Summary Annual Report 2013 - 2014
A message from the Chairman and Chief Executive
Welcome to our Summary Annual Report and Accounts 2013/14. We have achieved a great deal over the last 12 months and after three years of operation have established ourselves as a strong and credible community NHS Trust in Wirral and to the communities we serve. Our vision continues to underpin all our work, refreshed this year to reflect our ambition to provide excellent care. So too are our values, which have evolved through engagement with staff and highlight our commitment to ensure the patient is at the heart of everything we do. We have delivered our objectives and worked hard to meet and exceed the standards and expectations of our patients, our commissioners and our partners. Quality is top of our agenda and this report, alongside our Quality Account for 2013/14, describe the evidence of our actions and achievements in providing high quality community health services that are safe, effective, caring, responsive and well-led. We are delighted to have met all our Care Quality Commission(CQC) standards following routine inspections of our services in a number of areas
including our Community Dental Service and two of our Walk-in Centres. In addition the NHS Trust Development Authority (TDA) Winter Report, which sets out how Trusts have performed between August 2013 and January 2014, recorded the Trust as one of only 14 Trusts to be reported as no identifiable concerns. Our Leadership and Patient Safety Walkrounds have gained momentum and helped ensure frontline staff have the opportunity to engage on a frequent basis with the Trust Board and Executive Team. We have performed well against our financial targets and the next financial year will see another significant challenge with further savings of over ÂŁ3.3m to be realised.
The value of community services is apparent and, although progress has been made, further change is needed to realise the ambition of moving more care out of hospital and closer to people’s homes. Wirral Community NHS Trust is firmly committed to remaining at the heart of making this happen. We will continue to do this thanks to the dedication, energy and passion for quality care that our staff and volunteers display every day.
We have worked hard to develop a clear link between what our staff do, our organisational plan and what our
Our vision is to be the outstanding provider of high quality, integrated care to the communities we serve.
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commissioners expect from us. We are motivated to deliver on our key strategic service developments for the next two years and believe we have laid strong foundations for lasting organisational sustainability.
Frances Street Chairman
Simon Gilby
Chief Executive
Summary Annual Report 2013/2014
Strategic Report
Strategic Report
Our Trust Wirral Community NHS Trust is a high performing organisation with an excellent clinical reputation providing high quality primary, community, therapy and lifestyle services to the population of Wirral and its surrounding areas. Our focus is on achieving the best outcomes for the communities we serve.
What we do By providing integrated community based healthcare services at home and closer to home, we give people
greater personal control and choice, helping them to stay independent longer. As the importance of community healthcare grows against the backdrop of a changing NHS environment, the benefits of treating patients in their homes and in the communities where they are comfortable are evident and help us provide a more patient-focused service.
1.1million patient contacts each year. From our Community Nursing, Health Visiting and Sexual Health Services to our Walk-in Centres, Livewell Programme and Therapy Services our priority is to care for everyone as an individual, taking a holistic approach to care and working in partnership to bring about a patient journey that is where possible, seamless.
We serve approximately 319,800 people across Wirral and our local boundaries resulting in around
Visit our website for a full list of all our services www.wirract.nhs.uk
Our values will guide how we will achieve We give people our vision and face up to the challenges that lie ahead.personal greater
control andwithchoice, Health is our passion, patients at the heart of everything we do helping them to stay Exceptional care as standard independent longer. Actively supporting each other to do our jobs Responsive, professional and innovative Trusted to deliver
Summary Annual Report 2013/2014
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Operational performance
Operational performance
We have achieved a high level of performance against the community indicators that we are measured against.
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Our services continued to deliver high quality responsive care to Wirral residents from numerous clinical sites and in many cases in the patient’s own home. We have achieved a high level of performance against the community indicators that we are measured against and in 2013/14 we had around 1.1 million patient contacts across our core service divisions. For a third year we have: • performed above, or within defined tolerance thresholds of 92% of our contractual targets • treated all patients within the 18 week target • achieved all national indicators for urgent care services such as Walk-in Centres and GP Out of Hours, demonstrating the Trust’s commitment to delivering excellent urgent care across the Wirral
Here are just a few of our highlights for 2013/14: • Over 315,000 Community Nursing appointments / visits • 244,000 patient blood samples taken by our Phlebotomy Service • Over 115,000 Health Visitors Healthy Child team appointments • Nearly 84,000 patients treated at Walk-in Centres at Eastham, Wallasey and Arrowe Park • Over 68,500 consultations through the MSK/Community Therapy Service • Over 46,500 pieces of equipment delivered by our Community Equipment Service • 12,800 appointments and gym attendances with our Heart and Cardiac Services • Almost 30,000 people attended walk in and pre-booked appointments with Sexual Health Wirral • Approximately 22,500 Livewell contacts supporting individuals to make positive lifestyle changes through their stop smoking, weight management and healthy eating programmes
Summary Annual Report 2013/2014
Financial performance
Financial performance
The Trust has met all of its statutory financial duties for 2013/2014, our third successful year of operations as a standalone NHS Trust. In 2013/14 we: • Received a total of £70m income for delivering Healthcare services to commissioners and others. This is an increase of 5% on the total income received in 2012/13 • Delivered an operating surplus of £923k compared to £917k in 2012/13 • Performed well against the financial risk ratings applied to NHS providers by the independent regulator Monitor. Each measure scores out of 4 and Wirral
Sources of income:
Community NHS Trust has scored the maximum 4 in each category • Achieved the 4% efficiency requirement set by our commissioners of £3.3m • Invested £1,059k in capital infrastructure compared with £500k in 2012/13. This includes the implementation of our new IT system for Community Nursing and the roll out of mobile working across services • Paid over 87% of all undisputed supplier invoices within 30 days. Performance was below the level expected of an NHS Trust which is 95%. Whilst the Trust’s overall performance has improved in 2013/14 work is still required in 2014/15 to address this underperformance
£48.9m
NHS Clinical Commissioning Groups (CCGs)
Summary Annual Report 2013/2014
£9.5m
NHS England
Our Financial Future The Trust’s plans show that whilst it will remain financially stable with good levels of performance against Monitor’s financial risk ratings throughout the planning period, the required level of cost improvements will remain between 4% and 5% annually, equating to the release of some 23% of total costs by 2018/2019.
Cost Improvement Plans In 2013/14 our commissioners imposed a 4% efficiency requirement as part of the contract settlement for the year. This has required the Trust to deliver £3.3m of cost releasing savings. These savings targets have been delivered in full.
£7.7m
Wirral Council
…and limited income from other sources.
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Case Studies
Case studies
Patient, Community & Commissioner Telehealth systems The Trust introduced telehealth systems with attendees of the Cardiac Rehabilitation Service. A monitoring system for heart failure patients, Telehealth allows patients to take charge of their condition, understand their readings and allows the service to use it as an early warning system to intervene and prevent hospital admissions. Since 2012, 46 patients have been recruited with ten patients currently on the system being monitored. We have also actively supported the introduction of Telehealth programmes to underpin the development of robust Integrated Care Pathways in the Integrated Care Programme.
Livewell Programme In 2013/14 the Trust redesigned its offer in Public Health and established the Livewell Programme which has a focus on enhancing and developing public health and wellbeing promotion across communities. The service has now moved into flexible delivery teams which allow it to provide a more responsive service to local communities. The Livewell teams are specialists in a range of lifestyle themes and
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provide support to local people, schools, organisations and workplaces. Working across Wirral we’re helping people to: get more active, eat healthier, quit smoking, lose weight, relax and unwind.
by Wirral Clinical Commissioning Group. As a lead for integration within the community, we have progressed integration developments across a number of areas.
Dementia Care Screening
In 2013/14 the Trust were members of the Urgent Care Board, actively engaging with all key stakeholders to ensure effective pathways of care provided appropriate interventions following initial assessment.
Over 90% of community nursing patients in the last year were successfully screened for potential signs of early dementia and referred to their GP. This early screening has helped patients get the right treatment and find the best sources of support, as well as make decisions about the future. In addition, a new pain scoring chart has been introduced especially designed for patients who have been diagnosed with dementia to provide timely pain relief when required, improving quality of care.
Clinical Delivery Integrated care and Vision 2018 In 2013/14 the Trust became a lead partner and participator in the newly established Vision 2018 – a collaborative approach across the health and social care community delivering sustainable and effective services through transformation, led
Urgent Care
The Trust has led on a number of key initiatives including: • development of Integrated Care Coordination Teams • streaming patients from the A&E department to a more appropriate setting such as their own GP or one of our Walk-in Centres • expanded the scope of the Single Point of Access to support whole system decision making in urgent care • in depth review of safe staffing levels within Walk-in Centres
GP Visiting Scheme The GP Visiting Scheme is an initiative that has been adopted in collaboration with the Trust’s Single Point of Access Service and the North West Ambulance Service. Its remit is to enhance the integrated working of these services for the benefit of our patients. The aim of the service is to ensure that the patient is
Summary Annual Report 2013/2014
Case Studies
seen by the most appropriate medical professional for their presenting medical complaint.
Safety & Quality During 2013/14 we can point to many examples of where we are providing excellent clinical care including the achievement of our CQUIN schemes and quality objectives in areas such as Dementia Care, Long term Conditions, End of Life Care and Infection Prevention and Control. Read our Quality Account 2013/14 for more details.
People & Resources Staff Survey The results for our Trust are a great reflection on what we all try hard to achieve every day – making this a good place to work and provide care. • we have seen an increase from 73% to 76% in the number of staff who said “If a friend of relative needed treatment, I would be happy with the standard of care provide by this organisation” • we are above the national average for job satisfaction across community trusts
Public and staff engagement In addition to our usual channels 2013/14 has seen the development of visible Board leadership through a dedicated programme of Leadership and Patient Safety Walkrounds. Director blogs and Staff Council meetings ensure that two way communication is maintained and improved. We have developed relationships with our community through the development of volunteer and work experience programmes and the introduction of a highly successful careers event for 14-16 year olds.
Summary Annual Report 2013/2014
Management development We have introduced a core management programme for all our employees who have management responsibilities. This mandatory course equips all our managers and team leaders with the core skills they need to lead, manage and develop their teams effectively.
Rapid improvement events A programme of Rapid Improvement events took place where internal facilitators worked with individual teams to make radical changes to current processes and develop solutions to problems within very short timescales. Each solution was assessed against risks and impacts to:
and freeing up staff time through more modern and efficient ways of working.
Maximising our estate portfolio Estates reviews have been undertaken during 2013/14 and identified a number of changes to our utilisation of the Trusts estate. As a result in 2013/14 the Trust has developed a comprehensive Estates Strategy which will ensure our estate is fit for purpose – from utilisation, to disposal and income maximisation.
Caring for the environment
• patient experience
Since the creation of Wirral Community NHS Trust in April 2011 we have implemented a bespoke sustainability approach for our organisation. We have:
• and the quality of the service delivered
• reduced our carbon emissions to 2,054 tonnes CO2 equivalent
• patient safety
Supporting Functions SystmOne In February 2014 the Trust rolled out SystmOne to its community nurses, specialist nursing teams and health visitors. Staff now have the ability to collect all key data around the patient in an electronic patient record supporting a truly agile workforce
• recovered or recycled 67% of our waste – equivalent to 357 tonnes • engaged with local suppliers to monitor and reduce the amount of energy
Full copies of our Annual Report & Accounts and our Quality Account are available online at: www.wirralct.nhs.uk/ keypublications A limited number of printed copies will be sent to official statutory and non-statutory bodies.
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Our future
Our future
As the NHS continues to change, we have taken the opportunity to refresh our five year strategic objectives and ensure that they continue to be linked to our commissioners’ plan based around patient needs.
Our strategic service developments 2014/15 and 2015/16 We have identified a number of key service developments that will help us to achieve our strategic objectives and goals for the next two years. They are aligned to the priorities identifed by our commissioners and the wider healthcare economy and are detailed in the full Annual Report & Accounts.
Foundation Trust Journey During 2013/14 the Trust has continued to work closely with colleagues from the NHS Trust Development Authority (TDA) to demonstrate its readiness to become an NHS Foundation Trust (FT). Becoming an FT will allow the Trust greater freedom and flexibility in the way it provides and invests in services. The FT model will also give staff, public and stakeholders more say in how the Trust is run.
Membership We want membership to be useful, interesting and personal. We have over 4500 public members and also benefit from having many volunteers who enhance patient care and we are investing in the future by providing work placements for young people in Wirral. To become a member call Dave, Linda or Cathy on 0151 514 2452 / 0800 694 9985 or email foryouwithyou@wirralct.nhs.uk
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 patient.experience@wirralct.nhs.uk
www.wirralct.nhs.uk