Trust records improvement across the board for 2012/13

Despite one of the most challenging economic environments for many years and against a back drop of major reform across health and social care, the Trust ended the 2012/13 year achieving virtually every standard set nationally, regionally and locally covering:

  • Improving again the experience patients have of the care provided at the Trust’s hospitals;
  • Maintaining and developing the quality of care provided by the Trust’s clinical teams;
  • Reducing risks to patients’ health and well-being while in the Trust’s care;
  • Delivering waiting times standards;
  • Reconfiguring emergency and inpatient services;
  • Ensuring all financial measures set by the Trust were attained, including ending the year in surplus

The Trust’s chief executive, Nick Carver, said:
“Over the last 12 months, our staff have worked very hard to improve the services provided to patients using our hospitals. The Trust’s ambition is to become amongst the very best hospital groups in the English National Health Service and last year saw us begin that upward journey in moving from being at or close to the NHS average.
“In some areas already, for example our hugely reduced hospital-acquired infections rates and mortality levels for fractured hips, we are already performing alongside the best NHS trusts in the country. Across virtually every other indicator we monitor, we saw significant progress being made.”

Some of the performance highlights for the last 12 months are set out below.

Improving patient experience

  • 2012 inpatient survey (published March 2013) showed general improvement in most areas questioned compared to the previous year, reflecting a general upward trend in patient experience recorded through other means such as the Trust’s own in-house services and feedback left on national services such as NHS Choices and Patient Opinion;
  • The Trust was within the top performing quartile of NHS trusts in the Midlands and East region for the Government’s new Friends and family test for nine of the 12 months during 2012/13. In terms of response rates, the Trust consistently has been in the top five out of 46 NHS trusts;
  • Despite the Trust encouraging its patients actively to always raise matters of concern, the number of complaints received by the Trust fell by 5% in 2012/13.

Higher quality care

  • Mortality rates across the Trust have continued a steady improvement, which has been the case since the fourth quarter of 2010/11. Although the final figures for 2012/13 will not be known for a while yet, the Trust had an overall hospital standardised mortality ratio (HSMR) of 94.6 (the expected average is 100) for the first 10 months of the year;
  • For fractured neck of femur, which typically involves elderly frail patients with fractured hips, the HSMR rate for the same period was 88.1 – placing the Trust amongst the best performing hospital groups when it comes to treating this particularly vulnerable group of patients. This improved position follows the bringing together of the Trust’s fractured neck of femur services in to a single unit, which is based currently at Princes Wing at the QEII prior it moving to its longer-term home towards the end of 2014 in the redeveloped Lister hospital.

Reducing risk to patients

  •  The Trust’s nursing staff reduced the overall incidence of grade two to four pressure ulcers by 48% compared to the previous year – with no grade four ulcers (the most severe perform) found in any patient throughout 2012/13;
  • There was also a reduction of 26% in the number of falls involving inpatients, with 97.7% of the falls that did happen resulting in little or no harm;
  • Last year saw the Trust record just two hospital-acquired MRSA blood infections (bacteraemias) and 13 infections caused by Clostridium difficile (against targets of three and 14 respectively). This means that infection levels are at an all-time low – once again – for the Trust, placing it amongst the best performing NHS trusts in the country

Delivering waiting times standards

  • Despite some of the most challenging months over the winter period – March 2013 saw the Trust admit 400 more patients via A&E compared to the same month in 2012 – the year-end A&E standard (at least 95% of patients being seen, treated and admitted/discharged within four hours of arrival) was achieved;
  • All other waiting times standards, including 18-week referral to treatment and those covering cancer, were also delivered.

Managing finances well

  • For the fifth year in a row, the Trust returned a small surplus (£0.5 million – final figure subject to final confirmation once accounts are audited fully);
  • The Trust savings and efficiency programme – known as CIPs within the NHS – looks set to have been delivered (£15.021 million out of total turnover of circa £350 million – again subject to final year-end verification of CIPs).
    Reconfiguring emergency and inpatient services
  • With the Trust’s new maternity unit now based at the Lister, which is the site at which the vast majority of emergency surgery now takes places as well, the £150 million programme to redevelop facilities at the Lister is now well underway;
  • 2012/13 saw the Trust’s business case to build new emergency department, wards block and theatres unit at the Lister approved – building work is now well underway and these exciting new facilities will be ready by the end of 2014;
  • The local clinical commissioning group is leading the construction of the New QEII Hospital, which is set to be ready by Spring 2015;
  •  New radiotherapy services have been developed at the Mount Vernon Cancer Centre over the last 12 months, where work is also under way to secure ownership of this part of the Mount Vernon Hospital site so that major redevelopment works – including of the inpatient wards – can be undertaken in future years.

Commenting again on the Trust’s performance last year, its chief executive, Nick Carver, said:
“2012/13 saw the Trust build on improving performances that have been happening for several years now. This should not be confused with everything being done 100% right, first time and every time. That remains our ambition if we are to realise our vision of becoming amongst the best in the NHS.

“Part of the continued success that the Trust enjoys currently has been its focus on improving organisational culture. For two years – and in anticipation of the recommendations made in the Francis Report published recently – the Trust has been working devolve decision-making and responsibility increasingly to front line clinical teams and their leadership.

“There is plenty of evidence from across various sectors that show staff who feel engaged with the work they do, perform better in those roles. Emerging research also suggests that in the health service, this results in lower mortality rates and improved patient experience. After two years of our programme being rolled out, we are beginning to see that happen within the Trust.

“Our challenge now, working in partnership with our commissioners, is to foster and support this changing organisational culture – for us this is very much a long term commitment – at the same time we deliver services through our redeveloped Lister hospital, as well as the New QEII Hospital being built in Welwyn Garden City.

“So to summarise – a year of very good achievement, but – as always – more needs to be done. That good performance, however, must be seen as a tribute to some of the best staff to be found in the NHS. Whilst 2013/14 looks set to be equally challenging for the health service, I am confident that not only are we in good shape to meet those challenges but we can continue to prosper too.”