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A MESSAGE FROM THE CHAIR AND CHIEF EXECUTIVE

Welcome to Velindre University NHS Trust Annual Report for 2018-19.

“I started as Chair with the Trust in May 2018 and I have been inspired by the

dedication, innovation and enthusiasm I have seen, the commitment to ensuring we

always keep our patients and donors at the heart of everything we do.

There is no doubt that, like the rest of NHS Wales, we face challenging times ahead,

with funding, clinical recruitment, compliance, Welsh Language Standards

implementation, donor engagement, fundraising and other priorities all needing our

continued attention. But it is also a very exciting time, with our much needed new

Cancer Centre for Velindre on the horizon, revolutionary steps forward in cancer

treatments and gene and cell therapy, both service Divisions of the Trust continue to

build on to their global reputation for excellence and innovation, and the Trust being

consistently acknowledged as a valued gem in the NHS Wales crown.”

Professor Donna Mead, Chair.

We believe we have a story to tell and, while we have a statutory duty to produce an

Annual Report reviewing our operational and financial performance for 2018-19, we

are delighted that it also gives us a great opportunity to tell you more about our

organisation and the services we provide.

As we look back at 2018-19, we are delighted that this suite of Annual Report

documents provides us with the opportunity to celebrate some of the exceptional

achievements and successes we have seen across the Trust, and showcases at least

some of those innovative and award-winning successes.

Over the next couple of pages we have included stories of innovation, improvement

and staff recognition around their dedication in putting patients and donors at the heart

of everything we do, efforts that have been acknowledged through so many individual

and team awards that there are too many to mention in this short message.

As a Trust we continue to face financial constraints and pressures like never before,

challenges that have continuously tested our financial planning, strategic prioritising

and operational management. Nevertheless, we have worked hard, together as a

united team, to ensure that we spend these limited resources on all the right priority

areas, and that we have still been able to achieve so much, is testimony to the

professionalism and commitment of everyone working for and with our Trust.

Going forward, the Trust continues with an ambitious agenda and no doubt, equally

exciting, interesting, high achieving and challenging prospects are in store. Velindre

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University NHS Trust’s commitment to quality, care and excellence, together with our

talented, loyal and dedicated staff and volunteers, certainly means we can face the

future with confidence.

We are, as ever, grateful for the continued support we receive from the communities

we serve and from our partner organisations, and always welcome hearing your views

about our services.

You can join us at any of our regular public Board Meetings, if you want to hear more

about how we are doing, or you can contact us by telephone, in writing, or via social

media.

In the meantime, we hope you enjoy reading this Annual Report for the year

2018-19.

Professor Donna

Mead, OBE.

Chair

Mr Steve Ham,

Chief Executive

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WHAT THIS ANNUAL REPORT WILL TELL YOU:

Velindre University NHS Trust Annual Report is part of a suite of documents about

our organisation. It tells the story of the services and care we provide, what we do to

plan, deliver and improve healthcare for you, and how we are setting out to meet

changing demands and future challenges. It provides information about how we have

performed this year, what we have achieved in 2018-19 and our aims for improving

further next year. It explains how we are working with our patients and donors in

developing services for the future, and how we recognise the value of listening to

you and your needs in planning our services going forward.

Efforts to achieve the Trust’s vision and strategic objectives is driven by ‘Delivering

Excellence’, our Integrated Medium Term Plan (IMTP). Our IMTP sets out the

priorities we intend to deliver on a rolling 3 year basis. The Plan for 2019 – 2022 was

submitted to the Welsh Government in January 2019.

Our annual report for 2018-19 includes:

Our Performance Report, detailing how we have performed against our

targets and how we will seek to maintain or improve our performance further.

Our Accountability Report, providing information about how we manage and

control our resources and risks, and comply with our own Governance

arrangements.

Our Financial Statements, detailing how we have spent the Trust’s funding

allocation in meeting our obligations.

Our Annual Quality Statement (AQS), highlighting the actions we have

taken to improve the quality of our services.

If you would like copies of any of these publications in print form and/ or alternative

formats or languages, please contact us using the details below.

Velindre University NHS Trust,

Corporate Headquarters

Unit 2, Charnwood Court,

Parc Nantgarw,

Cardiff.

CF15 7QZ Tel: 029 2019 6161

Email: Corporate.Services2@wales.nhs.uk

Website: www.velindre-tr.wales.nhs.uk

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ABOUT VELINDRE UNIVERSITY NHS TRUST: THE SERVICES WE PROVIDE

The Trust has evolved significantly since its establishment in 1994 and is operationally

responsible for a number of services.

THE VELINDRE CANCER CENTRE

We are a specialist treatment, teaching, research and development centre for non-

surgical tertiary oncology services for patients across south-east Wales. Our ambition,

in terms of service delivery, is described in our recently published cancer strategy,

Velindre Cancer Centre – Shaping our Future Together.

Specialist teams provide care using a well-established network multi-disciplinary team

(MDT) model of service for oncology and palliative care. We work closely with local

partners in ensuring services are offered at

appropriate locations, in line with best practice

standards of care. All services are provided at

Velindre Cancer Centre with an increasing number of

services delivered on an outreach basis within local

health board locations around south-east Wales.

We have developed a strong reputation within Wales

and beyond. Over the years the ‘Velindre brand’ has

become synonymous with ‘excellence’.

THE WELSH BLOOD SERV ICE

The Welsh Blood Service is immensely

proud of the vital role it plays in modern,

prudent healthcare, striving to save and

transform lives through the generosity of

donors. We provide a range of essential

multifaceted, highly specialised services

for NHS Wales, ensuring that it has

access to blood and blood components to

treat patients and support the transplant programmes through the Welsh

Transplantation and Immunogenetics Laboratory.

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THE SERVICES WE HOST

The Trust is responsible for hosting the following organisations on behalf of the Welsh

Government and NHS Wales:

NHS Wales Informatics Service (NWIS);

NHS Wales Shared Services Partnership (NWSSP); and

Health Technology Wales (HTW).

THE PARTNERS WE WORK WITH

We work with a wide range of partners in a range of capacities including health, local

authorities, emergency services and the voluntary/charity sector.

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KEY ACTIVITY, DEVELOPMENT CELEBRATIONS DURING 2018-19

AWARDED UNIVERSITY STAT US

The delivery and management of high quality research,

development and innovation is a strategic priority for the

Trust. Through acquiring University status in 2018, we

have continued to build an excellent national and

international reputation. Our ambition is to achieve

international recognition for a wide range of clinical, social

and technological research, development and innovation.

Over the next three years we will continue to develop strong collaborative networks

with our neighbouring Health boards, Blood Services and Higher Education

Institutions, and embark on joint programmes of work to strengthen our research

capacity across the allied health portfolio, with an increasing social science lens to

improve the health and wellbeing of both donors, patients and their families.

APPROVED INTEGRATED MEDI UM TERM PLAN ( IM TP)

In March 2019, Velindre University NHS Trust had its IMTP

approved by the Minister for Health and Social Services and

accordingly met its statutory duty to have an approved IMTP in

place for 2019/20.

The Trust provided a reflection on progress against the key priorities, performance

and ambitions outlined in the IMTP for 2018 - 2021 within our new IMTP for 2019 –

2022. This assessment was a high level overview of performance against the overall

plan. This confirmed that delivery against objectives was broadly in accordance with

the forecast trajectory. The Trust will undertake a more in-depth review of its

achievements during 2018/19 once all performance information has been validated.

What is apparent at this juncture is that great progress has been made across the

organisation n working towards the realisation of the Velindre Cancer Centre’s

(VCC) and the Welsh Blood Service’s (WBS) strategic objectives. Key achievements

are described in some detail in the Trust’s Annual Performance Report.

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VELINDRE C ANCER C ENT RE FEATURED IN T HE B BC 2 HO RIZON DOC UMENTARY “WE NEED TO TALK ABO UT DEATH”

Velindre Cancer Centre featured on the 23rd January 2019 episode of Horizon on

BBC 2 at 9pm. Huge thanks to all staff and patients who were involved in the

filming:-

https://www.bbc.co.uk/programmes/b0c10f7h

RADIOT HERAPY PALLIAT IVE AWARD - HSJ PATI ENT SAFETY. UK WI DE AWARD.

A scheme to provide radiographer led care

to terminally ill patients at Velindre Cancer

Centre in Cardiff, making it quicker and

easier for patients to access radiotherapy

treatment, was awarded the HSJ 2018

Patient Safety Award for Palliative Care.

The award was presented to the Velindre

Cancer Centre Radiotherapy team at a

prestigious ceremony in Manchester in July

2018.

NHS AWARD F INALI ST

A valued partnership between Velindre NHS Trust and NHS Blood and Transplant

has been celebrated in the list of finalists for the prestigious NHS Wales Awards

2018. Shortlisted in the Improving Quality Using Improving Quality Together (IQT)

Methodology category (supported by Wales Deanery), Velindre NHS Trust,

together with the NHS Blood and Transplant, has been named a finalist for: “The gift

of sight: corneal donation in the hospice setting”

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BLOOD SUPPLY CHAIN 2 020

At the Welsh Blood Service, the Blood

Supply Chain 2020 initiative, continues to

take great strides forward realigning the

way in which we plan, collect, manufacture

and distribute blood components across

Wales. Several important milestones were

reached during 2018/19, including

implementation of a new platelet testing

method that extends the shelf life of platelets from 5 -7 days, improving the supply

to hospitals and patients and helping to reduce waste.

NEW VELINDRE CANC ER C ENTRE (NVCC)

Outline Business Case for a new Velindre Cancer Centre approved by Health

Boards during 2018.

A NEW ASSESSMENT UNI T FO R EMERGENC Y PATI ENTS AT VELINDRE C ANCER C ENT RE

A new Assessment Unit for emergency patients at Velindre Cancer Centre was

officially opened on 12th September 2018 with help from Macmillan Cancer Support.

The unit provides a rapid assessment for emergency cancer patients on arrival at

Velindre, has four dedicated beds and a team of highly trained health professionals

is being developed in partnership with Macmillan Wales.

The ‘one stop shop’ will benefit emergency cancer patients who are transferred to

the Assessment Unit following a call to the treatment support line or patients

transferred from a local hospital who require emergency radiotherapy or patients

who might become acutely unwell during a routine visit to Velindre.

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NHS CELEB RATES ITS 7 0 T H ANNIVERSARY

As the NHS celebrated its 70th Anniversary, two women, who have

dedicated their lives to the nursing profession were named

amongst the most influential nurses in 70 years of the NHS. They

were selected by the Nursing Standard - the UK’s most widely read

nursing journal. Professor Rosemary Kennedy and Professor

Donna Mead have more than a passion for nursing in common.

They are good friends and past and present chairs of Velindre

University NHS Trust respectively.

WO RLD CANC ER DAY, 4T H FEBRUARY 2019

World Cancer Day, ITV Wales, broadcasted from Velindre Cancer Centre

highlighting the incredible work of our staff in their care and treatment of Cancer

patients in south east Wales. The item featured on ITV Wales at Six on the evening

of 4th February 2019.

UK F I RST CANCER AWAR ENESS EDUCATION PRO G RAMME FOR BAME

The UK’s first Health and Cancer

Awareness educational programme to

be formally integrated in the English

Speakers of Other Languages (ESOL)

curriculum for Black, Asian and Minority

Ethnic communities was launched

during 2018. Research has found that

people from Black, Asian and Minority Ethnic (BAME) communities are less likely to

take part in cancer screening programmes. These communities also have lower

levels of awareness of cancer signs and symptoms. To help improve uptake of

cancer screening programmes and health awareness in BAME communities,

Velindre Cancer Centre and its charity have partnered with Cardiff and Vale College

and Public Health Wales to launch a unique educational programme.

NEW YEAR’S HONO URS F O R TWO OF VELINDRE’S F INEST

Professor Tom Crosby and Ceri Ann Harris were recognised for outstanding

achievements in their fields and have been awarded an Order of the British Empire

and British Empire Medal respectively.

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Consultant Clinical Oncologist at Velindre Cancer Centre, Professor Tom Crosby

received his OBE at a ceremony at Buckingham Palace in February this year for his

services to Cancer services in Wales.

Ceri Ann Harris, Diversity and Equality Manager at Velindre University NHS Trust

receives her award for charitable and volunteering services in south Wales.

VELINDRE COOKBOOK UP FO R GO URMAND WO RLD COOKBOOK AWARD

Our charity cookbook that charts the very personal

journeys of cancer patients and their families in South East

Wales, through their love of food, has been selected to

represent Wales in the prestigious Gourmand World

Cookbook Awards. Considered as the Oscars of the

cookbook world, the Velindre Cookbook scooped the

award for the best cookbook in Wales in the category of

Family and Fundraising. The book will now represent

Wales in the ‘Best in the World’ event held in Macau,

China on 3 July 2019.

The book was the brainchild of Ceri Harris from Velindre University NHS Trust who

has worked tirelessly over the past 12 months to see it published – recruiting

contributions from some of Wales’ finest chefs along the way, including an

introduction by Welsh actor Michael Sheen.

CELEB RAT ED 5 YEARS F REE OF MRSA BACT EREM IA

First Floor Ward at Velindre Cancer Centre celebrated 5 years free of MRSA

bacteraemia on the 22nd November 2018.

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NEW MICROBIOLO GY PLA TFO RM

Launch of the new microbiology

platform put WBS at the

‘forefront’ of Europe.

On Tuesday 15th January 2019,

the WBS Automated Testing

Laboratory officially launched its

new microbiology testing

platform, following a successful installation period. The new system will form a

significant part of the mandatory testing for: HIV, Hepatitis B&C, HTLV, Syphilis,

CMV and Malaria. These tests are required prior to units being issued from the WBS

to its 19 customer hospitals across Wales. The new platform provides improved

performance and resilience and increased the efficiency of blood component

manufacturing and testing.

FI RST WO RKPLACE MENO PAUSE CAFÉ IN WALES LAUNCHED BY VELINDRE UNIVERSITY NHS TRUST

Velindre University NHS Trust has become the first workplace

organisation in Wales to introduce a Menopause Café for staff –

of all genders and ages. The concept behind the Menopause

Café was the brainchild of Rachel Weiss from Rowan

Consultancy who was keen to remove some of the barriers that have so often made

the menopause an uncomfortable and off-limits subject for discussion for so many

women and their families.

Karen Wright, Assistant Director of Workforce at Velindre University NHS Trust felt

that organisations, sincere about the health and wellbeing of their staff, could no

longer ignore or allow colleagues experiencing the menopause to suffer in silence.

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ENHANC ED ONLINE APPO INTMENT SERVIC E

Donors across Wales now have more control of their

blood donation appointments following a series of

improvements to the Welsh Blood Service online

appointment system. Among the improvements,

donors that book an appointment online will now:

be given the chance to receive appointment

reminders via email, SMS or telephone call at 10

days and 2 days prior to their appointment;

receive a bespoke link in their reminder which will allow them to cancel their

appointment, should they be unable to attend; and

be encouraged to undertake a donor eligibility quiz before booking an

appointment to ensure donors are eligible to donate before they make an

appointment.

VELINDRE UNIVERSITY NHS TRUST C HARIT Y

The level of support the Charity receives continues to exceed expectations and for

this we are extremely grateful and fortunate. We have had yet again another

extremely successful year during 2018-19, raising a significant amount for Velindre

University NHS Trust Charity. This success is down to all our valued

fundraisers/supporters, and on behalf of the Corporate Trustees we extend a huge

vote of thanks for their continued generosity, not only in monetary terms, but also

for dedicating their own time and support throughout the year in continuing to help

support the Velindre University NHS Trust Charity.

The Velindre NHS Trust Charitable Funds Annual Reports are available here, these

reports demonstrate how the money raised through Charitable Funds allows us to

make a difference and enhance the services we provide.

Money raised from our “Victory over Cancer Campaign” will be

used to ensure the best possible support is offered to every patient,

their families and carers dealing with cancer. It will allow us to fund

ground breaking research, specialist equipment, and new

developments so our staff have access to the most up to date

training and techniques available. Velindre also has a number of

specialist fundraising appeals, for further information please visit the Fundraising

Website via the following link: http://www.velindrefundraising.com/ourappeals

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You do not have to specify a use for your donation. We will ensure it is put to the

best possible use by donating it to our Victory over Cancer Appeal.

We invite you to visit Velindre Fundraising Website which highlights some of the key

activities and events that have taken place and planning in coming months.

http://www.velindrefundraising.com/

I invite you now to read the further sections of the Velindre University NHS Trust

Annual Report.

SUITE OF ANNUAL REPORT DOCUMENTS

As indicated on page 4, Velindre University NHS Trust Annual Report is made up of a

suite of documents that describe our work between April 2018 and March 2019.

The following documents can be read together or as stand-alone documents.

1 PERFORMANCE REPORT

2 ACCOUNTABILITY REPORT

3 FINANCIAL REPORT

4 ANNUAL QUALITY STATEMENT

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CONTENT

Page

Performance Report Overview – Chief Executive Statement 3

About Us 6

Vision, Ambitions & Strategic Objectives 7

1. Delivering Against our Duties 9

2. Development Activity 23

3. Trust Organisational Development Strategy 29

4. Performance Summary 33

5. Performance Analysis 55

Sustainability Performance 2018-19 70

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PERFORMANCE REPORT OVERVIEW

C HI EF EXEC UTIV E STA T EMEN T - MR. STEV E HAM

Velindre University NHS Trust is a unique organisation within NHS Wales, delivering highly

specialised services that are broad, complex, focused on excellence and keeping our patients

and donors at the heart of everything we do.

Underpinning everything we do is our total commitment to Quality, Care and Excellence,

ensuring patients, donors and the hospitals we supply all benefit from the highest standards

of care, innovation and professionalism across the range of services we deliver.

Like the rest of NHS Wales, we are facing the combined challenge of rising costs and

increasing demand, while striving to continue improving the quality of care and patient and

donor outcomes. Inevitably, how to maintain these improvements, while continuing to meet

the needs of our population for Cancer, Blood and Transplant Services, is firmly at the

forefront of our thinking and planning for the coming year.

Our commitment, however, is to make sure we maintain our focus on providing an

excellent service and I am confident I speak for the whole Trust when I reassure you that

we are up to the challenge.

2018-19 has been a busy, productive and successful year for us and how we move forward

in delivering services into the future is an area we intend to build on during 2019-20. It is

our collective ownership of measures that will enable us to show how successful we are in

delivering our services in new and innovative ways, both in the coming year and beyond.

We recognise that the Well-being of Future Generations (Wales) Act 2015 will continue to

have a transformative effect on our organisation. The Act has allowed us to consider the

impact of what we do from a new, distinct perspective.

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The Act has set an expectation that public sector organisations will work in different ways.

We will continue to embrace the opportunity that the Act provides to seek opportunities for

greater collaboration with other bodies that will provide tangible benefits for our staff, donors

and patients. New strategic and operational relationships will result in the more effective

integration of services and, also, to long term improvements to the well-being of the Welsh

population.

Our appreciation of the wide reaching influence of the Act has developed and the sustainable

development principles at the heart of the legislation have begun to inform our thinking and

service development in a more immediate manner.

I am delighted to report that in March 2019, the Trust, in accordance with the set statutory

duty, had its Integrated Medium Term Plan (IMTP) covering the period 2019 to 2022

approved by the Welsh Government. Having an approved IMTP in place is a key way of

demonstrating to all of our stakeholders that the organisation possesses the requisite level

of maturity to plan and deliver our services with confidence over a three year period.

The IMTP for 2019 - 2022 reflects on progress against the key priorities, performance and

ambitions from the year 2018 - 2019, confirming that delivery/progress against objectives

was broadly in accordance with forecasts.

Our focus on excellence has seen us continue to improve the high quality services we provide

to our patients and donors. This Performance Report and our Annual Quality Statement,

provide wide ranging details about our performance. The details contained in this report show

that we are maintaining and improving our performance in a range of vital areas however

there is more to do and areas that need further attention.

Our plans for 2019 and beyond demonstrate the fundamental importance we place on

Research, Development and Innovation at its core. Work in these areas will help us push

forward our well-being agenda by raising our national and international profile, creating

highly skilled jobs and, crucially, delivering real clinical benefits for the population of Wales

both now and in the future.

We are hugely proud of our committed colleagues who help ensure that our unique

organisation continues to deliver the highest quality services. We are excited by the prospect

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of working with them to continue to deliver quality services and in making a tangible

difference to the health and well-being of all our families and the communities in which we

live and work.

I believe that we are well placed to assure you that our staff, volunteers, fundraisers and

partners are all firmly committed to delivering improved ‘Quality, Care and Excellence’.

Mr. Steve Ham

Chief Executive

Date: 19.6.2019

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ABOUT US

Established in 1994, Velindre University NHS Trust (the Trust) provides a range of

specialist services at local, regional and all Wales levels. We provide two core services which

includes Velindre Cancer Centre and the Welsh Blood Service. We also host a number of

organisations on behalf of Welsh Government and NHS Wales.

You can find out more about our Service Divisions and Hosted Organisations in the

Accountability section of the Annual Report document (Pages 3-5).

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VISION, AMBITIONS AND STRATEGIC OBJECTIVES

We are an ambitious organisation striving to provide services which are recognised as

excellent by the people who use them, the people who work in them and by our peer

organisations.

Our vision is that:

‘VELINDRE UNIVERSITY NHS TRUST WILL BE RECOGNISED

LOCALLY, NATIONALLY AND INTERNATIONALLY AS A RENOWNED

ORGANISATION OF EXCELLENCE FOR PATIENT AND DONOR CARE,

EDUCATION AND RESEARCH’

The achievement of our vision is driven by a number of key service strategies. These are:

Velindre Cancer Centre’s ‘Shaping our Future Together’.

Welsh Blood Supply 2020.

National Blood Health Plan.

We have developed a set of overarching objectives that will enable us to achieve our

vision. These are:

Equitable and timely services.

Providing evidence based care and research which is clinically effective.

Supporting our staff to excel.

Safe and reliable services.

First class patient /donor experience and

Spending every pound well.

Our vision and our objectives, alongside a range of national and local policies drive our

planning process. Last years’ approved Integrated Medium Term Plan (IMTP) for

2019/2020 – 2021/2022 provides a strong foundation for the development of a clear set

of actions for the next three years. The IMTP builds upon the excellent work undertaken

by teams across the Trust, working with our many partners, to develop a set of ambitious

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priorities, which build on our strengths and will result in people who use our services

receiving excellent care, service and support.

This IMTP sets out our plans in two distinct areas. First, the priorities related to implementing

our new model of care for cancer services and maintaining high quality blood and

transplantation services. This will have a fundamental impact on everything we do and

enable us to move closer to our ambition of delivering excellence in a sustainable way across

both services.

The second area, and related priorities, signal the continued strategic development of the

Trust and its transformation into new and potentially exciting areas of work in accordance

with the challenge laid down by ‘A Healthier Wales’. This will see us exploring opportunities

across the health and social care system and identifying areas where we can further support

our partners in achieving outcomes and benefits for the populations we serve. We will move

outside of our current scope of work e.g. cancer treatment, blood and transplantation into

areas of regional, national and international importance respectively.

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DELIVERING AGAINST OUR DUTIES

NATIONAL POLICY AND DRIVERS

We continually scan the environment at a population, national, regional and local level

to develop our knowledge and intelligence on key issues which we need to take account

of in the strategic planning and delivery of services. We use the Sustainable

Development Principles as the basis for our horizon scanning.

There are a number of important national strategies and policies which guide the

development and delivery of the services we provide and these are detailed with in our

Delivering Excellence: our three year Integrated Medium Term Plan (IMTP). A summary

of the strategic context for Velindre University NHS Trust is provided below.

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EQUALITY, DIVERSITY & HUMAN RIGHTS

We have made considerable progress over the last year against our five Strategic

Equality Objectives. These objectives recognise how the principles of dignity and

respect must be embedded across all areas of work, from policy, service design and

delivery. The objectives are:

Working with partner organisations, we have developed a number of initiatives internally

and in collaboration.

ENGLISH AS A SECOND LANGUAGE (ESOL) HEALTH PROMOTION PROJECT:

Working in partnership with Public Health Wales and Cardiff and Vale College, we were

the lead organisation on an innovative cancer health promotion curriculum that will be

delivered in the community through English as a Second language (ESOL) classes, for

those members of the public learning English.

The initiative uses health promotion messages as the vehicle for teaching English. This

will also allow for the dissemination of positive health messages to be fed back into the

community. ESOL pupils will also take on the role of health champions. The Project ran

We communicate

with people in ways

that meet their

needs (whether this

is via written

communication,

face to face,

signage, Welsh or

other community

languages including

British Sign

Language).

Staff are

paid

fairly.

People are and

feel respected;

this includes

staff, patients,

donors, carers

and family

members.

People

receive care

and access

services that

meet their

individual

needs.

Improved

engagement

with public,

patients and

Donors.

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during 2016-18. Cardiff College hosted the evaluation event in late 2018 and going

forward the Trust has the objective to expand this project to look at wider health areas.

http://www.cavc.ac.uk/en/about-us/news/cardiff-and-vale-college-hosts-launch-esol-

health-and-cancer-awareness-resource/

GENDER AGENDA:

Over the last year the Trust has held monthly events and awareness sessions exploring

our understanding of what is gender and how can gender bias impact on our staff and

services we provide. The feedback from staff has been that they had never previously

thought about the impact of gender bias in this way, from career choices, attitudes and

behaviours. It’s only when we can pause to look at our behaviour and listen to other

people’s experiences that we can learn and change as an organisation.

During 2019, these workshops will expand to look at all equality areas and start those

important conversations for change.

PA TI ENT AND FA MILY M EMB ER C OOKBOOK :

Many cancer patients report difficulties with food during their treatment, such as loss of

appetite, sore mouths and weight loss and their enjoyment of food can be massively

impacted. During the last year we have worked in partnership with our patients, past and

present, their families and those impacted by cancer to develop a charity cook book.

In developing the cook book we were keen to ensure that the recipes were reflective of

the patients we support, so the Trust worked with local equality groups and organisations

too to ensure diversity.

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The book includes tips on adaptations that can support someone going through cancer

treatment. Sales from the book will be given to Velindre Fundraising to support future

Projects.

The book is also available in English and Welsh, written and in audio versions available.

Nationally acclaimed chefs have also shown their commitment by picking their favourite

recipes and by taking part in British Sign Language inclusive cooking videos.

https://www.youtube.com/watch?v=H3bnzGdSOS8&feature=youtu.be

SPECIALISED TRAINING & ONLINE TRAINING:

In addition to mandatory equality training, the Trust has recognised the need for

specialist training and has subsequently offered a variety of training opportunities for

staff in key areas such as deaf awareness, use of auxiliary aids, domestic abuse and

patient dignity. LGBT+ and Cancer specialist training was also rolled out for the first

time, following specialist sessions with Macmillan Cancer Care, and these will be made

available each year for staff.

STONEW ALL DIV ERSI TY C HA MPI ONS:

We are members of the Stonewall Diversity Champions Programme and have provided

a range of evidence on policies, services and support provided to support LGBT staff as

part of our Diversity Index submission. Evidence includes the specialist training we have

developed as well as partnership events such as the 70th Anniversary of the NHS

celebration at Pride Cymru in August 2018.

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This last year has seen recognition of the progress made by the Trust in achieving its

Strategic Equality Objectives. These objectives set out how we will meet our duties

under the Equality Act 2010, building on our commitment to improve the lives of both

staff and service users, as well as setting out a range of key actions for the promoting

equality in health services.

WELSH LANGUAGE

SU PPORTING PEOPLE TO USE THEIR LAN GUA GE OF C HOIC E

Communication is an integral part of providing good care. The Trust is fully committed

to providing bilingual services for patients and donors and supporting the cultural values

of Welsh speakers across Wales.

We have developed a strategic statement, based on our vision

for bilingual services, and this is used as the central reference

point for everything we do within the organisation and underpins

our key strategies and plans relating to Welsh Language.

.

“Velindre University NHS Trust celebrates the Welsh Language and

its cultural importance to Wales. As a caring organisation that

promotes and understands the value of meeting communication

needs, we will provide person centred services and take a planned

approach to all that we do.”

The development of a Welsh culture and provision of services in Welsh continues to be

a major focus for the organisation and its importance has been further emphasised

following the publication of the Welsh Language Standards in 2018. The Welsh

language Standards sit under the Welsh language (Wales) Measure 2011, outlining the

requirements for public organisations to provide bilingual services to those who need

them in Wales.

The Standards are based on the principle that the Welsh language should not be treated

less favourably than the English language. They also provide a legal structure that

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strengthens the rights of individuals working within the NHS to use the Welsh language

as part of their daily communication needs.

The Trust has supported the aims of the Standards from the outset and has clearly

demonstrated a commitment to strengthening its current Welsh Language Scheme in

order to support the needs of its patients and donors.

Over the course of the last year we have also established a number of work streams to

lead our response to the new Standard. The work streams and their key areas of focus

are summarised below.

W ORKFOR CE PLANNIN G:

1. We have provided support for Welsh speaking staff to use the Welsh language across

the Trust within all administrative aspects of their roles by updating policies and

procedures to include services for bilingual requirements e.g. complaints and the

disciplinary process.

2. We have assessed the need to strengthen Welsh language skills within departments

in order to provide a bilingual service for patients and donors.

3. We have strengthened guidance for managers in relation to assessing skills for new

and vacant posts.

PROV IDING BI LIN GUAL SERVIC ES F OR PATIEN T S AN D DON ORS:

1. We have identified the need for direct communication with inpatients and have

developed a policy to deliver this in line with the time set out within the Standards

compliance notice.

2. We updated our policy of consent for patients to include Welsh language support and

have developed a process to successfully implement this change.

3. We have assessed the need to strengthen the sharing of information bilingually with

our service users as part of our social media communication.

4. We have strengthened our collection of patient and donor language choice in order

to influence the planning structures across the Trust.

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TRAININ G AN D DEV EL OP MENT:

1. We have assessed the current skills of the workforce using ESR in order to identify

the gaps in possible service needs across the Trust in line with the Trust’s Bilingual

Skills strategy.

2. We have significantly increased the number of staff completing the 10 hour on line

course and have provided support for current learners in order to ensure their skills

are used as part of their roles in support of patients and donors.

3. We have developed a robust process to ensure that staff can access Welsh language

training in line with the requirements set out within the Welsh Language Standards.

4. We have supported the first NHS on-line course for members of staff, working with

the Welsh Government funded organisation, and increasing the use of this training

will be a priority for us.

In supporting the delivery of our Welsh Language strategic objectives we have ensured

that our Equality Impact Assessment process continues to support staff in ensuring

Equality, including Welsh language, and that priorities are considered as part of any

Project or plan developed across the Trust.

OUR A PPROACH TO THE WELL -BEIN G OF FU TURE GEN ERA TI ONS AC T

In April 2016, the Well-Being of Future Generations (Wales) Act 2015 came into effect.

We see the Act as an opportunity to ensure our services are not only fit for the future but

that everything we do is framed (without impacting current services) for the long term,

considering prevention, integration, collaboration and involvement. The Act therefore

provides the central reference point for everything we do within the organisation and

underpins the development of all our strategies and plans.

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The Trust, recognised under the Act as a national body, it was required to develop and

publish a set of its own well-being objectives by the end of March 2017. These objectives

(see page 17) were developed following extensive engagement and were designed to

focus the Trust’s contribution to the realisation of the national well-being goals. The

upcoming years will undoubtedly witness an increased focus on well-being as we

attempt to embed the Sustainable Development Principle further and to make it a normal

part of everything that we do.

The journey we are on will see us implement a new approach to planning and delivery

within the Trust and the development of a different organisation that is more involved

across the breadth of health, social care and public services. This collaborative will see

us working across the organisation and with a range of partners to ensure the five ways

of working are embedded at the core of everything we do.

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The five ways of working are at the heart of this work.

This will involve:

Long term

Identifying where we can add value through action that supports

positive outcomes in the long term, both for current and future

generations. This will see us working with Regional Partnership

Boards and Public Service Boards in improving health, wealth

and healthcare.

Prevention

Prevention is a focus of our strategies and plans. We will look

to build upon the work we undertake in secondary prevention

and seek to develop our input and impact in primary prevention

and population health and well-being.

Integration Identifying how our strategic priorities and knowledge can make

a difference to the people we serve and the partners we work

with.

Collaboration Working in collaboration across the organisation and with

partner organisations to identify how we can work together to

achieve our individual and collective goals and outcomes.

Involvement Involving people who work for us, with us and who uses the

services we provide in everything we do. We use this approach

as part of ‘our way of doing things’.

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OUR W ELLBEING OBJECT IVES

1. Reduce health inequalities, make it easier to access the best possible healthcare when it is needed and help prevent ill health by collaborating with the people of Wales in novel

ways

2. Improve the health and well-being of families across Wales by striving to care for the needs of the

whole person

3. Create new, highly skilled jobs and attract investment by increasing our focus on research,

innovation and new models of delivery

4. Deliver bold solutions to the environmental challenges posed by our activities

5. Bring communities and generations together through involvement in the planning and delivery of

our services

6. Demonstrate respect for the diverse cultural heritage of modern Wales

7. Strengthen the international reputation of the Trust as a centre of excellence for teaching, research and technical innovation whilst also making a lasting

contribution to global well-being

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We appreciate that, given the generational scope of the Act, it is difficult to accurately

quantify our contribution to the realisation of the national well-being goals and the

progress we have made, to date, against the Trust’s own well-being objectives.

However, we have outlined below some of the work that we have taken forward in

2018/19 which has been informed by our determination to place the tenets of the Well-

being of Future Generations Act and the Sustainable Development Principle at the very

heart of everything we do.

We want to offer a true sense of the breadth of well-being focused activity taking place

across the Trust, from large scale change programmes to local, innovative projects. The

disproportionate positive impact that smaller initiatives can have demonstrates how each

of us can have a genuine influence on both the Trust’s and the national well-being

agendas.

MEN OPAUSE CAF É

Partly inspired by broadcaster, Kirsty Wark’s BBC

television programme Menopause and Me, Rachel

Weiss held the world’s first Menopause Café in Perth,

Scotland in June 2017. Adapting Rachel’s model, we

offered the first work place Menopause Café event to be held in Wales in November

2018.

The key objective of the Menopause Café is to increase awareness of the impact of the

menopause on those experiencing it, their friends, colleagues and families, so that

conscious and informed decisions can be made about the third stage of life.

A Menopause Café is a group directed discussion of menopause with no agenda, set

out-comes or themes. It is a discussion group rather than a support or counselling

session. Anybody interested in sharing their stories, experiences and questions about

menopause are welcome to attend. All genders and all ages are welcome.

This kind of initiative, which has been delivered as part of the Trust’s Workforce and

Organisational Development Health and Well-being offering, contributes towards the

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realisation of the Trust’s second well-being objective, improve the health and well-being

of families across Wales by striving to care for the needs of the whole person.

ECO-CU PS

In an effort to prevent the production of unnecessary waste, single use plastic cups were

removed from the Parkside dining room at Velindre Cancer Centre. Beverages are now

served in ceramic mugs and staff are encouraged to use re-useable Eco to Go cups

made from natural materials and supplied in collaboration with Keep Wales Tidy.

PA TI ENT AND COMMUNI T Y L EADER SHIP PR OGRA M ME

In 2017/18 the very first cohort successfully completed

our new Patient & Community Leadership Programme.

The Programme has continued to deliver important

benefits in 2018/19 and is a key focus for development

work in 2019/20.

Collaborating with Public Health Wales and The Centre

for Patient Leadership, Velindre recruited 10 Patient

Leaders who are now using their newly acquired leadership skills to help shape services

for the future, influence change and share their own expertise with clinical staff.

The first Programme of its kind in NHS Wales, we are incredibly proud to be leading the

way in our collaborative approach.

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NA TI ONAL BL OOD HEAL T H PL AN

The WBS has led on the development of the National Blood

Health Plan for NHS Wales. This will be a key driver for

WBS and other NHS organisations across the country in

the years to come. The Well-Being of Future Generations

Act, and a recognition of the key importance of the

Sustainable Development Principle, are fundamental to the

Plan and to its delivery.

The Plan’s strategic aims explicitly refer to the need to promote the involvement of the

Welsh population in the management of blood health. This is a very real example of

long-term thinking. The plan will prevent waste and harm and is founded on the principle

of integration and collaboration with our health board partners and others.

TRANSF OR MIN G C ANCER SERV ICES PR OGR AMME

Underpinning the Project to build a new Cancer Centre in the north of Cardiff and to

improve services right across south-east Wales is a genuine ambition to advance the

well-being agenda.

We want to move care closer to our patients homes where that is appropriate, can be

done safely and where quality service delivery can be ensured. These changes will have

many positive impacts. From an environmental perspective, as our patients will need to

travel less, there will be a fall in the production of CO2 and other, potentially harmful,

emissions.

The need to deliver economic, environmental, cultural and educational benefits to the

communities we serve and live along side is also key to our vision for a new Cancer

Centre. We are currently exploring ways that will ensure that our new estate will have a

range of uses other than its primary, clinical function. We want to limit our environmental

impact, to work with our potential neighbours to boost biodiversity and to develop and

support social prescribing schemes.

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C OMMUNI TY HEAL TH C OU NCIL S (C HC)

The Trust maintains excellent working relationships with all Community Health Council’s

(CHCs) across south-east Wales as demonstrated by examples such as involvement

with the Transforming Cancer Services Programme, complaints resolution etc.

There is CHC representation at Trust Board meetings and they are invited to contribute

towards service delivery and objectives as discussed at these meetings. A member of

the Executive Team attends Cardiff & Vale CHC meetings on a regular basis.

The Trust, in particular the Velindre Cancer Centre, is also subject to regular

unannounced visits from the CHCs as well as planned Hospital Environment

Assessment Team audits. The results of these have, on the whole, been very positive.

IN TERNATIONAL HEALTH DEVEL OPMENT

South Wales Sierra Leone Cancer Care Link: The SWSLCC was

developed to provide health care professionals in Sierra Leone with

specialist training in cancer and palliative care. The SWSLCC programme

aims to help health care professionals in Sierra Leone to improve quality

and access to cancer and palliative care services.

The SWSLCC Team work with a wide range of Sierra Leonean, UK, and

Welsh partners, to build political support and to raise the profile of cancer

and palliative care services in Sierra Leone.

In Wales, the team continue to share their experience with health professionals, Welsh

Universities and third sector organisations, writing articles and presenting at events and

conferences.

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DEVELOPMENT ACTIVITY

R ESEARCH, DEVELOPMEN T AN D INNOVA TI ON

Our ambition must be for a Velindre defined by its commitment

to innovation, demonstrated both in its support for Research and

its success in the rapid adoption and diffusion of the best,

transformative, most innovative ideas, products, services and

clinical practice.

The delivery and management of high quality research, development and innovation is

a strategic priority for the Trust. Through our recently acquired University status, we have

continued to build an excellent national and international reputation. Our ambition is to

achieve international recognition for a wide range of clinical, social and technological

research, development and innovation.

In delivering our ambition we have continued to further develop strong collaborative

networks with our neighbouring Health Boards, Blood Services and Higher Education

Institutions, and have embarked on joint Programmes of work to strengthen our research

capacity across the allied health portfolio, with an increasing emphasis on social science

to improve the health and well-being of donors, patients and their families.

We have a longstanding relationship with industry which continues to thrive with global

pharma companies selecting Velindre as a preferred site for their first line, complex

studies. We also have a number of our researchers being appointed as UK Chief

Investigator’s and have set-up, and led, a UK-wide study. The Trust continues to expand

its exciting portfolio of sponsored investigator lead non-commercial Clinical Trials of

Investigational Medicinal Products (CTIMP) studies in collaboration with Cardiff

University and well-designed high quality non-CTIMP studies.

The successful bid through Innovate UK for establishing Cell and Gene Therapy in

Wales has been led through the Trust by the Welsh Blood Service and provides an

exciting platform to develop clinical trials for solid tumours using advanced therapies.

This will bring opportunities for a collaborative research programme with our partners in

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Cardiff and Vale UHB, allowing us to build on the already successful delivery of early

phase/single contract model that has been welcomed by pharmaceutical companies and

has established Cardiff as an attractive site to conduct complex, regulatory rich studies.

The Welsh Blood Service also continues to contribute to research into blood and

transplant services, taking a proportionate role in delivering key research studies which

demonstrate value for the wider blood and transplant communities across the UK and

globally through our links with international organisations.

CL INICAL TRI AL S UNI T

The Clinical Trials Unit (CTU) continues to deliver a rich portfolio of high quality

commercial and non-commercial clinical trials across a wide range of tumour sites. There

are currently 17 commercial studies and 51 non-commercial studies open to recruitment

within the cancer centre. This activity is led by 24 Principal Investigators, and a total of

183 patients recruited to date this financial year. The department continues to be

recognised as a top achieving site for the UK amongst a number of trials.

In addition we have, over the course of the last year, continued to work in collaboration

with Higher Education Institutions to build capacity for nurse led research across

Velindre. As part of this work we have started to develop a joint programme of work with

the University of South Wales which will see the hosting of student nurses within the

cancer centre. This programme will aim to improve research literacy and co-facilitate

the teaching of research methods in nursing, co-application of funding bids for nurse led

research, exploration of education avenues for our staff interested in pursuing

Postgraduate taught and PhD Programmes and the development of future joint posts

between the University and Velindre.

EARLY PHASE TRIA LS

Established in 2013, the early phase research continues to be a major collaborative

success for Velindre and has recently secured an extension of funding from the Wales

Cancer Research Centre until April 2020 and the Experimental Cancer Medicine Centre

until 2022. The early phase team has been successful in delivering a balanced portfolio

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of high quality, innovative, commercial and non-commercial research. The recruitment

to date has grown year on year with around 800 patients visiting the unit over the last 12

months.

RA DI OTHERA PY

Radiotherapy research is well established at Velindre Cancer Centre. With the

increasing therapeutic profile of radiotherapy in oncology, there is an ongoing need for

research to optimise all aspects of radiotherapy use and delivery. Velindre has made a

commitment to prioritise radiotherapy research and continues to sponsor a number of

multicentre UK radiotherapy clinical trials as well as investing within radiotherapy

research through the development of a number of strategic consultant posts and clinical

research fellows.

UNIV ERSITY STA TUS

Earlier this year we secured University status demonstrating the continued achievement

in research, development and innovation for the Welsh Blood Service and Velindre

Cancer Centre. The award of University status is a significant milestone for the Trust

and demonstrates the commitment to research, development and innovation (RDI)

across the Trust. This achievement has given us a platform and the supported

credentials to further advance our work and has already attracted the attention of a

number of partners who are keen to work with us. Our reputation, and our collaborative

work with commercial and non-commercial partners, is allowing us to optimise and

expand our research portfolio and create a progressive RDI environment for patient

benefit.

INN OVA TI ON

The pace of innovation, clinical and technological change in cancer and blood services

is rapid. In response we have ensured that strategic innovation is a major area of

strategic focus for the Trust. Over the course of the last 12 months we have made major

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advances in the scope and implementation in the following key areas, using disruptive

technology through industry and academic collaboration:

Augmented and artificial intelligence (Innovate and Activate Programmes)

Virtual and augmented reality (Educate and Innovate Programmes)

Proton Beam Therapy (Innovate Programme)

Regenerative Medicine (Regenerate Programme)

Four KESS PhDs and one KESS MSc/MPhil (Educate Programme)

£0.710 million from industry inward investment (Pfizer, IBM) Potentiate

Grant award schemes pending (£0.300 million) Potentiate

DI GI TAL HEAL TH: INF O RMA TI ON MANAGEMENT &

TEC HN OLOGY (IM&T)

The development of digital services is a key enabler of services which are fit for the

future. Our digital vision for the future is based around:

Adopting a ‘digital first’ philosophy when designing and

delivering new services, to promote mobile, flexible, digitally-

enabled service & workforce models.

We have delivered a number of significant developments over the last twelve months in

support of this vision.

Across the Trust key activities have focused on developing a Cyber Security skillset,

resilience and action plan, which is aligned to the security tool kit and best practice

guidelines issued by the UK National Cyber Security Centre (NCSC) and the Centre for

Internet Security (CIS). This includes the trialling of cutting edge automated penetration

testing software that is deployed to identify vulnerabilities within local networks. By

purchasing software in late 2018, Velindre University NHS Trust is the first NHS Wales

organisation to exploit this exciting area of cyber security defence.

The Trust launched its Velindre University NHS Trust Information Portal providing an

online platform for the publishing of data, analyses and other information pertaining to

Trust Business Intelligence services. Whilst much work remains to be done, significant

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progress has been made to embed business intelligence into key operational

discussions, such as the weekly demand planning meetings.

Welsh Blood Service:

In April 2018, a major upgrade to the Welsh Blood Service Appointments System

took place to support the electronic management of appointments for apheresis (platelet)

donations. This upgrade meant that, for the first time, booking of all whole blood and

apheresis donors was paperless.

The 7 Day Platelets major change Project was completed in August 2018. This Project

re-shaped the process for the regular bacteriology monitoring of platelets held in Talbot

Green, prior to their issue to NHS Wales’s hospitals. This ensured an extended shelf

life of stock sent up to North Wales, thus helping to contribute to a reduction in wastage

levels for platelets within the WBS.

In October 2018 a replacement microbiology platform was installed into the

Automated Testing laboratory in Talbot Green. This has ensured that reliable, industry-

standard equipment is now in use to support the day-to-day microbiology testing that the

WBS needs to undertake to ensure a safe supply of blood components into NHS Wales.

Through the delivery of a number of its main Blood Establishment Computer System

‘delta’ releases, the WBS Business Systems department continued to respond to the

ongoing demand for enhancements to the system. Further ‘delta’ releases will be

delivered in 2019 and beyond, to ensure the system is continually developed to align

with new and changed ways of working across the organisation.

Work has continued in respect of the implementation of the Welsh Laboratory

Information Management System (WLIMS). The first module of the WLIMS solution

is due to be implemented in late-2019.

A range of infrastructure modernisation works have been completed across the WBS

estate and Wi-Fi services have now been enabled across all of the Talbot Green site. In

addition we have worked in collaboration with Betsi Cadwaladr University Health Board

in respect of the upgrading of telephony services across North Wales WBS sites, in

particular the changes associated with the Stock Holding Unit (SHU) in Wrexham.

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Velindre Cancer Centre:

Through a number of major up-grades to the Welsh Clinical Portal in January and

September 2018, increased functionality, including access to the GP Summary, patient

lists, Medicines Transcription e-Discharge, document and radiology investigation report

viewing was rolled out across the Cancer Centre.

The telephone system was up-graded in June 2018 across Velindre Cancer Centre

and Trust Headquarters. This up-grade delivered a more modern communication

system with additional functionality, resilience to meet the service needs and offers

future cost savings with the modernisation call routing scheduled for implementation in

the next financial year.

The Cancer Information System (Canisc) Business Case (Part 1) was approved by

Welsh Government in July 2018. This is a joint Business Case developed by the Trust

and NHS Wales Informatics Service to address risks associated with the current primary

system, Canisc. The focus of Part 1 refers to key national policy drivers including the

implementation of the Welsh Patient Administration System (WPAS).

In November 2018, Velindre Cancer Centre was the first Trust/Health Board in Wales to

up-grade to Synapse 5, Radiology Imaging Software, in an operational environment.

This goes some way to supporting the All Wales ambition to progress the sharing of

radiology images, irrelevant of Health Board boundaries, improving patient care and

supporting treatment decisions.

A nursing e-documentation steering group, led by the Chief Nursing Information

Officer, had its inaugural meeting in October 2018 with the remit of approving the

standardisation of national nursing documentation in line with the recommendations from

national groups. The steering group will plan and oversee the training needs and

integration of the digitisation of nursing documentation, including piloting the project as

appropriate. The nursing e-documentation group and Project Board are expecting to pilot

nursing e-documentation across Wales from September 2019 with a deadline of

November 2019 to go live.

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TRUST ORGANISATIONAL

DEVELOPMENT STRATEGY

WORKFORCE AND ORGANI SATIONAL DEVELOPMENT

Our staff recognise that being the best for our patients and donors underpins everything

that we do across the Trust and we know how lucky we are to have a committed and

highly talented workforce who make a difference on a daily basis.

Data source: NHS Staff Survey Results 2018

As we move forward during this period of transformational service change our

responsibility to our workforce is to enable them to continue to give of their best. We will

ensure that colleagues have:

The right skills and opportunities to continuously develop.

Care and attention paid to their health and wellbeing.

Are involved in change and influencing improvements all around them.

We will build on our existing approaches to ensure we have strong managers and

leaders who are confident to build on our successes and support a culture that enables

the workforce to embrace and deliver the organisational changes ahead.

96% of staff are prepared to go the extra mile

90% of staff understand, believe and share the Trust’s values

91% of staff are happy with the standard of care provided by the Trust

88% of staff are proud to work for Velindre UNHS Trust

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SU PPORTING OUR STA FF TO EXCEL

The need to continue the delivery of high quality services, whilst also achieving ambitious

service changes, underpins the Trust’s workforce and organisational development (OD)

ambitions. To further progress this ambition we have identified seven themes and six

enabling approaches, underpinned by our values.

W ORKFOR CE PLANNIN G

Our Strategy outlines how the Trust will develop a culture that enables each of us to be

great and achieve the delivery of ambitious and exciting service change plans. Through

conversations with staff we know we need a values driven culture where world class

services are delivered by a workforce that understands the difference it makes to the

donor and patient experience. The Trust will deliver this through its resilience and

flexibility, and a culture that encourages ambition and improvement and is agile and

responsive to change.

With patient/donor care central to everything we do, we have articulated through our

Integrated Medium Term Plan (IMTP) a future that involves significant change to the

scope and expectations of service delivery. With change comes the opportunity to

modernise and redesign services and the workforce, and further strengthen collaborative

relationships with patients and stakeholder organisations. Through the application of the

prudent healthcare principles across the Trust, moving forward we will continue to excel

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in the delivery of care and clinical services that are uniquely ours, while understanding

how to use the skills of our staff and available resources most effectively to continue to

improve.

THE STORY BEHIN D OUR VALU ES

Between April and July 2015, the Trust met with 145 staff

in team meetings, received 164 online Building Excellence

questionnaire submissions, 250 online Staff Pulse Survey

submissions, and carried out interviews with 96 staff as part

of our Investors in People reaccreditation process.

Everything that staff have told us has been distilled into four organisational values.

These values are for all staff, whether staff are working at the Welsh Blood Service,

Velindre Trust HQ or Velindre Cancer Centre.

We are working to explore new ways of working and making the best use of people and

advanced roles to provide better services.

The new Education and Training Strategy will assist in developing new training pathways

to support workforce plans and allow our staff to excel.

DEFINITIONS OF EXCEL LENCE

W ORKFOR CE PLANNIN G

Having the right people, in the right place, at the right time to deliver a safe, effective and

efficient service for our patients and donors, in an environment that supports proactive

planning and innovation to continuously improve service delivery.

C OMMUNI CATI ONS

A listening organisation with a well informed and engaged workforce.

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PERF OR MANC E MANA GEME NT

Velindre University NHS Trust lives an inspiring vision, which gives direction to our

employee’s behaviour and provides inspiration. Meaningful and open performance

conversations happen regularly to tighten the link between strategic business objectives

and day-to-day action. Performance updates are delivered compellingly and in a way

that will influence employee attitudes and behaviours.

SERVIC E I MPR OV EMENT

A learning organisation which aspires to always do better.

L EA DER SHIP & MANA GEM ENT DEVEL OPMEN T

A Leadership Team that takes calculated risks and makes timely and sometimes

‘uncomfortable decisions’ in support of a clear strategic direction.

A Management Team with proven and continually formally evaluated management

competencies in managing both people and the process.

TAL ENT MANA GEMENT & SUCC ES SI ON PLANNING

A transparent and flexible framework with a commitment to promote talent and ambition.

ORGANISA TI ONAL STRUC TURE & DESI GN

A business that thinks and acts proactively has open structures and engages

successfully with staff, donors and patients.

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PERFORMANCE SUMMARY

VELINDRE CANCER CENTRE

C ORE AC TIVI TY DURIN G 2018 /2019

2018/2019 has been an extremely busy and successful year for the Velindre Cancer

Centre. We have continued to deliver excellent care and support to our patients, their

carers and their families despite increasing demand and pressure upon key services.

This fact is a testament to our hardworking, caring and dedicated staff who continue to

go the extra mile to ensure high quality care. Looking back at 2018/19, we can feel

extremely proud of our achievements in delivering improved patient care and in

introducing a range of service developments and new treatment techniques.

Our work continues to be informed and guided by our two key strategies, ‘Shaping the

Future Together 2016 – 2026’ and ‘Shaping the Future of Radiotherapy 2016 –

2026’.

‘Shaping the Future Together 2016 – 2026’ sets out five strategic aims and how they

will be delivered:

1. Equitable and consistent care, no matter where

2. Access to state-of-the-art, world-class, evidence-based treatments

3. Improving care and support for patients to live well with cancer

4. To be an international leader in research, development, innovation and

education

5. To work in partnership with stakeholders to improve prevention and earlier

detection of cancer

‘Shaping the Future of Radiotherapy 2016 – 2026’ sets out the Cancer Centre’s

ambition to become an internationally recognised Centre of Excellence for Radiotherapy.

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The Strategy is underpinned by seven aims and sets out how they will be achieved:

1. Every patient has access to the best treatment appropriate for them, which

is timely and delivered in the most efficient and effective way possible.

2. The radiotherapy service will be at the forefront of technological advances

through its continual assessment and adoption, for the benefit of all patients.

3. An integrated and empowered workforce that is motivated, values driven

and innovative.

4. A service that is maintained and future proofed with effective and

appropriate funding to enable clinical, technological and research

developments.

5. To expand radiotherapy research through effective leadership, resources

and investment.

6. A high quality service which utilises comprehensive data, evidence based

practice and research to drive forward innovations.

7. Establish a culture of collaborative working and partnership that reflects and

prioritises the values of the organisation.

Velindre Cancer Centre: Summary of key achievements in 2018/19

Business Case approved for a new Velindre Cancer Centre

Introduction of an Assessment Centre at Velindre Cancer Centre

Continued development of Velindre Medicines at Home Service

Increased local provision of Cancer Services

Increased access to Clinical Trials

Recruited to new Consultant Radiographer post

Introduced Deep Inspiration Breath Hold (DIBH) radiotherapy technique

Training ‘Dementia Friends

Development of Patient & Community Leadership Programme

Business Case approved for a new Velindre Cancer Centre (nVCC): our

commissioners approved an Outline Business Case (OBC) for a nVCC to be

developed in Whitchurch, Cardiff. The OBC will now be considered by the Welsh

Government with a decision expected to be made in August, 2019.

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Introduction of an Assessment Centre at VCC: we opened an Assessment

Centre during 2018/19 as a key enabler for our plan to develop a regional Acute

Oncology Service (AOS). The introduction of the Assessment Centre at VCC

which has resulted in a significant reduction in inappropriate admissions and in

length of stay.

Continued development of Velindre Medicines at Home Service: This service

provides patients with the option to have oral Systemic Anti-Cancer Therapies

(SACT) delivered directly to their home, thus reducing the need for travel and

allowing us to focus more of our resources on treatments that must be delivered

in a hospital environment. Patient feedback has been extremely positive as

evidenced within our Patient Experience Survey.

Increased local provision of Cancer Services: we have, in partnership with

Aneurin Bevan University Health Board, established a Radiotherapy Satellite

Centre Project. The aim of this Project is to develop a Radiotherapy Satellite at

Nevill Hall Hospital, Abergavenny, thus providing improved access to

Radiotherapy services across South East Wales. In addition we continue to

increase the range of SACT, Outpatient and other patient services which are

available within local communities and close to the patient’s place of residence.

Increased access to Clinical Trials: we have continued to increase patient

access to clinical trials, with over 200 patients being recruited to clinical trials

during 2018/19. Furthermore the development of consistent services across all

locations and equitable access to clinical trials remains a key priority for the

service.

Recruited to new Consultant Radiographer post: we recruited to a new

Consultant Radiographer post during 2018/19, the first role of its kind in Wales.

This is an exciting career development opportunity for radiotherapists and allows

consultant oncologists to focus on aspects of service delivery they are best suited

to deliver in line with the principles of prudent healthcare.

Introduced Deep Inspiration Breath Hold (DIBH) radiotherapy technique: we

have introduced service development for left-sided breast cancer patients. This

36 | P a g e

technique reduces potential for cardiac damage related to the delivery of radiation

during treatment. The likely avoidance of harm improves long-term patient

outcomes and is in keeping with the prevention arm of the Sustainable

Development Principle.

Training ‘Dementia Friends: we have trained more than 300 'Dementia Friends',

far exceeding the initial target of 100.

Development of Patient & Community Leadership Programme: our very first

cohort successfully completed our new Patient & Community Leadership

Programme. Collaborating with Public Health Wales and The Centre for Patient

Leadership, Velindre recruited 10 Patient Leaders who are now using their newly

acquired leadership skills to help shape services for the future, influence change

and share their own expertise with clinical staff. The first programme of its kind

in NHS Wales, we are incredibly proud to be leading the way in our collaborative

approach.

Expansion of Pharmacy led Patient Education and Toxicity Assessment

Clinics: we have established new toxicity assessment services for patients with

breast and gynaecology cancers. These clinics, led by pharmacy technicians, are

undertaken by telephone and reduce the requirement for patients to come to

outpatient clinic appointments and thus release consultant clinician and outpatient

capacity in addition to improving patient experience. As an example of the

positive patient impact of this growing service, in 2018, 262 patients on one drug

alone, vinorelbine, benefited from this service.

V ELIN DRE CANC ER CEN T RE – ONGOIN G C HALL EN GES AND

OPPOR TUNI TI ES

Velindre Cancer Centre, currently, faces a number of key challenges. Additional detail

on how we will address these can be found in our three year plan, but it is important to

recognise that these issues effect the design of our services and our performance.

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CANC ER IN CI DENC E I S INCR EASIN G:

The incidence of cancer in Wales is forecast to increase by 2% per annum to 2031. This

is expected to result in an estimated 12,677 new cases per year in the VCC catchment

population by 2031, representing an increase of 35% since 2013.

THERE C ONTINU ES TO B E VAR IA TI ON IN OU TC O MES

THR OU GHOU T WAL ES:

While survival rates have improved, there continues to be significant variation in survival

rates between the least and most deprived in South-East Wales. We need to work with

our partners to reduce inequalities, improve prevention, improve the rates of earlier

detection and diagnosis and patients access and take up of treatment. The advent of the

Single Cancer Pathway (SCP) will have important ramifications for the delivery of cancer

services across Wales.

THERE IS A GAP BETW E EN F OR ECAST DEMAND A N D SU PPLY

W HIC H WE NEED TO CLO SE:

The increasing incidence of cancer, increasing survival rates of people with cancer and

the increasing complexity in treatments will create a significant pressure on our ability to

deliver the required level of services in the future.

During 2018/19 we have experienced a significant increase in demand for Radiotherapy

treatments. We have worked closely with our commissioners to develop robust plans

for responding to this challenge so that we are able to continue to deliver high quality

services and maintain current performance.

We are also experiencing the dawn of immunotherapy, a relatively new type of treatment,

considered a treatment ‘breakthrough’ for many cancer types. There is a growing list of

cancer types for which immunotherapy has shown promising results and a wave of new

medicines were approved in 2018/2019 and are set to be approved over the coming

years.

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TREA TMEN TS AR E BEC OM IN G MORE COMP LEX:

The pace of innovation, clinical and technological change in cancer services is rapid.

We know that on the immediate horizon are new advances in radiotherapy along with

personalised medicine.

MOR E PEOPL E AR E LIVI N G W ITH AN D B EYON D C ANC ER:

As treatments have improved survival in the UK has doubled over the last 40 years. A

new approach to longer term care is therefore required to support individuals with

ongoing treatment and rehabilitation, and to ensure patients are able to maximise their

potential and enjoy the highest quality of life.

There is a need to develop a broader range of services which support individuals and

helps them engage fully in society, including employment, following their recovery. We

need to ensure that we can continue to offer robust, high quality Therapies and Clinical

Psychology services. This will require a change in relationship between patient and

clinician, with patients taking an equal role in designing and co-producing care.

SU PPLY OF W ORKF ORCE:

We are experiencing a number of workforce challenges and we need to develop a

resilient, efficient and appropriately skilled workforce to meet those challenges. We are

already aware that our turnover in nursing is on an upward trend. We need to plan to

ensure that we can recruit posts to meet this predicted growth. The impact of national

shortages of consultant Oncologists, Healthcare Scientists, Core Medical Trainees and

Pharmacists means that we also need to review the ways in which we work to ensure

we can continue to deliver our service and meet the growing demand.

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V ELIN DRE C ANCER C ENT R E: HOW W E WIL L MEET OUR C HALL ENGES

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WELSH BLOOD SERVICE

C ORE AC TIVI TY DURIN G 201 8 -2019

The following infographics provide a snap shot of the core activity of the Welsh Blood Service

for the period 2018-2019.

The Welsh Blood Service collects voluntary donations from the general public across Wales

which are processed, tested and distributed to customer hospitals. The Welsh Transplantation

& Immunogenetics Laboratory, within the WBS, operates the Welsh Bone Marrow Donor

Registry and provides direct support to providers of Renal and Stem cell transplantation.

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WELSH BLOOD SERVICE: KEY ACHIEVEMENTS

IN 2018/2019

MISSIN G TYPE CA MPAI G N IN W AL ES R EAC HES O V ER 1 ,00 0,000

PEOPL E!

Organisations, influencers and blood

donors across Wales dropped the

letters A, B and O from their social

media names as part of an

International Missing Type campaign

between Monday 11 and Sunday 17

June 2018. The campaign was a huge

success in Wales, potentially reaching

over 1,000,000 people thanks to the

support from high profile Welsh brands

and loyal donors across the country.

ITV Wales covered the campaign on

Day 7, of the campaign talking about the purpose of the missing letters and the aim for more

donors to give blood.

ENHANC ED ONLIN E A PPO INTMEN T SERVIC E

Donors across Wales now have more control of

their blood donation appointments following a

series of improvements to the Welsh Blood

Service online appointment system. Among the

improvements, donors that book an appointment

online will now:

- be given the chance to receive appointment

reminders via email, SMS or telephone call

at 10 days and 2 days prior to their appointment;

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- receive a bespoke link in their reminder which will allow them to cancel their appointment,

should they be unable to attend; and

- be encouraged to undertake a donor eligibility quiz before booking an appointment to

ensure donors are eligible to donate before they make an appointment.

BL OOD SU PPLY C HAIN 2 020

At the Welsh Blood Service, the

Blood Supply Chain 2020

initiative, continues to take great

strides forward realigning the way

in which we plan, collect,

manufacture and distribute blood

components across Wales.

Several important milestones

were reached during 2018/19,

including implementation of a new platelet testing method that extends the shelf life of

platelets from 5 -7 days, improving the supply to hospitals and patients and helping to reduce

waste.

I MPROV ED SCR EENIN G F OR DONORS A CROSS WAL ES

A donor’s haemogloblin must be

within a recognised range to

enable them to donate. Effective

haemoglobin screening tests are

essential to maximise donor

health and to optimise blood

collection. The WBS has

introduced a secondary test to

help assess donor haemoglobin levels. This has resulted in a number of benefits including:

improved donor experience; reduction in unnecessary donor deferrals where previously they

would have been identified as unable to donate, when it was safe for them to do so; reduced

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‘worry’ for donors; less subjectivity for staff; and ensuring we’re making the most of every

generous donor we see.

I MPLEMENTA TION OF NE W GL OBAL DONOR NUMB E R

In 2019, the Welsh Bone

Marrow Registry

(WBMDR) worked with

registries across the

world to introduce a new

Global Registration

Identifier for donors

(GRID). With over 30 million donors on the worldwide register, it is important to have an

identification system that uniquely identifies potential donors on a global scale. This project

was no small task and involved changes to multiple IT systems and documents, impacting

not only the WBMDR and its international partners but also our Laboratories and Business

Systems. As such, successful implementation relied on cross departmental working

adopting a multidisciplinary approach. The WBS was one of the first organisations to

complete the upgrade of its IT systems to be compliant with the new standards, which will

help improve safety for patients in receipt of therapeutic bone marrow donations across the

world.

N EW MICR OBIOL OGY PLA TFORM

Launch of the new

microbiology platform puts

WBS at the ‘forefront’ of

Europe.

On Tuesday 15th January

2019, the WBS Automated Testing Laboratory officially launched its new microbiology

testing platform, following a successful installation period. The new system will form a

significant part of the mandatory testing for: HIV, Hepatitis B&C, HTLV, Syphillis, CMV and

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Malaria. These tests are required prior to units being issued from the WBS to its 19 customer

hospitals across Wales. The new platform provides improved performance and resilience

and increased the efficiency of blood component manufacturing and testing.

I MPROV ED DEMAN D PLANNIN G

In June 2018, the WBS established a weekly demand planning group.

This cross-departmental group involves staff from Manufacturing &

Distribution, Collections and Business Intelligence, collaborating in a

matrix style approach, with the aim of understanding how many donations

are required to supply the components needed by Welsh hospitals. The

group takes an operational perspective; developing insights into trends in demand,

developing an ever improving prediction model for hospital orders with the aim to reduce

variation in the Blood supply chain. The group has provided increasing assurance that

sufficient collections are planned to meet demand. Indeed, in the last six months of 2018/19,

the WBS was able to support a regular supply of Red Blood Cells to NHS Blood & Transplant

in England, without detriment to the supply of components for transfusion in Welsh hospitals.

I T INFRASTRUCTURE UP GRA DE

In March 2019, the WBS completed the first phase of a

major IT infrastructure upgrade in its primary data centre.

IT hardware and cabling was refreshed to deliver improved

performance and resilience for WBS IT systems and

services. The organisation also carried out a significant

business continuity exercise when IT systems were taken

fully offline in support of a wider piece of work to improve

the electrical infrastructure at its Talbot Green site. Further

tests will be carried out on the WBS IT infrastructure through 2019/20, to ensure processes

are in place to maintain business continuity in the event of possible future local and/or

national systems or network failures.

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N HS WAL ES BLOOD HEAL TH PL AN

Delivery of the Blood Health Plan (BHP) for NHS

Wales has continued following its initial publication in

2017. The WBS has a system leadership role in

supporting actions to deliver the plan, in collaboration

with colleagues across NHS Wales. In 2018, the Blood

Health National Oversight Group (NOG) was

established to oversee the delivery of the plan and in

July’18 the WBS hosted the official launch of the BHP,

at Cardiff Bay. The aim of the launch was threefold:

1. To raise awareness of the plan both within

the transfusion community and across the

wider NHS;

2. To provide an update on the work of the BH NOG to date, including key areas of

work and their priorities; and

3. To showcase current, ongoing and future initiatives that the BH NOG is/will be

involved in and the impact this will have on transfusion practice in Wales.

The launch day was represented by Health Boards across Wales from a variety of

specialities and was supported by experts in different aspects of Blood Transfusion. The

launch day allowed us to highlight the five key work streams identified by the BHNOG as

being integral to the BHP. These are: (1)Transfusion Associated Circulatory Overload

(TACO) / Single Unit Transfusion; (2) Management of Anaemia; (3) Appropriate use of O D

Negative; (4) Appropriate use of platelets and (5) Use of data.

CYB ER SECURI TY

As part of an ongoing programme of work, the WBS has made significant gains over the last

12 months in respect of strengthening its IT infrastructure to

help reduce the risk of a cyber-attack compromising Velindre

IT systems and services. More automated processes for

patching of IT systems and software have been introduced

alongside the introduction of new threat detection,

vulnerability scanning and monitoring services that have

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been implemented, in collaboration with the NHS Wales Informatics Service. Velindre

University NHS Trust is also pioneering the use of cutting edge automated penetration

testing technology, to help further protect its IT infrastructure from cyber security attack.

These measures, which will be further developed through the delivery of the Trust Cyber

Security Improvement Plan, will ensure better protection of sensitive patient and donor data,

as well as helping to ensure systems and services stay online and allow staff to deliver care.

ENHANC ED BMV TY PIN G

To improve the quality of our donor panel, in 2018/19 the Welsh Blood Marrow Donor

Registry (WBMDR) has performed retrospective

typing on 8,000 of our bone marrow volunteers

(BMV), to improve the level of stem cell typing

information available to each Transplant Centre.

With 8,000 registered donors having re-entered

the typing process, this should increase the donor

pool for potential matches to be found for

recipients around the world. The availability of a

broader donor panel will also serve to enhance

the reputation of the WBMDR on a national and

international level, ensuring that it is the registry

of choice.

Indeed, the WBMDR has gone from strength to

strength and has continued to see an overall

increase in the number of requests for cellular

therapy products (114 in 2018/19 v 111 in

2017/18). 2018/19 saw an increase in the number

of requests for cellular therapy products from

Welsh donors. This is not only a reflection of how

well the WBMDR is regarded internationally but

also of its speed in supplying vital cellular therapy

products to transplant centres.

47 | P a g e

WELSH BLOOD SERVICE – ONGOING CHALLENGE S AND

OPPORTUNITIES

MAIN TAIN ING AN ENGAG ED DON OR PANEL :

Blood services around the world maintain a register of donors which is made up of members

of the public who are willing and able to donate. The challenge of ensuring we have enough

donors to meet our demand is one that is being experienced by blood services globally. The

key specific challenges include an aging population, tailoring our service to meet each

donor’s preferences and managing donor health.

MEETIN G BLOOD C OMPON EN T AN D BL OOD PR ODUC T DEMAN D:

Recent analysis of data and a forecast of future trends indicates that demand for red blood

cells and O negative blood cells will increase over the next decade and that this will offset

any recent reductions achieved through delivery of the Blood Health Plan.

Aligning the supply of blood components, which have limited shelf life, to the varying demand

of hospitals is challenging. The current lack of granular information challenges us to be

smarter about our supply, a large proportion of hospital use is variable yet predictable

demand and, eventually, with effective use of more specific patient use data we should be

able to align blood collection activity more closely to meet specific need. This would enable

us to deliver a better service for patients and to drive out waste. It will also mean we are not

burdening our donor panels with repeated requests, but we can be more targeted and

specific with their donation.

Demand for stem cell donation and transplant immunology services is also expected to

increase and there has been a considerable drive to increase live transplant donors in the

last few years. Technological advances are also increasing our understanding and ability

to provide optimally matched donors. The use of Next Generation Sequencing for matching

donors is already in use in other UK H&I services and WBS needs to plan for this step.

Furthermore, Cardiff & Vale UHB have informed the WBS that they are working with Welsh

48 | P a g e

Health Specialised Services Committee (WHSSC) to increase capacity for blood stem cell

transplantation.

C ONTINUIN G TO MEET S TRIN GEN T BLOOD SEL EC TI ON

GUI DELINES AND REGUL ATORY R EQU IREMENTS:

Changes in science, technology and ways of working provide a continually evolving service

and developing regulatory requirements for blood services. Changes in requirements must

be rigorously planned and implemented to maintain the integrity of the supply chain, whilst

balancing current service pressures, alongside the development and implementation of our

future ambitions. The Falsified Medicines Directive and the In-vitro-diagnostic Device (IVDD)

Regulations are likely to mandate service changes and we will continue to monitor the impact

of Brexit on UK regulatory policy. In addition, the WBS will need to keep a watching brief on

the issues being considered by: SaBTO (Advisory Committee on the Safety of Blood,

Tissues and Organs); Donor Selection Guidelines (DSGs) and the Joint United Kingdom

(UK) Blood Transfusion and Tissue Transplantation Services Professional Advisory

Committee (JPAC) guidelines for the Blood Transfusion Services in the United Kingdom

(Red Book).

C HAN GIN G SC IENC E AN D THE SCI EN TIFI C WORK F ORCE:

Healthcare provision continues to evolve rapidly, underpinned by advances in both scientific

and medical understanding of the origin and management of disease, as well as broader

supporting technological developments, especially in IM&T. Collectively, these provide

opportunities for step changes in operational workflows, efficiencies and outputs though

automation and enabling approaches.

The WBS will continue to ‘horizon scan’ and support the Welsh Government and NHS Wales

on developing strategies to facilitate the adoption of these new therapies. Specifically, the

WBS will work closely with the public, private and third sector to make recommendations on

prioritised activities required for such a roll out.

The use of NGS testing for transplant services will improve the quality of matching donated

blood, subsequently improving clinical outcomes of transfusion. In the introduction of this

technology we will work in collaboration with the Wales Genomics Partnership to support

49 | P a g e

the system changes to data storage and manipulation in order ensure that we avoid

duplication of expensive resources across Wales.

Information technology has always been at the core of the blood service and interoperability

and automation of existing equipment and processes will be key in the development of a

more effective and efficient service in the future. Advances, such as artificial intelligence

driven data analysis and implementation of augmented reality enhanced routine procedures,

that increase throughput and quality, eliminate errors and identify issues earlier in a cost-

effective manner are emerging. Adoption of these techniques will enable major

developments in efficiency and quality of our services.

WBS has to respond to these advances in terms of its own workforce but also in the role it

plays in the training of the current and future scientific workforce for NHS Wales through its

support for undergraduate provision and its informal and formal outreach to support NHS

colleagues. Consideration also needs to be given to the throughput of entry level scientific

staff and their career progression within the NHS which already creates some pressure

within WBS. In addition, competition for scientists with the commercial sector will increase

the current difficulties in recruitment / retention, meaning that we will have to develop and

maintain attractive roles and opportunities. Education strategies that support succession

planning and develop a work force that is flexible and responsive to the transformation will

be needed as well as those which support the new and emerging skills requirements.

MI TI GA TIN G AND MANA G IN G RISK

Where appropriate key risks are escalated to the Trust Risk Register. Further information

on the risk management strategy and key risks on the risk register as at the 31st March

2019 are contained within the Governance Statement section of the Accountability Report,

see page 31 onwards.

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W ELSH BL OOD SERVIC E: HOW WE WILL MEET OUR C HA LL EN GES

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LI STENIN G AN D L EARNI N G FR OM PATIEN T / DON OR F EEDBACK

At Velindre, we are fully committed to listening to, learning from and involving patients and

carers in our work. By listening to the thoughts, ideas and opinions of our patients we know

that we are achieving excellence in some aspects of care, but we also know that there is

always scope to improve. We believe that the best people to help us are those who are

experiencing our services.

We continue to strive to make it as easy as possible to share

feedback on our services, raise questions, be heard and

involved.

SOC IAL MEDI A

Social Media has once again been a really useful two-way

conversation tool with our online community, helping us to listen and

respond to compliments, queries and concerns. Our Patient Advice

and Liaison Service team (PALS) are able to respond in a timely and

efficient manner, capturing mini-stories and signposting to wider online

surveys.

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SOMEON E ELSE’S SHOES

Velindre’s audio podcast Someone Else’s Shoes has continued to highlight patient, carer

and staff perspectives this year. The podcast aims to increase understanding and enable

learning opportunities for improvement and awareness. Clinical Psychology week focused

the psychological impact of cancer, raising awareness of the services available at Velindre

and broaching less-talked about topics like sex and intimacy. You can listen and subscribe

here.

We have also engaged extensively with our staff, patients, donors and their families over the

last year and this has been vital in the development of our services.

The Velindre Cancer Centre service plans have been developed following an extensive

Programme of engagement with patients, their families and carers, Velindre staff, Health

Boards, third sector and other partners. A range of engagement events and workshops

have been undertaken with key stakeholders, including:

Stakeholder Design Events –Key partners

have attended a series of events to develop the

Velindre Cancer Centre service model

Experience Based Workshops - Over 100

patients and carers have attended a series of

events to map and discuss patient pathways and

identify opportunities for improvement

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Patient Focus Groups - We have held a series of

detailed patient focus groups to discuss specific

service issues and to develop innovative solutions

Community Health Council Meetings - We

regularly attend Local Health Board Community Health

Council meetings to better understand what is most

important to our service users

Similarly the Welsh Blood Service plans have been shaped as a result of ongoing and

extensive engagement with donors, patients and their families.

For example, the Welsh Blood Service routinely receives over 1,100 blood donor feedback

responses each month and these are used to develop our operational and strategic plans.

From 2019/20, we are also undertaking a population survey to explore donor and public

preferences in respect of a number of areas within our operating model. Once complete, the

outputs will be explored in more depth in a series of donor focus groups.

The Welsh Bone Marrow Donor Registry regularly engage with our donors both before,

during and after donation, electronically via our website as well as face to face. We use this

feedback into the development and planning of our service improvements. From a patient

perspective we have weekly meetings with our local Transplant Team at UHW and

incorporate this feedback into our service planning.

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PERFORMANCE ANALYSIS

We have developed a wide range of measures which are routinely used to monitor the

quality and performance of our core services. The core measures for Velindre Cancer

Centre and the Welsh Blood Service are included in the tables below.

The performance summaries are explored further with supporting narrative in the Trusts

performance reports received by the Trust Board. These papers are available on the Trusts

internet site via the following link: http://www.velindre-tr.wales.nhs.uk/trust-board-

committees

VELINDRE CANCER CENT RE (VCC)

Performance metric Target 2016/17 2017/18 2018/19

Radiotherapy

% of patients commencing radical Radiotherapy within 28 days

98% 93% 98% 85%

% of patient commencing palliative Radiotherapy within 14 days

99% 99% 98% 93%

% of patient commencing emergency Radiotherapy within 2 days

100%

97% 100% 98%

SACT

% of patients commencing non-emergency chemotherapy within 21 days

99% 83% 98% 97%

% of patients commencing emergency chemotherapy within 5 days

100% 100% 100% 100%

Death within 30 days of Chemotherapy rates

1.6% 1.6% <2% <2%

Outpatient % of Outpatients seen within 20 mins 50.2% 53% n/a 52%

Infection, Prevention &

Control

No. of Velindre acquired infections – MRSA

0 1 0 0

No. of Velindre acquired infections – MSSA

2 2 0 0

No. of Velindre acquired infections – C.Difficile

1 4 0 1

No. of Velindre acquired Pressure Ulcers 30 28 0 25

Patient Experience

% of patients overall experience rated 9 or above

85% 76% >80% TBC

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WELSH BLOOD SERVICE (WBS)

Performance metric

2016/17

2017/18

2018/19

Target Actual Target Actual Target Actual

4,000 new Bone Marrow Volunteer

(BMV) registrations 3,294 3,313 4,000 3,540 4,000 3,607

100% of new Bone Marrow

Volunteers (BMV) samples aged 17-

30

100% 100% 100% 100% 100% 100%

≥80% deceased donor typing / cross

matching reported within 4 hours

(turnaround times target reduced from

6 to 4 hrs in 17/18)

≥90% 100% 80% 89% 80% 88%

≥90% Anti-D & -c Quantitation results

provided to customer hospitals within

5 working days

≥90% 97% 90% 99% 90% 97%

≥90% routine antenatal patient results

provided to customer hospitals within

3 working days

≥90% 99% 90% 98% 90% 97%

≥80% samples referred for red cell

reference serology work up provided

to customer hospitals within 2 working

days

≥80% 82% 80% 84% 80% 81%

Reduce number of reportable SABRE

events from (8) to (5) 5 3 5 5 5 9

Maintain 100% to close SABRE reports

to MHRA within 30 days 100% 100% 100% 100% 100% 100%

≥71% of blood donors scoring 5 or 6

out of 6 for satisfaction with overall

service

71% 89% 71% 92% 71% 95%

≥100 % of concerns answered within

30 days 100% 100% 100% 99% 100% 100%

<10% time expired platelets <7% 11.29% 7% 14.6% 10% 13.4%

<1% volume of waste (<0.5% until

March 2017) <0.5% 0.5% 1% 0.6% 1% 2.5%

<6% total losses prior to issue

previously <6% 4.4% 6% 5.9% 6% 5.3%

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PROGR ESS A GAINST OUR THR EE Y EAR PLAN

The Trust has made considerable progress and achievement with the objectives and

priorities it set out to deliver during 2018/19.

Further detail is available in “Our Three Year Plan - 2019 - 2022” which is available on the

Trust Internet Site via the following link: http://www.velindre-tr.wales.nhs.uk/key-

publications.

Progress against our three year plan objectives are reported to the Planning & Performance

Committee and Trust Board in our “Delivering Excellence Performance Report”. These

reports for are available on the internet site via the following link: http://www.velindre-

tr.wales.nhs.uk/planning-and-performance-committee-p-p- .

PROGR ESS A GAINST PER FOR MANC E

PROGR ESS A GAINST: EQ UI TABLE AN D TIMELY A CC ESS TARGETS

Performance during 2018/19 was of a high standard and reflected our on-going ambition to

deliver the best possible services. Areas not meeting set levels have been and are subject

to continued scrutiny and actions are being taken forward to improve. Below, we examine

our performance in 2018/19 in more detail.

PROGR ESS A GAINST: W A I TIN G TI MES AN D AC CE SS TO SERVICES

During the year we saw high demand for the radiotherapy and chemotherapy services

provided at the Velindre Cancer Centre. Our staff worked hard to meet this demand and

we continue to explore new ways of working which will reduce waiting times and improve

patient access to our services.

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PROGR ESS A GAINST: R A DIOTHERA PY

In 2018/19, we witnessed unprecedented demand for radiotherapy services. More patients

were referred to Velindre for radiotherapy treatment than in any previous year. Responding

to this need presented a very real challenge and we acknowledge that we did not always

see people referred for radical and palliative radiotherapy as speedily as we would have

liked to. We saw 85% of all patients referred for radical (curative) radiotherapy within 28-

days which was below our target of 98%. We saw 93% of all patients referred for palliative

radiotherapy treatment within 14-days which was also slightly below our target of 98% of

patients, but we are focused on improving this performance. We will continue to explore

new ways of working which will improve performance in these areas, but recognise that

high levels of demand for our services, the increasing complexity of treatments and medical

staffing shortages will continue to present challenges.

0%10%20%30%40%50%60%70%80%90%

100%

Ap

r-1

8

May

-18

Jun

-18

Jul-

18

Au

g-1

8

Sep

-18

Oct

-18

No

v-1

8

Dec

-18

Jan

-19

Feb

-19

Mar

-19

Patients receiving radical radiotherapy within 28 days

% in 28 days Target % in 28 days

0%10%20%30%40%50%60%70%80%90%

100%

Ap

r-1

8

May

-18

Jun

-18

Jul-

18

Au

g-1

8

Sep

-18

Oct

-18

No

v-1

8

Dec

-18

Jan

-19

Feb

-19

Mar

-19

Patients receiving palliative radiotherapy treated within 14 days

% in 14 days Target % in 14 days

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PROGR ESS A GAINST: CH EMOTHERA PY

The charts below show we have mostly been able to start chemotherapy within the target

time that we set for ourselves. We saw 97% of all patients referred for non-emergency

chemotherapy within 21-days in 2018/19. This was slightly below our target of 98%. We also

saw 100% of all patients referred for emergency chemotherapy within 5-days. We have

worked hard to understand why we missed our key non-emergency time to treatment target

and to improve how we do things so as to ensure that we offer the best possible levels of

service to our patients. We have learned a great deal and have already instigated new

processes which we are confident will lead to an upturn in our performance. We are always

striving to continuously improve our services.

We also recognise that in 2018/19 there was a marked increase in demand for the

chemotherapy services we offer at Velindre Cancer Centre. We responded to this by carefully

managing our available capacity, but acknowledge that, should demand continue to rise at

the rate that we experienced in 2018/19, maintaining our performance levels will be

challenging.

0%10%

20%30%

40%50%60%70%80%90%

100%

Ap

r-1

8

May

-18

Jun

-18

Jul-

18

Au

g-1

8

Sep

-18

Oct

-18

No

v-1

8

Dec

-18

Jan

-19

Feb

-19

Mar

-19

Patients receiving emergency radiotherapy treated within 2 days

% in 2 days Target % in 2 days

59 | P a g e

PROGR ESS A GAINST: AC CESS TO THERA PY SERV IC ES

Performance throughout 2018/19 was generally good, but we recognise that the small

number of therapies staff means that staff absence can have a disproportionate effect on

overall performance. Every effort is made to manage such situations effectively.

0%10%20%30%40%50%60%70%80%90%

100%

Ap

r-1

8

May

-18

Jun

-18

Jul-

18

Au

g-1

8

Sep

-18

Oct

-18

No

v-1

8

Dec

-18

Jan

-19

Feb

-19

Mar

-19

Non-emergency chemotherapy patients treated within 21 days

% in 21 days Target % in 21 days

10%20%30%40%50%60%70%80%90%

100%

Ap

r-1

8

May

-18

Jun

-18

Jul-

18

Au

g-1

8

Sep

-18

Oct

-18

No

v-1

8

Dec

-18

Jan

-19

Feb

-19

Mar

-19

Emergency chemotherapy patients treated within 5 days

% in 5 days Target % in 5 days

60 | P a g e

PROGR ESS A GAINST SAF E AND RELIABL E SERVI CES TAR GET

Hospital Acquired Infections: We have continued to maintain our low rates of hospital

acquired infections. We have zero tolerance with respect to hospital acquired infections,

such as MRSA, for example. We aim to see no such infections in our inpatients over the

0%

20%

40%

60%

80%

100%

Ap

r-1

8

May

-18

Jun

-18

Jul-

18

Au

g-1

8

Sep

-18

Oct

-18

No

v-1

8

Dec

-18

Jan

-19

Feb

-19

Mar

-19

% of therapies inpatients seen within 2 working days

% of Dietetics patients % of OT patients % of PT patients % of SLT patients Target %

0%

20%

40%

60%

80%

100%

Ap

r-1

8

May

-18

Jun

-18

Jul-

18

Au

g-1

8

Sep

-18

Oct

-18

No

v-1

8

Dec

-18

Jan

-19

Feb

-19

Mar

-19

% of urgent therapies outpatients seen within 2 weeks

% of Dietetics patients % of OT patients % of PT patients % of SLT patients Target %

0%

20%

40%

60%

80%

100%

Ap

r-1

8

May

-18

Jun

-18

Jul-

18

Au

g-1

8

Sep

-18

Oct

-18

No

v-1

8

Dec

-18

Jan

-19

Feb

-19

Mar

-19

% of routine therapies outpatients seen within 6 weeks

% of Dietetics patients % of OT patients % of PT patients % of SLT patients Target %

61 | P a g e

course of any year. However, we also recognise that our inpatients can be particularly

susceptible to infection because of the nature of the treatments that they undergo and their

physical condition.

Pressure Ulcers: We also have zero tolerance with respect to tissue damage and pressure

ulcers. Again, our inpatients can be particularly susceptible to this sort of damage.

Compliance with our Skin Care bundle, which has been developed to reduce the risk of skin

and tissue damage for our inpatients, showed some variation during 2018/19, but was

generally good.

National Early Warning Score (NEWS): NEWS was originally developed by the Royal

College of Physicians and is intended to help reduce the number of patients whose

conditions deteriorate whilst they are in hospital. When a patient is assessed using NEWS,

a score equal to, or greater than 3, indicates that a patient may be at a somewhat increased

risk of developing complications. At VCC, we use NEWS to determine whether our patients

are at an increased risk of complications related to neutropenic sepsis. Those patients that

are deemed to be at greater risk have the ‘Sepsis Six’ bundle (a combination of 3 different

treatments and 3 tests) administered to them within a set time. The graph below shows how

we performed against our target (that all patients be administered with the ‘Sepsi Six’ bundle

within the set timeframe) in 2018/19:

There are measures at Velindre Cancer Centre where further work is ongoing to improve

what we do but the overall services provided continue to be of a high quality, focusing on

excellent patient and donor care.

0%

20%

40%

60%

80%

100%

Ap

r-1

8

May

-18

Jun

-18

Jul-

18

Au

g-1

8

Sep

-18

Oct

-18

No

v-1

8

Dec

-18

Jan

-19

Feb

-19

Mar

-19

% of patients with NEWS score ≥3 that receive all 6 elements in required timeframe

% Target %

62 | P a g e

PROGR ESS A GAINST: ME ETIN G CLIN ICAL DEMAN D F OR RED

BL OOD C ELL S AN D PLA T EL ETS

Throughout 2018/19, the Welsh Blood Service successfully met all clinical demand for Red

Blood Cells (RBC) and Platelets for our customer hospitals across NHS Wales. The WBS also

provided additional support to the English Blood Service, NHS Blood and Transplant

(NHSBT) to meet their RBC demand and in doing so have helped them meet the needs of

the wider health system.

PROGR ESS A GAINST: GR O WIN G OUR B ONE MARR OW REGISTRY

Bone Marrow Volunteer (BMV) registrations increased in 2018/19 compared to 2017/18 by

4%. Registrations were slightly below our current target to recruit 4,000 new donors,

between the ages of 17 and 30. However, work is ongoing to further develop our recruitment

strategy and we are confident in our ability to meet our recruitment target next year. In the

graph below, the numbers of newly recruited donors is set-out by month.

0%

20%

40%

60%

80%

100%

120%

140%

Apr-18 May-18 Jun-18 Jul-18 Aug-18 Sep-18 Oct-18 Nov-18 Dec-18 Jan-19 Feb-19 Mar-19

% Red Cell Demand Met

0%

20%

40%

60%

80%

100%

120%

140%

160%

Apr-18 May-18 Jun-18 Jul-18 Aug-18 Sep-18 Oct-18 Nov-18 Dec-18 Jan-19 Feb-19 Mar-19

% Platelets Demand Met

63 | P a g e

PROGR ESS A GA INST: ME ETIN G TRANSPLAN T SER V ICES

R EQU ESTS

Out of the 69 donations collected by the Welsh Bone Marrow Donor Registry (WBMDR) over

the past year (April 2018 – March 2019), only five of these have originated from the UK. In

regard to exportation – 60% of what we collect each year will leave the UK. These figures

demonstrate the stark reality in finding a bone marrow match for a Welsh patient in need.

Not only does this rely heavily upon the interconnectivity of bone marrow registers around

the world, but also on the ability to be able to import successfully matched recipient stem

cells to Wales from further afield and vice versa for exportation.

In response to this, we have been issued an updated importation licence, in accordnace with

EU Tissues and Cells Directive who oversee law on movement of tissues and cells in and

around Europe. For cells originating from registries outside of Europe, countries will be

assessed for standard and quality. So if a donor is identified from outside UK for a patient

at UHW, we whave to ensure the source Registry is compliantr with this Body. If not, checks

need to be done to ensure they are accreduted, and this can involve WBMDR doing all of

the testing due to our processing being accredited. Acquiring this updated licence involved

us working closely with the EU Tissues & Cells Directive to reviev accredidation to import

cells from 97 registries thourght the world. The new license will place a vital role in ensuring

we can continue the safe and timely delivery of stem cells from donor to a recipient.

298511

7941092

1381

16742052

25302797

3069

3346

3607

331

697

1000

12751616

19522277

2771

30353338

36554000

0

500

1000

1500

2000

2500

3000

3500

4000

4500

Apr-18 May-18 Jun-18 Jul-18 Aug-18 Sep-18 Oct-18 Nov-18 Dec-18 Jan-19 Feb-19 Mar-19

New BMV Registrations

BMV YTD (Rolling) Total New BMV Projected Target

64 | P a g e

PROGR ESS A GAIN ST: MI NI MI SIN G WA STE TIME EX PIR ED RED

C ELLS AND PL ATEL ETS

Aligning the supply of blood components, which have limited shelf life, to the varying demand

of hospitals is highly complex and multifaceted. Currently, the WBS has set itself a target of

no more than 1% of Red Blood Cells (RBC) time expiring each month where they exceed

their 35-day ‘shelf-life’. During 2018/19, the levels of time expired red cells exceeded the

maximum tolerance threshold set. This was primarily due to a significant improvement in

performance from blood donation clinics combined with the ongoing work of the Blood

Health Team to improve the prudent use of blood in transfusion practice across Wales, thus

decreasing demand.

Both RBC and pooled platelets are dependent on the supply of whole blood, and through

2018/19, the demand for pooled platelets increased whilst the demand for RBC decreased

which results in conflicting influences on the demand for whole blood. These conflicting

influences have been slightly mitigated by the introduction of seven-day platelets as part of

the Blood Supply Chain 2020 (BSC2020) Programme, where the life of the platelet has been

extended, allowing increased flexibility in platelet stock management, a reduction in time

expiry of platelets and an increased availability of platelets over the short term.

0%

1%

2%

3%

4%

5%

6%

Apr-18 May-18 Jun-18 Jul-18 Aug-18 Sep-18 Oct-18 Nov-18 Dec-18 Jan-19 Feb-19 Mar-19

Time Expired Red Cell

65 | P a g e

During 2018/19, the WBS also established a weekly Demand Planning Leadership Group

whose primary aim was to ensure that clinical demand is met whilst developing an improved

understanding of how the operational factors, which effect supply, could continue to improve.

PROGR ESS A GAINST: CO MPLETE W HOLE BL OOD D ON ATION S

Part bag is the term we use to describe a whole blood donation of less than 420ml of blood

and which is therefore not viable for clinical use. There are various reasons why a donation

may need to be stopped before the required volume of blood has been collected. These

reasons include venepuncture technique, donors feeling unwell or equipment failure. Our

current target is to ensure that we collect less than an absolute maximum of 3% part bag

blood donations and during 2018/19 we achived this target. Despite strong performance in

this area the WBS will continue to modernise our service and to reduce the numbers of part

bags wherever possible.

0%

5%

10%

15%

20%

25%

Apr-18 May-18 Jun-18 Jul-18 Aug-18 Sep-18 Oct-18 Nov-18 Dec-18 Jan-19 Feb-19 Mar-19

Time Expired Platelets

0.00%

0.50%

1.00%

1.50%

2.00%

2.50%

3.00%

3.50%

4.00%

4.50%

5.00%

Apr-18 May-18 Jun-18 Jul-18 Aug-18 Sep-18 Oct-18 Nov-18 Dec-18 Jan-19 Feb-19 Mar-19

% Part Bags

Total % Part Bags % Part Bags - South Wales % Part Bags -North Wales Part Bag Tolerance

66 | P a g e

UNSUCCESSFUL V ENEPUN C TURE

Performance during 2018/19 was consistently within tolerance levels.

PROGR ESS A GA INST: F IRST CLASS PA TI EN T AN D DONOR

EX PERI ENC E TAR GET

Our patient and donor feedback is largely positive. The Trust has worked to improve the way

it collects and receives feedback from those who use our services. Work to understand how

best to collate feedback, identify themes and to use this information to aid improvement in

areas is crucial.

Patients at Velindre Cancer Centre consistently rated their own experience as being very

good, a score of 9 out of 10 or above, during 2018/19. The importance of learning from

patient feedback remains paramount in the development of our services.

0%

1%

2%

3%

4%

5%

6%

Apr-18 May-18 Jun-18 Jul-18 Aug-18 Sep-18 Oct-18 Nov-18 Dec-18 Jan-19 Feb-19 Mar-19

Time Expired Red Cell

0%

1%

2%

3%

Apr-18 May-18 Jun-18 Jul-18 Aug-18 Sep-18 Oct-18 Nov-18 Dec-18 Jan-19 Feb-19 Mar-19

% U

nsu

cce

ssfu

l ve

ne

pu

nct

ure

s

% Unsuccessful Venepuncture

Unsuccesful Venepuncture South Wales Unsuccesful Venepuncture North Wales Unsuccessful Venepuncture Tolerance

67 | P a g e

Welsh Blood Service donor satisfaction durng 2018/19 was consistently, and signifcantly,

above target. The importance of learning from donor feedback remains paramount in the

ongoing development of our services.

PROGR ESS A GAINST: SU PPOR TIN G OUR STAFF TO EXCEL T ARGET

Our workforce measures for sickness absence and Personal Appraisal Development

Reviews (PADR) were not met during 2018/19. This is an important area that the Trust is

working to improve. We recognise that there are significant change programmes currently

under way across the organisation and acknowledge that this sort of activity can have a

disruptive effect. Detailed analysis to understand areas that need particular focus has been

undertaken and actions are in place to try and improve performance.

We are involved with the NHS Wales National Sickness Group which helps share best

practice across the sector and we have developed a change tool-kit to help support the

PADR process during times of change.

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17 Jan-18 Feb-18 Mar-18

% S

core

5 o

r 6

Donor Satisfaction

Scored 5_6 out of 6 NW Scored 5_6 out of 6 SW

68 | P a g e

Sickness rates - work is ongoing to ensure sickness rates improve and that staff are

supported across the Trust.

2018/ 04

2018/ 05

2018/ 06

2018/ 07

2018/ 08

2018/ 09

2018/ 10

2018/ 11

2018/ 12

2019/ 01

2019/ 02

2019/ 03

Reviews Completed % 72.17%73.65%75.04%74.52%75.02%73.52%75.04%76.43%75.20%74.82%74.13%73.36%

Target 85% 85% 85% 85% 85% 85% 85% 85% 85% 85% 85% 85%

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

80.00%

90.00%

100.00% Trust Wide PADR Compliance (excluding Hosted)

2018 /04

2018 /05

2018 /06

2018 /07

2018 /08

2018 /09

2018 /10

2018 /11

2018 /12

2019 /01

2019 /02

2019 /03

Corporate 4.37% 3.25% 1.99% 3.68% 4.79% 2.93% 4.06% 3.87% 4.78% 4.66% 6.42% 5.27%

VCC 3.98% 5.29% 5.86% 5.94% 5.65% 5.16% 4.84% 4.55% 4.69% 4.92% 3.88% 3.04%

WBS 5.09% 5.23% 5.29% 6.36% 6.40% 4.79% 5.22% 5.27% 4.53% 5.30% 4.74% 4.53%

Target 3.54% 3.54% 3.54% 3.54% 3.54% 3.54% 3.54% 3.54% 3.54% 3.54% 3.54% 3.54%

0.00%

1.00%

2.00%

3.00%

4.00%

5.00%

6.00%

7.00%Sickness/Absence Rates

69 | P a g e

SUSTAINABILITY PERFORMANCE 2018-19 - INTRODUCTION

The Well-being of Future Generations (Wales) Act 2015 provides the central reference point

for everything we do within the organisation and underpins our strategies and plans. The

Act identifies seven well-being goals and requires all public-sector organisations in Wales

to focus on delivering long-term well-being goals in a sustainable manner.

The Act is designed to improve the social, economic, environmental and cultural well-being

of Wales. In accordance with the Act the Trust created and published 7 well-being objectives

in April 2017. The purpose of this report is to showcase progress we have made against the

elements of the Trusts objectives which relate to sustainability.

70 | P a g e

SUSTAINABILITY PERFORMANCE 2018/2019

The Trust actively reports and manages its performance against the sustainability goals and

targets it has set in accordance with good governance. This document has been produced

in line with the requirements of the Financial Reporting Manual.

The environmental sustainability agenda is taken forward within the Trust in a structured

manner and supported by strong governance arrangements. The Director of Strategic

Transformation, Planning, Performance and Estates is the lead Executive Officer for

environmental sustainability with a nominated Trust Board Independent Member supporting

the delivery of this important strategic goal through their role of Environmental Champion.

The planning and delivery arrangements related to sustainability within the Trust are set out

below in Figure 1.

Figure 1

Trust Board

Lead Director / Independent Member

Champion

Divisional / Hosted Organisation Energy and Environmental Forum

Planning and Performance

Committee Quality and Safety Committee

Trust Sustainability Group

71 | P a g e

SUSTAINABILITY PERFORMANCE CONTEXT

The Trust directly provides two main services:

- Welsh Blood Service (WBS)

- Velindre Cancer Centre (VCC)

The Trust also host a number of services on behalf of NHS Wales and have been working

in partnership to collect and publish sustainability performance information on behalf of

these hosted bodies. The Trust started including performance information in its returns as

follows:

NHS Wales Shared Services Partnership (NWSSP) - 2015/2016

NHS Wales Information Services (NWIS) - 2015/2016

Health Technology Wales (HTW) - Not included yet as hosting arrangements

established in 2017/2018. To date, data has been unavailable to report on, we expect

to be able to provide this data from 2019/2020 onwards.

It is important to highlight the addition of NWIS and NWSSP represents an additional gross

internal floor area of 6,160 m2 and 19,676 m2 respectively. This represents a further 50% of

gross internal floor area.

The reduction of DEFRA conversion factors attributable to the deployment of renewable

technology in the energy supply market has had a major impact in the Trusts reduced

emissions.

The Trusts performance against its goals and targets should therefore be seen within this

context with performance information for 2014/2015 covering the Welsh Blood Service and

VCC only. The performance data from 2015/2016 includes NWIS and NWSSP. Therefore,

the significant increase in usage and emissions between 2014/2015 and 2015/2016 results

from the provision of information on the wider estate.

The Trusts performance against a range of key performance indicators are set out below

with a brief analysis.

72 | P a g e

Figure 2 Green House Gas emissions

1 In the reporting of emissions the revised 2014/15 to 2018/2019 Defra grid average conversion factors

have been applied. This has been adopted to enable more accurate annual emission comparisons and

will continue in future reports following the publication of Defra guidance.

Utilising the newly applied conversion factors, Figure 2, demonstrates the Trust has reduced

total carbon emissions by 10% over the last year and by 15% compared to a base year of

2015-16. The Trust will continue to pursue a number of areas of activity to achieve a carbon

neutral future. This will include the following:

Introduction of renewables such as photo voltaic and air source heat pumps.

Installation of smart metering for analysis of consumption profiles.

Refresh the Trust Travel Plan.

Explore electrification of replacement fleet.

Improved building management control throughout the estate.

Revisit and update environmental awareness training programme.

Continue LED lighting replacement programme.

Green House Gas

Emissions 2014-15 2015-16 2016-17 2017-18

2018-19

Non-

Financial

Indicators

(1,000

tCO2e)

Total Gross

Emissions 4.041 4.941 4.921 4.701 4.201

Total Net

Emissions 4.041 4.941 4.921 4.701 4.201

Gross

Emissions

Scope 1

(direct)

0.91 1.06 1.39 1.39 1.24

Gross

Emission

Scope 2 & 3

(indirect)

3.13 3.88 3.53 3.31 2.96

73 | P a g e

Figure 3 Energy consumption

2 In Previous years the Trust has reported the provision of Renewable Electricity for use within its building

stock. The interpretation of this changed and the benefit has been accounted at source by the energy

suppliers.

3 For leased buildings with no information available on gas consumption, estimated figures have been

used for cost, consumption and emissions.

4 Business mileage figures include NWIS and NWSSP (as per previous year’s submission).

5 NWSSP relocated during the reporting year from Oldway House in Swansea to the Matrix House. It is

expected that quality of data will improve as a result of the move due to localised metering arrangements.

Related

Energy

Consumption

(million kWh)

2014-15 2015-16 2016-17 2017-18 2018-19

Electricity:

Non

Renewable 4.61 6.57 5.85 6.70 8.79 2

Electricity:

Renewable 0.792 0.792

1.782

1.732

0.00

Gas 4.763 5.523 7.313 7.253 6.783,5

LPG 0 0 0 0 0

Other 0.02 0.02 0.02 0.02 0.02

Financial

Indicators

(£million)

Expenditure

on Energy £0.83m3 £1.02m3 £1.45m3 £1.44m3 £1.49m3,5

CRC

License 0 0 0 0 0

Expenditure

on

Accredited

Offsets e.g.

GCOF

0 0 0 0 0

Expenditure

on Official

Business

Travel

£0.80m4 £0.75m4 £0.61m4 £0.59m4 £0.60m4

74 | P a g e

Electricity: VCC and WBS account for 61% of the electricity consumed by the Trust with

NWIS and NWSSP accounting for 16% and 23% respectively. Overall, the Trust recorded

a 4% increase in electricity consumption during 2018/2019 compared to the previous year.

This was largely attributable to;

VCC - an increase in the number of patients receiving radiotherapy treatments. This has

a significant impact upon electrical consumption as the treatment machines are energy

intensive.

NWSSP - moved locations to Matrix House which has no gas supply and this has

resulted in an increase in electricity consumption.

Gas: The Trust HQ, VCC and WBS account for 72% of the gas consumed by the Trust with

NWIS and NWSSP accounting for 8% and 20% respectively. The total gas consumption

throughout the Trust decreased by 6% on the previous year. This is in part due to;

VCC - increased Building Management Control.

NWSSP - moved from Oldway House (Swansea) to the Matrix House which is served by

electric heating, reducing overall gas consumption.

Financial performance: The Trust has increased its costs by 3% on the previous year.

This is due to the combination of increasing consumption (electricity) and tariff increases.

Expenditure on official business travel remains static when compared with previous years.

Figure 4 Water consumption

7 For leased buildings with no information available on water consumption; estimated figures have been

used for cost and consumption.

Finite Resource; Water Consumption 2014-15 2015-16 2016-17 2017-18 2018-19

Non-

Financial

Indicators

(000m3)

Water

Consumption

(Office)

supplied 1.026 24.286 38.126 31.406 33.426

abstracted N/A N/A N/A N/A N/A

Per FTE N/A N/A N/A N/A N/A

Water

Consumption

(Non-Office)

supplied 20.63 22.08 22.27 24.59 23.826

abstracted N/A N/A N/A N/A N/A

Financial

Indicators

(£million)

Water supply

costs (Office) £0.001m6 £0.039m6 £0.053m6 £0.043m6 £0.047m6

Water supply

costs (Non-

Office)

£0.029m £0.030m £0.030m £0.034m £0.034m6

75 | P a g e

Water Consumption: VCC and WBS account for 42% of the water consumed by the Trust

with NWIS and NWSSP accounting for 7% and 51% respectively. Water consumption in

office buildings throughout the Trust has increased by 6%, compared to the previous year,

which is mainly attributable to hosted organisations. There is a lack of metered data

available and the consumption is estimated on a pro-rata square meterage calculation.

Non-office (clinical) water consumption has decreased by 3% compared to the previous

year. Further investigation is required regarding office consumption. This will inform future

initiatives to reduce water consumption and reduce the overall cost.

Figure 5 Waste

7For leased buildings with no information available on waste disposal estimated figures have been used

for both cost and tonnage. 8There has been a 1% increase in total waste produced when compared with previous years. This reflects

a change in calculation methodology for NWIS.

Waste 2014-15 2015-16 2016-17 2017-18 2018-19

Non-

Financial

indicators

(tonnes)

Total Waste 334.48 1076.697 1161.237 1504.967 1521.67,8

Landfill 145.25 504.577 509.427 540.297 614.867,8

Re-used /

Recycled 116.96 513.277 529.157 811.707 854.217,8

Composted 0 0 0 4.488 3.18

Incinerated with

Energy

Recovery

72.27 58.84 122.657 148.487 106.17,7,8

Incinerated

without Energy

Recovery

0 0 0 0 0

Financial

Indicators

(£million)

Total Disposal

Cost £0.105m £0.115m7 £0.209m7 £0.327m7 £0.203m7

Landfill £0.026m £0.026m7 £0.054m7 £0.045m7 £0.053m7

Re-used /

Recycled £0.038m £0.051m7 £0.079m7 £0.172m7 £0.084m7

Composted 0 0 0 £0.003m7 £0.00081m7,8

Incinerated with

Energy

Recovery

£0.041m £0.038m £0.076m7 £0.109m7 £0.065m7

Incinerated

without Energy

Recovery

0 0 0 0 0

76 | P a g e

Waste: The total waste consumption for the Trust, when compared with 2017/2018, has

increased by 1%. This reflects a change in calculation methodology for NWIS which

previously accounted for 60% of the organisations total waste produced. With the revised

methodology NWIS now represents 17% of the total waste produced by the Trust.

The change in methodology has effectively reduced consumption across all the waste

streams identified.

Waste costs: The total waste costs for the Trust have reduced on the previous year, this is

primarily due to a reduction in NWSSP reported figures.

77 | P a g e

CARBON MANAGEMENT TARGETS

Welsh Government have an ambition for the public sector in Wales to be carbon neutral by

2030. This ambition, combined with legislative drivers such as the Environment (Wales) Act

2016 and Well–being of Future Generations (Wales) Act 2015, will progress the

decarbonisation of the public sector.

It is understood this ambition will reflect Scope 1 and Scope 2 emissions, and parts of Scope

3, and will potentially include emissions associated with staff commuting. In order to achieve

this goal, public bodies will have to adopt a range of measures to reduce their carbon

footprint over the next 11 years. This will include, but is not limited to, energy efficiency,

renewable energies, low carbon vehicles and land use management.

In 2013, a Trust Carbon Reduction Strategy was developed in conjunction with the Carbon

Trust. The implementation of the strategy aims to reduce the carbon emissions created by

the Trust services over a five year period (2014 to 2019).

Below, Figure 6 displays the annual percentage target reduction in electricity, gas and water

consumptions and emissions. Further to the figures, narrative is providing to explain why

each target has been set. This performance target for 2018-2019 has been highlighted in

green.

Figure 6 Annual targets

Financial Year Percentage Target

(%) Reason for Percentage Target

2014 - 2015 1%

This target was set in November 2014. It is

a low percentage due to the target being

set over half way through financial year

2014/15.

2015 - 2016 3%

Energy awareness strategies and targets

with suitable monitoring, being delivered by

behavioural change.

2016 - 2017 3%

Energy awareness strategies and targets

with suitable monitoring, continual

emphasis on behavioural change.

78 | P a g e

2017 - 2018 2% Investment required to maintain on-going

savings.

2018 - 2019 1.5%

Diminishing savings as investment required

to further increase savings. Extra 0.5% to

ensure 10% overall five year target is

achieved.

The Trust has reached the end of its 5 year cycle of targets which were created to achieve

the requirements of the sustainability agenda. The Trust will set new targets which reflect its

commitment to sustainability combined with the expectations highlighted in the Act. The

targets will include carbon reduction projects, targeting both energy efficiency and

renewable energy for immediate development. A significant proportion of the NHS Wales

Carbon Footprint is energy use, there are opportunities to utilise energy efficient technology.

Welsh Government has support schemes in place to aid project development for the public

sector.

TRAVEL AND TRANSPORT

During 2018/19 the Trust’s overall expenditure on official business travel has increased by

1% compared to 2017/18. The Trust continues to work towards a reduction in its carbon

emissions by implementing a number of projects.

A series of active, healthy and sustainable travel events have been held across NWSSP,

NWIS, WBS and VCC. The Trust has worked collaboratively with Sustrans Cymru and Cycle

Solutions. The partnership facilitated a series of events, ranging from Active Travel Stands,

Smoothie Bike Challenges, ‘Dr Bike’ maintenance sessions, to Cycle to Work Roadshows

and led walks/rides.

79 | P a g e

Sustrans Cymru have been working in partnership with the Trust to facilitate Workplace

Travel Champion Training. The organisation has been involved with the Trusts events and

are raising awareness via the Cymru Travel Challenge. We were very kindly presented with

Travel Legacy Packs which included various cycling resources that will be used over the

coming months to responsibly embed the sustainable travel agenda across the

organisations. The events have promoted active and sustainable travel, encouraging the

use of public transport, whilst provided resources and information about changing travel

habits. The Trusts current initiatives include how to take part in our Active Travel Pledge or

get involved as an Environmental Champion!

“We have had an absolute blast while promoting the agenda and changing behaviours and

cultures across our sites! We have built a great relationship with Sustrans and it has been a

pleasure to have collaborated on events with fellow colleagues from the Trust. You may be

surprised to learn that recently, following Sustrans’ encouragement, I got on a bicycle for the

first time in around 14 years, and now I have successfully cycled to work and am whizzing

down mountain bike trails at the weekend! Diolch yn fawr iawn, Sustrans!”

The Trusts transport emissions are dominated by staff commuting and visitor/patient travel

(~80%). A collaborative strategy to instigate behavioural change will be undertaken. Projects

will incentivise staff alongside infrastructure upgrades to support electric vehicle technology.

This will be undertaken in collaboration with local authorities and Welsh Government to

integrate the service in a practical and user friendly manner. Car-sharing and modal shift to

cycling or public transport will be particularly effective for our staff, visitors and donors.

80 | P a g e

WASTE MANAGEMENT

The Welsh Government has set a target for all organisations to recycle at least 70 per cent

of waste by 2025. Prior to the publication of the Welsh Government target, the Trust set a

target of recycling 60% of its waste materials. By 2025 this will be re-aligned to match the

Welsh Governments target of 70%.

The Trust’s chosen clinical waste contractor is now recovering residual waste (flock) from

clinical waste treatment plants. Therefore the Trust will now include any alternative treated

and energy recovery incinerated clinical waste as recycled waste. This will decrease the

landfill waste stream during 2019/20 and increase reused recycled figure.

The Trust continually to aims to increase its recycling rate by implementing a number of

projects, such as ‘bin the bin’ and the introduction of the reusable coffee cups in the VCC

restaurant.

81 | P a g e

LOOKING AHEAD 2019/20

The Trust will continue to work towards the delivery of a sustainable Wales to support the

delivery of the requirements of the Well-being of Future Generations Act (Wales) 2015.

There are a number of key activities which will support the Trust in continuing the progress

made to date. These include:

The development of a new sustainability strategy which sets out the priorities for the

next 5 years and the expected benefits.

The development of an implementation programme to enable the delivery of the

strategy at pace.

Changing business systems and processes across the Trust to support the cultural

and behavioural change in mainstreaming sustainable development within everything

we do.

Continuing to strengthen our IS014001 (environmental management system

accreditation).

Progressing the delivery of the simple changes at an operational level within the

support of the Office of the Future Generations Commissioner for Wales.

Whilst undertaking procurement for TCS Programme and other future schemes, the

Trust will use the Sustainable Development Principles as outlined the Act.

1

2

CONTENT

Page

Number

Scope of Responsibility 3

Scope of the Accountability Report 6

Corporate Governance Report 7

Director’s Report 8

Statement of the Chief Executive’s Responsibilities as

Accountable Officer of Velindre University NHS Trust

16

Statement of Director’s Responsibilities in respect of the

Accounts

17

Governance Statement

Financial Accountability Report 53

Code of Practice – Ethical Employment in Supply Chains 56

Remuneration & Staff Report 58

National Assembly for Wales – Accountability & Audit Report 70

The Certificate and Independent Auditor’s Report of the Auditor

General for Wales to the National Assembly for Wales

71

3

VELINDRE UNIVERSITY NHS TRUST –

SCOPE OF RESPONSIBILITY

Velindre University NHS Trust provides specialist services to the people of Wales.

The operational delivery of services is managed through Velindre Cancer Centre and

the Welsh Blood Service.

Specialist cancer services for South East Wales are delivered by Velindre University

NHS Trust using a hub and spoke model. The hub of our specialist cancer services

is Velindre Cancer Centre. This is a specialist treatment, teaching, research and

development centre for non-surgical oncology. We treat patients with chemotherapy,

Systemic Anti-Cancer Treatments (SACTs), radiotherapy and related treatments,

together with caring for patients with specialist palliative care needs.

The Welsh Blood Service plays a fundamental role in the delivery of healthcare in

Wales. It works to ensure that the donor’s gift of blood is transformed into safe and

effective blood components which allow NHS Wales to improve quality of life and

save the lives of many thousands of people in Wales every year.

The Trust Board is accountable for Governance, Risk Management and Internal

Control for those services directly managed and those managed via hosting

arrangements. As Accountable Officer, the Chief Executive has responsibility for

maintaining appropriate governance structures and procedures as well as a sound

system of internal control that supports the achievement of the organisation’s

policies, aims and objectives, whilst safeguarding the public funds and this

organisation’s assets for which the Chief Executive is personally responsible. These

are carried out in accordance with the responsibilities assigned by the Accounting

Officer of NHS Wales.

The Trust also hosts three organisations which are explained in more detail below.

Directors of the Hosted Organisations are bound by an Annual Governance

Compliance Statement (or their own Annual Governance Statement in the case of

NHS Wales Shared Services Partnership) with the Velindre University NHS Trust

Chief Executive and in accordance with the individual hosting agreements with

Velindre University NHS Trust.

4

Organisations hosted by Velindre University NHS Trust are:

NHS WALES SHARED SER VICES PARTNERSHIP (N WSSP)

On 11th May 2012, the Velindre National Health Service Trust Shared Services

Committee (Wales) Regulations 2012 No.1261 (W.156) was laid before the National

Assembly for Wales and came into force on 1st June 2012. The NWSSP is a

dedicated organisation that supports the statutory bodies of NHS Wales through the

provision of a comprehensive range of high quality, customer focused support

functions and services.

NWSSP is hosted by Velindre University NHS Trust via a formal Hosting Agreement,

signed by each statutory organisation in NHS Wales. The Director of NWSSP holds

Accountable Officer status and holds a separate Accountability Statement with the

Director General for Health in the Welsh Government. The Director of NWSSP

produces and signs his own Annual Governance Statement to support the Trust

Chief Executive in signing the Velindre University NHS Trust Annual Governance

Statement.

NHS WALES INFORMATIC S SERVICES (NWIS)

NWIS operates under the direction of the Deputy Director, Digital Health and Care of

the Welsh Government and is responsible for both the strategic development of

Information Communications Technology (ICT) and the delivery of operational ICT

services and information management across NHS Wales. NWIS has a national

remit to support NHS Wales, make better use of scarce skills and resources, and

facilitate a consistent approach to health informatics and the implementation of

common national systems. The Director of NWIS is accountable to the Deputy

Director, Digital Health and Care of the Welsh Government.

The Director signs an Annual Governance Compliance Statement to support the

Trust Chief Executive in signing the Velindre University NHS Trust Annual

Governance Statement.

During 2018, the Trust strengthened its Assurance Framework with NWIS and this is

explained in more detail on page 21.

5

HEALTH TECHNOLOGY WA LES (HTW)

The Trust received grant funding to continue the operation of Health Technology

Wales during 2018-19. HTW is funded by Welsh Government under the Efficiency

through Technology Programme. HTW was established to facilitate the timely

adoption of clinically and cost effective health technologies in Wales, working with,

but independently of, NHS Wales. Its remit covers all health technologies that are not

medicines. This could be medical devices, surgical procedures, telemonitoring,

psychological therapies, rehabilitation or any health intervention that isn’t a medicine.

HTW independently critically assesses the best available international evidence

about the clinical and cost effectiveness of a health technology. This evidence is

reviewed by experts and the HTW Appraisal Panel to put the evidence into the

Welsh context. HTW also coordinates a Front Door process to support health

technology developers to navigate NHS Wales. As well as its Front Door and

appraisal functions HTW also has roles in horizon scanning, evaluating uptake and

disinvestment of technologies and providing advice to health technology developers.

It does this in partnership with other organisations in NHS Wales to ensure there is

no duplication of work and sharing of limited skilled assessment resources. The

Director signs an Annual Governance Compliance Statement to support the Trust

Chief Executive in signing the Velindre University NHS Trust Annual Governance

Statement.

6

SCOPE OF THE ACCOUNTABILITY REPORT

In line with Welsh Government and HM Treasury Guidance, the Trust has produced

an Accountability Report for the financial reporting period 2018-19.

The purpose of the Accountability Report, which sits within the suite of Annual

Report documents, is to report to the National Assembly for Wales in respect of the

key accountability requirements.

The Accountability Report will be signed and dated by the Trust’s Accountable

Officer - Chief Executive and is made up of the following four sections:

1. CORPORATE GOVERNANCE REPORT

2. FINANCIAL ACCOUNTABILITY REPORT

3. REMUNERATION AND STAFF REPORT

4. NATIONAL ASSEMBLY FOR WALES ACCOUNTABILITY AND AUDIT

REPORT

7

CORPORATE GOVERNANCE REPORT

The purpose of the Corporate Governance Report is to explain the composition of

the Trust and its governance structures and how these support the achievement of

the Trust’s objectives.

The Corporate Governance Report includes the following sub sections:

DIRECTORS’ REPORT

THE STATEMENT OF ACCOUNTABLE OFFICERS

RESPONSIBILITIES

THE STATEMENT OF DIRECTORS RESPONSIBILITIES IN

RESPECT OF THE ACCOUNTS

GOVERNANCE STATEMENT

8

DIRECTORS’ REPORT

This Directors’ report brings together information about the Trust Board including the

Independent Members and Executive Directors, the composition of the Trust Board

and other elements of its governance and risk management structure. It also

includes the disclosures and reporting required by the Trust relating to the day to day

execution of the Trust’s business.

The Trust Board is made up of Executive Directors, who are employees of the Trust,

and Independent Trust Board Members (IMs), who were appointed to the Trust

Board by the Minister via an open and competitive public appointment process.

CHAIR AND INDEPENDENT MEMBERS OF THE TRUST – 2018-19

Professor Donna Mead, OBE, Chair

Appointment: Professor Mead was appointed Chair of Velindre University NHS Trust in May 2018. Area of Expertise: Education, Partnerships and Collaboration. Trust Board Committee Membership Professor Mead Chairs the Trust Board meeting, Remuneration Committee, Advisory Consultant Appointment Committee, Charitable Funds Committee and the Academic Partnership Committee (once established). Professor Mead is also a member of the Research, Development & Innovation Committee. Professor Mead is supported by six other Independent Members.

Mr. Stephen Harries, Interim Vice Chair/Independent Member

Appointment: Mr. Harries was appointed as an Independent Member of the Trust in April 2017. In November 2018, Mr. Harries was appointed as Interim Vice Chair. Area of Expertise: Information Governance & Information Management and Technology.

9

Trust Board Committee Membership Mr. Harries is Chair of the Information Governance & Information Management & Technology Committee. He is a member of the Remuneration Committee, Quality & Safety Committee, Planning & Performance Committee, Workforce and Organisational Development Committee and nVCC Scrutiny Committee. Champion Role: Trust Champion for Information. Trust Board’s Independent Member link with the Velindre Cancer Centre.

Professor Jane Hopkinson, Independent Member

Appointment: Professor Hopkinson was appointed as an Independent Member of the Trust in August 2012. Area of Expertise: University Representative. Trust Board Committee Membership Professor Hopkinson Chairs the Research & Development Committee, and is a member of Information Governance & Information Management & Technology Committee and the Academic Partnership Committee once established. Champion Role: Trust Champion for Research.

Mrs. Janet Pickles, Independent Member

Appointment: Mrs. Pickles was appointed as an Independent Member of the Trust in October 2012. Area of Expertise: Quality & Safety Trust Board Committee Membership Mrs. Pickles Chairs the Quality & Safety Committee, Workforce & Organisational Development Committee and the Moondance & Radiotherapy Programme Board (which is a Sub Committee of the Charitable Funds Committee). Mrs. Pickles will also be a member of the Learning Sub Committee once re-established (which is a Sub Committee of the Quality & Safety Committee). Champion Role: Trust Champion for Infection Control, Patients and Older People and

10

is the Trust Board’s Independent Member link with the Welsh Blood Service.

Mr. Phil Roberts, Independent Member

Appointment: Mr. Roberts was appointed as an Independent Member of the Trust in March 2012. In September 2018, Mr. Roberts accepted the invitation to continue to serve as Independent Member with the Trust for a further 11 months, 1st April 2019 to 29th February 2020. Area of Expertise: Estates Trust Board Committee Membership Mr. Roberts is Chair of the Planning & Performance Committee and nVCC Scrutiny Committee, and is a member of the Audit Committee (Trust) and Audit Committee (NHS Wales Shared Services Partnership). Champion Role: Trust Champion for Design, Sustainability, Welsh Language, Public & Patient Involvement.

Judge Ray Singh, Independent Member

Appointment:

Judge Singh was appointed as an Independent Member of the Trust in November 2011. Judge Singh accepted the invitation to continue to serve as Independent Member to the Trust in October 2018 and was re- appointed for 12 months from 1st November 2018 to 31st October 2019. Area of Expertise: Legal. Trust Board Committee Membership Judge Singh is a member of the Audit Committee (Trust), Audit Committee (NHS Wales Shared Services Partnership), Quality & Safety Committee, Remuneration Committee and the Investment Performance Review Sub Committee which is a Sub Committee of the Charitable Funds Committee.

Judge Singh will Chair the Learning Sub Committee once re-established (which is a Sub Committee of the Quality & Safety Committee). Champion Role: Trust Champion for Violence & Aggression, Safeguarding and Putting Things Right.

11

Mr. Martin Veale, JP, Independent Member

Appointment: Mr. Veale was appointed as an Independent Member of the Trust in April 2017. Area of Expertise: Finance, Audit & Governance. Trust Board Committee Membership Mr. Veale is Chair of the Audit Committee (Trust), Audit Committee (NHS Wales Shared Services Partnership) and the Investment Performance Review Committee (which is a Sub Committee of the Charitable Funds Committee). Mr. Veale is also a member of the Remuneration Committee and the Charitable Funds Committee. Champion Role: Trust Champion for Finance and Governance.

EXECUTIVE DIRECTORS (BOARD MEMBERS)

Mr. Steve Ham, Chief Executive (Accountable Officer)

Trust Board Committee Membership Mr. Ham is a member of the Charitable Funds Committee, Local Partnership Forum, Remuneration Committee and Advisory Consultant Appointments Committee.

Dr. Jacinta Abraham, Medical Director

Trust Board Committee Membership Dr. Abraham is a member of the Research, Development & Innovation Committee and Advisory Consultant Appointments Committee. Lead Function: Medical Director & Research

Professor Sue Morgan, Executive Director of Nursing & Service

Improvement (Professor Morgan retired from the Trust on the 28th

February 2018).

Trust Board Committee Membership

12

Professor Morgan was a member of the Research, Development & Innovation Committee. Lead Function: Quality & Safety and Nursing

Mrs. Jayne Elias, Interim Executive Director of Nursing &

Service Improvement (Mrs. Elias was appointed as Interim

Executive Director of Nursing & Service Improvement on the 1st

March 2019.)

Trust Board Committee Membership Mrs. Elias is a member of the Research, Development & Innovation Committee. Lead Function: Quality & Safety and Nursing.

Ms. Sarah Morley, Executive Director of Organisational

Development & Workforce

Lead Function: Organisational Development & Workforce Ms. Morley is Joint Chair of the Local Partnership Forum.

Mr. Mark Osland, Executive Director of Finance & Informatics

Trust Board Committee Membership Mr. Osland is a member of the Charitable Funds Committee, the Charitable Funds Sub Committee – Investment Performance Review Sub-Committee and the Local Partnership Forum. Lead Function: Finance, Informatics and Charitable Funds.

13

EXECUTIVE TEAM MEMBERS (NON BOARD MEMBERS)

Mr. Carl James, Director of Strategic Transformation, Planning,

Performance & Estates

Responsible for strategic developments and planning and the continuous improvement of performance on behalf of the Trust. Lead Function: Strategic Transformation, Planning, Performance & Estates

Mrs. Georgina Galletly, Director of Corporate

Governance/Board Secretary

Principal advisor to the Trust Board and the organisation as a whole on all aspects of governance and ensuring that the Trust meets the standards of good governance set for the NHS in Wales. Lead Function: Governance.

Mrs. Andrea Hague, Director Velindre Cancer Centre

Responsible for the operational management of the Service Division.

Ms. Cath O’Brien, Director Welsh Blood Service

Responsible for the operational management of the Service Division. Mr. Alan Prosser, Deputy Director of Welsh Blood Service ‘acted up’ as Director following Ms O’Brien’s appointment to Interim Chief Operating Officer as detailed below.

Ms. Cath O’Brien, Interim Chief Operating Officer

Ms O’Brien was appointed as Interim Chief Operating Officer a new

role within the Trust with effect from the 1st March 2019.

Further information in respect of the Trust Board and Committee Activity, the System

of Internal Control and the Trust Assurance Framework are captured in the

Governance Statement section of this report which starts on page 18 and Appendix

1.

14

PUB LIC INTEREST DECL ARATION

Each Trust Board Member has stated in writing that they have taken all the steps

that they ought to have taken as a Director in order to make the Trust’s auditors

aware of any relevant audit information.

All Trust Board Members and Senior Managers within the Trust (including Directors

of all Hosted Organisations) have declared any interests in companies which may

result in a conflict with their managerial responsibilities. No material interests have

been declared during 2018-19: a full register of interests for 2018-19 is available

upon request from the Director of Corporate Governance.

DI SCLOSURE STATEMENT S

The Trust would make the following disclosure statements for 2018-19:-

The Trust has had one lapse in the security of data that it considered required

reporting to the Information Commissioner’s Office (ICO) in 2018/19 as detailed

below:

Reported June 2018, an email containing a summarised account of clinical

assessment information, that was to be reviewed to ascertain claim

reimbursement information, was sent in error to another internal employee of the

Trust. Notification to the ICO was submitted within the General Data Protection

Regulation (GDPR) Principles 72 hour breach reporting timeframe. Following the

initial submission, further internal investigations were completed, and it was

subsequently concluded that the incident did not meet the threshold test for

reporting to the ICO. The incident was withdrawn and the Information

Commissioner’s Office confirmed they did not consider the incident to be a

reportable breach under the GDPR.

Whilst there is no requirement to comply with all elements of the Corporate

Governance Code for Central Government Departments, Velindre University

NHS Trust has undertaken an assessment against the main principles as they

relate to an NHS public sector organisation in Wales. This assessment has

been informed by the Trust's assessment of governance undertaken by the Trust

Board in April 2019 and also evidenced by internal and external audits. The

Trust is complying with the main principles of the Code where applicable, and

follows the spirit of the Code to good effect and is conducting its business openly

and in line with the Code. The Trust Board recognises that not all reporting

15

elements of the Code are outlined in this Governance Statement but are

reported more fully in the Trust's wider Annual Report.

There have been no reported/identified departures from the Corporate

Governance Code during the year.

Welsh Government have an ambition for the public sector to be carbon neutral

by 2030. This ambition sits alongside the Environment (Wales) Act 2016 and

Wellbeing of Future Generations (Wales) Act 2015 as legislative drivers for

decarbonisation of the Public Sector in Wales.

The Trust’s five year Carbon Reduction Strategy continues to be implemented

throughout the Trust and its hosted organisations. As part of this Strategy carbon

reduction projects have been identified and prioritised for implementation. For

the period 2018 – 2021, the Trust Sustainable Development Plan has been

embedded into the IMTP development process and Strategic Objectives have

been merged with the Trust’s Well-being Goals.

Moving forward the Trust will continue work previously undertaken on carbon

footprint monitoring in line with the recommendations of the recently published

NHS Wales Carbon Footprint document. In particular, it will review CO2e

emissions arising from the use of electricity consumption (Scope 2), and those

emissions associated with the use of Fleet vehicles (Scope 3).

The Trust recognises that its day to day operational activities have a direct

impact upon the environment and is committed to meeting the legislative drivers

set out by Welsh Government.

As an employer with staff entitled to membership of the NHS Pension Scheme,

control measures are in place to ensure all employer obligations contained within

the Scheme regulations are complied with. This includes ensuring that

deductions from salary, employer’s contributions and payments in to the Scheme

are in accordance with the Scheme rules, and that member Pension Scheme

records are accurately updated in accordance with the timescales detailed in the

Regulations.

16

STATEMENT OF THE CHIEF EXECUTIVE’S RESPONSIBILITIES AS ACCOUNTABLE OFFICER OF VELINDRE UNIVERSITY

NHS TRUST

The Welsh Ministers have directed that the Chief Executive should be the

Accountable Officer of Velindre University NHS Trust.

The relevant responsibilities of Accountable Officers, including their responsibility for

the propriety and regularity of the public finances for which they are answerable, and

for the keeping of proper records, are set out in the Accountable Officer's Memorandum

issued by the Welsh Government.

As Accountable Officer I can confirm that as far as I am aware there is no relevant audit

information of which Velindre University NHS Trust’s Auditors are unaware and that I

have taken all the steps that I ought to have taken to ensure that I and the auditors are

aware of relevant audit information.

I can confirm that the annual report and accounts as a whole are fair, balanced and

understandable and I take personal responsibility for these and the judgement required

for doing so.

To the best of my knowledge and belief, I have properly discharged the responsibilities

set out in my letter of appointment as an Accountable Officer.

Date: 28th May 2019 Mr. Steve Ham

Chief Executive

17

STATEMENT OF DIRECTORS’ RESPONSIBILITIES IN RESPECT

OF THE ACCOUNTS

The directors are required under the National Health Service Act (Wales) 2006 to prepare

accounts for each financial year. The Welsh Ministers, with the approval of the Treasury,

direct that these accounts give a true and fair view of the state of affairs of the NHS Trust

and of the income and expenditure of the NHS Trust for that period.

In preparing those accounts, the directors are required to:

apply on a consistent basis accounting principles laid down by the Welsh Ministers

with the approval of the Treasury

make judgments and estimates which are responsible and prudent

state whether applicable accounting standards have been followed, subject to any

material departures disclosed and explained in the account.

The directors confirm that they have complied with the above requirements in preparing

the accounts.

The directors are responsible for keeping proper accounting records which disclose with

reasonable accuracy at any time the financial position of the Trust and to enable them to

ensure that the accounts comply with requirements outlined in the above mentioned

direction by the Welsh Ministers.

By Order of the Trust Board

Signed:

Professor Donna Mead, OBE Chair

Dated: 28th May 2019

Mr. Steve Ham, Chief Executive

Dated: 28th May 2019

Mr. Mark Osland, Executive Director of Finance & Informatics

Dated: 28th May 2019

18

GOVERNANCE STATEMENT

T HE T RUST’S ASSURANC E FRAMEWO RK

This Governance Statement details the arrangements in place for discharging the Chief

Executive’s responsibility to manage and control Velindre University NHS Trust’s

resources, and the organisations which it hosts, during the financial year 2018-19.

Due to the unique Accountable Officer status of the Managing Director of Shared Services

Partnership (NWSSP), an Annual Governance Statement for NWSSP has been requested

and submitted by the Director of NWSSP to the Trust’s Chief Executive. This is available

from the Director of Corporate Governance upon request or via the following link and helps

to inform this report.

The Directors from the other bodies hosted by Velindre University NHS Trust where

appropriate have signed and submitted a ‘Governance Compliance Statement’ detailing

and declaring compliance with Velindre University NHS Trust governance arrangements

which is submitted at the end of March each year to the Velindre University NHS Trust

Chief Executive to provide assurance that Trust policy, systems and processes are being

complied with to support good governance.

DI SCHARGING RESPONSI BIL IT I ES

The Trust Board has been constituted to comply with the National Health Service Wales,

Velindre University NHS Trust (Establishment) Order 1993 No.2838 and subsequent

Amendment Orders (1995 No. 2492, 1999 No.808, 1999 No 826, 2002 No.442 (W.57) and

2002 No.2199 (W.219 2009 No.2059, 2012 No.1261, 2012 No.1262, 2015 No.22, 2017

No.912, 2018 No.887). In addition to responsibilities and accountabilities set out in terms

and conditions of appointment, Trust Board members also fulfil a number of “champion”

roles where they act as ambassadors for these matters. The Trust Board discharges its

responsibilities through its Committees (listed in the table on page 19) and scheme of

delegation which is set out in its Standing Orders.

There are 12 Committees, reporting directly to the Trust Board which is supported by sub-

Committees/groups in the discharge of functions;

19

At a local level, the Trust Board has agreed Standing Orders (SOs) for the regulation of

proceedings and business.

The Trust Standing Orders and Standing Financial Instructions have been adopted from

the Welsh Government’s Model Standing Orders for NHS Trusts in Wales and are

designed to translate the statutory requirements set out in the National Health Service

Trusts (Membership and Procedures) Regulations 1990 (1990/2024) into day to day

operating practice. Together with the adoption of a scheme of matters reserved to the

Trust Board; a scheme of delegations to officers and others; and Standing Financial

Instructions, the SOs provide the regulatory framework for the business conduct of the

Trust and define - its 'ways of working'.

These documents, together with the range of policies set by the Trust Board make up the

Governance and Accountability Framework. The Standing Orders have been periodically

updated to account for alterations in year; details in respect of the reviews are outlined on

page 24.

Committee Sub Committee

1. Advisory Consultant Appointments

Committee. N/A

2. Audit Committee (Trust) N/A

3. Audit Committee (For Shared Services to

consider NHS Wales Shared Services

Partnership (NWSSP) Matters)

N/A

4. Charitable Funds Committee Investment Performance

Review Sub-Committee

5. Information Governance & IM&T

Committee

N/A

6. Planning & Performance Committee N/A

7. Quality & Safety Committee Learning Sub Committee

(to be Re-established)

8. Remuneration Committee N/A

9. Research, Development and Innovation

Committee

10. Workforce & Organisational Development

Committee N/A

11. nVCC Project Scrutiny & Assurance

Committee N/A

12. Local Partnership Forum N/A

20

The dates the Trust Board and Committees met during the period 2018-19 is captured in

Appendix 1. All meetings were quorate during this period.

COMMITTEE ACTIVITY

In line with Standing Orders, each Committee formally reports annually to the Trust Board

on its work during the year detailing the business, activities, attendance and main issues

dealt with by the Committee in the reporting year. Copies of the Committee Annual

Reports are available on the Trust Internet site via the following link: http://www.velindre-

tr.wales.nhs.uk/the-board-committees.

In addition, each Trust Board meeting receives a highlight report outlining the issues and

activity considered and addressed by each Committee at its last meeting. The Trust has a

process where committees schedule a pause at the end of each meeting to discuss the

key issues they want to raise with the Trust Board through the highlight report process

under the following headings:

Escalate/Alert

Advise

Assure

Inform

The highlight reports are presented to the Trust Board by the Committee Chair. Similarly to

the annual reports the highlight reports are available within the Trust Board papers on the

Trust’s Internet site (http://www.velindre-tr.wales.nhs.uk/the-board-committees ) or from

the Head of Corporate Governance.

The Terms of Reference for each Committee are reviewed annually in line with the Trust

Standing Orders, or more frequently if deemed necessary by the Committee or Trust

Board. The Terms of Reference for all Committees are available from the Head of

Corporate Governance or can be found in the Trust Standing Orders and Standing

Financial Instructions.

Key highlights and issues considered by the Trust Board and its Committees during 2018-

19 are included at Appendix 1 of the Governance Statement.

Minutes and papers of all Public Trust Board and Committee meetings are published on

the Trust Internet site via the following link: Trust Board Papers and Minutes.

During 2018-19, key aspects of Trust Board business and issues delegated to the Audit

Committee for consideration and advice, including action taken included;

21

Agreement of the Internal and External Audit Plans for the year.

Receiving Internal and External Audit Reports and subsequently monitoring

progress against Audit Action Plans.

Agreeing the Annual Counter Fraud Plan and monitoring counter fraud activities.

Regular review of the Declaration of Interests and Gifts, Hospitality, Sponsorship

and Honoraria Register.

Monitoring the development and draft content of the Trust’s Accountability Report.

Monitoring of Governance Arrangements across the organisation, including hosted

bodies.

Monitoring the legislative Compliance Register.

Monitoring overall risk management process by reviewing the Trust Risk Register at

each meeting.

Review of the NWIS Hosting Assurance Requirements Framework and role of the

Audit Committee (explained further below).

Assurance Mapping (explained further below)

NWI S ASSURANCE FRAMEWO RK

As a result of a number of independent reviews undertaken relating to NWIS, in January

2018 the Trust Board approved an “NWIS Hosting Assurance Requirements Framework”,

the purpose of which was to clarify the assurance requirements from NWIS to the Velindre

University NHS Trust Board as host and how these assurances will be gained from NWIS.

The role of the Audit Committee in respect of this framework is to receive regular, standing

agenda reporting on;

1. Internal and External Audit Plans

2. Internal and External Audit Reports with completed management action plans

3. Progress reports against audit recommendations (to be highlighted to Welsh

Government if progress is deemed unsatisfactory)

4. Risk Register

5. Compliance and activity governed by the Trust Standards of Behaviour Policy (i.e.

Declarations of Interest, Gifts & Hospitality)

6. Single Tender Actions

This new approach was implemented with effect from the February 2018 Audit Committee

and was reviewed and strengthened during March / April 2019.

22

ASSURANC E MAPPING

To complement and support the development of the Board Assurance Framework (BAF),

the Head of Corporate Governance undertook a sub project of the BAF to develop an

Assurance Map for each Trust Function. The purpose of this project was to produce an

Assurance Framework for the Trust which will provide:

Visual representation of assurance activities.

Highlight the areas of too little or too much assurance.

Help inform Internal and External Audit Plans as appropriate.

As outlined above the particular focus will be on the business-as-usual risks / critical

success factors and will commence with function leads initially.

The completed assurance maps were received in the Audit Committee in July 2018.

Further detail in respect of the activity on the Audit Committee during 2018-19 is captured

in Appendix 1 on page 49.

ENGAGEMENT WIT H THE LOCAL PARTNERSHIP FO RUM

In support of the Trust Board, the Trust also has a Local Partnership Forum that met four

times during 2018-19, with Joint Chairs who are each nominated from the Trade Union

Representatives and Executive Directors. The role of the Local Partnership Forum is to

supply the main (but not only) forum within the Trust where the Directors of the Trust and

Trade Union Representatives can discuss together and develop appropriate directions and

responses to all major service development and change management issues.

Examples of engagement with the Local Partnership Forum during 2018-19 are outlined in

Appendix 1 on page 50.

T RUST BOARD DEV ELO PMENT AND EFFECTI VENESS

In addition to Trust Board and Committee meetings, with effect from January 2018, the

Trust introduced a new approach to Trust Board Development Sessions and split the

sessions into the following two forms:

Trust Board Seminars i.e. Training/development

Trust Board Briefings – ensuring the Trust Board is appraised of key

strategic priorities/programmes and other topical issues of interest.

23

The sessions that took place during 2018-19 are outlined below:

September 2018 – Trust Board Briefing Topics for Discussion

“Welsh Government Communication/Correspondence”

“ A Healthier Wales – Hosted Bodies”

“Infected Blood Inquiry”

“Future Transforming Cancer Services Leadership Arrangements”

September 2018 – Trust Board Development Session Topics for Discussion

A Healthier Wales – Plan for Health and Social Care – Presentation

Developing a whole systems approach to Cancer Vanguards

October 2018 – Trust Board Development Session Topics for Discussion

“NHS Wales Staff Survey – Trust Findings”

“Wales Blood Donor Marrow Registry – Proud to be in the fight against blood

cancer”

“Infected Blood Inquiry Update”

“Cell & Gene Therapy Update”

“Integrated Medium Term Plan (IMTP) Update”

“Real-time Information Technology Towards Activation (RITTA) Artificial

Intelligence Design Pilot – Demonstration”

February 2019

This session was used as a Joint Board Session with the Trust and the Wales

Ambulance Service Trust (WAST) – the topics for discussion were:

Board Governance and Constitution

University Status

Funding Sources/Commissioning Model

Prevention & Population Health

Regional Partnership Board Engagement

24

STANDING O RDERS AND STANDING F INANCIAL INST RUCTIONS

The Trust approved a revised set of Standing Orders and Standing Financial Instructions

for the regulation of proceedings and business to ensure the following issues were

addressed:

May 2018 - Version 29 was an amendment in respect of the Workforce & OD Committee

Terms of Reference and amendment to the financial limits.

July 2018 - Version 30 was an amendment to the Charitable Funds Committee, Quality &

Safety Committee, Research Development and Innovation Committee Terms of Reference

and an Amendment to Schedule 5 in the Standing Financial Instructions.

September 2018 - Version 31 was an amendment to the NWSSP Audit Committee Terms

of Reference.

November 2018 - Version 32 was an amendment to the Shared Services Partnership

Committee Voting Rights.

January 2019 – Version 33 was an amendment to the Charitable Funds Committee Terms

of Reference.

March 2019 – Version 34 was an amendment to the following Terms of Reference:

Information Governance & Information Management Technology Committee

Planning & Performance Committee

Workforce & Organisational Development Committee

NHS Wales Shared Services Partnership Committee

The Standing Financial Instructions were also updated in March 2019 in relation to the

following areas:

Change to the process of agreeing amendments to Schedule 1, Section 5 of the

Scheme of Delegation – Financial Limits

An increase in the delegated limit for wholesale blood products from £400k to £800k.

25

T RUST BOARD APPOINTM ENTS DURING 2018 -19

The Trust made the following Trust Board appointments/reappointments;

In May 2018, Professor Donna Mead was appointed as Chair of the Trust following the

departure of Professor Rosemary Kennedy as Chair at the end of March 2018.

In September 2018, Mr. Phil Roberts accepted the invitation to continue to serve as

Independent Member with the Trust for a further 11 months, 1st April 2019 to 29th

February 2020.

In October 2018, Judge Ray Singh, Independent Member accepted the invitation to

continue to serve as Independent Member to the Trust and was re- appointed for 12

months from 1st November 2018 to 31st October 2019.

In November 2018, Mr. Stephen Harries was appointed as Interim Vice Chair.

On the 1st March 2019, Mrs Jayne Elias was appointed as Interim Executive Director of

Nursing & Service Improvement.

PURPOSE OF T HE SYSTEM OF INT ERNAL CONT ROL (TRUST ASSURANC E FRAMEWORK)

The system of internal control (Trust Assurance Framework) is designed to manage risk to

a reasonable level rather than to eliminate all risks, it can therefore only provide

reasonable and not absolute assurances 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 policies, aims and objectives, to 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 has

been in place for the year ended 31st March 2019 and up to the date of approval of the

2018-19 annual report and accounts.

The Welsh Government requires that the Trust operates within the wider governance

framework set for the NHS in Wales and incorporating the standards of good governance

set for the NHS in Wales (as defined within the Citizen Centred Governance principles and

Standards for Health Services in Wales), together with its planning and performance

management frameworks.

26

27

GOVERNANCE OF T HE C H ARIT ABLE FUNDS

The Velindre University NHS Trust Board was appointed as Corporate Trustee of the

Charitable Funds by virtue of the Velindre National Health Service Trust

(Establishment) Order No. 2838 that came into existence on 1st December 1993,

and the Trust Board serves as its agent in the administration of the charitable funds

held by the Trust.

In October 2018, the Charity Commission accepted the change in name as

requested under supplemental deed in October 2018. The Charity Commission now

has the Charity registered as 1052501 – Velindre University NHS Trust Charity.

The Trust (and Charity) were delighted to welcome Rhian Gibson at the end of

January 2019: Ms. Gibson joined the Trust in the new Charity Director role.

As part of their induction programme, new Executive Directors and Independent

Members of the Trust are made aware of their responsibilities as Board Members of

Velindre University NHS Trust and as Corporate Trustees of Velindre University NHS

Trust Charity.

The Trust Board as Corporate Trustee is ultimately accountable for charitable funds

given to Velindre University NHS Trust Charity. In order to facilitate the

administration and management of these funds the Trust Board has established a

Charitable Funds Committee (CFC) to provide advice and recommendations to the

Board. Committee meetings are held every three months and otherwise as the

Committee Chair deems necessary. At least two members must be present to

ensure the quorum of the Committee.

The CFC is supported by the Charitable Funds Operational Management Group that

meets as and when required through a face to face or virtual format.

The CFC is also supported by an Investment Performance Review - Sub Committee,

to oversee the investments made by the Charity.

A meeting of all Trustees takes place on an annual basis and all Trustees were

invited to attend the CFC in November 2018 and approved the Charitable Funds

(Trustee) Annual Report for 2017-18.

Further information in respect of the Charitable Funds is available in the Trustee’s

Annual Report which can be accessed via the Charitable Funds page on the Trust

website: http://www.velindre-tr.wales.nhs.uk/key-publications

28

HOSTED ORGANISATIONS SYSTEMS OF INTERNAL CONTRO L AND ASSURANC E

Hosted organisations utilise the existing Trust’s Committee Structure illustrated

earlier in this report.

A separate Velindre University NHS Trust Audit Committee is held to consider issues

relating specifically to NWSSP, having the same Chair and Independent Membership

as the Velindre University NHS Trust Audit Committee. Information relating to the

governance arrangements in NWSSP is contained within the Director’s Annual

Governance Statement to the Velindre University NHS Trust Chief Executive which

is available from the Director of Corporate Governance upon request.

NWSSP has a ‘NHS Wales Shared Services Partnership Committee’ which was

established as a sub-committee of Velindre University NHS Trust Board in 2012 to

comply with Ministerial Directions. The NWSSP Committee has membership from

each statutory body in NHS Wales, and is chaired by an Independent Chair. The

NWSSP Committee reports to Velindre University NHS Trust Board and all other

health body Boards in Wales via their representative member on the Committee.

NWSSP have their own Standing Orders which are appended to the Velindre

University NHS Trust Standing Orders.

Cross-reference page 21, in relation to the review of the NWIS Hosting Assurance

Requirements developed and implemented during the period.

Currently, organisations hosted by Velindre University NHS Trust are able to link with

Trust Board Committees and Management Groups where appropriate to ensure

assurance is provided for the governance arrangements including statutory

compliance for the areas remaining within the Trust’s area of responsibility.

CAPACITY TO HANDLE R ISK

The organisations hosted by Velindre University NHS Trust maintain and manage

their own risk registers and comply with the Trust escalation processes to ensure the

Trust Board is made aware of any significant relevant risks relating to the Trust

Board’s responsibilities via the Trust Risk Register as necessary. Risks relating to

hosted organisations will only be escalated to the Velindre University NHS Trust risk

register where matters directly affecting the Trust are apparent. Matters relating to

service delivery and performance are a matter for hosted bodies to receive, manage,

and escalate as necessary to the relevant sponsor body.

29

The Trust involves its public stakeholders in managing risks that impact on them. For

example, there is ongoing public engagement as an integral part of the development

process of the Transforming Cancer Services (TCS) Programme and the

Infrastructure Project. A series of stakeholder events have been undertaken, and will

continue throughout the lifespan of the TCS Programme. Risks from the TCS

Programme are reviewed and monitored by the TCS Programme Board, and are

escalated to the Trust risk register in accordance with the Trust risk escalation

process. Information on the risks managed and mitigated during 2018-19 is detailed

in the Trust Risk Register which is received by the Trust Board. Trust Board papers

are available on the Trust Internet site, via the following link.

RISK MANAGEMENT

The Trust has an approved Risk Management Policy in place. The Policy details a

robust risk assessment process to identify, assess and manage organisational risks

which are reported on a risk register to the Trust Board. During 2018/19 the Trust

has developed a Risk Management Framework which will incorporate the Trust’s

Risk Management Policy when formally adopted in 2019/20. The Trust’s Risk

Management Policy is available from the Trust’s Internet Site via the following link:

http://www.velindre-tr.wales.nhs.uk/quality-safety-policies

The Trust Board is ultimately responsible for overseeing the Trust’s risk register and

holding the Executive to account for ensuring management action is taken to

minimise risk. The Trust Board delegates’ responsibility to the Trust’s Quality &

Safety Committee for overseeing the risk management process and the Trust’s Audit

Committee retains the oversight to ensure the system of risk management is

effective. The overall aim of the Trust’s Risk Management approach is to progress a

comprehensive risk management programme to ensure that:

There is compliance with statutory legislation

All sources and consequences of risk are identified

Risks are assessed and either eliminated or minimised

Damage and injuries are reduced, and people’s health and well-being is

optimised

Resources diverted away from patient/service user care to fund risk reduction

are minimised

Lessons are learnt from concerns in order to share best practise and prevent

reoccurrence.

30

The Trust has a series of controls in place to manage and mitigate these risks.

The Chief Executive, as Accountable Officer for the Trust, has overall accountability

and responsibility for having an effective risk management system in place within the

Trust, including hosted organisations. The Chief Executive is responsible for meeting

all statutory requirements and adhering to guidance issued by the Welsh

Government Department of Health & Social Services in respect of governance.

Within the Trust’s Risk Management Policy, the Chief Executive has set clear

measurable risk management objectives for the Executive Directors and Service

Directors with delegated responsibility for risk management and governance.

The Executive Director of Nursing & Service Improvement has organisational lead

responsibility to the Chief Executive and the Board for risk management. Each

Executive Director is responsible for overseeing effective management of risk within

their area of responsibility, and Executive Directors are supported in these duties by

the Service Directors and Senior Managers across the organisation.

Every member of staff, including clinicians, is responsible for ensuring that their own

actions contribute to the wellbeing of patients/service users, staff, visitors and the

organisation. They are expected to contribute to the identification, reporting and

assessment of risks and to take positive action to manage them appropriately.

Risk management is embedded in Trust decision making and service delivery. This

is supported by continually considering and assessing Trust compliance with key

clinical guidance including:

Guidance and technology appraisals from the National Institute for Health and

Care Excellence (NICE)

National Service Frameworks (NSFs)

National Enquiries for example Confidential Inquiries

Patient Safety Alerts

Professional Guidelines for example from Royal Colleges

Guidelines or standards from other national/local bodies

Local and national audit

Research & Development

Participation in clinical trials

Health and Care Standards (Wales)

Risk Management and risk resourcing is managed by Divisional Directors through

their business plans. All divisions/departments have processes for assessing risk

31

and risk registers are created as appropriate. Risks are updated and reviewed within

the service divisions. The divisional Strategic Management Team (SMT) works with

their supporting groups/Committees to ensure effective controls are in place for their

risks to be managed at a tolerable level.

Risks are referred to the appropriate Committees of the Trust Board for scrutiny and

to identify additional control measures. In turn, the Committees provide assurance to

the Trust Board that all reasonably practicable steps have been taken to reduce the

risk, that effective controls are in place and the risk is being managed at a tolerable

level.

T RUST RISK REGIST ER

The organisation’s risk profile is visible through the Trust Risk Register. Risks are

identified at the commencement of new or amended activities and through the

ongoing review of existing risks. Risk assessments are undertaken to assess the

impact upon the service and other stakeholders. Public Stakeholders are involved in

the assessment of risk through public consultations, Patient Liaison Group

representation and Community Health Council at Trust Board and Committee

meetings, feedback received in respect of Patient Experience surveys and Donor

Forums and learning from Concerns received from patients, donors, relatives and/or

carers.

All risks are assessed and awarded a score, informed by potential impact and

likelihood. Risks are escalated resulting in the highest level of risk being referred to

the Executive Management Trust Board for appraisal prior to inclusion on the Trust’s

risk register and reported to Trust Board and relevant Trust Board Committee/s.

Each risk entered onto the Trust register is given a ‘target’ score informed by the

appetite for the risk, which is the level of risk the Trust Board is prepared to accept

before action is deemed necessary to reduce it. The risk appetite is used in decision

making to inform the prioritisation of actions and the resources required to mitigate

risks on the Trust risk register.

During 2017-18, improvements were made to the risk register in respect of the

processes used to report and monitor risks by the Trust Board. The Executive Board

was proactive in developing the register and all risks included on the Trust risk

register underwent a review to improve the narrative description of the risk. The

process for closing risks and de-escalating risk to the service divisions was also

made more visible. During 2018-19 further work was undertaken to further develop

32

and strengthen the Trust’s risk register, and a revised format for the Trust Risk

register was adopted in August 2018.

The significant risks on the Trust Risk Register as at the 31st March 2019 are

outlined below. Further details in respect of the Trust’s key risks are outlined within

the Trust’s Annual Quality Statement (AQS). The AQS is included within the Trust

Annual Report which is held on the Trust Internet site under key publications

The Trust uses a Risk Quantification Matrix to evaluate its risk rating. A simple risk quantification is identified by multiplying the Impact X Likelihood = Risk Rating.

As at the 31st March 2019, the risks on the Trust’s risk register include:

Quality Risk Domain:

The availability of sufficient Registrar capacity to fulfil the medical rota from March 2018 (Risk Score of 12).

A failure in the electronic patient administration system (CANISC) will limit access to some patient records including radiotherapy workflow management and the patient administration system (Risk Score of 20).

The availability of sufficient consultant capacity to fulfil medical resource requirements for the service (Risk Score of 12).

Accommodation constraints within VCC do not meet the requirements of the service in some areas (Risk Score of 12).

The continued sustainability of Pharmacy Technical Services (Risk Score of 20).

The Welsh Transplantation and Immunogenetics Laboratory (WTAIL) Laboratory Information System (LIMS (Orpheus) will not meet user specifications within nationally-agreed contractual deadlines, compromising our ability to deliver improvements to WTAIL services, the risk of reputational damage and a reduction in service / user confidence (Risk Score of 16).

Research & Development Risk Domain

The availability of sufficient nuclear medicine clinical scientist (MPE) capacity to support clinical trials (Risk Score of 16).

Impact Description IMPACT Likelihood Description LIKELIHOOD Risk Score

Risk Level

Risk Rating

1 Insignificant No injury 5 Almost Certain

Will happen frequently

Score Risk Rating

2 Minor Minor injury 4 Likely Probably will happen, not regularly

1-3 Low

3 Moderate

Moderate injury RIDDOR reportable

3 Possible Might happen occasionally

4-6 Moderate

4 Major Major Injury Severe

2 Unlikely Not expected to happen

8-12 Significant

5 Catastrophic Death 1 Rare Never happened 15-25 Critical

33

Reputation & Public Confidence Risk Domain:

Achieving the proposed timescales for the opening of the new Velindre Cancer Centre (nVCC) (Risk Score of 16).

Non delivery of the expected benefits from the Transforming Cancer Services Programme (Risk Score of 16).

Non-achievement of the next Commercial Approval Point (CAP) for the new Velindre Cancer Centre Project due to lengthy process for land transfer/ access (Risk Score of 16).

Workforce & OD Risk Domain:

The potential impact on staff wellbeing during the change process of the WBS Blood Supply Chain 2020 Programme (Risk Score of 20).

Compliance Risk Domain:

Achieving compliance against the new Welsh Language Standards (under the Welsh Language (Wales) Measure 2011) within the timescales set by the Welsh Language Commissioner (Risk Score of 20).

Performance & Service Sustainability Risk Domain:

Disruption, delays or inability to provide full range of treatments and services if

the government fails to achieve a withdrawal agreement when the UK leaves the

EU 29th March 2019 (Risk Score of 12).

Further information on how risks are being managed and mitigated is detailed in the

Trust Risk Register which is received by the Trust Board. Trust Board papers are

available on the Trust Internet site, via the following link.

RISK MANAGEMENT ST RA TEGY

The Trust has a current Risk Management Strategy. During 2018/19 the Trust has

developed a Risk Management Framework which will incorporate the Trust’s Risk

Management Strategy along with the Trust’s Risk Management Policy and the

Trust’s Risk Assessment Policy when formally adopted in 2019/20.

Risk management continues to be an integral component of the Trust’s service

delivery, and will ensure alignment to the three year Integrated Business Plan and

other supporting strategies.

RISK APPETIT E STAT EM ENT

The Trust faces a broad range of risks reflecting its responsibilities. The risks arising

from its responsibilities can be significant. These risks are managed through detailed

processes that emphasise the importance of integrity, intelligent inquiry, maintaining

high quality staff and public accountability.

34

The Trust makes resources available to control operational risks at acceptable levels

and we recognise that it is not possible or indeed necessarily desirable to eliminate

some of the risks inherent in our activities. Acceptance of some risk is often

necessary to foster innovation within the services for which we are responsible.

The Trust’s Risk Appetite Statement was reviewed and approved at Trust Board in

September 2018, and considers the most significant risks to which the Trust is

exposed. It provides an outline of the approach to managing these risks. All strategic

and business plans for operational areas must be consistent with this Statement.

Given the range of the Trust’s activities and responsibilities, it is not appropriate to

make a single overarching statement of the Trust’s attitude to risk. Instead, a range

of risk appetite statements arising from the different areas of our work has been

developed in the following areas:

Safety

Quality

Compliance

Research & Development

Partnerships & Innovation

Reputation & Public Confidence

Performance & Service Sustainability

Financial Sustainability

Workforce & Organisational Development

Partnerships

The full Risk Appetite Statement is available is available via this link.

The Risk Appetite Statement will be reviewed in the autumn of 2019, unless

circumstances dictate that an earlier review is necessary.

HEALT H AND CARE STAN DARDS FOR WALES

The Health and Care Standards (previously the Standards for Health Services in

Wales) were reviewed and published in April 2015. The Health and Care Standards

set out the requirements for the delivery of health care in Wales at every level and in

every setting. The onus is on all NHS organisations to demonstrate that the

standards are being used and are met on a continuous basis.

35

Following the launch of the Health and Care Standards the Trust established

framework arrangements through which self-assessments can be undertaken and

action taken to implement improvements and changes required to enable the Trust

to deliver the highest quality of services to the people of Wales.

The framework, which builds on the previous protocol for the Standards for Health

Services, was developed to assist all Trust staff involved with the implementation of

the Health and Care Standards.

Divisions and hosted organisations and teams use the standards to self-assess at all

levels and across all activities to:

Map against their own professional standards and operational plans

Assess for themselves how well they currently meet the standards

Identify what they do well and what could be shared wider

Identify what they do less well and what can be done to improve delivery

Make changes which contribute to overall quality improvement within their

service.

The outcomes from the self-assessments were discussed and approved at the Trust

Integrated Governance Group on the 8th April 2019.

In addition, a selection of those completed Standards have been validated by

Internal Audit in March 2019:

Standard 1 - Governance, Leadership and Accountability

Standard 2.5 - Nutrition and Hydration

Standard 2.7 - Safeguarding Children and Safeguarding Adults at Risk

Standard 4.2 - Patient Information

Improvement actions, identified as part of the self-assessment audit, will be

monitored by relevant Management Groups and Board Committees to ensure the

Standards become part of everyday business management within the service areas

to drive improvements in quality.

36

GOVERNANCE & ACCO UNT ABIL ITY ASSESSMENT / T RUST BOARD EFFECTIVENESS

The Trust introduced a new approach for undertaking the Trust Board effectiveness

and Trust Board assessment of Governance & Accountability for the period 2018-19,

which was endorsed by the Board in February 2019.

Instead of following the previous approach of issuing a questionnaire for completion

the completed ‘Healthcare Standard (HCS) 1, Governance, Accountability &

Leadership’ assessment was shared with Board Members for review prior to the

Integrated Governance Meeting on the 8th April 2019.

At the Integrated Governance meeting, Board Members were taken through a

bespoke “Governance, Accountability and Leadership Assessment Tool” which

integrated with Healthcare Standard 1 and the Integrated Medium Term Plan (IMTP).

At the meeting the Board members collectively completed the tool having considered

the HCS 1 narrative and ensuring alignment to the IMTP and Wellbeing of Future

Generations Act ‘five ways of working’, as well as assessing the effectiveness of the

Board in the following areas:

• The Trust demonstrates effective leadership by setting direction, igniting passion,

pace and drive, and developing people.

• The trust’s strategy is set with a focus on outcomes, and choices based on

evidence and people insight. The approach is through collaboration building on

common purpose.

• The Trust fosters a culture of learning and self-awareness, and personal and

professional integrity.

• The Trust innovate and improve delivery, plan resource and prioritise, develop

clear roles, responsibilities and delivery models, and manage performance and

value for money.

At the conclusion of the Integrated Governance meeting Board members made a

judgment using the maturity matrix definitions on page below, to conclude how the

Trust has performed during 2018-19.

The Trust’s self-assessment of the overall maturity level for 2018-19 was assessed

as Level 4, the maturity level has remained the same since 2016-17.

37

The above process has been subject to independent internal assurance by the

organisation’s Head of Internal Audit. The internal audit review confirmed that a

satisfactory process exists for the review and completion of the Governance and

Accountability assessment, involving Executives and, Independent Members. There

were no recommendations received in respect of the completion of the Governance

and Accountability assessment.

The audit of the Health & Care Standards in Wales conducted by Internal Audit

sought to provide assurance that the Trust has adequate procedures in place to

ensure that it is operating in accordance with the Standards and that appropriate

self-assessment against the Standards is undertaken.

The level of assurance given as to the effectiveness of the system of internal control

in place to manage the risks associated with establishment controls within the Health

and Care Standards is Reasonable Assurance.

RATING INDICATOR DEFINITION

Reasonable

assurance

The Board can take reasonable assurance that

arrangements to secure governance, risk management

and internal control, within those areas under review, are

suitably designed and applied effectively. Some matters

require management attention in control design or

compliance with low to moderate impact on residual

risk exposure until resolved.

Governance,

Leadership &

Accountability

– Self

Assessment

1. Do not yet

have a clear,

agreed

understanding

of where they

are (or how

they are doing)

and what /

where they

need to

improve.

2. are aware of

the

improvements

that need to be

made and have

prioritised them,

but are not yet

able to

demonstrate

meaningful

action.

3. Are

developing

plans and

processes and

can

demonstrate

progress with

some of their

key areas for

improvement.

4. Have well

developed

plans and

processes

and can

demonstrate

sustainable

improvement

throughout the

organisation /

business.

5. Can

demonstrate

sustained

good practice

and

innovation

that is shared

throughout

the

organisation/

business, and

which others

can learn

from.

Rating

38

Guidance for the completion of the Health & Care Standards self-assessments has

been made available to relevant staff and Independent Members. There is also a

timetable in place that details key actions and related dates for the self-assessment

process.

Appropriate leads at Divisional, Corporate and Executive level have been identified

for the Standards, as well as Independent Members appointed to each area also.

The self-assessments have been completed in a timely manner by the divisions,

however it was found that there has been a lack of timely engagement from

Independent Members in returning comments and approval.

Evidence detailed within the self-assessments could be referenced back to

supporting documentation.

Improvement actions had been identified and detailed within the self-assessments,

however it was found that a number of the improvements listed within the

Governance, Leadership & Accountability standard were being carried forward from

findings within the 2016/17 self-assessment process.

REVI EW OF EFFECTIVEN ESS

As Accountable Officer, the Chief Executive has responsibility for reviewing the

effectiveness of the system of internal control. The Chief Executive’s review of the

effectiveness of the system of internal control is informed by the work of Internal and

External Auditors, the Executive Directors and other assessment and assurance

reports including the work of Healthcare Inspectorate Wales. The Chief Executive

has listened to the Board on their views of the strengths and opportunities in the

system of internal control and been advised by the work of the Audit Committee and

other Committees established by the Board.

The Chief Executive’s performance in the discharge of these personal

responsibilities is assessed by the Director General of the Department of Health &

Social Services/Chief Executive of NHS Wales.

At the Integrated Governance Group (mentioned above) the Trust Board concluded

an overall maturity level for 2018-19 as Level 4; which is defined as ‘having well

developed plans and processes and can demonstrate sustainable improvement

throughout the organisation’. Further detail is outlined on page 36-37 of this report.

39

The scrutiny of these arrangements is in part informed through the internal

mechanisms already referred to, but also through the independent and impartial

views expressed by a range of bodies external to the Trust, these include;

Children’s Commissioner Older Peoples Commissioner

Community Health Councils Wales Audit Office

Health & Safety Executive Welsh Government

Healthcare Inspectorate Wales Internal Audit (NHS Wales Shared Services)

Welsh Language Commissioner Welsh Risk Pool Services

Other accredited bodies

INTERNAL AUDIT O PINI ON & SCORES FOR 2018-19

Internal audit provides the Chief Executive and the Board through the Audit

Committee with a flow of assurance on the system of internal control. The Chief

Executive and Internal Audit agreed a programme of audit work which was approved

by the Audit Committee, and delivered in accordance with public sector internal audit

standards by the NHS Wales Internal Audit Service, part of the NHS Wales Shared

Services Partnership. The programme of audit work is designed to focus on

significant risks and local improvement priorities.

The overall opinion by the Head of Internal Audit on governance, risk management

and control is a function of this risk based audit programme and contributes to the

picture of assurance available to the Board in reviewing effectiveness and supporting

our drive for continuous improvement.

T HE HEAD OF INTERNAL AUDIT OPINION

The scope of my opinion is confined to those areas examined in the risk based audit

plan which has been agreed with senior management and approved by the Audit

Committee. The Head of Internal Audit assessment should be interpreted in this

context when reviewing the effectiveness of the system of internal control and be

seen as an internal driver for continuous improvement.

The Head of Internal Audit opinion on the overall adequacy and effectiveness of the

organisation’s framework of governance, risk management, and control is set out

below. In reaching the opinion the Head of Internal Audit has applied both

professional judgement and the Audit & Assurance “Supporting criteria for the overall

40

opinion” guidance produced by the Director of Audit & Assurance and shared with

key stakeholders.

The overall opinion was classified as Reasonable Assurance.

Reaso

nab

le

assu

ran

ce

- +

Yellow

The Board can take reasonable assurance that

arrangements to secure governance, risk management

and internal control, within those areas under review, are

suitably designed and applied effectively. Some matters

require management attention in control design or

compliance with low to moderate impact on residual risk

exposure until resolved.

In reaching this opinion the Head of Internal Audit identified that the majority of

reviews during the year concluded positively with robust control arrangements

operating in some areas.

From the reports issued during the year, five were allocated Substantial Assurance

and twelve were allocated Reasonable Assurance. However there is one audit (at

draft stage) that concluded with a Limited Assurance rating.

The Trust has not been issued with any No Assurance audit reports for 2018/19.

It has also been noted that there have been a number of audits undertaken during

the year, including Absence Management, Fire Safety, Cyber Security, which

followed up on previous year’s recommendations where Limited Assurance was

given originally and it has been seen that there have been improvements in the

assurance ratings in each case.

At the time of writing this report there was one audit at draft stage that concluded a

limited assurance rating. Whilst it is too early to confirm the management response

the Trust, where a limited assurance report is received, will ensure that the detailed

findings are considered by the Lead Officer for the function and the report received

by the Trust Audit Committee, where the lead officer will be in attendance. A follow

up audit will also be commissioned by the Trust Audit Committee for inclusion in the

2019/20 audit programme for the Trust as appropriate.

41

The management response to all assurance reports will be reviewed by the Audit

Committee and progress against management actions will be monitored at each

Audit Committee meeting until all actions have been appropriately implemented.

In addition, the Head of Internal Audit has considered residual risk exposure across

those assignments where limited or no assurance was reported. Further, where

audit assignments planned this year did not proceed to full audits following

preliminary planning work and these were either: removed from the plan; removed

from the plan and replaced with another audit; or deferred until a future audit year.

Where changes were made to the audit plan then the reasons were presented to the

Audit Committee for consideration and approval. Notwithstanding that the opinion is

restricted to those areas which were subject to audit review; the Head of Internal

Audit has considered the impact of changes made to the plan when forming their

overall opinion.

The Internal Audit Reports which outline the management responses and detailed

actions which have been agreed to address the weaknesses identified are published

within the Trust Audit Committee papers which are available on the Trust Internet

site by clicking here. The table in Appendix 1 details the dates of the meetings when

the reports were received.

WALES AUDIT OFFIC E ST RUCT URED ASSESSMENT 2018

The Trust’s External Auditors, Wales Audit Office (WAO), conducted a Structured

Assessment during 2018 that focussed on the corporate arrangements for ensuring

that resources are used efficiently, effectively and economically.

The main conclusions from the 2018 report are outlined below;

The Trust continues to strengthen its governance arrangements and while

systems of internal control are generally effective, progress to finalise the Board

Assurance Framework (BAF) is still ongoing.

The Trust is strengthening its strategic planning approach in line with its long-

term vision but capacity to deliver and manage strategic change is limited, and a

greater understanding of the cost of services is required.

The Trust manages its workforce, finance and physical assets well day to day,

but more focus on managing financial savings schemes is required, and progress

to standardise the corporate management of IM&T has been slow.

Recommendations are being addressed by the Executive Management Board and

progress will be monitored by the Audit Committee by scrutiny of the Audit Action

Plan. Velindre University NHS Trust– Structured Assessment 2018 report is

42

published and available from the Wales Audit Office internet site by clicking here.

The Trust’s management response to the 2018 structured assessment

recommendations is captured within the WAO report.

INFO RMATION GOVERNAN C E

The Trust has established arrangements for Information Governance to ensure that

information is managed in line with the relevant Information Governance law,

regulations and Information Commissioner’s Office guidance. The arrangements

include a Trust-wide Information Governance & Information Management &

Technology Committee, Trust, Divisional and Hosted Organisation Caldicott

Guardians, a Caldicott Guardian for the National Databases and Divisional

Information Governance leads.

During 2018/19, the General Data Protection Regulation (GDPR) came into force. In

response to the changes in the regulation, the Trust has worked collaboratively

across its divisions and associated organisations in respect of the requirements of

the GDPR, and in order to embed required new processes into the organisations

“Business as Usual” activities. Furthermore the Trust has appointed a Data

Protection Officer (DPO), which is a critical role for maintaining compliance against

the GDPR. In recognition of the evolving Trust Information Governance agenda,

during 2018, the Trust established an Information Governance Peer Working Group,

with regular reports on all IG related matters provided at Trust-wide forums, namely

Information Governance & Information Management & Technology Committee.

The statement on the quality of data reported to the Trust Board is included within

the Annual Quality Statement within the Velindre University NHS Trust Annual

Report. In summary, information is provided from our data management and quality

improvement systems. To the best of our knowledge, this information is accurate and

gives a true reflection of the organisation.

B USINESS CONTINUI TY AND EMERGENCY PREPAREDNE SS

The Trust has taken significant steps forward this year in its business continuity and

emergency preparedness framework.

These include the strengthening of a Trust wide business continuity steering group,

the review and refresh of a Trust wide policy, communications plan and command

and control guidance.

The changing environment of risk results in the strategies and plans being reviewed

regularly. Emerging threats are considered in the development and enhancement of

43

risk mitigation strategies and the organisation’s response mechanisms. These plans

are commensurate with the level of risk the Trust anticipates to be exposed to.

Plans have been tested in the last 12 months, and as such are being reviewed to

encompass lessons learned and to further improve the current procedures.

The Trust has undertaken a significant amount of work with regard to Brexit and

specifically undertaken detailed planning in relation to the UK’s transition from the

EU with regard to a ‘No Deal’ Brexit. The planning has been multi-faceted and

based on risk, across a number of varying themes and integrated with NHS Wales,

Local Authorities, the Welsh Government and the Local Resilience Forums it

partners with. There has been a specific focus on key risks which include supply

chain continuity for medicines, medical devices and clinical consumables. In

addition, the Welsh Blood Service has worked closely with UK blood services and

enhanced the mutual aid arrangements between services to ensure the safety of the

blood supply chain.

INTEGRATED MEDI UM TE RM PLAN ( IMT P)

Efforts to achieve the Trust’s vision and strategic objectives is driven by ‘Delivering

Excellence’, our Integrated Medium Term Plan (IMTP). Our IMTP sets out the

priorities we intend to deliver on a rolling 3 year basis. The Plan for 2019 – 2022

was submitted to the Welsh Government in January 2019.

In March 2019, Velindre University NHS Trust had its IMTP approved by the Minister

for Health and Social Services and accordingly met its statutory duty to have an

approved IMTP in place for 2019/22. Having an approved IMTP in place is a key

means by which the Trust is able to demonstrate to its patients and donors, staff,

partners and Welsh Government that the organisation is able to deliver services in

an effective and sustainable manner. The IMTP is refreshed on an annual basis and

approved by Trust Board in January each year.

The Trust provided a reflection on progress against the key priorities, performance

and ambitions outlined in the IMTP for 2018 - 2021 within our new IMTP for 2019 –

2022. This assessment was a high level overview of performance against the overall

plan. This confirmed that delivery against objectives was broadly in accordance with

the forecast trajectory. The Trust will undertake a more in-depth review of its

achievements during 2018/19 once all performance information has been validated.

In respect of the financial performance, the Trust reported a balanced position

against its income and expenditure position for the year ended 31st March 2019, as

reflected in the Annual Accounts. This review and reflection on the IMTP for the

three year period beginning in 2018/19 will be subject to scrutiny and assurance

44

through the Planning and Performance Committee and Trust Board, and ongoing

Trust priorities will continue to be monitored and scrutinised during 2019/20.

What is apparent at this juncture is that great progress has been made across the

organisation in working towards the realisation of the Velindre Cancer Centre’s

(VCC) and the Welsh Blood Service’s (WBS) strategic objectives. Key achievements

are described in some detail in the Trust’s Annual Performance Report, but

noteworthy progress against divisional strategic objectives in 2018/19 is summarised

on the following page.

45

A S UMMARY OF O UR KEY AC HIEVEMENTS IN 2018/1 9

Trust awarded University status

Joint Project established with ABUHB to

deliver a Radiotherapy Satellite Centre at

Nevill Hall Hospital

Trust financial balance

achieved

WBS maintained excellence and regulatory compliance in

the delivery of core services

WBS retained all operating

licenses

Opening of an assessment centre at VCC which has

resulted in a reduction in inappropriate admissions

and in length of stay

Increased delivery of cancer

treatments at patients home

UK patient award for

Radiographer led

Palliative Care Service

WBS launch of the Blood

Health Plan

Over 200 patients recruited to

clinical trials at VCC

Supply Chain 2020 Programme

delivering transformational change and

service improvements

WBS launched a lapsed

Donor Programme leading to

an increase in ‘active’ donors

Positive NHS Wales Staff Survey results with over 90% of staff

happy with the standard of care provided by the Trust

Outline Business Case for a new Velindre Cancer

Centre approved by Commissioners

Page 46 of 76

We recognise the success we have had in working towards our strategic objectives.

However, we are aware that we must focus our attention on certain areas given the

challenging context in which we work. Again, we discuss these issues at greater length

in the Trust’s Annual Performance Report.

The Trust Board approved the IMTP for 2019 - 2022 in accordance with the NHS Wales

Planning Framework on the 23rd January 2019.

The final version of the IMTP for 2019-2022 is available upon request from the Director of Corporate Governance.

Further information in respect of progress against the IMTP is captured within the Performance Report in the “Performance Summary” section.

MINIST ERI AL DI RECTIO NS

A list of Ministerial Directions issued by the Welsh Government during 2018-19 is

available at: https://gweddill.gov.wales/legislation/subordinate/nonsi/nhswales/2018/?lang=en

Whilst Ministerial Directions are received by Local Health Boards, these are not always

applicable to Velindre University NHS Trust. Those considered of relevance to the

Trust are listed below:

The Wales Infected Blood Support Scheme (Amendment) Directions 2018

(No.54)

The Trust has a principal role for managing and administering the Wales Infected

Blood Support Scheme in accordance with directions issued by the Welsh Ministers.

All Ministerial Directions issued throughout the year are listed on the Welsh Government

website link above.

Welsh Health Circulars issued by Welsh Government are logged by the Governance

Function and assigned an Executive Lead to assess the impact to the Trust and take

forward necessary actions as appropriate. A register and action log is maintained by the

Governance Function. A list of Welsh Health Circulars issued by the Welsh Government

during 2018-19 is available at: http://howis.wales.nhs.uk/whcirculars.cfm

47

EQUALITY & DIVERSITY

Control measures are in place to ensure that all the organisation’s obligations under

equality, diversity and human rights legislation are complied with.

The control measures include:

Trust Equality Monitoring Annual Report which includes the Gender pay report

this year.

Equality reports to Quality and Safety Committee on the Trust’s Equality

Objectives and Actions.

Reports to the Equality and Human Rights Commissions’ enquiries.

Reports to the NHS Centre for Equality and Human Rights enquiries.

Report to the Welsh Government Equalities Team.

Provision of evidence to the Health Care Standards Audit, specifically Standard

2.

Equality Impact Assessments.

CONCLUSION

The system of internal control has been in place for the year ended 31st March 2019

and up to the date of approval of the 2018-19 annual report and accounts.

There have been no significant governance issues identified during this period.

Signed by:

Mr. Steve Ham

Chief Executive Date: 28th May 2019

48

APPENDIX 1 – GOVERNAN C E STAT EMENT – T RUST BOARD AND COMMITTEE ACTIVITY 2018-19

The table below outlines the key highlights and activity considered by the Trust Board

and its Committees during 2018-19, please note this is not an exhaustive list.

Meeting: Meeting Dates: Activity:

Velindre University NHS

Trust - Public Trust

Board meeting.

Meeting Agendas,

Minutes and Papers are

available on the Trust

Internet site

30th May 2018

26th July 2018

13th September 2018

29th November 2018

23rd January 2019

28th March 2019

All meetings were

quorate.

Programme/Project Updates:

Transforming Cancer Services Programme.

New Velindre Cancer Centre (nVCC) Project.

Blood Supply Chain 2020.

Updates in respect of the Board Assurance

Framework.

Finance:

Updating the Board on the financial position

of the Trust.

Signing off the audited accounts in May 2019.

Performance:

Considered and scrutinised the Delivering

Excellence Performance reports at each meeting.

Planning:

Progress updates and approval in respect of

the Integrated Medium Term Plan (IMTP) and

consideration of IMTP Service Plans.

Fit for the Future: Enhancing Capabilities.

Risk Management:

Scrutiny of the Trust’s Risk Register.

Brexit Risk Assessment.

Welsh Language Standards Implementation

Risk Assessment.

Integrated Governance:

Updates in respect of the Infected Blood

Inquiry (IBI).

Updates in respect of the Welsh Language

Standards Implementation and Risk

Assessment.

Updates in respect of Brexit.

49

Meeting: Meeting Dates: Activity:

Advisory Consultant

Appointments

Committee

Panels were held:

1st November 2018

14th November 2018

18th January 2019

4th March 2019

As and when required the Advisory Consultant

Appointment Committee meet to manage the

arrangements for appointments to NHS

Consultant posts within the Trust.

Trust Audit Committee

Meeting Agendas,

Minutes and Papers are

available on the Trust

Internet site

24th April 2018

29th May 2018

19th July 2018

2nd October 2018

4th December 2018

5th February 2019

All meetings were

quorate.

The Audit Committee Annual Report for 2018,

which outlines the activity of the Committee for

the year ending 31st December 2018, is published

on the Trust Internet site via the following link:

http://www.velindre-tr.wales.nhs.uk/the-board-

committees

NHS Wales Shared

Services Partnership

Audit Committee

24th April 2018

5th June 2018

24th July 2018

23rd October 2018

22nd January 2019

All meetings were

quorate.

The NWSSP Audit Committee Annual Report for

2017-18 was received at their meeting in July

2018 and is available via the following link:

NWSSP Audit Committee Annual Report 2017-18

The 2018-19 Annual Report will be published

after the meeting in July 2019.

Charitable Funds

Committee

Meeting Agendas,

Minutes and Papers are

available on the Trust

Internet site

5th June 2018

6th September 2018

16th October 2018

28th November 2018

5th March 2019

All meetings were

quorate.

The Charitable Funds Committee Annual Report

for 2018, which outlines the activity of the

Committee for the year ending 31st December

2018, is published on the Trust Internet site via

the following link:

http://www.velindre-tr.wales.nhs.uk/the-board-

committees

Information Governance

& IM&T Committee

(IG&IMT)

Meeting Agendas,

Minutes and Papers are

available on the Trust

Internet site

21st May 2018

17th September 2018

10th December 2018

19th February 2019

All meetings were

quorate.

The IG&IM&T Committee Annual Report for 2018,

which outlines the activity of the Committee for

the year ending 31st December 2018, is published

on the Trust Internet site via the following link:

http://www.velindre-tr.wales.nhs.uk/the-board-

committees

50

Meeting: Meeting Dates: Activity:

Local Partnership

Forum (LPF)

17th May 2018

10th September 2018

6th December 2018

18th March 2019

All meetings were

quorate.

The LPF Annual Report for 2018, which outlines

the activity of the Committee for the year ending

31st December 2018, is published on the Trust

Internet site via the following link:

http://www.velindre-tr.wales.nhs.uk/the-board-

committees

Planning &

Performance

Committee

Meeting Agendas,

Minutes and Papers are

available on the Trust

Internet site

14th May 2018

12th July 2018

11th September 2018

13th November 2018

17th January 2019

14th March 2019

All meetings were

quorate.

The Planning & Performance Committee Annual

Report for 2018, which outlines the activity of the

Committee for the year ending 31st December

2018, is published on the Trust Internet site via

the following link:

http://www.velindre-tr.wales.nhs.uk/the-board-

committees

Quality & Safety

Committee

Meeting Agendas,

Minutes and Papers are

available on the Trust

Internet site

19th June 2018

27th September 2018

19th December 2018

6th March 2019

The Quality & Safety Committee Annual Report

for 2018, which outlines the activity of the

Committee for the year ending 31st December

2018, is published on the Trust Internet site via

the following link:

http://www.velindre-tr.wales.nhs.uk/the-board-

committees

Remuneration

Committee

30th May 2018

26th July 2018

13th September 2018

29th November 2018

23rd January 2019

20th February 2019

All meetings were

quorate.

Considered Voluntary Early Release

applications received during the year for

approval.

Considered the Impact of the Pension Tax

Rules on our Workforce.

Approved the Pay Award for Agenda for

Change and non-Agenda for Change

Employees.

Considered cases of potential

redundancies.

Approved appointment of an Interim

Executive Director of Nursing & Service

Improvement.

Approved the appointment of an Interim

Chief Operating Officer.

51

Meeting: Meeting Dates: Activity:

Research, Development

& Innovation (RDI)

Committee

Meeting Agendas,

Minutes and Papers are

available on the Trust

Internet site

27th June 2018

26th September 2018

5th December 2018

21st February 2019

All meetings were

quorate.

The RDI Committee Annual Report for 2018,

which outlines the activity of the Committee for

the year ending 31st December 2018, is published

on the Trust Internet site via the following link:

http://www.velindre-tr.wales.nhs.uk/the-board-

committees

Workforce &

Organisational

Development (WF&OD)

Committee

Meeting Agendas,

Minutes and Papers are

available on the Trust

Internet site

25th April 2018

25th July 2018

6th November 2018

12th February 2019

All meetings were

quorate.

The WF&OD Committee Annual Report for 2018,

which outlines the activity of the Committee for

the year ending 31st December 2018, is published

on the Trust Internet site via the following link:

http://www.velindre-tr.wales.nhs.uk/the-board-

committees

52

APPENDIX 2 –B oard Member At tendance - T rust Board MEETINGS 2018-19

30.05.18 26.07.18 13.09.18 29.11.18 23.01.19 28.03.19

Prof. Donna

Mead

Mr. Martin

Veale Apologies

Mr. Stephen

Harries Apologies

Prof Jane

Hopkinson Apologies

Judge Ray

Singh Apologies

Mr. Phil

Roberts

Mrs. Jan

Pickles Apologies

Mr. Steve

Ham Apologies

Dr Jacinta Abraham

Prof Susan

Morgan

Ms. Sarah

Morley

Mr. Mark

Osland Apologies

Georgina

Galletly Apologies

53

FINANCIAL ACCOUNTABILITY REPORT

The Trust continues to operate in a challenging financial environment. Opportunities to

make efficiency savings and identify recurring reductions in costs whilst maintaining

services are sought wherever possible by Directors, finance teams and staff across the

organisation.

Despite these challenges the Trust was able to achieve all four financial targets set by

Welsh Government in 2018/19, most notably that of expenditure not exceeding income.

This will remain a difficult task in 2019/20 and the foreseeable future, and therefore will

continue to be of priority focus for the organisation.

FINANCIAL TARGET S

The Trust has met all four of its financial targets for the year ended 31 March 2019:

Breakeven duty - The Trust achieved a surplus of £31,000 in 2018/19 (2017/18:

surplus of £49,000), resulting in a surplus of £115,000 over a three year period.

The Trust has therefore achieved its statutory financial duty to achieve financial

breakeven over a rolling three year period.

External Finance Limit (EFL) - The Trust is given an External Financing Limit by

the Welsh Government which it is permitted to ‘undershoot’ at any level but not

exceed. For 2018/19, the Trust met its target, with an ‘undershoot’ of £1,079,000

(2017/18: undershoot of £999,000). This target demonstrates that the Trust has

successfully delivered on its capital programme within the limit set by the Welsh

Government.

The Trust submitted an Integrated Medium Term Plan for the period 2018/19 -

2020/21 in accordance with the NHS Wales Planning Framework, which was

subsequently approved by the Cabinet Secretary. The Integrated Medium Term

Plan relates only to the Trust’s core activities and does not apply to the

organisations hosted by the Trust. The Trust has therefore met its statutory duty

to have an approved plan for the period 2018/19 to 2020/21.

Creditor payments - The Trust is required to pay 95% of the number of non-NHS

bills within 30 days of the receipt of goods or a valid invoice (whichever is the

54

later). The Trust has met this target, paying 97% (2017/18: 96%) within the

required time.

FEES AND CHARGES - AUDITOR REMUNERATION

Fees paid to the Wales Audit Office for their statutory audit and performance audit work

were £208,996.

MAT ERI AL REMOTE CONT INGENT L I ABIL IT IES

The Trust hosts the Welsh Risk Pool (WRP) as part of NHS Wales Shared Services

Partnership (NWSSP). The WRP returns from Welsh Health Organisations estimate

that in 2018/19 the Trust has remote contingent liabilities of £17.5m (2017/18: £27.7m)

which relate to potential litigation claims against NHS Wales that could arise in the

future due to known incidents. Due to the nature and uncertainty of these potential

claims, no provision has been made for them within the accounts.

LONG TERM EXPENDIT UR E TRENDS

2014/15 2015/16 2016/17 2017/18 2018/19

£000 £000 £000 £000 £000

Total Revenue 480,291 440,033 637,132 712,828 525,607

Pay 110,814 132,653 144,112 149,866 160,551

Non Pay 355,157 289,643 478,901 549,774 352,075

Depreciation 14,518 16,629 15,989 17,595 16,466

Total Expenditure 480,489 438,925 639,002 717,235 529,092

Non-operating

revenue and

costs

792 927 1,725 5,613

3,295

Total

Consolidated

surplus/(deficit)

594 2,035 (145) 1,206

(190)

The table above includes the income and expenditure of the Trust’s charitable fund and

assets that have been donated to the Trust. The Trust’s annual surplus / (deficit)

excluding the charitable fund and donated assets is shown below:

55

2014/15 2015/16 2016/17 2017/18 2018/19

£000 £000 £000 £000 £000

Surplus/(deficit)

excluding

charitable fund

and donated

assets

39 40 35 49

31

Notes

During 2014/15 Abertawe Bro Morgannwg and Aneurin Bevan stores transferred to the Trust.

During 2015/16 Health Courier Services and GP trainees transferred to the Trust.

During 2016/17 the Trust established a National Technology Adoption Hub. The Surgical Material Testing

Laboratory transferred to, and Health and Care Research Wales Workforce, transferred from the Trust.

During 2018/19 – the Wales Workforce Education & Development Services (WEDS), which was part of

NWSSP, was transferred from the Trust into the newly established Health Education & Improvement

Wales (HEIW). The transfer of WEDS resulted in a significant reduction in the income and expenditure

reported within the above table but had no impact on the surplus / deficit for the year.

56

CODE OF PRACTICE – ET HICAL EMPLOYMENT IN SUPPLY C HAINS

The Welsh Government’s Code of Practice: Ethical Employment in Supply Chains was introduced to highlight the need, at every stage of the supply chain, to ensure good employment practices exist for all employees, both in the United Kingdom and overseas. Velindre University NHS Trust fully endorses and is embedding the principles and requirements of the Code and the Modern Slavery Act 2015. In doing so the Trust is committed to playing its role as a major public sector employer, to eradicate unlawful and unethical employment practices, such as:

Modern Slavery and Human rights abuses;

The operation of blacklist/prohibited lists;

False self-employment;

Unfair use of umbrella schemes and zero hours contracts; and

Paying the Living Wage.

To promote this agenda within the Trust, we will raise awareness of the Code with our workforce as well as with our suppliers and contractors. It is recognised that the implementation of the commitments contained within the Code requires the full co-operation of NHS Wales Shared Services Partnership recruitment, buying and procurement staff. Over the next 12 months, the Trust will develop in partnership with relevant stakeholders and trade union partners an Action Plan which will clearly set out the Trust’s commitment to ensure the principles of ethical employment within our supply chains are implemented and adhered to. To date the Trust has taken the following actions to meet the Code’s commitments;

It has produced an Ethical Employment Statement, which will be made available on the Trust’s Internet and Intranet sites;

It has in place a Raising Concerns (Whistleblowing) Policy, which provides the workforce with a fair and transparent process, to empower and enable them to raise suspicions of any form of malpractice by either our staff or suppliers/contractors working on Trust premises;

The Trust has a target in place to pay our suppliers within 30 days of receipt of a valid invoice;

The Trust has introduced robust IR35 processes which ensures that there is no unfair use of false self-employed workers or workers being engaged under umbrella schemes. These processes also ensure the fair and appropriate engagement of all workers and prevents individuals from avoiding paying Tax and National Insurance contributions;

The Trust does not engage or employ staff or workers on Zero Hours Contracts;

57

The Trust makes no use of false self-employment, umbrella schemes or zero hours contracts which would result in avoidance of Tax/National Insurance or in any way unduly disadvantage its workers in terms of pay, rights, opportunities;

The Trust has in place an Equality and Diversity Policy which ensures that no potential applicant, employee or worker engaged by the Trust is in any way unduly disadvantaged in terms of pay, employment rights, employment or career opportunities;

Assurances are sought from suppliers, via the tender process, that they do not make use of blacklists/prohibited lists. The Trust is also able to provide confirmation and assurances that the Trust does not make use of blacklist/prohibited list information;

In accordance with Transfer of Undertaking (Protection of Employment) Regulations any Trust staff who may be required to transfer to a third party will retain their NHS Terms and Conditions of Service;

The Transparency in Supply Chain (TISC) Report – Modern Slavery Act (2015) compliance tracker is used, through contracts procured by NWSSP Procurement Services on the Trust’s behalf.

The Trust will continue to work with employees, trade union colleagues, service providers, suppliers and contractors to address the Ethical Employment in Supply Chains commitments, via our Action Plan. Updates on the progress made against the remaining commitments will be reported in the 2020 Accountability Report. In 2019 the Trust will also produce an annual written statement in relation to its obligations under the Modern Slavery Act 2015.

58

REMUNERATION & STAFF REPORT

The details of the Remuneration Relationship are reported on page 67 of this document,

and note 10.6 of the Annual Accounts.

The pay and terms and conditions of employment for the Executive Team and senior

managers have been, and will be determined by the Velindre University NHS Trust

Remuneration and Terms of Service Committee, within the framework set by the Welsh

Government. The Remuneration and Terms of Service Committee also considered and

approved applications relating to the voluntary early release scheme. The Trust

Remuneration Committee members are all Independent Members of the Board and the

Committee is chaired by the Trust Chair. Details of the membership of the

Remuneration & Terms of Service Committee are captured on pages 8-15 of the

Directors’ Report section of this report.

Existing public sector pay arrangements apply to all staff including members of the

Executive Team. In 2018/19 the Remuneration and Terms of Service Committee

considered and approved a revision to the salary of the Executive Director of Nursing

and Service Improvement, following a re-evaluation of the Job Evaluation for Senior

Posts (JESP) score, by the Welsh Government. This resulted in the post moving from

Pay Point 9 (£95,950) to a Pay Point 10 (£101,000). All members of the Executive

Team are on pay points and not pay scales. In accordance with the Welsh Government

Pay Letter ESP (W) 1/2018, all members of the Executive Team were entitled to a 2%

consolidated pay increase, with effect from the 1st April 2018.

The performance of members of the Executive Team is assessed against personal

objectives and against the overall performance of the Trust. The Trust does not operate

a performance related pay scheme.

All Executive Directors have the option to have a lease car, under the terms of the

Trust’s lease car agreement.

The Chief Executive and Executive Directors are employed on permanent contracts,

which can be terminated by giving due notice unless for reasons of misconduct.

59

There have been no payments to former Executives or other former senior managers

during the year.

The remuneration report is required to contain information about senior managers’

remuneration. The senior management team consists of the Chief Executive, the

Executive Directors and the Independent Members (Non-Executive Directors), the

Director of Strategic Transformation, Planning, Performance and Estates, Interim Chief

Operating Officer and the Director of Corporate Governance / Trust Secretary. Full

details of senior managers’ remuneration are shown later in the table on pages 64-66.

The totals in some of the following tables may differ from those in the Annual Accounts

as they represent staff in post at 31st March 2019, whilst the Annual Accounts (note

10.2) shows the average number of employees during the year.

Transparency of senior remuneration in the devolved Welsh Public Sector –

ANNEX 10.

Guide to Tackling Unfair Employment Practices and False Self-Employment -

https://gov.wales/docs/dpsp/publications/valuewales/170620-unfair-employment-en.pdf

- ANNEX 10

STAFF COMPOSIT ION BY GENDER

A breakdown of the workforce by gender is set out in the table below. This figure

represents the composition as at 31st March 2019.

*FTE – Full-time Equivalent

Gender Headcount FTE % of

Headcount

Female 2,538 2,242.34 60.01

Male 1,685 1,634.44 39.90

Grand Total 4,223 3,876.78 100.00

A breakdown of the Board Members and Senior Managers by gender is set out in the

table below. This figure represents the composition as at 31st March 2019. The data

60

confirms that there are more female than male Trust Board members and Senior

Managers. Female employees are employed in five out of the eight Trust Board and

Senior Manager posts. Until February 2018 the gender split was equally balanced. This

position changed when the Trust appointed a female Medical Director, into a post which

has traditionally been a male dominated Board position. The appointment of a female

Interim Chief Operating Officer in March 2019, has further increased the majority of

female Trust Board members and senior managers.

Job Title Gender Headcount FTE % of

headcount

Chief Executive Male 1 1.0 13.3

Interim Chief Operating Officer Female 1 1.0 13.3

Executive Director of Finance &

Informatics

Male 1 1.0 13.3

Medical Director Female 1 0.8 10.1

Executive Director of Nursing & Service

Improvement

Female 1 1.0 13.3

Executive Director of OD and Workforce Female 1 1.0 13.3

Director of Strategic Transformation,

Performance Planning & Estates

Male 1 1.0 13.3

Director of Corporate Governance / Trust

Secretary

Female 1 0.8 10.1

Grand Total

Male

Female

8

3

5

7.6

3

4.6

100.00

39

61

STAFF COMPOSIT ION BY STAFF GRO UP

During 2018/19 the average full time equivalent (FTE) number of staff permanently

employed by the Trust was 3,799. The average number of employees is calculated as

the full time equivalent number of employees in each week of the financial year divided

by the number of weeks in the financial year. The table below provides a breakdown of

the workforce by staff grouping and in addition to permanently employed staff, shows

staff on inward secondment, agency staff, and other staff.

61

SIC KNESS ABSENCE DAT A 2018/19

The data shows an overall increase in sickness absence levels during 2018/19 and as a

result the Trust did not achieve the Welsh Government Sickness Absence Rate of

3.54% during this period.

To respond to the increase in sickness absence levels, the Trust has implemented the

new NHS Wales Managing Attendance at Work (MAAW) Policy. The Workforce team

Average FTE Number of Employees

Permanently Employed

Staff on Inward

Secondment

Agency Staff

Other Staff

2018/19 Total

2017/18

Total

Administrative, Clerical and Board Members

2,335 16 29 22 2,402 2,287

Ambulance Staff 0 0 0 0 0 0

Medical and

Dental

470 1 0 5 476 465

Nursing and

Midwifery

Registered

184 0 1 0 185 181

Professional,

Scientific and

Technical Staff

52 0 0 0 52 53

Additional

Clinical Services

197 0 1 3 201 197

Allied Health

Professionals

110 0 8 1 119 114

Healthcare

Scientists

132 1 0 0 133 133

Estates and

Ancillary

319 0 5 12 336 329

Students 0 0 0 0 0 1

Total 3,799 18 44 43 3,904 3,760

62

has and continues to provide a number of MAAW policy training sessions for managers

and trade union representatives. The purpose of the training is to help embed a culture

whereby the organisation takes a more proactive approach to the management of

attendance at work. This is being supported by the Workforce team working closely

with managers, undertaking sickness audits and coaching them to manage their new

and ongoing sickness cases, in accordance with the policy. The Workforce team are

also providing Senior Management Teams and managers with sickness deep dive

reports, looking into specific absence issues and reason, monthly sickness absence

data, to assist them to identify those staff that are about to reach prompt levels. This

approach is intended to support managers to effectively manage their staff absences.

The Trust also provides staff with free access to a diverse range of traditional medical,

psychological and complementary therapy interventions, to assist them to proactively

and reactively manage their health and wellbeing. This includes an Employee

Assistance Programme, which family members can also access for free. The Trust

recognises that menopause related health and wellbeing issues can have a significant

impact on the whole workforce, not just our female employees. In 2018 / 2019 the Trust

launched a menopause education and awareness initiative, to address one of the last

workplace health and wellbeing taboos.

2018/19 2017/18 Variance

Total Days Lost (Long Term): 40,847 37,094 0.19

Total Days Lost (Short Term): 15,009 15,618 -4.06

Total Days Lost: 55,856 52,702 5.65

Total Staff Years Lost: (Average Staff Employed in the

Period – Full

Time Equivalent)

4,119

3,633

11.8

Average Working Days Lost: 7.9 8.82 -11.65

Total Staff Employed in Period (Headcount): 4,223 4,082 3.34

Total Staff Employed in Period with No Absence

(Headcount):

2,305 1,882 18.35

Percentage Staff with No Sick Leave: 48.26 46.10 4.48

63

STAFF PO LIC IES

During 2018/19 in accordance with the Trust workforce policy review schedule, a

number of policies and procedures were reviewed and approved by the Workforce and

Organisational Development Committee. All Trust policies and procedures are equality

impact assessed against the nine protected characteristics, to ensure that they do not

discriminate against people who apply to work in the Trust or are employed by the

Trust. All Trust policies and procedures are available to access via the Trust Internet

website, via the link.

SALARY AND PENSION D I SCLOSURE T ABLES (AUDITED) – S INGLE TOTAL F I GURE OF REMU NERATION

This Remuneration Report includes a single total figure of remuneration. The amount of

pension benefits for the year which contributes to the single total figure is calculated

based on guidance provided by the NHS Business Services Authority Pensions Agency.

The amount included in the table for pension benefit is based on the increase in

accrued pension adjusted for inflation. This will generally take into account an

additional year of service together with any changes in pensionable pay. This is not an

amount which has been paid to an individual by the Trust during the year; it is a

calculation which uses information from the pension benefit table. These figures can be

influenced by many factors e.g. changes in a person’s salary, whether or not they

choose to make additional contributions to the pension scheme from their pay, and

other valuation factors affecting the pension scheme as a whole.

The salary and pension disclosures reflect the senior managers’ information. As

indicated on page 59 the senior management team consists of the Chief Executive, the

Executive Directors and the Independent Members (Non-Executive Directors), the

Director of Strategic Transformation, Planning, Performance and Estates, the Interim

Chief Operating Officer, and the Director of Corporate Governance / Trust Secretary.

64

SALARY AND PENSION D I SCLOSURE T ABLES (AUDITED) – S INGLE TOTAL F IGURE OF REMUNERATION (CONTIN UED)

2018/19 2017/18

Name and Title

Salary

(bands of

£5,000)

Other

Remuneration

(bands of

£5,000)

Benefits in

Kind (to the

nearest

£100)

Pension

benefits

(to the

nearest

£1,000)

Total (to the

nearest

£5,000)

Salary

(bands of

£5,000)

Other

Remuneration

(bands of

£5,000)

Benefits

in Kind

(to the

nearest

£100)

Pension

benefits

(to the

nearest

£1,000)

Total (to

the

nearest

£5,000)

Executive Directors and Senior Managers

Steve Ham Chief Executive

135-140 0 0 12 145-150 135-140 0 0 27 160-165

Mark Osland Executive Director of Finance & Informatics

100-105 0 0 25 125-130 100-105 0 0 21 120-125

Jacinta Abraham Medical Director

110-115 25-307 11 172 310-315 25-30 55-60 11 33 115-120

Susan Morgan Executive Director of Nursing and Service Improvement4

105-1106 0 0 33 135-140 95-100 0 0 23 115-120

Jayne Elias Executive Director of Nursing and Service Improvement5

5-10 0 0 5 5

Catherine O’Brien Chief Operating Officer2

5-10 0 0 23 10-15

Sarah Morley Executive Director of OD and Workforce

90-95 0 0 0 90-95 90 - 95 0 0 45 135-140

Carl James Director of Strategic Transformation, Planning, Performance

110-115 0 261 24 135-140 110-115 0 351 40 150-155

Georgina Galletly Director of Corporate Governance/Trust Secretary

65-70 0 0 62 130-135 65-70 0 0 22 90-95

65

Notes: 1 - Benefits in kind for J Abraham relate to taxable mileage payments; and for C James relate to use of a Trust lease car and taxable mileage payments. 2 – C O’Brien was appointed as interim Chief Operating Officer on 1 March 2019. 3 – The pension benefit is pro-rata for the period as a board member. 4 - S Morgan retired on 28 February 2019. 5 - J Elias was appointed on an interim basis from 1 March 2019. The pension benefit has not been provided by the NHS Pensions Agency and therefore the total remuneration cannot be disclosed. 6 - The 2018/19 salary for S Morgan increased as a result of job re-evaluation. 7 - The Other Remuneration paid to J Abraham relates to clinical responsibilities.

66

SALARY AND PENSION D I SCLOSURE T ABLES (AUDITED) – S INGLE TOTAL F IGU RE OF REMUNERATION (CONTIN UED)

2018/19 2017/18

Name and Title

Salary (bands

of £5,000)

Other Remuneration

(bands of £5,000)

Benefits in Kind (to the nearest £100)

Pension benefits (to the nearest £1,000)

Total (to the

nearest £5,000)

Salary (bands

of £5,000)

Other Remuneration

(bands of £5,000)

Benefits in Kind (to the nearest £100)

Pension benefits (to the nearest £1,000)

Total (to the

nearest £5,000)

Independent Members/Non -Executive Directors

Donna Mead1 35-40 0 0 0 35-40

Ray Singh 5-10 0 0 0 5-10 5-10 0 0 0 5-10

Phil Roberts3 10-15 0 0 0 10-15 5-10 0 0 0 5-10

Jane Hopkinson

5-10 0 0 0 5-10 5-10 0 0 0 5-10

Janet Pickles 5-10 0 0 0 5-10 5-10 0 0 0 5-10

Martin Veale 5-10 0 0 0 5-10 5-10 0 0 0 5-10

Stephen Harries2

15-20 0 0 0 15-20 5-10 0 0 0 5-10

Notes: 1 - D Mead was appointed Chair on 1 May 2018. Costs are pro-rata for the period. 2 - S Harries was appointed as interim Vice Chair in November 2018. 3 - P Roberts covered the Chair role in April 2018. 4 - R Kennedy ended her tenure as Chair on 31 March 2018.

67

SALARY AND PENSION DISCLOSURE

CASH EQUIVALENT TRAN SFER VALUES

A Cash Equivalent Transfer Value (CETV) is the actuarially assessed capital value of

the pension scheme benefits accrued by a member at a particular point in time. The

benefits valued are the member’s accrued benefits and any contingent spouse’s

pension payable from the scheme. A CETV is a payment made by a pension scheme

or an arrangement to secure pension benefits in another pension scheme or an

arrangement when the member leaves a scheme and chooses to transfer the benefits

accrued in their former scheme.

The pension figures shown relate to the benefits that the individual has accrued as a

consequence of their total membership of the pension scheme, not just their service in a

senior capacity to which disclosure applies. The CETV figures and the other pension

details include the value of any pension benefits in another scheme or arrangement

which the individual has transferred to the NHS pension scheme. They also include any

additional pension benefit accrued to the member as a result of their purchasing

additional years of pension service in the scheme at their own cost. CETVs are

calculated within the guidelines and framework prescribed by the Institute and Faculty of

Actuaries.

REAL INCREASE IN CET V

This reflects the increase in CETV effectively funded by the employer. It takes account

of the increase in accrued pension due to inflation, contributions paid by the employee

(including the value of any benefits transferred from another scheme or arrangement)

and uses common market valuation factors for the start and end of the period.

68

SALARY AND PENSION DI SCLOSURE T ABLES (AUDITED) – BOARD MEMB ER AND VERY SENIOR MANAGER PENSIONS

Name and Title Real increase

in pension at

age 60 (bands

of £2,500)

Real increase

in pension

lump sum at

aged 60 (bands

of £2,500)

Total accrued

pension at age

60 at 31 March

2019 (bands of

£5,000)

Lump sum at age

60 related to

accrued pension

at 31 March 2019

(bands of £5,000)

Cash

Equivalent

Transfer

Value at 31

March 2019

Cash

Equivalent

Transfer

Value at 31

March 2018

Real increase

in Cash

Equivalent

Transfer

Value

Employer’s

contribution

to

stakeholder

pension

£000 £000 £000 £000 £000 £000 £000 £000

Steve Ham

Chief Executive

0-2.5 2.5-5 35-40 110-115 906 779 84 -

Mark Osland Executive

Director of Finance &

Informatics

0-2.5 0 5-10 0 74 40 19 -

Jacinta Abraham Medical Director

7.5-10 17.5-20

35-40 90-95 764 519 210 -

Susan Morgan1

Director of Nursing and

Service Improvement

0-2.5 5-7.5 40-45 120-125 984 833 112 -

Catherine O’Brien Chief Operating Officer

0-2.5 0 15-20 0 253 192 4 -

Sarah Morley

Executive Director of OD

and Workforce

0-2.5 (2.5-5) 20-25 60-65 486 425 36 -

Carl James Director of Strategic Transformation, Planning & Performance

0-2.5 0 40-45 0 545 437 79 -

Georgina Galletly Director of Corporate Governance/Trust Secretary

2.5-5 5-7.5 20-25 45-50 343 249 77 -

Notes: 1 – S Morgan retired on 28th February 2019 and J Elias was appointed on an Interim Basis. The pension benefit for J Elias has not been provided by the NHS Pensions Agency and therefore cannot be disclosed. 2 - As Independent Members do not receive pensionable remuneration, there are no entries in respect of pensions for Independent Members.

67

REPORTING OF OT HER C OMPENSATION SC HEMES – EX IT PAC KAGES

During 2018/19 exit packages were approved for 16 staff with a value of £434,256.

These packages were paid in accordance with recognised NHS terms and conditions of

service/Trust Policy. None of the exit packages reported related to senior officers and

none of the payments related to a special severance payment. The actual date of

departure might be in a subsequent period.

REMUNERATION RELATIO NSHI P

Reporting bodies are required to disclose the relationship between the remuneration of

the highest paid Director in their organisation and the median remuneration of the

organisation’s workforce.

The banded remuneration of the highest paid Director in Velindre University NHS Trust

in the financial year 2018/19 was £135,000 - £140,000 (2017/18, £135,000 - £140,000).

This was 5.0 times (2017/18, 5.2) the median remuneration of the workforce, which was

£27,581 (2017/18, £26,244).

In 2018/19, 14 (2017/18, 10) employees received remuneration in excess of the highest

paid Director. These employees are Medical Consultants.

Remuneration for all staff ranged from £17,500 to £202,700 (2017/18 £16,300 to

£205,600).

Total remuneration includes salary and benefits in kind. It does not include severance

payments, employer pension contributions and the cash equivalent transfer value of

pensions.

Overtime payments are included in the calculation of both elements of the relationship.

In establishing the highest paid Director (Chief Executive) the Trust has taken into

account the proportion of remuneration received by Directors for clinical and director

responsibilities.

68

EXPENDIT URE ON CONSU LTANCY

During 2018/19 the Trust spent £1,758,801 on external consultancy fees (£1,109,204

related to the NHS Wales Informatics Service). Examples include:

Accountancy fees

Legal fees

Design fees

Project management fees & support costs

IT consultancy and advice

Fees relating to building management, including surveyor & electrical costs.

TAX ASSURANC E FO R OF F-PAYROLL ENGAGEMENT S

Following the Review of Tax Arrangements of Public Sector Appointees published by

the Chief Secretary to the Treasury on 23 May 2012, departments must publish

information on their highly paid and/or senior off-payroll engagements. The information,

contained in the three tables below, includes all off-payroll engagements as at 31 March

2019 for those earning more than £245 per day and that last longer than six months for

the core department, its executive agencies and its arm’s length bodies.

Table 1: For all off-payroll engagements as of 31 March 2019, for those earning more

than £245 per day and that last for longer than six months

No. of Existing Engagements as of 31 March 2019 29

Of which the number that have existed:

for less than one year at time of reporting. 8

for between one and two years at time of reporting. 15

for between two and three years at time of reporting. 5

No. that have existed for between three and four years at time of

reporting. 1

No. that have existed for four or more years at time of reporting. 0

69

Within the total number of off-payroll engagements disclosed, two engagements related

to staff seconded from other NHS Wales Organisations.

All the off-payroll engagements, outlined above, have at some point been subject to a

risk based assessment as to whether assurance is required that the individual is paying

the right amount of tax, and where necessary, that assurance has been sought.

Table 2: For all new off-payroll engagements, or those that reached six months in

duration, between 1st April 2018 and 31 March 2019, for more than £245 per day and

that last for longer than six months

No. of new engagements, or those that reached six months in

duration, between 1st April 2018 and 31 March 2019 18

Of which:

No. assessed as caught by IR 35 17

No. assessed as not caught by IR 35 1

No. engaged directly (via PSC contracted to department) and are

on the departmental payroll. 0

No. of engagements reassessed for consistency/assurance

purposes during the year 16

No. of engagements that saw a change to IR 35 status following

the consistency review 0

Within the total number of new off-payroll engagements disclosed, no engagements

related to staff seconded from another NHS Wales Organisations.

Table 3: For any off-payroll engagements of board members, and/or, senior officials

with significant financial responsibility, between 1st April 2018 and 31 March 2019

No. of off-payroll engagements of board members, and/or, senior

officials with significant financial responsibility, during the financial

year.

0

No. of individuals that have been deemed “board members, and/or,

senior officials with significant financial responsibility”, during the

financial year. This figure should include both off-payroll and on-

payroll engagements.

0

70

NATIONAL ASSEMBLY FOR WALES ACCOUNTABILITY AND AUDIT REPORT

Where the Trust undertakes activities that are not funded directly by the Welsh

Government the Trust receives income to cover its costs. Further detail of income

received is published in the Trust’s annual accounts; within note 4 headed ‘other

operating revenue’.

The Trust confirms it has complied with cost allocation and the charging requirements

set out in HM Treasury guidance during the year.

The Trust ensures public funds are used appropriately and to deliver the intended

objectives. Expenditure is compliant with the relevant legislation. Charges for services

provided by public sector organisations pass on the full cost of providing those services.

The Trust hosts the Welsh Risk Pool (WRP) as part of NHS Wales Shared Services

Partnership (NWSSP) and therefore its accounts include the estimates of remote

contingent liabilities from Welsh Health Organisations for potential litigation claims that

could arise in the future due to known incidents. In 2018/19, the financial statements of

the Trust are reporting total remote contingent liabilities of £17.5m.

71

THE CERTIFICATE AND INDEPENDENT AUDITOR’S REPORT OF THE AUDITOR

GENERAL FOR WALES TO THE NATIONAL ASSEMBLY FOR WALES

REPORT ON THE AUDIT OF T HE F INANCIAL STA TEMENT S

Opinion I certify that I have audited the financial statements of Velindre University NHS Trust for the year ended 31 March 2019 under Section 61 of the Public Audit (Wales) Act 2004. These comprise the Statement of Comprehensive Income, the Statement of Financial Position, the Cash Flow Statement and the Statement of Changes in Tax Payers Equity and related notes, including a summary of significant accounting policies. The financial reporting framework that has been applied in their preparation is applicable law and HM Treasury’s Financial Reporting Manual based on International Financial Reporting Standards (IFRSs). In my opinion the financial statements:

give a true and fair view of the state of affairs of Velindre University NHS

Trust as at 31 March 2019 and of its surplus for the year then ended; and

have been properly prepared in accordance with the National Health Service

(Wales) Act 2006 and directions made there under by Welsh Ministers.

Basis for opinion I conducted my audit in accordance with applicable law and International Standards on Auditing in the UK (ISAs (UK)). My responsibilities under those standards are further described in the auditor’s responsibilities for the audit of the financial statements section of my report. I am independent of the Trust in accordance with the ethical requirements that are relevant to my audit of the financial statements in the UK including the Financial Reporting Council’s Ethical Standard, and I have fulfilled my other ethical responsibilities in accordance with these requirements. I believe that the audit evidence I have obtained is sufficient and appropriate to provide a basis for my opinion.

72

Conclusions relating to going concern I have nothing to report in respect of the following matters in relation to which the ISAs (UK) require me to report to you where:

the use of the going concern basis of accounting in the preparation of the

financial statements is not appropriate; or

the Chief Executive has not disclosed in the financial statements any

identified material uncertainties that may cast significant doubt about the

Trust’s ability to continue to adopt the going concern basis of accounting for a

period of at least twelve months from the date when the financial statements

are authorised for issue.

Other information The Chief Executive is responsible for the other information in the annual report and accounts. The other information comprises the information included in the annual report other than the financial statements and my auditor’s report thereon. My opinion on the financial statements does not cover the other information and, except to the extent otherwise explicitly stated in my report, I do not express any form of assurance conclusion thereon. In connection with my audit of the financial statements, my responsibility is to read the other information to identify material inconsistencies with the audited financial statements and to identify any information that is apparently materially incorrect based on, or materially inconsistent with, the knowledge acquired by me in the course of performing the audit. If I become aware of any apparent material misstatements or inconsistencies I consider the implications for my report. Opinion on regularity In my opinion, in all material respects, the expenditure and income in the financial statements have been applied to the purposes intended by the National Assembly for Wales and the financial transactions recorded in the financial statements conform to the authorities which govern them.

REPORT ON OTHER REQU I REMENTS

Opinion on other matters In my opinion, the part of the remuneration report to be audited has been properly prepared in accordance with the National Health Service (Wales) Act 2006 and directions made there under by Welsh Ministers. In my opinion, based on the work undertaken in the course of my audit:

73

the information given in the Governance Statement for the financial year for

which the financial statements are prepared is consistent with the financial

statements and the Governance Statement has been prepared in accordance

with Welsh Ministers’ guidance;

the information given in the Foreword and Accountability Report for the

financial year for which the financial statements are prepared is consistent

with the financial statements and the Foreword and Accountability Report

have been prepared in accordance with Welsh Ministers’ guidance.

Matters on which I report by exception

In the light of the knowledge and understanding of the Trust and its environment

obtained in the course of the audit, I have not identified material misstatements in the

Foreword and Accountability Report or the Governance Statement.

I have nothing to report in respect of the following matters, which I report to you, if, in my opinion:

proper accounting records have not been kept;

the financial statements are not in agreement with the accounting records and

returns;

information specified by HM Treasury or Welsh Ministers regarding

remuneration and other transactions is not disclosed; or

I have not received all the information and explanations I require for my audit.

Report I have no observations to make on these financial statements.

RESPONSIBI L IT IES

Responsibilities of Directors and the Chief Executive As explained more fully in the Statements of Directors’ and Chief Executive’s Responsibilities [set out on pages ... and ...], the Directors and the Chief Executive are responsible for the preparation of financial statements which give a true and fair view and for such internal control as the Directors and Chief Executive determine is necessary to enable the preparation of financial statements that are free from material misstatement, whether due to fraud or error. In preparing the financial statements, the Directors and Chief Executive are responsible for assessing the Trust’s ability to continue as a going concern, disclosing as applicable,

74

matters related to going concern and using the going concern basis of accounting unless deemed inappropriate. Auditor’s responsibilities for the audit of the financial statements My objectives are to obtain reasonable assurance about whether the financial statements as a whole are free from material misstatement, whether due to fraud or error, and to issue an auditor’s report that includes my opinion. Reasonable assurance is a high level of assurance, but is not a guarantee that an audit conducted in accordance with ISAs (UK) will always detect a material misstatement when it exists. Misstatements can arise from fraud or error and are considered material if, individually or in the aggregate, they could reasonably be expected to influence the economic decisions of users taken on the basis of these financial statements. A further description of the auditor’s responsibilities for the audit of the financial statements is located on the Financial Reporting Council's website www.frc.org.uk/auditorsresponsibilities. This description forms part of my auditor’s report. Responsibilities for regularity The Chief Executive is responsible for ensuring the regularity of financial transactions. I am required to obtain sufficient evidence to give reasonable assurance that the expenditure and income have been applied to the purposes intended by the National Assembly for Wales and the financial transactions conform to the authorities which govern them. Adrian Crompton 24 Cathedral Road

Auditor General for Wales Cardiff

11 June 2019 CF11 9LJ

Velindre University NHS Trust Annual Accounts 2018-19

Foreword

Velindre University NHS Trust

These accounts for the period ended 31 March 2019 have been prepared to comply with InternationalFinancial Reporting Standards (IFRS) adopted by the European Union, in accordance with HMTreasury's FReM by Velindre University NHS Trust under schedule 9 section 178 Para 3 (1) of theNational Health Service (Wales) Act 2006 (c.42) in the form in which the Welsh Ministers, with theapproval of the Treasury, directed.

Statutory background

The Trust was established by Statutory Instrument on 1 April 1994, and at that time was a singlespecialty Trust providing only Cancer Services. Over the last 25 years, the Trust has significantlyevolved and expanded. The main function of the Trust is to provide all-Wales and regional clinicalhealth services to the NHS and the people of Wales. Velindre University NHS Trust consists of twoclinical divisions: the Welsh Blood Service and Velindre Cancer Centre.

In addition to the above services, the Trust is host to a number of organisations. At period ended 31March 2019, these included:

- NHS Wales Informatics Service (NWIS) which was establisted as a hosted body on 1 April 2010;- NHS Wales Shared Services Partnership (NWSSP) which was established as a hosted body on 1June 2012. Following the initial establishment, the functions of a number of separate bodies havebeen transferred into NWSSP. During the 2018-19 financial year, the NHS Wales' WorkforceEducation and Development Services (WEDS), which was part of NWSSP, was transferred from theTrust into the newly established Health Education and Improvement Wales (HEIW); and- Health Technology Wales (HTW) which continued to receive grant funding from Welsh Governmentunder the Efficiency through Technology Programme.

Performance Management and Financial Results

This Welsh Health Circular WHC/2016/054 replaces WHC/2015/014 ‘Statutory and AdministrativeFinancial Duties of NHS Trusts and Local Health Boards’ and further clarifies the statutory financialduties of NHS Wales bodies and is effective for 2018-19. The annual financial duty has been revokedand the statutory breakeven duty has reverted to a three year duty, with the first assessment of thisduty in 2016-17.

Under the National Health Services (Wales) Act 2006 the financial obligations of the NHS Trust arecontained within Schedules 4 2(1) and 4 2(2). Each NHS Trust is required to achieve financialbreakeven over a rolling 3 year period and must ensure that its revenue is not less than sufficient,taking one financial year with another, to meet outgoings properly chargeable to the revenue account.The first assessment of performance against the 3-year statutory duty under Schedules 4 2(1) and 42(2) was at the end of 2016-17, being the first three year period of assessment.

1

Velindre University NHS Trust Annual Accounts 2018-19

STATEMENT OF COMPREHENSIVE INCOME FOR THE YEAR ENDED 31 MARCH 2019

2018-19 2017-18 2018-19 2017-18

Note £000 £000 £000 £000

Consolidated

Revenue from patient care activities 3 244,367 409,573 244,367 409,573

Other operating revenue 4 280,679 301,613 281,240 303,255

Operating expenses 5.1 (528,132) (716,574) (529,092) (717,235)

Operating (deficit)/surplus (3,086) (5,388) (3,485) (4,407)

Investment revenue 6 100 59 254 230

Other gains and losses 7 45 98 45 98

Finance costs 8 2,996 5,285 2,996 5,285

Consolidated Total (190) 1,206

Retained surplus 2.1.1 55 54

Other Comprehensive Income

Items that will not be reclassified to net operating costs:

Net gain/(loss) on revaluation of property, plant and equipment 849 (1,292) 849 (1,292)

Net gain/(loss) on revaluation of intangible assets 0 0 0 0

Net gain/(loss) on revaluation of financial assets 0 0 146 (176)

Movements in other reserves 0 0 0 0

Net gain/(loss) on revaluation of PPE and Intangible assets held for sale 0 0 0 0

Net gain/(loss) on revaluation of financial assets held for sale 0 0 0 0

Impairments and reversals 0 0 0 0

Transfers between reserves 0 0 0 0

Net gain/loss on Other Reserve 0 0 0 0

Reclassification adjustment on disposal of available for sale financial assets 0 0 0 0

Sub total 849 (1,292) 995 (1,468)

Items that may be reclassified subsequently to net operating costs

Net gain/(loss) on revaluation of financial assets held for sale 0 0 0 0

Sub total 0 0 0 0

Total other comprehensive income for the year 849 (1,292) 995 (1,468)

Total comprehensive income for the year 904 (1,238) 805 (262)

The notes on pages 6 to 66 form part of these accounts.

2

Velindre University NHS Trust Annual Accounts 2018-19

STATEMENT OF FINANCIAL POSITION AS AT 31 MARCH 2019

Note 31 March 31 March 31 March 31 March

2019 2018 2019 2018

Consolidated

£000 £000 £000 £000

Non-current assets Property, plant and equipment 13 126,554 106,971 126,554 106,971

Intangible assets 14 15,043 18,872 15,043 18,872

Trade and other receivables 17.1 798,646 782,239 798,646 782,239

Other financial assets 18 0 0 5,406 5,567

Total non-current assets 940,243 908,082 945,649 913,649

Current assets Inventories 16.1 8,960 6,023 8,960 6,023

Trade and other receivables 17.1 384,216 377,820 383,846 377,860

Other financial assets 18 0 0 0 0

Cash and cash equivalents 19 20,949 19,893 22,384 20,937

414,125 403,736 415,190 404,820

Non-current assets held for sale 13.2 0 0 0 0

Total current assets 414,125 403,736 415,190 404,820

Total assets 1,354,368 1,311,818 1,360,839 1,318,469

Current liabilities Trade and other payables 20 (122,983) (113,232) (123,099) (113,422)

Borrowings 21 (24) (24) (24) (24)

Other financial liabilities 22 0 0 0 0

Provisions 23 (283,743) (281,866) (283,743) (281,866)

Total current liabilities (406,750) (395,122) (406,866) (395,312)

Net current assets/(liabilities) 7,375 8,614 8,324 9,508

Total assets less current liabilities 947,618 916,696 953,973 923,157

Non-current liabilities Trade and other payables 20 0 0 0 0

Borrowings 21 (29) (52) (29) (52)

Other financial liabilities 22 0 0 0 0

Provisions 23 (799,411) (782,654) (799,411) (782,654)

Total non-current liabilities (799,440) (782,706) (799,440) (782,706)

Total assets employed 148,178 133,990 154,533 140,451

Financed by Taxpayers' equity:

Retained earnings 12,353 13,945 12,353 13,945

Public dividend capital 108,461 93,567 108,461 93,567

Revaluation reserve 27,364 26,478 27,364 26,478

Other reserves 0 0 0 0

Funds Held on Trust Reserves 6,355 6,461

Total taxpayers' equity 148,178 133,990 154,533 140,451

Steve Ham, Chief Executive and Accountable Officer Date: 28th May 2019

The notes on pages 6 to 66 form part of these accounts.

The financial statements were approved by the Board on 28th May 2019 and signed on behalf of the Board by:

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Velindre University NHS Trust Annual Accounts 2018-19

STATEMENT OF CHANGES IN TAXPAYERS' EQUITY

Restated

2018-19

Public

Dividend

Capital

Retained

earnings

Revaluation

reserve

Other

reserves Total

FHOT

Reserves

Consolidated

Total

£000 £000 £000 £000 £000 £000 £000Changes in taxpayers' equity for 2018-

19

Balance as at 31 March 2018 93,567 13,945 26,478 0 133,990 6,461 140,451

Adjustment for Implementation of IFRS 9 0 (1,610) 0 0 (1,610) 0 (1,610)

Balance at 1 April 2018 93,567 12,335 26,478 0 132,380 6,461 138,841

Retained surplus/(deficit) for the year 55 55 55Net gain/(loss) on revaluation of property,

plant and equipment 0 849 0 849 849

Net gain/(loss) on revaluation of intangible

assets 0 0 0 0 0

Net gain/(loss) on revaluation of financial

assets 0 0 0 0 146 146

Net gain/(loss) on revaluation of PPE and

Intangible assets held for sale 0 0 0 0 0

Net gain/(loss) on revaluation of financial

assets held for sale 0 0 0 0 0

Impairments and reversals 0 0 0 0 0

Movements in other reserves 0 0 0 0 0

Transfers between reserves (37) 37 0 0 0Reclassification adjustment on disposal of

available for sale financial assets 0 0 0 0 0

Reserves eliminated on dissolution 0 0 0

Net gain/loss on Other Reserve (specify) 0 0 0

Total in year movement 0 18 886 0 904 146 1,050

New Public Dividend Capital received 14,894 14,894 14,894

Public Dividend Capital repaid in year 0 0 0

Public Dividend Capital

extinguished/written off 0 0 0

Other movements in PDC in year 0 0 0

FHoT - Endowment 0 0 0

FHoT - Restricted 0 0 0

FHoT - Unrestricted 0 (252) (252)

Balance at 31 March 2019 108,461 12,353 27,364 0 148,178 6,355 154,533

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Velindre University NHS Trust Annual Accounts 2018-19

STATEMENT OF CHANGES IN TAXPAYERS' EQUITY

2017-18

Public

Dividend

Capital

Retained

earnings

Revaluation

reserve

Other

reserves Total

Funds held

on Trust

Reserves

Consolidated

Total

£000 £000 £000 £000 £000 £000 £000

Changes in taxpayers' equity for 2017-

18

Balance at 1 April 2017 94,969 13,813 27,848 0 136,630 5,489 142,119

Retained surplus/(deficit) for the year 54 54 54

Net gain/(loss) on revaluation of property,

plant and equipment 0 (1,292) 0 (1,292) (1,292)

Net gain/(loss) on revaluation of intangible

assets 0 0 0 0 0

Net gain/(loss) on revaluation of financial

assets 0 0 0 0 (176) (176)

Net gain/(loss) on revaluation of PPE and

Intangible assets held for sale 0 0 0 0 0

Net gain/(loss) on revaluation of financial

assets held for sale 0 0 0 0 0

Impairments and reversals 0 0 0 0 0

Movements in other reserves 0 0 0 0 0

Transfers between reserves 78 (78) 0 0 0

Reclassification adjustment on disposal of

available for sale financial assets 0 0 0 0 0

Reserves eliminated on dissolution 0 0 0

Net gain/loss on Other Reserve (specify) 0 0 0

Total in year movement 0 132 (1,370) 0 (1,238) (176) (1,414)

New Public Dividend Capital received 0 0 0

Public Dividend Capital repaid in year (1,402) (1,402) (1,402)

Public Dividend Capital

extinguished/written off 0 0 0

Other movements in PDC in year 0 0 0

FHoT - Endowment 0 0 0

FHoT - Restricted 0 0 0

FHoT - Unrestricted 0 1,148 1,148

Balance at 31 March 2018 93,567 13,945 26,478 0 133,990 6,461 140,451

The notes on pages 6 to 66 form part of these accounts.

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Velindre University NHS Trust Annual Accounts 2018-19

Reclassified Reclassified

2018-19 2017-18 2018-19 2017-18

Note £000 £000 £000 £000

Cash flows from operating activities NHST Consolidated

Operating surplus/(deficit) SOCI (3,086) (5,388) (3,485) (4,407)

Movements in working capital 30 (17,393) (198,534) (16,772) (198,534)

Other cash flow adjustments 31 145,485 317,228 145,485 316,655

Provisions utilised (110,409) (98,490) (110,409) (98,490)

Interest paid (3) (3) (3) (3)

Net cash inflow (outflow) from operating activities 14,594 14,813 14,816 15,221

Cash flows from investing activities

Interest received 100 59 254 230

(Payments) for property, plant and equipment (25,366) (9,868) (25,366) (9,868)

Proceeds from disposal of property, plant and equipment 45 98 45 98

(Payments) for intangible assets (3,188) (2,701) (3,188) (2,701)

Proceeds from disposal of intangible assets 0 0 0 0

(Payments) for investments with Welsh Government 0 0 0 0

Proceeds from disposal of investments with Welsh Government 0 0 0 0

(Payments) for financial assets. 0 0 (328) (1,547)

Proceeds from disposal of financial assets. 0 0 343 1,418

Rental proceeds 0 0 0 0

Net cash inflow (outflow) from investing activities (28,409) (12,412) (28,240) (12,370)

Net cash inflow (outflow) before financing (13,815) 2,401 (13,424) 2,851

Cash flows from financing activities

Public Dividend Capital received 14,894 0 14,894 0

Public Dividend Capital repaid 0 (1,402) 0 (1,402)

Loans received from Welsh Government 0 0 0 0

Other loans received 0 0 0 0

Loans repaid to Welsh Government 0 0 0 0

Other loans repaid 0 0 0 0

Other capital receipts 0 0 0 0

Capital elements of finance leases and on-SOFP PFI (23) 6 (23) 6

Cash transferred (to)/from other NHS Wales bodies 0 0 0 0

Net cash inflow (outflow) from financing activities 14,871 (1,396) 14,871 (1,396)

Net increase (decrease) in cash and cash equivalents 1,056 1,005 1,447 1,455

Cash [and] cash equivalents 19 19,893 18,888 20,937 19,482

at the beginning of the financial year

Cash [and] cash equivalents

at the end of the financial year 19 20,949 19,893 22,384 20,937

The notes on pages 6 to 66 form part of these accounts.

STATEMENT OF CASH FLOWS FOR THE YEAR ENDED 31 MARCH 2019

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Velindre University NHS Trust Annual Accounts 2018-19

Notes to the Accounts

Accounting policies

1. Accounting policies

The Minister for Health and Social Services has directed that the financial statements of NHS Trusts in Walesshall meet the accounting requirements of the NHS Trust Manual for Accounts. Consequently, the followingfinancial statements have been prepared in accordance with the 2018-19 NHS Trust Manual for Accounts. Theaccounting policies contained in that manual follow the European Union version of the International FinancialReporting Standards to the extent that they are meaningful and appropriate to the NHS, as determined by HMTreasury, which is advised by the Financial Reporting Advisory Board. Where the NHS Trust's Manual forAccounts permits a choice of accounting policy, the accounting policy which is judged to be most appropriate tothe particular circumstances of the Trust for the purpose of giving a true and fair view has been selected. Theparticular policies adopted by the Trust are described below. They have been applied consistently in dealing withitems considered material in relation to the accounts.

1.1 Accounting convention and basis of consolidationThese accounts have been prepared under the historical cost convention modified to account for the revaluation ofproperty, plant and equipment, intangible assets and inventories.

1.2 Acquisitions and discontinued operationsActivities are considered to be ‘acquired’ only if they are taken on from outside the public sector. Activities areconsidered to be ‘discontinued’ only if they cease entirely. They are not considered to be ‘discontinued’ if theytransfer from one public sector body to another.

1.3 RevenueRevenue in respect of services provided is recognised when, and to the extent that, performance occurs, and ismeasured at the fair value of the consideration receivable.

Where income is received from Non NHS bodies for a specific activity that is to be delivered in the following yearthat income is deferred. Only non-NHS income may be deferred.

The Trust receives income under the NHS Injury Cost Recovery Scheme, designed to reclaim the cost of treatinginjured individuals to whom personal injury compensation has subsequently been paid e.g. by an insurer. TheTrust recognises the income when it receives notification from the Department of Work and Pension'sCompensation Recovery Unit that the individual has lodged a compensation claim. The income is measured at theagreed tariff for the treatments provided to the injured individual, less a provision for unsuccessful compensationclaims and doubtful debts. Interest revenue is accrued on a time basis, by reference to the principal outstandingand interest rate applicable.

From 2018-19, IFRS 15 Revenue from Contracts with Customers is applied, as interpreted and adapted for thepublic sector, in the Financial Reporting Manual (FReM). It replaces the previous standards IAS 11 ConstructionContracts and IAS 18 Revenue and related IFRIC and SIC interpretations. Upon transition the accounting policyto retrospectively restate in accordance with IAS 8 has been withdrawn. All entities applying the FReM shallrecognise the difference between previous carrying amount and the carrying amount at the beginning of theannual reporting period that includes the date of initial application in the opening general fund within Taxpayer'sequity.

A review consistent with the portfolio approach was undertaken by the NHS Technical Accounting Groupmembers, which

• identified that the only material income that would potentially require adjustment under IFRS 15 was that forpatient care provided under Long term Agreements (LTAs) for episodes of care which had started but notconcluded as at the end of the financial period;

• demonstrated that the potential amendments to NHS Wales NHS Trust and Local Health Board Accounts asa result of the adoption of IFRS 15 are significantly below materiality levels.

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Velindre University NHS Trust Annual Accounts 2018-19

Under the Conceptual IFRS Framework due consideration must be given to the users of the accountsand the cost restraint of compliance and reporting and production of financial reporting. Given theincome for LTA activity is recognised in accordance with established NHS Terms and Conditions,affecting multiple parties across NHS Wales, it was considered reasonable to continue recognising inaccordance with those established terms, on the basis that this provides information that is relevant tothe user and to do so does not result in a material misstatement of the figures reported.

1.4 Employee BenefitsSalaries, wages and employment-related payments are recognised in the period in which the service isreceived from employees. The cost of leave earned but not yet taken by employees at the end of theperiod is recognised in the financial statements to the extent that employees are permitted to carryforward leave into the following period.

Retirement benefit costsPast and present employees are covered by the provisions of the NHS Pensions Scheme. Thescheme is an unfunded, defined benefit scheme that covers NHS employers, General Practices andother bodies, allowed under the direction of the Secretary of State, in England and Wales. The schemeis not designed to be run in a way that would enable NHS bodies to identify their share of theunderlying scheme assets and liabilities. Therefore, the scheme is accounted for as if it were a definedcontribution scheme: the cost to the NHS body of participating in the scheme is taken as equal to thecontributions payable to the scheme for the accounting period.

For early retirements other than those due to ill health the additional pension liabilities are not fundedby the scheme. The full amount of the liability for the additional costs is charged to expenditure at thetime the trust commits itself to the retirement, regardless of the method of payment.

Where employees are members of the Local Government Superannuation Scheme, which is a definedbenefit pension scheme this is disclosed. The scheme assets and liabilities attributable to thoseemployees can be identified and are recognised in the accounts. The assets are measured at fairvalue and the liabilities at the present value of the future obligations. The increase in the liability arisingfrom pensionable service earned during the year is recognised within operating expenses. Theexpected gain during the year from scheme assets is recognised within finance income. The interestcost during the year arising from the unwinding of the discount on the scheme liabilities is recognisedwithin finance costs.

NEST Pension SchemeThe NHS Trust has to offer an alternative pension scheme for employees not eligible to join the NHSPension scheme. The NEST (National Employment Savings Trust) Pension scheme is a definedcontribution scheme and therefore the cost to the NHS body of participating in the scheme is equal tothe contributions payable to the scheme for the accounting period.

1.5 Other expensesOther operating expenses for goods or services are recognised when they have been received. Theyare measured at the fair value of the consideration payable.

1.6 Property, plant and equipmentRecognitionProperty, plant and equipment is capitalised if:● it is held for use in delivering services or for administrative purposes;● it is probable that future economic benefits will flow to the Trust, or service potential will be

supplied;● it is expected to be used for more than one financial year;● the cost of the item can be measured reliably; and● the item has cost of at least £5,000; or

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Velindre University NHS Trust Annual Accounts 2018-19

● Collectively, a number of items have a cost of at least £5,000 and individually have a cost of more

than £250, where the assets are functionally interdependent, they had broadly simultaneouspurchase dates, are anticipated to have simultaneous disposal dates and are under singlemanagerial control; or

● Items form part of the initial equipping and setting-up cost of a new building, ward or unit,irrespective of their individual or collective cost.

Where a large asset, for example a building, includes a number of components with significantlydifferent asset lives, the components are depreciated over their own useful economic lives.

Valuation

All property, plant and equipment are measured initially at cost, representing the cost directly

attributable to acquiring or constructing the asset and bringing it to the location and condition

necessary for it to be capable of operating in the manner intended by management.

Land and buildings used for the trust’s services or for administrative purposes are stated in the balance

sheet at their revalued amounts less any subsequent accumulated depreciation and impairment losses.

Revaluations are performed with sufficient regularity to ensure that carrying amounts are not materially

different from those that would be determined at the balance sheet date. Fair values are determined

as follows:

- Land and non specialised buildings – market value for existing use

- Specialised buildings – depreciated replacement cost

From 1 April 2009 the depreciated replacement cost valuation applies the Modern Equivalent Asset

(MEA) cost basis of estimation to arrive at the cost of replacing the capacity and utility of a building

rather than a like for like replacement cost.

Properties in the course of construction for service or administration purposes are carried at cost, less

any impairment loss. Cost includes professional fees but not borrowing costs, which are recognised as

expenses immediately, as allowed by IAS 23 for assets held at fair value. Assets are revalued and

depreciation commences when they are brought into use.

From 2015-16, IFRS 13 Fair Value Measurement must be complied with in full. However, IAS 16 and

IAS 38 have been adapted for the public sector context which limits the circumstances under which a

valuation is prepared under IFRS 13. Assets which are held for their service potential and are in use

should be measured at their current value in existing use. For specialised assets current value in

existing use should be interpreted as the present value of the assets remaining service potential, which

can be assumed to be at least equal to the cost of replacing that service potential. Where there is no

single class of asset that falls within IFRS 13, disclosures should be for material items only.

In accordance with the adaptation of IAS 16 in table 6.2 of the FREM, for non-specialised assets in

operational use, current value in existing use is interpreted as market value for existing use which is

defined in the RICS Red Book as Existing Use Value (EUV).

Assets which were most recently held for their service potential but are surplus should be valued at

current value in existing use, if there are restrictions on the entity or the asset which would prevent

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Velindre University NHS Trust Annual Accounts 2018-19

access to the market at the reporting date. If the Trust could access the market then the surplus assetshould be used at fair value using IFRS 13. In determining whether such an asset which is not in use issurplus, an assessment should be made on whether there is a clear plan to bring the asset back into useas an operational asset. Where there is a clear plan, the asset is not surplus and the current value inexisting use should be maintained. Otherwise the asset should be assessed as being surplus and valuedunder IFRS13.

In 2017-18 a formal revaluation exercise by the District Valuation Office was applied to the Land andProperties of NHS Wales Trusts. The carrying value of existing assets at that date was written off overtheir remaining useful lives, new fixtures and equipment were carried at depreciated historic cost as thiswas not considered to be materially different from fair value.

An increase arising on revaluation is taken to the revaluation reserve except when it reverses animpairment for the same asset previously recognised in expenditure, in which case it is credited toexpenditure to the extent of the decrease previously charged there. A revaluation decrease that does notresult from a loss of economic value or service potential is recognised as an impairment charged to therevaluation reserve to the extent that there is a balance on the reserve for the asset and, thereafter, toexpenditure. Impairment losses that arise from a clear consumption of economic benefit should be takento expenditure. The accounting policy for this treatment changed in 2014/15, prior to which allimpairments were taken to the revaluation reserve to the extent that a balance was held for that asset andthereafter to expenditure. However, to ensure that the outcome as reflected in the reserves figure on theStatement of Financial Position is consistent with the requirements of IAS 36 had this adaptation not beenapplied, the balance on any revaluation reserve (up to the level of the impairment) to which theimpairment would have been charged under IAS 36 should be transferred to Retained earnings.

Assets which are not held for their service potential should be valued in accordance with IFRS 5 or IAS40 depending on whether the asset is actively held for sale. Where an asset is not being used to deliverservices and there is no plan to bring it back into use, with no restrictions on sale, and it does not meetthe IAS 40 and IFRS 5 criteria, these assets are surplus and are valued at fair value using IFRS 13.

Subsequent expenditureWhere subsequent expenditure enhances an asset beyond its original specification, the directlyattributable cost is capitalised. Where subsequent expenditure restores the asset to its originalspecification, the expenditure is capitalised and any existing carrying value of the item replaced is written-out and charged to operating expenses.

1.7 Intangible assetsRecognitionIntangible assets are non-monetary assets without physical substance, which are capable of saleseparately from the rest of the trust’s business or which arise from contractual or other legal rights. Theyare recognised only when it is probable that future economic benefits will flow to, or service potential beprovided to the trust; where the cost of the asset can be measured reliably, and where the cost is at least£5,000.

Intangible assets acquired separately are initially recognised at fair value. Software that is integral to theoperating of hardware, for example an operating system, is capitalised as part of the relevant item ofproperty, plant and equipment. Software that is not integral to the operation of hardware, for exampleapplication software, is capitalised as an intangible asset. Expenditure on research is not capitalised: it isrecognised as an operating expense in the period in which it is incurred. Internally-generated assets arerecognised if, and only if, all of the following have been demonstrated:● the technical feasibility of completing the intangible asset so that it will be available for use● the intention to complete the intangible asset and use it● the ability to sell or use the intangible asset● how the intangible asset will generate probable future economic benefits or service potential● the availability of adequate technical, financial and other resources to complete the intangible asset

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Velindre University NHS Trust Annual Accounts 2018-19

and sell or use it● the ability to measure reliably the expenditure attributable to the intangible asset during its development

MeasurementThe amount initially recognised for internally-generated intangible assets is the sum of the expenditureincurred from the date when the criteria above are initially met. Where no internally-generated intangibleasset can be recognised, the expenditure is recognised in the period in which it is incurred.

Following initial recognition, intangible assets are carried at fair value by reference to an active market, or,where no active market exists, at amortised replacement cost (modern equivalent assets basis), indexedfor relevant price increases, as a proxy for fair value. Internally-developed software is held at historic costto reflect the opposing effects of increases in development costs and technological advances.

1.8 Depreciation, amortisation and impairmentsFreehold land, assets under construction and assets held for sale are not depreciated.

Otherwise, depreciation and amortisation are charged to write off the costs or valuation of property, plantand equipment and intangible non-current assets, less any residual value, over their estimated usefullives, in a manner that reflects the consumption of economic benefits or service potential of the assets.The estimated useful life of an asset is the period over which the Trust expects to obtain economicbenefits or service potential from the asset. This is specific to the Trust and may be shorter than thephysical life of the asset itself. Estimated useful lives and residual values are reviewed each year end,with the effect of any changes recognised on a prospective basis. Assets held under finance leases aredepreciated over the shorter of the lease term and estimated useful lives.At each reporting period end, the trust checks whether there is any indication that any of its tangible orintangible non-current assets have suffered an impairment loss. If there is indication of an impairmentloss, the recoverable amount of the asset is estimated to determine whether there has been a loss and, ifso, its amount. Intangible assets not yet available for use are tested for impairment annually.

References in IAS 36 to the recognition of an impairment loss of a revalued asset being treated as arevaluation decrease to the extent that impairment does not exceed the amount in the revaluation surplusfor the same asset, are adapted such that only those impairment losses that do not result from a clearconsumption of economic benefit or reduction of service potential (including as a result of loss or damageresulting from normal business operations) should be taken to the revaluation reserve. Impairment lossesthat arise from a clear consumption of economic benefit should be taken to the Statement ofComprehensive Income (SOCI).

1.9 Research and developmentResearch and development expenditure is charged to operating costs in the year in which it is incurred,except insofar as it relates to a clearly defined project, which can be separated from patient care activityand the benefits can reasonably be regarded as assured. Expenditure so deferred is limited to the value offuture benefits expected and is amortised through the SOCI on a systematic basis over the periodexpected to benefit from the project.

1.10 Non-current assets held for saleNon-current assets are classified as held for sale if their carrying amount will be recovered principallythrough a sale transaction rather than through continuing use. This condition is regarded as met when thesale is highly probable, the asset is available for immediate sale in its present condition and managementis committed to the sale, which is expected to qualify for recognition as a completed sale within one yearfrom the date of classification. Non-current assets held for sale are measured at the lower of theirprevious carrying amount and fair value less costs to sell. Fair value is open market value including

alternative uses.

The profit or loss arising on disposal of an asset is the difference between the sale proceeds and thecarrying amount and is recognised in the SOCI. On disposal, the balance for the asset on the revaluationreserve is transferred to retained earnings.

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Velindre University NHS Trust Annual Accounts 2018-19

Property, plant and equipment that is to be scrapped or demolished does not qualify for recognition asheld for sale. Instead, it is retained as an operational asset and its economic life is adjusted. The assetis de-recognised when it is scrapped or demolished.

1.11 LeasesLeases are classified as finance leases when substantially all the risks and rewards of ownership aretransferred to the lessee. All other leases are classified as operating leases.

1.11.1 The Trust as lesseeProperty, plant and equipment held under finance leases are initially recognised, at the inception of thelease, at fair value or, if lower, at the present value of the minimum lease payments, with a matchingliability for the lease obligation to the lessor. Lease payments are apportioned between finance chargesand reduction of the lease obligation so as to achieve a constant rate on interest on the remainingbalance of the liability. Finance charges are recognised in calculating the Trust’s surplus/deficit.

Operating lease payments are recognised as an expense on a straight-line basis over the lease term.Lease incentives are recognised initially as a liability and subsequently as a reduction of rentals on astraight-line basis over the lease term.

Contingent rentals are recognised as an expense in the period in which they are incurred.

Where a lease is for land and buildings, the land and building components are separated and individuallyassessed as to whether they are operating or finance leases.

1.11.2 The Trust as lessorAmounts due from lessees under finance leases are recorded as receivables at the amount of the Trust’snet investment in the leases. Finance lease income is allocated to accounting periods so as to reflect aconstant periodic rate of return on the Trust’s net investment outstanding in respect of the leases.

Rental income from operating leases is recognised on a straight-line basis over the term of the lease.Initial direct costs incurred in negotiating and arranging an operating lease are added to the carryingamount of the leased asset and recognised on a straight-line basis over the lease term.

1.12 InventoriesInventories are valued at the lower of cost and net realisable value using a weighted average costformula. This is considered to be a reasonable approximation to fair value due to the high turnover ofstocks.

1.13 Cash and cash equivalentsCash is cash in hand and deposits with any financial institution repayable without penalty on notice of notmore than 24 hours. Cash equivalents are investments that mature in 3 months or less from the date ofacquisition and that are readily convertible to known amounts of cash with insignificant risk of change invalue.

In the Statement of Cash Flows, cash and cash equivalents are shown net of bank overdrafts that arerepayable on demand and that form an integral part of the Trust’s cash management.

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Velindre University NHS Trust Annual Accounts 2018-19

1.14 ProvisionsProvisions are recognised when the Trust has a present legal or constructive obligation as a result of apast event, it is probable that the Trust will be required to settle the obligation, and a reliable estimatecan be made of the amount of the obligation. The amount recognised as a provision is the bestestimate of the expenditure required to settle the obligation at the end of the reporting period, takinginto account the risks and uncertainties. Where a provision is measured using the cash flowsestimated to settle the obligation, its carrying amount is the present value of those cash flows usingdiscount rates supplied by HM Treasury.

When some or all of the economic benefits required to settle a provision are expected to be recoveredfrom a third party, the amount receivable is recognised as an asset if it is virtually certain thatreimbursements will be received and the amount of the receivable can be measured reliably.Present obligations arising under onerous contracts are recognised and measured as a provision. Anonerous contract is considered to exist where the Trust has a contract under which the unavoidablecosts of meeting the obligations under the contract exceed the economic benefits expected to bereceived under it.

A restructuring provision is recognised when the Trust has developed a detailed formal plan for therestructuring and has raised a valid expectation in those affected that it will carry out the restructuringby starting to implement the plan or announcing its main features to those affected by it. Themeasurement of a restructuring provision includes only the direct expenditures arising from therestructuring, which are those amounts that are both necessarily entailed by the restructuring and notassociated with ongoing activities of the entity.

1.14.1 Clinical Negligence and personal injury costsThe Welsh Risk Pool (WRP) operates a risk pooling scheme which is co-funded by the WelshGovernment with the option to access a risk sharing agreement funded by the participative NHS Walesbodies. The risk sharing option was not implemented in 2018-19. The WRP is hosted by the Trust.

1.15.Financial InstrumentsFrom 2018-19 IFRS 9 Financial Instruments is applied, as interpreted and adapted for the publicsector, in the FReM. The principal impact of IFRS 9 adoption by NHS Wales bodies, will be to changethe calculation basis for bad debt provisions, changing from an incurred loss basis to a lifetimeexpected credit loss (ECL) basis.

All entities applying the FReM shall recognise the difference between previous carrying amount andthe carrying amount at the beginning of the annual reporting period that includes the date of initialapplication in the opening general fund within Taxpayer's equity.

1.16 Financial assetsFinancial assets are recognised when the trust becomes party to the financial instrument contract or, inthe case of trade receivables, when the goods or services have been delivered. Financial assets arederecognised when the contractual rights have expired or the asset has been transferred.Financial assets are initially recognised at fair value.

The accounting policy choice allowed under IFRS 9 for long term trade receivables, contract assetswhich do contain a significant financing component (in accordance with IFRS 15), and leasereceivables within the scope of IAS 17 has been withdrawn and entities should always recognise aloss allowance at an amount equal to lifetime Expected Credit Losses. All entities applying the FReMshould utilise IFRS 9's simplified approach to impairment for relevant assets.NHS Wales Technical Accounting Group members reviewed the IFRS 9 requirements and determineda revised approach for the calculation of the bad debt provision, applying the principles of expectedcredit loss, using the practical expedients within IFRS9 to construct a provision matrix.

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Velindre University NHS Trust Annual Accounts 2018-19

1.16.1 Financial assets are classified into the following categories: financial assets ‘at fair value throughSoCI’; ‘held to maturity investments’; ‘available for sale’ financial assets, and ‘loans and receivables’.The classification depends on the nature and purpose of the financial assets and is determined at thetime of initial recognition.

1.16.2 Financial assets at fair value through SOCIEmbedded derivatives that have different risks and characteristics to their host contracts, and contractswith embedded derivatives whose separate value cannot be ascertained, are treated as financial assetsat fair value through SOCI. They are held at fair value, with any resultant gain or loss recognised incalculating the trust’s surplus or deficit for the accounting period. The net gain or loss incorporates anyinterest earned on the financial asset.

1.16.3 Held to maturity investmentsHeld to maturity investments are non-derivative financial assets with fixed or determinable payments andfixed maturity, and there is a positive intention and ability to hold to maturity. After initial recognition,they are held at amortised cost using the effective interest method, less any impairment. Interest isrecognised using the effective interest method.

1.16.4 Available for sale financial assetsAvailable for sale financial assets are non-derivative financial assets that are designated as available forsale or that do not fall within any of the other three financial asset classifications. They are measured atfair value with changes in value taken to the revaluation reserve, with the exception of impairmentlosses. Accumulated gains or losses are recycled to the income statement on de-recognition.

1.16.5 Loans and receivablesLoans and receivables are non-derivative financial assets with fixed or determinable payments which arenot quoted in an active market. After initial recognition, they are measured at amortised cost using theeffective interest method, less any impairment. Interest is recognised using the effective interestmethod.

For financial assets carried at amortised cost, the amount of the impairment loss is measured as thedifference between the asset’s carrying amount and the present value of the revised future cash flowsdiscounted at the asset’s original effective interest rate. The loss is recognised in expenditure and thecarrying amount of the asset is reduced through a provision for impairment of receivables.

If, in a subsequent period, the amount of the impairment loss decreases and the decrease can be relatedobjectively to an event occurring after the impairment was recognised, the previously recognisedimpairment loss is reversed through expenditure to the extent that the carrying amount of the receivableat the date of the impairment is reversed does not exceed what the amortised cost would have been hadthe impairment not been recognised.

Fair value is determined by reference to quoted market prices where possible, otherwise by valuationtechniques. The effective interest rate is the rate that exactly discounts estimated future cash receiptsthrough the expected life of the financial asset, to the initial fair value of the financial asset. At the end ofthe reporting period, the trust assesses whether any financial assets, other than those held at ‘fair valuethrough profit and loss’ are impaired. Financial assets are impaired and impairment losses recognised ifthere is objective evidence of impairment as a result of one or more events which occurred after theinitial recognition of the asset and which has an impact on the estimated future cash flows of the asset.

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Velindre University NHS Trust Annual Accounts 2018-19

1.16.6 Other financial assetsListed investments are stated at market value. Unlisted investments are included at cost as anapproximation to market value. Quoted stocks are included in the balance sheet at mid-market price, andwhere holdings are subject to bid / offer pricing their valuations are shown on a bid price. The shares arenot held for trading and accordingly are classified as available for sale. Other financial assets areclassified as available for sale investments carried at fair value within the financial statements.

1.17 Financial liabilitiesFinancial liabilities are recognised on the statement of financial position when the Trust becomes party tothe contractual provisions of the financial instrument or, in the case of trade payables, when the goods orservices have been received. Financial liabilities are de-recognised when the liability has beendischarged, that is, the liability has been paid or has expired. Loans from the Welsh Government arerecognised at historical cost.

1.17.1 Financial guarantee contract liabilitiesFinancial guarantee contract liabilities are subsequently measured at the higher of: -the premium received (or imputed) for entering into the guarantee less cumulative amortisation; -the amount of the obligation under the contract, as determined in accordance with IAS 37 Provisions,Contingent Liabilities and Contingent Assets.

1.17.2 Financial liabilities at fair value through SOCIEmbedded derivatives that have different risks and characteristics to their host contracts, and contractswith embedded derivatives whose separate value cannot be ascertained, are treated as financial liabilitiesat fair value through profit and loss. They are held at fair value, with any resultant gain or loss recognisedin the Trust’s surplus/deficit. The net gain or loss incorporates any interest payable on the financialliability..1.17.3 Other financial liabilitiesAfter initial recognition, all other financial liabilities are measured at amortised cost using the effectiveinterest method, except for loans from the Welsh Government, which are carried at historic cost. Theeffective interest rate is the rate that exactly discounts estimated future cash payments through the life ofthe asset, to the net carrying amount of the financial liability. Interest is recognised using the effectiveinterest method.

1.18 Value Added TaxMost of the activities of the trust are outside the scope of VAT and, in general, output tax does not applyand input tax on purchases is not recoverable. Irrecoverable VAT is charged to the relevant expenditurecategory or included in the capitalised purchase cost of fixed assets. Where output tax is charged orinput VAT is recoverable, the amounts are stated net of VAT.

1.19 Foreign currenciesThe Trust's functional currency and presentational currency is sterling. Transactions denominated in aforeign currency are translated into sterling at the exchange rate ruling on the dates of the transactions.At the end of the reporting period, monetary items denominated in foreign currencies are retranslated atthe spot exchange rate on 31 March. Resulting exchange gains and losses for either of these arerecognised in the trust’s surplus/deficit in the period in which they arise.

1.20 Third party assetsAssets belonging to third parties (such as money held on behalf of patients) are not recognised in theaccounts since the Trust has no beneficial interest in them.

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Velindre University NHS Trust Annual Accounts 2018-19

1.21 Losses and Special PaymentsLosses and special payments are items that the Welsh Government would not have contemplated whenit agreed funds for the health service or passed legislation. By their nature they are items that ideallyshould not arise. They are therefore subject to special control procedures compared with the generalityof payments. They are divided into different categories, which govern the way each individual case ishandled.

Losses and special payments are charged to the relevant functional headings in the income statementon an accruals basis, including losses which would have been made good through insurance cover hadNHS Trusts not been bearing their own risks (with insurance premiums then being included as normalrevenue expenditure). However, the note on losses and special payments is compiled directly from thelosses and compensations register which is prepared on a cash basis.

The Trust accounts for all losses and special payments gross (including assistance from the Welsh RiskPool). The Trust accrues or provides for the best estimate of its future payouts for certain or probableliabilities and discloses all other potential payments as contingent liabilities, unless the probability of theliabilities becoming payable is remote.

All claims for losses and special payments are provided for, where the probability of settlement of anindividual claim is over 50%. Where reliable estimates can be made, incidents of clinical negligenceagainst which a claim has not, as yet, been received are provided in the same way. Expectedreimbursements from the Welsh Risk Pool are included in debtors. For those claims where theprobability of settlement is below 50%, the liability is disclosed as a contingent liability.

1.22 Pooled budgetsThe Trust has not entered into any pooled budget arrangements with Local Authorities.

1.23 Critical Accounting Judgements and key sources of estimation uncertaintyIn the application of the trust's accounting policies, management is required to make judgements,estimates and assumptions about the carrying amounts of assets and liabilities that are not readilyapparent from other sources. The estimates and associated assumptions are based on historicalexperience and other factors that are considered to be relevant. Actual results may differ from thoseestimates and the estimates and underlying assumptions are continually reviewed. Revisions toaccounting estimates are recognised in the period in which the estimate is revised if the revision affectsonly that period, or the period of the revision and future periods if the revision affects both current andfuture periods.

1.24 Key sources of estimation uncertaintyThe following are the key assumptions concerning the future, and other key sources of estimationuncertainty at the end of the reporting period, that have a significant risk of causing a materialadjustment to the carrying amounts of assets and liabilities within the next financial year.

ProvisionsThe amount recognised as provisions give rise to significant judgement and uncertainty. The amountrecognised as a provision is the best estimate of the consideration required to settle the presentobligation at the balance sheet date, taking in to account the risks and uncertainties surrounding theobligation. Where a provision is measured using the cash flows estimated to settle the presentobligation, its carrying amount is the present value of those cash flows. A change in the assumptionscould cause an increase or decrease in the amounts recognised as a provision which could materiallyimpact the results of operations.

The NHS trust provides for legal or constructive obligations for clinical negligence, personal injury and defence costs that are of uncertain timing or amount at the balance sheet date on the basis of the best estimate of the expenditure required to settle the obligation.

Claims are funded via the Welsh Risk Pool Services (WRPS) which receives an annual allocation from Welsh Government to cover the cost of reimbursement requests submitted to the bi-monthly WRPS Committee. Following settlement to individual claimants by the Health Board or Trust, the full cost is recognised in year and matched to income (less a £25K excess) via a WRPS debtor, until reimbursement has been received from the WRPS Committee.

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Velindre University NHS Trust Annual Accounts 2018-19

Probable & Certain Cases – Accounting Treatment

A provision for these cases is calculated in accordance with IAS 37. Cases are assessed and divided intofour categories according to their probability of settlement;

Remote Probability of Settlement 0 – 5%

Accounting Treatment Contingent Liability.

Possible Probability of Settlement 6% - 49%

Accounting Treatment Defence Fee - Provision

Contingent Liability for all other estimated

expenditure.

Probable Probability of Settlement 50% - 94%Accounting Treatment Full Provision

Certain Probability of Settlement 95% - 100%

Accounting Treatment Full Provision

The provision for probable and certain cases is based on case estimates of individual reported claimsreceived by Legal & Risk Services within NHS Wales Shared Services Partnership.

The solicitor will estimate the case value including defence fees, using professional judgement and fromobtaining counsel advice. Valuations are then discounted for the future loss elements using individual lifeexpectancies and the Government Actuary’s Department actuarial tables (Ogden tables) and PersonalInjury Discount Rate of -0.75%.

Future liabilities for certain & probable cases with a probability of 95%-100% and 50%- 94% respectivelyare held as a provision on the balance sheet. Cases typically take a number of years to settle, particularlyfor high value cases where a period of development is necessary to establish the full extent of the injurycaused.

Discounting provisionsThe WRPS discounts estimated future lump sums within the provisions which are assumed to settle overa 3 year period.

A proportion of the lump sum estimates are assumed to settle with RPI indexed annual payments and theremainder as Annual Survey of Hours and Earnings (ASHE) indexed annual payments.

The HM Treasury short term nominal discount rate of 0.76% (2017/18: -2.42%) is applied to the RPIproportion of the lump sum estimate using the retail price index (RPI) inflation rate of 3.6%.The remainder is discounted by applying the Annual Survey of Hours and Earnings (ASHE) real discountrate of 0.7%.

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Velindre University NHS Trust Annual Accounts 2018-19

PPO ProvisionsThe majority of high value (>£1M) claims settle with a Periodical Payment Order (PPO) where part or allof the final settlement value is paid over the life time of the claimant.

When cases settle with a PPO arrangement, an individual provision is created by multiplying theclaimants’ index linked annual payment value by the number of years’ life expectancy. Future cashflowsare modelled based on individual claim data and includes any agreed future steps in payment value.

The number of years’ life expectancy is discounted according to the Ogden table multipliers using HMTreasury’s nominal discount rate for general provisions issued annually in the Public ExpenditureSystem (PES) paper and an inflation factor.

For 2018-19, the nominal short, medium, long and very long term rates are; 0.76%, (0-5 years),1.14%, (+5-10 years) 1.99%(+10-40 years) and 1.99% (over 40 years) respectively.

The inflation factor applied is dependent upon the rate agreed as part of the settlement of the claimant’scase. Where annual payments are required to be uplifted by the RPI, the RPI rate of 3.6% has beenused. Where annual payments are required to be uplifted based on market data for carers’ wages, theannual survey of hours and earnings (ASHE) discount rate of 0.7% has been applied.

The probabilities of survival for each claimant are based on estimated life expectancy, agreed bymedical experts in each case.

1.25 Private Finance Initiative (PFI) transactionsThe Trust has no PFI arrangements.

1.26 ContingenciesA contingent liability is a possible obligation that arises from past events and whose existence will beconfirmed only by the occurrence or non-occurrence of one or more uncertain future events not whollywithin the control of the Trust, or a present obligation that is not recognised because it is not probablethat a payment will be required to settle the obligation or the amount of the obligation cannot bemeasured sufficiently reliably. A contingent liability is disclosed unless the possibility of a payment isremote.

A contingent asset is a possible asset that arises from past events and whose existence will beconfirmed by the occurrence or non-occurrence of one or more uncertain future events not wholly withinthe control of the trust. A contingent asset is disclosed where an inflow of economic benefits isprobable.

Where the time value of money is material, contingencies are disclosed at their present value. Remotecontingent liabilities are those that are disclosed under Parliamentary reporting requirements and notunder IAS 37 and, where practical, an estimate of their financial effect is required.

1.27 Carbon Reduction Commitment SchemeCarbon Reduction Commitment Scheme allowances are accounted for as government grant fundedintangible assets if they are not realised within twelve months and otherwise as current assets. Theasset should be measured initially at cost. Scheme assets in respect of allowances shall be valued atfair value where there is evidence of an active market.

1.28 Absorption AccountingTransfers of function are accounted for as either by merger or by absorption accounting, dependentupon the treatment prescribed in the FReM. Absorption accounting requires that entities account fortheir transactions in the period in which they took place with no restatement of performance required.For transfers of functions involving NHS Wales Trusts in receipt of PDC the double entry for the fixedasset NBV value and the net movement in assets is PDC or General Reserve as appropriate.

1.29 Accounting standards that have been issued but have not yet been adoptedThe following accounting standards have been issued and or amended by the IASB and IFRIC but havenot been adopted because they are not yet required to be adopted by the FReM:

- IFRS14 Regulatory Deferral Accounts (The European Financial Reporting Advisory Grouprecommended in October 2015 that the Standard should not be endorsed as it is unlikely to be adoptedby many EU countries.),

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Velindre University NHS Trust Annual Accounts 2018-19

- IFRS 16 Leases, HMT have confirmed that IFRS 16 Leases, as interpreted and adapted by the FReM is to be effective from 1st April 2020,- IFRS 17 Insurance Contracts,- IFRIC 23 Uncertainty over Income Tax Treatment.

1.30 Accounting standards issued that have been adopted earlyDuring 2018-19 there have been no accounting standards that have been adopted early. All early adoption of accounting standards will be led by HM Treasury.

1.31 For Consolidated NHS Trust CharitiesFollowing Treasury’s agreement to apply IAS 27 to NHS Charities from 1 April 2013, the NHS Trust hasestablished that as the Trust is the corporate trustee of the linked charitable funds, Velindre UniversityNHS Trust Charitable Funds, it is considered for accounting standards compliance to have control ofVelindre University NHS Trust Charitable Funds as a subsidiary and therefore is required to consolidatethe results of Velindre University NHS Trust Charitable Funds within the statutory accounts of the Trust.

Details of the transactions with the charity are included in the related parties’ notes.

1.32 SubsidiariesMaterial entities over which the Trust has the power to exercise control so as to obtain economic or otherbenefits are classified as subsidiaries and are consolidated. Their income and expenses; gains andlosses; assets, liabilities and reserves; and cash flows are consolidated in full into the appropriatefinancial statement lines. Appropriate adjustments are made on consolidation where the subsidiary’saccounting policies are not aligned with the Trust’s or where the subsidiary’s accounting date is before 1January or after 30 June.

Subsidiaries that are classified as ‘held for sale’ are measured at the lower of their carrying amount or‘fair value less costs to sell’.

1.33 Borrowing costsBorrowing costs are recognised as expenses as they are incurred.

1.34 Public Dividend Capital (PDC) and PDC dividendPDC represents taxpayers’ equity in the NHS Trust. At any time the Minister for Health and SocialServices with the approval of HM Treasury can issue new PDC to, and require repayments of, PDC fromthe NHS Trust. PDC is recorded at the value received. As PDC is issued under legislation rather thanunder contract, it is not treated as an equity financial instrument.

From 1 April 2010 the requirement to pay a public dividend over to the Welsh Government ceased.

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Velindre University NHS Trust Annual Accounts 2018-19

2. Financial Performance

2.1 STATUTORY FINANCIAL DUTIES

2.1.1 Financial Duty

2017-19

2016-17 2017-18 2018-19 Financial

£000 £000 £000 duty

£000

Retained surplus 427 54 55 536

Less Donated asset / grant funded revenue adjustment (392) (5) (24) (421)

Adjusted surplus 35 49 31 115

2.1.2 Integrated Medium Term Plan (IMTP)

Financial duty

2018-19

to

2020-21

Status

The Minister for Health and Social Services approval

status Approved

Annual financial performance

The NHS Wales Planning Framework issued to NHS Trusts places a requirement upon NHS Trusts to prepare and submit Integrated Medium Term Plans to the Welsh Government.

The Trust has submitted an Integrated Medium Term Plan for the period 2018-19 to 2020-21 in accordance with NHS Wales Planning Framework.

Under the National Health Services (Wales) Act 2006 the financial obligations of the NHS Trust are contained within Schedules 4 2(1) and 4(2).

The Trust is required to achieve financial breakeven over a rolling 3 year period.

Welsh Health Circular WHC/2016/054 replaced WHC/2015/014 ‘Statutory and Financial Duties of Local Health Boards and NHS Trusts’ and further clarifies the statutory financial duties of NHS Wales bodies.

Velindre University NHS Trust has met its financial duty to break even over the 3 years 2016-17 to 2018-19.

Velindre University NHS Trust has met its annual financial duty to have an approved financial plan for the period 2018-19 to 2020-21.

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Velindre University NHS Trust Annual Accounts 2018-19

2. Financial Performance (cont)

2.2 ADMINISTRATIVE REQUIREMENTS

2.2.1. External financing

The Trust is given an external financing limit which it is 31 March 31 March

permitted to undershoot 2019 2018

£000 £000 £000

External financing limit set by the Welsh Government 14,894 (1,402)

Cash flow financing 13,815 (2,401)

Finance leases taken out in the year 0 0

Other capital receipts 0 0

External financing requirement 13,815 (2,401)

Undershoot (overshoot) 1,079 999

The Trust has achieved its external financing limit.

2.2.2. Creditor payment

The Trust is required to pay 95% of the number of non-NHS bills within 30 days of receipt of goods or

a valid invoice (whichever is the later). The Trust has achieved the following results:

2018-19 2017-18

Total number of non-NHS bills paid 70,966 67,985

Total number of non-NHS bills paid within target 69,141 65,288

Percentage of non-NHS bills paid within target 97.4% 96.0%

The Trust has met the target.

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Velindre University NHS Trust Annual Accounts 2018-19

3. Revenue from patient care activities 2018-19 2017-18 2018-19 2017-18

NHS Trust

£000 £000 £000 £000

Local health boards 65,772 58,994 65,772 58,994

Welsh Health Specialised & Emergency Ambulance

Services Committees (WHSSC & EASC) 40,451 39,183 40,451 39,183

Welsh NHS Trusts 1,506 4,504 1,506 4,504

Health Education and Improvement Wales (HEIW) 0 0 0 0

Other NHS England bodies 754 561 754 561

Foundation Trusts 0 0 0 0

Local Authorities 0 0 0 0

Welsh Government 3,130 1,359 3,130 1,359

Welsh Government Welsh Risk Pool Reimbursements 130,638 302,898 130,638 302,898

Other NHS Trusts 0 1 0 1

Non NHS:

Other revenue from activities 27 0 27 0

Private patient income 2,089 2,073 2,089 2,073

Overseas patients (non-reciprocal) 0 0 0 0

Injury Costs Recovery (ICR) Scheme 0 0 0 0

Total 244,367 409,573 244,367 409,573

ICR income is subject to a provision for impairment of 21.89% to reflect expected rates of collection.

4. Other operating revenue 2018-19 2017-18 2018-19 2017-18

£000 £000 £000 £000

NHS Trust

Income generation 1,323 853 1,323 853

Patient transport services 0 0 0 0

Education, training and research 4,507 2,713 4,507 2,713

Charitable and other contributions to expenditure 3,654 4,555 892 1,841

Incoming FHoT Revenue

Unrestricted - donations and legacies 3,323 4,356

Restricted - donations and legacies 0 0

Receipt of donations for capital acquisitions 24 5 24 5

Receipt of government grants for capital acquisitions 0 0 0 0

Non-patient care services to other bodies 499 717 499 717

Rental revenue from finance leases 0 0 0 0

Rental revenue from operating leases 0 0 0 0

Other revenue:

Provision of pathology/microbiology services 0 0 0 0

Accommodation and catering charges 163 149 163 149

Mortuary fees 0 0 0 0

Staff payments for use of cars 53 330 53 330

Business unit 0 0 0 0

Other 270,456 292,291 270,456 292,291

Total 280,679 301,613 281,240 303,255

Other revenue comprises:

NHS Wales Shared Services Partnership 196,131 232,647 196,131 232,647

NHS Wales Informatics Services 70,790 56,615 70,790 56,615

Other 3,535 3,029 3,535 3,029

Total 270,456 292,291 270,456 292,291

Consolidated

Consolidated

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Velindre University NHS Trust Annual Accounts 2018-19

5. Operating expenses 2018-19 2017-18 2018-19 2017-18

5.1 Operating expenses £000 £000 £000 £000

NHS Trust

Local Health Boards 5,671 3,209 5,671 3,209

Welsh NHS Trusts 330 2,066 330 2,066

Health Education and Improvement Wales (HEIW) 0 0 0 0

Goods and services from other NHS bodies 0 0 0 0

WHSSC/EASC 37 146 37 146

Local Authorities 68 52 68 52

Purchase of healthcare from non-NHS bodies 0 0 0 0

Welsh Government 0 0 0 0

Other NHS Trusts 0 3 0 3

Directors' costs 1,098 1,055 1,098 1,055

Staff costs 159,453 148,811 159,453 148,811

Supplies and services - clinical 53,984 48,334 53,984 48,334

Supplies and services - general 41,660 36,711 41,660 36,711

Consultancy Services 1,759 2,113 1,759 2,113

Establishment 14,569 13,614 14,569 13,614

Transport 2,230 1,995 2,230 1,995

Premises 42,100 31,523 42,100 31,523

FHoT Resources expended

Costs of generating funds 0 551 317

Charitable activites 0 409 344

Governance Costs 0 0 0

Impairments and Reversals of Receivables 0 0 0 0

Depreciation 9,439 9,236 9,439 9,236

Amortisation 7,027 8,359 7,027 8,359

Impairments and reversals of property, plant and equipment 0 0 0 0

Impairments and reversals of intangible assets 0 0 0 0

Impairments and reversals of financial assets 0 0 0 0

Impairments and reversals of non current assets held for sale 0 0 0 0

Audit fees 209 209 209 209

Other auditors' remuneration 0 0 0 0

Losses, special payments and irrecoverable debts 133,496 308,285 133,496 308,285

Research and development 0 0 0 0

Other operating expenses 55,002 100,853 55,002 100,853

Total 528,132 716,574 529,092 717,235

Consolidated

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Velindre University NHS Trust Annual Accounts 2018-19

5. Operating expenses (continued)

5.2 Losses, special payments and irrecoverable debts:

Charges to operating expenses 2018-19 2017-18 2018-19 2017-18

Increase/(decrease) in provision for future payments: £000 £000 £000 £000

NHS Trust

Clinical negligence 131,383 269,312 131,383 269,312

Personal injury 748 4,185 748 4,185

All other losses and special payments 1 5 1 5

Defence legal fees and other administrative costs 985 2,424 985 2,424

Structured Settlements Welsh Risk Pool 379 32,359 379 32,359

Gross increase/(decrease) in provision for future payments 133,496 308,285 133,496 308,285

Contribution to Welsh Risk Pool 0 0 0 0

Premium for other insurance arrangements 0 0 0 0

Irrecoverable debts 0 0 0 0

Less: income received/ due from Welsh Risk Pool 0 0 0 0

Total charge 133,496 308,285 133,496 308,285

Consolidated

Clinical negligence includes £1,671,439 (2017-18 £11,000) in respect of payments made under redress. A further £841,932 for thefinal quarter is within the creditor balance pending reimbursement in 2019/20. Redress was previously administered directly byWelsh Government.

Personal injury includes £nil in respect of permanent injury benefits (2017-18 £nil). This expenditure includes a change of £nilrelating to the change in the rate at which the provision for future payments is calculated.

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Velindre University NHS Trust Annual Accounts 2018-19

6. Investment revenue 2018-19 2017-18 2018-19 2017-18

Rental revenue : £000 £000 £000 £000

NHS Trust

PFI finance lease revenue:

Planned 0 0 0 0

Contingent 0 0 0 0

Other finance lease revenue 0 0 0 0

Interest revenue:

Bank accounts 100 59 100 59

Other loans and receivables 0 0 0 0

Impaired financial assets 0 0 0 0

Other financial assets 0 0 154 171

Total 100 59 254 230

7. Other gains and losses 2018-19 2017-18 2018-19 2017-18

£000 £000 £000 £000

NHS Trust

Gain/(loss) on disposal of property, plant and equipment 45 98 45 98

Gain/(loss) on disposal of intangible assets 0 0 0 0

Gain/(loss) on disposal of assets held for sale 0 0 0 0

Gain/(loss) on disposal of financial assets 0 0 0 0

Gains/(loss) on foreign exchange 0 0 0 0

Change in fair value of financial assets at fair value through income statement 0 0 0 0

Change in fair value of financial liabilities at fair value through income statement 0 0 0 0

Recycling of gain/(loss) from equity on disposal of financial assets held for sale 0 0 0 0

Total 45 98 45 98

8. Finance costs 2018-19 2017-18 2018-19 2017-18

£000 £000 £000 £000

NHS Trust

Interest on loans and overdrafts 0 0 0 0

Interest on obligations under finance leases 3 3 3 3

Interest on obligations under PFI contracts:

Main finance cost 0 0 0 0

Contingent finance cost 0 0 0 0

Interest on late payment of commercial debt 0 0 0 0

Other interest expense 0 0 0 0

Total interest expense 3 3 3 3

Provisions unwinding of discount (2,604) (5,669) (2,604) (5,669)

Periodical Payment Order unwinding of discount (395) 381 (395) 381

Other finance costs 0 0 0 0

Total (2,996) (5,285) (2,996) (5,285)

Consolidated

Consolidated

Consolidated

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Velindre University NHS Trust Annual Accounts 2018-19

9. Operating leases

9.1 Trust as lessee

Payments recognised as an expense 2018-19 2017-18 2018-19 2017-18

£000 £000 £000 £000

NHS Trust

Minimum lease payments 3,009 3,111 3,009 3,111

Contingent rents 0 0 0 0

Sub-lease payments 0 0 0 0

Total 3,009 3,111 3,009 3,111

Total future minimum lease payments 2018-19 2017-18 2018-19 2017-18

Payable: £000 £000 £000 £000

NHS Trust

Not later than one year 2,994 2,873 2,994 2,873

Between one and five years 6,606 7,095 6,606 7,095

After 5 years 1,599 1,942 1,599 1,942

Total 11,199 11,910 11,199 11,910

Total future sublease payments expected to be received 0 0 0 0

Consolidated

Consolidated

Operating lease payments represent rentals payable by Velindre University NHS Trust for properties and equipment.

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Velindre University NHS Trust Annual Accounts 2018-19

9. Operating leases (continued)

9.2 Trust as lessor

Rental Revenue

Receipts recognised as income 2018-19 2017-18 2018-19 2017-18

£000 £000 £000 £000

NHS Trust

Rent 0 0 0 0

Contingent rent 0 0 0 0

Other 0 0 0 0

Total rental revenue 0 0 0 0

Total future minimum lease payments 2018-19 2017-18 2018-19 2017-18

Receivable: £000 £000 £000 £000

NHS Trust

Not later than one year 0 0 0 0

Between one and five years 0 0 0 0

After 5 years 0 0 0 0

Total 0 0 0 0

Consolidated

Consolidated

There are no significant leasing arrangements where the Trust is the lessor.

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Velindre University NHS Trust Annual Accounts 2018-19

10. Employee costs and numbers

2018-19 2017-18

10.1 Employee costs Permanently Staff on Agency Other £000 £000

employed Inward Staff Staff

staff Secondment

£000 £000 £000 £000 £000 £000

Salaries and wages 128,997 1,132 1,843 1,281 133,253 123,214

Social security costs 12,093 36 0 0 12,129 12,697

Employer contributions to NHS Pensions Scheme 16,269 30 0 0 16,299 15,234

Other pension costs 14 0 0 0 14 5

Other post-employment benefits 0 0 0 0 0 0

Termination benefits 0 0 0 0 0 0

Total 157,373 1,198 1,843 1,281 161,695 151,150

Of the total above:

Charged to capital 1,255 1,284

Charged to revenue 160,440 149,866

Total 161,695 151,150

Net movement in accrued employee benefits (untaken staff leave accrual included above) (21) (62)

10.2 Average number of employees 2018-19 2017-18

Permanently Staff on Agency Other Total Total

Employed Inward Staff Staff

Secondment

Number Number Number Number Number Number

Administrative, clerical and board members 2,335 16 29 22 2,402 2,287

Ambulance staff 0 0 0 0 0 0

Medical and dental 470 1 0 5 476 465

Nursing, midwifery registered 184 0 1 0 185 181

Professional, scientific and technical staff 52 0 0 0 52 53

Additional Clinical Services 197 0 1 3 201 197

Allied Health Professions 110 0 8 1 119 114

Healthcare scientists 132 1 0 0 133 133

Estates and Ancillary 319 0 5 12 336 329

Students 0 0 0 0 0 1

Total 3,799 18 44 43 3,904 3,760

10.3 Retirement costs due to ill-health

10.4 Employee benefits

During 2018-19 there were 5 (2017-18, 5) early retirements from the Trust agreed on the grounds of ill-health. The estimated

additional pension costs of these ill-health retirements is £668,774 (2017-18, £285,000). The cost of these ill-health retirements

will be borne by the NHS Business Services Authority - Pensions Division.

The Trust operates four salary sacrifice schemes (childcare vouchers, cycle to work bikes, home electronics and lease cars) forthe financial benefit of its employees. It also provides an Easter and summer childcare subsidy scheme, a respite care subsidyscheme, and a purchase of annual leave scheme. In addition, staff have access to a non contributory Employee AssistanceProgramme which provides financial wellbeing support.

Other staff includes temporary workers paid directly by Velindre University NHS Trust and staff sub-contracted or recharged fromother NHS or public bodies.

27

Velindre University NHS Trust Annual Accounts 2018-19

10.5 Reporting of other compensation schemes - exit packages

2018-19 2018-19 2018-19 2018-19 2017-18

Exit packages cost band (including

any special payment element)

Number of

compulsory

redundancies

Number of

other

departures

Total number

of exit

packages

Number of

departures

where special

payments

have been

made

Total number

of exit

packages

Whole

numbers only

Whole

numbers only

Whole

numbers only

Whole

numbers only

Whole

numbers only

less than £10,000 2 0 2 0 2

£10,000 to £25,000 0 7 7 0 1

£25,000 to £50,000 1 5 6 0 5

£50,000 to £100,000 0 1 1 0 0

£100,000 to £150,000 0 0 0 0 0

£150,000 to £200,000 0 0 0 0 1

more than £200,000 0 0 0 0 0

Total 3 13 16 0 9

2018-19 2018-19 2018-19 2018-19 2017-18

Exit packages cost band (including

any special payment element)

Cost of

compulsory

redundancies

Cost of other

departures

Total cost of

exit packages

Cost of

special

element

included in

exit packages

Total cost of

exit packages

£ £ £ £ £

less than £10,000 8,397 0 8,397 0 16,013

£10,000 to £25,000 0 114,307 114,307 0 10,228

£25,000 to £50,000 28,424 211,885 240,309 0 192,446

£50,000 to £100,000 0 71,243 71,243 0 0

£100,000 to £150,000 0 0 0 0 0

£150,000 to £200,000 0 0 0 0 187,831

more than £200,000 0 0 0 0 0

Total 36,821 397,435 434,256 0 406,518

Redundancy, voluntary early release, and other departure costs have been paid in accordance with the provisions of therelevant schemes / legislation. Where the Trust has agreed early retirements or compulsory redundancies, the additional costsare met by the Trust and not by the NHS pensions scheme. Ill-health retirement costs are met by the NHS pensions scheme andare not included in the table (see note 10.3 for details of ill health retirement costs).

The disclosure reports the number and value of exit packages agreed in the year in line with the Welsh Government manual foraccounts.

28

Velindre University NHS Trust Annual Accounts 2018-19

10.6 Remuneration Relationship

Reporting bodies are required to disclose the relationship between the midpoint of the bandedremuneration of the highest-paid director/employee in their organisation and the medianremuneration of the organisation’s workforce.

The banded remuneration of the highest-paid director in Velindre University NHS Trust in thefinancial year 2018-19 was £135,000 to £140,000 (2017-18, £135,000 to £140,000). This was 5.0times (2017-18, 5.2 times) the median remuneration of the workforce, which was £27,581 (2017-18,£26,244).

In 2018-19, 14 (2017-18, 10) employees received remuneration in excess of the highest-paiddirector.

Remuneration for all staff ranged from £17,500 to £202,700 (2017-18, £16,300 to £205,600).

Total remuneration includes salary and benefits-in-kind. It does not include severance payments,employer pension contributions and the cash equivalent transfer value of pensions.

Overtime payments are included for the calculation of both elements of the relationship.

29

Velindre University NHS Trust Annual Accounts 2018-19

11. Pensions

PENSION COSTS

Past and present employees are covered by the provisions of the two NHS Pension Schemes.Details of the benefits payable and rules of the Schemes can be found on the NHS Pensionswebsite at www.nhsbsa.nhs.uk/pensions. Both are unfunded defined benefit schemes thatcover NHS employers, GP practices and other bodies, allowed under the direction of theSecretary of State for Health in England and Wales. They are not designed to be run in a waythat would enable NHS bodies to identify their share of the underlying scheme assets andliabilities. Therefore, each scheme is accounted for as if it were a defined contribution scheme:the cost to the NHS body of participating in each scheme is taken as equal to the contributionspayable to that scheme for the accounting period.

In order that the defined benefit obligations recognised in the financial statements do not differmaterially from those that would be determined at the reporting date by a formal actuarialvaluation, the FReM requires that “the period between formal valuations shall be four years,with approximate assessments in intervening years”. An outline of these follows:

a) Accounting valuationA valuation of scheme liability is carried out annually by the scheme actuary (currently theGovernment Actuary’s Department) as at the end of the reporting period. This utilises anactuarial assessment for the previous accounting period in conjunction with updatedmembership and financial data for the current reporting period, and is accepted as providingsuitably robust figures for financial reporting purposes. The valuation of the scheme liability asat 31 March 2019, is based on valuation data as 31 March 2018, updated to 31 March 2019with summary global member and accounting data. In undertaking this actuarial assessment,the methodology prescribed in IAS 19, relevant FReM interpretations, and the discount rateprescribed by HM Treasury have also been used.

The latest assessment of the liabilities of the scheme is contained in the report of the schemeactuary, which forms part of the annual NHS Pension Scheme Accounts. These accounts canbe viewed on the NHS Pensions website and are published annually. Copies can also beobtained from The Stationery Office.

b) Full actuarial (funding) valuationThe purpose of this valuation is to assess the level of liability in respect of the benefits dueunder the schemes (taking into account recent demographic experience), and to recommendcontribution rates payable by employees and employers.

The latest actuarial valuation undertaken for the NHS Pension Scheme was completed as at31 March 2016. The results of this valuation set the employer contribution rate payable fromApril 2019. The Department of Health and Social Care have recently laid Scheme Regulationsconfirming that the employer contribution rate will increase to 20.6% of pensionable pay fromthis date.

The 2016 funding valuation was also expected to test the cost of the Scheme relative to theemployer cost cap set following the 2012 valuation. Following a judgment from the Court ofAppeal in December 2018 Government announced a pause to that part of the valuationprocess pending conclusion of the continuing legal process.

30

Velindre University NHS Trust Annual Accounts 2018-19

c) National Employment Savings Trust (NEST)

NEST is a workplace pension scheme, which was set up by legislation and is treated as a trust-basedscheme. The Trustee responsible for running the scheme is NEST Corporation. It’s a non-departmentalpublic body (NDPB) that operates at arm’s length from government and is accountable to Parliamentthrough the Department for Work and Pensions (DWP).

NEST Corporation has agreed a loan with the Department for Work and Pensions (DWP). This has paidfor the scheme to be set up and will cover expected shortfalls in scheme costs during the earlier yearswhile membership is growing.

NEST Corporation aims for the scheme to become self-financing while providing consistently lowcharges to members.

Using qualifying earnings to calculate contributions, currently the legal minimum level of contributions is5% of a jobholder’s qualifying earnings, for employers whose legal duties have started. The employermust pay at least 2% of this. The legal minimum level of contribution level is due to increase to 8% inApril 2019.

The earnings band used to calculate minimum contributions under existing legislation is called qualifyingearnings. Qualifying earnings are currently those between £6,032 and £46,350 for the 2018-19 tax year(2017-18 £5,876 and £45,000).

Restrictions on the annual contribution limits were removed on 1st April 2017.

31

Velindre University NHS Trust Annual Accounts 2018-19

12. Public Sector Payment Policy

12.1 Prompt payment code - measure of compliance

2018-19 2018-19 2017-18 2017-18

Number £000 Number £000

NHS

Total bills paid in year 2,396 34,421 2,348 33,209

Total bills paid within target 1,904 26,558 1,943 28,365

Percentage of bills paid within target 79.5% 77.2% 82.8% 85.4%

Non-NHS

Total bills paid in year 70,966 248,731 67,985 281,855

Total bills paid within target 69,141 244,073 65,288 277,351

Percentage of bills paid within target 97.4% 98.1% 96.0% 98.4%

Total

Total bills paid in year 73,362 283,152 70,333 315,064

Total bills paid within target 71,045 270,631 67,231 305,716

Percentage of bills paid within target 96.8% 95.6% 95.6% 97.0%

12.2 The Late Payment of Commercial Debts (Interest) Act 1998 2018-19 2017-18

£ £

Amounts included within finance costs from claims made under legislation 0 0

Compensation paid to cover debt recovery costs under legislation 0 0

Total 0 0

The Welsh Government requires that trusts pay all their trade creditors in accordance with the CBIprompt payment code and Government Accounting rules. The Welsh Government has set as part ofthe trust financial targets a requirement to pay 95% of the number of non-NHS creditors within 30days of delivery or receipt of a valid invoice, whichever is the later.

32

Velindre University NHS Trust Annual Accounts 2018-19

13. Property, plant and equipment :

2018-19

Cost or valuation £000 £000 £000 £000 £000 £000 £000 £000 £000 £000 £000

At 1 April 2018 17,751 53,144 255 12,530 29,987 4,574 24,340 1,099 143,680 0 143,680

Indexation 355 523 3 0 0 0 0 0 881 0 881

Additions - purchased 0 11,662 0 9,540 2,231 1,577 2,886 262 28,158 0 28,158

Additions - donated 0 0 0 0 0 0 15 0 15 0 15

Additions - government granted 0 0 0 0 0 0 0 0 0 0 0

Transfers from/(into) other NHS bodies 0 0 0 0 0 0 0 0 0 0 0

Reclassifications 0 469 0 (469) 0 0 0 0 0 0 0

Revaluation 0 0 0 0 0 0 0 0 0 0 0

Reversal of impairments 0 0 0 0 0 0 0 0 0 0 0

Impairments 0 0 0 0 0 0 0 0 0 0 0

Reclassified as held for sale 0 0 0 0 0 (21) 0 0 (21) 0 (21)

Disposals other than by sale 0 (254) 0 0 (87) (313) (983) (84) (1,721) 0 (1,721)

At 31 March 2019 18,106 65,544 258 21,601 32,131 5,817 26,258 1,277 170,992 0 170,992

Depreciation

At 1 April 2018 0 4,002 8 0 17,209 2,908 11,895 687 36,709 0 36,709

Indexation 0 31 1 0 0 0 0 0 32 0 32

Transfers from/(into) other NHS bodies 0 0 0 0 0 0 0 0 0 0 0

Reclassifications 0 0 0 0 0 0 0 0 0 0 0

Revaluation 0 0 0 0 0 0 0 0 0 0 0

Reversal of impairments 0 0 0 0 0 0 0 0 0 0 0

Impairments 0 0 0 0 0 0 0 0 0 0 0

Reclassified as held for sale 0 0 0 0 0 (21) 0 0 (21) 0 (21)

Disposals other than by sale 0 (254) 0 0 (87) (313) (983) (84) (1,721) 0 (1,721)

Charged during the year 0 2,224 8 0 2,630 487 3,972 118 9,439 0 9,439

At 31 March 2019 0 6,003 17 0 19,752 3,061 14,884 721 44,438 0 44,438

Net book value

At 1 April 2018 17,751 49,142 247 12,530 12,778 1,666 12,445 412 106,971 0 106,971

Net book value

At 31 March 2019 18,106 59,541 241 21,601 12,379 2,756 11,374 556 126,554 0 126,554

Net book value at 31 March 2019 comprises :

Purchased 18,106 55,008 241 21,601 12,272 2,756 11,353 556 121,893 0 121,893

Donated 0 4,533 0 0 107 0 19 0 4,659 0 4,659

Government Granted 0 0 0 0 0 0 2 0 2 0 2

At 31 March 2019 18,106 59,541 241 21,601 12,379 2,756 11,374 556 126,554 0 126,554

Asset Financing:

Owned 18,106 59,391 241 21,601 12,378 2,756 11,326 556 126,355 0 126,355

Held on finance lease 0 150 0 0 1 0 48 0 199 0 199

On-SoFP PFI contract 0 0 0 0 0 0 0 0 0 0 0

PFI residual interest 0 0 0 0 0 0 0 0 0 0 0

At 31 March 2019 18,106 59,541 241 21,601 12,379 2,756 11,374 556 126,554 0 126,554

The net book value of land, buildings and dwellings at 31 March 2019 comprises :

£000 £000 £000

Freehold 62,181 0 62,181

Long Leasehold 11,163 0 11,163

Short Leasehold 4,544 0 4,544

Total 77,888 0 77,888

FHoTConsolidated

TotalLand

Buildings,

excluding

dwellings

Dwellings

Assets under

construction and

payments on

account

TotalPlant &

machinery

Transport

Equipment

Information

Technology

Furniture

and fittings

The NHS Trust Land and Buildings were revalued by the Valuation Office Agency with an effective date of 1st April 2017. The valuation has been prepared in accordance with the terms of the Royal Institution of Chartered Surveyors' Valuation Standards, 6th Edition. Trusts are required to apply the revaluation model set out in IAS 16 and value its capital assets to fair value. Fair value is defined by IAS 16 as the amount for which an asset could be exchanged between knowledgeable, willing parties in an arms length transaction. This has been undertaken on the assumption that the property is sold as part of the continuing enterprise in occupation.

33

Velindre University NHS Trust Annual Accounts 2018-19

13. Property, plant and equipment :

2017-18

Cost or valuation £000 £000 £000 £000 £000 £000 £000 £000 £000 £000 £000

At 1 April 2017 16,870 60,884 256 9,314 31,269 5,010 22,738 951 147,292 0 147,292

Indexation 0 0 0 0 0 0 0 0 0 0 0

Additions - purchased 0 2,562 0 3,389 872 16 4,449 172 11,460 0 11,460

Additions - donated 0 0 0 0 5 0 0 0 5 0 5

Additions - government granted 0 0 0 0 0 0 0 0 0 0 0

Transfers from/(into) other NHS bodies 0 0 0 0 0 0 0 0 0 0 0

Reclassifications 0 135 0 (173) 0 0 38 0 0 0 0

Revaluation 881 (10,437) (1) 0 0 0 0 0 (9,557) 0 (9,557)

Reversal of impairments 0 0 0 0 0 0 0 0 0 0 0

Impairments 0 0 0 0 0 0 0 0 0 0 0

Reclassified as held for sale 0 0 0 0 0 (336) 0 0 (336) 0 (336)

Disposals other than by sale 0 0 0 0 (2,159) (116) (2,885) (24) (5,184) 0 (5,184)

At 31 March 2018 17,751 53,144 255 12,530 29,987 4,574 24,340 1,099 143,680 0 143,680

Depreciation

At 1 April 2017 0 10,030 54 0 16,568 2,812 11,188 606 41,258 0 41,258

Indexation 0 0 0 0 0 0 0 0 0 0 0

Transfers from/(into) other NHS bodies 0 0 0 0 0 0 0 0 0 0 0

Reclassifications 0 0 0 0 0 0 0 0 0 0 0

Revaluation 0 (8,211) (54) 0 0 0 0 0 (8,265) 0 (8,265)

Reversal of impairments 0 0 0 0 0 0 0 0 0 0 0

Impairments 0 0 0 0 0 0 0 0 0 0 0

Reclassified as held for sale 0 0 0 0 0 (336) 0 0 (336) 0 (336)

Disposals other than by sale 0 0 0 0 (2,159) (116) (2,885) (24) (5,184) 0 (5,184)

Charged during the year 0 2,183 8 0 2,800 548 3,592 105 9,236 0 9,236

At 31 March 2018 0 4,002 8 0 17,209 2,908 11,895 687 36,709 0 36,709

Net book value

At 1 April 2017 16,870 50,854 202 9,314 14,701 2,198 11,550 345 106,034 0 106,034

Net book value

At 31 March 2018 17,751 49,142 247 12,530 12,778 1,666 12,445 412 106,971 0 106,971

Net book value at 31 March 2018 comprises :

Purchased 17,751 44,498 247 12,530 12,600 1,666 12,435 412 102,139 0 102,139

Donated 0 4,644 0 0 178 0 6 0 4,828 0 4,828

Government Granted 0 0 0 0 0 0 4 0 4 0 4

At 31 March 2018 17,751 49,142 247 12,530 12,778 1,666 12,445 412 106,971 0 106,971

Asset Financing:

Owned 17,751 48,977 247 12,530 12,775 1,666 12,376 410 106,732 0 106,732

Held on finance lease 0 165 0 0 3 0 69 2 239 0 239

On-SoFP PFI contract 0 0 0 0 0 0 0 0 0 0 0

PFI residual interest 0 0 0 0 0 0 0 0 0 0 0

At 31 March 2018 17,751 49,142 247 12,530 12,778 1,666 12,445 412 106,971 0 106,971

The net book value of land, buildings and dwellings at 31 March 2018 comprises :

£000 £000 £000

Freehold 61,993 0 61,993

Long Leasehold 7 0 7

Short Leasehold 5,140 0 5,140

Total 67,140 0 67,140

FHoTConsolidated

TotalLand

Buildings,

excluding

dwellings

Dwellings

Assets under

construttion and

payments on

account

TotalPlant &

machinery

Transport

Equipment

Information

Technology

Furniture

and fittings

34

Velindre University NHS Trust Annual Accounts 2018-19

13. Property, plant and equipment :

Gain/(Loss) on Sale

Gain/(Loss) on sale

Asset description Reason for sale £000

NWSSP commercial vehicles (22) Replenishment 37

Temperature controlled storage & racking Obsolete 8

45

Disclosures:

i) Donated AssetsVelindre University NHS Trust received the following donated assets during the year:IT equipment £ 2,047IT Server £ 12,486

Total £ 14,533

ii) ValuationsThe Trust's land and Buildings were revalued by the Valuation Office Agency with an effective date of 1st April 2017.The valuation has been prepared in accordance with the terms of the Royal Institute of Chartered Surveyors'Valuation Standards, 6th edition.

The Trust is required to apply the revaluation model set out in IAS 16 and value its capital assets to fair value. Fairvalue is defined by IAS 16 as the amount for which an asset could be exchanged between knowledgeable, willingparties in an arms length transaction. This has been undertaken on the assumption that the property is sold as partof the continuing enterprise in operation.

iii) Asset LivesDepreciated as follows:- Land is not depreciated.- Buildings as determined by the Valuation Office Agency.- Equipment 5-15 years.

iv) CompensationThere has been no compensation received from third parties for assets impaired, lost or given up, that is included inthe income statement.

v) Write DownsThere have been no write downs.

vi) The Trust does not hold any property where the value is materially different from its open market value.

vii) Assets Held for Sale or sold in the period.There are assets held for sale or sold in the period.

35

Velindre University NHS Trust Annual Accounts 2018-19

13.2 Non-current assets held for sale

£000 £000 £000 £000 £000 £000 £000 £000

Balance b/f 1 April 2018 0 0 0 0 0 0 0 0

Plus assets classified as held for sale in

year 0 0 0 0 0 0 0 0

Revaluation 0 0 0 0 0 0 0 0

Less assets sold in year 0 0 0 0 0 0 0 0

Plus reversal of impairments 0 0 0 0 0 0 0 0

Less impairment for assets held for sale 0 0 0 0 0 0 0 0

Less assets no longer classified as held for

sale for reasons other than disposal by sale 0 0 0 0 0 0 0 0

Balance c/f 31 March 2019 0 0 0 0 0 0 0 0

Balance b/f 1 April 2017 0 0 0 0 0 0 0 0

Plus assets classified as held for sale in

year 0 0 0 0 0 0 0 0

Revaluation 0 0 0 0 0 0 0 0

Less assets sold in year 0 0 0 0 0 0 0 0

Plus reversal of impairments 0 0 0 0 0 0 0 0

Less impairment for assets held for sale 0 0 0 0 0 0 0 0

Less assets no longer classified as held for

sale for reasons other than disposal by sale 0 0 0 0 0 0 0 0

Balance c/f 31 March 2018 0 0 0 0 0 0 0 0

FHoT assetsConsolidatedTo

talOther assets TotalLand

Buildings,

including

dwellings

Other property

plant and

equipment

Intangible

assets

The Trust (NWSSP) has 2 vehicles that are being held for sale at 31st March 2019, with current net book value of nil.

36

Velindre University NHS Trust Annual Accounts 2018-19

14. Intangible assets

Cost or valuation £000 £000 £000 £000 £000 £000 £000 £000 £000

At 1 April 2018 45,075 3,512 4,862 0 0 0 53,449 0 53,449

Revaluation 0 0 0 0 0 0

Reclassifications 0 0 0 0 0 0 0 0 0

Reversal of impairments 0 0 0 0 0 0 0 0 0

Impairments 0 0 0 0 0 0 0 0 0

Additions

- purchased 648 2,540 0 0 0 0 3,188 0 3,188

- internally generated 0 0 0 0 0 0 0 0 0

- donated 10 0 0 0 0 0 10 0 10

- government granted 0 0 0 0 0 0 0 0 0

Reclassified as held for sale 0 0 0 0 0 0 0 0 0

Transfers from/(into) other NHS bodies 0 0 0 0 0 0 0 0 0

Disposals other than by sale (210) (90) 0 0 0 0 (300) 0 (300)

At 31 March 2019 45,523 5,962 4,862 0 0 0 56,347 0 56,347

Amortisation

At 1 April 2018 30,216 2,508 1,853 0 0 0 34,577 0 34,577

Revaluation 0 0 0 0 0 0

Reclassifications 0 0 0 0 0 0 0 0 0

Reversal of impairments 0 0 0 0 0 0 0 0 0

Impairments 0 0 0 0 0 0 0 0 0

Charged during the year 5,663 394 970 0 0 0 7,027 0 7,027

Reclassified as held for sale 0 0 0 0 0 0 0 0 0

Transfers from/(into) other NHS bodies 0 0 0 0 0 0 0 0 0

Disposals other than by sale (210) (90) 0 0 0 0 (300) 0 (300)

Accumulated amortisation at

31 March 2019 35,669 2,812 2,823 0 0 0 41,304 0 41,304

Net book value

At 1 April 2018 14,859 1,004 3,009 0 0 0 18,872 0 18,872

Net book value

At 31 March 2019 9,854 3,150 2,039 0 0 0 15,043 0 15,043

Net book value

Purchased 9,839 0 2,039 0 0 0 11,878 0 11,878

Donated 16 0 0 0 0 0 16 0 16

Government granted 0 0 0 0 0 0 0 0 0

Internally Generated 0 3,149 0 0 0 0 3,149 0 3,149

At 31 March 2019 9,855 3,149 2,039 0 0 0 15,043 0 15,043

Total FHoTConsolidated

Total

Computer

software

purchased

Computer

software

internally

developed

Licenses and

trade-marksPatents

Development

expenditure

internally

generated

CRC Emission

Trading

Scheme

37

Velindre University NHS Trust Annual Accounts 2018-19

14. Intangible assets

Cost or valuation £000 £000 £000 £000 £000 £000 £000 £000 £000

At 1 April 2017 42,485 2,724 4,131 0 0 0 49,340 0 49,340

Revaluation 0 0 0 0 0 0

Reclassifications 0 0 0 0 0 0 0 0 0

Reversal of impairments 0 0 0 0 0 0 0 0 0

Impairments 0 0 0 0 0 0 0 0 0

Additions

- purchased 3,159 788 731 0 0 0 4,678 0 4,678

- internally generated 0 0 0 0 0 0 0 0 0

- donated 0 0 0 0 0 0 0 0 0

- government granted 0 0 0 0 0 0 0 0 0

Reclassified as held for sale 0 0 0 0 0 0 0 0 0

Transfers from/(into) other NHS bodies 0 0 0 0 0 0 0 0 0

Disposals other than by sale (569) 0 0 0 0 0 (569) 0 (569)

At 31 March 2018 45,075 3,512 4,862 0 0 0 53,449 0 53,449

Amortisation

At 1 April 2017 23,641 2,125 1,021 0 0 0 26,787 0 26,787

Revaluation 0 0 0 0 0 0

Reclassifications 0 0 0 0 0 0 0 0 0

Reversal of impairments 0 0 0 0 0 0 0 0 0

Impairments 0 0 0 0 0 0 0 0 0

Charged during the year 7,144 383 832 0 0 0 8,359 0 8,359

Reclassified as held for sale 0 0 0 0 0 0 0 0 0

Transfers from/(into) other NHS bodies 0 0 0 0 0 0 0 0 0

Disposals other than by sale (569) 0 0 0 0 0 (569) 0 (569)

Accumulated amortisation at

31 March 2018 30,216 2,508 1,853 0 0 0 34,577 0 34,577

Net book value

At 1 April 2017 18,844 599 3,110 0 0 0 22,553 0 22,553

Net book value

At 31 March 2018 14,859 1,004 3,009 0 0 0 18,872 0 18,872

Net book value

Purchased 14,848 0 3,009 0 0 0 17,857 0 17,857

Donated 11 0 0 0 0 0 11 0 11

Government granted 0 0 0 0 0 0 0 0 0

Internally Generated 0 1,004 0 0 0 0 1,004 0 1,004

At 31 March 2018 14,859 1,004 3,009 0 0 0 18,872 0 18,872

FHoTConsolidated

Total

Development

expenditure

internally

generated

Total

Computer

software

purchased

Computer

software

internally

developed

Licenses

and trade-

marks

Patents

CRC

Emission

Trading

Scheme

38

Velindre University NHS Trust Annual Accounts 2018-19

14. Intangible assets

Disclosures:

i) Donated Intangible Assets

Velindre University NHS Trust received the following donated assets during the year:

Sensory Projector software £ 9,708

Intangible assets comprise of licences for use of purchased IT software such as financial systems, internally generated ITsoftware and various licences and trade marks.

An assessment is performed on an annual basis to determine that the assets are still available for use and that there is acontinued market for their use. The fair values are based on the original cost and amortised based upon finite lives detailedbelow, and are as detailed in the note to the accounts.

The useful lives and amortisation rates used are 3 and 5 years and no intangible assets are assessed as having indefiniteuseful lives.

No intangible assets have been acquired by Government Grant.

39

Velindre University NHS Trust Annual Accounts 2018-19

15. Impairments

Impairments in the period arose from: Property, plant Intangible Property, plant Intangible

& equipment assets & equipment assets

£000 £000 £000 £000

Loss or damage from normal operations 0 0 0 0

Abandonment of assets in the course of construction 0 0 0 0

Over specification of assets (Gold Plating) 0 0 0 0

Loss as a result of a catastrophe 0 0 0 0

Unforeseen obsolescence 0 0 0 0

Changes in market price 0 0 0 0

Other (Specify) 0 0 0 0

Reversal of impairment 0 0 0 0

Impairments charged to operating expenses 0 0 0 0

FHoT Impairments charged to operating expenses 0 0 0 0

Consolidated impairment charged to operating expenses 0 0 0 0

Analysis of impairments :

0 0 0 0

0 0 0 0

Total 0 0 0 0

0 0 0 0

FHoT reserves 0 0 0 0

NHS Consolidated Total 0 0 0 0

Operating expenses in Statement of Comprehensive Income

Revaluation reserve

2018-19 2017-18

FHoT Operating expenses in SoCNI

There have been no impairments during the year ended 31st March 2019.

40

Velindre University NHS Trust Annual Accounts 2018-19

16. Inventories

16.1 Inventories

31 March 31 March 31 March 31 March

2019 2018 2019 2018

£000 £000 £000 £000

NHS Trust

Drugs 1,152 1,321 1,152 1,321

Consumables 5,719 3,258 5,719 3,258

Energy 0 0 0 0

Work in progress 0 0 0 0

Other 2,089 1,444 2,089 1,444

Total 8,960 6,023 8,960 6,023

Of which held at net realisable value: 0 0 0 0

16.2 Inventories recognised in expenses 31 March 31 March 31 March 31 March

2019 2018 2019 2018

£000 £000 £000 £000

NHS Trust

Inventories recognised as an expense in the period 48,525 49,182 48,525 49,182

Write-down of inventories (including losses) 33 33 33 33

Reversal of write-downs that reduced the expense 0 (267) 0 (267)

Total 48,558 48,948 48,558 48,948

Consolidated

Consolidated

41

Velindre University NHS Trust Annual Accounts 2018-19

17. Trade and other receivables

17.1 Trade and other receivables

31 March 31 March 31 March 31 March

2019 2018 2019 2018

Current £000 £000 £000 £000

NHS Trust

Welsh Government 354,914 354,254 354,914 354,254

WHSSC & EASC 855 514 855 514

Welsh Health Boards 10,616 9,961 10,616 9,961

Welsh NHS Trusts 579 826 579 826

Health Education and Improvement Wales (HEIW) 435 0 435 0

Non - Welsh Trusts 133 0 133 0

Other NHS 59 79 59 79

Welsh Risk Pool 105 0 105 0

Local Authorities 98 181 98 181

Capital debtors 0 153 0 153

Other debtors 6,316 4,795 5,840 4,426

FHoT debtor 106 409

Provision for impairment of trade receivables (1,931) (314) (1,931) (314)

Pension Prepayments

NHS Pensions Agency 0 0 0 0

NEST 0 0 0 0

Other prepayments 9,371 6,578 9,371 6,578

Accrued income 2,666 793 2,666 793

Sub-total 384,216 377,820 383,846 377,860

Non-current

Welsh Government 798,646 782,239 798,646 782,239

WHSSC & EASC 0 0 0 0

Welsh Health Boards 0 0 0 0

Welsh NHS Trusts 0 0 0 0

Health Education and Improvement Wales (HEIW) 0 0 0 0

Non - Welsh Trusts 0 0 0 0

Other NHS 0 0 0 0

Welsh Risk Pool 0 0 0 0

Local Authorities 0 0 0 0

Capital debtors 0 0 0 0

Other debtors 0 0 0 0

FHoT debtor 0 0

Provision for impairment of trade receivables 0 0 0 0

Pension Prepayments

NHS Pensions Agency 0 0 0 0

NEST 0 0 0 0

Other prepayments 0 0 0 0

Accrued income 0 0 0 0

Sub-total 798,646 782,239 798,646 782,239

Total trade and other receivables 1,182,862 1,160,059 1,182,492 1,160,099

Consolidated

The great majority of trade is with other NHS bodies. As NHS bodies are funded by Welsh Government, no credit scoring of them is considered necessary.

The value of trade receivables that are past their payment date but not impaired is £3,955,000 (£1,453,000 in 2017-18). These are analysed further in note 17.2.

42

Velindre University NHS Trust Annual Accounts 2018-19

17.2 Receivables past their due date but not impaired

31 March 31 March 31 March 31 March

2019 2018 2019 2018

£000 £000 £000 £000

NHS Trust

By up to 3 months 3,209 490 3,209 490

By 3 to 6 months 210 330 210 330

By more than 6 months 536 633 536 633

Balance at end of financial year 3,955 1,453 3,955 1,453

17.3 Expected Credit Losses (ECL) Allowance for bad and doubtful debts

31 March 31 March 31 March 31 March

2019 2018 2019 2018

£000 £000 £000 £000

NHS Trust

Balance at 31 March 2018 (314) (314)

Adjustment for Implementation of IFRS 9 (1,610) (1,610)

Balance at 1 April (1,924) (372) (1,924) (372)

Transfer to other NHS Wales body 0 0 0 0

Provision utilised (Amount written off during the year) 10 5 10 5

Provision written back during the year no longer required 0 0 0 0

(Increase)/Decrease in provision during year (17) 53 (17) 53

ECL/Bad debts recovered during year 0 0 0 0

Balance at end of financial year (1,931) (314) (1,931) (314)

17.4 Receivables VAT 31 March 31 March 31 March 31 March

2019 2018 2019 2018

£000 £000 £000 £000

NHS Trust

Trade receivables 62 134 62 134

Other 0 0 0 0

Total 62 134 62 134

Consolidated

Consolidated

Consolidated

Due to the implementation of IFRS9, the above table now includes receivables from Welsh Government andNHS Wales. The significant increase of receivables past their due date by up to 3 months but not impaired ispredominantly due to this addition.

43

Velindre University NHS Trust Annual Accounts 2018-19

18. Other financial assets

31 March 31 March 31 March 31 March

2019 2018 2019 2018

£000 £000 £000 £000

NHS Trust

Current

Shares and equity type investments

Held to maturity investments at amortised costs 0 0 0 0

At fair value through SOCI 0 0 0 0

Available for sale at FV 0 0 0 0

Deposits 0 0 0 0

Loans 0 0 0 0

Derivatives 0 0 0 0

Other (Specify)

Held to maturity investments at amortised costs 0 0 0 0

At fair value through SOCI 0 0 0 0

Available for sale at FV 0 0 0 0

Total 0 0 0 0

Non-Current

Shares and equity type investments

Held to maturity investments at amortised costs 0 0 0 0

At fair value through SOCI 0 0 0 0

Available for sale at FV 0 0 0 0

Deposits 0 0 0 0

Loans 0 0 0 0

Derivatives 0 0 0 0

Other (Specify)

Held to maturity investments at amortised costs 0 0 0 0

At fair value through SOCI 0 0 5,406 5,567

Available for sale at FV 0 0 0 0

Total 0 0 5,406 5,567

Consolidated

44

Velindre University NHS Trust Annual Accounts 2018-19

19. Cash and cash equivalents

31 March 31 March 31 March 31 March

2019 2018 2019 2018

£000 £000 £000 £000

NHS Trust

Opening Balance 19,893 18,888 20,937 19,482

Net change in year 1,056 1,005 1,447 1,455

Closing Balance 20,949 19,893 22,384 20,937

Made up of:

Cash with Government Banking Service (GBS) 20,934 19,875 20,934 19,875

Cash with Commercial banks 0 0 1,435 1,044

Cash in hand 15 18 15 18

Total cash 20,949 19,893 22,384 20,937

Current investments 0 0 0 0

20,949 19,893 22,384 20,937

Bank overdraft - GBS 0 0 0 0

Bank overdraft - Commercial banks 0 0 0 0

Cash & cash equivalents as in Statement of Cash Flows 20,949 19,893 22,384 20,937

Cash and cash equivalents as in SoFP

Consolidated

In response to the IAS 7 requirement for additional disclosure, the changes in liabilities arising for financing activities are:

Lease Liabilities £nilPFI liabilities £nil

The movement relates to cash, no comparative information is required by IAS 7 in 2018-19.

45

Velindre University NHS Trust Annual Accounts 2018-19

20. Trade and other payables at the SoFP Date 31 March 31 March 31 March 31 March

2019 2018 2019 2018

Current £000 £000 £000 £000

NHS Trust

Welsh Government 16 9,750 16 9,750

WHSSC & EASC 24 0 24 0

Welsh Health Boards 72,394 75,324 72,394 75,324

Welsh NHS Trusts 2,799 2,245 2,799 2,245

Health Education and Improvement Wales (HEIW) 0 0 0 0

Other NHS 263 554 263 554

Local Authorities 119 19 119 19

Taxation and social security payable / refunds: 0

Refunds of taxation by HMRC 0 0 0 0

VAT payable to HMRC 0 0 0 0

Other taxes payable to HMRC 1,364 6 1,364 6

National Insurance contributions payable to HMRC 1,880 17 1,880 17

Non-NHS trade payables - revenue 12,114 10,803 12,114 10,803

Trade payables - capital 9,867 7,228 9,868 7,228

FHoT payables 115 190

Rentals due under operating leases 0 0 0 0

Obligations due under finance leases and HP contracts 0 0 0 0

Imputed finance lease element of on SoFP PFI contracts 0 0 0 0

Pensions: staff 2,268 30 2,268 30

Accruals 17,332 4,304 17,332 4,304

Deferred Income:

Deferred income brought forward 2,950 1,838 2,950 1,838

Deferred income additions 1,060 2,466 1,060 2,466

Transfer to/from current/non current deferred income 0 0 0 0

Released to the Income Statement (1,467) (1,352) (1,467) (1,352)

Other liabilities - all other payables 0 0 0 0

PFI assets – deferred credits 0 0 0 0

PFI - Payments on account 0 0 0 0

Sub-total 122,983 113,232 123,099 113,422

Consolidated

In respect of the Pensions figure shown above, £2,265,000 relates to the NHS Pension scheme (2017-18 £30,000) and £2,568 to theNEST pension scheme (2017-18 £902).

46

Velindre University NHS Trust Annual Accounts 2018-19

20. Trade and other payables at the SoFP Date (cont)

31 March 31 March 31 March 31 March

2019 2018 2019 2018

Non-current £000 £000 £000 £000

NHS Trust

Welsh Government 0 0 0 0

WHSSC & EASC 0 0 0 0

Welsh Health Boards 0 0 0 0

Welsh NHS Trusts 0 0 0 0

Health Education and Improvement Wales (HEIW) 0 0 0 0

Other NHS 0 0 0 0

Taxation and social security payable / refunds:

Refunds of taxation by HMRC 0 0 0 0

VAT payable to HMRC 0 0 0 0

Other taxes payable to HMRC 0 0 0 0

National Insurance contributions payable to HMRC 0 0 0 0

Non-NHS trade payables - revenue 0 0 0 0

Local Authorities 0 0 0 0

Non-NHS trade payables - capital 0 0 0 0

FHoT payables 0 0

Rentals due under operating leases 0 0 0 0

Obligations due under finance leases and HP contracts 0 0 0 0

Imputed finance lease element of on SoFP PFI contracts 0 0 0 0

Pensions: staff 0 0 0 0

Accruals 0 0 0 0

Deferred Income:

Deferred income brought forward 0 0 0 0

Deferred income additions 0 0 0 0

Transfer to/from current/non current deferred income 0 0 0 0

Released to the Income Statement 0 0 0 0

Other liabilities - all other payables 0 0 0 0

PFI assets – deferred credits 0 0 0 0

PFI - Payments on account 0 0 0 0

Sub-total 0 0 0 0

Total 122,983 113,232 123,099 113,422

Consolidated

The Trust aims to pay all invoices within the 30 day period directed by the Welsh Government.

47

Velindre University NHS Trust Annual Accounts 2018-19

21. Borrowings 31 March 31 March 31 March 31 March

Current 2019 2018 2019 2018

£000 £000 £000 £000

NHS Trust

Bank overdraft - Government Banking Service (GBS) 0 0 0 0

Bank overdraft - Commercial bank 0 0 0 0

Loans from:

Welsh Government 0 0 0 0

Other entities 0 0 0 0

PFI liabilities:

Main liability 0 0 0 0

Lifecycle replacement received in advance 0 0 0 0

Finance lease liabilities 24 24 24 24

Other 0 0 0 0

Total 24 24 24 24

Non-current

Bank overdraft - OPG 0 0 0 0

Bank overdraft - Commercial bank 0 0 0 0

Loans from:

Welsh Government 0 0 0 0

Other entities 0 0 0 0

PFI liabilities:

Main liability 0 0 0 0

Lifecycle replacement received in advance 0 0 0 0

Finance lease liabilities 29 52 29 52

Other 0 0 0 0

Total 29 52 29 52

21.2 Loan advance/strategic assistance funding

Consolidated

The Trust has not received a loan advance or strategic funding from the Welsh Government.

.

48

Velindre University NHS Trust Annual Accounts 2018-19

22. Other financial liabilities

31 March 31 March 31 March 31 March

2019 2018 2019 2018

Current £000 £000 £000 £000

NHS Trust

Financial Guarantees

At amortised cost 0 0 0 0

At fair value through SoCI 0 0 0 0

Derivatives at fair value through SoCI 0 0 0 0

Other

At amortised cost 0 0 0 0

At fair value through SoCI 0 0 0 0

Total 0 0 0 0

31 March 31 March 31 March 31 March

2019 2018 2019 2018

Non-current £000 £000 £000 £000

NHS Trust

Financial Guarantees

At amortised cost 0 0 0 0

At fair value through SoCI 0 0 0 0

Derivatives at fair value through SoCI 0 0 0 0

Other

At amortised cost 0 0 0 0

At fair value through SoCI 0 0 0 0

Total 0 0 0 0

Consolidated

Consolidated

49

Velindre University NHS Trust Annual Accounts 2018-19

23. Provisions

2018-19

23.1 NHS Trust and Welsh Risk Pool

Current

£000 £000 £000 £000 £000 £000 £000 £000 £000 £000

Clinical negligence 258,701 (65,119) (2,819) 76,292 0 189,133 (87,901) (103,568) (2,604) 262,115

Personal injury 6,672 0 0 (18) 0 4,073 (4,862) (3,625) 0 2,240

All other losses and special payments 0 0 0 0 0 1 0 0 0 1

Defence legal fees and other administration 4,543 0 0 579 0 3,090 (1,189) (2,382) 0 4,641

Structured Settlements - WRPS 11,187 2,148 0 0 0 13,372 (12,054) (439) (395) 13,819

Pensions relating to: former directors 0 0 0 0 0 0 0 0 0

Pensions relating to: other staff 20 (7) 25 0 0 (19) 0 0 19

Restructurings 0 0 0 0 0 0 0 0

Other 743 0 0 0 999 (834) 0 908

Total 281,866 (62,971) (2,826) 76,878 0 210,668 (106,859) (110,014) (2,999) 283,743

FHoT 0 0 0 0 0 0 0 0 0 0

Consolidated Total 281,866 (62,971) (2,826) 76,878 0 210,668 (106,859) (110,014) (2,999) 283,743

Non Current

Clinical negligence 420,776 0 0 (76,488) 0 53,662 (3,446) (7,844) 0 386,660

Personal injury 6 0 0 (6) 0 300 0 0 0 300

All other losses and special payments 0 0 0 0 0 0 0 0 0 0

Defence legal fees and other administration 3,178 0 0 (359) 0 644 (104) (367) 0 2,992

Structured Settlements - WRPS 358,279 62,971 0 0 0 4,024 0 (16,578) 0 408,696

Pensions relating to: former directors 0 0 0 0 0 0 0 0 0

Pensions relating to: other staff 132 0 (25) 0 (5) 0 0 0 102

Restructurings 0 0 0 0 0 0 0 0

Other 283 0 0 0 378 0 0 661

Total 782,654 62,971 0 (76,878) 0 59,003 (3,550) (24,789) 0 799,411

FHoT 0 0 0 0 0 0 0 0 0 0

Consolidated Total 782,654 62,971 0 (76,878) 0 59,003 (3,550) (24,789) 0 799,411

TOTAL

Clinical negligence 679,477 (65,119) (2,819) (196) 0 242,795 (91,347) (111,412) (2,604) 648,775

Personal injury 6,678 0 0 (24) 0 4,373 (4,862) (3,625) 0 2,540

All other losses and special payments 0 0 0 0 0 1 0 0 0 1

Defence legal fees and other administration 7,721 0 0 220 0 3,734 (1,293) (2,749) 0 7,633

Structured Settlements - WRPS 369,466 65,119 0 0 0 17,396 (12,054) (17,017) (395) 422,515

Pensions relating to: former directors 0 0 0 0 0 0 0 0 0

Pensions relating to: other staff 152 (7) 0 0 (5) (19) 0 0 121

Restructurings 0 0 0 0 0 0 0 0

Other 1,026 0 0 0 1,377 (834) 0 1,569

Total 1,064,520 0 (2,826) 0 0 269,671 (110,409) (134,803) (2,999) 1,083,154

FH0T 0 0 0 0 0 0 0 0 0 0

Consolidated Total 1,064,520 0 (2,826) 0 0 269,671 (110,409) (134,803) (2,999) 1,083,154

Expected timing of cash flows:

Between

In year 1 April 2020 to Thereafter Totals

to 31 March 2020 31 March 2024

£000 £000 £000 £000

Clinical negligence 262,115 276,403 110,257 648,775

Personal injury 2,240 300 0 2,540

All other losses and special payments 1 0 0 1

Defence legal fees and other administration 4,641 2,992 0 7,633

Structured Settlements - WRPS 13,819 57,822 350,874 422,515

Pensions - former directors 0 0 0 0

Pensions - other staff 19 67 35 121

Restructuring 0 0 0 0

Other 908 661 0 1,569

Total 283,743 338,245 461,166 1,083,154

FHoT 0 0 0 0

Consolidated Total 283,743 338,245 461,166 1,083,154

At 31 March

2019

Transfers

(to)/from

other NHS

body

Arising

during the

year

Utilised

during the

year

Reversed

unused

At 1 April

2018

Structured

settlement

cases

transferr-ed

to Risk Pool

Transfers

to creditors

Transfers

between

current and

non current

Unwinding

of discount

49(2)

Velindre University NHS Trust Annual Accounts 2018-19

23. Provisions

2018-19

23.2 NHS Trust

Current

£000 £000 £000 £000 £000 £000 £000 £000 £000 £000

Clinical negligence 316 0 0 0 0 365 (340) (326) 0 15

Personal injury 115 0 0 0 0 15 (14) (115) 0 1

All other losses and special payments 0 0 0 0 0 1 0 0 0 1

Defence legal fees and other administration 46 0 0 0 0 122 92 (238) 0 22

Structured Settlements - WRPS 0 0 0 0 0 0 0 0 0 0

Pensions relating to: former directors 0 0 0 0 0 0 0 0 0

Pensions relating to: other staff 20 (7) 25 0 0 (19) 0 0 19

Restructurings 0 0 0 0 0 0 0 0

Other 743 0 0 0 999 (834) 0 908

Total 1,240 0 (7) 25 0 1,502 (1,115) (679) 0 966

Non Current

Clinical negligence 0 0 0 0 0 0 0 0 0 0

Personal injury 0 0 0 0 0 0 0 0 0 0

All other losses and special payments 0 0 0 0 0 0 0 0 0 0

Defence legal fees and other administration 0 0 0 0 0 0 0 0 0 0

Structured Settlements - WRPS 0 0 0 0 0 0 0 0 0 0

Pensions relating to: former directors 0 0 0 0 0 0 0 0 0

Pensions relating to: other staff 132 0 (25) 0 (5) 0 0 0 102

Restructurings 0 0 0 0 0 0 0 0

Other 283 0 0 0 378 0 0 661

Total 415 0 0 (25) 0 373 0 0 0 763

TOTAL

Clinical negligence 316 0 0 0 0 365 (340) (326) 0 15

Personal injury 115 0 0 0 0 15 (14) (115) 0 1

All other losses and special payments 0 0 0 0 0 1 0 0 0 1

Defence legal fees and other administration 46 0 0 0 0 122 92 (238) 0 22

Structured Settlements - WRPS 0 0 0 0 0 0 0 0 0 0

Pensions relating to: former directors 0 0 0 0 0 0 0 0 0

Pensions relating to: other staff 152 (7) 0 0 (5) (19) 0 0 121

Restructurings 0 0 0 0 0 0 0 0

Other 1,026 0 0 0 1,377 (834) 0 1,569

Total 1,655 0 (7) 0 0 1,875 (1,115) (679) 0 1,729

Expected timing of cash flows:

Between

In year 1 April 2020 to Thereafter Totals

to 31 March 2020 31 March 2024

£000 £000 £000 £000

Clinical negligence 15 0 0 15

Personal injury 1 0 0 1

All other losses and special payments 1 0 0 1

Defence legal fees and other administration 22 0 0 22

Structured Settlements - WRPS 0 0 0 0

Pensions - former directors 0 0 0 0

Pensions - other staff 19 67 35 121

Restructuring 0 0 0 0

Other 908 661 0 1,569

Total 966 728 35 1,729

Utilised

during the

year

Reversed

unused

Unwinding

of discount

At 31 March

2019

At 1 April

2018

Structured

settlement

cases

transferr-ed

to Risk Pool

Transfers

to creditors

Transfers

between

current and

non current

Transfers

(to)/from

other NHS

body

Arising

during the

year

49(3)

Velindre University NHS Trust Annual Accounts 2018-19

23. Provisions

2018-19

23.3 Welsh Risk Pool

Current

£000 £000 £000 £000 £000 £000 £000 £000 £000 £000

Clinical negligence 258,595 (65,119) (2,819) 76,292 0 188,799 (87,661) (103,370) (2,604) 262,113

Personal injury 6,619 0 0 (18) 0 4,058 (4,910) (3,510) 0 2,239

All other losses and special payments 0 0 0 0 0 0 0 0 0 0

Defence legal fees and other administration 4,573 0 0 579 0 2,968 (1,356) (2,144) 0 4,620

Structured Settlements - WRPS 11,187 2,148 0 0 0 13,372 (12,054) (439) (395) 13,819

Pensions relating to: former directors 0 0 0 0 0 0 0 0 0

Pensions relating to: other staff 0 0 0 0 0 0 0 0 0

Restructurings 0 0 0 0 0 0 0 0

Other 0 0 0 0 0 0 0 0

Total 280,974 (62,971) (2,819) 76,853 0 209,197 (105,981) (109,463) (2,999) 282,791

Non Current

Clinical negligence 420,776 0 0 (76,488) 0 53,662 (3,446) (7,844) 0 386,660

Personal injury 6 0 0 (6) 0 300 0 0 0 300

All other losses and special payments 0 0 0 0 0 0 0 0 0 0

Defence legal fees and other administration 3,178 0 0 (359) 0 644 (104) (367) 0 2,992

Structured Settlements - WRPS 358,279 62,971 0 0 0 4,024 0 (16,578) 0 408,696

Pensions relating to: former directors 0 0 0 0 0 0 0 0 0

Pensions relating to: other staff 0 0 0 0 0 0 0 0 0

Restructurings 0 0 0 0 0 0 0 0

Other 0 0 0 0 0 0 0 0

Total 782,239 62,971 0 (76,853) 0 58,630 (3,550) (24,789) 0 798,648

TOTAL

Clinical negligence 679,371 (65,119) (2,819) (196) 0 242,461 (91,107) (111,214) (2,604) 648,773

Personal injury 6,625 0 0 (24) 0 4,358 (4,910) (3,510) 0 2,539

All other losses and special payments 0 0 0 0 0 0 0 0 0 0

Defence legal fees and other administration 7,751 0 0 220 0 3,612 (1,460) (2,511) 0 7,612

Structured Settlements - WRPS 369,466 65,119 0 0 0 17,396 (12,054) (17,017) (395) 422,515

Pensions relating to: former directors 0 0 0 0 0 0 0 0 0

Pensions relating to: other staff 0 0 0 0 0 0 0 0 0

Restructurings 0 0 0 0 0 0 0 0

Other 0 0 0 0 0 0 0 0

Total 1,063,213 0 (2,819) 0 0 267,827 (109,531) (134,252) (2,999) 1,081,439

Expected timing of cash flows:

Between

In year 1 April 2020 to Thereafter Totals

to 31 March 2020 31 March 2024

£000 £000 £000 £000

Clinical negligence 262,114 276,403 110,257 648,774

Personal injury 2,239 300 0 2,539

All other losses and special payments 0 0 0 0

Defence legal fees and other administration 4,620 2,992 0 7,612

Structured Settlements - WRPS 13,820 57,822 350,874 422,516

Pensions - former directors 0 0 0 0

Pensions - other staff 0 0 0 0

Restructuring 0 0 0 0

Other 0 0 0 0

Total 282,793 337,517 461,131 1,081,441

At 31 March 2019

Transfers

(to)/from

other NHS

body

Arising

during the

year

Utilised

during the

year

Reversed

unusedAt 1 April 2018

Structured

settlement

cases

transferr-ed to

Risk Pool

Transfers

to creditors

Transfers

between

current and

non current

Unwinding

of discount

Timing of cashflow has been profiled to match total current liabilities. However, the total will include cases which may settle with a structured settlement, so theunderlying cashflow may be over a number of years. There can also be delays in settlement dates anticipated for next year which will further impact the cash flowtiming. During 2019-20 the Welsh Risk Pool best estimate is that £110million will be paid out on legal claims.

50

Velindre University NHS Trust Annual Accounts 2018-19

23. Provisions (continued)

2017-18

NHS Trust and Welsh Risk Pool

Current

£000 £000 £000 £000 £000 £000 £000 £000 £000 £000

Clinical negligence 236,684 (27,006) (5,717) (5,452) 0 165,609 (75,430) (25,088) (4,899) 258,701

Personal injury 5,019 0 0 (10) 0 6,407 (2,508) (2,222) (14) 6,672

All other losses and special payments 44 0 0 0 0 6 (49) (1) 0 0

Defence legal fees and other administration 4,983 0 0 (938) 0 3,015 (1,080) (1,412) (25) 4,543

Structured Settlements - WRPS 10,755 550 0 0 0 11,363 (10,869) (993) 381 11,187

Pensions relating to: former directors 0 0 0 0 0 0 0 0 0

Pensions relating to: other staff 22 (6) 24 0 0 (20) 0 0 20

Restructurings 0 0 0 0 0 0 0 0

Other 1,284 0 0 0 738 (709) (570) 743

Total 258,791 (26,456) (5,723) (6,376) 0 187,138 (90,665) (30,286) (4,557) 281,866

FHoT 0 0 0 0 0 0 0 0 0 0

Consolidated Total 258,791 (26,456) (5,723) (6,376) 0 187,138 (90,665) (30,286) (4,557) 281,866

Non Current

Clinical negligence 298,210 0 (3,200) 5,312 0 146,474 (7,615) (17,683) (722) 420,776

Personal injury 0 0 0 6 0 0 0 0 0 6

All other losses and special payments 0 0 0 0 0 0 0 0 0 0

Defence legal fees and other administration 1,494 0 0 1,082 0 1,111 (210) (290) (9) 3,178

Structured Settlements - WRPS 309,834 26,456 0 0 0 26,977 0 (4,988) 0 358,279

Pensions relating to: former directors 0 0 0 0 0 0 0 0 0

Pensions relating to: other staff 153 0 (24) 0 3 0 0 0 132

Restructurings 0 0 0 0 0 0 0 0

Other 175 0 0 0 108 0 0 283

Total 609,866 26,456 (3,200) 6,376 0 174,673 (7,825) (22,961) (731) 782,654

FHoT 0 0 0 0 0 0 0 0 0 0

Consolidated Total 609,866 26,456 (3,200) 6,376 0 174,673 (7,825) (22,961) (731) 782,654

TOTAL

Clinical negligence 534,894 (27,006) (8,917) (140) 0 312,083 (83,045) (42,771) (5,621) 679,477

Personal injury 5,019 0 0 (4) 0 6,407 (2,508) (2,222) (14) 6,678

All other losses and special payments 44 0 0 0 0 6 (49) (1) 0 0

Defence legal fees and other administration 6,477 0 0 144 0 4,126 (1,290) (1,702) (34) 7,721

Structured Settlements - WRPS 320,589 27,006 0 0 0 38,340 (10,869) (5,981) 381 369,466

Pensions relating to: former directors 0 0 0 0 0 0 0 0 0

Pensions relating to: other staff 175 (6) 0 0 3 (20) 0 0 152

Restructurings 0 0 0 0 0 0 0 0

Other 1,459 0 0 0 846 (709) (570) 1,026

Total 868,657 0 (8,923) 0 0 361,811 (98,490) (53,247) (5,288) 1,064,520

FHoT 0 0 0 0 0 0 0 0 0 0

Consolidated Total 868,657 0 (8,923) 0 0 361,811 (98,490) (53,247) (5,288) 1,064,520

At 31 March

2018

Transfers

to creditors

Utilised

during the

year

Transfers

(to)/from

other NHS

body

Transfers

between

current and

non current

At 1 April

2017

Structured

settlement

cases

transferred

to Risk Pool

Arising

during the

year

Reversed

unused

Unwinding

of discount

The expected timing of cashflows are based on best available information; but they could change on the basis of individual case changes.Included within the above are no clinical negligence provisions arising from Redress.In addition to the provision shown above, contingent liabilities are given in the 'Contingent liabilities' note.Other Provisions include:- Dilapidations - Decommissioning cessium sources - Employee Costs

51

Velindre University NHS Trust Annual Accounts 2018-19

24 Contingencies

24.1 Contingent liabilities

Provision has not been made in these accounts for 31 March 31 March 31 March 31 March

the following amounts: 2019 2018 2019 2018

£000 £000 £000 £000

Legal claims for alleged medical or employer negligence 936,248 814,718 936,248 814,718

Doubtful debts 0 0 0 0

Equal pay cases 0 0 0 0

Defence costs 0 0 0 0

Other (Please specify) 117 0 117 0

Total value of disputed claims 936,365 814,718 936,365 814,718

Amount recovered under insurance arrangements in the event of

these claims being successful (936,133) (814,591) (936,133) (814,591)

Net contingent liability 232 127 232 127

24.2. Remote contingent liabilities

31 March 31 March 31 March 31 March

2019 2018 2019 2018

£000 £000 £000 £000

Guarantees 0 0 0 0

Indemnities 17,465 27,654 17,465 27,654

Letters of comfort 0 0 0 0

Total 17,465 27,654 17,465 27,654

24.3 Contingent assets

31 March 31 March 31 March 31 March

2019 2018 2019 2018

£000 £000 £000 £000

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

NHS Trust Consolidated

NHS Trust Consolidated

NHS Trust Consolidated

Other litigation claims could arise in the future due to known incidents. The expenditure which may arise from such claimscannot be determined and no provision has been made for them.

Liability for Permanent Injury Benefit under the NHS Injury Benefit Scheme lies with the employer. Individual claims to the NHSPensions Agency could arise due to known incidents.

Contingent liabilities includes claims relating to alleged clinical negligence, personal injury and permanent injury benefits underthe NHS Injury Benefits Scheme. The above figures include contingent liabilities for all Health Bodies in Wales. "Other"includes £117,000 (2017/18, £nil) relating to the Trust's treatment of VAT in respect of advisory legal services, pending advicefrom HMRC.

The Trust has no contingent assets.

52

Velindre University NHS Trust Annual Accounts 2018-19

25. Capital commitments

Commitments under capital expenditure contracts at the statement of financial position sheet date were:

31 March 31 March 31 March 31 March

2019 2018 2018 2017

NHS Trust

£000 £000 £000 £000

Property, plant and equipment 904 1,533 904 1,533

Intangible assets 2,678 1,627 2,678 1,627

Total 3,582 3,160 3,582 3,160

Consolidated

53

Velindre University NHS Trust Annual Accounts 2018-19

26. Losses and special payments

Gross loss to the Exchequer

Number of cases and associated amounts paid out or written-off during the financial year

Number £ Number £

Clinical negligence 382 96,829,125 383 97,158,970

Personal injury 46 6,494,275 44 6,483,683

All other losses and special payments 301 1,773,797 296 1,769,295

Total 729 105,097,197 723 105,411,948

FHoT losses and special payments 0 0 0 0

Consolidated Total 729 105,097,197 723 105,411,948

Analysis of cases:

Amounts Approved to

Case Reference Number Case Type paid out in Cumulative write-off

year amount in yearCases where cumulative amount

exceeds £300,000 £ £ £

Abertawe Bro Morgannwg University

Health Board

10 10 Clinical negligence

14,756,294 17,493,937 14,756,294

Aneurin Bevan Health Board 5 5 Clinical negligence 6,802,359 9,354,780 6,802,359

Betsi Cadwaladr Health Board 10 10 Clinical negligence 12,192,410 15,146,504 12,192,410

Cardiff & Vale University Health 18 18 Clinical negligence 25,200,753 29,870,530 25,200,753

Cwm Taf University Health Board 4 3 Clinical negligence, 1

Personal injury 1,922,376 4,574,127 1,922,376

Hywel Dda Local Health Board 7 7 Clinical negligence 8,593,154 8,593,154 8,593,154

Public Health Wales NHS Trust 3 3 Clinical negligence 1,288,142 1,288,142 1,288,142

0

Welsh Ambulance Services Trust 4 1 Clinical negligence, 3

Personal injury 5,274,429 5,812,134 5,274,429

Sub-total 61 76,029,917 92,133,308 76,029,917

All other cases 668 29,067,280 142,917,209 29,382,031

Total cases 729 105,097,197 235,050,517 105,411,948

Approved to write-off

year to 31 March 2019

Amounts paid out during

year to 31 March 2019

Losses and special payments are charged to the Income statement in accordance with IFRS but are recorded in the losses and special payments register when payment is made. Therefore this note is prepared on a cash basis.

53(1)

Velindre University NHS Trust Annual Accounts 2018-19

26. Losses and special payments

26.2 Velindre University NHS Trust excluding Welsh Risk Pool

Gross loss to the Exchequer

Number of cases and associated amounts paid out or written-off during the financial year

Number £ Number £

Clinical negligence 7 340,468 8 670,313

Personal injury 3 13,592 1 3,000

All other losses and special payments 15 16,041 10 11,539

Total 25 370,101 19 684,852

Analysis of cases:

Amounts Approved to

Case reference Number Case Type paid out in Cumulative write-off

year amount in year

Cases where cumulative amount

exceeds £300,000 £ £ £

0 0 0 0

Sub-total 0 0 0 0

All other cases 25 370,101 1,022,763 684,852

Total cases 25 370,101 1,022,763 684,852

Approved to write-off

year to 31 March 2019

Amounts paid out during

year to 31 March 2019

Losses and special payments are charged to the Income statement in accordance with IFRS but are recorded in the losses and special payments register when payment is made. Therefore this note is prepared on a cash basis.

53(2)

Velindre University NHS Trust Annual Accounts 2018-19

26. Losses and special payments

26.3 Welsh Risk Pool

Gross loss to the Exchequer

Number of cases and associated amounts paid out or written-off during the financial year

Number £ Number £

Clinical negligence 375 96,488,657 375 96,488,657

Personal injury 43 6,480,683 43 6,480,683

All other losses and special payments 286 1,757,756 286 1,757,756

Total 704 104,727,096 704 104,727,096

Analysis of cases:

Amounts Approved to

Number Case Type paid out in Cumulative write-off

year amount in yearCases where cumulative amount

exceeds £300,000 £ £ £

Abertawe Bro Morgannwg University

Health Board 10 10 Clinical negligence 14,756,294 17,493,937 14,756,294

Aneurin Bevan Health Board 5 5 Clinical negligence 6,802,359 9,354,780 6,802,359

Betsi Cadwaladr Health Board 10 10 Clinical negligence 12,192,410 15,146,504 12,192,410

Cardiff & Vale University Health Board 18 18 Clinical negligence 25,200,753 29,870,530 25,200,753

Cwm Taf University Health Board 4

3 Clinical negligence, 1

Personal injury 1,922,376 4,574,127 1,922,376

Hywel Dda Local Health Board 7 7 Clinical negligence 8,593,154 8,593,154 8,593,154

Powys Local Health Board 0 0 0 0

Public Health Wales NHS Trust 3 3 Clinical negligence 1,288,142 1,288,142 1,288,142

Velindre University NHS Trust 0 0 0 0

Welsh Ambulance Services Trust 4

1 Clinical negligence, 3

Personal injury 5,274,429 5,812,134 5,274,429

Sub-total 61 76,029,917 92,133,308 76,029,917

All other cases 643 28,697,179 141,894,446 28,697,179

Total cases 704 104,727,096 234,027,754 104,727,096

Approved to write-off

year to 31 March 2019

Amounts paid out during

year to 31 March 2019

Losses and special payments are charged to the Income statement in accordance with IFRS but are recorded in the losses and special payments register when payment is made. Therefore this note is prepared on a cash basis.

54

Velindre University NHS Trust Annual Accounts 2018-19

27. Finance leases

27.1 Finance leases obligations (as lessee)

Amounts payable under finance leases:

LAND 31 March 31 March 31 March 31 March

2019 2018 2019 2018

£000 £000 £000 £000

Minimum lease payments

Within one year 0 0 0 0

Between one and five years 0 0 0 0

After five years 0 0 0 0

Less finance charges allocated to future periods 0 0 0 0

Minimum lease payments 0 0 0 0

Included in: Current borrowings 0 0 0 0

Non-current borrowings 0 0 0 0

Total 0 0 0 0

Present value of minimum lease payments

Within one year 0 0 0 0

Between one and five years 0 0 0 0

After five years 0 0 0 0

Total present value of minimum lease payments 0 0 0 0

Included in: Current borrowings 0 0 0 0

Non-current borrowings 0 0 0 0Total 0 0 0 0

ConsolidatedNHS Trust

Velindre University NHS Trust leases certain items of plant and equipment, which are mainly printers, under financeleases. The average lease term is 5 years. All leases are on a fixed repayment basis and no arrangements havebeen entered into for contingent rental payments.

The fair value of Velindre University NHS Trust's lease obligations is approximately equal to their carrying amount.Velindre University NHS Trust's obligation under finance leases are secured by the lessors' rights over the leasedassets disclosed in note 13.

55

Velindre University NHS Trust Annual Accounts 2018-19

27.1 Finance leases obligations (as lessee) continued

Amounts payable under finance leases:

BUILDINGS 31 March 31 March 31 March 31 March

2019 2018 2019 2018

Minimum lease payments £000 £000 £000 £000

Within one year 0 0 0 0

Between one and five years 0 0 0 0

After five years 0 0 0 0

Less finance charges allocated to future periods 0 0 0 0

Minimum lease payments 0 0 0 0

Included in: Current borrowings 0 0 0 0

Non-current borrowings 0 0 0 0

Total 0 0 0 0

Present value of minimum lease payments

Within one year 0 0 0 0

Between one and five years 0 0 0 0

After five years 0 0 0 0

Total present value of minimum lease payments 0 0 0 0

Included in: Current borrowings 0 0 0 0

Non-current borrowings 0 0 0 0

Total 0 0 0 0

OTHER 31 March 31 March 31 March 31 March

2019 2018 2019 2018

Minimum lease payments £000 £000 £000 £000

Within one year 26 27 26 27

Between one and five years 30 55 30 55

After five years 0 0 0 0

Less finance charges allocated to future periods (3) (6) (3) (6)

Minimum lease payments 53 76 53 76

Included in: Current borrowings 24 24 24 24

Non-current borrowings 29 52 29 52

Total 53 76 53 76

Present value of minimum lease payments

Within one year 24 24 24 24

Between one and five years 29 52 29 52

After five years 0 0 0 0

Total present value of minimum lease payments 53 76 53 76

Included in: Current borrowings 24 24 24 24

Non-current borrowings 29 52 29 52

Total 53 76 53 76

Consolidated

Consolidated

NHS Trust

NHS Trust

56

Velindre University NHS Trust Annual Accounts 2018-19

27.2 Finance lease receivables (as lessor)

Amounts receivable under finance leases:

31 March 31 March 31 March 31 March

2019 2018 2019 2018

Gross investment in leases £000 £000 £000 £000

Within one year 0 0 0 0

Between one and five years 0 0 0 0

After five years 0 0 0 0

Less finance charges allocated to future periods 0 0 0 0

Present value of minimum lease payments 0 0 0 0

Included in: Current borrowings 0 0 0 0

Non-current borrowings 0 0 0 0

Total 0 0 0 0

Present value of minimum lease payments

Within one year 0 0 0 0

Between one and five years 0 0 0 0

After five years 0 0 0 0

Total present value of minimum lease payments 0 0 0 0

Included in: Current borrowings 0 0 0 0

Non-current borrowings 0 0 0 0Total 0 0 0 0

ConsolidatedNHS Trust

There are no finance lease receivables.

57

Velindre University NHS Trust Annual Accounts 2018-19

27.3 Rental Revenue 31 March 31 March 31 March 31 March

2019 2018 2019 2018

£000 £000 £000 £000

Contingent rent 0 0 0 0

Other 0 0 0 0

Total rental revenue 0 0 0 0

27.4 Finance Lease Commitment

28. Private finance transactions

Private Finance Initiatives (PFI) / Public Private Partnerships (PPP)

ConsolidatedNHS Trust

The Trust has no PFI or PPP schemes.

The Trust has entered into one new contract to lease additional space, within a building already occupied, via finance lease during 2018-19.

58

Velindre University NHS Trust Annual Accounts 2018-19

29. Financial Risk Management

Certificate of Chief Financial Officer/Director of Finance

IFRS 7, Derivatives and Other Financial Instruments, requires disclosure of the role that financialinstruments have had during the period in creating or changing the risks an entity faces in undertaking itsactivities.

NHS Trusts are not exposed to the degree of financial risk faced by business entities. Financialinstruments play a much more limited role in creating or changing risk than would be typical of the listedcompanies to which IFRS 7 mainly applies. NHS Trusts have limited powers to borrow or invest surplusfunds and financial assets and liabilities are generated by day to day operational activities rather thanbeing held to change the risks facing NHS Trusts in undertaking its activities.

The Trust's treasury management operations are carried out by the finance department within parametersdefined formally within the Trust's standing financial instructions and policies agreed by the board ofdirectors. The Trust treasury activity is subject to review by the Trust's internal auditors.

Liquidity riskThe Trust's net operating costs are incurred under annual service agreements with various Health bodies,which are financed from resources voted annually by parliament. NHS Trusts also largely finance theircapital expenditure from funds made available from the Welsh Government under agreed borrowing limits.NHS Trusts are not, therefore, exposed to significant liquidity risks.

Interest-rate risksThe great majority of NHS Trust's financial assets and financial liabilities carry nil or fixed rates of interest.NHS Trusts are not, therefore, exposed to significant interest-rate risk.

Foreign currency riskNHS Trusts have no or negligible foreign currency income or expenditure and therefore are not exposed tosignificant foreign currency risk.

Credit RiskBecause the majority of the Trust's income comes from contracts with other public sector bodies, the Trusthas low exposure to credit risk. The maximum exposures are in receivables from customers as disclosedin the trade and other receivables note.

GeneralThe powers of the Trust to invest and borrow are limited. The Board has determined that in order tomaximise income from cash balances held, any balance of cash which is not required will be invested.The Trust does not borrow from the private sector. All other financial instruments are held for the solepurpose of managing the cash flow of the Trust on a day to day basis or arise from the operating activitiesof the Trust. The management of risks around these financial instruments therefore relates primarily to theTrust's overall arrangements for managing risks to their financial position, rather than the Trust's treasurymanagement procedures.

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Velindre University NHS Trust Annual Accounts 2018-19

30. Movements in working capital 31 March 31 March 31 March

2019 2018 2019

£000 £000 £000

Movements in working capital NHST Consolidated

Decrease / (increase) in inventories (2,937) (185) (2,937)

(Increase) in trade and other receivables - non-current (16,407) (172,692) (16,135)

(Increase) / decrease in trade and other receivables -current (6,396) (44,286) (5,986)

Increase/(Decrease) in trade and other payables- non-current 0 0 0

Increase / (decrease) in trade and other payables- current 9,751 22,226 9,677

Total (15,989) (194,937) (15,381)

Adjustment for accrual movements in fixed assets -creditors (2,639) (3,550) (2,640)

Adjustment for accrual movements in fixed assets -debtors (153) (22) (153)

Other adjustments 1,388 (25) 1,402

Total (17,393) (198,534) (16,772)

31. Other cash flow adjustments

31 March 31 March

2019 2018

Other cash flow adjustments £000 £000

Depreciation 9,439 9,236

Amortisation 7,027 8,359

(Gains)/Loss on Disposal 0 0

Impairments and reversals 0 0

Release of PFI deferred credits 0 0

Donated assets received credited to revenue but non-cash (24) (5)

Government Grant assets received credited to revenue but non-cash 0 0

Non-cash movements in provisions 129,043 299,638

Total 145,485 317,228

Consolidated figures are not included at 31 March 2018 as the Cash Flow Statement was prepared in a different format.

60

Velindre University NHS Trust Annual Accounts 2018-19

32. Third party assets

33. Events after reporting period

The Trust held £nil cash at bank and in hand at 31 March 2019 (31 March 2018, £nil) which relates to monies held by the Trust on behalf of patients. Cash held in Patient's Investment Accounts amounted to £nil at 31 March 2019 (31 March 2018, £nil).

The Trust had no events after the reporting period.

61

Velindre University NHS Trust Annual Accounts 2018-19

34. Related Party transactions

The Trust is a body corporate established by order of the Welsh Minister for Health and Social Services.

The Welsh Government is regarded as a related party. During the year NHS Trust have had a significant number of

material transactions with the Welsh Government and with other entities for which the Welsh Government is regarded as the parent body, namely

Payments to Receipts from Amounts owed Amounts due

related party related party to related party from related party

£000 £000 £000 £000

Welsh Government 12,000 314,971 16 6,385

WHSSC/EASC 129 40,716 24 855

Abertawe Bro Morgannwg University Health Board 5,292 25,498 1,253 2,053

Aneurin Bevan Health Board 5,877 36,978 1,803 2,003

Betsi Cadwaladr Health Board 4,972 19,866 1,043 1,375

Cardiff & Vale University Health Board 6,392 32,602 1,248 1,970

Cwm Taf University Health Board 4,270 19,951 979 1,920

Hywel Dda Local Health Board 2,157 12,051 811 1,107

Powys Local Health Board 451 2,853 161 188

Public Health Wales NHS Trust 491 3,302 140 302

Welsh Ambulance Services Trust 1,386 1,656 93 276

Health Education and Improvement Wales (HEIW) 44 11,098 0 435

Welsh Local Authorities 2,580 115 119 98

Cardiff University 13,968 527 301 60

Swansea University 9,531 125 2 1

Cardiff Metropolitan University 2,055 0 99 0

University of South Wales 8,778 121 35 0

University of Wales 139 0 54 0

Bangor University 7,631 0 145 0

Glyndwr University 0 0 56 0

Other 0 0 0 0

Charities 81 878 81 168

88,224 523,308 8,463 19,196

During the year none of the board members or members of the key management staff or parties related to them has undertaken any

material transactions with the Trust.

In addition, the Trust has had a number of material transactions with other Government departments and other central and local Government bodies.The majority of these transactions have been with universities as disclosed above, other transactions include payments to English, Scottish and IrishNHS organisations amounting to £493,181 (2017-18: £1,630,000).

The Trust Board is the corporate trustee of Velindre University NHS Trust Charitable Funds. During the year the Trust received £2,762,000 (2017-18:£2,714,000) from Velindre University NHS Trust Charitable Funds.

The Welsh Government receipts exclude £14,894,000 that relates to PDC capital received during 2018-19 (2017-18: returned £1,402,000).

62

Velindre University NHS Trust Annual Accounts 2018-19

35. Pooled budgets

Velindre University NHS Trust has no pooled budgets.

63

Velindre University NHS Trust Annual Accounts 2018-19

36. Operating Segments

2018-19 2017-18 2018-19 2017-18 2018-19 2017-18 2018-19 2017-18 2018-19 2017-18 2018-19 2017-18 2018-19 2017-18 2018-19 2017-18

Operating Revenue £000 £000 £000 £000 £000 £000 £000 £000 £000 £000 £000 £000 £000 £000 £000 £000

Segmental Income 127,487 119,026 70,790 56,615 196,130 232,647 130,638 302,898 525,045 711,186 3,323 4,356 (2,762) (2,714) 525,606 712,828

127,487 119,026 70,790 56,615 196,130 232,647 130,638 302,898 525,045 711,186 3,323 4,356 (2,762) (2,714) 525,606 712,828

Operating Expenses £000 £000 £000 £000 £000 £000 £000 £000 £000 £000 £000 £000 £000 £000 £000 £000

Welsh Government 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

WHSSC & EASC 0 146 0 0 37 0 0 0 37 146 0 0 0 0 37 146

Local Health Boards 291 1,175 1,646 1,159 3,735 875 0 0 5,671 3,209 0 0 0 0 5,671 3,209

Welsh NHS Trusts 0 2,066 163 0 168 0 0 0 330 2,066 0 0 0 0 330 2,066

Other NHS Trusts 0 2 0 0 0 1 0 0 0 3 0 0 0 0 0 3

Goods and services from other NHS bodies 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Purchase of healthcare from non-NHS bodies 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Welsh Local Authorities 27 0 40 52 0 0 0 0 68 52 0 0 0 0 68 52

Other Local Authorities 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Directors' costs 1,098 1,055 0 0 0 0 0 0 1,098 1,055 0 0 0 0 1,098 1,055

Staff costs 54,322 51,394 27,906 24,249 77,225 73,168 0 0 159,453 148,811 0 0 0 0 159,453 148,811

Supplies and services - clinical 53,473 47,622 21 12 490 700 0 0 53,984 48,334 0 0 0 0 53,984 48,334

Supplies and services - general 592 447 263 110 40,805 36,154 0 0 41,660 36,711 0 0 0 0 41,660 36,711

Consultancy Services 313 (100) 1,109 1,423 336 790 0 0 1,758 2,113 0 0 0 0 1,758 2,113

Establishment 2,342 2,464 4,912 4,001 7,315 7,149 0 0 14,569 13,614 0 0 0 0 14,569 13,614

Transport 928 898 15 18 1,286 1,079 0 0 2,229 1,995 0 0 0 0 2,229 1,995

Premises 6,493 5,491 26,897 16,542 8,710 9,490 0 0 42,100 31,523 0 0 0 0 42,100 31,523

0 0

Costs of generating funds 0 0 0 0 0 0 743 513 (192) (196) 551 317

Charitable activites 0 0 0 0 0 0 2,935 2,822 (2,526) (2,478) 409 344

Governance Costs 0 0 0 0 0 0 44 40 (44) (40) 0 0

0 0

Impairments and Reversals of Receivables 0 0 0 0 0 0 0 0 0 0 0 0

Depreciation 5,944 6,163 2,052 1,614 1,444 1,459 0 0 9,440 9,236 0 0 0 0 9,440 9,236

Amortisation 383 259 6,344 7,817 302 283 0 0 7,029 8,359 0 0 0 0 7,029 8,359

Impairments and reversals of property, plant and eq 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Impairments and reversals of intangible assets 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Impairments and reversals of financial assets 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Impairments and reversals of non current assets he 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Audit fees 209 209 0 0 0 0 0 0 209 209 0 0 0 0 209 209

Other auditors' remuneration 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Losses, special payments and irrecoverable debts (203) 9 0 9 61 81 133,637 308,186 133,496 308,285 0 0 0 0 133,496 308,285

Research and development 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Other operating expenses 1,331 (146) (578) (391) 54,247 101,390 0 0 55,000 100,853 0 0 0 0 55,000 100,853

Total 127,543 119,154 70,790 56,615 196,161 232,619 133,637 308,186 528,131 716,574 3,722 3,375 (2,762) (2,714) 529,091 717,235

Investment Revenue 100 59 0 0 0 0 0 0 100 59 154 171 0 0 254 230

Other Gains and Losses 0 98 0 0 45 0 0 0 45 98 0 0 0 0 45 98

Finance Costs (3) (3) 0 0 0 0 2,999 5,288 2,996 5,285 0 0 0 0 2,996 5,285

SURPLUS / (DEFICIT) 41 26 0 0 14 28 0 0 55 54 (245) 1,152 0 0 (190) 1,206

IFRS 8 requires organisations to report information about each of its operating segments.

ELIMINATIONS CONSOLIDATEDVELINDRE NWIS NWSSP WRP TOTAL FHOT

64

Velindre University NHS Trust Annual Accounts 2018-19

37. Other Information

IFRS15

Work was undertaken by the Technical Accounting Group (TAG) IFRS sub group, consistent

with the ‘portfolio’ approach allowed by the standard. Each income line in the notes from a

previous year’s annual accounts (either 2016/17 or 2017/18) was considered to determine how

it would be affected by the implementation of IFRS 15. It was determined that the following

types of consideration received from customers for goods and services (hereon referred to as

income) fell outside the scope of the standard, as the body providing the income does not

contract with the body to receive any direct goods or services in return for the income flow:

• Charitable Income and other contributions to expenditure;

• Receipt of donated assets;

• WG funding without direct performance obligation (e.g. SIFT/SIFT®/Junior Doctors &

PDGME Funding).

Income that fell wholly or partially within the scope of the standard included:

• Welsh LHB & WHSCC LTA income;

• Non Welsh Commissioner income;

• NHS Trust income;

• Foundation Trust income;

• Other WG income;

• Local Authority income;

• ICR income;

• Training & education income;

• Accommodation & catering income

It was identified that the only material income flows likely to require adjustment for compliance

with IFRS15 was that for patient care provided under Long Term Agreements (LTAs). The

adjustment being, for episodes of patient care which had started but not concluded (FCEs) as

at period end, eg 31 March. Inclusion of these was not deemed to have a material impact

within the Trust's financial statements and therefore no adjustment for compliance with IFRS15

has been made.

65

Velindre University NHS Trust Annual Accounts 2018-19

37. Other Information (continued)

IFRS 9

For consistency across Wales, the practical expedient provision matrix was used to estimate

expected credit losses (ECLs) based on the ‘age’ of receivables as follows:

• Receivables were segregated into appropriate groups

• Each group, was analysed into:

a) age-bands

1-30 days (including current)

31-60 days

61-90 days

91-180 days

181- 365 days

> 1 year

b) at historical back-testing dates (data points)

• For each age-band, at each back-testing date the following were determined:

a) the gross receivables

b) the amounts ultimately collected/written-off. If material, adjustments were

made to exclude the effect of non-collections for reasons other than credit loss

(eg credit notes issued for returns, short-deliveries or as a commercial price

concession)

The average historical loss rate by age-band was calculated, and adjusted where necessary totake account of changes in:a) economic conditionsb) types of customerc) credit management practices

Consideration was given as to whether ECLs should be estimated individually for any period-end receivables, eg because information was available for specific debtors.

Loss rate estimates were applied to each age-band for the other receivables.

The percentages calculated and shown overleaf have been applied to those invoicesoutstanding as at 31st March 2019 (which don’t already have a specific provision against them)to recalculate the value of the Trust non-specific provision under IFRS9.

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Velindre University NHS Trust Annual Accounts 2018-19

37. Other Information (continued)

Age Band

Referred to

Debt

Collection

Agency

NHS Wales &

Welsh

Government

NHS

England /

Ireland /

Scotland

Non NHS

Charities Non NHS

Universities &

Government

Funded

Bodies Overseas

Private

Patients

(Deceased)

Private

Patients

Salary

Overpayments

Within maturity (0-30 days) 4.72% 2.71% 1.14% 4.36% 7.87% 1.15% 2.39% 9.20% 5.77% 31.86%

31-60 days 5.37% 9.52% 2.60% 7.45% 10.70% 7.37% 2.85% 15.28% 17.28% 30.98%

61-90 days 7.00% 14.78% 4.89% 16.12% 18.44% 9.46% 6.64% 20.06% 25.27% 34.52%

91-180 days 8.09% 20.72% 7.32% 36.98% 26.37% 10.78% 13.52% 29.32% 37.07% 37.26%

181-365 days 72.20% 37.11% 19.22% 67.90% 44.51% 32.67% 31.69% 74.82% 54.22% 44.14%

1 year + 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00%

BREXIT Update

On 29 March 2017, the UK Government submitted its notification to leave the EU in accordance with Article 50. The triggering of Article 50 started a two-

year negotiation process between the UK and the EU. On 11 April 2019, the government confirmed agreement with the EU on an extension until 31

October 2019 at the latest, with the option to leave earlier as soon as a deal has been ratified.

In 2018-19 the NHS Estate has been valued using indices provided by the District Valuer and disclosed in the Manual For Accounts.

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Velindre University NHS Trust Annual Accounts 2018-19

THE NATIONAL HEALTH SERVICE IN WALES ACCOUNTS DIRECTION GIVEN BY WELSH MINISTERS IN ACCORDANCE WITH SCHEDULE 9 SECTION 178 PARA 3(1) OF THE NATIONAL HEALTH SERVICE (WALES) ACT 2006 (C.42) AND WITH THE APPROVAL OF TREASURY

NHS TRUSTS

1. Welsh Ministers direct that an account shall be prepared for the financial year ended 31March 2010 and subsequent financial years in respect of the NHS Wales Trusts in the formspecified in paragraphs [2] to [7] below.

BASIS OF PREPARATION

2. The account of the NHS Wales Trusts shall comply with:

(a) the accounting guidance of the Government Financial Reporting Manual (FReM), which is inforce for the financial year for which the accounts are being prepared, as detailed in the NHSWales Trust Manual for Accounts;

(b) any other specific guidance or disclosures required by the Welsh Government.

FORM AND CONTENT

3. The account of the Trust for the year ended 31 March 2010 and subsequent years shallcomprise a foreword, an income statement, a statement of financial position, a statement ofcash flows and a statement of changes in taxpayers’ equity as long as these statements arerequired by the FReM and applied to the NHS Wales Manual for Accounts, including such notesas are necessary to ensure a proper understanding of the accounts.

4. For the financial year ended 31 March 2010 and subsequent years, the account of the Trustshall give a true and fair view of the state of affairs as at the end of the financial year and theoperating costs, changes in taxpayers’ equity and cash flows during the year.

5. The account shall be signed and dated by the Chief Executive.

MISCELLANEOUS

6. The direction shall be reproduced as an appendix to the published accounts.

7. The notes to the accounts shall, inter alia, include details of the accounting policies adopted.

Signed by the authority of Welsh Ministers

Signed : Chris Hurst Dated : 17.06.2010

1 Please see regulation 3 of the 2009 No 1558(W.153); NATIONAL HEALTH SERVICE,WALES; The National Health Service Trusts (Transfer of Staff, Property Rights and Liabilities)