Local Healthcare Now and in the

Future (and AGM)

Welcome to The Princess Alexandra Hospital Local Healthcare Event and

Annual General Meeting

“To deliver the best possible patient care in a safe, reliable, effective

and respectful environment”

Who We Are and What We Do

2995 people work to provide a range of safe and reliable hospital services to a local population of 258,000. Responding to local need and accountabilityby becoming an NHS Foundation Trust.

DID YOU KNOW?

• Good rating for quality of services • 86,000 emergency attendances• 3596 babies were born• £9.5 million was invested into the Estate• 80.8% day case rate, compared to national average of 69.5%

Source: 07/08 Annual Report

Seeing A&E attendance within four hours

C-Diff and MRSA rates

18 Weeks

Promoting Clinical Excellence

Delivering Local Healthcare

It is about…..

• Improving Patient Care, Safety and Access

• Providing Care in the Most Appropriate Setting

• Improving the Quality of Facilities and Accommodation

• Being a Model Employer

• Improving Efficiency

• Growing the Trust

Thank You

The Agenda 6:30pm The Importance of Health in Sport

Bob Winnington, Commercial Manager

Bishops Stortford Rugby Club

6:45pm Infection Control – We’ve Got It Covered

Dr Jeff Phillips, Consultant Intensivist/Clinical Lead

Infection Control

7:00pm Investing in the Patient ExperienceSharon Cullen, Associate Director of Nursing

7:15pm Update on the Year Chris Pocklington, Chief Executive

7:25pm Finances of The TrustGordon Flack, Executive Director of Finance

7:30pm Questions to the Trust

The Importanceof Health in

Sport

Bob Winnington,Commercial Manager

Bishop’s Stortford Rugby Football Club

Bob Winnington, Commercial Manager

Bishop’s Stortford Rugby Football Club

9

Developing a Community Club

• Bishop’s Stortford Rugby Club was formed in 1920 and has been at its current home at Silver Leys since 1963.

• On a Saturday we are able to field 5 Senior Teams each playing regular league and cup fixtures whilst on a Sunday there are over 500 Mini and Youth players either training or representing the club.

• Our 1st XV will normally contain 8 or more players who have come through the club from Minis level and our other 4 senior sides are principally made up of home grown players.

• This makes us all aware of the contribution the club makes to the local community and to our dependence on the support of individuals and local businesses.

How the club has grown over the last 88 years!

Physiotherapist’s Role

– Some clubs remain advocates of the “bucket and sponge” approach but B.S.R.F.C. has taken a strategic decision to employ a Senior Chartered Physiotherapist for the past 5 years.

– Our present physiotherapist, Julie Wright, has intermediate and advanced sports aid skills through specialised training.

– Julie’s role covers:-• Medical welfare of all players• First Aider• Treatment of injuries – on/off pitch• Return to play• Prevention of injuries• Prevention of re-occurrence• Advice and education• Legal Responsibility

Rugby Injuries

– 1 in 8 chance at club level– 1 in 4 at international level– 72% in CONTACT– 51% in TACKLE situation– Average of 18 days absence– 19% of calendar year absent– Most occur during final quarter– Last season, 24% occurred during training at

B.S.R.F.C.! This resulted in 24 days absent

Most Common Injuries

Injuries resulting in most lost time

FORWARDS BACKSCalf Muscle Hamstrings

Haematoma thigh Haematoma thigh

Ankle Ankle

Hamstring Calf Muscle

Neck Concussion

FORWARDS BACKSBack Hamstrings

Knee – cartilage/degeneration

ACL

Shoulder Shoulder

Achilles Tendonitis MCL

Calf Muscle Knee

Why Injury Prevention is important

– Team Remains intact– Player Morale– Continuous season means player and team improve

over season. Injured players may set whole team strategy back

– Treatment and time costs!– Players and support staff are less likely to leave the

sport prematurely– Lifts team morale

KICK INJURIES INTO TOUCH!

How do we prevent injuries?

– Team involvement– WARM UP and COOL DOWN– Training– Position specific drills and conditioning– Strength and Reaction– Technique– Flexibility– Hydration and nutrition– Listen to your body!

This is not exclusive to rugby!

It is important for all general and reactive skills.

The fitter people are the less likely they will be injured!

15

Preparation

16

Pre-Season Training!

Nutrition

– Readily available energy for quicker recovery and protection of joints and muscles from injury

– Ensures body performs at best– Avoid high fat pre and post exercise– ½ food intake should come from carbohydrates – potatoes,

pasta, bananas etc– Increase intake of carbohydrate foods 2-3 days before

game– Ensure 15% of diet is protein – eggs, fish, meat etc– Manage alcohol intake and timing!

All our 1st Team players are given advice and guidance on their diets and are actively encouraged to maintain

a strict personal programme to reach peak fitness.

17

Water

Did you know? – Your body is 60% water– If you are thirsty you are dehydrated– Performance decreases if by 25% when you dehydrate– You lose 1-2 litres of water every hour in a light training session!!

Remaining Hydrated is essential for high performance and prevention of injuries. So we ensure our players …….– Drink plenty of water each + every day & make it a habit– Start hydrated– Keep water levels up all week– Have a sports drink 2-3 hours pre game + 10-20mins post game

 Get water On Board Quickly + as often as possible during a game or training session.

 Only you can ensure you are hydrated properly!!

Conclusions

– The health of players is important for 7 days a week not just a Saturday or Sunday!

– Notwithstanding the fact we are not a professional club, we put the health and safety of our players top of our priority list.

– This is relevant to not just the 1st team but throughout the club to our newest Under 7 recruits!

– Awareness of injuries and injury prevention is key. – Nutrition and the importance of water are paramount.– However, the club cannot monitor every player across its senior,

youth and mini sides; it is the Individuals’ responsibility!

The fitter people are the less likely they will be injured!

19

ENJOY YOUR SPORT AND STAY INJURY FREE!

Thank you

Infection Control –

We’ve Got It Covered

Dr Jeff Phillips

Consultant Intensivist and Clinical Lead for Infection

Control

Reducing Healthcare Acquired Infections

Jeff PhillipsConsultant, Intensive Care

National Clinical Champion for Infection Control

Infection is an insult to our patients!

What will make the biggest difference?

• Individual and Team ownership

• Screening and decolonisation

• Utilise the Care Bundles/HIIs

• Act on compliance data to improve reliability

• Agreed antibiotic prescribing policy• Monitoring of cleaning standards

CYHCYH DHDH

Cumulative MRSA Bacteraemias - Actuals Vts Trajectory 2008/09

0123456789

1011121314

Apr08

May08

Jun08

Jul 08 Aug08

Sep08

Oct08

Nov08

Dec08

Jan09

Feb09

Mar09

Bac

tera

emia

s

Pre 48 HrPost 48 HrSHA target trajectory Cumulative

Cumulative C -DIF - Actuals Vts Trajectory 2008/09

0

10

20

30

40

50

60

70

80

90

100

110

120

Apr08

May08

Jun08

Jul08

Aug08

Sep08

Oct08

Nov08

Dec08

Jan09

Feb09

Mar09

C -

DIF

Actuals Cumulative

SHA target trajectory Cumulative

Ever tried? Ever failed? No matter. Try again.Fail again. Fail better.

Samuel BeckettPlaywright

Pray for the dead and fight like hell for the living.

Mary Harris (Mother) Jones, Social and political activist

Investing in the Patient

Experience

Sharon Cullen,Associate Director - Nursing

The Patient Experience

• The patient is at the centre of everything we do

• Our aim is to deliver effective services in partnership with the people that need to use the hospital

• We want to be the hospital that the local community choose to use for healthcare.

Patient

The NursingDirectorate Infection

ControlNurses

Matron

Estates

Facilities(CleanlinessStandards)

Nursing, Midwifery

& Operating Department

Practitioners

Transformation Team

PracticeDevelopmentNursing Team

The Patient

• Patient experience tracker provides immediate feedback on five key areas raised in the annual patient survey

• Feedback from Patient Council• Patient involvement across all areas

of our work including:– Environmental assessments– Service improvement projects– Self assessment audits against

national standards

Matron• Role reviewed (November - March)• Trust has invested in an additional 8 matrons• Increased visibility in wards & departments 7 days

a week• Four main areas of responsibility. Their

duties include:– Environmental checks– Infection control audits– Challenging standards of practice– HR issues– Patient experience tracker– Privacy and dignity audit

Infection Control NursesOur Aims

• Achieve transparency in our communication• Share information with openness and honesty• Make infection prevention and control everyone’s business

Infection Control Nurses

• Enhanced communication with matrons and nursing workforce

• Influencing best practice and providing advice

• Promoting a clear message to all concerned about healthcare associated infections and how to prevent cross infection

• Development of ward information boards to share progress against minimising the risk of infection

• Changes to clinical practices to enhance patient safety in line with national directives

• Enhanced screening for MRSA to enable early treatment

Practice Development Nursing Team

• Provide training for nursing staff to enhance and sustain standards of care

• The team ensure that national and professional guidance is embedded in clinical practice

• All newly appointed healthcare assistants are trained and assessed in essential care delivery

Facilities

• Additional £500,000 spending on additional cleaning staff• Standards monitored using the national cleanliness

standards• Investment in cleaning equipment at ward level• Increased training for supervisors• Annual deep cleaning for clinical areas• Working on greater integration of

domestic team into clinical areas

Estates

• Very close links with domestic and nursing staff to address environmental issues

• Executive director of nursing influencing trust expenditure on the patient’s environment to meet

privacy, dignity and safety standards

Nursing, Midwifery &ODP Workforce

Our strategy• Staff fitness for purpose• Clear understanding of professional responsibilities

Themes• Essential care• Infection prevention & control• Leadership• Communication & record keeping

Transformation

Service improvement including:

• Ward standardisation • Environment• Equipment • Common patient processes• Releasing time to care • Patient medication• Patient assessment & observation

Assurance Framework

Sharing our progress in an open and transparent way with:Patients, Staff, Trust Board members, Commissioners, Strategic Health Authority and up to the Department of Health

Key Performance Indicators:

• Infection prevention and control

• Patient Feedback

• Privacy and Dignity

• Quality of Care and Treatment

Thank you

Now and in the Future

Chris Pocklington - Chief Executive

The Here and Now… 2008/09

“To become the best general hospital in the East of England”

Continuing to Deliver Innovation in Healthcare

Our clinical achievements place us amongst some of the best Trusts in the Country

The work of our support staff is recognisedby many

Journey to Foundation Trust Status

FT status is about giving individual hospitals the opportunity to develop forward looking services in response to the needs for the local population

6,900 people have signed up at FT members

Visit www.pah.nhs.uk for more information or speak to one of the

Executive team

Thank you

Finances of The Trust

Gordon Flack - Executive Director of Finance

Headline Results Steady delivery of surpluses since deficit in 2005/06:

Income & ExpenditureSurplus/-Deficit

-6000

-4000

-2000

0

2000

4000

6000

2005/06 2006/07 2007/08

£m

Continued growth of the Trust which is expected to remain a feature of the

future:

Turnover

0

50000

100000

150000

2005/06 2006/07 2007/08

£m

Continued investment in infrastructure over and above the “wearing” out of our

assets:

Capital Cashflow& Depreciation

0

2000

4000

6000

8000

10000

2005/06 2006/07 2007/08

£000

Depreciation

How we spent your money: 2007/08 Costs

4.6%0.7%

0.7%

64.3%

17.4%

0.8%

6.0%

3.7% 1.8%

Services from the NHS Purchase of healthcare from non NHS bodies

Directors' costs Staff costs

Supplies & services Consultancy

Premises, transport & establishment Depreciation

Clinical negligence & Other

Staff Resources remain at the heart of our business and account for the largest

proportion of our costs:

Staff

0

1000

2000

3000

2005/06 2006/07 2007/08

WTE

Medical Nursing Healthcare assistants & support Scientific, therapeutic Admin & Estates

The Auditors Local Evaluation (ALE) assesses how well NHS organisations manage and use their financial

resources.

The Trust can show strong and steady progress over the last three years and aspires to excellent ratings.

Auditors Local Evaluation"Use of Resources"

0

1

2

3

4Excellent (4)

Good (3)

Adequate (2) Inadequate (1)

2005/06

2006/07

2007/08

Thank you

Open forum for questions to the Executive Team.

Please join us for refreshments