Annual Members Meeting 27 September Gillian Norton, Chairman

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1 Annual Members Meeting 27 September 2018 Gillian Norton, Chairman

2 Council of Governors update Kathryn Harrison, Lead Governor

3 Celebrating the NHS at 70 A short film

4 Patient story Libby Keating I ve had nothing but kindness and compassion.

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8 2017/18 a year of progress Jacqueline Totterdell, Chief Executive

9 Overview Introduction Who we are and what we do/a year of progress Cardiac surgery at St George s Outstanding Care, Every Time delivering on our objectives Personal reflections/the future

10 Who we are: St George s cares for a population of 1.3 million across south west London. Two main hospitals, plus a range of community settings. Queen Mary s Hospital St George s Hospital As well as our two main hospitals, we provide care in the community We share our Tooting campus with St George s, University of London.

11 What we do Key services, and an organisation to be proud of Local, tertiary and specialist services: - Centre of excellence for neurosciences, fetal medicine, plus renal transplantation - Major trauma and heart attack centre - 24/7 thrombectomy service for stroke - Growing influence in research - Trusted services for local people; including Emergency Department and maternity service

12 A year of progress Stabilised executive and senior team Reduced vacancy rate and spending on agency staff Launched Quality Improvement Plan Reduced financial deficit Rolling programme of operating theatre and ward refurbishment Friends and Family Test scores improving Upgraded to Requires Improvement by CQC But..a huge amount still to do

13 Cardiac surgery at St George s Taking action to deliver much needed improvements We commissioned independent external review We are implementing recommendations at pace Taken steps to stabilise the service, including: - Transferring complex cardiac surgery to other hospitals - Removing cardiac surgery trainees - New programme director appointed Separate HR review is looking at team behaviours External independent panel convened by NHS Improvement

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15 Treat the patient, treat the person Delivering fundamentals of patient care: - MRSA/Clostridium difficile rates below national average - Mortality rates better than many other teaching hospitals - Dementia carers passport launched - Ward accreditation scheme introduced CQC upgraded Trust from Inadequate to Requires Improvement in July 2018 Working with Institute for Healthcare Improvement and our own Quality Improvement Academy

16 Right care, right place, right time Indicator Target 16/17 17/18 18/19 to date ED 4 hour >= 95% 91.6% 87.56% 91.75% Referral to Treatment (RTT) incomplete pathways 62 day wait for first treatment for urgent GP cancer referral >=92% We are not currently reporting our RTT position due to data quality challenges >=85% 84.9% 82.60% 88.90% Diagnostic waits >=1% 2.9% 0.2% 0.2% MRSA

17 Balance the books, invest in our future Finished 2017/18 with deficit of 53.1 million ( 78.7 million in 16/17) Plan to reduce the deficit to 29 million by March 2019 We will do this by: - Increasing the number of patients we treat - Reducing waste and inefficiencies By balancing our books, we can invest in our future Benefiting from generosity of St George s Hospital Charity

18 Build a better St George s New strategy in development Improving our IT including the roll-out of electronic patient administration system DEVELOPMENT OF TRUST STRATEGY Renovated theatres at St George s Rolling ward refurbishment programme Opened Energy Centre on Tooting site Improving response to small-works requests

19 Champion Team St George s Reduced vacancy rate from 17% to 10% Staff Appreciation Awards with St George s Hospital Charity New health and wellbeing initiatives for staff Improved Staff Friends and Family Test scores King s Fund leadership development Appointed Guardian of Safe Working Highest staff flu vaccination rate in London

20 What our staff are telling us

21 Develop tomorrow s treatments today Surgical firsts, including first robotic hysterectomy Highest ever increase in recruitment to clinical trials Staff recognised in academic promotions Training partnership with Royal College of Surgeons Trial of artificial intelligence in fetal medicine Part of 100,000 Genomes project

22 Celebrating what we do

23 Personal reflections A year of progress but more to do Some problems are years in the making and will take longer to resolve Priority is to make life easier for our staff from the hospital estate to information technology The job is challenging and rewarding and fun! The support we have from local people is tremendous

24 The future Development of our strategy Return to financial balance and improve key services Exit special measures regime for quality and finance Support and champion our 9,500 staff Greater focus on patient and public engagement

25 Annual accounts 2017/18 Andrew Grimshaw, Chief Financial Officer

26 Audit opinion Present the Accounts for year ended 31 March 2018 Audit undertaken by Grant Thornton Conclusions of the Audit; - Unqualified audit conclusion - Adverse conclusion in relation to the arrangements for securing economy, efficiency and effectiveness in the use of resources - Emphasis of matter opinion due to the Trust s dependence on cash support from the NHS The Auditors noted that the production of the Financial Statements had improved again from the previous year The Trust continues to be in Financial Special Measures with NHS Improvement (NHSI)

27 Key elements of financial performance Financial duty 2017/ /17 Comment Deficit 53.1m 78.7m Expectation from NHS Improvementis that Trusts should aim plan to be in financial balance. Failure to identify and deliver cost improvement plans Failure to qualify for additional funding Income 820.3m 799.1m Increase of 21.2 million (2.6%) Expenditure 873.4m 877.8m Decrease of 4.6 million (0.5%). Capital Investment 53.2m 34.0m Investment in IT New Energy Centre at St George s Medical Equipment Borrowings 79.7m 86.0m Borrowings were to support working capital, as well as to support finance urgent capital investment.

28 Actions to deliver improvements Financial performance - Financial plan agreed with NHSI to reduce 2018/19 deficit to 16.4 million - This includes 12.6m of Provider Sustainability funding, which is dependent on delivery of financial and performance metrics - Process in place to identify and deliver Cost Improvement Plans Borrowing - NHSI have agreed to support working capital in line with the deficit Capital investment - Investing 18.5 million of internally generated capital funding in 2018/19. We will continue to seek additional resources for further investment Systems and processes - Actions in place to improve the working of the Finance Department, including upgrade of the financial system

29 Annual audit letter Paul Dossett, Partner, Grant Thornton

30 Questions/feedback