Annual Report and Accounts - The Great Western Hospital

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3.27 Development of services with others The Trust is in the process of reviewing community and acute pathways between Great Western Hospital and its boarder counties. The aim is to establish a single process of referral between acute and community to ensure that patients are in the right place, at the right time, with the right skills to meet their needs. This includes proactive planning of care from the point of admission and the development of pathways between community services and the front door (Emergency Department, Ambulatory Care and Linnet Assessment Medical Unit). This will enable patients to be returned directly home when feasible. Page 39 of 211
3.28 Working with our partners to strengthen the service we provide During the course of the year significant effort has gone in to focussing on how the Trust can achieve its objectives through better working in partnership with local key stakeholders. The merger with Wiltshire Community Health services (WCHS) in June 2011 presented a unique opportunity to shift from being an acute hospital provider to being an integrated healthcare provider with much closer links to GPs, Local Authorities and the Third Sector in particular. This shift has also seen the Trust operate across a much wider geographical area and has required us to build greater knowledge of the surrounding area and an understanding of the partnerships there so we can tap into the effective relationships that already exist on the ground. As evidence of our commitment to working in partnership, work has taken place with our partners to: • Redesign the Older People’s Pathway with the aim of making the best use of providing both acute and community services under a single organisation so that the various stages of clinical care for an elderly patient are provided in the appropriate setting and in a timely fashion. To be successful this project involves a wide variety of local stakeholders including our commissioners, Clinical Commissioning Group, and Acute Geriatric Medicine Consultants, Social Care, and Community Hospital representatives. The group aims to reduce reliance on the acute sector to provide clinical care, support more care in the community or at home and reduce the risk of elderly patient becoming institutionalised in hospital due to the challenges of getting social care and other support services in place following long stays in hospital. • Instigating a project to improve patient flow not only to reduce the amount of time patients spend in our hospitals but to improve their overall NHS experience whether they come to us through their GP or through the Emergency Department. This work relies on close working with our partners in social care to support patients and users in getting back to where they originally came from and then working closely together to develop effective plans to prevent unnecessary readmission. The work of our Discharge Liaison Nurses is instrumental in this area in working with social care to help ease the transition from hospital back into the community. • Engage more with the emerging Clinical Commissioning Groups to secure early GP input into discussions around pathways and potential future commissioning intentions so that services are built around our customers – patients and GPs. Over the coming year the Trust will be engaging with GPs to secure their input into the development of the Trust strategy running from 2012 – 2017. This is to ensure that our new strategy reflects future commissioning intentions and is responsive to the rapid changes in the local health economy. • Regular attendance at Wiltshire Involvement Network (WIN) to discuss key developments in the community and at the GWH which is helping establish more productive working relationships in an area that the Trust had not previously engaged with. This relationship will continue to develop as we engage with them on changes to local community services in the years ahead. Page 40 of 211
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Great Western Hospitals NHS Foundat
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CONTENTS 1 Chair and Chief Executiv
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The Great Western Hospital became a
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Underpinning this, our values are t
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3.2 Principal activities of the Tru
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Further Companies Act Disclosures 3
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Business Review / Management Commen
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3. To ensure that staff are proud t
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6. To work in partnership with othe
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With funding received from the Depa
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3.13 Contractual arrangements The T
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Patient care 3.16 Development of se
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3.20 New or significantly revised s
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3.24 Complaints Handling For the Tr
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The Trust actively responds to feed
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3.25 Using patient experience to dr
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The table below shows the CQUIN res
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Action plans based on the Quarterly
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3.27 Development of services with o
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3.29 Health and Overview Scrutiny C
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3.32.5 Interests held by Directors
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4.3 Attendance at meetings of the R
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4.7 Board of Directors’ employmen
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Remuneration Name Title Salary (Ban
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4.8.4 Additional disclosures The Tr
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5.1.2 Elected Governors - Public Co
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5.1.4 Nominated Governors Name Nomi
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5.1.6 Lead and Deputy Lead Governor
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“Eyes and Ears” - An initiative
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5.1.12 Nominations and Remuneration
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Rowland Cobbold, Non-Executive Dire
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Lyn Hill-Tout, Chief Executive (unt
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5.2.3 Length of appointments of Non
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5.2.6 Attendance at meetings of the
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5.3 Audit Committee 5.3.1 The Audit
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5.4 Directors’ responsibility for
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Note: Angela Gillibrand and Rowland
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The Mental Health Act / Mental Capa
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The Trust has a wide range of staff
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5.8.6 Membership Strategy To encour
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5.9 Code of Governance Disclosure S
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6 QUALITY REPORTS Part 1 - Statemen
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Part 2 - Priorities for improvement
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6.3.1 Review of services and partic
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The trust chose not to contribute t
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No. Audit Title Reconstruction Audi
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The reports of 273 local clinical a
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No. Audit Title 15. Non Invasive Ve
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No. Audit Title Antibiotic Prescrib
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No. Audit Title 50. NICE CG111 - No
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Part 3 - Other Information 6.4 Over
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GRAPH - Clostridium Difficile WCHS2
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GRAPH - Medicine incidents by type
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Harm from falls WCHS: It was not po
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• Rolling educational programme w
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CHART - Relative risk SW Acute Trus
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Following the Trust’s merge in Ju
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Priority 7: Participation on the Re
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All the guidelines have been dissem
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This has been achieved by: • Mont
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• As a result of complaints and c
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CHART - National Sentinel Stroke Au
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Priority 16: To ensure patients are
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6.5 Care Quality Commission (CQC) I
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6.7 Statement of Directors’ respo
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a Quality Account and the opportuni
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Overall, the Trust has good plans t
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Graph 1 - GWH carbon footprint (ton
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The Trust is working with local bus
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Graph 9 - Total tonnes of waste pro
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The Trust will be working towards a
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Detailed below is a summary of the
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Wiltshire Community Health Services
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providers. Feedback obtained across
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The Musculoskeletal Disorder team a
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10.2.2 Governance risk rating The t
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11 OTHER DISCLOSURES IN PUBLIC INTE
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13 AUDITOR’S OPINION AND CERTIFIC
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14 ANNUAL GOVERNANCE STATEMENT 14.1
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• the key controls to mitigate ag
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14.4.6 Organisation Culture The Tru
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14.5 Review of economy, efficiency
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Process Board Role and Conclusions
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15 GLOSSARY OF TERMS BARS - Blood A
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16 FOREWORD TO THE ACCOUNTS 16.1 Fo
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Page 199 and 200: Great Western Hospitals NHS Foundat
Page 209: Great Western Hospitals NHS Foundat
Page 214: Great Western Hospitals NHS Foundat
Page 217 and 218: 1 CHAIR AND CHIEF EXECUTIVE’S REP
Page 219 and 220: 2 OUR TRUST 2.1 Vision - Your healt
Page 221 and 222: 3 DIRECTOR’S REPORT General Compa
Page 223 and 224: 3.3.2 The Brunel Treatment Centre O
Page 225 and 226: 14 In relation to the use of financ
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Page 229 and 230: organisations to adapt to these cha
Page 231 and 232: TABLE - Wiltshire Community Activit
Page 233 and 234: The Trust is currently reviewing it
Page 235 and 236: Enhanced Quality Governance Reporti
Page 237 and 238: The Trust is using its foundation t
Page 239 and 240: of implementing the programme. Incl
Page 241 and 242: As part of the corporate back offic
Page 243 and 244: What patients and service users hav
Page 245 and 246: 3.25.3 Patient Surveys The PICKER I
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Page 253 and 254: 3.31 Statement as to disclosures to
Page 255 and 256: 4 REMUNERATION REPORT Information n
Page 257 and 258: 4.5 Remuneration of senior managers
Page 259 and 260: 4.8 Pension Benefits and Remunerati
Page 261 and 262: The accounting policies for pension
Page 263 and 264: 5 NHS FOUNDATION TRUST CODE OF GOVE
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Page 267 and 268: 5.1.5 Attendance at meetings of the
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Page 271 and 272: 5.1.11 Council of Governors Meeting
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Page 277 and 278: Helen Bourner, Director of Business
Page 279 and 280: 5.2.4 Statement about the balance,
Page 281 and 282: 5.2.9 Significant Commitments of th
Page 283 and 284: 5.3.2 The work of the Audit, Risk a
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Page 297 and 298: and Governors. We have also commenc
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Audit / confidential enquiry title
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Audit Title Submitted/Required (%)
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No. Audit Title Learning From The P
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No. Audit Title 8. Diabetes Ketoaci
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No. Audit Title Audit Summary/Learn
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No. Audit Title Audit Summary/Learn
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6.3.4 Registration with Care Qualit
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Steering Group, provides a quarterl
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Clostridium Difficile: The goal for
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Priority 2: To reduce harm associat
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Priority 3: To reduce harm associat
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Pressure ulcers Community: The comm
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Safe care of the patient receiving
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CHART - Serious Incidents grouped b
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The three top serious incident caus
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West conference call in August 2011
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Priority 9: To review the clinical
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Priority 12: To undertake nutrition
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• A regular ongoing training prog
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Community: • Q1 Performance April
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The survey results demonstrate that
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6.6 Performance against key nationa
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6.8 Statements from Primary Care Tr
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6.8.4 Wiltshire Primary Care Trust
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6.9 Independent Assurance Report to
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7 SUSTAINABILITY REPORTING 7.1 Stro
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Graphs 3 and 4 show energy consumpt
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Graph 7 - Water consumption in WCHS
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8 EQUALITY REPORTING 8.1 Equality d
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9 STAFF SURVEY REPORT 9.1 Our staff
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It was agreed that we would focus o
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Appraisal rates. The overall rate f
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A quarterly “Voluntary Service Ma
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10 REGULATORY RATINGS REPORT 10.1 M
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10.3.2 Explanation for differences
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12 STATEMENT OF ACCOUNTING OFFICER
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14.4 The risk and control framework
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Risk Licence to operate (compliance
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The governors and wider stakeholder
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Steps which have been put in place
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14.8 Conclusion I have not identifi
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SHA - Strategic Health Authority SW
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Annual Report and Accounts - The Great Western Hospital

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