to our future

“This is one of the first Cancer Research UK Centres and we are delighted to be involved for the simple reason that it will bring huge benefits to patients, and patient care is at the heart of everything we do.”

Clatterbridge hosts world renowned cancer specialists The Centre welcomed some of the world’s leading experts in radiation treatment in November 2008. A one day conference brought seven experts together to guide delegates through the whole spectrum of advances in radiation therapy. These included two world-famous radiation physicists. Professor Jack Fowler, a world-renowned scientist who is personally responsible for many of the breakthroughs in applying radiobiology to radiotherapy, gave a talk on ‘The history of the treatment of cancer by radiation’. Professor Rock Mackie, who is widely considered to be the leading radiotherapy physicist in the world, flew in from America to give his talk on ‘The future treatment of tumours by radiation beams’. Professor Alan Nahum, Head of Physics Research at Clatterbridge Centre for Oncology said: “We were honoured to welcome some of the world’s leading specialists in the field of cancer treatment to our hospital. The conference highlighted the huge advances made in radiation therapy since its discovery more than 100 years ago, which show no sign whatsoever of slowing down.”

achieving excellence

4,300

More than 4,300 outpatient attendances to see our Allied Health Professionals (excluding radiographers)

Annual Review 2008-09

Committed to our future

â&#x20AC;&#x153;The best things to come out of this for me have been the things that have stayed the same. My amazing family have remained my lifeline throughout. The friends that still treat me the same as before, laughing with, and at me, are the ones I now class as true friends for life.â&#x20AC;? Rachel White 24-year-old Rachel White was diagnosed with malignant ostesarcoma (cancer of the bone) in early 2009.

Annual Review 2008-09

Committed to our future

“The best aspect of fundraising for me is meeting people and hopefully, inspiring the ones who are less confident to become involved, there is still a lot to do, but that’s where the likes of me come in – and hopefully, you!” Pauline Pilkington Ormskirk resident Pauline Pilkington MBE is one of the many loyal fundraising supporters at the hospital. During the past year she has raised almost £4,000.

Annual Review 2008-09

Committed to our future

Clatterbridge, your cancer centre

Our plans for the future

The Centre continues to grow from strength to strength, so it is only natural that our fundraising function grows too. Charitable funds help make considerable advances to the facilities we are able to offer patients, but developing this function has been new ground for the Centre as it has not had it’s own dedicated Fundraising team before.

The Trust Board is developing a strategy to look at how chemotherapy, radiotherapy and other services will develop at the Centre by 2020. The Vision 2020 strategy is being influenced by external factors such as the Cancer Reform Strategy and the Lord Darzi Report, which state services need to be developed to respond to the predicted demographic changes and services need to be provided as close to the patient as possible.

Subject to agreement by commissioners an acute oncology service will be implemented at all Trusts by 2011.

Annual Review 2008-09

‘Clatterbridge, your cancer centre’ is led by our Head of Fundraising who is supported by a Fundraising Manager, Fundraising Coordinator and Fundraising Administrator. Two additional posts were filled during the summer to cope with increased demand. Funds raised through our charity go directly towards improving facilities at the Centre allowing us to offer an NHS+ service for our patients and their families that is above and beyond what they expect. Items purchased last year included a new car to allow chemotherapy to be delivered within the community, new radiotherapy equipment and the build and furnishing of a new conservatory for our refurbished out-patients department. Diane Hummerston, Head of Fundraising said: “Clatterbridge is the only charity that raises funds to directly benefit the hospital’s patients and their families. We are very excited about the development of the charity and greatly encouraged by and thankful of the wonderful support that we have and continue to receive from our patients, their families, the general public and our staff.”

Committed to our future

Developments have already been made in taking our services closer to patients and during 2009/10 the number of chemotherapy off-site clinics will be increased and the doors will open to Liverpool’s first satellite radiotherapy treatment centre in 2010.

To meet future demand and ensure that we give our patients the gold standard of quality we have undertaken a full review of the chemotherapy triage service. The new service, which is due to be launched in September, will link to all the District General Hospitals and will offer advice to other healthcare professionals and to patients. This service will be a flagship for chemotherapy and will be one of the most comprehensive triage services in the country.

The Trust will continue to develop its services at the Clatterbridge site with on-going investment spent on improving the environment and quality of services for both patients and staff. We will continue to make sure patient care is the number one priority by ensuring we are compliant with all targets and guided by our core values. The Trust is also leading the development of an acute oncology service in close collaboration with the Merseyside and Cheshire Cancer Network. The project will see the establishment of an Acute Oncology Team at Trusts with an emergency department and will result in the early input of specialist care for patients.

Over the forthcoming year, the team will be focusing their efforts into developing relationships within the community and corporate sectors in an attempt to secure long term support of the charity and increase income.

The service will enable faster and better care of patients with complications of chemotherapy, faster and better care of patients with complications of cancer and appropriate investigation of patients who might benefit from treatment for unknown primary cancers.

achieving excellence

7,400 More than 7,400 outpatient attendances to see our nursing staff (specialist, lymphoedema and palliative care services)

Annual Review 2008-09

Committed to our future

â&#x20AC;&#x153;My motivation comes from the patients that walk through the door. They keep my spirits up and give me a reason to continue. What always amazes me about this centre is that every patient here has cancer but they never seem to feel worse off than anyone else.â&#x20AC;? Ted Dillon 72-year-old Ted Dillon MBE is a father of four, grandfather of five and was appointed as the commissionaire to the Centre in 1993.

Annual Review 2008-09

Committed to our future

“There is nothing more rewarding than being able to help a patient, and what attracted me to working in oncology was how a lot of oncology patients put things in perspective, they’ve got a really positive outlook.” Susan Reynolds Susan Reynolds is a chemotherapy nurse. She has worked at the Centre for five years.

Annual Review 2008-09

Financial Report

Annual Review 2008-09

Financial Report

the Trust’s revenue surplus and cash balances will fall significantly but to sustainable levels.

national tariffs, with the remainder from locally determined prices. Both PbR and the local tariff arrangements are based on the principle that the Trust is reimbursed based on activity performed. Therefore a reduction in activity levels represents a financial risk to the Trust, largely because most of the costs it incurs are fixed or semi-fixed for its foreseeable activity levels. However the Trust is able to mitigate in part against this risk by:

future. The Trust will increase its efforts to deliver continuous improvements in its efficiency. The risk is increased to the extent that a significant part of the financial headroom will be removed due to the Trust’s commitment in respect of the development of our new radiotherapy centre in Liverpool. Finally the policy direction of the Department of Health is to widen the scope of activity subject to national rather than local tariffs. Although it is unlikely that tariffs will be set for radiotherapy and the majority of chemotherapy before 2011/12 this may be a source of future income volatility.

Financial Report Financial Summary The Trust has again had a successful year and has achieved or exceeded all of its key financial targets. The table below summarises performance in the key areas. It should be noted that the additional recurrent surplus generated in 2008/09 provides the opportunity to meet the additional running costs of the new radiotherapy treatment facility to be developed adjacent to The Walton Centre in North Liverpool. The surplus also helps generate cash balances to make a significant contribution to the capital cost of the investment. Once the facility is operational (towards the end of 2010)

Key Financial Risks Each year the Trust faces a number of short-term financial risks that are considered and addressed in the annual financial planning round. The majority (89%) of the Trust’s income is received for the provision of non-surgical cancer treatments to the residents of Merseyside, Cheshire, and parts of Lancashire, North Wales and the Isle of Man. Approximately 23% of the Trust’s clinical income is funded by Payment by Results (PbR)

Financial Target

Outcome

Planned income and expenditure surplus of £1.98m

Achieved actual surplus of £4.45m

Earnings Before Interest, Tax, Depreciation and Amortisation (EBITDA) of £5.88m

Achieved actual EBITDA of £8.44m

I&E surplus margin of 3.4%

Achieved margin of 8.0%

EBITDA margin of 10.1%

Achieved margin of 13.8%

Return of Assets employed of 7.8%

Achieved return of 15.0%

Liquid ratio of 92.8 days (measures liquidity of the Trust. The higher the ratio the more liquid the Trust).

Achieved ratio of 88.1 days

Overall Financial Risk Rating determined by the independent regulator (Monitor) of 5. (where 5 represents lowest financial risk and 1 highest).

Achieved Financial Risk Rating of 5.

Prudential Borrowing Limit (PBL): The long term prudential borrowing limit is set by Monitor. The Trust’s current cumulative long term limit is £12.7m.

CCO has not taken out any loans in 2008/09, therefore net debt is nil. The Trust is within the PBL.

Private Patient Income Cap: Under the terms of authorisation as a Foundation Trust private patient income must not exceed 2.2% of total clinical income.

Private Patient income of £0.27m represents approximately 0.5% of total Trust clinical income. Therefore the Trust has remained within the Private Patient Income Cap.

• Employing contract tolerances to reduce in-year income volatility. • Agreeing local tariffs with commissioners for 77% of clinical income that are not, therefore, subject to the same degree of price volatility as the nationally determined tariffs within Payment by Results. • Agreeing cancer drug developments to ensure drug funding based on actual drug usage. • Setting a prudent level of financial reserves and maintaining strong levels of liquidity. Another key financial risk is the delivery of the Trust’s cost improvement programme (CIP) and improvements in unit efficiency. However the target was achieved in 2008/09 and 75% of the 2009/10 programme has been identified.

Activity As noted above, the majority of the Trust’s income is derived from providing non-surgical cancer treatments and support (such as Radiotherapy, Chemotherapy, palliative care, diagnostic imaging, psychiatric and other support). During 2008/09 the Trust has continued to experience steady growth for most of its services, with the exception of Proton Therapy. However the latter is a national service providing complex treatment for specific rare tumours and activity is difficult to predict for low volume services (actual activity of 600 treatment attendances equates to circa 100 patients, or 8 a month, whereas the plan was for 10 patients a month).

In addition to the above, there are also a number of medium term risks that need to be kept under review, with appropriate action plans being developed and executed to manage any adverse consequences. It is becoming increasingly clear that the difficult economic outlook and the consequences for NHS funding, in particular beyond 2010/11, will pose a significant challenge to the Trust and its Commissioners as it seeks to deliver more and higher quality treatments in the

Forecast growth is related to the increase in estimated numbers of our catchment population that are over 50 years of age, and is based on the same assumptions that underpin the Trust’s five year Service Development Strategy and three year Forward Plan.

Activity

2008/09 Actual

2008/09 Plan

% Variance

% Growth Forecast 2009/10

Chemotherapy attends

29,670

27,869

6.5%

Radiotherapy attends

98,945

98,686

2.6%

1.5%

Proton therapy attends

600

729

-17.7%

In-patient spells

4,723

4,570

3.3%

Out-patient consultations

56,418

53,378

5.7%

Annual Review 2008-09

Financial Report

Annual Review 2008-09

Other Income and Nonhealthcare Activities

All of the above represented investments in assets that are protected to deliver cancer services to our patients as part of the core business of the Trust, with the expectation that the improvements will build on the existing high standard of care provided.

Charitable Funding

The majority of the Trust’s income is derived from providing clinical cancer services. In addition, the remaining 11% of income is derived from:

• Support from charities and recharges to other NHS and non-NHS bodies.

In addition to completing the Sulby / teen and young adult unit and continuing with our radiotherapy development in Liverpool, the Trust is planning further capital expenditure in 2009/10 to commence the next phase of the ward refurbishment programme, and continue with its on-going equipment replacement programme. Capital investment will be made to enable the expansion of the stereotactic radio-surgery service in partnership with The Walton Centre NHS Foundation Trust. A number of projects are also planned to improve Information Management and Technology services and systems at the Trust.

Investment Activity

In the longer term the Trust’s plans for capital investments include:

• Undertaking research and development. • Education and training. • External drug sales to the private sector. • Hosting non-clinical services, such as the National Cancer Services Analysis Team. In CCO’s accounts income for these services matches expenditure and therefore there is no impact on the Trust’s EBITDA and overall I&E surplus.

The Trust invested just under £2 million in new and replacement capital equipment and building refurbishment in 2008/09. The main schemes were: • £0.9m for the radiotherapy centre in Liverpool. The total cost of this scheme is forecast to be £17.5m, and the new centre is expected to open in December 2010. It will increase the Trust’s capacity to deliver radiotherapy treatments to meet increasing forecast demand as well as providing access to services closer to a significant proportion of the Trust’s population.

•R efurbishing the remaining wards on the Clatterbridge site. •R ationalising the estate to reduce the number of modular buildings, improve storage and office capacity. • E valuating the case for a second radiotherapy treatment centre in Liverpool, in conjunction with the Cancer Network, commissioners and the Royal Liverpool University Hospitals. This may take the form of a Trust response to a tender for radiotherapy services led by Liverpool PCT.

Financial Report

The Board are also the Corporate Trustee of Clatterbridge Centre for Oncology Charitable Funds. During 2008/09, £142,949 has been spent by the charity in support of the Foundation Trust. The main areas of expenditure were: • Contribution to capital - refurbishment of outpatients department £35,000 • Research and development - £104,876 • Improving patient welfare - £1,110 • Improving staff welfare - £1,963

Summary Financial Statements The summary financial statements below are a summary of the information contained within the full accounts of the Trust. Requests for copies of the full annual report and accounts (including the directors remuneration report) can be made to John Andrews, Acting Director of Finance, Clatterbridge Centre for Oncology NHS Foundation Trust, Clatterbridge Road, Bebington, Wirral CH63 4JY. The full accounts for the Trust can also be viewed on our website www.ccotrust.nhs.uk

INCOME AND EXPENDITURE ACCOUNT FOR THE YEAR ENDED 31ST MARCH 2009

2008/09 £ 000s

2007/08 £ 000s

Income from activities

54,412

46,613

Other operating income

6,726

6,734

Operating expenses

(56,216)

(49,442)

OPERATING SURPLUS / (DEFICIT)

4,922

3,905

SURPLUS / (DEFICIT) BEFORE INTEREST

4,922

3,905

• £0.2m to replace a Cobalt source for the Cobalt treatment machine.

Finance income Finance costs - interest payable Other net gains/(losses) on financial instruments Other finance costs - unwinding of discount Other finance costs - change in discount rate on provisions

556 0 0 0 0

582 0 0 0 0

SURPLUS / (DEFICIT) FOR THE FINANCIAL PERIOD

5,478

4,487

Public Dividend Capital dividends payable

(927)

(1,119)

RETAINED SURPLUS / (DEFICIT) FOR THE PERIOD

4,551

3,368

• £0.5m to improve outpatient facilities, increase accommodation and maintain the good physical condition of the Trust’s estate. • £0.2m commencing works for Sulby ward refurbishment. The Trust is committed to spend a further £1.25m in 2009/10 to complete the project, which includes the construction of a dedicated teen and young adult unit.

•W orking in partnership with the Royal Liverpool University Hospitals and the University of Liverpool to develop an Academic Oncology Centre. •D eveloping an evaluation of the Trust’s options in respect of providing a high-energy proton therapy service if the Department of Health seek to establish such a facility in England.

Profit / (loss) on disposal of fixed assets

Annual Review 2008-09

“The Centre is a small Trust – but that’s nice. It’s an organisation where everybody has a ‘place’ and feels they belong. I certainly felt that when I worked here, and now being involved as a Governor has shown me how that hasn’t changed.” Gill Oliver Dame Gill Oliver was elected Foundation Trust public Governor in 2006 for the Chester, Ellesmere Port and Vale Royal constituency.

Annual Review 2008-09

Financial Report

Annual Review 2008-09

Balance sheet as at 31st March 2009

Cash Flow Statement for the Year Ended 31st March 2009

31st March 2009

31st March 2008

£ 000s

FIXED ASSETS Intangible assets 9 Tangible assets 31,217 Investments 0 31,226

14 33,076 0 33,090

CURRENT ASSETS Stocks and work in progress 404 Debtors 2,343 Investments 0 Cash at bank and in hand 18,171

332 3,376 0 11,998

20,918

15,706

(9,867)

(11,180)

NET CURRENT ASSETS / (LIABILITIES)

11,051

4,526

TOTAL ASSETS LESS CURRENT LIABILITIES

42,277

37,616

CREDITORS: Amounts falling due within one year

Financial Report

CREDITORS: Amounts falling due after more than one year

(561)

(958)

PROVISIONS FOR LIABILITIES AND CHARGES

(818)

(11)

TOTAL ASSETS EMPLOYED

40,898

36,647

FINANCED BY: Public dividend capital 21,245 Revaluation reserve 5,503 Donated asset reserve 1,721 Other reserves 0 Income and expenditure reserve 12,429

21,245 5,804 2,021 0 7,577

TOTAL FUNDS

36,647

40,898

The Financial Statements were approved by the Board on 27th May 2009 and signed on its behalf.

2008/09

2007/08

£ 000s

OPERATING ACTIVITIES Net cash inflow / (outflow) from operating activities 10,116

6,874

RETURNS ON INVESTMENTS AND SERVICING OF FINANCE: Interest received 556 Interest paid 0 Interest element of finance leases 0 Net cash inflow / (outflow) from returns on investments and servicing of finance 556 Taxation paid / received

582 0 0 582

CAPITAL EXPENDITURE Payments to acquire tangible fixed assets (3,572) Receipts from sale of tangible fixed assets 0 Payments to acquire intangible fixed assets 0 Receipts from sale of intangible fixed assets 0 (Payments)/receipts for fixed asset investments 0 Net cash inflow / (outflow) from capital expenditure (3,572)

(3,383) 0 (14) 0 0 (3,397)

DIVIDENDS PAID

(927)

(1,119)

Net cash inflow / (outflow) before management of liquid resources and financing

6,173

2,940

MANAGEMENT OF LIQUID RESOURCES (Purchase) of current asset investments 0 Sale of current asset investments 0 Net cash inflow / (outflow) before financing 6,173

0 0 2,940

FINANCING Public dividend capital received 0 Public dividend capital repaid 0 Loans received from Foundation Trust Financing Facility 0 Other loans received 0 Loans repaid to Foundation Trust Financing Facility 0 Other loans repaid 0 Other capital receipts 0 Capital element of finance lease rental payments 0 Net cash inflow / (outflow) from financing 0

692 0 0 0 0 0 0 0 692

Signed: …………………………………………………………….Acting Chief Executive Date: 8th June 2009

Increase / (decrease) in cash

6,173

3,632

Annual Review 2008-09

Financial Report

Statement of Total Recognised Gains and Losses for the 12 Months Ended 31st March 2009

Board of Directors The Board of Directors has responsibility for setting the strategic direction of the Trust and for understanding and managing significant risks. The Trust recognises that the Board of Directors should provide a portfolio of skills and expertise to reflect the business, patient care and clinical requirements of a high performing and effective organisation. The Board members provide a breadth of public and private sector expertise at executive level.

2008/09 £ 000s

2007/08 £ 000s

5,478

4,487

Fixed asset impairment losses

Unrealised surplus / (deficit) on fixed asset revaluations / indexation

229

Net gains / losses on available for sale investments

Increase in the donated asset reserve due to receipt of donated assets

(300)

(306)

Additions / (reductions) in “other reserves”

Other recognised gains and losses

Total gains and losses relating to the financial period

5,178

4,410

Total gains and losses recognised since last annual report

5,178

4,410

Surplus / (deficit) for the financial year before dividend payments

Reductions in the donated asset reserve due to depreciation

Board of Directors

Annual Review 2008-09

Chief Executive and Executive Directors

Andrew Cannell Acting Chief Executive

Dr David Husband Medical Director

Dawn Jennings Director of Human Resources

John Andrews Acting Director of Finance

Helen Porter Director of Nursing and Quality

Silas Nicholls Director of Operations and Performance

Chair and Non Executive Directors

Alan White Chairman

Douglas Buchanan Vice Chair

Dr Vicky Tagart

Graham Morris

Carol Eastwood

Louise Martin

Annual Review 2008-09

Board Committees

Board Committees Members of the Board also have membership of the Board Committees Audit Committee

Remuneration Committee

The Audit Committee provides the central means by which the Trust Board ensures effective internal control arrangements are in place. In addition, the Audit Committee provides a form of independent check upon the executive arm of the Board. It does this by holding regular meetings in which internal and external auditors are in attendance.

The Remuneration Committee decides the terms and conditions of office including the remuneration and allowances of all the Executive Directors, including pension rights and any compensation payments.

Membership: Non Executive Directors only, excluding the Chairman.

Integrated Governance Committee The Integrated Governance Committee provides strategic oversight to all areas of governance within the Trust, by giving careful consideration to the Clinical, Organisational and Performance arrangements in place. Membership: Three Non Executive Directors and all Executive Directors.

Membership: Chairman and all Non Executive Directors.

Nomination Committee The Nomination / Appointment Committee for a Chief Executive is made up of the Non Executive Directors, chaired by the Chairman. The appointment is subject to the approval of a majority of the members of the Council of Governors present and voting at a general meeting. The Nomination / Appointment Committee for the Directors is made up of a committee consisting of the Chairman, the Chief Executive and the other Non Executive Directors. During 2008-09 there were no new Executive Director appointments.

In addition, the Board also has ‘Task and finish’ committees; Information Management and Technology, Research and Development, Vision 2020 and Investment Committee.

Council of Governors

Annual Review 2008-09

Council of Governors Governor

Constituency

Term of office

Michael Ashley

Warrington & Halton

2010

Trevor Benn

Wirral, Wales and the rest of England

2011

Michèle Christopherson

Sefton

2009

Stuart Clutton

Warrington & Halton

2011

Alan Comyns

Chester, Ellesmere Port & Vale Royal

2011

Kerry Connon

Sefton

2010

Reg Cox

Liverpool

2009

Mary Doddridge

Liverpool

2010

Tom Fisher

Wirral, Wales and the rest of England

2011

Denys Floyd

St Helens & Knowsley

2011

Ernie Natrass

Liverpool

2010

Gill Oliver

Chester, Ellesmere Port & Vale Royal

2009

Susan Ramsay

Wirral, Wales and the rest of England

2010

Margaret Warriner

St Helens & Knowsley

2010

Eleanor Williams

Wirral, Wales and the rest of England

2011

Peter Benson

Non staff

2011

Doug Errington

Doctor

2010

Deborah Ferns

Non Clinical

2011

Philip Mayles

Other Clinical

2010

Kate Perkins

Radiographer

2009

Kate Smith

Nurse

2009

Andrea Chambers

Manx Cancer Help Association

2010

Nicola Cook

Macmillan Cancer Support

2009

John Earis

Aintree University Hospitals NHS Foundation Trust

2009

Ray Murphy

Cheshire and Merseyside Cancer Network

2009

Cheryl Povall

Metropolitan Borough of Wirral

2011

Alistair Watson

University of Liverpool

2009

Ewan Wilkinson

Liverpool PCT

2009

Elected

Staff

Nominated

Annual Review 2008-09

“I wasn’t sure I could cope with working in a cancer centre but I knew he would be fine. I had nothing to worry about though, I was so surprised and encouraged by the atmosphere at the Centre everyone was so positive and cheerful.” Sue & Bryn Sue Yates and therapy dog Bryn make three voluntary visits a week to the Centre as part of the Pets as Therapy service. Pets as Therapy (PAT) is a National charity which provides animal-assisted therapy.

Clatterbridge Centre for Oncology NHS Foundation Trust Clatterbridge Road Bebington Wirral CH63 4JY Telephone: 0151 334 1155 www.ccotrust.nhs.uk

Design: Paver Smith www.paversmith.co.uk Photography: Deana Kay www.deanakay.co.uk