WHHT - Annual Report 06/07 - Accounts

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Annual Report 2004-2005: Introduction

Introduction to annual report 2004-05

As a Trust we have needed to...
Comments from Jessie Winyard, Chair, Patients' Panel
Comments from Dr Sarah Hill, Associate Medical Director, Consultant Development
Comments from Dr Ian Barrison, Associate Medical Director, Postgraduate Education
Comments from Dr Adam Young, Associate Medical Director, Clinical Governance: Clinical Effectiveness, Audit, Research & Development
Comments from Alfa Sa'adu, Deputy Medical Director

Download a printable version of the Trust's 2004/05 Annual Report

Introduction: On the road to recovery

The NHS experienced one of its most challenging years in 2004/05. There has been very substantial public investment in the service to improve the standards and timeliness of care. In return for this investment, the performance of the NHS has to improve to meet the changing expectations of patients and the population. In West Herts the pressures have been intensified by a long history of financial and organisational problems.David Law, Chief Executive and Robin Douglas, Acting Chairman

As a Trust we have needed to:

The key objective for the Trust must continue to be the efficient provision of high quality services to people who need acute health care. We have been privileged to witness many examples of superb clinical care within this organisation.

The turnaround of performance in A&E has been outstanding and shows the importance of strong clinical leadership and multidisciplinary working. We have recently celebrated success in nursing and midwifery, and there are many other examples of excellence in the medical, therapy and other clinical professions.

We will continue to focus on the quality of treatment and care that we offer. We achieved a one star rating as a Trust which was a deserved improvement on last year. We were pleased to have the progress we have made acknowledged. Whilst our clinical services are good and score well on the relevant league tables, we let ourselves down on the star ratings because we are not so good on some of the measures which are important to patients - infection control, waiting times for cancer treatment, the cleanliness of our facilities, cancelled operations and so on.

In future these issues will, rightly, be of increasing importance and the health of the organisation will depend on how well we perform. It is a cliché to refer to staff as our greatest asset. But it is true. Motivated, dedicated staff, with the right clinical skills and with the right managerial skills are key to the success of the organisation and to the well-being of the patient. We will put in place a programme of development to support staff and improve services.

We are confident that we can turn the organisation around and redevelop our sites so that we become the employer of choice as well as the provider of choice for local people. The Trust Executive, which now has strong clinical representation on it, will provide leadership.

The challenge for all of us is to work well together, concentrating on patients’ needs and the efficiency of our services. We are at a crossroads as an organisation and the next twelve months will be critical. We have great challenges to face but we have every confidence that we can succeed.

Jessie Winyard, Chair, Patients’ Panel

The past year has been difficult for the Trust and for the staff as a whole. There are still many hurdles to cross but we are on the right road again. We are not the only Trust going through a rough time but already we have made inroads by regaining one star in the 2004/05 performance ratings, although from a patient point of view the way in which staff have pulled together, in my view, has made you all five star status.

We, the Patients’ Panel, appreciate everything that is being done – the new Dermatology Units at Watford and Hemel hospitals, the new Breast Centralisation Unit at St Albans City Hospital, which will open in the autumn and the new Endoscopy suite that will shortly be opening at Watford General Hospital.

This year’s ‘Celebrating our Success’ Conference, held in July, was so uplifting. We saw the dedication of staff in their various fields and learnt so much. So thank you to a great team, whatever part you play, from a Patients’ Panel who are also your patients and critical friends.

Dr Sarah Hill, Associate Medical Director, Consultant Development

It's been an exciting year with achievements and some challenges. For the first time, we achieved 100% compliance with consultant appraisal for the year 04/05. We are now awaiting guidance from the GMC regarding the link between appraisal and revalidation. Our challenge will be to prepare all the doctors working within the Trust for revalidation expected in 2006.

Our second success was the transfer of over 70% of consultants onto the new consultant contract. This means that the Trust is now in a strong position to adapt to future changes within the NHS.

We have established an induction programme designed for new consultants, introducing them to key personnel within the Trust, PCTs and community.

The British Association of Medical Managers (BAMM) are supporting this programme, offering an insight for new consultants into management methods.

Dr Ian Barrison, Associate Medical Director, Postgraduate Education

The past twelve months have been both challenging and successful for Postgraduate Education. The Trust has begun the Foundation Year 1 programme, with an additional seven PRHO posts and excellent rotations with the University College London and Imperial College. The Foundation Year 2 programme is under development and the Trust has achieved funding for innovative posts linked with Public Health and Palliative Care.

The February and August induction days were well received and passed a recent CNST inspection. We have continued to use a rolling induction programme to complement the main Induction days and to ensure that all mandatory training sessions are covered.

We continue to accept an increased number of medical students from the London medical schools. The Undergraduate Administrator has successfully set up a rolling teaching programme for Medical Students that incorporates clinical skills and the University noted this as an area of good practice during a recent visit.

The Clinical Skills Laboratory has seen an increase in its use during the past twelve months with both Undergraduates and Postgraduates using it on a weekly basis.

Dr Adam Young, Associate Medical Director, Clinical Governance: Clinical Effectiveness, Audit, Research & Development

Clinical Governance is now well established within the Clinical Divisions and sub specialties. Emphasis has been on the patient’s experience and satisfaction, communication with patients and relatives, and getting the basics right (record keeping, food and nutrition, privacy and dignity, communications, hospital cleanliness).

Promotion and monitoring of the use of national clinical guidance throughout the Trust has been successful, with 85% full or partial compliance with NICE guidelines. Collaborations with primary care have increased to promote clinical effectiveness standards and to share information on best practice.

A new R&D consortium has been established incorporating East and North Herts NHS Trust, hosted by West Hertfordshire Hospitals NHS Trust, with a strategy to promote and further develop research in Hertfordshire. Response criteria for management of ovarian cancer developed by West Hertfordshire Hospitals NHS Trust have been adopted internationally.

National and mandatory audits have been completed and delivered on time by Clinical Audit. Clinical Divisions carry out regular audits of guidelines and priority projects as part of an agreed audit program.

Alfa Sa’adu, Deputy Medical Director

Shorter waiting times in our A&E departments, independent acknowledgment that we have an excellent stroke service and gaining a star in the performance ratings, form, for me, the three major highlights for this past year.

The Watford Stroke Unit was recently ranked 15 out of 246 hospitals in the ‘National Sentinel Audit for Stroke 2004’ commissioned by the Healthcare Commission. This independent audit has given us the chance to compare our performance with every other organisation caring for stroke. It is a tribute to the huge amount of work by everyone involved that we came eighth out of all District General Hospitals and 10 most improved Trusts since the last audit in 2002. This will motivate us all to stay on top, and help attract new members to the team.

The Trust is now consistently meeting the target to see, treat and admit or discharge 98% or more patients attending A&E within four hours. This is not easy and I see first hand how hard our staff work to make reach this challenging

Hearing from patients, their relatives and carers is so important. West Hertfordshire Hospitals NHS Trust is lucky to have the ‘critical friendship’ of both the Patient and Public Involvement Forum and the Patients’ Panel, and an army of Patient Representatives. Thank you.

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