2015/2016 Annual Report & Annual Accounts

223 Pages·2016·2.91 MB·English

Torbay and South Devon NHS Foundation Trust

Annual Report and Annual Accounts 2015/16

Torbay and South Devon NHS Foundation Trust
Annual Report and Annual Accounts 2015/16

Presented to Parliament pursuant to Schedule 7,
paragraph 25 (4) (a) of the National Health Service Act 2006.
©2016 Torbay and South Devon NHS Foundation Trust
Annual Report and Annual Accounts 2015/2016
Incorporating the performance report, accountability report and quality report.

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Laid before Parliament

This Annual Report 2015/16 has been produced to be laid before Parliament in July 2016,
together with the full accounts for the same period, and to be presented to the Trust’s
Council of Governors at its annual members’ meeting. It will be available on the Trust’s
website www.torbayandsouthdevon.nhs.uk/ and Monitor’s website.

A Summary Annual Review, based on this report will also be available later in the year.

Torbay and South Devon NHS Foundation Trust
Hengrave House
Torquay
TQ2 7AA
Switchboard: 01803 614567
HQ Fax: [phone]
www.torbayandsouthdevon.nhs.uk/
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Contents

Part I: Performance Report 08

Overview of performance
Chairman’s statement 08
Chief executive’s statement 09
A brief history about the foundation trust and its statutory background 11
Performance analysis 14

Part II: Accountability Report 19

Directors report 20
Remuneration report 26
Staff report 38
The disclosures set out in the NHS foundation trust code of governance 46
Regulatory ratings 54
A statement of accounting officer’s responsibilities 58
An annual governance statement 59

Part III: Quality Report 76

Includes the independent auditors’ limited assurance report to the Council of Governors of
Torbay and South Devon NHS Foundation Trust on the annual quality report

Annual Accounts 2015/16 165

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Part I: Performance Report

Overview of performance

Chair’s statement
Richard Ibbotson

I write this foreword to our annual report for the first time as the Chairman of Torbay and
South Devon NHS Foundation Trust. The merger of South Devon Healthcare NHS
Foundation Trust with Torbay and Southern Devon Health and Care NHS Trust meant this
new integrated care organisation became a reality on 1 October last year. Since then a
great deal has happened, but we are still at the beginning of a journey and the pace of
change continues to increase. We must keep in the forefront of our minds that the motive
for these changes is simply that we provide the best we can with the resources available
for the people that we serve. Making these changes during a period of remarkable
operational pressures and increasingly limited money is difficult and is having an impact
on the pace of delivery. Nevertheless, your Board remains determined to achieve
success.

Many of the Board team are new since last year, and from August this year (when our
Director of Human Resources and Organisational Development arrives) we will have a full
set of substantive executives for the first time in ages. This is a strong, carefully selected
team that will lead us through the challenges ahead, of which there will be plenty. I write
this whilst awaiting our Care Quality Commission (CQC) inspection report; inevitably there
will be implications for us from this. The success regime work in the neighbouring North,
East, West (NEW) Devon area will impact on us, and the Clinical Commissioning Group
led public consultation work on the reconfiguration of community services is gathering
momentum. Finally, there is due diligence work underway on children’s social services in
our area. This latter is currently not delivered from within the Trust, but may well be in the
future. All these topics will have consequences for us as we move the integrated care
organisation (ICO) forwards.

Internally I remain in awe of our health and social care professionals who handle the
unrelenting pressure with compassion, patience, and friendly efficiency for our patients
and clients. Our emergency department (ED) typifies this approach. Here the problems
remain very significant, but the determined ED engagement, not solely in the department
but across the whole Trust, is starting to deliver positive change.

So, my message is firstly thank you to all Trust staff for holding the line during exceedingly
challenging times, and secondly that I judge we remain well placed to take the Trust
forward as we move into the delivery phase of being an integrated care organisation. This
is a phase where local people will really start to see the benefits of integration, and where
we are able to deliver health and care services that are truly centred around them and
their needs.

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Chief Executive’s statement
Mairead McAlinden

This report marks both an exciting and challenging year, exciting because October saw
the launch of our new Integrated Care Organisation and brought together our two local
Trusts into the Torbay and South Devon NHS Foundation Trust - one of the first in
England to bring community health, adult social care and acute hospital provision into a
single provider organisation. We are now a large and complex Trust with 6,000 staff and
an annual budget of around £375 million. I thank all the partners who worked so hard to
achieve the approval for our new ICO, particularly South Devon and Torbay Clinical
Commissioning Group (CCG) and Torbay Council, the leadership of both our legacy
Trusts, our many supporters across our community and, importantly, our dedicated staff
who saw the benefits for our local population and put their needs first.

This level of organisational change is always a challenge for staff, and I commend them
all for the support and patience they have shown, as well as ensuring local people
received effective care throughout the transition and beyond. We have also faced
significant pressures on our services, urgent care in particular, and staff have done their
very best, right across our system of care, to manage these pressures through a difficult
winter. These challenges are still with us, and that is why this change is so important - it
creates the conditions for delivering a new model of care that moves resources from bed
based care to care in the community, closely working with our local GPs, and developing
stronger partnership working with our local voluntary sector and other public services to
deliver truly 'place based' care in or local to home.

We are working with our commissioners to change how care is delivered, and we are
asking local people to understand the need for change and help us to deliver a better
model of care, one that better meets the needs of the most vulnerable and supports
people to live their life to the full.

There are two main performance issues I wish to highlight during the year in relation to
Monitor’s targets:

- the accident and emergency (A&E) four-hour target and
- the Trust’s failure to meet the 18-weeks in aggregate referral to treatment (RTT)
time for incomplete pathways.

The four hour standard has remained a challenge throughout the year with timely flow of
patients being the most significant problem.
A number of initiatives are being introduced to streamline assessment processes to
ensure patients can be seen by a senior doctor and vital signs are taken promptly by the
clinical team. An additional ward has been permanently staffed to address the ongoing
pressures on bed capacity. Work has been ongoing to improve discharge processes and
a new IT system was introduced in the summer of 2015 to improve the quality of clinical
and management information recorded in the emergency department.
Referral to treatment waiting lists for treatment in several specialities including
ophthalmology, upper gastroenterology and orthopaedics have been the main challenges
in achieving RTT in 2015-16.

Significant progress has been made during the year to improve performance in these
areas with overall compliance with RTT standards by July 2016.
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The Trust continues to perform well against all cancer targets with compliance being
maintained throughout the year.

Other references to performance for 2015-16 are covered in several sections throughout
this report:

- Performance Analysis (pages 14 to 18)
- Regulatory Ratings (pages 54 to 57)
- Annual Governance Statement (pages 59 to 73)
- Part three of the Quality Report (pages 143 to 147)

Keys issues and risks to Trust objectives can be found with the annual governance
statement (pages 61 to 65).

This report sets out our progress during the last year against our targets and shows you
how we have used our resources to provide health and care to local people.

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