For assurance For decision For discussion To note

AGENDA ITEM 05 CHIEF EXECUTIVE S REPORT BOARD OF DIRECTORS 29 MARCH 2018 Report title Report from Prepared by Previously discussed at Attachments Chief executive s report David Probert, chief executive David Probert and the executive team Management Executive STF end of year process and notification of incentive and bonus funds letter Brief summary of report The report covers the following areas: CQC Action Plan update Flu vaccination update Financial performance (Month 11) Emergency planning exercise Moorfields Stars Apprenticeship week Staff survey headlines Gender pay gap headlines UK Ophthalmology Alliance meeting London Project to Cure Blindness Action required/recommendation. The board is asked to note the chief executive s report. For assurance For decision For discussion To note 1 of 5

1. Quality and safety MOORFIELDS EYE HOSPITAL NHS FOUNDATION TRUST PUBLIC BOARD MEETING 29 MARCH 2018 Chief Executive s report CQC action plan update Progress continues well and on target against the 50 point action with 83% of these actions now complete. 8 actions remain outstanding for completion in 2018. Flu vaccination update I am pleased to inform the board that a total of 73% of our frontline staff were vaccinated against the flu virus, meeting the 70% target set by NHS England. Information governance toolkit Information governance is the framework by which the NHS combines the requirements, standards and best practice that applies to the handling of information, and each year trusts are required to make a submission based against the information governance toolkit. At the time of writing this report, the Trust is on track to submit a Satisfactory return in 2017/18, with a score of 74%. The chief financial officer has been recommended by the management executive to be the board lead for cyber and data security in line with national requirements. 2. Financial M11 position The Trust has posted a breakeven position in February, 0.2M ahead of plan. Year to date the reported surplus is 3.8M against a planned surplus of 1.0M. The forecast for the year remains at 6.3M, inclusive of all Sustainability and Transformation Fund (STF). The Trust forecast is a breakeven position when the full 4.6M STF and 1.7M rights to light payments are removed from the forecast. Notification has been received that there will be a further allocation of STF from any unused allocation of the total national fund. This will be notified to the Trust on the 20 th of April for inclusion in the draft accounts submission on the 24 th of April. (The guidance received is attached). The board should note that the required year-end valuation of the trust s land and buildings is complete. This will result in an impairment being charged to expenditure which will reduce the 6.3M forecast surplus. The exact value of the impairment will be calculated once the final capital expenditure and accruals are known during the final accounts process. 3. People Moorfields Stars of 2017 The Moorfields Stars of 2017 annual awards ceremony took place on Tuesday 6 March 2018 at Plaisterers Hall, London. Moorfields Stars annual awards scheme recognises staff for their professional and academic achievements over the past 12 months. Supported by Moorfields Eye Charity, the awards scheme continues to grow year-on-year. 2017 saw the introduction of a new award category to recognise the valuable contribution of volunteers to the trust, taking the total number of award categories to 12. More nominations were received for 2 of 5

Moorfields Stars of 2017 than in the scheme s nine year history: over 400 from staff, volunteers and patients. Find out more and watch videos about the shortlisted finalists on the trust s website. Apprenticeship week Monday 5 th - Friday 9 th March was National Apprenticeship Week 2018 (NAW). NAW encourages people to consider an apprenticeship as part of their career development and celebrates the success of apprentices across the UK. The trust marked the week with a range of activities to celebrate the contribution of our apprentices as part of the trust s strategy to attract, retain and develop great people: A team of apprentices completed the 14 mile Eye to Eye course to kick off NAW. I hosted an apprenticeship Q&A session on Monday 5 March, where I spoke to apprentices about their experience and aspirations. We hosted a number of apprenticeship roadshow events across the network, and these are continuing throughout the year view the roadshow dates I joined colleagues as the trust held a celebration event for NAW on Friday 9 March to celebrate the achievements of our apprentices; speeches were given by Health Education England, a manager of apprentices from our North East network and also one of our apprentices, all talking about their experiences. Jo Moss and Emral Jarrold both hosted job swap opportunities, where an apprentice came along to take on some of their work as a development opportunity and they went to the apprentice s place of work to get involved in some work back on the shop floor. Staff Survey headlines The results of the 2017 national staff survey were published by NHS England on 6 March 2018. We surveyed all our staff and achieved an excellent response rate of 1153, which at 57% is our highest ever, and above average for acute specialist trusts in England for whom the average is 53%. Staff rated Moorfields as one of the best places to work and receive care, with an overall Staff Engagement score above the average for acute specialist trusts. Moorfields also achieved a higher than average score in a number of areas which compare favourably with other acute specialist trusts in England. These include staff being satisfied with the quality of work and care they are able to deliver, staff motivation, confidence and security in reporting unsafe clinical practice, quality of appraisals and quality of training, learning and development. However, there continues to be need for improvement in a number of areas. The areas where Moorfields achieved scores that compare least favourably with other acute specialist trusts in England are in experiencing discrimination at work, experiencing harassment, bullying or abuse from patients, the public and staff, and percentage of staff believing that the organisation provides equal opportunities for career progression or promotion. The People committee will be reviewing the results in detail and a full report with associated action plans will come to the Board in May. Gender pay gap headlines UK companies and organisations with 250 or more employees must publish their gender pay gap data by 30 March 2018 in the public sector. Organisations are required to calculate their gender pay gap and publish their figures on a designated government website, and then follow this up with a report to be published annually.

The People committee will be reviewing our published data and reporting back in more detail to the Board in May. However, the following headlines can be noted: On average, men are paid more than women in our organisation. This appears to be because there are proportionately more men in higher-paid jobs and proportionately more women in lower-paid jobs. The figures indicate that the gap has been skewed by a minority of staff members. Men were more likely to be paid a bonus than women. However, of those employees who received a bonus, women were paid a larger bonus on average than their male counterparts. It should be noted that for the purposes of gender pay gap reporting NHS organisations are advised to treat Clinical Excellence Awards as a bonus payment. 4. Operations Emergency planning exercise The trust is required to prepare for, and respond to, a wide range of incidents or emergencies that could impact on health or patient care. This is to assure itself and NHS England that it is internally resilient and can respond safely to such incidents or disruptions, whilst maintaining its services to patients. In order to achieve this assurance an annual command post exercise is held. This year s exercise ran on the 23 February 2018. The exercise focused on a targeted terrorist attack on the City Road site which resulted in the invocation of all three command levels strategic (gold), tactical (silver) and operational (bronze). The exercise assessed a number of internal incident response plans and the trust s interface with the external tactical command team, made up of blue light responders, local authority and NHS England London. The exercise was well attended and received by participants with good learning emerging from the exercise. A follow-on exercise is being scheduled with the focus on recovery from this major incident for the trust. 5. Strategy UK Ophthalmology Alliance (UKOA) meeting The UKOA quarterly meeting took place on 1 st March 2018 with around 30 attendees. John Ashcroft, the new CEO for Manchester Royal Eye Hospital opened the meeting. Items included: UKOA progress including 20 more organisations invited, the soon to be launched UKOA website, and development of a Board; The GIRFT ophthalmology leads updated on the planned recommendations and took feedback on the practicalities of the GIRFT implementation phase; Prof Matthew Cripps, National Director of NHS Right Care explained this national initiative which is now the main way in which STPs obtain funding for transformation of services. Right Care has just started work with ophthalmic stakeholders including the UKOA. Ophthalmology procurement workshop involving members reviewing their own ophthalmology packs against others to develop generic national packs. Glaucoma presentation on patient materials from the International Glaucoma Association and Moorfields Know Your Drops to develop a national glaucoma support package and patient standards. A number of actions arose from the meeting and will be taken forward by the group. 6. Research London Project to Cure Blindness Last week, the first results of the London Project to Cure Blindness were announced. The results of this groundbreaking clinical study have shown that a new stem-cell based treatment has been successfully used to treat wet age-related macular degeneration (AMD) in two patients.

The results which will be published in Nature Biotech, describe the implantation of a specially engineered patch of retinal pigment epithelium cells derived from stem cells to treat people with sudden severe sight loss from wet AMD. It is hoped that it will also help treat dry AMD in the future. It s the first description of a complet e engineered tissue that has been successfully used in this way. The study is a major milestone for the London Project to Cure Blindness, a partnership between Professor Pete Coffey from University College London and Professor Lyndon da Cruz, retinal surgeon at Moorfields Eye Hospital NHS Foundation Trust. The Project has been also been supported by the UCL Institute of Ophthalmology and the National Institute for Health Research (NIHR) Moorfields Biomedical Research Centre. David Probert Chief Executive 29 March 2018

Sustainability and Transformation Fund Year-End Process and Notification of Incentive and Bonus Funds March 2018

We support providers to give patients safe, high quality, compassionate care within local health systems that are financially sustainable.

1. Introduction 1.1 This paper provides details of the year end accounting process for the Sustainability and Transformation Fund (STF) and the notification of Incentive and Bonus values. 2. Timetable for collection of information and calculation of STF 2.1 NHS Improvement will collect the key (finance) data from providers on 17 April 2018 in advance of draft accounts. This information will be validated on 18 and 19 April 2018 and combined with the published March 2018 A&E performance. STF will be calculated and providers formally notified by letters sent to chief executives and directors of finance by e-mail on 20 April 2018. NHS Improvement will also issue a fixer to populate these values into templates alongside this letter which will be issued on the same day. 2.2 The calculation of indicative STF will be the full value (Core / Incentive / Bonus). Providers must have accurately assessed their adjusted financial performance, both including and excluding STF, in order for NHS Improvement to calculate the indicative values accurately. The A&E performance element will be calculated based on the March 2018 A&E performance data which is published on 12 April 2018. 2.3 The STF value supplied by NHS Improvement will need to be included in the draft accounts submitted by providers on midday 24 April 2018. These figures will be validated against those populated by the fixer. The STF information will also be supplied to NHS England to help inform the agreement of balance process and providers should ensure they include the values as detailed by NHS Improvement. 2.4 Providers will need to formally notify NHS Improvement of any changes to the figures supplied at key data as this will impact on the calculation of STF. Please send details to the sector reporting mail box nhsi.sector.reporting@nhs.net NHS Improvement does not expect any movement in reported performance between formal notification of key data and submission of draft accounts. As in any year, movements between draft and final accounts must be managed and NHS Improvement expects providers to have sufficiently accurate draft accounts so to not require adjustments as a result of the audit process. 2.5 NHS Improvement must be notified as soon as possible of any changes that will affect providers performance against their control total (CT), with the final deadline being midday 15 May 2018. Where this results in a provider not being entitled to STF income, these funds will be returned to the bonus pot and may be subject to further redistribution. Providers will be notified directly of any changes through redistribution. 2.6 It is important to recognise that the process above describes the recording of estimates for STF; the actual payment will not be finally agreed and paid until after the final accounts are complete and submitted at the end of May 2018. 1

The final process for agreeing and making payment will be formally notified at a later date. Table 1: Detailed timetable Tuesday 17 April (midday) Wednesday / Thursday 18/19 April Friday 20 April (COP) Tuesday 24 April (midday) Tuesday 15 May (midday) Key data received from providers (local assessment of STF excluding bonus) NHS Improvement review key data Indicative STF (full including bonus) notified to providers Draft accounts submitted including notified STF Final date to notify changes to CT performance 3. Calculation of STF Incentive and Bonus Funds 3.1 The funds available to distribute through the incentive and bonus schemes will be the value of all unallocated and unearned STF. 3.2 It is recognised that including the incentive and bonus will result in a circular effect on the Public Dividend Calculation (PDC) calculation. It has been agreed by the Department of Health and Social Care that these elements can be excluded from the calculation of the dividend, for both opening and closing relevant net assets. The adjustment lines should be used in the calculation of the PDC dividend in the PFR return. Finance Incentive Scheme ( for ) 3.3 Providers will receive a pound for pound ( for ) incentive for any agreed achievement above their control total (CT). There are some items that are excluded from the over achievement; these items will be adjusted out before the calculation of the for incentive. The PFR return will currently adjust for the following item: Underspends resulting from additional discretionary payments from commissioners or zero sum accounting adjustments between commissioners and providers. 2

Bonus Scheme 3.4 The total bonus pot will be the remaining balance available after payments relating to the core STF entitlement and finance incentive fund ( for ) has been calculated. 3.5 For providers within an Accountable Care System (ACS) the bonus will be paid where the ACS delivers or exceeds its system control total. 3.6 For all other providers, the bonus will be paid if they deliver their individual control total, weighted to reward providers that exceed their control total and committed to the improvement earlier in the financial year via their reported forecast position in the monthly financial monitoring returns. 3

Contact us: NHS Improvement Wellington House, 133-155 Waterloo Road, London, SE1 8UG 0300 123 2257 enquiries@improvement.nhs.uk improvement.nhs.uk @NHSImprovement This publication can be made available in a number of other formats on request.