HULL AND EAST YORKSHIRE HOSPITALS NHS TRUST ANNUAL GENERAL MEETING 27 SEPTEMBER 2013

Leadership Development Partnership Working Service Development Time for Reflection Robust systems & processes for Clinical Governance Board Development Elective Access Financial Management Involvement Staff Emergency Access Patient Involvement Communications Teamwork Themes

Outline Finances Performance Quality and Safety Staff engagement Francis review Issues and Challenges for this next year and beyond…

Finances How we used all of our money…

FINANCIAL PERFORMANCE REVIEW 2012/13 The Trust achieved all of its financial duties in 2012/13 To Break Even To Achieve A 3.5% Return on Capital To Operate Within Our External Finance Limit To Operate Within Our Capital Resource Limit

BREAK EVEN DUTY As an NHS Trust we are required to at least break even. For the seventh successive year we achieved an operating surplus. The £34M we have generated over the last 7 years has been used to repay loans and invest in our property, plant and equipment. We generate surpluses so that we can ensure a sound financial basis for the future particularly recognising the challenging economic environment. 2006/07 (£M) 2007/08 (£M) 2008/09 (£M) 2009/10 (£M) 2010/11 (£M) 2011/12 (£M) 2012/13 (£M)

HOW DO WE SPEND OUR MONEY (£M) Pay294 Supplies and Services - Clinical107 Supplies and Services - Other 14 Premises 21 Depreciation 13 Establishment Expenses 7 Clinical Negligence 10 Other 14 Total480 Our expenditure in 2012/13 was £480M (excluding impairments), which can be summarised as:

HOW WE SPENT OUR MONEY During the year we invested additional resources into a number of clinical services: DEVELOPMENTS(£000) Winter Pressures – extra beds, 7 day Therapy and Pharmacy Service1528 PRH Physiotherapy X-Ray Relocation 250 AAA Screening Service 137 Diabetes Structured Education 128 Neuropsychologist 125 Expansion of Cystic Fibrosis Service 45 Move to Digital Mammography 66 Community Paediatrics – Staffing and IT Equipment 72 Breast Screening Expansion 24 Total2375

FACTS YOU DIDN’T KNOW ABOUT OUR CATERING SERVICES…… 691,600 PORTIONS OF POTATOES £110, ,104 SLICES OF TOAST £33, ,024 PINTS OF MILK £246,848 PATIENTS CONSUMED 761,761 MEALS PATIENTS, VISITORS AND STAFF CONSUMED 3,010,620 HOT BEVERAGES

FACTS YOU DIDN’T KNOW ABOUT OUR DOMESTIC SERVICES…… 200,000 CLEANING CLOTHS ARE USED EACH YEAR WE USE 4,320 LITRES OF TOILET CLEANER WE USE 292,000 MOPS PER YEAR WITHIN THE TRUST THE TRUST WASHING MACHINES OPERATE 8760 HOURS PER YEAR CLEANING MOPS AND CLOTHS

HOW WE SPENT OUR MONEY We invested £20M in property, plant and equipment (£M) Building Projects New Emergency Department Upgrade to the façade of the Hull Royal Infirmary Programmes Backlog maintenance Other Equipment Medical and Scientific Equipment Information technology TOTAL SPENT ____ 19.7 ____

IN SUMMARY We’ve had another successful financial year Our sound financial management has helped us grow, develop and invest in our clinical services The impact of the economic environment will set significant challenges for the NHS over the next few years

Performance How we delivered national targets…

National Requirements A and E 95% in 4 hrs 18 weeks to treat Cancer 2 week wait Cancer 31 days diagnosis Cancer 62 days MRSA 7 maximum C-Diff 60 maximum Learning Disability MET

Quality and Safety How we made it better for our patients…

Issues Mortality Complaints Never Events and SUIs Patient Experience Friends and Family Test

Complaint numbers Complaints per 1000 spells 2012/13 against similar sized and local trusts

Benchmarking our complaint numbers against other Trusts per 1000 FCE

Never Events and SUIs Smaller than us Bigger than us Same size as us

Friends and Family data July 2013 Trusts ranked by net promoter score Source NHS England July 2013 data

Top Ten Hospitals for number of Inpatient returns Source NHS England July 2013 data LEEDS TEACHING HOSPITALS NHS TRUST 2,301 NOTTINGHAM UNIVERSITY HOSPITALS NHS TRUST 2,213 BARKING, HAVERING AND REDBRIDGE UNIVERSITY HOSPITALS NHS TRUST 1,866 EAST LANCASHIRE HOSPITALS NHS TRUST 1,835 HULL AND EAST YORKSHIRE HOSPITALS NHS TRUST 1,771 UNIVERSITY HOSPITALS OF LEICESTER NHS TRUST 1,630 BARTS HEALTH NHS TRUST 1,508 SHEFFIELD TEACHING HOSPITALS NHS FOUNDATION TRUST 1,417 COUNTY DURHAM AND DARLINGTON NHS FOUNDATION TRUST 1,324 PORTSMOUTH HOSPITALS NHS TRUST 1,316

HEY 30% % 10.1% 3.2% 5.0% 11.2% 91.7% 8.4% 39% 1.3%

Changes in Senior Doc Numbers at HEY

Staff Engagement How we listened and responded to our people…

Initiatives Pioneer Teams Make it happen fund Lottery Flu day Big Conversations Pulse check Great Leaders Link Listeners Golden Hearts Valentine’s Ball Dragon’s Den Pathfinders Setting the Standard Consultant Conference Nurse Conference AHP Conference Pathfinders Moments of Magic Summer BBQ Christmas Tree and Carols

Francis Report How we responded to national concerns about the NHS…

Progress Identified quickly top 11 and top 27 most important themes Steering Board and sub-groups set up Supervisory Ward Sisters Nurse Senate established Intentional rounding Transparency project pilot site Setting the standard for Wards developed Acuity and dependency levels of patients Staffing numbers to be displayed Additional nurse staffing on some wards

Issues and Challenges for this next year and beyond How we face an uncertain future…

Zanussi washing machine

THE FINANCIAL FUTURE The NHS, along with the rest of the public sector, faces significant financial challenges. In England, continuing with the current model of care will result in the NHS facing a funding gap of around £30BN between 2013/14 and 2020/21. This estimate is before taking into account any productivity improvements and assumes that the health budget will remain protected in real terms. Funding cuts have not impacted on the NHS as much as other public services, despite this we expect little growth in our funding over the next few years, alongside growing demand for our services and the need to maintain and improve the quality of our services. We need to save £95M over the next five years in order to remain on a sound financial footing and we will do this by becoming more efficient and more productive.

% GDP “The scissors of doom…”

Treasury forecast at 90% GDP “The scissors of doom…” “Real” forecast at 161% GDP

Paying off the debt at £1 per second… If we owed £1m If we owed £1bn We owe over £1trillion 11.5 days 33.5 years 33,500 years Debt is increasing at £14,000 per second

“100 Years Old” Telegrams sent YearNumber Sent ,000,000

How our staff feel…

How our organisation feels…

Being Vulnerable… CQC NHS England TDA DoHMonitor We’re here to help….

How our patients must sometimes feel…

How I feel…

Why we do it??