Annual Report and Accounts - The Great Western Hospital

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Great Western Hospitals NHS Foundation Trust Accounts for the year ended 31 March 2012 28 Financial instruments and related disclosures The key risks that the Trust has identified relating to its financial instruments are as follows:- 28.1 Financial risk Because of the continuing service provider relationship that the Trust has with Primary Care Trusts (PCTs) and the way those PCTs are financed, the Trust is not exposed to the degree of financial risk faced by business entities. Also financial instruments play a much more limited role in creating or changing risk than would be typical of listed companies, to which the financial reporting standards mainly apply. The Trust has limited powers to borrow or invest surplus funds and financial assets and liabilities are generated by day-to-day operational activities rather than being held to change the risks facing the Trust in undertaking its activities. The Trust’s treasury management operations are carried out by the finance department, within parameters defined formally within the Trust’s standing financial instructions and policies agreed by the board of directors. Trust treasury activity is subject to review by the Finance & Investment Committee. 28.2 Currency risk The Trust is principally a domestic organisation with the great majority of transactions, assets and liabilities being in the UK and Sterling based. The Trust has no overseas operations. The Trust therefore has low exposure to currency rate fluctuations. 28.3 Credit risk The majority of the Trust's income comes from contracts with other public sector bodies, resulting in a low exposure to credit risk. The maximum exposures as at 31 March 2012 are in receivables from customers, as disclosed in note 17 to the accounts. The Trust mitigates its exposure to credit risk through regular review of debtor balances and by calculating a bad debt provision at the period end. The following shows the age of such financial assets that are past due and for which no provision for bad or doubtful debts has been raised: 31 March 31 March 2012 2011 £000 £000 By up to three months 2,835 2,020 By three to six months 237 413 By more than six months 2,417 1,536 5,489 3,969 The Trust has not raised bad or doubtful debt provisions against these amounts as they are considered to be recoverable based on previous trading history. The increase in the amounts is primarily due to an increase in income from the Injury Recovery Scheme for both GWH and Wiltshire Community Health Services (£1,321k) and Non-NHS Debtors (£272k) 28.4 Liquidity risk The NHS Trust's net operating costs are incurred under annual service agreements with local PCTs, which are financed from resources voted annually by Parliament. The Trust also largely finances its capital expenditure from funds obtained within its prudential borrowing limit. The Trust is not, therefore, exposed to significant liquidity risks. It should also be noted that the Trust has a Working Capital Facility of £14 million available within its terms of authorisation as an NHS Foundation Trust which reduces its liquidity risk still further. Page 207 of 211
Great Western Hospitals NHS Foundation Trust Accounts for the year ended 31 March 2012 28.5 Fair Values of Financial Instruments All the financial assets and all the financial liabilities of the Trust are measured at fair value on recognition and subsequently at amortised cost. The following table is a comparison by category of the carrying amounts and the fair values of the Trust’s financial assets and financial liabilities at 31 March 2012 and 31 March 2011. Carrying Value Fair Value Carrying Value Fair Value 31 March 31 March 31 March 31 March 2012 2012 2011 2011 £000 £000 £000 £000 Current financial assets Cash and cash equivalents 14,482 14,482 11,216 11,216 Loans and receivables: Trade and receivables 7,540 7,540 12,141 12,141 22,022 22,022 23,357 23,357 Non-current financial assets Loans and receivables: Trade and receivables 0 0 0 0 Total financial assets 22,022 22,022 23,357 23,357 Current financial liabilities Financial liabilities measured at amortised cost: Obligations under PFI 4,430 4,430 1,425 1,425 Obligations under Finance Leases 103 103 0 0 Trade and other payables 22,917 22,917 12,704 12,704 Provisions under contract 27,450 27,450 14,129 14,129 Non-current financial liabilities Financial liabilities measured at amortised cost: Obligations under PFI 127,605 127,605 132,036 132,036 Obligations under Finance Leases 528 528 0 0 Provisions under contract 2,900 2,900 2,900 2,900 131,033 131,033 134,936 134,936 Total financial liabilities 158,483 158,380 149,065 149,065 Net financial assets (136,461) (136,358) (125,708) (125,708) The fair value on all these financial assets and financial liabilities approximate to their carrying value. The following table reconciles the financial assets and financial liabilities that fall within the scope of IAS 39 to the relevant on- Statement of Financial Position amounts. Cash and cash equivalents and finance lease liabilities fall wholly within the scope of IAS 39. Current Non-current 31 March 31 March 31 March 31 March 2012 2011 2012 2011 £000 £000 £000 £000 Trade and other receivables: 1,474 347 0 0 Non-financial assets 114 49 0 0 Prepayments 4,450 1,009 0 1,733 6,038 1,406 0 1,733 Trade and other payables: Taxes payable 3,430 2,056 0 0 Non-financial liabilities 0 0 0 0 3,430 2,056 0 0 Provisions: Financial liabilities 0 206 0 0 Provisions under legislation 147 144 1,783 1,732 147 350 1,783 1,732 The provisions under legislation are for personal injury pensions £519,266 (31 March 2011: £538,845) and early retirement pensions £1,411,343 (31 March 2011: £1,199,428). These liabilities are not contracted, but are defined by legislation and are owed to the NHS Pensions Agency. Page 208 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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1 CHAIR AND CHIEF EXECUTIVE’S REP
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2 OUR TRUST 2.1 Vision - Your healt
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3 DIRECTOR’S REPORT General Compa
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3.3.2 The Brunel Treatment Centre O
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14 In relation to the use of financ
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Checklist, a World Health Organisat
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organisations to adapt to these cha
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TABLE - Wiltshire Community Activit
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The Trust is currently reviewing it
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Enhanced Quality Governance Reporti
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The Trust is using its foundation t
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of implementing the programme. Incl
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As part of the corporate back offic
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What patients and service users hav
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3.25.3 Patient Surveys The PICKER I
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3.25.5 Annual Inpatient Survey The
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CHART - Percentage of patients who
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3.28 Working with our partners to s
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3.31 Statement as to disclosures to
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4 REMUNERATION REPORT Information n
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4.5 Remuneration of senior managers
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4.8 Pension Benefits and Remunerati
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The accounting policies for pension
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5 NHS FOUNDATION TRUST CODE OF GOVE
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There is currently a vacancy for th
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5.1.5 Attendance at meetings of the
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In addition, in preparing the Trust
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5.1.11 Council of Governors Meeting
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5.2 Board of Directors 5.2.1 The Bo
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Roger Hill, Non-Executive Director
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Helen Bourner, Director of Business
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5.2.4 Statement about the balance,
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5.2.9 Significant Commitments of th
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5.3.2 The work of the Audit, Risk a
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5.6 Nominations Committee 5.6.1 The
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5.7 Mental Health Act / Mental Capa
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5.8 Membership 5.8.1 Membership The
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The groupings of the members in the
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5.8.8 Membership development propos
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G.1.2 - The Board should clarify in
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and Governors. We have also commenc
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Regulation 1. To sustain compliance
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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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Page 375 and 376: 14.4 The risk and control framework
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Annual Report and Accounts - The Great Western Hospital

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