Summary Annual Report 2012/13
b Welcome A message from the Chairman and Chief Executive
As we celebrate two years since becoming a community trust in 2011 we can reflect on the significant progress we have made in providing improved outcomes for our local communities delivering services that are better able to meet a wide range of health needs across our diverse communities. Our strategic vision is clear; to be the outstanding provider of high quality, integrated community care services in Wirral and beyond. At the heart of this vision is the creation of an integrated care system for Wirral, with us, as a strong and credible Trust right at the centre, doing what we do best supporting people as partners in care in their own homes, facilitating speedy access to hospital when people need it and rapid discharge back home as soon as they are ready. And with quality and care at the heart of everything we do. Although we are confident in our services, we are not complacent. The opportunity to review the recommendations of reports such as the Francis Report help ensure we implement any changes that will further improve our services and care of patients.
• Approval in October 2012 as a Qualified Provider (AQP) for the delivery of Core Podiatry services beyond Wirral into the wider NHS Merseyside area. This year we have also seen significant progress in our plan to become a Foundation Trust. Our membership continues to grow and demonstrates the increasing connection we have with local people, staff and partners who are informed and involved in the life of the Trust. We also thank our volunteers for their passion and ongoing commitment to supporting our services. Finally we must recognise all our staff who are dedicated to providing excellent services. It was a pleasure and privilege to celebrate and recognise their achievements in 2012/13 with our first For You Thank You staff awards highlighting the innovation and commitment of individuals and teams within our Trust.
We have continued to ask patients and staff for feedback on our services and are delighted that 96% of patients over the last year said they would recommend our services to family and friends. Amongst our many achievements over the last year, we include:
Frances Street, Chairman.
• Our lead role in the integration and improvement of services focusing on people with long term conditions • The opening of the new St Catherine’s Health Centre - significantly improving patient facilities and experience • Our successful bid to deliver integrated sexual health services across Wirral from 1 April 2013 with Wirral University Teaching Hospital NHS Foundation Trust (WUTH) and Wirral Brook
Simon Gilby, Chief Executive.
b Our Trust
We provide the care and support needed to reduce health inequalities, promote health and wellbeing within our communities and play a vital role in supporting those people of all ages who live with on-going health problems enabling them in many cases to continue to live at home.
Our services are delivered by dedicated health professionals and supported by equally committed staff behind the scenes who strive to continue to develop and improve our services by working with and listening to our patients, partners and commissioners. Our services Nursing – providing nursing care in people’s homes. We also provide specialist nursing services for people with specialist requirements including continence, heart services, end of life care and Parkinson’s disease. Therapies – offering a diverse and integrated range of therapy services
including, physiotherapy and rehabilitation, podiatry, nutrition and dietetics, speech and language, wheelchair service and independent living centre. Primary Care – including two GP practices, GP Out of Hours, Dental Out of Hours and Community Dental. Unplanned Care – consisting of three walk-in centres, a minor injuries department, the newly launched centralised booking service, which incorporates Single Point of Access (SPA), a specialist Deep Vein Thrombosis service and a community based Phlebotomy service. Lifestyle Services – supporting people to make positive lifestyle changes, maximise community resources and signpost residents to activities close to where they live.
“The staff were friendly and helpful at all times. They are a credit to the nursing profession. Community Nursing patient
b Financial performance
The Trust has had a second successful year of operation meeting all our financial duties for 2012/13. In 2012/13 we: • Received £66m income for delivering healthcare services to commissioners in 2012/13 • Delivered an operating surplus of £917k compared with £717k in 2011/12 which was in line with plans and represents around 1.4% of overall turnover • Performed well against the financial risk ratings applied to NHS Foundation Trusts by the independent regulator Monitor. (Had the Trust been subject to this regime in 2012/13, we would have received an overall risk rating of 3, a good level of financial performance) • Paid over 87% of all undisputed supplier invoices within 30 days. With a target of 95%, plans are in place to ensure that figure is much improved in 2013/14 • Achieved the 4% efficiency requirement set by our commissioners as in 2011/12
Our Financial Future The Trusts business plan shows that whilst it will remain financially stable with good levels of performance against Monitor’s financial risk rating, the required level of cost improvements will remain between 4% and 5% annually to release some 23% of total costs by 2016/17 whilst maintaining quality service delivery.
• Invested £500k on capital and infrastructure compared with £323k in 2011/12.
Cost Improvement Plans
Our main income sources:
In 2012/13 our commissioners imposed a 4% efficiency target requiring the trust to deliver £2.8m of cost savings. These savings targets have been delivered in full by individual services and departments through their cost improvement plans.
£62.2m NHS Wirral £900k Wirral Metropolitan Borough Council £900k NHS Western Cheshire ...and limited income from other sources.
“Very impressed all round, long live the NHS. All Day Health Centre patient
Financial risks In addition to meeting the need for cost improvements, our financial risks include: • Commissioning changes • Competition through the introduction of Any Qualified Provider (AQP) contracts.
b Operational performance
The Trust has achieved a high level of performance based on the indicators we are measured against.
This year we have: • Met or exceeded 98% of our contractual targets • Exceeded the quality target with over 99% of patients spending less than 4 hours in our Walk In Centres • Improved 23% of key findings in the staff survey with 18 of the 28 key findings showing better than average performance • Increased patient feedback by 30% sharing patient stories and feedback at our monthly Trust Board meetings • Shown consistency in the number of patient contacts with an increase of over 30,000 within our Therapies Division.
1.1 million patient contacts Here are just a few of our highlights for 2012/13: • Over 281,500 Community Nursing appointments / visits • 230,000 patient blood samples taken by our Phlebotomy Service • Over 115,000 Health Visitors Healthy Child team appointments • Nearly 85,000 patients treated at Walk in Centres at Eastham, Wallasey and Arrowe Park • Over 72,000 consultations through the Musculoskeletal/Community Therapy Service • Over 41,000 pieces of equipment delivered by our Community Equipment Service • 16,600 appointments and gym attendances with our Heart and Cardiac Services • Over 14,600 people attended walk in and pre-booked appointments with our Sexual Health team • Over 34,000 walk in patients treated and nearly 10,500 pre-booked patients treated by our GP Out of Hours and All Day Health Centre, helping to reduce pressure on A&E services.
“I received excellent care from all staff, from Reception to Nursing. Many thanks Walk-in Centre patient
b Case studies Patient, Community & Commissioners b Liverpool Podiatry Services AQP
b Public Health Re-design
The Trust was approved in October 2012 as a Qualified Provider (AQP) for the delivery of Core Podiatry services across the NHS Merseyside area reaching patients registered with a GP practice within: Liverpool, Knowsley, Sefton, St Helens, Halton, Southport and Formby.
Following the transfer of Public Health commissioning to the local authority, the Trust’s Public Health Team was redesigned in 2012 to offer an integrated and holistic service.
b Integration Programme During 2012, the Trust has played a leading role in developing the structures and processes that underpin the delivery of more effective integrated care to patients with long term conditions across Wirral. Bringing together health, social care and third sector organisations, the way that people receive care in a community setting services will need to change and to avoid unnecessary hospital admissions delivering better outcomes to patients.
From the 1 April 2013 six geographically based teams now deliver all elements of the service - Stop Smoking, Weight Management, Health Trainers, Community Programme, Health Promotion and Healthy Settings. They offer a single point of access and streamlined pathways making it easy for individuals to access the services and for health professionals to refer in.
Clinical Delivery b Wirral Integrated Sexual Health b Services In January 2013, the Trust in partnership with Wirral University Teaching Hospital NHS Foundation Trust and Brook were awarded the contract for Sexual Health Services and from 1 April 2013 now deliver the new integrated service for three years. Sexual Health Wirral provides sexual health clinics available seven days a week at seven locations across Wirral. We now offer most of our services at all clinics including a range of contraception choices, health screening, treatment and sexual health advice for people regardless of age or gender.
b Centralised Booking Our centralised booking service operates 8am - 8pm, seven days a week providing patients with one phone number to be able to book appointments with the following services: • Podiatry • Phlebotomy • Emergency Dental • All Day Health Centre GP Practice • Community Nursing Service.
b Safety and Quality In April 2012, the Care Quality Commission (CQC) registered all our services without conditions and in November 2012 our Walk-in Centre at Arrowe Park Hospital was inspected and assessed as demonstrating compliance in all areas. We have achieved our CQUIN schemes and quality objectives in areas such as dementia care, long term conditions, end of life care and infection prevention and control.
b Engaging with Patients A programme of leadership walk-rounds has enabled members of the Trust Board to visit services and discuss with patients and carers their experiences of our services. Our Patient Experience Champions appointed in 2011/12 have led to improvements in how patients access our services and the information we provide.
People and Resources Engagement with staff has developed significantly with the introduction of Listening Events providing opportunities for staff to talk to directors and board members giving first hand feedback on the services we provide. Other developments include:
Issue Two Sprin
• Quarterly Staff and Member Magazine - ‘For You’
for staff, members
• Staff Zone - staff intranet (with 80% of staff registered as of 31/3/2013).
b ‘For You Thank You’ staff awards In March 2013, we celebrated achievements across the Trust at our For You Thank You staff awards. Judged by a panel including patient representatives, the awards highlighted the passion and commitment to patient care not just on the front line, but also from those people behind the scenes that support the work of the Trust.
b Staff Survey 2012 • Staff reporting greater job satisfaction compared to 2011 • An increase in the number of staff recommending the Trust as a place to work or receive treatment.
Oh what a nig ht The Francis Inq
We talk to Lisa Cooper, Director, Quality & Governance. - page 4
A Day in the Life
We spend a day with Liz Barrington of the Physio team. - page 8
See page 9 Listening Eve
Staff are invited to put forward their views at one of our even ts. - page 13
It started with a bid. Sexual Health made simple in Wirral. - page 14
Supporting Functions b St Catherine’s Health Centre
b Caring for the environment
In August 2012, services left the historic former hospital building and moved into the new St Catherine’s Health Centre providing a modern clinical community base to support the delivery of high quality services.
• Reduced our carbon emissions to 2,897 tonnes CO2 equivalent; • Recovered or recycled 65% of our waste – equivalent to 232 tonnes.
b Our future
Our five year business plan sets out how we will achieve our vision against our four strategic themes. In 2013/14 our objectives are: 1: Patient, Community and Commissioner
3: People and Resources
• Working with commissioners to support self care
• Facilitating increased seven day working
• Working with partners in the context of welfare reform, the current economic climate and provision of information, advice and guidance.
• Making best use of technology
2: Clinical Delivery • Progressing the integration agenda - from Children and Young People to Older People’s services with partners
• Continuing to improve public and staff engagement. 4: Enabling Functions • Enhancing our use of information and informatics • Effective use of workforce planning
• Developing our urgent care services with partners
• Improving approaches to organisational development
• Further development of the Trust’s provision of primary care services.
• Making sure we use our estates portfolio as efficiently as possible.
The Trust has made significant progress in its application to become an NHS Foundation Trust which will enable the Trust to offer a unique and accessible range of healthcare to all our patients. Developing a membership that is large enough to fully represent the people of Wirral has been a focus during 2012/13. By the end of the year we have recruited over 3600 local people and our aim is to add a further 900 members by April 2014. During the coming year we look forward to holding governor elections and inducting and providing training for those elected, in preparation for our authorisation as a Foundation Trust.
A full copy of our Annual Report & Accounts, as well as our Quality Account is available online at www.wirralct.nhs.uk/key-publications A limited number of printed copies will be sent to official statutory and non-statutory bodies.
Compliments, concerns, complaints.
If you would like this information in another format or language, or would like to provide feedback about any of our services, please contact our Patient Experience Service: T: 0151 514 6311 Freephone: 0800 694 5530 or firstname.lastname@example.org