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South Tyneside NHS Foundation Trust · PDF fileSouth Tyneside NHS Foundation Trust 2015/16...
Transcript of South Tyneside NHS Foundation Trust · PDF fileSouth Tyneside NHS Foundation Trust 2015/16...
Annual Members Meeting
5th December 2016
South Tyneside NHS
Foundation Trust
Welcome and Introduction
Reports for the Year
2015/16
Review of the Year
Chief Executive
Ken Bremner
Key Performance for 2015/16 • Emergency Care 4 hour standard
– 93.4% for all types of A & E attendances including our Urgent Care Hub were seen and treated within 4 hours. National performance was 91.91%.
– 92.87% of Hospital A & E attendances were seen and treated within 4 hours. Nationally, for Type 1 units, the figure was 87.88%.
• Cancer targets met
• 18 week Referral To Treatment targets met
• No cases of MRSA bacteraemia 6 cases of C. Difficile (against a target of 8)
2015/16 Patient Safety Priorities
1. To develop and publish a 3 year Safety Improvement
Plan as part of a 5-year Quality Strategy
2. To create and roll out quality improvement training
3. To further develop our culture of learning from
experience
4. To provide assurance to the Board and patients that we
are continually focused on demonstrating safe staffing
levels
CQC inspection headlines • Overall assessment ‘Requires Improvement’
• 70% all individual assessments ‘good’ or ‘outstanding’
• ‘Outstanding’ for ‘Are services caring?’
• ‘Good’ or ‘Outstanding’ for every community services assessment
• Areas for improvement and include the following - Safety, Quality, Staffing, Environment, Corporate
Annual Report 2015/16
2015/16 Annual Report &
Summary Financial Statements
• Accountability Report
• Governance & Disclosures
• Key Performance Figures
• Annual Governance Statement
• Remuneration Report
• Quality Report
• Assurance Statements from Commissioners, Healthwatch
and Local Authority Oversight and Scrutiny Committee
• Financial Performance
Financial Performance
April 2015 - March 2016 STATEMENT OF COMPREHENSIVE 2015/16 2014/15
INCOME
£000 £000
Income from continuing operations 200,899 208,235
Operating expenses (212,081) (209,063)
Operating deficit (11,182) (828)
Net Finance Costs* (1,782) (2,395)
Transfer by Absorption (St. Benedict’s Hospice) 9,811 -
DEFICIT FOR THE YEAR (3,153) (3,223)
Net revaluations/ (impairments) 10,733 (29,109)
TOTAL COMPREHENSIVE INCOME/(EXPENSES) 7,580 (32,332) * Includes Public Dividend Capital Dividends (1,703) (2,411)
Financial Performance
April 2015 - March 2016 • Underlying Deficit £8,295k after:
• Transfer of St. Benedict’s Hospice £9,811k
• Restructuring costs of (£3,500k)
• Impairments of (£767k)
• Equal pay costs (£402k)
• Achievement of a £10.7m cost improvement
• Closing Cash £15.5m. This includes approximately £12m of loans drawn
down in advance of capital expenditure
• Capital investments £10.3m
• Revised Risk assessment Framework from August 2015. Assessed by
NHS Improvement as ‘2’ for Financial Sustainability Risk Rating and
‘Under Review’ for the Governance Risk Rating
Auditors Report 2015/16
South Tyneside NHS Foundation Trust
2015/16 Audit
Presentation to the Annual Members Meeting
5 December 2016
Deloitte-LBG UK screen 4:3 (19.05 cm x 25.40 cm)
© 2015 Deloitte LLP. Private and confidential.
Scope of our work Accounts, Quality Report and Annual Report Consolidation Schedules
Identification and testing of the key risk areas.
Performance of sample testing and analytical review.
Testing of the auditable sections of the Remuneration
Report.
Review of the work of relevant regulatory bodies.
Review and testing of the Quality Report.
Review of:
The Annual Report for consistency with the
content of the Financial Statements.
The Annual Governance Statement.
Comparison of the Consolidation Schedules to the
audited Annual Report and Accounts.
‘True and Fair’ Opinion
on Accounts
Value for Money & Going
Concern
Consistency of the Consolidation
Schedules
Confirmation to National Audit
Office over content
of WGA schedules
The opinion on the Quality Report was qualified on the A&E 4 hour waits & 18 week RTT indicator.
All other opinions were unmodified.
Standard ‘Limited Assurance’
opinion on
Quality Report
External Audit presentation to Council of Governors
Deloitte PowerPoint timesaver – March 2011
Key Findings
©2015 Deloitte LLP. Private and Confidential
Audit Findings -
Accounting Performance
The Trust submitted its draft and
audited Annual Report and
Accounts ahead of the Monitor
timetable.
Regular meetings have been held
with management through the year.
Early discussions were held to
improve the efficacy and efficiency
of the audit process in certain
areas.
The working papers produced to
support the draft accounts were of
a very high standard and we
received full co-operation from
management throughout the audit
visit.
Annual Governance Statement
The review of the Trust’s Annual
Governance Statement identified no
significant issues.
Accounting policies and
financial reporting
As part of our audit, we
consider the quality and
acceptability of the Trust’s
accounting policies and
financial reporting. We
provided comments to the
Trust on presentational
matters which have been
reflected in the financial
statements.
Annual Report
The Trust provided a largely complete
draft of the Annual Report during the
audit process, and management were
keen to reflect recommendations made.
Controls Findings
We did not identify any significant deficiencies in the financial reporting
systems.
Three recommendations were raised during the audit in relation to the IT
environment. We raised four recommendations with regard to the District Valuer
Service in relation to property valuations.
External Audit presentation to Annual Members Meeting
Deloitte-LBG UK screen 4:3 (19.05 cm x 25.40 cm)
© 2015 Deloitte LLP. Private and confidential.
Value for Money & Going Concern
The Trust faces a number of significant financial challenges in both the short and medium
term that will require careful management going forwards.
Nature of
Risk
The Trust operates in an increasingly financially constrained environment, with significant
ongoing cost pressures.
Work
performed
In order to gain assurance over the Trust’s financial sustainability in relation to value for
money, we completed additional focussed work in this area which included:
• review of the Trust’s financial performance during the year and outturn position and
challenge of management’s assessment of going concern.
• review of correspondence with Monitor in relation to the Trust’s FSRR rating.
• review of Board papers and other documentation in respect of the Trust’s
deficit/variance to plan.
• review of CIP performance in 2015/16.
• review Trust plans for 2016/17 including strategy and mitigating actions to achieve
financial sustainability.
• review of the cash position of the Trust and its future cashflow forecast including
mitigating options agreed to ensure the Trust has sufficient cash headroom to meet its
future liabilities as they fall due.
Based upon the evidence provided to us by management we have accepted the Trust’s
ability to continue as a going concern for the 12 month period to May 2017. We gave a clean
opinion on VfM for the year ended 31st March 2016.
External Audit presentation to Annual Members Meeting
Deloitte-LBG UK screen 4:3 (19.05 cm x 25.40 cm)
© 2015 Deloitte LLP. Private and confidential.
Significant Audit Risks
3 significant risks were identified as part of the 2015/16 audit:
• Risk identified in relation to contract income which may not recognised in the correct period at year end.
• Tested income on a sample basis with no issues to report
Revenue recognition
• Risk required by auditing standards in relation to the potential misstatement of the financial statements as a result of management override of controls.
• No issues noted from our testing.
Management Override of
Controls
• Valuations of Trust properties are by nature significant estimates which are based on specialist and management assumptions.
• We are satisfied that key assumptions are appropriate.
• We raised four recommendations regarding commentary in the valuation report received from the valuer, the inclusion of St Benedict’s Hospice and Haven Court, as well as providing more detail on reasons for changes in the asset portfolio.
Property Valuations
External Audit presentation to Annual Members Meeting
Deloitte-LBG UK screen 4:3 (19.05 cm x 25.40 cm)
© 2015 Deloitte LLP. Private and confidential.
Quality Report Audit
• The scope of our work is to support a “limited assurance” opinion, which is
based upon procedures specified by Monitor in their “Detailed Guidance for
External Assurance on Quality Reports 2015/16”.
• Our audit responsibilities are to review the content and consistency of the quality
report and to undertake testing of three performance indicators, two of which are
mandated and one of which is selected by the Council of Governors.
• In response to the growth of performance indicators across the NHS, we have
developed a framework of considerations for evaluating data quality. We have
used this framework in evaluating our findings and the recommendations we
have raised.
• We have completed our review, including validation of the selected indicators, of
the 2015/16 quality report and documentation.
• We issued a modified opinion in relation to the A&E 4 Hour waits and 18 weeks
RTT indicators.
External Audit presentation to Annual Members Meeting
Chief Executives Update
Ken Bremner
• Single Oversight Framework
• Group Update
• Sustainability and Transformation Plan
(STP)
Forward planning – our draft STP
The Northumberland Tyne and Wear
and North Durham (NTWND) STP
footprint is a new collaboration
covering a total population of 1.7
million residents across three
Localities:
• Newcastle Gateshead
• Northumberland and North
Tyneside
• South Tyneside, Sunderland and
North Durham
STP: Our 3 key gaps
Our STP local plans • ‘Path to Excellence’ Programme of clinical service reviews
• Developing our Out of Hospital services including building on the success of our Sunderland Vanguard Programme and our South Tyneside Pioneer Self Care Programme
• Increasingly working with partners across health and social care to enable greater prevention and earlier intervention
• Developing our Single Executive and Management Team and the South Tyneside and Sunderland Healthcare Group to support both Foundation Trusts
• In the longer term, develop further collaborative opportunities with North Durham
Council of Governors
Reports
Neil Mundy
Chairman
Re-appointment of Non
Executive Director
• Re-appointment of Mrs Pat Harle for a
further 3 years
• Robust appraisal process
• Approved by Council of Governors at
meeting of 22 September 2016
Membership as at end November 2016
Public Members 5518
Gateshead 175
South Tyneside 5109
Sunderland 234
Staff Members 3854
Clinical 2707
Non Clinical 1147
Broad Aims
•To achieve a year on year increase in the Trust’s
membership to ensure an appropriate representation of
the diversity of the community
•Using a range of methods to engage with our members
about the Trust’s vision, mission and objectives
Membership Strategy
Trust Membership
Election Results 2016
Public Constituencies
• Gateshead (elected unopposed)
– Tom Scott
• South Tyneside
– Alan Cormack
– Mo Abuzahra
– David Herbert
– Margaret Eaglesham
• Sunderland
– Hemendra Gandhi
– Chris Morgan
Staff Constituencies
• Staff – Non Clinical (elected unopposed)
– Marion Langley
• Staff – Clinical (elected unopposed)
– Simon Ayre
– Susan Goldsbrough
Congratulations to all our
new and returning Governors
Thank you and Goodbye Dr Rob Bolton, Clinical Staff Governor
Tom Defty, South Tyneside Public Governor
Graeme Hunt, South Tyneside Public Governor
Sophie Marchal, Gateshead Public Governor
Michael McDonnell, Sunderland Public Governor
Elaine Richards, South Tyneside Public Governor
South Tyneside NHS
Foundation Trust
• Thank you
• Annual Members Meeting
• 2016