Annual Report & Accounts - bdct.nhs.uk · Our vision is to provide the best care for the people of...

Annual Report & Accounts2013/14

You and Your CareYou and Your Carewww.bdct.nhs.uk You and Your Carewww.bdct.nhs.uk

2

Foreword by Chair and Chief Executive p3

Directors’ Report:

About the Trust p5

Integration Across Localities p8

Delivery Against 2013/14 Operational Plan p12

Our Commitment to Quality p16

Our Workforce p22

Progress with our Foundation Trust Application p30

Sustainability p32

Statement of the Accountable Officer’s Responsibilities p33

2013/14 Financial Review p34

References to Annual Accounts p38

Annual Governance Statement p40

Summary of Financial Statements p48

Remuneration Report p56

Auditor’s Statement p62

Appendix 1: NHS Services provided by BDCT in 2013/14 p67

Appendix 2: Board biographies p68

Appendix 3: Register of Board Members’ Interests p72

Appendix 4: Commentary on Key Performance Indicators and Glossary of terms p74

Appendix 5: Feedback on Annual Report p76

Contents

3Michael Smith Chair

The last 12 months have been an exciting and challenging time for Bradford District Care Trust (BDCT).

Our vision is to provide the best care for the people of Bradford, Airedale, Wharfedale and Craven and to be one of the country’s leading providers of integrated community health care services. ‘You and Your Care’ is at the heart of our work and this year we have been focusing our efforts on how different services can work together for the benefit of patients, enhancing the quality of care we provide, whilst responding to financial challenges and the pressure of increasing demand for our services. We are transforming our services to provide ‘care closer to home’ with our expert staff providing integrated physical and mental health care working in teams based around GP practices.

Financially, we need to respond to the ‘Nicholson Challenge’ where the NHS is required to deliver an unprecedented £20 billion of savings over 5 years; within the Bradford health economy the challenge equates to £167 million and providers are expected to achieve these savings without any reduction in quality. Joining services together to make a smooth system that people can navigate easily and provides the most appropriate care is a challenge across our local health economy and we are collaborating with commissioners, care partners and local communities to do this. We hope you will find it interesting to read how our staff are changing their working practices with a greater emphasis on doing more in community settings, complementing hospital care through ‘joined up’ care pathways.

After delays in the approval system outside our control, 2013/14 has seen renewed progress with our plans to become a Foundation Trust. We have worked closely with the NHS Trust Development Authority (NTDA) in progressing our application, been part of a pilot assessment with Monitor (the independent NHS regulator) about quality governance and believe we are well prepared for our forthcoming inspection by the Care Quality Commission (CQC). Foundation Trust status will bring benefits of stronger, more local accountability and we now have over 9,000 members. We have hosted various recruitment events, membership talks and GP master classes throughout the year to develop a closer relationship with our supporters and to generate interest in Governor roles at the Trust.

In terms of changes to the Board, we have seen the arrival of Helen Bourner as our new Commercial Director, and David Banks, Non Executive Director who have brought some valuable commercial experience to our team. We have seen the departure of Ian Cherry, a Non Executive Director and Carol Stubley, Director of Finance, Contracting and Estates (albeit in April 2014) to take up a new position as Area Finance Director for South Yorkshire and Bassetlaw Local Area Team. Thank you to both of them for their strategic contribution to the organisation and we wish them well in their new roles.

On behalf of the whole Board we would both like to thank all our staff for their commitment over the last year, for their innovation in seeking out and embracing new ways of working and for their resilience in delivering high quality care under what can be, at times, extremely challenging circumstances.

Simon Large Chief Executive

Foreword by Chair and Chief Executive

Directors Report

4

5

BDCT was established in 2002 as a specialist Care Trust under section 5 of the National Health Service and Community Care Act 1990 and section 45 of the Health and Social Care Act 2001.

During 2013/14, we provided 62 different NHS services across Bradford, Airedale, Wharfedale and Craven. These can be divided into four main areas:

• Mental Health services;

• Learning Disability services;

• Community Health services; and

• Dental services.

Many of these services will be familiar to you, your families or your friends such as district nursing, health visiting, school nursing, or mental health services supporting adults, older people or children and adolescents. In addition we provide a large number of other specialist services which include supporting people with issues such as alcohol and substance misuse, early intervention in psychosis and palliative care. A full list of our services can be found at Appendix 1.

Trust VisionOur vision is:

To provide the best possible care for the people of Bradford, Airedale and Craven and to be recognised as one of the country’s leading providers of integrated community healthcare services.

In support of this vision we recognise the need to focus on service user, patient and staff satisfaction and have put the statement You and Your Care at the centre of everything we aim to achieve.

Trust ValuesAlongside You and Your Care, we have made a commitment to how the Trust and its staff will behave. This is set out in a set of values developed through a process involving many staff, patients and other stakeholders. The Trust will work hard to promote:

Respect• We value people as individuals, working with them to

achieve their goals

• We treat people with dignity and kindness

• We embrace diversity and celebrate difference

Openness• We encourage and demonstrate honest

communication

• We ensure everyone has a voice

• We are open to change and new ways of working

Improvement• We maximize use of resources to deliver best value

• We adopt a ‘right first time’ approach and learn from our mistakes, acting promptly to put them right

• We encourage accepting personal, individual responsibility at all levels, challenging each other to find better ways of doing things

Excellence• We provide high quality, safe and efficient services

• We are customer focused and deliver on our promises

• We use and develop the expertise of our staff to provide the best possible service user and carer experience

Together• We work best through teamwork celebrating our

successes together

• Users and carers are part of our team

• We work well with our partners for the benefit of the communities we serve

We believe that our values, together with You and Your Care, captures the underpinning values of the NHS as enshrined in the NHS Constitution and we work to promote these with all our staff.

About the Trust

6

PATI

ENT

EXPERIENCE

QUALITY

VALU

E FOR MONEY

RELATIO

NSHIP

S

Pers

onal

“You

giv

e m

e ch

oice

w

hen

resp

ondi

ng

to m

y ne

eds.

”

Safe

“I fe

el su

pported

and se

cure

in th

e

care

you g

ive m

e.”

Effective

“You use the latest

research so that I get

the best care.”

Involving

“You share your plans

with me and work

with my community.”

Integrated

“You bring the

experts together.”

Clear

“I’m given the latest

information to help

me m

ake a decision.”

Right Place

“My care is always

provided in the most

appropriate place to

meet my needs.”

Right Skil

ls

“I am

confiden

t that

the p

rofe

ssionals

I

see h

ave t

he skil

ls to

meet m

y nee

ds.”

Righ

t Fi

rst

Tim

e“M

y ne

eds

are

met

wit

hout

any

unn

eces

sary

dupl

icat

es, t

his

mus

t

cost

less

.”

Local

“ I can get the

care I need

close to home.”

Responsive

“ My records are shared

quickly and safely with the

people who need them

.”

Easy Access“ I understand how and

where I can get the support

I need and I don’t have

to explain myself to lots

of different people.”

RESPECT OPENNESS I MPROVEMENT EXCELLE

NCE

TO

GET

HER

You and Your Care

Vision WheelWe have four key aims to help deliver this vision illustrated through our Vision Wheel (see below) which are:

• To provide a top quality service

• To achieve excellence in patient experience

• To ensure great relationships between the Trust, its staff and stakeholders

• To deliver excellent value for money

7

Haworth

Oakworth

Riddlesden

Burley inWharfedale

Silsden

Addingham

Grassington

Horton inRibblesdale

Bentham

Cross Hills

SETTLE

ILKLEY

SKIPTON

KEIGHLEYEsholt

Idle

Eccleshill

AllertonDenholme

WilsdenCottingley

Wibsey

Low Moor

Wyke

Queensbury

BRADFORD

SHIPLEY

BINGLEY

THORNTON

BAILDON

Oxenhope

Our PartnersWe have worked closely with the three local Clinical Commissioning Groups (CCGs) – Bradford City, Bradford District and Airedale, Wharfedale and Craven CCGs – who were the main commissioners of the Trust’s health care services in 2013/14. With the changes in the commissioning landscape we have also developed relationships with other commissioners such as NHS England (who commission health visiting, dental and low secure services), Bradford Metropolitan District Council (for school nursing and substance misuse services) and Cumbria CCG (for mental health services in Craven). In 2013/14 we received a total income of £131m to invest in healthcare services.

A map of the area covered by our services by our main CCGs is shown to the right.

Our services in the context of the wider NHSIn the local context, partners across our health and social care economy have recognised that the NHS is facing enormous challenges over the next three to five years, including demographic, social and technological changes and trends that will demand a different way of delivering health and social care. There are a number of current and emerging healthcare challenges, many of which are unique to Bradford, Airedale, Wharfedale and Craven’s urban and rural districts, which will have consequences on the demand for our services.

Our services are not provided in isolation but have been shaped by a number of factors throughout the year:

• The expectations of the public, patients and partner organisations for high quality services that are available locally;

• Meeting the demands of a growing population in an area of significant health inequality;

• The ‘Nicholson Challenge’ to the NHS to find efficiency savings amounting to £20 billion over 5 years combined with severe financial pressures faced in local government and other partner organisations;

• National policy initiatives and best practice guidance, in particular the Planning Guidance issued by both NHS England and the NTDA; and

• A desire to achieve a parity of esteem between mental and physical health where the majority of mental health services are funded through a block contract arrangement.

Our Executive team has therefore been heavily involved in developing shared thinking about the nature and delivery of locally integrated health and social care functions. We have been active members of the Integration and Change Board and the two Transformation and Integration Groups across the district and have helped to shape the inter-agency agreement about integration of services: ‘Better for Bradford, Airedale, Wharfedale and Craven: Right care, Right place, First time’ (March 2014). There is a growing consensus about the need to change and we recognise that whole system reforms outlined in this agreement need to happen at a scale and pace to help deliver our own 5 year strategy.

Bradford district

H

H

airedale, Wharfedale & craven

Bradford city

8

Haworth

Oakworth

Riddlesden

Burley inWharfedale

Silsden

Addingham

Grassington


Bentham

Cross Hills

SETTLE

ILKLEY

SKIPTON

KEIGHLEY

Oxenhope

Integration across localitiesThroughout 2013/14 we have embedded a wide range of our services into four key localities. Three of these are based around CCG boundaries, subdivided into smaller geographical areas connected to GP practices as shown below. This means our staff are more connected to local populations and their healthcare (both physical and mental health) needs.

Integration Across Localities

airedale, Wharfedale & craven

H

9

Esholt

Idle

Eccleshill

AllertonDenholme

Wilsden

Cottingley

Wibsey

Low Moor

Wyke

Queensbury

BRADFORD

SHIPLEY

BINGLEY

THORNTON

BAILDON

HAWORTH

Haworth

Oakworth

Riddlesden

Burley inWharfedale

Silsden

Addingham

Grassington


Bentham

Cross Hills

SETTLE

ILKLEY

SKIPTON

KEIGHLEY

Oxenhope

Our fourth locality is based around our inpatient services, which include ward facilities at Lynfield Mount hospital and the Airedale Centre for Mental Health for adults and older people, low secure services, learning disabilities services, our intensive home treatment service, A&E liaison and psychological therapies.

East Bowling

Tyersal

Laiseterdyke

Thornbury

Broomfields

Mannigham

University ofBradford

Main Campus

Brow Wood

Peel Park

HortonPark

BRADFORD

Bradford district

Bradford city

H

10

Introduction of electronic discharges (Inpatients)

We have successfully introduced an electronic discharge process across five of our inpatient wards where GPs are now notified of a service user’s discharge within 48 hours of them leaving a ward, providing information

about the health of the service user and

any medications being taken. This was in response to commissioners and is part of our ‘Do it

once, Do it well’ approach that reduces

duplication and mitigates the risk of serious incidents through providing timely

information to other healthcare partners.

Developing information about our Adult Mental Health Acute Care pathway (Inpatients)Our Adult Mental Health Acute Care (AMHAC) pathway focuses on improving access to our acute services whilst offering high quality alternatives to hospital. We have reviewed and developed new AMHAC literature to ensure all our staff have clear and transparent information about the delivery of the service and that service users and their families are clearly told what they can expect from the service we provide.

Ward information for all Inpatient teams (Inpatients)We have developed dashboard information that is now displayed within each team/ward area across our Acute Care Pathway so members of staff, service users and carers can see information on admissions and discharges, lengths of stay, incidents, complaints and compliments, as well as HR data about levels of mandatory training, sickness and labour turnover of our staff. This information is also discussed at monthly team meetings so staff can share their successes and understand where there are areas for improvement.

Health visiting expansion (all three CCG localities)We have achieved a very challenging target to recruit more health visitors across our three localities. At the end of 2013/14 we saw an increase of 22 posts from the previous year (from 132 to 154 whole time equivalent (WTE) posts). Health visitors have a crucial role in ensuring that children have the best possible start in life and NHS England has set a collective target of increasing the number of health visitors by a further 4,200 by 2015. This increase aims to create improvements in the quality of the health visiting service for children and families with more targeted and tailored support for those who need it.

Community falls assessments (all three CCG localities)We recognise that falls and fall-related injuries can be a common and serious problem, particularly for older people who have the highest risk of falling. Falls can cause distress and a loss of independence which can also affect family members and carers, so impacting on the overall quality of life. Our district nursing service has successfully met its target around offering all patients a falls assessment and a subsequent package of care if they are found to be at risk of falls.

A selection of achievements during 2013/14 across these localities is shown below.

11

Podiatry service (AWC locality)In response to the local introduction of Any Qualified Provider our podiatry service has reviewed its workforce structure and developed a number of clinical pathways which has resulted in a central booking process and a practice of clustering home visits. The service has also introduced a new patient focus group to engage with local people using our service so we can be responsive to their needs.

Advanced nurse practitioners (Bradford District locality)The development of advanced nurse practitioners (ANPs) during 2013/14 has helped to reduce consultant caseloads. ANPs focus on both the physical and mental health needs of the services users and have been supporting our consultants by offering assessments in people’s own homes to ensure care is coordinated at the right level. As they are qualified prescribers they can also complete medication reviews and change medication in a shorter period of time.

CAMHS transition (Bradford City locality)With the number of young people requiring support on mental health related issues across inner city Bradford, our Children’s and Adolescent Mental Health Services (CAHMS) team has adapted its local practices to extend their support to school leavers from 16 to 18 year olds who are not in education. This family orientated service also helps young people with the transition into adult mental health services.

Integration of support services: Admin Hubs and introduction of the Single Point of Access (all localities)In addition to how services are organised geographically we have streamlined our administration functions, moving staff from 54 locations into six Admin hubs, and a single point of access for patients and service users was rolled-out. Calls are now handled by trained staff who either deal with a person’s query, navigate them to the correct support, such as contact with a clinical or duty team, or through to an Admin hub (such as for change of appointments). These changes have been made not only to improve and simplify access and support the wider integration of our services but will also provide clinical benefits in releasing time to care.

Changes across Information Management and Technology (IMT)We have also been looking at how we can use our IMT services to better support our clinicians. A review of information technology led to the Board approving an IMT strategy for 2014/15 which aims to provide quality information and systems to patients, commissioners and our staff. The strategy includes:

• Development of an integrated digital care record so information on SystmOne and RiO is more accessible;

• Implementation of agile working technologies for staff so that care can be delivered where it is needed closer to the patient;

• Establishing formal clinical leadership posts within the Trust for Informatics.

12

At the start of the year we set ourselves some challenging objectives to redesign some of our services and better reflect the communities we serve. Here is a summary of how we have delivered against these plans, seeing significant improvements across a number of services.

objective Progress

A reconfiguration of the services we provide for people with dementia, older people with schizophrenia and depression and adults who use our Psychiatric Intensive Care Unit (PICU) services.

Our new 12 bed PICU successfully transferred from the Airedale Centre for Mental Health to Lynfield Mount hospital in May 2013. We have approved investments for the redesign and refurbishment of both our dementia unit functional mental health unit which will result in state of the art facilities at our two main clinical sites in 2014/15.

Further development of the Acute Care Pathway which improves access to acute services and offers quality alternatives to hospital admissions.A restructuring of our psychological therapies services to support the acute care pathway and integrated local team projects.

The continuity of care medical model has been introduced where Consultants ‘follow’ service users across both community and inpatient pathways. There is a strong focus on providing more community support that should lead to a reduction in the length of stay and occupancy on our wards.

A new psychological therapies structure has been introduced following engagement of staff and during the year we received additional funding to improve access to psychological therapies (IAPT).

A review of community health services to bring together adult community teams supporting people with both physical and mental health needs.

We have reviewed the role of district nurses to get a clear view of the capacity and demand challenges we face. This year we delivered over 333,000 contacts (compared to 312,000 contacts the previous year) and satisfaction levels with district nursing services stood at 97%.

Development of integrated teams to support populations around GP practices.

We have introduced a single point of access for patients requiring access to adult mental health services across Bradford, with clinical and admin teams working together to ensure timely and effective responses.

Delivery against 2013/14 Operational Plan

13

National Targets

national indicator2011/12

performance2012/13

Performance2013/14target

2013/14 performance

trust position

Number of in-patients being followed up (Patients receiving Contact within 7 days Discharge)

97% 95.5% 95% 97.9% Target met

CPA patients having a formal review within 12 months

96.% 95.1% 95% 95.1% Target met

Minimising Delayed Transfers of Care (Health)

1.0% 3.1%Less than

7.5%3.8% Target met

Admissions to Hospital were accessed via Intensive Home Treatment Teams (IHTT)

99.4% 96.4% 95% 100% Target met

Access to healthcare for people with a learning disability

6 Green 6 Green 6 Green 6 Green Target met

Completeness of Mental Health Minimum Data Set (MHMDS) – Part 1

99.4% 99.3% 97% 99.1% Target met

Completeness of MHMDS – Part 2 84.2% 90.6% 50% 85.3% Target met

New psychosis cases by Early Intervention teams

100% 244.3% 95% 215.4%* Target met

Dental referrals to treatment – waiting times (admitted)

18.6% 100% 90% 100% Target met

Dental referrals to treatment – waiting times (non-admitted)

13.2% 97% 95% 100% Target met

Dental referrals to treatment – waiting times (incomplete pathways)

- 99.7% 92% 100% Target met

* EIP has a historical target of supporting 97 new cases a year. BDCT currently takes on more cases than the target each year, resulting in a higher percentage reported.

Transforming Care ProgrammmeIn addition to these service development plans we have also been delivering a major programme of transformational change through our Transforming Care Programme (TCP) which complements ongoing service development work and has longer term benefits in delivering our 5 year strategic plan.

This programme has included:

• Development of our children and families services, seeing an expansion of our health visitor, family nurse partnership and school nursing services;

• Development of our allied health professionals, particularly our podiatry and speech and language services;

• A review of our substance misuse services ahead of any market testing exercise; and

• Ongoing work to create detailed packages of care for each of the twenty mental health clusters (groups of people identified with a similar diagnosis).

Further work is planned for 2014/15 mapping out a vision for a number of clinical pathways around alcohol liaison, dementia, tissue viability and continence.

Operational performanceIn terms of monitoring our performance we have a framework in place which routinely measures our business against a range of key performance indicators (KPIs). These KPIs are a mixture of nationally recognised targets and those which our Board of Directors has identified to monitor the efficiency and effectiveness of the organisation.

During the year our Board monitored performance monthly against CQC registration, compliance with national outcomes and our own quality and risk profile. The Board has also agreed a wide range of other local KPIs which are reported to the Board’s Service Governance, Mental Health Legislation, and Finance, Business and Investment Committees.

The tables below highlight our performance during the year set against national targets, local commissioner targets and workforce targets, with previous data as a comparison. A brief description about what each KPI means is included at Appendix 4.

In 2013/14 we were asked by the NTDA to set some aspirational ‘stretch’ improvement targets. These have been reported to the Board since April 2013 and have shown mixed performance. Year end position shows the highly challenging nature of these targets but the trend of performance is moving in a positive direction.

14

National Targets

local indicator2011/12

performance2012/13

Performance2013/14 target

2013/14 performance

trust position

Improving access to psychological therapies – percentage of people completing treatment and moving to recovery

57% 94.8% 60% 64.8% Target met

Percentage of mothers with breast feeding status recorded

96.5% 95.9% 95% 96.9% Target met

Percentage of mothers breast feeding at 6-8 weeks

41.75% 39.7% 42% 40.1%Target not

met

Percentage received HPV vaccine – Dose 3 cumulative

89.9% 91% 90% 93.7% Target met

Number of health visitors in post 116.7 132.44 146.66 154.17 Target met

Workforce targets

local indicator2011/12

performance2012/13

Performance2013/14 target

2013/14 performance

trust position

Mandatory training 75.1% 80.9% 80% 83.7% Target met

% Staff receiving appraisal 68.1% 82.4% 80% 83.9% Target met

% Medical staff appraisals 89.4% 96.2% 100% 100% Target met

Labour turnover 9.8% 7.9% 10% 9.1% Target met

Sickness absence rate 5.6% 5.5% 4% 5.63%Target not

met

NTDA ‘Stretch’ Improvement targets

local indicator2013/14 target

2013/14 performance trend

CPA patients receiving follow up within 3 days of discharge 95% 76.6% hCPA patients having a formal review within 12 months 97% 95.1% nAdult mental health average length of stay(YTD) 35 48.7% iAdult mental health occupancy rate (excluding Leave) <85% 98.9% iPrevalence of pressure ulcers, recorded using the Safety Thermometer (YTD)

4.4% 3.5% h

15

Delivering our CQUIN targetsCommissioning for Innovation and Quality (CQUIN) schemes are a package of quality and improvement goals and targets locally agreed with commissioners that aim to incentivise trusts to deliver new priorities related to quality. In 2013/14 we agreed CQUIN schemes with a number of commissioners to the potential value of £2.4 million. The indicators within the CQUIN schemes were based on local and national priorities to reflect innovation and quality.

The benefits from these schemes have included:

Improved partnership working with other local agencies – identifying the people at

greatest risk of admission to acute and long term care and making sure they

receive one assessment from a range of health care experts involved in their care.

On discharge from our adult mental health wards, an electronic document is sent to the service users GP within 48 hours, identifying

on-going care needs.

Proactively identifying people who are at risk of falling and putting

interventions in place to prevent falls.

Improved low secure service patients physical health and wellbeing by receiving

healthcare screening and interventions.

16

Improving patient safety, ensuring effective service delivery and improving the patient experience, are crucial in terms of providing high quality services. We strive to make year on year improvements in these areas to ensure that we continue to provide a positive experience for our patients.As with previous years, we have produced a separate Quality Account which sets out our commitment to improving the quality of services that we deliver. This also helps to demonstrate to our commissioners, patients, service users, carers and the wider community our commitment to delivering excellent services. The Quality Account summarises our progress against the targets we agreed last year with our commissioners and other statutory bodies. In response to feedback from service users, patients and carers we have included more qualitative text in this year’s report (rather than measures and numbers) to describe the work we have been doing. A selection of items from the 2013/14 Quality Account is included in this report. To access the full report please go to www.bdct.nhs.uk/qualityaccount

Care Quality Commission Registration StatusAs a provider of NHS services we are required to register with the CQC and our current registration status is ‘fully registered’. During the year we have participated in four routine inspections undertaken by the CQC; two at Lynfield Mount hospital and two at the Airedale Centre for Mental Health. The CQC reviewed five areas and we were deemed to be fully compliant with all CQC outcomes. The CQC has not taken any enforcement action against us during 2013/14.

Our approach to patient involvementInvolving patients and listening to their experiences is at the heart of our vision and our ‘You and Your Care’ approach. During 2013/14 we commissioned Professor Mark Gamsu of Leeds Metropolitan University to review our Involving You 3 strategy, which aims to describe the way in which we should be involving people. Findings from this review have identified recommendations which will be implemented to improve the way we work going forward into 2014/15 and will have a positive impact on our quality outcomes.

We have also had some significant achievements during 2013/14 and some examples are described below:

• Fifteen Steps Quality Challenge: a number of challenge visits have taken place across our in-patient and community services. Service users and carers have been fully engaged in conducting these visits, the results of which are fed back to services to support improvement. We also invite all complainants to join us in our 15 Steps Quality Challenges;

• Quality Accounts consultation: an event was held in January 2014 and was well attended; prior to the event, a service user and carer workshop, a staff survey and a members’ survey were undertaken and information from these approaches fed into the main event. This has resulted in a robust and challenging set of quality indicators being developed including a number of stretch targets; and

• Patient Stories: these were introduced at Trust Board meetings in early 2013 to provide Board members with a greater understanding of the services we provide and a more personalised connection with our patients, service users and carers.

Our Commitment to Quality

17

Dealing with ComplaintsWe take complaints very seriously and use them as a way of improving services. Service users and carers are encouraged to contact our Patient Advice and Liaison Service (PALS) or complaints service if they are unhappy with a service they have received.

Every three months we have a Complaints Review Panel. This is chaired by a Non Executive Director. An individual complaint and investigation is looked at in greater detail, and feedback provided on the lessons learnt is reported to our Service Governance Committee.

We want to work with any individual who has a complaint in a fair, open and honest way. If problems are found, we share any lessons learnt across the whole organisation. Our complaints process helps us to clearly set out a person’s issues, our response and look at where we might improve our services as a result. At the end of the complaints process, we ask that person to tell us how they think we handled their complaint. Any actions are then looked at by the service managers involved.

During 2013/14, we received 80 complaints, compared to 84 complaints in 2012/13, as shown below:

2011/12 2012/13 2013/14

Total number of formal complaints

71 84 80

Responses within timescales agreed with complainant

100% 100% 96%

Total number of compliments

188 199 473

Complainants who are dissatisfied with our response have the right to ask the Parliamentary and Health Service Ombudsman (PHSO) to reconsider their complaint. The PHSO has published a guide that we follow called the ‘Principles of Remedy’ which sets out solutions where an injustice or hardship has been caused as a result of the way a complaint has been handled or because of poor service.

In 2013/14 we are aware of one complaint referred to the PHSO. The case file has been shared with the Ombudsman for review prior to them deciding if they will investigate further.

During the year we have continued to look again at our services in light of complaints received. Several improvements have been made as a result. These include:

• Guidance on confidentiality situations which will be added into the Carers toolkit for clear guidance to staff;

• A secure system for sharing written information is now available for school nursing staff and can be shared with social care staff where detailed health information is required for the purposes of completing assessments;

• Arrangements for the cover of therapists absent for long periods of time, with therapists working within secondary care becoming part of a larger locality therapy team as they combine with Primary Care Mental Health Teams; and

• A Prescribing Medication Audit will be undertaken against an agreed criteria of standards regarding the process of prescribing medication and the communication to GPs.

PALS (Patient Advice and Liaison Service)Our PALS service provides support in resolving initial problems and concerns that service users, patients and carers may have. It offers confidential advice, often acting as a sign posting service for information about the NHS and health related matters. Our PALS service received 1,323 enquires this year. The top three issues highlighted were issues around information, staff attitude, and support. This year we have reviewed our PALS and Complaints publicity, including leaflets and information for patients which are on the Trust website and provided staff with more information about local resolution of complaints and good practice in complaints handling.

18

Risk ManagementEffective risk management is the cornerstone of safety and we embrace an open and learning culture which encourages all staff to report risks, incidents and potential incidents thereby facilitating individuals and the organisation as a whole to learn from such reports. We are one of the highest reporting Trusts of patient safety incidents in the country (seen as a positive approach) but have lower than average levels of harm, illustrating our open and transparent reporting culture.

Our risk management strategy sets out both the collective responsibilities of the Trust Board and its Committees and the individual responsibilities of the Chief Executive, Directors and all levels of staff across the Trust. The overall aim of the strategy is to ensure that high quality health services are delivered to reflect the safety and well being of those using our services and those working within the organisation.

A Board workshop in 2012/13 instigated a number of risk workshops in 2013/14 across our services. This work has enabled us to identify the knowledge and skills levels on risk processes and the capture of views and opinions of Executives, Senior Managers and front line staff. The outcomes of the workshops is being utilised to enhance the programme of work for 2014/15 which will also include further development work on our risk appetite.

2013/14 saw risk registers being rolled out further across all community services leaving no gaps. This now means that all local services have live risk registers allowing all staff to have access and input to risk registers ensuring frontline staff are involved in the dynamic identification and mitigation of risks and allows for a wider degree of analysis across the whole Trust.

Emergency PlanningOur staff need to be prepared to respond effectively to significant and major incidents. Such incidents could involve us working with and alongside a range of public and emergency services. To enable this process we have regular membership on a number of multi – agency groups to support such collaborative working.

We maintain a significant and major incident plan which complies with the NHS England Emergency Preparedness Framework and associated national NHS emergency on-call core competencies for key individuals and teams. This plan is supported by a business continuity management system and additional specific plans, for example, a pandemic plan. Improvement and embedding of the organisation’s emergency preparedness is being continuously achieved through the regular review and validation exercises of our emergency systems and processes.

The Business Continuity Management System established and implemented in 2012/13 has been strengthened as a result of lessons learned from both the validation exercise process and from actual incidents where gaps have been identified and appropriate action taken to address the issues identified. 2014/15 will include a detailed validation exercise focusing on our command and control framework following the introduction of specific training for key individuals with allocated emergency response roles and responsibilities.

The key achievements during 2013/14 include:

• A full review, revision and approval of our resilience documentation;

• Delivery of a full programme of internal validation exercises conducted for all service areas with approved Business Continuity Plans; and

• Improved partnership working through the mental health emergency planning forum which includes similar organisations across the North of England region.

Patient-Led Assessments of the Care Environment (PLACE)We believe that a high quality inpatient environment can help with recovery. A new patient-led assessment of the in-patient ward environments commenced in April 2013 replacing the annual Patient Environment Action Team (PEAT) assessment. The PLACE team comprises at least 50% patients and/or members of the public, demonstrating the commitment to increased public involvement and ensuring the patient voice plays a significant role in determining assessment outcomes and further actions. The PLACE team undertakes an annual inspection of all in-patient wards scoring non-clinical aspects of patient care including:

• Cleanliness;

• Food and hydration;

• Privacy, dignity and well-being; and

• Condition, maintenance and appearance of the ward environment.

Comments from the patient assessors have included:

• The hospital was light and airy, no smells and well maintained;

• Staff very open and friendly and attentive to service user needs;

• Food exceeded expectations. Range and choice is exemplary. Meals were well-thought out, nutritious, of a high standard and beautifully presented; and

• The seating areas are comfortable, well lit and inviting.

Our PLACE scores for 2013/14 were above the national average in the 4 domains of PLACE:

Place doMainnational

averaGe %trUst

ratinG %

CleanlinessReceptionCorridors, lifts & stairwellsWard areasPatient equipmentHand hygiene

95.74 99.52

Food & HydrationMenu cycle;Choice & availability;Quality & quantity (portion size);Temperature;Presentation;Service & support;Beverages

84.98 95.51

Privacy, Dignity and WellbeingSleeping accommodation;Toilets & bathrooms;Privacy;Confidentiality;Modesty, dignity and respect;Social spacesWomen only day areas;Activity areas (indoor).

88.87 95.06

Condition Appearance and MaintenanceSignageBuilding maintenance & appearanceGrounds appearance, maintenance & tidinessInternal decorationInternal fixtures & fittingsFurniture

88.75 92.14

19

20

Cleanliness AuditsCleanliness audits are carried out in all of our patient areas. The target is for each area to achieve an audit score of 87% or higher. The following chart shows our cleanliness audit scores for 2013/14; all areas exceeded the 87% target.

Area Performance

Organisation = BDCT In-Patient For Audits made between: 01/04/2013 and 01/04/2014

Overall performance: 94.07%

BlocKno of audits

no of checks % 0% 100%

Ashbrook 12 2477 93.70

Assessment & Treatment Centre 12 2539 95.27

Baildon Ward 12 2616 94.27

Clover Ward 13 2914 96.71

Duchy Court 12 2505 95.65

Fern Ward 12 2450 94.94

Heather Ward 12 2546 93.87

Ilkley Ward 12 2478 93.50

LMH Out patients, Helios, Psychotherapy

12 2429 91.60

Maplebeck 12 2395 92.70

Moors Suite 12 2115 94.85

Oakburn 12 2477 90.43

Step Forward Centre 12 2540 95.87

Thornton Ward 12 2461 93.74

21

Research and Development (R&D)Taking part in clinical research shows our commitment to improving the quality of care we offer. It also makes sure we are contributing to wider health improvements. Research helps our clinical staff stay at the cutting edge of treatment possibilities, which can lead to even better patient outcomes.

Over the past year, our continued investment in research, together with West Yorkshire Comprehensive Local Research Network (WY CLRN) funding, has resulted in real progress in achieving and exceeding the goals of our research strategy. The aim is to develop our ability and reputation to deliver excellent applied health research, with the potential to improve the health and well being of the people we serve.

Over the past year our staff have been involved in twelve publications. Examples of these are:

• Understanding the ‘guide’ in guided self-help for disordered eating: a qualitative process study – British of Psychological Society.

• Smoking cessation in Long term conditions: Is there an opportunity in every difficulty – International Journal of Population Research.

• A pilot cluster randomised controlled trial of Stop Delirium! (PiTStop) – A complex intervention to prevent delirium in care homes for older people: study protocol – Trials.

Information governanceWe recognise the importance of managing information appropriately and securely and Helen Bourner, Commercial Director, is our Senior Information Risk Officer (SIRO). This role is responsible for ensuring the Board has assurance that appropriate controls are in place and that risks are properly managed in relation to all the information used for clinical, operational and financial purposes.

Information governance and information risks are controlled and managed through our Information Governance (IG) Toolkit, which provides a framework to enable organisations to assess their compliance with current legislation, Government directives and other national guidance. The Toolkit encompasses 45 criteria, each of which has four score levels: 0, 1, 2 or 3. In order to be compliant with the toolkit in 2013/14, a minimum score of 2 in all 45 criteria must be achieved. We have once again reached full compliance. The final submission had 35 requirements at level 2, nine at level 3 and one which was deemed not relevant to the Trust.

Charging for InformationWe are also required to report our compliance on setting any charges for information as detailed in the Treasury’s report Managing Public Money. We have a charging policy for accessing personal records which is in keeping with the Data Protection Act 1998. The number of requests for information under the Freedom of Information Act (FOI) and the Data Protection Act (DPA) is shown below, reflecting the increase in services provided by the Trust.

2011/12 2012/13 2013/14

Requests under FOI 145 158 200

Requests under DPA 317 403 442

Disclosure of Serious Untoward Incidents (SUIs)The number of Serious Incidents reported on STEIS (categories relating to incidents resulting in severe harm or death to patients) in 2013/14 has tripled since 2012/13 to 111 Serious Incidents, which is a direct result of the 75 Pressure ulcers that have been reported as a new category on STEIS throughout the year. There were 36 other Serious Incidents reported in total in the year and this is in line with previous year’s figures. The Trust has not had any ‘Never Events’.

Since June 2013 the NHS Serious Incident Framework reduced the timescales for completion of Serious Incident reports from 12 weeks to 9 weeks. As a result of this the amount of reports that were compliant with the timescales has reduced to 87.9%. All pressure ulcers have been reported within the 9 week timescale. Learning from serious incidents has included discussions at the Serious Incident Forum and Clinical and Safety Learning Forum, acting on recommendations from the National Confidential Inquiry for Suicides and Homicides and the production of a Serious Incident newsletter shared with frontline staff.

22

Workforce strategyWe have approved and are actively implementing a new 5 year workforce strategy across the organisation. The strategy aims to ensure that:

• Our organisation has an expertly led, flexible, skilled, engaged, healthy and motivated workforce with the necessary competencies, capacity and capability to enable transformation; and

• We become an employer of choice, able to attract and retain talented individuals.

The strategy is based upon the locality-based structure that delivers integrated care across multi – disciplinary teams. Teams will work flexibly supported by technology to access patient information, so reducing the need to work from or return to base to update records. We are working hard with staff to ensure they are fully engaged and they are able to contribute to the wider transformation agenda.

Leadership and Talent managementPart of our workforce strategy is to provide a planned approach to leadership development and talent management. The challenges within the NHS are much more complex and varied than we have previously experienced; this requires a different style of leadership to help staff successfully navigate through new ways of working. To help identify and nurture future leaders we have put in place a number of developments including:

• A team leader development programme;

• A BME leadership programme;

• A successor to Exciting Futures pilot programme;

• Coaching and mentoring programmes (to develop capacity and capability at all grades);

• A medical leadership development programme; and

• Leadership development centres to identify candidates for the Exciting Futures programme and support career development and management.

Staff partnershipsStaff Side representatives continue to play a key role in staff engagement and involvement, during very challenging times. During the year we have invested in the development of our Staff Side representatives to improve partnership working and we have well established mechanisms for engagement and consultation through our Staff Partnership Forum. Significant changes have been implemented working with the unions to deliver workforce efficiencies whilst maintain the quality of services. Agreement has been reached on recruiting to 36 hour contracts and we continue to offer staff a flexible range of benefits as part of our wider employment offer.

Workforce analysisOur age profile indicates that the Trust has an ageing workforce with over 29% of the workforce aged 50 or over. Whilst this provides us with a tremendous amount of experience it does present some challenges in terms of retaining staff in key roles such as health visiting and district nursing, where it is known that demand for these services will increase significantly. It also provides us with opportunities to change the profile of our workforce.

Our Workforce

We rely on a well-motivated and skilled workforce to look after our service users and patients with care and compassion. We know that good quality services can be enhanced when people enjoy their work and are committed to the values of an organisation. We therefore take time and effort to involve our staff and keep them informed about changes taking place across the Trust and any opportunities for personal development.

9 people Below 20 years old

352 people 21-30 years old




109 people 61+ years old

23

Information on health and safety performanceOur Board is committed to providing and maintaining a safe and health working environment and compliance with all relevant health and safety legislation. The Trust has an approved health and safety policy and a report about health and safety is submitted annually to the Finance, Business and Investment Committee, which includes issues such as RIDDOR (Reporting of Injuries, Diseases or Dangerous Occurrences) reportable incidents, first aid training and health and safety targets adopted across our organisation.

NHS Staff survey 2013Every year our staff take part in the NHS Staff Survey which is an important way of measuring staff satisfaction. The results of the 2013 survey showed a number of improvements and highlighted a number of areas where further improvements are required. We were placed within the mental health and learning disabilities sector; the group within which our performance is most easily compared. The average response rate from mental health and learning disability trusts was 46% compared to our response rate of 47%.

Key Workforce indicators from the 2013 Staff Survey:

indicatorsagreed improvement target / Benchmark 2013/14 2012/13

% Of staff able to contribute towards improvements at work (NHS Staff Survey)

72% National Average

76% 73%

Staff recommendation of the trust as a place to work or receive treatment (NHS Staff Survey)

3.55 National Average

3.58 3.69

Staff motivation at work3.85

National Average3.91 3.97%

% Of staff agreeing that their role makes a difference to patients


89% 90%

% Of staff able to contribute to improvements at work


76% 73%

The key findings for our Trust meant that:

• We are in the best 20% of organisations for 9 out of 28 key findings;

• We are average or better than average in 13 out of 28 key findings;

• We are worse than average in 4 key findings;

• We are in the worst 20% of organisations for 2 key findings;

• The overall staff engagement score has slightly decreased from last year’s score and we are now better than average whereas previously we were in the top 20% when compared to other similar Trusts;

• The overall risk profile of the Trust has been broadly maintained in relation to the HSE Stress Management report. There have been 8 improvements and 6 deteriorations; and

• Key improvements and areas of satisfaction are in the percentage of staff:

o witnessing potentially harmful errors, near misses or incidents

o reporting errors, near misses or incidents

o fairness and effectiveness of incidents reporting procedures

o lower levels of physical violence, harassment, bullying or abuse from patients, relatives or the public

o lower levels of physical violence, harassment, bullying or abuse from staff

o able to contribute towards improvements at work

o staff motivation at work.

The key areas for development and improvement were in the percentage of staff:

• Experiencing work pressure;

• Feeling pressure to attend work when unwell;

• Feeling supported by their immediate managers;

• Having equality and diversity training;

• Believing the Trust provides equal opportunities for career progression or promotion; and

• Experiencing discrimination at work.

In response to staff feedback, in 2014/15 we will be looking closely at developing ways to address workplace stress and wellbeing, equality and diversity training and management, leadership and team leader development.

The results of the full staff survey can be found at www.nhsstaffsurveys.com


24

Sickness absenceReducing levels of sickness absence continues to be one of our major workforce challenges. Our end of year performance recorded a figure of 5.6% against a challenging target of 4%. There has been significant activity at all levels from the Board of Directors down to individual teams to manage sickness. A ‘deeper dive’ discussion was held by the Board into the causes of long term and short term sickness, the interventions to support reducing sickness absence rates and planned developments to address this target in 2014/15.

The Trust Board has recognised that some sickness absence is related to the scale and pace of organisational change compounded by the wider economic climate. A number of developments to help managers and their staff have been introduced during the year including:

• A health a wellbeing strategy for staff, including health eating, resilience/mindfulness classes, stress management advice and exercise challenges;

• A review of the sickness absence policy looking at best practice from elsewhere;

• Robust management of cases involving HR, occupational health and service managers; and

• Plans to introduce the ‘Bradford Score’, a review tool to examine short-term patternable absences, as it is recognised that this can be more disruptive than longer absences.

Details of the number of staff days lost are found below:

staff sickness absence

total2012/13number

total2013/14number

Total Days Lost 32,776 24,390

Total Staff Years 2,665 1,927

Average working Days Lost

12 13

Promoting equality and valuing diversityThe Trust embraces diversity, celebrates difference at all levels and takes active steps to promote good practice both as a service provider and an employer. This is particularly important to us as it is a reflection of the richly diverse community that we serve across Bradford, Airedale and Craven.

We have a diverse highly skilled workforce and recognise the importance of diversity across teams. Details of the ethnicity profile of our workforce are shown below. We have seen a steady increase in BME staff employed within the workforce between 2011 and 2014, from 18.8% in March 2011 to 19.7% in March 2014. The highest proportions of BME staff are located within Medical & Dental Staff, and unqualified staff. The lowest proportions of BME staff remain within management.

As a result, a concerted effort has been made during 2013/14 to progress the BME diversity in employment agenda. Whilst it is acknowledged that the diversity and inclusion agenda is far wider than BME issues, we recognise the importance of the workforce reflecting the communities served and the two-way benefits this provides.

To create an environment where our workforce, at all levels, is representative of the community we serve, we are embarking on plans over the next two years to:

• Target development interventions for BME staff in Bands 5 and 6;

• Create a senior led sponsorship programme;

• Review the impact of the BME network to ensure it is structured in a way to support the delivery of the strategy; and

• Identify a Board champion for diversity.

25

Ethnicity

Any Other Ethnic Group (12 staff)

Chinese (4 staff)

Any Other Black Background (7 staff)

African (49 staff)

Caribbean (38 staff)

Any Other Asian (21 staff)

Bangladeshi (19 staff)

Pakistani (201 staff)

Indian (98 staff)

Any Other Mixed (4 staff)

White & Asian (13 staff)

White & Black African (2 staff)

White & Black Caribbean (12 staff)

Any other White Background (57 staff)

White Irish (27 staff)

Breakdown of our workforce by ethnicity

NHS Equality Delivery SystemIn 2012 we agreed to use the NHS Equality Delivery System (EDS) as a framework for meeting the Equality Act general duties to:

• Eliminate discrimination, harassment, victimisation and any other conduct that is prohibited by or under this Act;

• Advance equality of opportunity between persons who share a relevant protected characteristic and persons who do not share it; and

• Foster good relations between persons who share a relevant protected characteristic and persons who do not share it.

We have worked in partnership other local providers and commissioners to consider equality across the whole health economy. Evidence of equality performance and activity has been presented annually to a group of 40 local stakeholder organisations from the voluntary, community and faith sector. The Airedale, Bradford and Craven NHS Equality Group has agreed performance grades for each organisation. Our performance grades (which are available at http://www.bdct.nhs.uk/equalityanddiversity/) show that we are compliant with the Equalities Act using the EDS process, having 93 objectives rated as ‘achieving’, 60 objectives rated as ‘developing’ and no areas that were marked as ‘not achieving’.

We can demonstrate our commitment to the principles outlined in the Mindful Employer Charter, ensuring that we are positive about recruiting, retaining and supporting those who have experienced mental ill health. We are committed to selecting candidates on merit and work hard to ensure we comply with anti-discrimination legislation. We also hold the ‘Two Ticks’ symbol that demonstrates our commitment to employing people with disabilities and ensures that those applicants with a disability that meet the short listing requirements are guaranteed an interview.

26

Celebrating with our staff – You’re A Star Awards (YASA)Now in its sixth year, and once again supported by Sovereign Healthcare, the YASA highlight the hard work and commitment shown by our staff every day. This year’s event was organised around the four aims of our Vision Wheel – Patient Experience, Quality, Value for Money and Relationships and a special You and Your Care Award. Over 60 nominations were received and the winners will be honoured at an awards ceremony in June 2014. Congratulations go to all those who were nominated, with a special recognition to the five winners shown below:

Patient exPerienceSafe Swallowing Recipe Book Team

Value for MoneyThe Salaried Dental Service and Bradford Working Women’s Service

Working togetherFern Ward, Airedale for Mental Health

you and your careMuqtader Ahmed, Healthcare Support Worker at Airedale Centre for Mental Health

QualityContinence Service

27

Wider recognition of our staffIndividual members of staff and teams across the Trust have also been recognised externally for the contribution they have made during the year, illustrating the diversity of our services, as shown below:

Winners

Kate Dale won the award for Patient Safety in Mental Health at the National Patient Safety awards.

Debra Gilderdale won the Yorkshire and Humber NHS Leader of the Year award for Partnership/System leadership.

The Housekeeping team at the Airedale Centre for Mental Health won the Best Cleaned Premises award at the Golden Service Awards.

The Human Resources team won the Best Improvement of HR Capability award at the national Healthcare People Management Association awards.

Isabelle Macdougall was awarded the Community Practitioner Team Leader of the Year at the national Community Practitioners and Health Visitors Association awards.

Sally Rushworth was identified as the Health Visiting Practice Teacher of the Year by Leeds Metropolitan University.

Neil Buckingham was awarded a Florence Nightingale Foundation’s Travel Scholarship.

Courtenay White won the Yorkshire and Humber Advanced Non-Clinical Apprentice of the Year.

Shortlisted

The Estates Maintenance team and the Energy and Environment team were both shortlisted in the national HSJ Efficiency Awards.

Fiona Sherburn was shortlisted in the regional NHS leadership awards under the category ‘Mentor / Coach of the Year’.

The Trust was highly commended in two areas of the national Good Practice awards for its work around best practice in managing safe discharges and for excellence in monitoring and evaluating the Care Programme Approach process.

28

Long service awardsIn February 2013, the Chair and other members of the Board hosted our long service awards, to recognise staff with 25 or 40 years continuous service in the NHS, with over 1,300 years’ service in total. We have celebrated long service awards for over 17 years to show our support to those members of staff who have demonstrated a long term commitment to delivering healthcare locally.

30

In terms of recruiting and engaging members we now have over 9,000 members and during the year:

The key achievements in the year are summarised below:

• Submission in April 2014 of an action plan to the NTDA about how the Trust responded to the recommendations of the Francis Inquiry – known as our Taking Quality Forward 2 programme;

• A successful quality visit by the NTDA in May 2013 and subsequent observation of the Board’s Committees;

• Submission of a refreshed 5-year Plan in June 2013;

• Two Board-2-Board meetings with the NTDA in May and September 2013; and

• Submission of a 2-year business plan to the NTDA in March 2014.

Two key events during the year have affected our FT application. Firstly, in response to the publication of various Francis-related reports, the CQC announced it was to develop a new quality assessment and inspection process for all providers. This meant that aspirant FTs are required to pass the new CQC inspection in order to be assessed by Monitor. The first tranche of inspections in early 2014 were focused on aspirant FTs already in the Monitor pipeline. Our CQC inspection was confirmed for the first quarter of 2014/15 and we have been communicating widely with staff to help us prepare for this.

Secondly, we were one of two Trusts invited to take part in a pilot carried out by Monitor to assess our quality governance arrangements. The pilot has been very useful to check how we evidence quality against Monitor’s own assessment process and we received a positive assessment which reinforced our ability to continue on our FT trajectory.

Monitor has identified some areas of work for 2014/15 which include:

• Developing our risk management arrangements at locality levels;

• Embedding the quality impact assessment process on our Cost Improvement Programmes;

• Demonstrating how the Service Governance Committee seeks assurance on quality issues; and

• Linking our strategic quality objectives more with local plans.

Progress with our Foundation Trust application

2013/14 has seen significant progress in our preparations to become a Foundation Trust. The Board of Directors, senior management and staff have worked closely with the NTDA (who took over the role of considering FT applications from the Department of Health) to demonstrate we are a high performing, sustainable organisation.

We have been out in the community talking to people about our work and

membership opportunities in Bentham, Bingley, Bradford, Keighley and Skipton.

We held four events in Ilkley to successfully raise our profile in this area where we

have previously been under-represented.

We hosted and number of membership health promotion/

engagement events covering Overcoming Dental Anxieties (April), Diabetes and Footcare

(October), Overcoming Depression through Wellness Recovery Action

Planning (March) and Unusual Thinking (such as hearing voices and delusional thinking) (March).

We have been developing our relationships with GPs and other clinicians through our Primary Care

Master Class Programme. During the last year, these have focused on: our Secure Psychiatric

Services (April), Adolescents and the Drugs they Use (October), Early Intervention in Psychosis (December), Introduction to Motivational Techniques (February).

We hosted nine external Governor Awareness events

aimed at attracting members who might consider themselves for the role of a Public or Staff

Governor. These resulted in over 50 people expressing an interest in the Governor role and would mean all elections being contested later in 2014.

We arranged our Annual General Meeting which attracted over 300 people who were also given an

opportunity to receive a free healthcare MOT.AGM

31

32

Ongoing Energy UsageWe are now using 29% less electricity and 54% less gas compared with our historic baseline of energy use and we are emitting 2,845 fewer tonnes of carbon dioxide per year, a 45% reduction in our historic baseline emissions.

electricity Gastotalco2

tonnes

co2 reduction from Base

yearkWh

conversion factor

co2 tonnes kWhconversion

factorco2

tonnes

2007/08 5,246,000 0.43 2,256 21,163,000 0.19 4,021 6,277

2008/09 4,915,000 0.43 2,113 19,861,000 0.19 3,774 5,887 6%

2009/10 4,700,000 0.43 2,021 17,921,000 0.19 3,405 5,426 14%

2010/11 4,425,000 0.43 1,903 16,130,000 0.19 3,065 4,967 21%

2011/12 4,305,000 0.43 1,851 14,114,000 0.19 2,682 4,533 28%

2012/13 4,140,884 0.43 1,781 11,270,934 0.19 2,141 3,922 38%

2013/14 3,708,351 0.445 1,650 9,679,725 0.184 1,781 3,432 45%

The table above shows the sustained reduction in energy use and carbon emissions achieved over the last seven years.

Waste

Sustainability Report

In 2012 we moved to a total recycling contract for all domestic wastes. An ongoing awareness campaign throughout 2012 and 2013 provided staff with guidance documents and bespoke training sessions for domestic and clinical staff. Significant progress has been made, and whilst there are still further opportunities for improvements, we remain focused on achieving the full waste recycling segregation by the end of 2014.

Currently we have recycling in place for all electrical items, reuse of mobile phones, IT equipment, batteries, paper, card, plastics, metals, glass, food oils, toners and ink cartridges where applicable. The clinical waste streams are now split into incineration grades and autoclave grades. The separate disposal of autoclave grade wastes produces significantly less CO2. Food Services is looking to process food waste through a site based Biogester to meet proposed new legislation, a capital bid is being prepared.

Carbon Reduction Commitment Energy – Efficiency Scheme (CRC)The CRC Energy Efficiency Scheme is a mandatory energy saving and carbon emissions reduction scheme for the UK. Duties under the scheme are based on total energy usage. Our sustained reduction in energy use means we have no Duties under the Scheme.

EU ETS – Greenhouse Gas Allowance – Trading SchemeUnder the EU Emissions Trading Scheme (ETS), large emitters of carbon dioxide within the EU must monitor their CO2 emissions, and annually report them. Our sustained reduction in carbon dioxide emissions means we have no Duties under the Scheme.

Display Energy Certificate PerformanceDisplay Energy Certificate (DEC) performance continues to be a priority for NHS Trusts. A performance rating of 100 (grade D) is considered to be typical performance compared with other buildings of its type and use. Due to estates rationalisation we now have eight properties over 1000m3 requiring DECs. Of these five are above the typical performance rating and we are focusing energy efficiency programmes at the remaining sites.

In addition from January 2012, DECs were required for buildings exceeding 500m3. DECs for these properties are only required once in every 10 years. We have seven properties in this category and DECs have been registered for all these properties. Six of these seven properties have performance ratings better than 100 (grade D).

33

Statement of the Accountable Officer’s ResponsibilitiesThe Chief Executive of the NHS Trust Development Authority has designated that the Chief Executive should be the Accountable Officer to the Trust. The relevant responsibilities of Accountable Officers are set out in the Accountable Officers Memorandum issued by the Chief Executive of the NHS Trust Development Authority. These include ensuring that:

• There are effective management systems in place to safeguard public funds and assets and assist in the implementation of corporate governance;

• Value for money is achieved from the resources available to the trust;

• The expenditure and income of the trust has been applied to the purposes intended by Parliament and conform to the authorities which govern them;

• Effective and sound financial management systems are in place; and

• Annual statutory accounts are prepared in a format directed by the Secretary of State with the approval of the Treasury to give a true and fair view of the state of affairs as at the end of the financial year and the income and expenditure, recognised gains and losses and cash flows for the year.

To the best of my knowledge and belief, I have properly discharged the responsibilities set out in my letter of appointment as an Accountable Officer.


Significant Sustainability Projects in 2013/14• Computer Management Software has been rolled out across the Trust

which will hibernate computers left idle and make significant electricity and CO2 savings. The software is projected to save the Trust £10k per year in saved energy and reduce carbon emissions by 44,000kg;

• The Lynfield Mount LED [High Efficiency Lighting] Scheme has installed new high efficiency lighting in all car parks and external areas, and replaced traditional lighting in 3 projects and schemes with LED lighting including movement and daylight controls; and

• The Environmental Improvement Investment Plan continues to identify schemes and developments in many departments where funding can support sustainable choices which will make long term environmental and cost savings. In 2013/14 projects included a renewable energy source as part of the Lynfield Mount Hospital Energy Centre replacement project and the development of a Green Travel Plan.

34

Financial Review 2013/14

35

2013/14 has been a challenging but successful year for the Trust from a financial perspective. The Trust has delivered a surplus of £3,524k; slightly ahead of its planned surplus of £3,481k. Delivering this level of surplus allowed the Trust to achieve a Financial Risk Rating of 3; a requirement for all NHS Trusts during 2013/14.

A key achievement for the Trust has been the development of its integrated business plan and associated long term financial model for the five year period 2014/15 to 2018/19. The plan supports delivery of Trust’s strategic vision and provides a level of financial head room in order to mitigate against the financial risks posed by the bleak economic outlook.

Plans that have been formulated reflect the need for pump priming investment in information technology and other vital infrastructure that will support delivery of the Trust’s vision for services. As a consequence the level of planned surplus will reduce to around 1%; or £1,335k in 2014/15.

HMRC proposals to standardise NHS VAT recovery with the whole of government are expected to impact on the Trust’s future financial plans. Due to ongoing national debate and consultation it is too early to have a clear view of these impacts therefore the Trust’s plans do not take account of this risk.

The Trust’s 2013/14 financial plan required the Trust to deliver an overall cost reduction of £7,230k. The Trust delivered £7,260k; equivalent to 5.7% of final expenditure. The impact of planned savings on quality was risk assessed in advance by the Medical Director and monitored by the Board, and when implemented did not reduce quality.

Rationalising the Trust’s estate forms a key strand of the Trust’s Cost Improvement Plans (CIP). Substantial progress has been made in this area, including the disposal of the Moor Lane Hospital site, Daisy Bank and a number of smaller assets.

Financial Review 2013/14

Financial Outlook 2014/15The Trust’s financial plan represents the second year of the five year integrated business plan developed in 2013. Plans support delivery of our key financial ratings; a continuity of services risk rating of 4 under the new Monitor risk assessment framework and the achievement of a surplus of £1,335k, or 1%.

The Trust is targeting a reduced level of planned surplus in 2014/15 in order to finance costs to pump prime service transformation; including major investment in information technologies and agile working.

Monitor introduced a new measure for assessing NHS Foundation Trust’s financial risks in 2013/14 however this did not apply to NHS Trusts until 2014/15. The new continuity of services rating is a more realistic risk measure for the Trust and despite a reduced planned surplus of £1,335k the plans still demonstrate achievement of a risk rating of 4.

The Trust is planning to achieve this level of surplus by delivering a CIP of £6.2m (4.6%) against budgets.

The focus for 2014/15 has been to continue to protect frontline services by restructuring back office functions, improving procurement, making estates efficiencies and marketing inpatient facilities to out of area commissioners. In addition, further savings will be delivered through a number of transformational change programmes which deliver service, quality and productivity gains.

The impact of the proposed savings on quality has been risk assessed by the Medical Director and Deputy Chief Executive / Director of Nursing.

Financial Performance Report 2013/14NHS organisations are required to prepare their accounts using International Financial Reporting Standards (IFRS). A short glossary of some of the key IFRS terms used is set out below:

ifrs definition

Revenue The total resources that the Trust receives for the year.

Statement of Financial Position

Snapshot at the end of the year of what the Trust owns and owes (assets and liabilities).

Non Current Not short term usually expected to relate to a period of more than one year.

Inventories Stock held by the Trust.

Receivables Money earned and owed to the Trust.

Payables Money the Trust owes, but has not yet paid.

Retained Earnings

The total net deficit or surplus since the creation of the Trust.

Statement of Comprehensive Income

Records the Trust’s income and expenditure for the year and any recognised gains and losses.

36

As an NHS Trust, Bradford District Care Trust has to meet four statutory financial duties, as directed by the Government. It is pleasing to report that the Trust has met all of its four statutory financial targets in 2013/14 which are:

1. Break-even The reported surplus of £3,292,000 includes

impairments charged to expenditure of £232,000.

An impairment recognises a reduction in the value of an asset. If the reduction in value results from a change in market prices for land or buildings, then this results in a charge to the Trust’s reserves (subject to certain other conditions). Other impairments are charged to expenditure.

£232,000 impairments have been charged to expenditure and show as a technical adjustment in accordance with NHS accounting guidance. This means the charge is excluded when the Trust’s break even performance is calculated, resulting in a surplus of £3,524,000.

The Trust therefore achieved the break-even target by making an in year retained surplus of £3,524,000 after impairments which is in line with the Trust’s planned position of £3,481,000.

2. Capital Absorption Rate The Trust achieved a capital absorption rate of 3.5%.

Trusts are required to earn a rate of return on the assets they employ to deliver services. The bulk of such assets are property, plant and equipment. The rate of return is set by the Treasury and is currently 3.5%.

3. External Financing Resource Limit The Trust is required to manage its cash resources

within the external financing resource limit set by the Department of Health. The Trust’s actual cash requirements were £7,000 lower than the external financing resourcing limit.

This means that the Trust had a marginally higher cash balance at 31 March 2014 than originally planned.

4. Capital resource limit. The Trust is required to manage capital expenditure

within the capital resource limit (CRL) set by the Department of Health. For 2013/14 the Trust achieved an under spend of £264,000 against a limit of £1,174,000.

5. Capital resource limit. A summary of the Trust’s financial performance over the last 5 years is summarised in the table below:

financial targets 2009/10£000

2010/11£000

2011/12£000

2012/13£000

2013/14£000

Retained surplus / (deficit) for the year 103 104 108 1,462 3,524

% Of Turnover 0.09 0.09 0.06 1.08 2.68

Capital Absorption Limit (Target 3.5%)

Rate achieved 3.5 3.5 3.5 3.5 3.5

External Financing Resource Limit

Undershoot / EFL achieved 399 48 5 2,039 7

Capital Resource Limit

Capital Resource Limit (CRL) 2,620 3,068 3,834 1,081 1,174

Undershoot / CRL Achieved 420 283 798 374 264

6. Better Payment Practice Code Performance 2013/14

Under the Better Payment Practice Code, the Trust is required to aim to pay 95% of all undisputed invoices by the due date or within 30 days of receipt of goods or a valid invoice, which ever is later. This is measured by both volume and value of transactions in year.

In 2013/14, the Trust has paid 91.4% (by volume) and 96.6% by value of Non NHS trade invoices, against a target of 95%.

The same measures of compliance are also applied to NHS invoices and the percentages of these invoices paid within the target were 94.9% (by volume) and 97.4% (by value) against a 95% target.

37

7. Key Items of Income and Expenditure 2013/14

During 2013/14, we committed our capital resources in the following areas:

• A review of how in-patient services are configured within the Trust which has resulted in a phased approach to change and improve the ward based facilities. This has led to work to enable the longer term reconfiguration of inpatient beds for older people across the Bradford and Airedale sites and a specific functional ward re-development in this financial year.

• Relocation of administrative staffing into six administrative hubs and using new technologies to increase efficiency.

• Investment in information technology to upgrade systems, infrastructure and support the roll out of mobile technology to community based staff. This supports more efficient ways of working.

• Backlog maintenance which keeps our buildings in good order as well as ensuring we comply with legal requirements including fire safety.

• Improvements and adaptations to the physical condition of Trust buildings to ensure continued suitability for existing use in the short to medium term.

The following two charts illustrate graphically from where the Trust receives its income and what it spends it on.

Sources of Income in 2013/14

How Resources were Spent in 2013/14

Key

n Clinical Commissioning Groups

n NHS England

n Local Authorities

n Other Income

69%

7%

8%

16%

n Staff costs

n Supplies and services

n Establishment

n Transport

n Premises

n Depreciation

n Other including impairment & reversal of impairments of property, plant and equipment

n Services from Foundation Trusts

n Purchase of Healthcare from Non-NHS bodies

77%

1%2%

2%2%

8%

0%

3%

5%

Key

38

References to the Annual Accounts

39

The Department of Health’s Manual for Accounts 2013/14 requires Trusts to make reference in their Annual Report to certain areas that included in their Annual Accounts. These are included below:

References to the Annual Accounts

Pension LiabilitiesPast and present employees are covered by the provisions of the NHS Pensions Scheme. The scheme is an unfunded, defined benefit scheme that covers NHS employers, General Practices and other bodies, allowed under the direction of the Secretary of State, in England and Wales. The scheme is not designed to be run in a way that would enable NHS bodies to identify their share of the underlying scheme assets and liabilities. Therefore, the scheme is accounted for as if it were a defined contribution scheme: the cost to the NHS body of participating in the scheme is taken as equal to the contributions payable to the scheme for the accounting period.

For early retirements other than those due to ill health the additional pension liabilities are not funded by the scheme. The full amount of the liability for the additional costs is charged to expenditure at the time the Trust commits itself to the retirement, regardless of the method of payment.

This is set out at accounting policy note 1.7 in the Trust’s Annual Accounts. Pension disclosures relating to senior managers are set out in the Remuneration Report.

Auditors’ Remuneration for non-audit workThis relates to taxation services provided by KPMG and is disclosed at Note 9 Operating Expenses in the Trust’s annual accounts.

Better Payment Practice CodeDetailed information on this is included within the summary financial statements included within this report.

Accounts DirectionThe accounting requirements for NHS bodies are determined by the Department of Health with the approval of HM Treasury. Those bodies within the Resource Accounting boundary are automatically bound to follow Treasury’s Financial Reporting Manual (FReM). The Department has also agreed that NHS trusts, such as the Bradford District Care Trust, will similarly comply with FReM guidance, with certain agreed departures. A copy of the FReM can be accessed on the Financial Reporting website on www.gov.uk/government/publications/ government-financial-reporting-manual.

Trusts also refer to the Manual for Accounts which has been prepared to give guidance to NHS bodies on fulfilling their statutory duties in preparing and completing their annual report and accounts, summarisation schedules and financial returns.

The Manual for Accounts and the FReM follow International Financial Reporting Standards (IFRS) to the extent that it is meaningful and appropriate in the NHS context. NHS bodies will therefore prepare IFRS compliant accounts, and merit a “true and fair” audit opinion, if the Manuals for Accounts are followed.

Annual Governance Statement

40

41

1. Scope of ResponsibilityThe Board is accountable for the Trust’s system of internal control. As Accountable Officer and Chief Executive of this Board, I have responsibility for maintaining a sound system of internal control that supports the achievement of the organisation’s policies, aims and objectives. I also have responsibility for safeguarding quality standards and public funds and the organisation’s assets for which I am personally responsible, as set out in the Accountable Officer Memorandum.

Bradford District Care Trust (BDCT) forms part of the Bradford health economy. During the year, as Accountable Officer, I have worked closely with the three local Clinical Commissioning Groups (CCGs) – Bradford City, Bradford District and Airedale, Wharfedale and Craven CCGs – which were the main commissioners of the Trust’s health care services in 2013/14. With the changes in the commissioning landscape I have also worked closely with NHS England (who commission health visiting, dental and low secure services), Bradford Metropolitan District Council (school nursing and substance misuse services) and Cumbria CCG (mental health services). I have worked with the NHS Trust Development Authority (NTDA) who has had a performance management role to fulfil with regard to the Trust’s delivery of its objectives.

2. Corporate Governance & Board Evaluation

The Trust Board is made up of a Chairperson, Non-Executive Directors, Chief Executive and Executive Directors. The role of the Trust Board is to:

• Set the overall strategic direction of the Trust;

• Regularly monitor our performance against goals;

• Provide effective financial stewardship through value for money, financial control and financial planning;

• Ensure that the Trust provides high quality, effective services; and

• Promote good communication with the people we serve.

The Board of Directors meets monthly (with the exception of August) and discharges its day-to-day management of the Trust through the Chief Executive, individual Executive Directors and senior staff through a scheme of delegation which is approved by the Board.

The Board receives an integrated performance report at each Board meeting measuring performance against national and local targets relating to finance, quality and governance indicators. Where there is any deviation from plan, exception reports are presented for consideration of any necessary remedial action.

The Board recognises the importance of regular performance evaluation. During 2013/14, a 360 feedback review about the effectiveness of the Board was completed with key stakeholders (both internal and external) and actions identified to be taken forward. In addition, each Board Committee reviews its own performance and submits an annual report to the Trust Board.

Individual Board member performance is reviewed through a formal appraisal process whereby the Chair appraises the Chief Executive and Non-Executive Directors (with NED appraisals sent to the NTDA), the Chief Executive appraises the Executive Directors (with reports sent to the Board’s Remuneration Committee) and the Senior Independent Director seeks views from other Board members on the performance of the Trust Chair (to supplement the NTDA’s own formal appraisal).

The Board received an independent review of its Board Governance Assurance Framework (BGAF) in July 2012, aimed at assessing the effectiveness of its corporate governance systems. In April 2014, the Board completed a further refreshed self assessment for the period 2013/14 concluding that the Board has maintained good governance arrangements and there were no significant issues that needed immediate action or resulted in gaps in governance arrangements.

As an aspirant foundation trust, the Trust is not subject to the ‘comply and explain’ principle set out in Monitor’s Code of Governance. However in preparation for FT authorisation, the Board has considered each area of the Code with all major areas assessed as compliant.

The Board has set out how it monitors its performance against the national priorities set out in the Planning Guidance issued by both NHS England and the NTDA, has a range of measures that are regularly reviewed at Board and Committee meetings and has seen a steady improvement during this reporting period.

Board Committee structure

The Board has established a number of Committees to exercise its functions and provide assurance that the Trust is carrying out its duties effectively, efficiently and economically, described below. The Board has co-opted a small number of senior managers to different Committees. The main duties of each Committee are set out below. Each Committee undertakes an annual evaluation and submits an Annual Report to the Board. These reports are considered by the Board at its May meeting as assurance against the wider Annual Report by the Trust. At each Board meeting there is also a written report highlighting any significant issues from Committees and Committee minutes are circulated to all Board members. Over the course of 2013/14 work has continued, particularly on service governance areas, to review how assurances are provided under the new locality structures.

Annual Governance Statement

42

Audit CommitteeThe Audit Committee is responsible for the Trust’s systems of internal control. It provides the Board with an independent and objective review of financial and corporate governance, risk management, external and internal audit programmes. It is responsible for making sure the Trust is well governed. Taking a risk-based approach, the Committee has worked to an annual plan covering the main elements of the Assurance Framework. The Committee has appointed external auditors (KPMG) and internal auditors (West Yorkshire Audit Consortium) and met five times in 2013/14.

Service Governance CommitteeThe Service Governance Committee has responsibility to monitor, review and report to the Board the adequacy of the Trust’s processes in the areas of clinical and social care governance and where appropriate facilitate and support existing systems operating across the Trust. This includes the monitoring of incidents and complaints, clinical policies, research and development, clinical audit and service improvements. The Committee met six times in 2013/14.

Finance, Business and Investment Committee (FBIC)The Finance, Business and Investment Committee has responsibility to monitor financial performance of the Trust against plan (reporting any proposed remedial action to the Board as necessary) consider the Trust’s medium to longer term financial strategy and provide an oversight of the development and implementation of financial systems across the Trust. The Committee met six times during 2013/14.

Mental Health Legislation Committee (MHLC)The Mental Health Legislation Committee has a wide cross section of membership comprising Non-Executive and Executive Directors, an Associate Hospital Manager, senior clinicians and service user and carer representatives. The Committee has responsibility to monitor, review and report to the Board on the adequacy of the Trust’s processes relating to all mental health legislation. It meets on a quarterly basis and met four times in 2013/14.

Remuneration CommitteeIn addition to these assurance committees, the Board has an established Remuneration Committee, comprised exclusively of Non-Executive Directors, which considers the terms and conditions of appointment of the Executive Directors and Chief Executive. The Committee met five times in 2013/14.

Nominations CommitteeThe Nominations Committee has the responsibility to review the structure, size and composition of the Board and, where necessary, be responsible for identifying and nominating for appointment candidates to fill posts within its remit. All Non-Executive Directors are members of this Committee, which met twice in 2013/14. Its key responsibility in 2013/14 was to consider the appointment of a new Director of Finance, which is currently being supported by an Executive search agency. Non-Executive Director appointments are made by the NTDA.

Charitable Funds CommitteeThe Charitable Funds Committee oversees the Trust’s charitable activities and ensures we are compliant with the law and regulations set by the Charity Commissioners for England and Wales. The Board is responsible for this area but this Committee looks in detail at charitable matters and works with the Charity Commissioners where necessary. It met twice in 2013/14.

Division of responsibilitiesThe Board is satisfied that there is a clear division of responsibilities between the Chair and Chief Executive. The Board discussion held at its meeting in January 2013 remains extant. Further work is planned following the Board’s development ‘time-out’ in July 2014.

Conflicts of interestThe Board is satisfied that no direct conflicts of interest exist for any member of the Board, an accurate register of interests is regularly maintained and that each Non-Executive Director is considered to be independent.

Discharge of statutory functionsThe Board is satisfied that, through its own Standing Orders and the work of its Committees, arrangements are in place for the discharge of its statutory duties, checked for any irregularities and are legally compliant.

43

Board attendanceAttendance at Board and committee meetings is shown in the table below.

Board Member Attendance at Committees and Board Meetings April 2013 – March 2014

Name aud

it

serv

ice

Gov

erna

nce

fina

nce,

Bu

sine

ss a

nd

inve

stm

ent

Men

tal h

ealt

h le

gisl

atio

n

rem

uner

atio

n

nom

inat

ions

char

itab

le

fund

s

Boar

d

Michael Smith (Chair) 6/6 5/5 2/2 12/12

Simon Large 5/6 2/2 1/2 12/12

Nicola Lees 5/6 4/4 1/2 12/12

Nadira Mirza 3/6 2/4 5/5 2/2 10/12

Derrick Palmer 5/5 3/4 3/5 2/2 2/2 12/12

Andy McElligott 5/6 3/4 11/12

Sandra Knight 12/12

Ralph Coyle 6/6 4/6 2/2 2/2 10/12

Carol Stubley 5/5 6/6 2/2 12/12

Sue Butler 6/6 6/6 4/4 2/2 12/12

Helen Bourner 4/6 11/12

Rob Vincent 4/5 5/6 2/2 2/2 12/12

David Banks 1/1 2/2 1/1 1/1 4/4

Ian Cherry 1/4 3/4 1/3 0/1 4/7

Key

n Attended

n Did Not Attend

44

3. The Purpose of the System of Internal Control

The system of internal control is designed to manage risk to a reasonable level rather than to eliminate all risk of failure to achieve policies, aims and objectives; it can therefore only provide reasonable and not absolute assurance of effectiveness. The system of internal control is based on an ongoing process designed to:

• Identify and prioritise the risks to the achievement of the organisation’s strategic intents, policies, aims and objectives; and

• Evaluate the likelihood of those risks being realised and the impact should they be realised, and to manage them efficiently, effectively and economically.

The system of internal control has been in place in BDCT for the year ended 31 March 2014 and up to the date of approval of the annual report and accounts.

4. Risk AssessmentProcess for assessing risk

The Board has endorsed the Trust’s revised Risk Management Strategy and Policy which drives the process for the assessment and management of risk throughout the organisation. This strategy includes a comprehensive approach to assessing risks through the Trust Risk Assessment Matrix (TRAM) which measures the severity of potential harm against the likelihood of the risk occurring, providing a level of consistency to the process.

Continued progress has been achieved in 2013/14 in relation to the continued evolution, embedding and improvement of the electronic risk register (e-RR) process across the Trust. This included a realignment of the risk management system to meet the revised operational services structure. This approach supports continued effective assessment of risk including supporting decisions to escalate / de-escalate risks dependant on the current assessed risk rating.

Consideration of risk occurs at all levels of the organisation and electronic risk registers are in place at team, senior manager, locality/operational, directorate and corporate levels. This enables risks to be identified, assessed and managed at the most appropriate level. To ensure the quality and content of the risk registers bi-monthly senior management qualitative risk register reports have been developed and introduced. These reports monitor the activity of risk, grading and related actions related to risks across the Trust.

The Quality and Risk Profile produced by the Care Quality Commission provides a valuable overview of potential risk issues and is reported upon and reviewed by the Executive Management Team and the Trust Board, with actions in place to address risk issues identified.

Risk Profilea) New risks identified during 2013/14

The Trust has in place a Corporate Risk Register which is integrated into the electronic Risk Register, (e-RR), process. The CRR has been reviewed by the Board and Committees throughout the year.

During 2013/14 the Trust’s Executive and Board accepted the inclusion of the following risks onto the CRR. One risk related to Any Qualified Provider (Podiatry) was de-escalated from the CRR in November 2013.

changes to the crr and Baf in 2012/13

corporate risk register

April 2013Information Management & Technology; capacity and capability

July 2013High average length of stay in adult inpatient services

August 2013 Information Governance compliance

The electronic risk register system enables a wider view of the Trust’s risk profile as a whole with each risk allocated to a specific ownership.

45

The Board considered its use of the Board Assurance Framework (BAF) in quarter four of 2013/14, and the BAF format and content were revised to reflect those discussions, and to facilitate more strategic consideration of the potential risks to the delivery of the Trust’s strategy. As the potential risks to the Trust’s strategy are strategic and long term, they remain relatively static. The BAF has been updated every quarter, for the Board’s consideration, to reflect significant changes or issues in the environment that could affect the Trust’s strategy, as well as any actions taken since the last Trust Board report to positively influence the risk score. The Trust’s Audit Committee also regularly reviews the BAF at each meeting. At March 2014, the key potential risks to the Trust’s strategy identified in the BAF were:

Board assurance framework (strategic risks)

Be great in our own patch

• Gap between demand for services and capacity, adversely affecting quality, safety, financial position, relationships and reputation

• Inability to deliver service transformation and organisational change, resulting in non-delivery of quality and financial benefits in full and on schedule

• Imposition of greater tariff reduction than planned, adversely affecting financial position, quality and safety

• The Trust’s response to the Francis report does not meet the expectations of staff, service users and the public, losing the opportunity to understand and improve service quality and adversely affecting relationships and reputation

Adapt to the commissioner landscape

• Failure to re-organise services around commissioning organisations and meet their requirements

• Failure to redesign business model to support whole system transformation and associated increase to income

Develop market opportunities

• Failure to respond successfully to competition for services and to exploit opportunities for acquisition or merger of services

The Executive Management Team will develop the BAF for 2014/15 in conjunction with the refresh of the five year Integrated Business Plan, and this will be presented to the June 2014 Trust Board meeting for discussion and approval.

The key risks identified for 2014/15 are:

• Maintaining activity and quality as the gap between demand and capacity grows;

• Maintaining sound systems of internal control during period of significant transformation; and

• Failure to respond successfully in a competitive market to secure market share and new income through business opportunities.

b) Breaches of data security

Such lapses are reported internally through the web based incident reporting system (IR-e) and notified immediately to the Information Governance (IG) & Records Manager for logging on the Serious Incidents Requiring Investigation section of the Information Governance Toolkit and with the Trust’s Serious Incident Lead where appropriate. Incident data is regularly reported to and monitored by the IG Group. 48 were reported on the IG Toolkit and investigated, 5 of these were also logged on the Trust’s Serious Incident system during 2013/14 for a root cause analysis investigation, none resulting in serious harm.

The Trust reported four IG breaches through the IG Toolkit to the Information Commissioner’s Office (ICO) in the year 2013/14. Of those, two have been closed by the ICO with no further action required, and the Trust is awaiting feedback on the remaining two. The Caldicott Guardian provided advice in those IG breaches which concerned patient confidentiality. For all serious incidents the learning was fed back to teams and shared wider across the Trust to maximise the learning.

46

5. The Risk and Control FrameworkKey elements of the Trust’s Risk Management Strategy include the principles, processes, accountabilities and the regulatory framework for managing risk.

The Trust Board has overall accountability for the risk management framework, systems, policy, procedures and activities of the organisation. The Medical Director is the nominated Executive Director lead for risk management and the Caldicott Guardian for information governance. The Commercial Director is the nominated Senior Information Risk Officer (SIRO) for the Trust.

The Service Governance Committee is a formally constituted Committee of the Board. This Committee has delegated responsibility and authority for monitoring the risk management process. However all formal Committees of the Trust Board also have responsibility for monitoring the risks relating to the work of that Committee. This is achieved by specific risks within the CRR being allocated to a named Committee; each Committee then undertakes regular, programmed reviews of allocated risks, seeking assurance as appropriate.

Each Committee is supported by the Directors Meeting (including Deputy Directors) which is chaired by the Chief Executive.

The Trust Board receives assurance from all formally constituted Committees of the Board, reporting back on meetings at the next Board meeting. The Audit Committee provides independent assurance on all aspects of governance and controls; this includes internal and external audit.

The Executive Management Team also routinely reviews the corporate risk register and assures itself that mitigating actions are in place to address and mitigate the risks.

The Clinical & Safety Learning Forum and the Health & Safety Learning Group encourage, embrace and share learning across the Trust from both good practice and lessons learned when things have gone wrong.

Risk management is firmly embedded within the governance processes and structures in both clinical services and support directorates and contributes to the quality and safety report which provides monthly reports on key performance indicators and provides an additional early warning system of risk which may affect delivery of a strategic objective. Service Governance groups have regular agenda items which include reviewing risks and incidents.

The Trust shares all alerts and reports on serious incidents with commissioners as soon as they occur or as soon as there is knowledge of the event. These individual reports are supported by quarterly reports which are presented internally to the Trust Board and Service Governance Committee. All patient safety and remaining incidents are

reported quarterly to the Service Governance Committee. Both of these quarterly reports are also presented at the Quality Performance Group for analysis and scrutiny by Commissioners.

In terms of deterrents against fraud, the Trust has a very proactive nominated Local Counter Fraud Specialist provided via the West Yorkshire Audit Consortium, who is fully accredited by the NHS Counter Fraud and Security Management Service. The Audit Committee approved the Annual Counter Fraud Plan for 2013/14 in May 2013 and received regular updates on progress of counter fraud work during the year. Areas of work during the year have included: an ongoing programme of presentations to staff about fraud, attendance at Safeguarding Forums, and the introduction of a new Trust policy around anti-fraud, bribery and corruption.

6. Review of the Effectiveness of Risk Management and Internal Control

The embedding of the electronic risk register system (e-RR) has resulted in a set of quarterly quality reports which has further improved the content and management of risk registers.

Activity reports, trends and risk issues are reviewed by the Directors Meeting (including Deputy Directors) which provides assurance to the Board Committees on the process and escalates risks to the allocated Committee as appropriate and required.

An Internal Audit on risk management processes was undertaken in-year which provided a significant assurance opinion to the Audit Committee and was discussed at its meeting held on 12 May 2014.

7. Review of EffectivenessAs Accountable Officer, I have responsibility for reviewing the effectiveness of the system of internal control. My review is informed in a number of ways. The Head of Internal Audit provides me with an opinion on the overall arrangements for gaining assurance through the BAF and on the controls reviewed as part of the internal audit work. A significant opinion has been given for 2013/14 including reference to five reports in 2013/14 issued with a ‘limited assurance’ opinion. Three of these (Service Level Agreements, Legal Services and Consultant Job Plans) have been implemented in line with the agreed action plans. Two others (Length of Stay and E-Rostering) have action plans recently agreed with management and submitted to the Audit Committee. Robust procedures are also in place for following up all internal audit recommendations.

Executive Directors, Deputy Directors and Senior Managers within the organisation, who have responsibility for the

development and maintenance of the system of internal control, provide me with assurance.

The Trust’s BAF provides me with evidence that the effectiveness of controls that manage the risks to the organisation achieving its strategic intents have been reviewed.

My review is also informed by external assessments carried out by:

• Care Quality Commission

• Audit Commission/KPMG (our external auditors – at a cost of £67,000 for 2013/14)

• Registration Assessment

• Health and Safety Executive

• National patient and staff surveys

• Local Healthwatch

• Bradford & Airedale and North Yorkshire Overview and Scrutiny Committees

Internal audits are undertaken to report on effectiveness throughout the year; all internal audit reports are presented at Audit Committee.

I have been advised on the implications of the result of my review of the effectiveness of the system of internal control by:

• Executive Management Team

• Executive Directors’ letters of representations

• Trust Board

• Audit Committee

• Service Governance Committee

• Finance, Business and Investment Committee

• Mental Health Legislation Committee

• Risk Assurance Group/Directors’ meetings

With the exception of the internal control issues that I have outlined in this statement, my review confirms that BDCT has a generally sound system of internal controls that supports the achievement of its policies, aims and objectives and that those control issues have been or are being addressed.

8. Statement as to disclosure to auditors

In the case of each of the persons who are Directors at the time the report is approved:

• So far as each Director is aware, there is no relevant audit information of which the company’s auditor is unaware; and

• Each Director has taken all the steps that he/she ought to have taken as a Director in order to make themselves aware of any relevant audit information and to establish that the company’s auditor is aware of that information.

9. Significant issues

During 2013/14, no significant control issues have been identified by the Trust’s systems of internal control. My review confirms that Bradford District Care Trust has generally sound systems of internal control that supports the achievement of its policies, aims and objectives.

Name: Simon LargePosition: Chief ExecutiveDate: 5 June 2014

47

Summary of Financial Statements

48

49

Statement of Comprehensive Income for Year Ended 31 March 2014

2013/14£000

2012/13£000

Gross employee benefits (98,578) (102,317)

Other operating costs (29,410) (33,940)

Revenue from patient care activities 122,786 125,205

Other Operating revenue 8,754 10,653

Surplus / (deficit) 3,552 (399)

Investment revenue 66 67

Other gains 998 0

Finance costs (212) (230)

Surplus / (Deficit) for the financial year 4,404 (562)

Public dividend capital dividends payable (1,112) (1,299)

Retained surplus / (deficit) for the year 3,292 (1,861)

Other Comprehensive Income

Impairments and reversals taken to the Revaluation Reserve (804) (793)

Net gain on revaluation of property, plant & equipment 594 323

Total comprehensive income for the year* 3,082 (2,331)

Financial performance for the year

Retained surplus / (deficit) for the year 3,292 (1,861)

Impairments (excluding IFRIC 12 impairments) 232 3,323

Adjusted retained surplus 3,524 1,462

* This sums the rows above and the deficit for the year before adjustments for PDC dividend and absorption accounting.

Financial PerformanceA Trust’s Reported NHS financial performance position is derived from its retained surplus/(deficit), but adjusted for the following:

Impairments to Fixed Assets. Impairments of £232,000 have been charged to expenses during 2013/14 and are excluded from the calculation of the Trust’s break even position, resulting in a surplus of £3,524,000 (£1,462,000 2012 /13)

A receivable balance of £31,000 for PDC dividends at 31 March 2014 is included within these accounts (£101,000 receivable 2012/13).

Summary of Financial Statements

50

Statement of Financial Position as at 31 March 2014

31 March 2014 £000

31 March 2013 £000

Non-Current Assets

Property, plant and equipment 48,081 47,829

Trade and other receivables 0 0

Total non-current assets 48,081 47,829

Current Assets

Inventories 17 9

Trade and other receivables 3,944 4,396

Cash and cash equivalents 19,145 16,326

Total current assets 23,106 20,731

Non-current assets held for sale 0 2,175

Total current assets 23,106 22,906

Total assets 71,187 70,735

Current Liabilities

Trade and other Payables (12,051) (11,625)

Provisions (798) (2,947)

Borrowings (299) (278)

Total current liabilities (13,148) (14,850)

Net current assets / (liabilities) 9,958 8,056

Non-current assets plus / less net current assets / liabilities 58,039 55,885

Non-current liabilities

Provisions (532) (511)

Borrowings (3,730) (4,028)

Total non-current liabilities (4,262) (4,539)

Total Assets Employed: 53,777 51,346

Financed by Taxpayers’ equity

Public Dividend Capital 33,458 34,109

Retained earnings (4,240) (8,077)

Revaluation reserve 14,363 15,118

Other reserves 10,196 10,196

Total Taxpayers’ Equity: 53,777 51,346

51

Statement of Changes in Taxpayers’ Equity for the Year Ended 31 March 2014

Public dividend capital £000

retained earnings

£000

revaluation reserve £000

other reserves

£000

totalreserves

£000

Balance at 1 April 2013 34,109 (8,077) 15,118 10,196 51,346

Changes in taxpayers’ equity for 2013/14

Retained surplus / (deficit) for the year 3,292 3,292

Net gain on revaluation of property, plant, equipment 594 594

Impairments and reversals (804) (804)

Transfers between reserves 545 (545) 0

Reclassification Adjustments

New PDC Received – Cash 49 49

PDC Repaid in Year (700) (700)

Net recognised revenue / (expense) for the year (651) 3,837 (755) 0 2,431

Balance at 31 March 2014 33,458 (4,240) 14,363 10,196 53,777

Balance at 1 April 2012 34,109 (7,072) 16,444 10,196 53,677

Changes in taxpayers’ equity for the year ended 31 March 2013

Retained surplus / (deficit) for the year (1,861) (1,861)

Net gain on revaluation of property, plant, equipment 323 323

Impairments and reversals (793) (793)

Transfers between reserves 856 (856) 0

Net recognised (expense) for the year 0 (1,005) (1,326) 0 (2,331)

Balance at 31 March 2013 34,109 (8,077) 15,118 10,196 51,346

52

Statement of Cash Flows for the Year Ended 31 March 2014

2013/14 £000s

2012/13 £000s

Cash Flows from Operating Activities

Operating Surplus/ (Deficit) 3,552 (399)

Depreciation and Amortisation 2,421 2,303

Impairments and Reversals 232 3,323

Interest Paid (212) (230)

Dividend (Paid) / Refunded (1,042) (1,378)

(Increase) / Decrease in Inventories (8) 3

(Increase) / Decrease in Trade and Other Receivables 383 3,383

Increase / (Decrease) in Trade and Other Payables 944 (3,530)

(Increase) / Decrease in Other Current Liabilities 0 (1,893)

Provisions Utilised (1,969) (1,458)

Increase / (Decrease) in Provisions (159) 1,601

Net Cash Inflow from Operating Activities 4,142 1,725

Cash flows from investing activities

Interest Received 66 67

(Payments) for Property, Plant and Equipment (3,823) (3,061)

Proceeds of disposal of assets held for sale (PPE) 3,363 3,308

Net Cash Inflow / (Outflow) from Investing Activities (394) 314

NET CASH INFLOW BEFORE FINANCING 3,748 2,039

Cash Flows from financing activities

Public Dividend Capital Received 49 0

Public Dividend Capital Repaid (700) 0

Capital Element of Payments in Respect of Finance Leases and On-SoFP PFI and LIFT (278) (255)

Net Cash (Outflow) from Financing Activities (929) (255)

NET INCREASE IN CASH AND CASH EQUIVALENTS 2,819 1,784

Cash and Cash Equivalents (and Bank Overdraft) at beginning of the period 16,326 14,542

Cash and Cash Equivalents (and Bank Overdraft) at year end 19,145 16,326

Better Payment Practice Code

Better Payment Practice code – measure of compliance

2013/14 2012/13

number £000 number £000

Total Non-NHS trade invoices paid in the year 12,720 28,334 16,819 33,747

Total Non-NHS trade invoices paid within target 11,623 27,372 15,382 31,803

Percentage of Non-NHS trade invoices paid within target 91.4% 96.6% 91.5% 94.2%

Total NHS trade invoices paid in the year 908 13,134 890 15,474

Total NHS trade invoices paid within target 862 12,796 796 14,724

Percentage of NHS trade invoices paid within target 94.9% 97.4% 89.4% 95.2%

The Better Payment Practice Code requires the Trust to aim to pay all undisputed invoices by the due date or within 30 days of receipt of goods or a valid invoice, whichever is later.

The Trust has applied to sign up to the Prompt Payments Code.

53

54

Related Party TransactionsDetails of related party transactions with individuals are as follows:

During the year one Non Executive Board Member had transactions with Agencia Consulting in relation to a contract with Central England CSU £456 and with the Community Performance Partnership in relation to travel expenses for pro bono coaching provided to Voluntary Action North Lincolnshire £390. (In the last financial year, two Non Executive Members had transactions with the Department of Health totalling £65,000, the NHS Institute of Innovation & Improvement totalling £2,853 and with Hull Teaching PCT £666).

During the year none of the Department of Health Ministers, Trust Board members or members of the key management staff, or parties related to any of them, has undertaken any material transactions with Bradford District Care Trust.

The Department of Health is regarded as a related party. During the year Bradford District Care Trust has had a significant number of material transactions with the Department, and with other entities for which the Department is regarded as the parent Department. These entities are:

2013/14 income£000

expenditure£000

Airedale, Wharfedale and Craven CCG 19,239 27

Bradford City CCG 15,914 29

Bradford Districts CCG 53,726 94

NHS England 21,460 1,147

Bradford Teaching Hospitals NHS Foundation Trust 989 2,023

Airedale NHS Foundation Trust 194 1,968

Bradford Metropolitan District Council 10,776 614

2012/13 – Prior Period comparators income£000

expenditure£000

Bradford & Airedale Teaching Primary Care Trust 116,104 5,764

Barnsley PCT 4,540 3

North Yorkshire & York Primary Care Trust 3,747 0

Yorkshire and the Humber SHA 2,630 398

Bradford Teaching Hospitals Foundation Trust 1,009 1,742

Airedale NHS Foundation Trust 169 2,119

Bradford Metropolitan District Council 3,680 2,514

The Trust has had a number of material transactions with other government departments and other central and local government bodies, most of these transactions have been with Bradford Metropolitan District Council shown above. The sums shown for 2013/14 relate to new local authority commissioning responsibilities from April 2013. (2012/13 Bradford Metropolitan District Council comparator values relate to the Section 75 agreement for social care service provision which terminated in 2012/13).

The Trust manages charitable funds on behalf of the Bradford District Care Trust Charitable Fund whose accounts are published the Charity Commission website. An administration charge of £6,864 in 2013/14 was levied on the Care Trust charity for the services provided by the Trust.

56

Audited Remuneration Report for 2013/14

57

Audited Remuneration Report for 2013/14

Remuneration ReportThe Remuneration Committee assesses the performance objectives set by the Chief Executive for each Director and the Chair for the Chief Executive. The tables below contain details of senior managers’ remuneration and pensions relating to individuals who have held office during the reporting year and details of exit packages agreed during 2013/14.

Salary & Allowances2013/14 2012/13

name and title

salary(Bands of £5,000)

£000

expense Payments (taxable)Rounded to the nearest

£100

all Pension related Benefits (bands of £2,500)

£000

total (bands of £5,000)

£000


£000


£100


£000


£000

B Seal – Chairman (to 30.4.12) 0 – 5 0 – 5

M Smith – Chairman (Acting from 1.5.12, substantive from 6.9.12)

20 – 25 300 20 – 25 15 – 20 100 15 – 20

M Smith – Non Executive Director (to 30.4.12)

0 – 5 0 – 5

D Palmer – Non Executive Director

5 – 10 300 5 – 10 5 – 10 200 5 – 10

R Coyle – Non Executive Director

5 – 10 300 5 – 10 5 – 10 200 5 – 10

N Mirza – Non Executive Director

5 – 10 5 – 10 5 – 10 5 – 10

S Butler – Non Executive Director (from 3.5.12)

5 – 10 5 – 10 5 – 10 5 – 10

R Vincent – Non Executive Director (from 1.3.13)

5 – 10 5 – 10 0 – 5 0 – 5

L Cherry – Non Executive (from 1.3.13 to 31.10.13)

0 – 5 100 0 – 5 0 – 5 0 – 5

D Banks – Non Executive Director (from 1.12.13)

0 – 5 100 0 – 5

D Smith – Non Executive Director (from 21.7.11 to 30.4.12)

0 – 5 0 – 5

J Smithies – Non Executive Director (from 20.10.11 to 30.4.12)

0 – 5 0 – 5

R Pattinson – Special Advisor (to 8.5.12)

0 – 5 100 0 – 5

Continued over...

58

The Trust makes no payments for performance pay or bonuses.

Expense payments relate to taxable travelling allowances and the benefit in kind relating to lease cars.

The Remuneration Committee, which is made up entirely of Non Executive Directors, considers the terms and conditions of the Chief Executive and the Directors. The remuneration of the Chief Executive and Directors is in accordance with a locally developed framework which uses nationally benchmarked information for the market rates in similar types of Trusts. It takes account of both the job size and the complexity of the role. The pay scales, which have been developed within this framework, allow for progression and were developed in conjunction with the framework by an external organisation on the Trust’s behalf. Progression is subject to satisfactory performance against objectives as assessed by the Chief Executive but also taking feedback from the Chair and Non Executive Directors. The Trust would give 6 months’ notice of termination of a contract and the Chief Executive or Director would be required to give 3 months’ notice. All other terms and conditions relating to the Chief Executive and Directors are in accordance with Agenda for Change.

Reporting bodies are required to disclose the relationship between the remuneration of the highest paid director in their organisation and the median remuneration of the organisation’s workforce. The banded remuneration of the highest paid director in Bradford District Care Trust in the financial year 2013/14 was £130,000 – £135,000 (2012/13 £125,000 to £130,000). This was 4.8 times (2012/13 – 4.6 times) the median remuneration of the workforce which was £27,901 (2012/13 – £27,625).

The median salary has been calculated by using the salary costs as set out below for all employees as at 31 March 2014. Where employees work part time, the salary cost has been grossed up to the full time

equivalent salary. The calculation does not include bank or agency staff as these staff are engaged on a need to cover a shift basis rather than a full time equivalent basis. Information on the annual salary costs for individual bank and agency staff is not available. Any other form of proxy methodology to calculate a salary cost would not be deemed to provide a fair representation of the median salary of the organisation.

In 2013/14 no employees (2012/13 – one employee) received remuneration in excess of the highest paid director. This change is due to differences in pay awards. Remuneration ranged from £5,000 to £133,000 ( 2012/13 £5,000 to £131,000). Total remuneration includes salary, benefits in kind but not severance payments.

It does not include employer pension contributions and the cash equivalent transfer value of pensions. In 2013/14, the highest paid director was the Chief Executive.

2013/14 2012/13

Mid Point of the banded remuneration of the highest paid director

132,500 127,500

Median Total Remuneration (£)

27,901 27,625

Ratio 4.8 4.6

Salary & Allowances (continued)2013/14 2012/13

name and title


£000


£100


£000


£000


£000


£100


£000


£000

S Large – Chief Executive 130 – 135 200 47.5 - 50 180 - 185 125 – 130 800 40 - 42.5 170 - 175

C Stubley – Director of Finance, Contracting & Estates

95 – 100 300 37.5 - 40 135 - 140 95 – 100 800 32.5 - 35 130 - 135

S Knight – Director of Human Resources and Organisational Development

85 – 90 1,200 32.5 - 35 125 - 130 85 – 90 1,100 27.5 - 30 115 - 120

N Morris – Director of Performance, Planning and Information (to 31.10.12)

50 – 55 200 50 - 55

P Hogg – Trust Secretary 80 – 85 500 15 - 17.5 95 - 100 75 – 80 300 70 - 72.5 145 - 150

N Lees – Deputy Chief / Director of Nursing

100 – 105 3,900 (20 - 22.5) 80 - 85 100 – 105 47.5 - 50 150 - 155

A McElligott – Medical Director (from 1.4.12)

120 – 125 3,700 30 - 32.5 155 - 160 120 – 125 2,400 42.5 - 45 165 - 170

S Ince – Acting Director of Performance, Planning and Information (from 1.11.12 to 31.3.2013)

35 – 40 15 - 17.5 50 - 55

H Bourner – Commercial Director (from 2.4.13)

95 – 100 200 32.5 - 35 125 - 130

59

** Nick Morris retired as Director of Performance, Planning and Information on 31.10.12 and received his pension benefits from 1 November 2012.

*** Susan Ince was Acting Director of Performance, Planning and Information from 1 November 2012.

As Non-Executive members do not receive pensionable remuneration, there will be no entries in respect of pensions for Non-Executive members.

A Cash Equivalent Transfer Value (CETV) is the actuarially assessed capital value of the pension scheme benefits accrued by a member at a particular point in time. The benefits valued are the member’s accrued benefits and any contingent spouse’s pension payable from the scheme. A CETV is a payment made by a pension scheme, or arrangement to secure pension benefits in another pension scheme or arrangement when the member leaves a scheme and chooses to transfer the benefits accrued in their former scheme. The pension figures shown relate to the benefits that the individual has accrued as a consequence of their total membership of the

pension scheme, not just their service in a senior capacity to which the disclosure applies. The CETV figures and the other pension details, include the value of any pension benefits in another scheme or arrangement which the individual has transferred to the NHS pension scheme. They also include any additional pension benefit accrued to the member as a result of their purchasing additional years of pension service in the scheme at their own cost. CETVs are calculated within the guidelines and framework prescribed by the Institute and Faculty of Actuaries.

Real Increase in CETV – This reflects the increase in CETV effectively funded by the employer. It takes account of the increase in accrued pension due to inflation, contributions paid by the employee (including the value of any benefits transferred from another scheme or arrangement) and uses common market valuation factors for the start and end of the period. CPI inflation of 2.2% has been used in accordance with DH guidance in 2013/14 (5.2% in 2012/13).

No directors have a stakeholder pension.

Pension Benefits

name & title

real increase

in Pension at age

60 (Bands Of £2,500)

£000

real increase

in Pension lump

sum at age 60 (Bands Of £2,500)

£000

total accrued

Pension at age 60 at 31 March

2014 (Bands Of £5,000)

£000

lump sum at age 60 related to

accrued Pension at 31 March

2014 (Bands Of £5,000)

£000

cash equivalent transfer

value at 1 april 2013

£000

cash equivalent transfer value at 31 March

2014

£000

real increase in cash

equivalent transfer

value

£000

S Large – Chief Executive 0 – 2.5 5 – 7.5 45 - 50 145 - 150 871 955 64

C Stubley – Director of Finance, Contracting & Estates

0 – 2.5 2.5 – 5 30 - 35 100 - 105 496 545 39

S Knight – Director of Human Resources and Organisational Development

0 – 2.5 2.5 – 5 30 - 35 95 - 100 607 667 46

N Morris – Director of Performance, Planning and Information (to 31.10.12)**

P Hogg – Trust Secretary 0 – 2.5 0 – 2.5 25 - 30 75 - 80 385 414 21

N Lees – Deputy Chief Executive /Director of Nursing

(2.5 – 0)(0.2.5 – 0)

45 - 50 145 - 150 875 893 1

A McElligott – Medical Director (from 1.4.12)

0 – 2.5 2.5 – 5 30 - 35 100 - 105 511 558 36

S Ince – Acting Director of Performance, Planning and Information (from 1.11.12 to 31.3.13)***

H Bourner – Commercial Director (from 2.4.13)

0 – 2.5 2.5 – 5 20 - 25 60 - 65 331 376 38

60

Exit Packages agreed in 2013/14

exit Packages agreed in 2013/14 exit Packages agreed in 2012/13

exit package cost band (including any special payment element)

number of compulsory

redundancies

number of other

departures agreed

total number of exit

packages by cost band

number of compulsory

redundancies

number of other

departures agreed

total number of exit

packages by cost band

Less than £10,000 3 25 28 6 1 7

£10,000 – £25,000 3 28 31 4 6 10

£25,001 – £50,000 4 18 22 8 0 8

£50,001 – £100,000 0 10 10 7 2 9

£100,001 – £150,000 0 0 0 2 0 2

Total number of exit packages by type (total cost) 10 81 91 27 9 36

Total resource cost £s 203,240 1,923,661 2,126,901 1,205,503 246,504 1,452,007

Redundancy and other departure costs have been paid in accordance with the provisions of the NHS Scheme. Exit costs in this note are accounted for in full in the year of departure. Where the Trust has agreed early retirements, the additional costs are met by the Trust and not by the NHS pensions scheme. Ill-health retirement costs are met by the NHS pensions scheme and are not included in the table.

This disclosure reports the number and value of exit packages agreed in the year.

Exit packages in 2013/14 include 2 substantial; trust-wide, service reviews that were provided for in 2012/13; i) to centralise admin staff in admin hubs and ii) to review psychological therapies. Voluntary redundancy schemes ran alongside these 2 major staff consultations in 2013 and account for £1,079k (Admin) and £638k Psychological Therapies). The balance relates to smaller corporate restructures in Payroll and Equality & Diversity.

Exit packages – Other Departures analysis

2013/14 2012/13

agreements Number

total value ofagreements

£000sagreements

Number

total value ofagreements

£000s

Voluntary redundancies including early retirement contractual costs

78 1,895 9 247

Contractual payments in lieu of notice 3 19 0 0

Exit payments following Employment Tribunals or court orders

0 0 1 10

Total 81 1,914 10 257

This disclosure reports the number and value of exit packages agreed in the year.

As single exit packages can be made up of several components each of which will be counted separately in this disclosure, the total number above will not necessarily match the total numbers above.

61

Off Payroll EngagementsFor all off-payroll engagements as of 31 March 2014, for more than £220 per day and that last longer than six months:

number

Number of existing engagements as of 31 March 2014 4

Of which, the number that have existed:

for less than one year at the time of reporting 2

for between one and two years at the time of reporting 1

for between two and three years at the time of reporting 0

for between three and four years at the time of reporting 1

for four or more years at the time of reporting 0

For all new off-payroll engagements between 1 April 2013 and 31 March 2014, for more than £220 per day and that last longer than six months:

number

Number of new engagements, or those that reached six months in duration, between 1 April 2013 and 31 March 2014

2

Number of new engagements which include contractual clauses giving Bradford District Care Trust the right to request assurance in relation to income tax and National Insurance obligations

2

Number for whom assurance has been requested 0

of which:

assurance has been received 0

assurance has not been received 2

engagements terminated as a result of assurance not being received 0

In any cases where, exceptionally, the reporting entity has engaged without including contractual clauses allowing it to seek assurance as to their tax obligations – or where assurance has been requested and not received, without a contract termination – the body should set out the reasons for this

Instances where reporting entities are still waiting for information from the individual at the time of reporting should be reported as not received. The Trust obtains assurance annually in September and assurance was provided in September 2013 for the two contracts in place at that time. Assurance will be sought in September 2014 for all contracts in place.

number

Number of off- payroll engagements of board members, and/or senior officers with significant financial responsibility, during the year

0

Number of individuals that have been deemed “board member and/or senior officers with significant financial responsibility” during the financial year. This figure includes both off-payroll and on-payroll engagements

7

Auditor’s Statement

62

63

INDEPENDENT AUDITOR’S REPORT TO THE BOARD OF DIRECTORS OF BRADFORD DISTRICT CARE NHS TRUST

We have audited the financial statements of Bradford District Care NHS Trust for the year ended 31 March 2014 comprising the Statement of Comprehensive Income, the Statement of Financial Position, the Statement of Changes in Taxpayers’ Equity, the Statement of Cash Flows and the related notes. These financial statements have been prepared under applicable law and the accounting policies directed by the Secretary of State with the consent of the Treasury as relevant to the National Health Service in England. We have also audited the information in the Remuneration Report that is subject to audit.

This report is made solely to the Board of Directors of Bradford District Care NHS Trust, as a body, in accordance with Part II of the Audit Commission Act 1998. Our audit work has been undertaken so that we might state to the Board of the Trust, as a body, those matters we are required to state to them in an auditor’s report and for no other purpose. To the fullest extent permitted by law, we do not accept or assume responsibility to anyone other than the Board of the Trust, as a body, for our audit work, for this report or for the opinions we have formed.

Respective responsibilities of Directors and auditor

As explained more fully in the Statement of Directors’ Responsibilities, the Directors are responsible for the preparation of financial statements which give a true and fair view. Our responsibility is to audit, and express an opinion on, the financial statements in accordance with applicable law and International Standards on Auditing (UK and Ireland). Those standards require us to comply with the Auditing Practices Board’s Ethical Standards for Auditors.

Scope of the audit of the financial statements

An audit involves obtaining evidence about the amounts and disclosures in the financial statements sufficient to give reasonable assurance that the financial statements are free from material misstatement, whether caused by fraud or error.

This includes an assessment of: whether the accounting policies are appropriate to the Trust’s circumstances and have been consistently applied and adequately disclosed; the reasonableness of significant accounting estimates made by the Directors; and the overall presentation of the financial statements.

In addition we read all the financial and non-financial

information in the annual report to identify material inconsistencies with the audited financial statements and to identify any information that is apparently materially incorrect based on, or materially inconsistent with, the knowledge acquired by us in the course of performing the audit.

If we become aware of any apparent material misstatements or inconsistencies we consider the implications for our report.

Opinion on financial statements

In our opinion the financial statements:

• give a true and fair view of the financial position of the Trust as at 31 March 2014 and of the Trust’s expenditure and income for the year then ended; and

• have been prepared properly in accordance with the accounting policies directed by the Secretary of State with the consent of the Treasury as relevant to the National Health Service in England.

Opinion on other matters prescribed by the Code of Audit Practice 2010 for local NHS bodies

In our opinion:

• the part of the Remuneration Report subject to audit has been properly prepared in accordance with the accounting policies directed by the Secretary of State with the consent of the Treasury as relevant to the National Health Service in England; and

• the information given in the Strategic Report and Director’s Report tor the financial year for which the financial statements are prepared is consistent with the financial statements.

Matters on which we are required to report by exception

We have nothing to report in respect of the following matters where the Code of Audit Practice 2010 for local NHS bodies requires us to report to you if:

• in our opinion, the Governance Statement does not reflect compliance with the Department of Health’s requirements;

• any referrals to the Secretary of State have been made under section 19 of the Audit Commission Act 1998; or

• any matters have been reported in the public interest under the Audit Commission Act 1998 in the course of, or at the end of the audit.

Auditor’s Statement

64

Conclusion on the Trust’s arrangements for securing economy, efficiency and effectiveness in the use of resources

Trust’s responsibilities

The Trust is responsible for putting in place proper arrangements to secure economy, efficiency and effectiveness in its use of resources, to ensure proper stewardship and governance, and to review regularly the adequacy and effectiveness of these arrangements.

Auditor’s responsibilities

We are required under Section 5 of the Audit Commission Act 1998 to satisfy ourselves that the Trust has made proper arrangements for securing economy, efficiency and effectiveness in its use of resources. The Code of Audit Practice 2010 for local NHS bodies issued by the Audit Commission requires us to report to you our conclusion relating to proper arrangements, having regard to relevant criteria specified by the Audit Commission.

We report if significant matters have come to our attention which prevent us from concluding that the Trust has put in place proper arrangements for securing economy, efficiency and effectiveness in its use of resources. We are not required to consider, nor have we considered, whether all aspects of the Trust’s arrangements for securing economy, efficiency and effectiveness in its use of resources are operating effectively.

Basis of conclusion

We have undertaken our work in accordance with the Code of Audit Practice 2010 for local NHS bodies, having regard to the guidance on the specified criteria, published by the Audit Commission in April 2014, as to whether the Trust has proper arrangements for:

• securing financial resilience; and

• challenging how it secures economy, efficiency and effectiveness.

The Audit Commission has determined these two criteria as those necessary for us to consider under the Code of Audit Practice 2010 for local NHS bodies in satisfying ourselves whether the Trust put in place proper arrangements for securing economy, efficiency and effectiveness in its use of resources for the year ended 31 March 2014.

We planned and performed our work in accordance with the Code of Audit Practice 2010 for local NHS bodies. Based on our risk assessment, we undertook such work as we considered necessary to form a view on whether,

in all material respects, the Trust had put in place proper arrangements to secure economy, efficiency and effectiveness in its use of resources.

Conclusion

On the basis of our work, having regard to the guidance on the specified criteria published by the Audit Commission in April 2014, we are satisfied that, in all material respects, Bradford District Care NHS Trust put in place proper arrangements to secure economy, efficiency and effectiveness in its use of resources for the year ending 31 March 2014.

Certificate

We certify that we have completed the audit of the accounts of Bradford District Care NHS Trust in accordance with the requirements of the Audit Commission Act 1998 and the Code of Audit Practice 2010 for local NHS bodies issued by the Audit Commission.

John Graham Prentice for and on behalf of KPMG LLP, Statutory Auditor

Chartered Accountants 1 The Embankment, Neville Street Leeds LS1 4DW

5 June 2014

66

AppendicesAppendix 1: NHS Services provided by BDCT in 2013/14 p67

Appendix 2: Board biographies p68

Appendix 3: Register of Board Members’ Interests p72

Appendix 4: Commentary on Key Performance Indicators and Glossary of terms p74

Appendix 5: Feedback on Annual Report p76

67

1. A&E Liaison

2. Adult Mental Health Acute Inpatient Services

3. Intensive Home Treatment

4. Psychiatric Intensive Care Unit

5. Psychiatric Rehabilitation Services

6. Older People’s Mental Health – Acute Inpatient Services

7. Criminal Justice Liaison Team

8. Low secure and forensic – community team

9. Low secure and forensic – inpatient service

10. Primary Care Mental Health Services

11. Health Trainer Service

12. Psychological Therapies – specialist service

13. Alcohol Specialist Clinical Nurse Service

14. Bradford Working Women’s Service

15. Substance Misuse – GPSI Service

16. Substance Misuse – Physical Health Nurse Team

17. Substance Misuse Service – Fountains Hall

18. Substance Misuse Service – Keighley Primary Care

19. Substance Misuse Service – North Bradford

20. Substance Misuse Services – Secondary Care

21. Carers Support Service

22. Champions Show the Way

23. Community Nursing Children with Special Needs in Special Schools

24. Chronic Obstructive Pulmonary Disease

25. End of Life Education Team

26. Palliative Care Team

27. Pulmonary Rehabilitation

28. Tissue Viability

29. Continence Service (adults)

30. Speech and Language Therapy

31. Podiatry

32. Dental Public Health Programmes, including fluoride varnish, oral health and epidemiology

33. Salaried Dental Service: clinical plus decontamination

34. Dental unscheduled care

35. Assertive Outreach

36. Community Mental Health Teams – working age adults

37. Older People’s Mental Health – Community Mental Health Teams

38. Child and Adolescent Mental Health Services

39. Learning Disabilities – Assessment and Treatment Unit

40. Learning Disabilities – Health Facilitation and Community Matron Service

41. Learning Disabilities – Intensive Support Team [formerly known as Behavioural Outreach Service]

42. Learning Disabilities – Specialist Therapies Clinical Liaison Team

43. Learning Disabilities – Speech and Language Therapy

44. Early Intervention in Psychosis

45. Case Managers

46. Community Matrons

47. District Nursing

48. Nursing Support Team

49. Family Nurse Partnership

50. Health Visiting

51. School Nursing

52. Looked After Children’s Health Team

53. Safeguarding Children – Child Protection

54. Youth Offending Team: Health Team

55. Falls Exercise Classes

56. Men and Boys Health Team [formerly known as Health of Men Team]

57. Health on the Streets

58. Health Trainers

59. Homeless and New Arrivals Team

60. Hospice at Home

61. Housing for Health

62. Child and Adolescent Mental Health Services – Eating Disorders Tier 3

Appendix 1: NHS Services provided by BDCT in 2013/14

68

Michael Smith Trust Chair(Appointed from 17 September 2012

to 16 September 2016)

As a graduate in systems engineering from the Open University and a MBA from Huddersfield University, Michael has held a number of senior management

positions in the water industry, culminating in Director of Human Resources at Yorkshire Water until 2007. Michael is also involved with a voluntary organisation supporting

people with learning disabilities.

Derrick Palmer Non-Executive Director(Appointed 1 December 2007 again in

December 2011 to December 2015)

Derrick brings a wide range of experience in finance, business planning and governance to our organisation.

He is a qualified accountant and was Finance Director of Bradford Community Housing Trust from its formation

in 2003 until July 2008. Derrick has a portfolio of consultancy and Non-Executive directorships.

Nadira Mirza Non-Executive Director(Appointed from 1 April 2011 – 31 March 2015)

Nadira Mirza is the interim Director of Student and Academic Services at the University of Bradford and is responsible for the student experience ranging from academic skills support to the welfare and careers

services. Nadira is an experienced Board member having sat on a number of NHS and educational Boards and

Committees nationally and internationally. She is currently Chair of the University Academy Keighley and is an

advisor to the international consultancy based in the Netherlands, Management Development Foundation.

Ralph Coyle Non-Executive Director(Appointed 3 May 2011 to 2 May 2016)

Ralph has a wealth of law experience. He has held a variety of positions during his career including Legal

Director and Company Secretary at Yorkshire Television in 1985, company secretary at CANAL+ International and deputy group company secretary for Commercial Union. Ralph is also Vice Chair of Scarborough Museums Trust

and a Member of the Court at the University of Leeds. He was previously a Special Adviser to the Board prior to his

appointment as a Non-Executive Director.

Appendix 2: Board biographies

69

Dr Sue Butler Non-Executive Director, Chair of the Mental Health Legislation

Committee(Appointed from 3 May 2012 – 2 May 2016)

Prior to joining the Trust Board, Sue spent more than 20 years as a general practitioner, and a further nine years as a Primary Care Trust medical director, most recently of NHS Hull. After retiring Sue continued her interest in commissioning as a Clinical Commissioning Champion for the Royal College of General Practitioners and as a member of the NHS III Faculty of Primary Care. Sue has extensive knowledge and experience of the NHS and has worked with a range of stakeholders to increase engagement of the local community. More recently she has continued her public sector interest as an

independent consultant and in a range of voluntary roles.

David Banks Non-Executive Director, Chair of the Finance, Business and

Investment Committee(Appointed 1st December 2013 to 30th November 2017)

David is a chartered accountant with substantial experience of helping businesses through periods of

rapid change. Over his 40 year career, David has held a number of senior private sector roles, including Finance

Director and later Non-Executive Chairman at Zytronic PLC and Non–Executive Director at Castle Support Services

PLC. He has also been involved in a number of company turnarounds and is a founding director of ProTurn Limited, a company specialising in pro-active corporate turnaround.

Rob Vincent CBE Non-Executive Director, Deputy Chair and Chair of the

Charitable Funds Committee(Appointed from 1 March 2013 to 28 Feb 2017)

Rob is a former Chief Executive of two metropolitan councils. He has in-depth experience of managing the changing relationships between local government and the NHS. Rob has most recently been acting as a Local

Government Adviser to Public Health England.


Simon was appointed as Chief Executive of our Trust in September 2006. Simon has a wealth of experience across mental health and community care. Starting out his NHS career as a nurse followed by supporting the

joint implementation of the Community Care Act across the Yorkshire Region with Social Services Inspectorate. In the mid-1990s he led the planning arrangements for

the re-provision of learning disability services and mental health services from institutional settings in Leeds to a

network of community based care and support functions. Simon then became a Health Authority director for

mental health services at Wigan and Bolton and led the planning to move services away from General Hospital site

provision into specialist Trusts. He then project directed the integration of NHS services across Bolton, Salford

and Trafford to form a new mental health trust. He held various positions in that Trust culminating in the interim

chief executive post.

70

Nicola Lees Deputy Chief executive/Director of Nursing

Nicola has worked in mental health services for 30 years. She is a Registered Mental Health Nurse and holds a

Masters degree in practitioner research. Nicola specialised in forensic mental health and has worked in low, medium and high secure services. Nicola joined us March 2009 on

secondment from Greater Manchester West Mental Health Foundation Trust where she was Network Director for

specialist mental health services including eating disorders, CAMHS, low and medium secure services, mental health and deafness and prison in-reach across the North West.

Nicola was appointed substantively as Executive Director of Operations and Nursing in May 2010.

Carol Stubley Director of Finance, Contracting and Estates

Carol has more than 20 years of NHS experience, mainly in the acute sector. Before joining the Care Trust she was seconded from Bradford Teaching Hospitals, where she had been Assistant Director of Finance. Following the merger of the ambulance services, Carol undertook a

number of short term secondments including an external review of governance arrangements at Scarborough

Healthcare NHS Trust and Interim Turnaround Director at Kirklees PCT.

Dr Andy McElligott Medical Director

Andy has worked in the NHS for over 20 years, including 14 years as a GP in Bradford. He has Board level

experience as both a commissioner and provider, having joined our Trust in April 2012 from Bradford and Airedale Primary Care Trust where he was also Medical Director.

Prior to becoming a Medical Director, Andy held a number of clinical-managerial posts including urgent care lead and clinical governance lead. More recently, he has been a member of NHS Employers’ national negotiating

team involved in annual reviews of the GP contract.

Sandra Knight Director of Human Resources and Organisational

Development

Sandra has worked in the NHS for most of her career in a variety of corporate, human resources and organisational

development roles at regional, district, hospital, community and primary care level. She joined our Trust in May 2007 having worked previously as Director of

Corporate Development in Bradford City Teaching PCT and as interim director leading the HR, Communications and PALS/Patient and Public Involvement workstreams, as the four PCTs merged to form Bradford and Airedale

Teaching PCT. She is a qualified executive Coach and ACAS trained mediator.

71

Helen Bourner Commercial Director

Throughout her career, Helen has held a number of high profile NHS management roles. She was also Regional

Director for the Hilton Hotels Group for five years. Helen has held responsibility for customer experience within her previous roles and will bring this wealth of knowledge to the Trust as part of improving patient experience. Helen

was appointed as Commercial Director in April 2013.

Liz Romaniak Director of Finance from June 2014 (Acting Director of Finance

from April 2014)

Liz has enjoyed 23 years working in the NHS, and is a CIMA qualified accountant with various NHS Finance

experience. This includes roles in commissioning as well as provider organisations.

Her previous roles include 9 years’ experience at Community and Mental Health Trusts in Leeds and Wakefield and 7 years in PCG/PCT commissioning.

Liz worked in North Yorkshire from 2000, working to establish the Scarborough, Whitby & Ryedale PCT; where she became Associate Director of Finance. When the 4 North Yorkshire PCTs merged, from North Yorkshire & York PCT, Liz became Assistant Director of Capital and

Financial Accounting.

Liz lives in Guiseley with her husband and joined the Care Trust on a contract basis in late 2007, to provide

Foundation Trust project input. Following a period as Head of Financial Management, Liz was appointed as Deputy Director of Finance, Planning & Performance in 2009.

72

name Position date of interest interests comments

Michael Smith

Non-Executive Director

2007Trustee and Chair, Dark Horse Theatre Company

A theatre company for professional actors and Learning Disabilities, Huddersfield

2011Trustee of Thornton Grammar School Trust, Bradford

Representing BDCT who are members of the Trust

Nadira Mirza


2000 Ishico Lighting Distributors (Owner)

2011Chair of Governors and Trustee, University Academy, Keighley

April 2014Director of Student & Academic Services

Derrick Palmer


April 2009On-going

Governor Heptonstall Junior School

March 2013On-going

Non-Executive Member Audit Committee Land Registry

December 2013On-going

Non-Executive Director Audit Committee Bradford University

January 2014 on-going

Governor Calderdale College

Ralph CoyleNon-Executive Director

Jan 2004Trustee/ Director of Scarborough Museums Trust

2011Member of the Court, Leeds University

Dr Sue Butler


Sole Trader – Performance Development coach

Senior Consultant at Agencia Consulting Ltd

Clinical Governance advisor to provision of substance misuse services in North Lincs

Associate at The Community Performance Partnership

Coaching senior managers at VANL, North Lincs

Trustee Ilkley and District U3A

Robert Vincent


Director of New Ing ConsultantsCurrently contracted to provide advice to Public Health England

Trustee of Lawrence Batley Theatre

Co-owner of New Ing Consulting

Chair of Kirklees Theatre Trustees,

Director of Dartmouth Residential

Appendix 3: Register of Board Members’ Interests

73

David BanksNon-Executive Director

Director of ProTurn Limited(Private company)

Simon LargeChief Executive

Trustee, Bulls Foundation

A registered charity promoting community engagement, health and wellbeing across the Bradford district.

Andy McElligott

Medical Director

- None

Nicola Lees

Chief Operating Officer /Director of Nursing

- None

Sandra Knight

Director of Human Resources & OD

- None

Carol Stubley

Director of Finance, Contracting & Estates

- None

Helen Bourner

Commercial Director

- None

74

Here is a brief description about the main key performance indicators under which the Trust was assessed in 2013/14:

national indicator commentary

Number of in-patients being followed up (Patients receiving Contact within 7 days Discharge)

The number of people under adult mental health specialities on CPA receiving follow up (by phone or face-to-face contact) after discharge


Minimising Delayed Transfers of Care (Health)The number of inpatients whose transfer of care was delayed.

Admissions to Hospital were accessed via Intensive Home Treatment Teams (IHTT)

The number of admissions to the Trust’s inpatient wards where a service user had been assessed before admission or if they were involved in the decision making process which resulted in admission.

Access to healthcare for people with a learning disability

Meeting the six criteria for meeting the needs of people with a learning disability, based on the Department of Health publication ‘Healthcare for All’.

Completeness of MHMDS – Part 1Measures information such as date of birth, gender, NHS number etc.

Completeness of MHMDS – Part 2

Measures levels of recorded outcome measures, and whether individuals’ employment status and settled accommodation has been appropriately recorded within the CPA areas of the clinical system

New psychosis cases by Early Intervention teams The number of new cases seen each year.

Dental referrals to treatment – waiting times (admitted)

Target of 18 weeks from date of referral to actual treatment

Dental referrals to treatment – waiting times (non-admitted)


Dental referrals to treatment – waiting times (incomplete pathways)


Improving access to psychological therapies – percentage of people completing treatment and moving to recovery

Measures the quality of IAPT service outcomes.

Percentage of mothers with breast feeding status recorded

Appendix 4: Commentary on Key Performance Indicators and Glossary of terms

75

Percentage of mothers breast feeding at 6-8 weeks

Percentage received HPV vaccine – Dose 3 cumulative

Data §generated by School Nurses and fed into the Child Health System.

Number of health visitors in postMeasures progress against a national commitment to increase health visitor numbers by 2015.

CPA patients receiving follow up within 3 days of discharge

Measures when service users discharged from inpatient wards are followed up by community teams.


Measures when service users have a formal review with their care coordinator.

Adult mental health average length of stay (YTD)

Adult mental health occupancy rate (excluding Leave)

Measures the use of available beds against the agreed commissioned target.

Prevalence of pressure ulcers, recorded using the Safety Thermometer (YTD)

Mental health clustersMeasures the number of service users that have been allocated to a cluster (a particular diagnosis).

76

It is important our Annual Report is easy to read and understand and is available in a variety of versions including other languages and large print. In producing the Annual Report we have used guidance from the Department of Health and looked at how other Trusts have reported on their own performance.

We would value your feedback on this year’s report. Please complete the feedback form below and post the page to the address shown below. Alternatively you may email your comments to [email protected]

strongly agree agree neither agree nor disagree

disagree strongly disagree

The information in this report was easy to understand

There was enough information about the Trust and its services

There was enough information about the Trust and its achievements

There was enough information about the Trust’s finances

The layout of the document was clear

Please post any feedback to:

Communications Department Bradford District Care Trust New Mill Victoria Road Shipley BD18 3LD

Or telephone: 01274 228351

Appendix 5: Feedback on the Annual Report

78

To ‘Like’ our facebook page, search: Bradford District Care Trust

Follow us on twitter for the latest news: @Bradford_DCT

You and Your Care

Bradford District Care Trust Trust Headquarters New Mill Victoria Road Saltaire Shipley BD18 3LD

Tel: 01274 228300 Web: www.bdct.nhs.uk Email: [email protected]

Your opinions are valuable to us. If you have any views about this report please contact us at the above address.

If you need any help to understand this document please contact our communications team on 01274 363551.

Translation Information:

Annual Report & Accounts - bdct.nhs.uk · Our vision is to provide the best care for the people of...

Documents

Transcript of Annual Report & Accounts - bdct.nhs.uk · Our vision is to provide the best care for the people of...