Annual Report 2004-2005:Putting Patients First
Board Directors
Non Executive Directors
Declaration of Directors'
interests
Value for Money
Statement on Internal Control
2004/05
Download a printable version of the Trust's 2004/05 Annual Report
Chief Executive, Left the Board as Director of Planning May 2004 Joined the Board as Chief Executive May 2004 V R FP |
Director of Operations NV RM FP |
Director of HR, Trust H&S lead V R RM |
Medical Director V RM CG FP |
Director of Nursing, Midwifery & quality & Risk V RM CG |
Director of Capital Planning, Estates and Facilities, Joined the Board August 2004 NV RM |
Director of Finance, Joined the Board October 2004 V A RM FP |
Acting Director of Finance V A RM FP |
Value for Money
Hertfordshire Supply Management Confederation (HSMC) was established in April 2002 to deliver value for money for the NHS in Hertfordshire. As such it is HSMC’s vision to ensure that it provides the NHS in Hertfordshire with the right goods and services, at the right cost and at the right time by implementing best-practice purchasing and supply chain management techniques, whilst also ensuring the Trusts meet their patient health care and legal obligations. In terms of the right cost, this means the lowest economic cost without compromising quality or service.
Furthermore, value for money needs to take into account the whole life costs for products and services as well as processing and transaction costs incurred as part of the procurement process.
HSMC have been performing this role on behalf of West Hertfordshire Hospitals NHS Trust and have delivered significant cost savings as well as process improvements during the last financial year. Cost savings of £678,000 were delivered during the year. Process improvements, this year, included NHS Logistics (NHSLA) out-of-hours deliveries which helped to reduce costs for both West Hertfordshire Hospitals NHS Trust and NHSLA. As a result of these deliveries we are now able to deliver stock earlier to the wards as well as make more effective use of receiving and ward inventory management time.
Further process improvements included the rollout of NHSLA on-line ordering system (Logistics-on-line) which has resulted in reduced paperwork in the system, increased trace ability and reduced phone calls. There were also a number of standardisation projects implemented, which has not only resulted in reduced product costs but will also deliver benefits in terms of standardised products and reduced inventory.
Statement on Internal Control 2004/05*
Scope of Responsibility
The Board is accountable for internal control. As Accountable Officer, and Chief Executive of this Board, I have responsibility for maintaining a sound system of internal control that supports the achievement of the organisation’s policies, aims and objectives. I also have responsibility for safeguarding the public funds and the organisation’s assets for which I am personally responsible as set out in the Accountable Officer Memorandum.
The system of internal control is designed to manage risk to a reasonable level rather than to eliminate all risk of failure to achieve policies, aims and objectives; it can therefore, only provide reasonable and not absolute assurance of effectiveness. The system of internal control is based on an ongoing process designed to:
- Identify and prioritise the risks to the achievement
of the organisation’s policies, aims and objectives,
- Evaluate the likelihood of those risks being realised and the impact should they be realised, and to manage them efficiently, effectively and economically.
The system of internal control and Assurance Framework has been in place in West Hertfordshire Hospitals NHS Trust for the whole year ended 31 March 2005, and up to the date of approval of the annual report and accounts.
Capacity to Handle Risk
The Trust has considered the management and handling of risk as one of its top priorities. The identification and management of risk is seen within the Trust as every employee’s responsibility on a day-to-day basis. To provide leadership and structure in the management of risk, the Director of Nursing, Midwifery, Quality & Risk has specific responsibility for leading the risk management process. This responsibility is discharged throughout the organisation through the Trust’s Head of Quality & Risk and Divisional Risk Leads.
All employees are introduced to Risk Management and Health and Safety at Induction and this is revisited at mandatory staff updates yearly. The Trust hosts regular study days for Managers on Risk Management and Health and Safety, which addresses their individual responsibilities in detail. As Accountable Officer I seek to learn from good practice via exchange of information with other Chief Executives regarding good practice in their organisations, reading of relevant articles and documentation and advice from managers and staff within the Trust as to what has worked well in handling risk and should be rolled out across the organisation.
An improved incident reporting procedure was further embedded during 2004/5, accompanied by a significant increase in incident reporting. This has ensured that there is a proactive as well as reactive mechanism for conducting
risk assessment thus ensuring risk prioritisation, reduction of errors and Trust
wide learning from incidents.
The Assurance Framework is supported by the
ongoing review of the Trust’s compliance with the 22 Control Assurance standards
until its abolishment in August 2004. There was Executive responsibility for
each of the Controls Assurance Standards. The Trust has now commenced
self-assessment against the new ‘Standards for Better Health’.
As
Accountable Officer, I have responsibility for reviewing the effectiveness of
the system of internal control. My review is informed in a number of ways. The
Head of Internal Audit will provide me with an opinion statement on the overall
arrangements for gaining assurance through the Assurance Framework and on the
controls reviewed as part of the internal audit work. Executive Directors within
the organisation who have responsibility for the development and maintenance of
the system
of internal control provide me with assurance.
Significant Internal Control Issues
- The Trust failed to break even on its income and expenditure account in
2004/05, reporting a deficit of £9.978m. The Trust has forecast that if this
deficit is carried forward, and known cost and income trends continue, a further
substantial deficit would result in 2005/06. The steps the Trust is taking to
remedy the situation include:
- Agreeing a financial recovery plan with the Strategic Health Authority to achieve financial balance over a three-year period, and
- Putting in place a Board approved agreed action plan to strengthen the financial management and governance arrangements of the Trust.
- Following a Health and Safety Executive visit and review, a number of risk areas were identified for the Trust. The Trust agreed an action plan to address these risk areas. These actions have been implemented during the course of the year and the Trust is continuing discussions with the Health and Safety Executive about any further measures that are required to ensure compliance.
David Law, Chief Executive
*this is an abridged version of the full
statement of internal control which can be found in the Trust's full
accounts
Emergency Preparedness
The NHS faces a number of new challenges in the field of emergency planning. Although Trusts have long had plans to handle major incidents, they are now faced with new threats of increased scale and uncertain nature. It is therefore essential that plans are robust and accurate, and that West Herts Trust works closely with other agencies throughout the region in order that we are able to respond together to major incidents and emergencies.
The Emergency Planning Group is responsible for ensuring that emergency plans are in place, and that lessons are learnt from exercises and incidents. The Group is comprised of staff from all Divisions within the Trust, as well as representatives from the Primary Care Trust, Hertfordshire Partnership Trust, Ambulance Trust and County Council. The Trust is committed to adopting a multi-agency approach to Emergency Planning, and is also represented on a number of external emergency planning groups led by HESMIC (Hertfordshire Emergency Services Major Incident Committee).
A number of training events and exercises have taken place throughout the year. Notably a two-day exercise run in February 2005, facilitated by the Emergotrain team from the Coventry University Centre for Disaster Management. The exercise was run in real-time using the Emergo format of magnetic simulated patients and departments, giving a hands-on approach in making decisions under pressure and treating the 'patients'. Some 28 staff took part, taking on the role that they would play in a real incident and working in three core teams: Control Room, A&E and Rest of Hospital. The scenario was a roof collapse, involving large numbers of casualties being treated at both Watford General and Hemel Hempstead General Hospitals. A debrief was held after the exercise, with lessons learnt being incorporated into the formal Major Incident Plan Review.
The Trust continually works on reviewing and improving its emergency procedures, and new legislation (i.e. the Civil Contingencies Act) and new Department of Health guidelines underpins the Emergency Planning process. An emergency planning schedule outlines the key projects to be taken forward over the coming months, including ongoing training sessions and exercises, planning for Pandemic Flu, Hospital Evacuation Plans and Business Continuity.
Auditor's Report
Independent Auditor’s Report to the Directors of the Board of West Hertfordshire Hospitals NHS Trust on the Summary Financial Statements.
I have examined the summary financial statements set out in the >>Financial Review. This report is made solely to the Board of West Hertfordshire Hospitals NHS Trust in accordance with Part II of the Audit Commission Act 1998 and for no other purpose, as set out in paragraph 54 of the Statement of Responsibilities of Auditors and of Audited Bodies, prepared by the Audit Commission.
Respective responsibilities of directors and auditors
The directors are responsible for preparing the Annual Report. My responsibility is to report to you my opinion on the consistency of the summary financial statements with the statutory financial statements. I also read the other information contained in the Annual Report and consider the implications for my report if I become aware of any misstatements or material inconsistencies with the summary financial statements.
Basis of opinion
I conducted my work in accordance with Bulletin 1999/6 ‘The auditors' statement on the summary financial statement’ issued by the Auditing Practices Board for use in the United Kingdom.
Opinion
In my opinion the
summary financial statements are consistent with the statutory financial
statements of the Trust for the year ended 31 March 2005 on which I have issued
an unqualified opinion.
*this is an abridged version of the full
statement of internal control which can be found in the Trust’s full
accounts.
Rob Murray
Date: 24 August 2005
Address:
Audit Commission, Sheffield House,
Lytton way, Off Gates Way Stevenage Herts
SG1 3HG