We plan. We achieve. Salford Royal NHS Foundation Trust has a lot to tell you... l Our achievements of 2009/10 l Our plans for 2010/11

We plan. We achieve. Salford Royal NHS Foundation Trust has a lot to tell you... l Our achievements of 2009/10 l Our plans for 2010/11

PAGE 2 WE PLAN. WE ACHIEVE We achieve 2009/10 was another great year at Salford Royal NHS Foundation Trust, as shown by the progress we made in implementing our Annual Plan and our success in the national performance ratings. This reflects the hard work and commitment of our staff, the contribution that our members and governors make and the positive relationship we have with partner organisations. This document is set out in two clear sections: 1. We achieve: this section illustrates the achievements of Salford Royal against last year s Annual Plan (2009/10); 2. We plan: this section sets out Salford Royal s Annual Plan for 2010/11. Best track record in NHS We are delighted to have, again, achieved all national and local quality, performance and financial targets. We have also been awarded, for the fourth time in a row, an Excellent rating for the quality of our services by the NHS regulator, the Care Quality Commission. This means Salford Royal has one of the best track records in the NHS. EXCELLENT Award winning Throughout 2009/10, the Trust and many staff continued to receive national recognition and awards. National awards include: Winner of the Nursing Times/Health Service Journal Award 2009 for our Quality Improvement Strategy; Winner of the BUPA Foundation Award 2009 for Patient Safety; Winner of the Health Service Journal Award 2009 for Acute and Primary Care Innovation; Winner of the Nursing Times Award 2009 for Accident and Emergency Nursing; Winner of the Chief Nursing Officer Award 2009.

WE PLAN. WE ACHIEVE PAGE 3 Improving Quality and Productivity Leading quality improvement and patient safety We launched an ambitious Quality Improvement Strategy in April 2008 which pledged to save 1,000 lives and reduce harmful events by 50%. Key achievements to date are: 523 lives have been saved; Cardiac arrests have reduced by 41%; The number of patients who have NO missed doses of medication has increased from 68% to 90% on pilot wards; Patients at high risk from falling are reviewed hourly by the nursing team to ensure their needs are being met. (The 4ps assessment pain, position, patient needs and possessions); Our improvement projects and working practices have been rewarded by winning patient safety awards. Improving patient experience Over the past year our patients have told us what they think of our services and care through both internal and national surveys. We do these surveys to help us continuously improve patient experience. Key highlights include: 96.6% of our patients would recommend Salford Royal to family and friends; The Care Quality Commission have rated the Trust in the top 20% of Trusts in their survey; We were rated as one of the top 20 organisations within the Healthcare 100 survey. A number of patient focus groups have been established to ensure effective member, patient and public engagement for our service redesign and service developments. The Council of Governors have worked with patient interest groups, community committees and at public events such as open days.

PAGE 4 WE PLAN. WE ACHIEVE Over the last year we have worked to improve patient information and to ensure all staff treat patients with dignity and respect. We have reviewed and produced patient information leaflets to ensure they are up-to-date and helpful to patients. We have had the benefit of involving patients to ensure information is given in a clear and understandable way. Our staff continue to strive to provide care to patients that is both dignified and respectful; this is supported by our senior nursing team and by many of our staff having signed up to the national Dignity Challenge. Increasing productivity and efficiency Following a review of Outpatient services, triage and one-stop services have been introduced and booking systems improved. Booking and scheduling systems have been redesigned for our theatres to reduce delays and maximise the use of theatre time. Delivering high quality education, and, research and development In March 2009 we welcomed Professor William Ollier to the post of Director of Research and Development. We are delighted to be one of the founding partners of the Manchester Academic Health Science Centre (MAHSC) that was officially launched at the end of 2009. MAHSC aims to be a leading global centre for the delivery of innovative applied research and education into healthcare. The Northwest e-health Board (NWeH) has been established to develop e-health capability. Working with both the University of Manchester and University of Salford, we continue to deliver high standards of teaching to Undergraduate and Postgraduate healthcare professionals; receiving excellent feedback from students.

WE PLAN. WE ACHIEVE PAGE 5 Transforming Service Delivery Ensuring timely access to services We achieved all the access targets for an increasing number of patients. These include: The four hour waiting time target for Accident and Emergency; The maximum 18 week wait from referral to treatment; The cancer diagnosis and treatment standards. Redesign existing clinical services Services have been reconfigured to ensure compliance with same sex accommodation which positively contributes to a better patient experience. The redesign of services to deliver onestop care has continued across a range of specialities, including: Urology, Oral Surgery and ENT (Ear Nose and Throat). The PANDA Unit has extended provision of services to provide 24/7 opening from May 2009; it was officially opened by HRH The Princess Royal in July 2009. Extend existing services into new markets There have been significant developments in Dermatology Services, key areas include: An innovative community service was established in Bury and has since won an award; The Manchester Skin Care service, which provides services to all of Manchester, became operational in June 2009. We are now providing a local radiology service at Pendleton Gateway centre. Develop new clinical and non-clinical services A Lithotripsy Service has been established for Salford patients; offering a non surgical treatment option for kidney stones. Plans were progressed in preparation for Salford Royal to become the Manchester Comprehensive Stroke Centre on 1 April 2010. A Carotid Surgery Service was established, which will support the development of our Stroke services.

PAGE 6 WE PLAN. WE ACHIEVE We have been working closely with The Christie NHS Foundation Trust to prepare for the new Christie at Salford Royal Radiotherapy Centre; construction of the development is well underway and will open in 2011. Deliver the hospital redevelopment programme Salford Royal is investing 200 million into an extensive redevelopment and new build of the hospital site. Over the past year, significant milestones of the project have been achieved, these include: Mayo Building was officially opened in May 2009 by Dr. Anthony Windebank from the world renowned Mayo Clinic; The Dermatology scheme in the Maternity block is progressing and services will transfer in 2010; Plans were agreed for the development of the Acute Stroke Unit and Stroke Rehabilitation Unit; A new Heart Care Unit has been planned for the Ladywell Building and will open in December 2010; Both Worthington and Webb House were demolished in May 2009 to make way for the new Hope Building. Develop organisational infrastructure to improve service delivery The Information Management and Technology Strategy has progressed this year. There has been significant development of the Electronic Patient Record project which offers improved support to the clinical teams and improves the quality of care to our patients. New organisational arrangements have been put in place to ensure we are best placed to deliver our plans and improve performance. The role of Clinical Directors has been reviewed and new accountability arrangements are being implemented. Integrating Care Integrating care across primary, community and acute settings The Trust started work with Salford Community Health to integrate care for patients with diabetes and patients requiring anticoagulation. The Trust was selected as the preferred future provider for the majority of community services; a decision in principle has been supported by our Board. Work will progress during 2010/11 to take this forward. An Unscheduled Care Partnership was also established to redesign urgent care services across the health economy whilst safely reducing costs. Work will continue throughout 2010.

WE PLAN. WE ACHIEVE PAGE 7 Reconfigure acute services to support improved clinical outcomes and performance We have been implementing the Making It Better plans in preparation for the transfer of our Maternity Services. We are working closely with the Royal Bolton Hospitals NHS Foundation Trust, with a Partnership Board established to progress the transfer of responsibility. An implementation plan is in place for the provision of Neurology outpatient and inpatient services across Greater Manchester; with Salford Royal taking the lead. This will ensure more consistent care across Greater Manchester. A procurement process has been confirmed for the development of a further dialysis unit in Oldham; it is expected that clinical input will be provided by Salford Royal. Improved access to vascular services has been secured with Central Manchester University Hospitals NHS Foundation Trust. Additional outpatient and diagnostic services have been provided on site since April 2010; this will improve quality of care and patient safety. The capacity for Intestinal Failure Services has increased and a bid has been submitted to develop AUGiR (Bowel Lengthening) surgery which will strengthen our role as a national centre. Improve Health and Wellbeing Act to support public health improvement We have been working closely with NHS Salford to reduce teenage pregnancy and to improve access to Chlamydia screening (working with RUClear). Salford was one of the four areas to achieve the national screening targets. Work has been undertaken to identify alcohol related admissions and frequent flyers; a reporting tool has been developed to quantify the impact of this patient group. Early intervention for this group of patients has demonstrated significant improvements to their care and a reduction in the unnecessary use of NHS resources. The smoking cessation project is on target; successfully screening nearly 7000 patients in eight months. As part of the project, patient display stands and staff motivational interviewing training are all now in place.

PAGE 8 WE PLAN. WE ACHIEVE We Plan... Following a period of unprecedented growth in the NHS there is now a significant financial challenge to the NHS and wider public sector. In March 2010, we launched the Salford Royal Way which aims to safeguard our services to patients over the next three years. There are four principal priorities within the Salford Royal Way, these are: Safely reducing our costs by 15% over three years; Pursue the ambition to be the safest hospital in the NHS; Create the right culture with agreed shared aims and shared values; Improve pathways of care for patients (integration with primary care, community services and other secondary care services). Every year we produce an annual plan, our strategic business plan. This has been updated to reflect the aim and priorities of the Salford Royal Way. The Salford Royal Way Safely reducing our costs by 15% over 3 years Pursuing Quality Improvement to become the safest hospital in the NHS Safeguarding our services to patients Agreeing shared aims, shared goals and shared values Improving care pathways by integrating with community health services

WE PLAN. WE ACHIEVE PAGE 9 The objectives within this year s Annual Plan (for 2010/11) are: Implement a programme of projects which safely reduce costs by 16m Deliver the Quality Improvement Strategy and improve patient experience Deliver the Organisational Development Strategy Improve pathways of care for patients (integration with primary care, community services and other secondary care services) Maintain compliance with mandatory standards Implement enabling strategies Implement a programme of projects which safely reduce costs by 16m The Trust is aiming to safely reduce costs by 16 million during 2010/11. There are a number of planned projects to reach this target, all of which staff are involved in. Examples of activities will include: staff suggestion scheme; vacancy management and changing some of the ways we work. Projects will be measured and monitored through three workstreams: Waste; The cost of corporate services; Staff resources. Each project will use the collaborative approach developed in quality improvement projects and by agreeing change with our staff. Smar health savings Deliver the Quality Improvement Strategy and improve patient experience The Trust will continue to prioritise improving quality of services through our Quality Improvement Strategy. During this, our third year of the strategy, we will deliver further reductions in mortality rates and harm. The aims for 2010/11 are to: Reduce hospital mortality rates and be within the top 10% of acute Trusts in the country (as measured by the Hospital standardised mortality rate, HSMR); Reduce harmful events by encouraging reporting of adverse incidents and supporting specific collaborative projects including those focusing on falls, pressure ulcers; Improve patient experience and maintain performance in top 20% nationally; as measured by real-time patient feedback, Trust and national surveys, and feedback from PALS and complaints.

PAGE 10 WE PLAN. WE ACHIEVE Deliver the Organisational Development Strategy Shared aims, values and behaviours The Trust, together with the help of staff, will develop and share a set of common values; these are vitally important to create a workforce that is held accountable to each other for attitude and behaviour. A new approach of individual assessment will be adopted to maintain the position of excellence and continue with ambitious plans for further service improvement. Clinical leadership The Trust will encourage all clinical staff to take an active management role. A Clinical Director development programme will be pursued to ensure clinical leaders have appropriate skills to lead service redesign and improve efficiencies. The Clinical Quality Academy will be further developed, alongside current leadership development courses, to give staff the skills and confidence to make significant improvements. The Membership Strategy will be pursued to increase overall and representative membership; to ensure continued engagement with members, service users and the public in service developments and redesign. Improve pathways of care for patients (integration with primary care, community services and other secondary care services) Integrating with community health services The proposal to integrate community health services within Salford Royal has many potential benefits, including improved pathways for patients, reduced fragmentation and waste. During this year the Trust will carefully consider this proposal. Subject to a formal decision in the Autumn, plans will be developed for services to transfer on 1 April 2011. Integrating with secondary care services The Trust will work with the Royal Bolton Hospitals NHS Foundation Trust to implement the Making it Better recommendations by planning for the transfer of maternity and neonatal intensive care services. Gynaecology services will remain on site and the model for service delivery will be confirmed Joint working within the North West sector (Bolton and Wigan) will continue with the aim to better use facilities and expertise to help reduce costs through economies of scale. A joint sterile services facility will be operational by the end of 2010 as the first of these projects. The development of cancer services will continue, with plans to: Expand capacity for Oeosphagastric Cancer services with Pennine Acute Hospitals NHS Trust; Work in partnership with The Christie NHS Foundation Trust to open the The Christie at Salford Royal facility; Develop plans for Stereotactic Radiosurgery; Ensure the strategy for Urology, Gynaecology and Breast cancer services is resilient. The Trust will work with commissioners and other primary and secondary care providers to develop the model for Dermatology service provision across Greater Manchester with Salford Royal as a hub organisation. Planned management changes are being made in Neurology with Salford Royal taking the management responsibility for services on all hospital sites across Greater Manchester. Discussions will continue with the Greater Manchester Neurosciences Network Board and commissioners to develop and implement the model for Intermediate Rehabilitation Units.

WE PLAN. WE ACHIEVE PAGE 11 Maintain compliance with mandatory standards The Trust is committed to maintaining the high standards associated with: Clinical and Quality standards (as required by Monitor, Care Quality Commission and Commissioners); Financial standards; Information Management and Technology (IM&T) standards; Access standards (including A&E, 18 weeks and Cancer); Workforce standards (including appraisal, PDP, mandatory training). Implement enabling strategies The following strategies underpin the delivery of the Trust plans: Research and Development (including developing e-health capability, clinical trails facility and working with MAHSC partners to deliver the joint strategy); Undergraduate and postgraduate teaching requirements; The hospital redevelopment programme; The IM&T strategy; The strategy for Corporate Social Responsibility (including: green travel plan, minimising the impact on the environment, reducing carbon emissions).

Contact us If you are interested in finding out more about Salford Royal or reviewing a full version of the Annual Report and Accounts, feel free to visit www.srft.nhs.uk/media-centre Salford Royal NHS Foundation Trust Stott Lane Salford M6 8HD Telephone 0161 789 7373 Fax 0161 206 4809 Email enquiries@srft.nhs.uk Web www.srft.nhs.uk