Annual report 2010-2011 - NHS Portsmouth

Annual report
2010-2011
1

Annual report 2010-2011
Foreword 4
About us 6
Ensuring a sustainable local NHS 8
Making a difference in our community - our year in headlines 11
Taking care of every pound - our financial headlines 16
Encouraging better health 17
Working together for a healthier city 20
Planning and performance in 2010-2011 32
Helping our staff - listening, learning and development 35
Experience, engagement, evaluation - finding out what people think 40
Ensuring appropriate governance 42
Committee structure 43
PCT Board and Clinical Executive Committee membership 44
Estates and Facilities - building our vision for the future 46
Being seen to be green - our environmental impact 47
Technological change 48
Data security 50
The challenge ahead - looking forward 51
Register of interests and board membership 54
Leavers 62
Finance report 63
Contacts 80
3

Foreword
We were delighted to welcome the Lord Mayor of Portsmouth, Councillor
Paula Riches, to St James’ Hospital in the spring to plant a tree as part of
our celebrations to mark the tenth anniversary of the primary care trust.
We were officially formed on 1 April 2001, and with the current reform
of the NHS locally and nationally we felt ten years was an achievement
worth celebrating.
Having not visited St James’ before Cllr. Riches said that she felt she had
‘uncovered a hidden gem in the city.’ She was highly impressed with the
staff she met and the facilities provided for those who use our services.
St James’ has also been home to the PCT during its ten year life to
date and those of us fortunate enough to work here recognise the
benefits of working in one of the city’s most attractive green spaces
which has had a beneficial effect on the health and well being of
patients and public alike for so many years. I am very proud of the
fact that one of the PCT’s lasting legacies will be the way we have
transformed the St James’ site for all to use and benefit from.
Modern state of the art facilities for patients, such as The Orchards and
The Limes, have greatly enhanced adult and older people’s mental health
services. They sit side by side with thriving, historic buildings that have
been transformed to support all manner of health related activity. The
grounds have also been given a new lease of life and now form part
of a busy community site enjoyed by voluntary groups, dog walkers,
cricketers, joggers and school sports day participants to name just a few!
But it is not just St James’ Hospital that has undergone a transformation.
The new Queen Alexandra Hospital, the soon to be completed St Mary’s
community health campus, Healthy Living Centres in Paulsgrove and
Portsea, the St Mary’s NHS treatment centre and the GP walk in centre
in Guildhall Walk, together with several new NHS dental practices,
revamped GP surgeries, improved accommodation for people with
learning disabilities - all are modern, 21st century facilities that give
people more choice and better NHS care, and all have arrived in the
lifetime of the PCT.
4
Alongside the millions of pounds invested in new facilities we have also
seen shorter waiting times for treatment emerge: in March 2000, more
than 10,000 people were on NHS waiting lists in the Portsmouth area,
many waiting longer than a year. That figure has fallen some 90% over
the past ten years and those that do wait are generally seen within 18
weeks.
People in the city now enjoy better life expectancy: residents are now
living longer than ever before in Portsmouth - life expectancy rates
locally are above the national average (82 years) for women, and an
improving 77.5 years for men.
Thousands of people have been supported to stop smoking (and not
start again) over the past ten years, adding pounds to their pockets
and years to their lives. Levels are down from one in three of the
population in 2001 to one in four now.
We have worked with others to develop a healthier Portsmouth.
From initiatives like Sure Start and Change4Life with their focus on
families, through to support for Community First, joint commissioning
with Portsmouth City Council, the new breed of healthy living
pharmacies and even, with Portsmouth Football Club, giving city
residents access to a health bus and healthy living schemes - these have
all made a contribution to the city’s overall health and wellbeing.
It is also important to remember that over the vast majority of its
ten years, the PCT was responsible for offering high quality care
and treatment to tens of thousands of people through much loved
community services it provided directly and which now form part of
Solent NHS Trust.
Our performance continues to be good, year-on-year we’ve hit
our targets and met our financial obligations in spite of some very
challenging economic pressures, particularly over the past couple of
years.

And finally, we’ve developed excellent relationships with valued
partners right across the city - all of whom have helped us in our
successes.
The PCT’s vision highlights our aim to enable local people to
enjoy good health and a high quality of life, with consistent and
measureable improvements - but the city continues to face some
significant health challenges, particularly in some of our most
deprived areas.
The NHS, too, is facing its own set of challenges and we are currently
undergoing the biggest period of change and reorganisation for a
generation. Clinical Commissioning Groups and Health and Wellbeing
Boards are being established and will be at the forefront of the new
NHS, with revised arrangements for the work of public health teams,
too.
Meanwhile we are now working collaboratively within a cluster
with three other local PCTs - Southampton, Hampshire and the Isle of
Wight - to support greater efficiencies, ensure greater resilience in this
time of change but above all to ensure that patients can still benefit
from high quality services across the area.
Everyone in the local NHS is working, and will continue to work,
together towards a common goal, no matter how we are organised.
That is, to improve the health and wellbeing of all our residents by
working efficiently, finding the best way to do things and giving
people the ability to have a positive impact on their own health.
Portsmouth’s Lord
Mayor Cllr. Paula
Riches plants a tree at
St James’ Hospital to
mark the PCT’s tenth
anniversary.
Richard Hibbert CBE
Chairman
5

About us
Established in 2001, NHS Portsmouth is responsible for commissioning
services to meet the health needs of the city.
The boundaries we work to are similar to those of Portsmouth City
Council, a unitary authority. The city is amongst the most densely
populated in Europe (around 200,000 people) and is very varied with
pockets of poor health and deprivation existing side by side with
areas of relative affluence.
Four of Portsmouth’s 20 electoral wards are in the most deprived group
in the country. Children make up 22% of the city’s population and the
greatest number live in Charles Dickens ward, the single most deprived
ward of 500 in the NHS South Central (the strategic health authority)
area. Half of the city’s over 65 population has a long term limiting
illness. This underlines the need to tailor health and social care services
to each sector of our local population.
Primary care trusts are required to assess local health need and engage
with partners, patients and the public about that need and the delivery
and development of their health care.
We must then commission, or contract for, health services of high quality
for our local population and lead the local NHS in its ongoing planning,
development and delivery of health services.
We work closely with our fellow south coast primary care trusts, NHS
Hampshire, NHS Southampton City and NHS Isle of Wight, and with two
main providers of health services, Portsmouth Hospitals NHS Trust and
Solent NHS Trust.
Much of the work we do, particularly around financial planning and
the delivery of sustainable health services, focuses on a broader health
system that encompasses Portsmouth and south east Hampshire and
embraces a population of around 600,000 people.
Our approach to improving health in Portsmouth
We see our mission as:
Commissioning the best possible outcomes for our
population from a range of high quality providers.
We have a vision that sets out our overarching ambition for our local
population and for the future for health care in Portsmouth.
Building a healthcare system in Portsmouth that enables local people
to enjoy good health and a high quality of life, with consistent and
measurable improvements.
Working with a representative group of staff from across our
commissioning workforce, we have developed values and behaviours
which we wish to see modelled within NHS Portsmouth. These will
shape our organisational identity and identify what behaviours are
critical if we are to fulfil our vision and mission and deliver on our
promises to the people of Portsmouth.
Our values are:
Achieving
Bold
Leading
Engaging
NHS Portsmouth aims to be an ABLE organisation; the values will
act as a measure of the way in which we plan and undertake our
organisational development.
6

Our seven strategic aims in full are to:
1 Improve people’s quality of life, along with an increase in life
expectancy, raising the lowest to the best to ensure equity and
equality of access for all.
2 Invest in health services and ill-health prevention advice, focusing on
the young and recognising the long term benefits this brings to them,
and future generations, in both health and social attainment.
3 Improve the quality and safety of services ensuring dignity, control and
choice for those who use our services.
4 Improve access to services for the most vulnerable people amongst our
local population (such as those with mental health problems or
learning disabilities) and those from the most deprived populations.
5 Invest in health promotion and social marketing, in partnership
with Portsmouth City Council, to help people stay healthy and to
take greater responsibility for their own health and wellbeing.
6 Invest in health promotion and social marketing, in partnership
with Portsmouth City Council, to help people stay healthy and to
take greater responsibility for their own health and wellbeing.
7 Achieve sustained financial stability ensuring good use of all our
resources (including financial, workforce, buildings, information
and technology.)
7

Ensuring a sustainable local NHS
We are facing challenging times in the NHS and therefore our vision for
Portsmouth becomes more important than ever before. The challenge
over the coming years will be to improve health and the quality of our
healthcare services for the people of Portsmouth in an environment of
limited resources and ever increasing expectations.
Our strategy is based on meeting this challenge. It brings together the
challenges we face, the opportunities we wish to develop and the aims
we have into an overall plan that sets out the outcomes we hope to
ensure by the middle of this decade.
We want to achieve further improvements in life expectancy and in
particular reduce the number of early deaths from conditions such as
cancer and vascular disease.
We will do this by concentrating on both prevention and early
intervention with a specific focus on the main lifestyle contributors to
poor health - alcohol, obesity and smoking - as well as improving uptake
of screening to promote early detection and rapid treatment of ill health.
We also want to build a sustainable system of high quality providers
delivering NHS services for the people of Portsmouth, reducing the
numbers of both emergency and planned admissions to hospital where
there is a better alternative.
Significant pressures in the city’s health system have arisen over the last
12 to18 months, particularly in terms of demand for services and
financial sustainability.
We are therefore working with others in our health system to plan for
the future to ensure that people in the area still have the best possible
access to a viable and sustainable range of NHS services.
NHS reform
The White Paper ‘Equity and Excellence: Liberating the NHS’ was
published on 12 July 2010 and sets out the Government’s plans to
reform the NHS during this Parliament and for the long-term.
The aim is that professionals will be free to focus on improving health
outcomes so that these are amongst the best in the world. Improving
the quality of care will become the main purpose of the NHS.
Patients will get more choice and control, backed by an information
revolution, so that services are more responsive to patients and
designed around them, rather than patients having to fit around
services. The principle will be “no decisions about me without me”.
GPs and clinicians will be given freedom and responsibility for
commissioning care for their local communities. Providers of services
will have new freedoms and they will be more accountable. There will
be greater competition in the NHS and greater cooperation. Services
will be more joined up, supported by a new role for local authorities to
support integration across health and social care.
Over the course of the year a number of associated consultation
documents were published and, in December, the White Paper on
public health, ‘Healthy Lives, Healthy People’ was launched. This sets
out the Government’s long-term vision for the future of public health
in England. The aim is to create a ‘wellness’ service (Public Health
England) and to strengthen both national and local leadership.
As a result of the changes, the NHS will be streamlined. Strategic
health authorities and primary care trusts will be phased out.
Management costs will be reduced so that as much resource as possible
supports frontline services.
8

Since the White Paper was published we have been working with
our partner primary care trusts and the strategic health authority
to establish a means by which the transition to GP and clinical
commissioning can be effectively managed.
Each PCT has been working with its emerging local Clinical
Commissioning Group (CCG) to ensure a smooth transfer of
responsibility. We have also been planning the transfer of Public Health
services and responsibilities with Portsmouth City Council.
To ensure that PCTs retain sufficient resilience, together with efficient
and cost-effective working practices until they are phased out in 2013,
a decision has been taken nationally to ‘cluster’ PCTs into area groups.
For us this means working together with NHS Southampton, NHS
Hampshire and NHS Isle of Wight to form the SHIP cluster which builds
on the successful joint working and planning approaches that we have
already adopted from previous years.
The role of the cluster will be to maintain resilience during the
transition, whilst at the same time, making sure the right conditions
are in place for the establishment of successful CCGs, Health and
Wellbeing Boards and future arrangements for Public Health.
Work to create a single executive team and to establish a new
management structure that will ensure the cluster is able to deliver its
core functions will be undertaken in early 2011/12.
Local planning
In spite of the reorganisation nationally and locally as a result of
publication of the White Paper, the PCT will still have a responsibility to
deliver our financial and performance targets year on year until 2013.
The QRO plan consists of QIPP (Quality, Innovation, Productivity,
Prevention), Reform and Operating Plan, which was influenced by the
release of key documents such as the Coalition’s Equity and Excellence:
Liberating the NHS White Paper and the NHS Operating Framework.
Through local priorities, regional and national initiatives commissioning
leads have produced workstream strategies which have established more
efficient and effective care pathways or services, to improve the health
and wellbeing of the local population.
During the production of these strategies, it was important for
commissioning leads to consider and ensure that the future
commissioning of these priorities was economical, due to limited financial
resource, whilst also maintaining or improving high standards of quality.
The projects and initiatives illustrated in the workstream strategies are
incorporated into the overall QRO Plan.
The plan identifies the strategic aims and commissioning intentions of
NHS Portsmouth and informs stakeholders of how we plan to deliver
these important priorities from 2010 to 2015.
A copy is available to view on our website www.portsmouth.nhs.uk
Sustainability
A Portsmouth and South East Hampshire Sustainability Plan has been
devised to implement new ways of working which improve the quality
of services for local people, increase productivity and therefore reduce
costs across the NHS (in response to the national financial position.) The
four year plan has been agreed by partner NHS organisations and was
approved by South Central Strategic Health Authority in May 2010.
This year has seen some changes to NHS Portsmouth’s planning process
with the introduction of the QRO Plan which has replaced the previous
year’s Strategic Plan and Operating Plan.
9

We know that, based on current financial forecasts and anticipated
demand on NHS services across Portsmouth and south east Hampshire,
there will be a gap of about £230 million over the next four years if
spending continues at previous rates and we do nothing to address it.
The plan is the collaborative work of NHS Hampshire, NHS Portsmouth,
Portsmouth Hospitals NHS Trust, Solent NHS Trust, Southern Health NHS
Foundation Trust and NHS South Central.
Working at the heart of the overall sustainability programme is the
Clinical Leaders Group. This provides clinical leadership, drive and input
to the programme and its work.
An artist’s impression
of how the St Mary’s
Community Health
Campus will look
once completed.
Members of the Clinical Leaders Group include
• A number of local GPs
• Director of Public Health for NHS Portsmouth
• Clinical Director for NHS Hampshire
• Medical Director for Portsmouth Hospitals NHS Trust
• A representative from the Local Medical Committee.
The first year of the programme identified savings of around £60m and a
target figure of £70m savings has been identified for 2011-2012.
Key achievements during 2010/11 include:
• Changing how the Emergency Department (ED) at Queen Alexandra
Hospital (QAH), Cosham, works to reduce the delay in assessing
patients, and improving the quality of care and patient experience
• Moving the Out of Hours GP Service from Drayton to QAH so
patients who arrive at the ED can be seen by a GP if this is clinically
appropriate for their condition
• Reducing the length of stay at QAH so patients are discharged as
soon as it is clinically appropriate.
10

Making a difference in our community - our year in review
St Mary’s Community Health Campus
The opening of the new Out-Patients Department in January 2011 was
the first major milestone in the completion of this project to transform
part of the hospital site into community health facilities. These will
include a new midwife-led maternity centre, to replace the existing
temporary facility; an integrated sexual health and genito-urinary
service (replacing the Ella Gordon Unit) and a 12 to 16-bed GP-led
intermediate care wards for patients.
This has involved converting and refurbishing the former St Mary’s
Hospital maternity and paediatric blocks which have been vacant since
Portsmouth Hospitals NHS Trust (PHT) transferred its services to the
redeveloped Queen Alexandra Hospital in 2009. Around two-thirds
of the St Mary’s site is being sold off by PHT, but NHS Portsmouth is
redeveloping the rest of it.
Access to NHS Dentistry
In May 2010, a ceremony was held to mark the official opening of
three new dental surgeries in Paulsgrove, Portsea and Hilsea.
In response to the feedback to the first survey of adult health oral
needs in the city, commissioned by NHS Portsmouth, these surgeries
have been opened in the areas of the city where residents said there
was the greatest need for them. The three surgeries are expected to
see up to 12,000 NHS patients in their first year.
Members of the public can call the Portsmouth Dental Helpline on
0845 050 8345 for information about which dentists are accepting new
NHS patients in their area or can visit the website at
www.portsmouthdentalhelpline.nhs.uk
Healthy Living Pharmacies
The Healthy Living Pharmacy scheme awards an NHS quality mark to
pharmacies that provide a range of NHS services to a high standard. They
must also be focused on the health and wellbeing of their community
and have a ‘health trainer champion’ in post. The health trainer
champion has a vital role in directing customers to local health services
and promoting healthy lifestyles.
Health Minister Lord Howe welcomed the concept of Healthy Living
Pharmacies when he came to see them in action in Portsmouth in
December.
During his visit he heard from pharmacists, health trainer champions and
other frontline staff about how they rated the Healthy Living Pharmacy
scheme for improving both their own job satisfaction and making a real
difference to the lives of many individuals using the services.
Primary Care Information Portal (PIP)
A major new channel of communications between NHS Portsmouth
and the local GP community went live in October 2010. The PIP was
introduced as an extranet site accessible to all the city’s GP practices and
their staff. It keeps them up-to-date with a range of information as well
as news from the primary care trust and it is hoped it can be well utilised
as GPs take on a broader range of commissioning functions in due course.
It is intended that PIP will become a ‘one stop shop’ for essential
information for Portsmouth GP staff and their primary care
colleagues. The design and content development has been a highly
collaborative endeavour through the GP-led PIP Steering Group, together
with feedback from GP events and a number of demonstrations.
11

Portsmouth GP Dr
Jim Hogan lends
his support to the
transformation of the
St Mary’s site into the
new health campus.
12

We used a poster
campaign called Faces
of Able to highlight
our PCT values
with staff able to
nominate peers they
felt best promoted
the values.
13

Top rating for Portsmouth’s stroke services
The Care Quality Commission (CQC) conducted a major review on
stroke care across 151 PCTs, focusing on the care provided to stroke
survivors and carers from the point patients are transferred home. It
found wide variations in how patients are supported in coping with
life after stroke.
Of the 15 areas looked at, NHS Portsmouth scored five (‘better than
most areas’) in four categories, and achieved the second highest
grading in a further five. Overall, NHS Portsmouth has been rated as
one of the ‘best performing’ PCTs.
The main entrance
to The Limes, a new
£8m unit for the
care of older people
with conditions such
as dementia and
depression.
The audit looked at a number of areas including community services;
transfer home; outcomes after one year; ‘mini-stroke’ care and services
for carers. In particular the audit showed that there were strongly
performing services for community rehabilitation, ensuring a timely
discharge for patients and a reduced length of stay in a hospital
setting.
The Limes, St James’ Hospital: official opening
Celebrated actor and Chancellor of the University of Portsmouth, Sheila
Hancock CBE, officially opened The Limes in February 2011.
The Limes, situated at St James’ Hospital, is an £8 million unit which
provides 36 beds for older people experiencing conditions such as
dementia and depression. It was commissioned by NHS Portsmouth
and is operated by Solent NHS Trust.
The building has been purpose designed to meet the needs of its
service users and has a range of features incorporated with the specific
clinical needs of older mental health patients in mind.
14

Chairman’s awards
NHS Portsmouth staff were recognised for their contribution to
keeping the local NHS running smoothly at our annual Chairman’s
Awards ceremony held in November.
The event also marked the achievements of staff that had gained
qualifications during the last 12 months. Winners and runners up in the
four main award categories this year were:
Achieving
Winners: St Mary’s Hospital domestic team leaders - Eva Prekrit,
Ewalina Majda, Beverley Pape and Audrey Parkes, who ensure the
highest standards of cleanliness for the St Mary’s Hospital wards and
clinics.
Runners Up: Property Information Team - Debbie Bowden, Margaret
Pratt, Michael O’Connor and Debbie Martin.
Bold
Winners: Financial Planning Team - Clare Bryan, Ian Howard, Helen
Dickinson and Lee Williams, who provide financial support to the PCT’s
strategic planning process and oversee the PCT’s financial position
on a monthly basis, providing financial information to the Board, its
Committees and external stakeholders, such as the Department of
Health and the Strategic Health Authority.
Leading
Winner: Victoria Fry, for her work as Business Manager for the
Performance and Development Directorate, Personal Assistant to the
Director and managing the employee resourcing function for NHS
Portsmouth.
Runner Up: Rebecca Lau, Governance Programme Manager.
Engaging
Winner: Vicky Griffin, Communications Manager, for her innovative
work in support of the Healthy Living Pharmacies project, promoting it
both locally and nationally through a range of media.
Runner Up: Justina Jeffs, Associate Director (Governance).
Health and Social Care Awards 2010
Two teams from NHS Portsmouth were nominated for the South
Central Regional Awards, part of the national Health and Social Care
Awards programme.
The Healthy Living Pharmacy team was shortlisted in the Primary
Care and Community-based Integration category. The Systems
Management - Planned Care Team was short-listed in the Excellence in
Commissioning category for the Planned Care for the Musculoskeletal
project.
Runners Up: Estates Legal and Property team - Nicola Booth, Michelle
Day, Helen Williams, Sabrina Tims, Richard Rosher and Joanna Luckett.
15

Taking care of every pound - our financial headlines
A full financial review of the year can be found towards the end of this
report, from page 53 onwards.
The PCT entered 2010/11 on a sound financial footing, and was able to
invest in a number of key areas, in line with national and local priorities.
At the end of the year, we achieved all our statutory financial targets:-
Despite the overall economic outlook, the PCT has received a 2.2%
increase to its revenue allocation in 2011/12, which was the average
level allocated to PCTs in England. This compares to a 5.5% increase
in 2010/11, and therefore we must find considerable savings to meet
rising healthcare costs.
How we spent our money 2010/11
Keeping our revenue expenditure to within the Revenue Resource
Limit
Keeping our capital expenditure to within the Capital Resource Limit
Keeping our cash requirements to within the Cash Limit.
The PCT ended the financial year with a revenue surplus of £0.7 million.
This was a planned surplus which will be carried forward into 2011/12.
The Department of Health requires NHS organisations to deliver year on
year efficiency savings and we delivered savings of £4.0m, excluding the
efficiency savings passed onto NHS providers. The savings were from a
combination of service redesign and demand management initiatives,
prescribing costs and PCT management costs.
How we intend to spend our money 2011/12
Whilst we ended the financial year with a surplus and are in robust
financial health, there are financial pressures in the broader health
community. During 2010/11, we worked closely with NHS Hampshire and
Portsmouth Hospitals NHS Trust to develop the sustainability plan for
south east Hampshire (see page 9.)
Each organisation has significant savings to find, and by working
together, each can ensure that health services are designed and provided
in the most cost effective way, whilst maintaining quality across the local
health community.
16

Encouraging better health
Background
Portsmouth has a diverse population with areas of high deprivation
alongside relative wealth. All but one of the 14 electoral wards in the
city are within the most deprived 20 per cent of wards in the South
Central area.
As a consequence the population presents a wide range of health
needs, and health inequalities are high particularly amongst vulnerable
groups. There are significant numbers of people who have issues with
poor health, including:
• Higher than national levels of deaths due to cancer and low access
to screening services for the more common cancers
• High number of deaths due to coronary heart disease, vascular
disease and chronic obstructive pulmonary disease.
Amongst the health challenges we face across the city are:
More people admitted to hospital for alcohol specific conditions
than the England average
Estimated smoking rates at around 24% of the adult population
The death rate from smoking is higher than the England average
with smoking killing around 330 people every year
Early death rates from heart disease, stroke and cancer are higher
than those for England.
Our Annual Health Profile for 2010 showed that the health of people in
Portsmouth is generally worse than the England average though there
are some improvements:
• Over the last ten years, the rate of death from all causes has fallen.
Early death rates from cancer, and from heart disease and stroke,
have also fallen but remain above the England averages
• Life expectancy for men living in the most deprived areas is nearly
eight years lower than for men living in the least deprived areas.
For women the gap is four years
• The proportion of children in Reception year (Year R) who are
classified as obese is higher than the England average
• The teenage pregnancy rate is also higher then the England average
• It is estimated that more than one in four adults smoke - above
average. The city sees over 330 smoking related deaths each year
• The rates of alcohol related hospital stays and violent crime are
higher than the England average.
Whilst these headlines demonstrate that there is a considerable way to
go in improving the health and wellbeing of the people of Portsmouth
the rest of this section indicates the level of investment and achievement
being made to deal with the challenge.
And there are improvements in some local figures which are welcomed,
such as life expectancy. We work hard with organisations across the city,
including the City Council and Portsmouth Football Club, to help improve
the health of people living in the city.
Initiatives such as the Healthy Pompey programme and the Save Dave
campaign encourage people to change behaviour in a way that will
improve their long term health.
17

The Healthy Pompey
team promoted a fruit
factor competition
during the year
encouraging families
to exercise and eat
more healthily.
18

Local MP Penny
Mordaunt (seated)
joined us for the
official opening of
one of three new
dental centres in the
city.
19

Working together for a healthier city - our year in public health and primary care
Joint Strategic Needs Assessment
Over the past 12 months we have worked closely with Portsmouth City
Council to further develop the Joint Strategic Needs Assessment (JSNA)
and make it more user friendly and more readily accessible.
This overarching compendium paints the ‘big picture’ of local needs so
we can work together to improve the health and wellbeing of people in
Portsmouth.
It is the basis for commissioning decisions about where to target
resources and what services to commission. It can be viewed at
www.jsna.portsmouth.gov.uk
In future, it is proposed that there will be a new legal obligation on
NHS and local authority commissioners to have regard to the JSNA in
exercising relevant commissioning functions, and responsibility for
producing the JSNA will transfer as part of the Public Health function to
Portsmouth City Council.
Local Area Agreement
Following a decision by central government the LAA ceased at the end of
March 2011 and will not be renewed.
Public health annual report
As in previous years, the Director of Public Health published a public
health annual report, from the perspective of his joint role with the
PCT and Portsmouth City Council. This year’s report focused on health
inequalities and the wider influences on health. It was based on a
number of pieces of work that have taken place throughout the year.
The report presents the impact of social and environmental factors
on health. It also highlights the impact of the world economic
situation and looks at the impact of healthcare on health and wider
determinants of health. It also presents the latest information for the
Joint Strategic Needs Assessment (JSNA) for Portsmouth (see left.)
Life expectancy
Residents are now living longer than ever before in Portsmouth.
Figures for the three-year period for 2007 to 2009 (released by the
Office for National Statistics in October 2010) show that a baby boy
born in the city today can expect to live until they are 77.5 years –
and a girl to 82.3 years (national averages are 78.3 years and 82.3
respectively.)
However, it will be replaced by a more truly locally agreed programme
of work, the details of which are still being worked on but we expect it
to support the new Public Health Outcomes Framework and form part of
consultation process on future public health services.
20

Healthy weight
The increase in obesity is an important public health threat - tackling it
will make a significant contribution to reducing health inequalities in
the city.
In the past year we have seen an increase in service provision for
people needing support to lose weight. These include community and
specialist weight management services provided at numerous venues
across the city. We have developed programmes for new mothers and
programmes are planned to link with maternity services to support
pregnant women.
The PCT is a regional leader in tackling healthy weight both in the
amount we have invested and in the breadth and multi-agency
approach we have facilitated. We are continuing to look at innovative
ideas for tackling obesity and supporting people to maintain healthy
weight.
Alcohol harm reduction
Portsmouth has the highest rate of alcohol related hospital admissions
in the south east of England, 1993 per 100,000 population in 2009/10,
compared to an England average of 1743 (south east: 1335.)
This means around 4,000 of our residents ended up in hospital from
issues related to drinking. Despite this high rate, 2010/11 has seen
positive improvements. The rate growth of these admissions, during
the first six months, reduced to 0% in Portsmouth (9% for England
and 8% for the south east.)
During 2010/11 significant new investment has increased the amount
of support available to people with alcohol problems. The impact of
the new Alcohol Specialist Nurse Service launched at Queen Alexandra
Hospital, providing alcohol treatment to patients attending the
Emergency Department or admitted to hospital, has been immediate
with hundreds of patients receiving treatment that was not previously
available. Linked to this service are therapy groups, which are well
attended and run on site within the hospital, which is a unique
innovation.
Portsmouth has received recognition for its innovative work in relation
to patients who have frequent admissions to hospital. The Portsmouth
Frequent Flyers project has been adopted by the South East Alcohol
Innovation Programme as a ‘high impact innovation’, with trials in other
areas. This intensive work has led to savings as hospital admissions have
been prevented.
Alcohol advice and support in the community has been expanded with
the development of the pharmacy alcohol advice project as well as the
Safe Space project, which provides minor injuries treatment and support
in the city centre on Friday and Saturday nights. This supported 435
people over a 6 month period. Of these, 293 received medical treatment
from the paramedics, preventing Emergency Department attendances.
The Save Dave campaign (www.savedave.info) continues to target men
aged 35 plus with alcohol advice. This age group makes up over half our
alcohol related admissions.
Tobacco control and smoking cessation
Tobacco control continues to be one of our most important priorities.
Smoking is known to be the biggest contributor to the reduced life
expectancy, health inequalities and ill health that we see in Portsmouth.
A number of programmes contribute to the tobacco control agenda and
the diversity of these highlights our commitment to tackling this issue.
Portsmouth is one of two national pilots (with Liverpool) for tackling
illegal tobacco use. This programme is a joint initiative between NHS
Portsmouth and the Department of Health, HM Revenue & Customs and
Portsmouth City Council.
21

We continue to support national work on tobacco control including
supporting ASH’s work to lobby the government on taxation and
supporting the proposed change in legislation to place cigarettes out of
sight.
Portsmouth has had good success in terms of smoking quitters by
providing a variety of services to help people to stop smoking. The
challenging target reflects our determination to drive down the
prevalence of smoking in the city and there is evidence that this is
working. However smoking rates still remain significantly above the
national average.
A social marketing project focused on female smokers in areas of high
prevalence has been developed to use innovative ways to support
women to quit smoking using a programme based on women socialising
together.
In all the local NHS has supported over 3000 people to stop smoking in
the past year and there is a commitment to reduce smoking rates further.
Immunisation and vaccination
In 2010/11 we achieved the target for one year olds receiving diphtheria,
tetanus, pertussis, polio and haemophilus influenzae type b.
Whilst other Vital Signs targets were not achieved, partly due to higher
targets in 2010/11, it is encouraging that all of the remaining vaccination
uptake rates are still increasing steadily and consistently.
In 2010/11 an Immunisation and Vaccination Action Plan was developed
which was monitored by the Immunisation and Vaccination Umbrella
Group, a group of care providers, commissioners and immunisation
experts who advise on immunisations in Portsmouth. The key aim of
this plan was to develop interventions and processes to ensure that
vaccination uptakes rates in the city improved.
This involved auditing GP practices across the city to measure current
achievement against the Strategic Health Authority’s immunisation
guidelines.
Work will also continue across Portsmouth to improve compliance with
the SHA immunisation guidelines, and generate closer working with
GP practices over vaccination uptake rates.
Data from the 2010/11 influenza campaign showed that 74.4% of
over 65s and 51.7% of under 65s in at risk groups had been vaccinated
against influenza. Both of these rates were higher than national
uptake rates.
Influenza vaccination rates have decreased slightly in PCT staff from
31.9% to 31.7%, where the rate is below national uptake (34.2%.)
To address these rates, an influenza action plan will be developed
through the flu steering group with the aim of improving influenza
uptake rates, particularly in the under 65 at risk and staff groups.
MRSA and clostridium difficile
We continue to work closely with Portsmouth Hospitals NHS Trust
and Solent NHS Trust to sustain the reduction in healthcare associated
infections (HCAIs).
The 2010/11 MRSA bacteraemia targets have been achieved with
Portsmouth Hospitals recording six MRSA bacteraemias against a target
of eight, and NHS Portsmouth recording six MRSA bacteraemias against
a target of nine.
The clostridium difficile targets have also been achieved with PHT
recording 88 cases (target: 107) and NHS Portsmouth recording 54 cases
(target: 84.)
22

The Children’s Trust
Board brings together
a range of different
organisations to
support the health
and wellbeing of
children in the city.
During 2010/11 there was a lot of work across the health economy to
enhance procedures and capacity to enable targets to be achieved,
as well as to ensure that root cause analyses (RCAs) were completed
thoroughly.
Lessons learned from the RCAs have been identified and shared with
appropriate staff in an effort to prevent further cases. Further support
has been offered to GPs with respect to infection control issues.
Portsmouth City Children’s Trust Board
The Children’s Trust Board in Portsmouth has strong multi agency
membership that leads the direction for all agencies who commission
and offer services to children and families pre birth to 19 years.
It has three age banded partnership boards:
• Pre birth to 5 years board
• 6-13 board
• 14-19 board.
The age banded focus of these boards has enabled a strategic
commissioning approach to be developed across seven priority areas:
• Early identification and intervention for children pre birth to 5 years
• Families with multiple problems
• Schools
• Children and young people at risk
• Safeguarding and early intervention
• Looked after children
• Children with disabilities.
Commissioning strategies have been written and agreed with
involvement from children and families, voluntary organisations and
statutory partners.
23

Chlamydia screening
Chlamydia Trachomatis infection is the most commonly diagnosed
bacterial sexually transmitted infection in Genito-urinary Medicine clinics
in the UK, affecting both men and women. Prevalence rates are highest
in young sexually active adults; especially women aged between16-24,
and in men aged 18-29.
The annual targets set by the national screening team have risen year on
year to achieve a minimum screening coverage nationally of 35%.
We have achieved the targets for the last three years and this year
successfully over-achieved the target for 2010/11 which was set at 35%
of the 15-24 year population. This was the third best performance
in the country
The screening programme has been commissioned to offer screening
within contraception clinics, ‘out reach’ clinics within a variety of venues
including schools, colleges and the local university.
The programme runs targeted campaigns and takes screening teams
to young people, for example offering screening in night club venues,
alongside text messaging services to request postal kits.
Social marketing
Social marketing uses systematic processes and adapts commercial
marketing techniques for social good. It allows the Public Health teams
to develop and implement innovative, customer orientated interventions
with robust evaluations to demonstrate direct impact on positive
behaviour and return on investment over the following years.
With partner agencies, projects have included:
• Breast and cervical cancer screening campaign
We developed a profile of women who do and do not
attend screening. We profiled those women not attending
by location, consumer preferences and preferences for ways of
receiving information. As a result, a publicity event was held in
Fratton where recruitment of peer-educators took place.
• Reducing paediatric emergency admissions
Analysis of patterns of admissions, including the profiles, was
presented to the commissioner/provider emergency admissions
group. The social marketing profile will now help the campaign/
marketing sub-group decide where and how best to inform
parents about appropriate treatment routes.
• School deprivation reports
Social marketing data are included within a report produced
for each school that looks at the socio-economic backgrounds
of pupils. These are used by head teachers to understand their
pupils’ backgrounds and to help explain the makeup of their
population to other organisations eg Ofsted.
• Demographic profiles for children from pre-birth to 5 years
The Public Health Intelligence team profiled children aged 0-5
years registered with Portsmouth GPs to determine how they
differed from the registered population of all ages.
Such children are significantly over-represented in the more
deprived ‘moderate means’ and ‘hard pressed’ groups.
We use social marketing software to profile communities. This geosegmentation
helps us to identify the most effective ways to reach
people and support them in achieving long-term behaviour goals.
24

Healthy Towns Initiative
This year saw the final year for the grant funding of Healthy Pompey,
one of England’s nine Change4Life Healthy Towns.
This was a PCT and City Council programme which secured an
additional £3m of Government funding over the three years, to
encourage healthy lifestyles through increasing opportunities for local
people to be more physically active and make healthier food choices.
In this year, there has been a focus on ensuring the continuation
of Healthy Pompey following the end of funding. Initiatives in
Portsmouth have included:
• Development of the website to ensure that it offers comprehensive
lifestyle advice for residents of Portsmouth and becomes a hub for
supporting people to make positive lifestyle changes
• The Yellow Kite, a catering company set up as the social enterprise
component of the Healthy Pompey project. Its mission is to improve
the health of the people of Portsmouth by introducing healthier
food options and Yellow Kite’s flagship cafe at Southsea Castle
opened in May. The cycle lanes that have been developed in the
city are a clear legacy from the project which will support people to
becoming more active.
National Support Team visits
In the past year we have been part of three visits from Department of
Health National Support Teams to identify good practice and support
further work in areas where there are challenges. These visits focused
on alcohol, smoking and inequalities
Smoking: The smoking visit took place in 2009 and this year saw the
follow-up visit to assess progress and identify further areas to develop.
This enabled us to review what progress had been made in the past year
and what further work should take place to support Portsmouth as a
place which reduces smoking.
The visit highlighted the need to develop work with secondary care and
this project has made significant progress being supported by clinical
leaders from primary and secondary care.
Alcohol: The Alcohol Harm Reduction National Support Team visited
Portsmouth in September 2010. They were impressed with our local
alcohol strategy, innovative project plans and with the additional
investment we were making in alcohol services during 2010/11.
A number of recommendations were made and have led to an improved
focus on alcohol issues within Queen Alexandra Hospital, a new
treatment service for under 25s and improved co-ordination between
different partner agencies
Health inequalities: During the visit a number of programmes were
reviewed and actions suggested. Our work on social marketing was
strongly highlighted as exemplary practice, as was our health trainer
programme.
The visit highlighted the need for a programme of short, medium and
long term interventions to tackle the challenge of health inequalities.
Working with primary care is essential to identify those whose disease
status is not known. This will support better and earlier treatment. Part
of the challenge of health inequalities is the broad solutions needed.
This visit engaged with numerous agencies which facilitated cross agency
actions.
25

General Practice
The White Paper announcements have been the main headline in
General Practice this year but local practices have also had to deal with
a further outbreak of flu-like illness during the winter period, and a
subsequent flu vaccine shortage, which put a great deal of pressure onto
surgeries and the out of hours services over the Christmas and New Year
period.
Quality and value for money
The PCT’s primary care team continues to assess all areas of the delivery
of GP services to ensure value for money. A major source of funding
within primary care is directed towards the Quality and Outcome
Framework and the primary care team has developed a very robust
system of GP peer and PCT management assessments and validations.
Directed, Local and National Enhanced Services (DES/LES/NES)
The PCT currently commissions 26 enhanced services from practices,
providing a wide range of GP services, such as minor surgery, health
checks for patients with learning disabilities, childhood, MMR, HPV and
influenza immunisations and IUCD fitting and checks. Some of these
enhanced services make a significant contribution to local provision, for
example, GPs provide 74,000 phlebotomy appointments via a LES,
during the course of each year.
Several of the Local Enhanced Services will be reviewed in 2011/12.
Some of the reviews have been prompted to reflect changes in guidance
or local strategic plans and some will be a continuation of the QIPP work
started in 2010/11.
26
Access
The primary care team has continued to work with practices to
maintain and improve patient access.
The Guildhall Walk Healthcare Centre opened in August 2009 to
improve patient choice. The centre reported very high levels of walk-in
and unregistered patient activity throughout 2010/11. Many of these
patients are registered with other local practices. The primary care
team is working with practices to understand why patients make this
choice and how they manage this demand.
Extended hours
This Directed Enhanced Service funds practices to provide additional
GP appointments outside normal core hours, ie. before 8 am and after
6.30 pm on weekdays and at weekends. All Portsmouth practices took
up this DES, providing greater choice of appointment times for local
residents.
Information management and technology (IM&T)
We are currently working on four significant IM&T projects:
• Hampshire health record (HHR): a combined primary and secondary
care record which enables clinical staff to look at a wider range of
patient information than currently available to them;
• Electronic prescription service: working towards enabling electronic
transmission of a patient’s prescription, direct to the pharmacy;
• Electronic discharge summary: the PCT and Portsmouth Hospitals
Trust are working on plans to import discharge documents directly
into a practice’s clinical systems via a document management
solution to meet the national target of sending them within 24
hours of discharge;
• Web migration: There is a drive nationally to migrate practice
clinical systems onto a hosted system instead of having clinical
software and records stored on a practice server.

Practice based commissioning
Under practice based commissioning GPs have the opportunity to play
a greater role in the commissioning of services for local people. This
has included:
• undertaking internal peer review and clinical audit to ensure
patients are accessing the right care at the right time and getting
the best possible clinical outcomes and
• participating in shaping the way services are designed and delivered
to best meet patients’ needs.
GPs and practices have made a significant contribution to the PCT’s
demand management strategy in the last year, ensuring the quality of
GP referrals and implementing locally agreed pathways of care. There
has been a sustained decrease in the numbers of secondary care GP
referrals being generated, with practices understanding how best to
manage patients in the community.
With the planned changes to commissioning, and GPs taking a
lead role in the future, it is clear that we need to build on the solid
foundations already established under PBC and ensure that the CCG
and its constituent practices are supported throughout the transition
period. Our priorities for 2011/12 are to support the activities of CCG,
in both the planned care and unscheduled care agendas.
The CCG has identified unscheduled care as a priority and members are
linking with existing work to ensure a stronger GP voice in bringing
together a coherent vision for unscheduled care in the city and
determining how to make it a reality.
Pharmaceutical Needs Assessment (PNA)
In January 2011 we published our Pharmaceutical Needs
Assessment (PNA). This document will be used to help plan future
pharmaceutical services across the city. It includes data on existing
provision, the health of the city and how to meet residents’ health needs.
It summarises services provided by the network of community pharmacies
locally and identifies areas of potential development to support health
care provision and help tackle health inequalities.
Healthy Living Pharmacies (HLP)
Fifteen pharmacies in Portsmouth attained Healthy Living Pharmacy
status. This local kitemark is awarded to pharmacies who consistently
deliver a range of high quality public health and well being services,
underpinned by staff who have developed their skills in proactively
promoting good health. More than 50 staff attained a qualification in
Understanding Health Improvement whilst over 40 pharmacists and
managers undertook leadership development and training.
Raising public awareness has been a major component of this initiative.
During the summer around16,000 people were estimated to have seen a
road show across five sites in Portsmouth and more than 500 people took
part in an associated healthy lifestyle survey.
A local pharmacy website now offers up to date information about
services across the city: www.pompey-pharmacy.info
Over the next year we will be undertaking work to ensure the quality
of service from our Healthy Living Pharmacies is maintained; supporting
more pharmacies to achieve Healthy Living Pharmacy status and
developing level two services and status for our existing HLPs.
Two new services have been launched this year: a needle exchange
service for injecting drug users and an alcohol advice service. Community
pharmacy has also taken part in a pilot for NHS Health Checks.
27

PCT chairman Richard
Hibbert presents
actress Dame Sheila
Hancock with a lime
green bouquet after
she officially opened
The Limes.
28

It was business at
usual at St James’
in spite of the harsh
wintry conditions
that hit the city in
December.
29

Optometry
In Portsmouth there are currently 17 practices providing ‘high street’
NHS ophthalmic services under the General Ophthalmic (Mandatory)
Services (GOS) contract. There are also 11 domiciliary providers covering
the area providing NHS optometric services to residential/care homes, day
centres and those who need home visits, under the General Ophthalmic
(Additional) Services contract.
During 2010/2011 we completed monitoring visits to review compliance
of NHS ophthalmic contractors with the requirements of their GOS
contracts and with relevant legislation. We currently commission the Low
Vision Scheme which involves an assessment to determine if low vision
aids can help make the most of a person’s remaining sight.
Dental
We have worked hard over the last few years to improve access to NHS
dental care and over the last 12 months there has seen a significant rise
in the number of patients attending NHS dental practices in the city.
May 2010 saw the official opening of three new dental practices in
Paulsgrove, Hilsea and Portsea, attended by Department of Health
representatives, MPs and other key stakeholders. The Health Bus was at
two of the locations to provide dentistry information to residents and
help them sign up for NHS dental care.
The PCT dental team has attended a number of events during 2010/11 in
the city to promote NHS dental access and have given out a number of
promotional materials to highlight the availability of the Dental Helpline.
The Dental Academy opened its doors in September 2010, and aims to
see approximately 2000 patients per year.
The Academy is an educational facility with final year students from
Kings College London Dental Institute providing treatment along with
dental therapy and hygienist students. Funding for the treatment is
provided by the NHS.
Planning for the unexpected (emergency planning)
This year we used the lessons and good practice learnt from the
national H1N1 swine influenza outbreak (April 2009 to February 2010)
to revise our pandemic influenza plan which has now received Board
approval.
Meanwhile, to ensure continued improvement in our response to a
major incident the PCT’s major incident plan has also been thoroughly
reviewed and, again, was approved by the Board.
Fortunately, there have been no major emergencies in the Portsmouth
area for the period covered by this report, however learning from
the 2009/10 pandemic flu outbreak helped to streamline an effective
local response to the rise in seasonal flu cases during December 2010/
January 2011.
Emergency planning exercises this year have included:
• Exercise Watermark in March 2011; a national led exercise in which,
in collaboration with local multi-agency partners, we tested the
city’s response to a flooding incident;
• Exercise Chubby Cub in June, and Swift Vixen and Golden Fox in
October 2010; these exercises, organised in collaboration with
Portsmouth City Council and the Royal Navy, tested the multi-agency
response to a nuclear incident at Portsmouth dockyard. In the very
unlikely event of an incident of this type NHS Portsmouth must
ensure the local health response is coordinated and meets the needs
of the people in the city.
We continue to chair the Portsmouth and south east Hampshire multiagency
Joint Health Emergency Planning Group (JHEPG) - work from
this group feeds into the wider Hampshire and Isle of Wight Local
Resilience Forum.
30

Our emergency
planning team
worked with the
City Council to test
the multi-agency
response to a nuclear
incident in the
dockyard.
31

Planning and performance in 2010-2011
The PCT continues to perform strongly across all of its nine Strategic
Programmes. Compared with last year, our performance improved across
all the Strategic Programme areas.
NHS Portsmouth 2010-2011 Annual Performance Report
Of the 49 key performance indicators (KPIs), 40 indicators were fully
achieved (Green), two were not achieved (Red) and seven were almost
achieved (Amber).
Our Chlamydia Screening Programme was ranked 3 rd nationally out of
152 PCTs and was the best in the South Central SHA cohort. We helped
3060 people to quit smoking, the first year we have exceeded 3000
quitters and achieving 14% more than our target.
We have robust plans in place not only to improve performance where
necessary but also to maintain all the areas where we are doing well.
32

Areas of concern
Childhood obesity
The current performance on this indicator is:
12.5% of Year R children classified as obese according to the 2009/10
National Child Measurement Programme (NCMP) data (published
December 2010).
It is worth noting we have the highest overall (Years R and 6)
participation rate in South Central, and the second highest Year R NCMP
participation rate.
This means that a higher percentage of our eligible children are being
measured. We have a comprehensive programme to support healthy
weight and help people lose weight. This includes the Healthy Pompey
programme which has supported various initiatives:
• We have helped pre-schools develop a healthy approach to nutrition
and physical activity through the Pre-school Challenge;
• Weight management for young people - helping them to learn more
about healthy behaviours and start to make changes;
• Healthy cooking skills for parents and young people.
We have a new post for a health visitor (healthy weight) working on the
‘pre-birth’ to five agenda. This post has been piloting a multidisciplinary
programme known as MEND - Mind, Exercise and Nutrition…Do it!
MEND combines all the elements known to be vital in treating and
preventing overweight or obesity in children and is also designed to help
post-natal mothers lose weight and develop healthy habits that can then
be passed on to their families. A second post will be added to the 2011/12
business plan.
In 2011/12, we will commission further programmes of the MEND 7-13
scheme to ensure weight management is available for those young
people who need it, too.
We hope that this early years focus will kick start the children’s obesity
agenda and show effects on this performance measure in the future.
It may not be a quick fix, as it takes time to embed programmes and
bring about behaviour change.
Teenage conception rate
Inter-generational issues linked to educational attainment, aspirations
and teenage pregnancy have long influenced this indicator and a
recent commissioning review on teenage pregnancy highlights a very
high correlation between poor attendance and persistent absence rates
for girls who later became pregnant at school or shortly after leaving
school.
An Outreach Contraceptive Nurse is working with vulnerable groups
in community settings, colleges and schools to provide advice and
support.
A Sex Sense worker is also providing drop in clinics on all further
education campuses across the city, targeting the 16-17 year old cohort.
A Sex Relationship and Education Targeted Intervention Programme
is also working with 13-16 year olds initially in five schools as a pilot
project and then offered to all secondary schools within Portsmouth.
34

Helping our staff - listening, learning and development
Members of our Workforce and Development Directorate continue
to work with our partner organisations to ensure the most effective
management of staffing resources, increased capability, improved
development opportunities and enhanced staff engagement. We are
committed to ensuring our approach remains progressive and uses
technological solutions to best advantage.
Human Resources processes remain consistent with both legislative
requirements and best practice, and this is recognised through the
continuation of the ‘2 tick’ disability symbol and our ‘Age Positive
Employer Champion’ status. We also have a single equality scheme
(currently under review) and this is on our website.
Learning and development
The NHS reforms have prompted a review of Learning and
Development priorities to identify business critical activity. Out of this
has come a change in focus to support staff during transition. Career
and performance coaching, workshops and team development have
supported individuals and teams throughout the year and we employ
four qualified coaches.
A focus on take up of appraisals has resulted in considerable
improvement with an average of over 85% of staff across the PCT now
receiving an appraisal.
This year has also seen all staff able to access e-learning for the first
time, with e-induction available for those joining the organisation.
A national drive for all NHS employees to complete Information
Governance training by June 2011 has resulted in 91% of our staff
completing by April.
Wellness
Staff wellbeing continues to be a high priority, and massage, yoga and
pilates sessions are among options available on site to staff outside
working hours. We have also introduced a range of informal lunchtime
‘bite size’ skills sessions for staff with a diverse and wide ranging
programme.
A satisfaction survey resulted in a change of Employee Assistance
Programme provider in April 2011. The service is now provided by Right
Corecare, with counselling, advice and guidance available to our staff 24
hours a day.
Staffing levels
As at March 2011, the workforce of NHS Portsmouth was 531.4 full-time
equivalents (FTEs), with a headcount of 683.
Based on Occupation Codes FTE Headcount
Staff groups FTE %FTE Headcount %Headcount
Consultant 1.0 0% 1 0
General Practitioner 2.4 0% 15 2%
Other Medical Staff 1.0 0% 1 0%
Total Medical Staff 4.4 1% 17 2%
Qualified Nurse 8.4 2% 10 1%
Unqualified Nurse 0.0 0% 0 0%
Student Nurse 0.0 0% 0 0%
Total Nursing staff 8.4 2% 10 1%
Qualified Professional & Technical 9.0 2% 13 2%
Unqualified Professional & Technical 1.0 0% 1 0%
Total Professional & Technical 10.0 2% 14 2%
Support staff 216.8 41% 324 47%
Building & Maintenance 53.5 10% 59 9%
Admin & Clerical 192.7 36% 211 31%
Managers 45.5 9% 48 7%
Board Member 0.0 0% 0 0%
Total Support Staff 508.5 96% 642 94%
Total PCT Staff 531.4 100% 683 100%
35

Pompey players
past and present
helped us promote
the Choose Well
messages during the
year.
37

This represents staffing across all areas in the Commissioner
configuration. Estates and Facilities staff represent a large proportion of
the workforce at 364.5 FTE (483 headcount).
Sickness absence
Staff sickness/absence rates rose throughout the year, ending at an
average of 3.5%, against a Strategic Health Authority average of 3%.
We saw an increase in absence over the last few months of the year (to
April.) Stress/anxiety was the highest cause, around 14%, of all absences,
followed by colds and flu (11.7%.)
The cost of sickness absence to the PCT this year was an average of
£0.5m (staff salary costs), with 58% of sickness absence being long term
and 42% short term (less than 28 days.) The HR department continues
to work with managers to help reduce sickness across the organisation,
managing it appropriately in line with policy and legislation.
Workforce
We have continued to work across directorates to improve the availability
and utilisation of workforce information to improve performance.
During 2010/11, we held a number of corporate events for commissioning
members of staff, with similar events for Estates and Facilities employees,
to ensure they were familiar with the White Paper proposals and
acquainted with the possible outcomes for them. The events served to
ensure positive staff engagement and an opportunity for early, open
dialogue on the issues facing both the PCT and the workforce more
broadly.
Our staff have also made good use of activities as diverse as massage,
yoga, pilates and lindy hop dance classes. Exercise classes run by staff, for
staff, have been so popular that the number of sessions has increased to
three per week.
Staff survey
This national, annual survey was conducted between September and
December 2010 with all our staff invited to participate.
We achieved a response rate of 64%, an increase of 3% from last year.
Results for 2010 show we have made some important improvements.
Staff are:
• more satisfied, scoring 3.73 (where 5 = highest level of satisfaction)
in 2010, up from 3.65 in 2009;
• feeling less work related stress, 20% of staff, down from 26% in
2009;
• working fewer additional hours, 51% in 2010, down from 67% in
2009.
There is still some work to do, however, not least in the areas where
we have seen a deterioration in results since last year. These included:
• a fall in accessing work-related training to 72%, from 81% last year;
• fewer staff feeling valued by their colleagues, 77%, from 81%;
• fewer staff receiving an appraisal, 56% down from 60% in 2009.
We will share the learning from these areas and make more
improvements over the coming year.
We will run directorate level events, so that subject-focused action
plans can be drawn up and will discuss the areas where improvements
have already been made, acknowledging the effort that has gone into
this.
We hope that all staff will continue to engage with the survey and
help us build positive improvements for the future.
38

Staff involvement
Following the separation of our commissioning and provider functions
last year, our Staff Involvement Forum (SIF) has been replaced by a new
group representing NHS Portsmouth employees, which held its first
meeting in June 2010.
The new group, called the Staff Engagement and Wellbeing Group,
represents a cross section of staff and meets several times a year.
The main purpose is to discuss ideas and suggestions relating to
employment, working conditions and working practice.
It is a chance for staff to have their say and ultimately influence
operational and strategic decisions.
Staff involvement
has always been a
key priority for the
PCT and we continue
to look at ways to
ensure that all staff
have the opportunity
to have their say.
39

Experience, engagement, evaluation - finding out what people think
Patient experience
Between April 2010 and March 2011 our Engagement and Experience
Service received 480 contacts from patients, relatives or members of the
public raising complaints, highlighting concerns for local resolution or
requesting help and advice.
Of these, 148 members of the public contacted the service for a wide
variety of advice or signposting to services, such as how to register with
a GP on return to the UK, how to obtain contraception and sexual health
advice or how to access health and wellbeing events.
The 332 contacts that dealt with comments or concerns related to:
NHS Provider GP Dentist Other
Portsmouth services independent
contractors
Complaint 26 31 34 35 7
Concern 27 40 54 60 9
Plaudit 5 1 3
Total 53 76 89 98 16*
* 6 pharmacy
2 opticians
8 walk-in treatment centres
Complaints about the PCT are fully investigated and managed by the
Engagement and Experience Service.
We aim to resolve the complaints or concerns of the public by contacting
them directly to discuss the most beneficial way of managing their
complaint or concern.
Patients can choose to make a complaint either verbally or in writing or
can choose to have a concern dealt with by liaison between the parties
to secure an agreed positive outcome.
We will offer a meeting to discuss the management of the complaint
or concern to facilitate these decisions.
We deal with complaints about independent contractors or local health
care providers sent to us by:
acknowledging the complaint;
forwarding the complaint to the provider service;
Liaising with the provider on the best way to manage the complaint;
supporting the independent contractors by monitoring
adherence to timescales for responses and advising them of
actions required to keep the complainant informed;
supporting the iIndependent contactors with response letters;
monitoring the response for service improvement and learning;
highlighting trends and themes to the commissioning managers.
Wherever possible we try and support improvements to services as a
result of a complaint or concern. Examples over the past year include:
improving referral arrangements for specialist treatment for
patients at one dental practice where it was found that the correct
policy for individual funding requests was not followed;
another dental practice implementing a new policy whereby there
are no mobile phones in a clinical areas after a patient was upset by
a dentist taking calls while in surgery;
pharmacy staff being reminded of the correct procedures regarding
providing ‘prescription owing slips’ after a patient had difficulty
in obtaining the balance of their prescription, when previously their
medication had been out of stock.
Complaint/concern topics regarding pharmacies are highlighted on
the newsletter Express and published on the Primary Care Information
Portal website.
40

Freedom of Information Act 2000
With effect from January 2005 all public authorities must comply with
the Freedom of Information Act 2000. On receipt of a written request
the Act places a duty on the PCT to:
• Confirm whether the information is held by the PCT;
• Release a copy of the information to the requester.
From January 2010 to December 2010 we received 296 Freedom of
Information requests - this is an increase of 6% on last year. We have
a process in place to handle all requests centrally, and must respond
within 20 working days following receipt of the request.
However, as last year’s figures also included provider requests (now
the responsibility of Solent NHS Trust), the real increase in requests
regarding NHS Portsmouth’s information is closer to 28%. This amply
demonstrates the increasing trend in the use of this Act to access
information.
2010 2009 2008 2007 2006
Total requests 296 280 207 76 41
During 2010 the majority of requests have been sent by the media
(27%), individual members of the public (27%), commercial companies
(21%) and professional organisations (20%).
Of the total requests received during 2010, 99% received a response
within the 20 day deadline. Only three responses were delayed, two of
these had an agreed extension. The average response time was 17.8
days.
A disclosure log is now available to the public on our website. This
has been implemented in line with the Information Commissioner’s
directive on the disclosure of information under the Act.
This makes available anonymised responses to Freedom of Information
requests:
www.portsmouth.nhs.uk/About-Us/foi-disclosure-log.htm
The Act requires the PCT to adopt a Publication Scheme which has
recently been updated:
www.portsmouth.nhs.uk/About-Us/publication-scheme.htm
The Publication Scheme is regularly updated and utilised to publish
information thereby ensuring the PCT is open and accountable.
Engaging people in health issues
We regularly seek the views of members of the public in line with our
statutory requirements and we now publish a formal report (‘duty to
report’) annually about our consultation and engagement activity. This
is available in hard copy form and on our website. Produced over the
summer, an updated version is published in September.
During the course of 2010/11 we have engaged with people in
Portsmouth on a wide range of health issues.
Many relate to our public health role, and include our work in
updating the Joint Strategic Needs Assessment (see also page 20), the
Pharmaceutical Needs Assessment (page 27) and our social marketing
activity (page 24.)
Members of the public locally have also been involved in helping us
assess a preferred contract provider for the St Mary’s NHS treatment
centre (contract renewal), supported our work in delivering the Healthy
Living Pharmacy scheme and in relocating some children and family
services from Northern Parade Clinic to Battenburg Avenue Clinic in the
north of the city.
We have supported locally the national consultations and engagement
activity around the Government White Paper Liberating the NHS and the
Public Health White Paper Healthy Lives, Healthy People.
41

Ensuring appropriate governance
We have also worked closely with NHS Hampshire and Portsmouth
Hospitals NHS Trust in delivering significant communications and
engagement activity around the local sustainability programme
(see page 9.)
Whilst not directly part of the sustainability programme we have
also been working together to support the work of the Independent
Reconfiguration Panel who were requested by the Secretary of State for
Health to consider whether the closure of the G5 end-of-life care ward at
Queen Alexandra Hospital in Portsmouth enables the provision of safe,
sustainable and accessible end-of-life care for the local population.
The Panel’s report was published in spring 2011 and we are working with
Portsmouth Hospitals NHS Trust and NHS Hampshire on an action plan to
deliver the recommendations.
We retain, and appreciate, a close working relationship with our Local
Involvement Network (LINk) and provide regular updates for the
Portsmouth Health Overview and Scrutiny Panel.
We include a four page insert into each edition of Flagship, Portsmouth
City Council’s residents’ magazine. This affords us an opportunity to
communicate directly with every household in the city on health issues.
We also contribute to the Council’s voluntary services newsletter which
reaches around 500 organisations every month.
In addition, during the year we launched our email newsletter, Contact,
which we send to all our stakeholders and partners in the city on a
monthly basis.
Assurance Framework
The Assurance Framework and Strategic Risk Register is a means
by which the PCT’s key threats to achieving our strategic aims and
objectives are categorised and monitored with controls identified to
mitigate these risks.
It is supported by our Risk Management Strategy which determines the
approach we take to managing the processes involved with, and the
escalation of, risks where appropriate.
We have consistently maintained a grade ‘A’ score (as scored by the
SHA) for this.
Business assurance
We meet national requirements by ensuring appropriate and robust
internal control mechanisms are in place to provide transparency on
the decision-making and working of the Board and its sub-committees.
Risk management
We foster and promote a risk-aware culture where risk management
is seen to have an essential and positive impact on meeting
organisational objectives.
Identification of risks and their management has been a key part in
business planning across the PCT and this includes partnership working
arrangements.
As a commissioning organisation, we also ensure that services, agencies
and organisations from whom we commission services or work with as
partners have risk management processes in place.
42

Committee structure
Regulation
We meet regulation requirements for all assessments through robust
governance processes. We also work to achieve, monitor and report
standards/targets set by regulatory bodies including the NHS Litigation
Authority, Audit Commission, Department of Health etc. And we
continue to utilise national information on services and organisations
from whom we commission to assist our decision-making.
Policy development
We have ensured that policy development has reflected the changing
organisation. This will continue in line with national requirements to
ensure that we meet legal and statutory duties as well as the most upto-date
‘best practice’.
Our Directorate of Corporate and Support Services coordinates,
administers and services all the formal committees of the PCT. As part
of this support, the Board will have access to specialist legal advice, and
appropriate professional advice, as necessary.
Audit
Committee
Portsmouth City PCT Committee Structure Chart
Workforce &
Remuneration
Committee
Estates
Committee
PCT Board
Strategic
Programme
Committee
Clinical
Executive
Committee
Executive
Management
Committee
Charitable
Funds
Committee
The PCT Board provides strategic leadership and direction for the local
health system and takes action to protect the public’s health, alleviate
the causes of poor health and oversee the performance and development
of service providers. In carrying out these roles, the Board is responsible
to the Secretary of State, the Department of Health and, ultimately, to
Parliament through its reporting arrangements with the South Central
Strategic Health Authority. The Board is also accountable to the citizens
of Portsmouth, as patients, carers and taxpayers, for the way in which the
development of their local health services is overseen.
In response to the national policy ‘Transforming Community Services’,
Portsmouth Community and Mental Health Services (PCMHS) merged
with Southampton Community Healthcare (SCH), with Southampton
City PCT hosting the merged organisation from 1 April 2010. In view of
changes within both the commissioner and provider functions of the PCT,
the Board and Committee governance and business arrangements were
reviewed and revised to reflect these changes and new arrangements
were implemented with effect from 1 April 2010.
The major changes applied to the establishment of the Strategic
Programme Committee and the Clinical Executive Committee and
re-establishment of the Executive Management Committee.
43

PCT Board and Clinical Executive
Committee membership
The Strategic Programme Committee is concerned with overseeing
and directing the commissioning programmes which would deliver the
Board’s vision and objectives. The Clinical Executive Committee secures
clinical direction and engagement and embraces the professional role of
the former Professional Executive Committee (PEC.) It fulfils the statutory
requirements relating to PECs.
The Executive Management Committee is concerned with the delivery
of executive responsibilities and has a focus on quality and safety,
performance and delivery, and operational capacity.
The Board committees are supported by a number of sub-committees
that routinely and regularly report to the Board committees, which also
routinely and regularly receive minutes and/or reports from appropriate
and relevant meetings, for example the SHIP Board and the Specialised
Commissioning Group.
The lead accountable Executive Director, who provides the Board with
regular reports on the activity of each committee, is set out within the
portfolio for each of the Directors, and is summarised as follows:
PCT BOARD AUDIT COMMITTEE CLINICAL EXECUTIVE COMMITTEE WORKFORCE &
REMUNERATION
COMMITTEE
Richard Hibbert (C)
Rob Dalton*
Paul Edmondson-
Jones
Margaret Geary*
Jo Gooch***
Ted Griggs*
Pam Hobbs**
Jim Hogan
Fiona Loughran
Cllr Leo Madden*
****
Brian Mansbridge
Tom Morton
Malcolm Noyce
Innes Richens
Tracy Sanders
Andy Silvester
Jackie Powell
Ros Jack*
Tim Wilkinson
*Non voting
**To 30 June 2010
***From 1 July 2010
****From January
2011
Malcolm Noyce (C)
Brian Mansbridge
Tom Morton
Andy Silvester
Dr Leslie Dinapala - GP
Dr Paul Edmondson-Jones -
Director of Public Health &
Primary Care
Dr Elizabeth Fellows - GP
Pam Hobbs - Director of Finance
(until 30 June 2010)
Jo Gooch - Director of Finance
(from 1 July 2010)
Christine Hayward –
Professional Adviser (Physiotherapy),
Solent NHS Trust
Dr Jim Hogan - GP
Simon Holmes - Medical Director,
Portsmouth Hospitals Trust
Katie Hovenden - Associate Director
Medicines Management
Margaret Meikle –
Professional Adviser, SLT,
Solent NHS Trust
John Parke - Head of AMH
Psychological Services, Solent
NHS Trust (until 31 July 2010)
Tracy Sanders - Chief Executive
Dr Tim Wilkinson - Clinical Director,
(Chair)
Richard Hibbert (C)
Fiona Loughran**
Malcolm Noyce*
Andy Silvester
*To 10 June 2010
**From 10 June 2010
More detailed information about Board membership, together with a
register of interests can be found on page 54.
44

An awards night
marked the end of our
successful first year
piloting the Healthy
Living Pharmacies
scheme - now 60 other
PCT areas have signed
up.
45

Estates and Facilities - building our vision for the future
We have ambitious plans to provide patients, clients, visitors and staff
with the best quality accomodation and associated support services
Our Estate Strategy (2009/14) has supported the Portsmouth and south
east Hampshire sustainability project to review our accommodation
usage and requirements.
This takes account of our commissioning intentions and considers how
the estate and related infrastructure will need to be delivered over the
next five years, recognising that the healthcare needs of our local
health community should be the fundamental driver of the estate
provision.
It also highlights the need to:
deliver care closer to home in a community setting;
facilitate integrated personalised care;
enable patient choice, drive up quality and value for money;
protect assets and their value, especially the Estate.
The scope of the strategy includes land and buildings where the
freehold is owned or held on a lease by NHS Portsmouth. It is based on
an evidence-based analysis of this estate looking at quality, accessibility
and whether the estate represents value for money. This then helps us
consider how the estate meets our vision for the future and to identify
any gaps, need for changes or developments, affordability permitting.
PEAT assessments 2010
The patient environments at St James’ Hospital, St Mary’s Hospital and
Jubilee House in Cosham achieved high scores in the Patient Environment
Action Team (PEAT) assessments for the year.
The self-assessments, which include patient representation, are submitted
to the National Patient Safety Agency. The results are particularly
pleasing given the large amount of construction work and change in
service provision that took place during the year.
Compared with last year’s results:
Jubilee House environment score improved from good to excellent
and privacy and dignity score improved from good to excellent;
St James’ Hospital privacy and dignity score improved from good to
excellent.
Capital schemes and estate improvements
A number of schemes were started, reached completion or were
officially opened or occupied during 2010/2011. These included:
• Official opening of The Limes (see page 14)
• Battenburg Avenue Clinic: major refurbishment and
upgrade as part of our estate rationalisation programme to
facilitate the relocation of clinical staff and services from Northern
Parade Clinic, which will be sold;
• Hamilton House/Avenue House: refurbishment and upgrade to these
services, following consultation with carers, for people with learning
disabilities before the premises transfer to Portsmouth City Council;
• Reducing energy use: to cut our carbon emissions and reduce energy
usage we have installed a number of power rectification units at
sites where electricity consumption is high. The units reduce energy
usage, and our carbon footprint and extend the life of the electrical
equipment;
• St Mary’s Community Health Campus (see page 11)
• University dental academy (see page 30)
46

Being seen to be green - our environmental impact
We have embraced the NHS Carbon Reduction Strategy for England
which targets a 10% reduction in carbon emissions for all NHS
organisations by 2015.
We have a Sustainable Development Management Plan that covers
environmental legislation, governance, organisational/workforce
development, partnerships, finance, energy and carbon management,
water and waste management, procurement, travel and design and
operation of buildings.
The plan will be important in helping us to maintain the progress we
have made to date in these important environmental areas. And we
will continue to seek opportunities to engage staff in this process.
In the past year;
• we have reduced our domestic waste output by 20% from 478
tonnes in 2009/10 to 399 tonnes in 2010/11;
• we have increased total waste recycled to 23% (19.5% last year;)
• using energy recovery facilities in our clinical and domestic waste
contracts helped us recover or recycle around 98% of the waste
produced;
• carbon footprint from energy usage in our buildings has gone up
from 4.9 tonnes CO2e to 5.6 tonnes in 2010/11,due to the transfer of
part of the St Mary’s site to the PCT.
We continue to
promote cycling
as a healthy, and
environmentally
friendly, travel
alternative in
Portsmouth.
We support the annual Big Green Commuter Challenge event run by
Portsmouth City Council to reduce traffic flow into the city whilst,
in our Public Health work and initiatives such as Healthy Towns, we
promote walking and cycling as a healthy travel alternative.
We support the Council in its Walking Strategy, which aims to get more
people to walk for short journeys and encourage sustainable travel.
The St James’ catering service continues its policy of using local and
sustainable sources of food and produce wherever possible.
47

Technological change
Investment in information technology can realise significant benefits and
one such example of this over the past year is the implementation of
the RiO Community and Mental Health system. This now provides online
access to patient records across the community to multi-disciplinary care
teams and care professionals involved with direct patient care.
The introduction of the Portsmouth Primary Care Information Portal
(PIP) has supported GPs and health professionals in providing access
to information and communication networks to encourage sharing of
knowledge and best practice.
Technology plays a key
role in the provision
of health care and in
making it easier for
clinicians to access
information about
patients.
The Commissioning Enablement Service (CES), now in place across the
South Central area, supports the development of appropriate systems
and procedures, promotes analytical expertise and the good use of data
and information.
We are working to ensure that health professionals have access to the
information they need, when they need it to improve the healthcare of
their patients as well as the health and wellbeing of the population of
Portsmouth.
However, we recognise that good health care is the outcome of a
partnership between patients and healthcare professionals and that
more work is needed to provide patients and the public with the
information they need in order to make informed choices and decisions
about their health and treatment.
Improved information and technology is a recurring theme in the
Government’s White Paper “Equity and Excellence: Liberating the NHS.”
We support its vision which, while challenging, is fully endorsed by
the PCT and its NHS and social care partners. Much of the information
needed for its delivery is already available within the systems and
databases we use, many of which feed into the Hampshire Health Record
providing an integrated care record service to health professionals across
Hampshire.
48

Whilst the Hampshire Health Record has the potential to provide
patients with access to their care records we are also exploring a
number of options and opportunities such as:
• the summary care record supporting ‘My Health Space’ connecting
patients to their care records via the Internet;
• discussions with GPs and their system providers to provide patient
access to a range of online services such as booking appointments,
receiving test results, getting advice etc;
• the NHS interoperability service that will support the notion of
‘Healthcare Information Hubs’ to connect clinicians with clinicians,
patients with clinicians and health care providers with the public.
As we move towards the implementation of a SHIP Cluster we look
forward to taking advantage of, and sharing, our individual health
informatics strengths that will benefit the health and social care
system of Hampshire as a whole.
Our belief that strategic investment in information systems and
technology produces significant benefits is demonstrated by the
outcomes and realisation of investment made in previous years. Of
course the PCT needs to ensure that future investment continues
to realise benefits effectively, particularly in these economically
challenging times. Such benefits include:
• implementation of the Electronic Prescription Service that will:
- reduce unclear prescriptions which may compromise safety
- allow instant cancellation of prescriptions no longer clinically
appropriate
- prevent the loss of prescription forms
- reduce the opportunity for fraud
- relieve patients of the need to collect prescriptions from the
prescriber
- eliminate the need for pharmacists to re-enter prescription
information
- allow faster and more accurate processing of prescriptions;
• supporting patients to make use of their right to choose their
care provider, location and a type of care. Using technology to book
appointments or to rearrange and receive notification of
appointments;
• enabling the public to get access to simple, trustworthy information;
• achieving financial savings through efficient working and using
technology to minimise manual administration.
• increasing the availability of shared access to clinical data, either
patient specific or collective data to inform the commissioning
process and drive improvements in quality and in making evidence
based decisions;
• enabling patients to have access to their clinical information in
order to empower them to make decisions about their health care;
49

Data security
We need to ensure that the way we store and transfer data, particularly
personal identifiable information, is as secure as possible and we work
hard to develop systems to improve the security of person identifiable
data.
We have a number of policies in place to guide staff in their handling of
sensitive data, including those relating to:
• Data protection
• Portable devices
• Record management
• Email
• IT security
• Safe haven (secure transfer of information, including patient
identifable information.)
These are regularly reviewed and we remind our staff of their
importance. New employees receive data protection training on
induction.
NHS organisations must now include details of serious untoward
incidents involving data loss or confidentiality breach in annual reports
(a Department of Health requirement under its Information Governance
Assurance Programme.) These are classified on a scale of 0-5 in terms of
severity, risk to reputation and risk to individuals.
We have incorporated the ‘Serious Untoward Incident’(SUI) reporting
guidance regarding Information Governance incidents within our Policy
for the Reporting and Management of Adverse Events and Significant
Adverse Events (approved in January 2009).
We will continue to report any detected data breaches or losses of
information in accordance with this policy. The SUI reporting process
enables us to analyse each incident, any particular trends and make
adjustments to the way we work to minimise risk of future occurrence.
50

The challenge ahead - looking forward
The White Paper ‘Equity and Excellence: Liberating the NHS’ sets
out the Government’s vision for the future of the NHS. Its ambitious
proposals aim to:
• give people more choice, better information and control over their
care;
• put GPs in control of the commissioning decisions that influence the
quality and productivity of care;
• enable providers and clinicians to innovate to meet the needs of
patients;
• strengthen local partnership working and develop a first class Public
Health Service.
In essence, it seeks to transfer leadership responsibilities in relation
to health care commissioning from primary care trusts to Clinical
Commissioning Groups under the direction of a newly formed National
Commissioning Board and embed public health services within local
authorities. We will facilitate and support the development of new
arrangements to deliver the intentions of the White Paper.
The NHS Operating Framework has mandated the creation of PCT
clusters with a single Chief Executive and Executive Management Team
for each cluster. It has been agreed that locally this should be formed
across SHIP and this was put in place in June 2011. Clusters have two
broad roles:
• overseeing delivery during transition and close down of the old
system ensuring PCT statutory duties are delivered up to at least
April 2013;
• supporting emerging consortia, the development of commissioning
support providers and the emergence of the new system.
In addition a number of key priorities are already emerging for the
cluster in managing the transition:
• maintaining a clear focus on delivery (financial and operational
performance, implementation of QIPP and reform plans);
• maintaining a clear focus on safety and quality during the
transition, including the delivery of the statutory duties of the
existing PCTs and the robust management of risk;
• supporting the establishment of GP Commissioning Consortia;
• developing robust commissioning support services for GPCCs;
• supporting the development of the new Health and Wellbeing
Boards;
• overseeing the transfer of Public Health into each of the local
authorities;
• ensuring the delivery of the plans to ensure that all Trusts in the
SHIP Cluster achieve Foundation Trust status;
• undertaking the commissioning duties of the new National
Commissioning Board, until such time as this is established.
Alongside this the Portsmouth CCG is already involved in the PCT’s
routine business and has a key role to play in taking forward the QIPP,
Reform and Operating Plan process in future and the delivery of the
required savings in the forthcoming years.
We are working with the CCG to help it identify the resources it will
require to take on its commissioning responsibilities.
We are keen to establish strong Public Health links with the CCG as well
as maintaining those we already have with the City Council so that the ill
health agenda is not separated from that of prevention and wellbeing.
Primary care will continue to play a vital role in health protection and
improvement.
However, the White Paper suggests the national Public Health Service will
have a strong local focus within local authorities and we will work with
the Council, in partnership with the SHA, to take this forward.
51

All NHS providers are required to become free-standing organisations
by 2014 and we will continue to support Portsmouth Hospitals NHS Trust
and Solent NHS Trust to achieve this.
We recognise the importance of our workforce and the need for us to
ensure that this is maintained and supported appropriately to meet
our statutory obligations and fulfil future needs. We will be working
hard to ensure that staff are engaged in the processes that surround
the outcomes of the White Paper and what this means for us as an
organisation.
Jean Jones, our
first patient at
the revamped St
Mary’s outpatients
department, received
flowers to mark the
occasion from nonexecutive
director
Tom Morton.
Keeping staff focused on business critical work streams throughout the
transition period will remain a key imperative. Roles and objectives will
be subject to constant review to ensure this is achieved.
It will be important as part of this process to ensure a sufficiently local
focus is retained for the city whilst also exploiting the benefits of
clustering.
The PCT Board will continue to oversee and drive the implementation
of the requirements of the White Paper until such time as Cluster
arrangements are in place to pick this up. It will, after this point, continue
to have a role to play in ensuring that business critical and statutory
duties are fulfilled locally and that the interests of Portsmouth people are
effectively supported in the planning and delivery of local services.
NHS Portsmouth is well placed to fulfil this through the commitment
of all parties to the health and wellbeing of the city and through our
continued and strong commitment to collaborative and integrated
working in the future.
52

Statutory Reports
and Financial
Information
53

Register of interests and board membership PCT BOARD & CEC MEMBERSHIP & REGISTER OF INTERESTS as at March 2011
TRUST BOARD
NAME
CHAIR TPCT
MR RICHARD HIBBERT
TPCT Board Member (Voting - Non Officer)
INTERESTS DECLARED:
• Fellow of Institute of Mechanical Engineers
• Fellow of Chartered Institute of Personnel Development
• Old Portsmouth Forum/Friends of Old Portsmouth - Regular
attendee and supporter at local meetings
• Associate Hospital Manager for Solent Healthcare
(Southampton City PCT)
DIRECTOR OF CORPORATE AND SUPPORT SERVICES
• Member of the Chartered Institute of Public Relations
MR ROB DALTON
TPCT Board Member (Non Voting Officer)
DIRECTOR OF PUBLIC HEALTH AND PRIMARY CARE
DR PAUL EDMONDSON-JONES
TPCT Board Member (Voting - Officer)
TPCT Clinical Executive Committee Member
• Fellow of the Faculty of Public Health
• Secretary of the UK Association of Directors of Public Health
• Chair of the Local Strategic Partnership
• Joint Director of Public Health and Well-being between
Portsmouth City Teaching Primary Care Trust and Portsmouth
City Council
• Director of “Dot to Dot” a local Arts for Health charity
• Season ticket holder for Portsmouth Football Club
54

NAME
PORTSMOUTH CITY COUNCIL CEO NOMINATED BOARD REPRESENTATIVE
MRS MARGARET GEARY
Strategic Director and Director of Adult Services
Portsmouth City Council
TPCT Board Member (Non Voting Officer)
INTERESTS DECLARED:
• Member of the Portsmouth Race Equality Network
Organisation (PRENO)
• Member of the Association of Directors of Adult Social
Services (ADASS)
• Lead for ADASS South East for ‘Putting People First’ and, in
that capacity, a member of the Joint Improvement Partnership
in the region (linked to the Regional Improvement &
Efficiency Partnership)
DIRECTOR OF FINANCE
MRS JO GOOCH
TPCT Board Member (Voting Officer)
TPCT Clinical Executive Committee Member
• Husband is Deputy Director of Finance at Portsmouth
Hospitals NHS Trust
• Substantive employee of Solent Healthcare (Southampton
City PCT) seconded to Portsmouth City tPCT)
DIRECTOR OF ESTATES AND FACILITIES MANAGEMENT
MR TED GRIGGS
TPCT Board Member (Non Voting Officer)
• Chartered member of the Royal Institution of Chartered
Surveyors
• Chartered member of the Society of Environmentalists
• Occasional lecturer for the University of Brighton
• Member of the Health Estates & Facilities Management
Association
• Member of the First Division Association
• Member of the Rotary Club of Shoreham and Southwick
• Joint Child Protection Officer, Church of the Good Shepherd,
Parish of Shoreham Beach, Shoreham-by-Sea.
55

NAME
VICE CHAIR OF CLINICAL EXECUTIVE COMMITTEE
DR JIM HOGAN
INTERESTS DECLARED:
• Foundation School Governor at Oaklands Catholic School
• General Practitioner practising from Lake Road Practice,
Portsmouth
GP practising from Lake Road Practice, Portsmouth
TPCT Board Member (Voting - Officer)
TPCT Clinical Executive Committee Member
DIRECTOR OF PERFORMANCE & DEVELOPMENT
MRS ROSALYN JACK
TPCT Board Member (Non Voting Officer)
• Chartered Fellow of Chartered Institute of Personnel and
Development
• Accredited Member of the Association of Coaching
• Husband is a member of Uplands Mental Health Act
Managers Panel
• Husband is a Non-executive Director of Age Concern
NON EXECUTIVE DIRECTOR
FIONA LOUGHRAN
• Director of Planning, University of Portsmouth
• Member of Unison
• Married to Chief Executive of West Sussex County Council
TPCT Board Member (Voting - Non Officer)
PORTSMOUTH CITY COUNCIL PCT APPOINTED BOARD REPRESENTATIVE
COUNCILLOR LEO MADDEN
• Portsmouth City Councillor (Nelson Ward)
• PCC Councillor representative on Portsmouth Hospitals NHS
Trust Council of Governors
PORTSMOUTH CITY COUNCIL
TPCT Board Member (Non Voting – Non-Officer)
56

NAME
NON EXECUTIVE DIRECTOR
MR BRIAN MANSBRIDGE
TPCT Board Member (Voting - Non Officer)
INTERESTS DECLARED:
• Adviser for Portsmouth Branch of Citizen’s Advice Bureaux
• Honorary Treasurer Christ Church Portsdown, Havant
Deanery, Portsmouth
• Member of the Nautical Institute
• Associate Hospital Manager for Solent Healthcare
(Southampton City PCT)
NON EXECUTIVE DIRECTOR
MR TOM MORTON
TPCT Board Member (Voting - Non Officer)
• Chief Executive Officer - Chichester Counselling Services
• Member of the Board of the Royal Naval Museum
• Trustee of the Portsmouth Cathedral Development Trust
• Vice Chairman of the Agamemnon Housing Association
• Chairman of the Portsmouth Community Network
• President of the Royal Naval Association (Waterlooville
Branch)
• Associate Hospital Manager for Solent Healthcare
• Appointed Governor at Hampshire Partnership
Foundation Trust
NON EXECUTIVE DIRECTOR
MR MALCOLM NOYCE
• Fellow, Institution of Civil Engineers
• Fellow, Chartered Institution of Highways and Transportation
• Executive Director, Major Projects Association
TPCT Board Member (Voting - Non Officer)
57

NAME
NON EXECUTIVE DIRECTOR
JACKIE POWELL
TPCT Board Member (Voting - Non Officer)
INTERESTS DECLARED:
• Mental Health Act Review Manager for Hampshire Partnership
NHS Trust
• Mental Health Act Review Manager for Solent Healthcare
• Representative Council of Governors for Portsmouth Hospitals
NHS Trust
• Young Persons Counsellor for Off The Record (third sector
organisation, child counselling) Also Member of OTR’s
Management Committee
DIRECTOR OF STRATEGY & SYSTEM MANAGEMENT
• Member of the NHS Alliance
MR INNES RICHENS
TPCT Board Member (Voting - Officer)
CHIEF EXECUTIVE
MS TRACY SANDERS
• Husband is the Chief Executive of Rainbow Centre for
Conductive Education, based in Fareham
TPCT Board Member (Voting - Officer)
TPCT Clinical Executive Committee Member
NON EXECUTIVE DIRECTOR/ VICE CHAIR
MR ANDY SILVESTER
TPCT Board Member (Voting - Non Officer)
• Chairman of SignPost
• Hampshire Police Authority - Independent Custody Visitor
• UNITE - South East Region Council Member
• Employee - Ministry of Defence
• Married to an employee of Portsmouth Hospitals NHS Trust
58

NAME
CHAIR OF CLINICAL EXECUTIVE COMMITTEE
DR TIM WILKINSON
INTERESTS DECLARED:
• General Practitioner - Co-owner surgery premises at
27-29 Derby Road, North End and 358 Copnor Road, Copnor
GP practising from Derby Road Practice, Portsmouth
TPCT Board Member (Voting - Officer)
TPCT Clinical Executive Committee Member
59

CLINICAL EXECUTIVE COMMITTEE
NAME
MEMBER OF CLINICAL EXECUTIVE COMMITTEE
DR LESLIE DINAPALA
GP practising from the Waverley Road practice, Southsea
TPCT Clinical Executive Committee Member
INTERESTS DECLARED:
• General Practitioner - Co-owner surgery premises at
34-36 Waverley Road, Southsea
• Member/share holder of Spinnaker Health Ltd
• Director/share holder of Urgent Doctors Ltd, a private
limited company providing GP locum services
• The practice partnership has shares in Portsmouth Health
Limited
MEMBER OF CLINICAL EXECUTIVE COMMITTEE
DR ELIZABETH FELLOWS
• General Practitioner practising from Milton Park Practice,
Portsmouth
General Practitioner practising from Milton Park Practice, Portsmouth
TPCT Clinical Executive Committee Member
MEMBER OF CLINICAL EXECUTIVE COMMITTEE
CHRISTINE HAYWARD
• Guide Leader - Girl Guiding UK
• Employee of Solent Healthcare (Southampton City PCT)
Physiotherapy Manager, St Mary’s Hospital
TPCT Clinical Executive Committee Member
60

NAME
MEMBER OF CLINICAL EXECUTIVE COMMITTEE
INTERESTS DECLARED:
• Employee of Portsmouth Hospitals NHS Trust
MR SIMON HOLMES
Medical Director, Portsmouth Hospitals NHS Trust
MEMBER OF CLINICAL EXECUTIVE COMMITTEE
KATIE HOVENDEN
• Occasional lecturer for University of Southampton and
University of Portsmouth
• Member of the Royal Pharmaceutical Society of Great Britain
Head of Medicines Management
TPCT Clinical Executive Committee Member
MEMBER OF CLINICAL EXECUTIVE COMMITTEE
MARGARET MEIKLE
Speech And Language Therapy Service Manager
TPCT Clinical Executive Committee Member
• Member of Royal College of Speech and Language Therapists
• Registered with the Health Professions Council
• Member of the SHA SLT Managers Forum
• Employee of Solent Healthcare (Southampton City PCT)
• Solent Healthcare AHP link with the South Central AHP Forum
• Member of Spinnaker Chorus
61

Leavers 2010-2011
PCT BOARD
NAME
DIRECTOR OF FINANCE
MRS PAM HOBBS
TPCT Board Member (Voting Officer)
INTERESTS DECLARED:
• Member of the Healthcare Financial Management Association
• Trustee of the Portsmouth and South East Hampshire
Partnership
• Committee Member of Art for Arts charity (under charitable
trust fund of Portsmouth and South East Hampshire Charitable
Trust Fund)
CLINICAL EXECUTIVE COMMITTEE
NAME
MEMBER OF CLINICAL EXECUTIVE COMMITTEE
MR JOHN PARKE
• Employed by Solent Healthcare
• Member of Doctorate in Clinical Psychology Programme Board,
Southampton University
Head of Adult Mental Health Psychological Services
TPCT Clinical Executive Committee Member
62

Financial report 2010-2011
Portsmouth City Teaching PCT (NHS Portsmouth) has a statutory
requirement to produce Annual Accounts (also known as financial
statements) and an Annual Report and these must be formally
approved by the PCT Board.
The key elements within the Accounts are the:
Statement of Comprehensive Net Expenditure - outlines the costs
incurred by the PCT during the year, net of miscellaneous income
(which is income other than the PCT’s main Revenue Resource
Allocation from the Department of Health).
Statement of Financial Position - provides a snapshot of the PCT’s
financial standing at a specific moment in time; in this case as at 31
March 2011. It identifies assets (everything the PCT owns that has
monetary value), liabilities (money owed to external parties) and
taxpayers’ equity (public funds invested in the PCT).
Statement of Cash Flows - summarises the cash flows of the PCT during
the accounting period. These cash flows include those resulting from
operating and investment activities, capital transactions and financing.
Statement of Changes in Tax Payers Equity - shows the impact of
changes in revenue and expenditure on the PCT’s reserves.
NHS Portsmouth recognises that, for those who may not be dealing
with them on a regular basis, these accounts pages can be full of
technical jargon. The Healthcare Financial Management Association,
in conjunction with the Audit Commission, has produced a very helpful
document entitled ‘Primary care trust accounts – a guide for nonexecutives’
from which the definitions above were taken and abridged.
It provides a comprehensive explanation of the terminology used
within the NHS accounting process, and although intended primarily
for PCT Non-Executive Directors, it is a useful reference document for
anyone who wishes to understand more about PCT accounts.
This guide is available from the Audit Commission website: www.auditcommission.gov.uk
in the financial management section of the health
pages.
Financial Review of 2010/11
We entered 2010/11 on a sound financial footing, and were to invest in a
number of key areas, in line with national and local priorities.
However, it was important that we remained financially vigilant ensuring
that:
• Financial governance and controls were robust.
• Our financial targets were met.
• New investment represented value for money.
• Efficiency savings were delivered.
• Financial plans were developed for future years.
At the end of the year, we achieved all our statutory financial targets:-
• Keeping our revenue expenditure to within the Revenue Resource
Limit
• Keeping our capital expenditure to within the Capital Resource Limit
• Keeping our cash requirements to within the Cash Limit.
The PCT ended the financial year with a revenue surplus of £0.7 million.
This was a planned surplus which will be carried forward into 2011/12.
However, despite meeting our planned surplus, the 2010/11 financial year
was not without financial pressures. Whilst the PCT secondary healthcare
costs remained within budget, 2010/11 saw increases in cost beyond that
planned in Specialist Services commissioning, Continuing Health Care
clients, and Mental Health clients requiring specialist treatment that
could not be delivered locally. These areas of expenditure will remain a
focus of review during 2011/12 to ensure expenditure is within budget.
63

During the financial year, we received a central cash allocation to
purchase the St Mary’s Treatment Centre building. This is reflected in our
Statement of Financial Position which shows a reduction in borrowings
(finance lease liabilities) and therefore an overall reduction in net
liabilities.
The PCT is not permitted to borrow or invest money, it is therefore
subject to negligible exposure to financial risks associated with interest
rate fluctuation.
The estate was valued by the District Valuer as at 31 March 2011. This
valuation was based on a modern equivalent asset valuation (MEA).
The effect of the valuation was a net Impairment of land and buildings
of £19.912m, consisting of £18.286m charged to the Statement of Net
Comprehensive Expenditure and £1.626m charged to the Revaluation
Reserve.
The Department of Health requires NHS organisations to deliver year on
year efficiency savings. In the 2010/11 financial year, the PCT delivered
efficiency savings of £4.0m, excluding the efficiency savings passed
onto NHS providers. The savings were from a combination of service
redesign and demand management initiatives, prescribing costs and PCT
management costs.
Investment in Service Improvements
During the 2010/11 financial year, we had an investment plan in line with
our Strategic Plan, including:-
• The development of St Mary’s Community Health Campus
• Contributing to the University of Portsmouth’s Dental Academy
development
• Chlamydia screening expansion
• Alcohol initiatives including specialist nurse service
• Re-ablement services
• Bowel cancer screening
Health Community Financial Sustainability
Whilst the PCT ended the financial year with a surplus and is in robust
financial health, there are financial pressures in the broader Health
Community. During 2010/11, we worked closely with NHS Hampshire
and Portsmouth Hospitals NHS Trust to develop a sustainability plan
for South East Hampshire. Each organisation has significant savings
to find, and by working together each can ensure that health services
are designed and provided in the most cost effective way, whilst
maintaining quality across the local health community.
This combined work has resulted in a four year plan to secure financial
resilience by improving productivity, efficiency and asset utilisation
across the South East Hampshire locality.
Separation of the PCT Provider Function - Solent NHS Trust
On the 1 April 2010, the provider arm of the PCT which provides
community and mental health services to the city, merged with the
provider arm of Southampton City PCT (NHS Southampton City)
to form ‘Solent Healthcare’. This newly formed community and
mental health provider was managed directly by NHS Southampton
City. Before this, Solent Healthcare had been approved to become a
standalone NHS Trust from 1 April 2011. This new NHS organisation is
now known as Solent NHS Trust, and it aims to become a Community
Foundation Trust in the future.
As a result of the transfer of provider services, 1,719 whole time
equivalent staff transferred to NHS Southampton City, along with
assets of £0.214m.
At the date of the Statement of Financial Position, the PCT remained
the owner of estate occupied by Solent NHS Trust, and lease
arrangements existed between the PCT and Solent. In accordance with
Department of Health ‘Transforming Community Services’ guidance,
aspirant Community Foundation Trusts may opt to take on the
64

ownership of the estate during 2011/12. If this should come to fruition,
estate with an estimated value of £114 million (as at 31 March 2011),
will transfer to the ownership of Solent NHS Trust.
The Financial Outlook for 2011/12
Despite the overall economic outlook, the PCT has received a 2.2%
increase to its revenue allocation in 2011/12, which was the average
level allocated to PCTs in England. This compares to a 5.5% increase
in 2010/11, and therefore we must find considerable savings to meet
rising healthcare costs. The PCT is also required to lodge 2% of its
allocation (£6.6 million) with the Strategic Health Authority, which will
be used non-recurrently in year to mitigate financial risk and facilitate
reform in the local health system. In addition, to ensure we maintain
financial resilience, we will plan to achieve a surplus of £1.7 million in
2011/12, which we can carry forward to future years.
Summary of Financial Performance
The table below summarises the PCT’s financial performance against
Revenue and Capital Resource limits over the last 4 years.
2010/11 2009/10 2008/9 2007/8
£000 £000 £000 £000
Under spend against 724 5,207 5,810 7,839
Revenue Resource Limit
Under spend against 79 59 1 0
Capital Resource Limit
In 2011/12 the PCT has to make recurrent savings of £15.2 million
(£67 million over the next four years) 1 , and as part of the South East
Hampshire sustainability work, has developed a Quality, Innovation,
Productivity and Prevention (QIPP) Plan to address this challenge.
Investment in new services will be limited to existing commitments
such as the St Mary’s Community Health campus, and will address key
national priorities such as increasing the number of Health Visitors,
and Social Services support (for which the PCT received a specific
allocation).
In addition, as part of our QIPP plan, we will be taking steps to
further reduce demand for some secondary care Services, particularly
emergency and planned inpatient care where we spend significantly
more than would be expected for the population we serve. This will
look at alternative ways of delivering care in a more appropriate and
cost effective way.
1
This includes efficiency passed on to healthcare providers
65

What we spent our money on
Chart 1 Actual spend 2010/11
Chart 2
Purchase of Primary Health Care
10/11 Actual Expenditure £m
GP and other primary care services £52.8
Healthcare bought from other NHS organisations £218.7
Healthcare bought from outside the NHS £27.3
Organisational and other costs £88.7
Primary Care Prescribing £28.1
Grand Total £415.6
Purchase of Primary Healthcare £m
GMS/PMS/APMS/PCTMS £31.4
Prescribing costs £28.1
Contractor led GDS & PDS £11.7
Salaried Led GDS & PDS £1.1
General Ophthalmic Services £1.5
New Pharmacy Contract £7.1
Grand Total £80.9
66

Better Payment Practice Code (measure of compliance)
Chart 3 Purchase of Secondary Health Care
Purchase of Secondary Healthcare £m
Learning Difficulties £6.5
Mental Illness £42.2
Maternity £7.7
General and Acute £136.6
Accident and Emergency £13.0
Community Health services £34.2
Other Contractual £5.8
Total Secondary Healthcare Purchased £246.0
The Department of Health requires that NHS organisations pay non-
NHS creditors in accordance with the CBI prompt payment code and
Government accounting rules. The target is to pay 95% of NHS and non-
NHS creditors within 30 days of receipt of goods or a valid invoice (which
ever is the later) unless alternative payment terms have been agreed.
2010/2011 2009/2010
Number £000 Number £000
Total bills paid 25,136 335,066 39,123 297,647
Total bills paid
within target 24,148 329,825 37,649 289,617
Percentage of bills
within target 96.1% 98.4% 96.2% 97.3%
The PCT became an approved signatory of the Prompt Payment Code
in December 2009. The Prompt Payment Code requires the PCT to
undertake to pay suppliers on time. Continued membership relies on
payment performance being confirmed with suppliers twice a year.
Remuneration Report
The PCT has a Workforce and Remuneration Committee that is chaired
by Richard Hibbert (the PCT chairman.) Membership of this committee is
limited to all Non-Executive Directors. The Chief Executive and Director of
Performance and Development are in attendance by invitation.
The PCT’s policy on the remuneration of senior managers is based on
principles agreed nationally by the Department of Health taking into
account market forces and benchmarking. The Chief Executive and
Director of Finance are paid according to the nationally agreed pay
bandings for Very Senior Managers, subject to annual appraisal and
recommendations by the Workforce and Remuneration Committee, as
approved by the Strategic Health Authority’s Remuneration Committee
67

in its scrutiny role. The rest of the executive team, with the exception
of the Director of Public Health and Well Being who is employed on a
Medical Consultant contract, are subject to Agenda for Change terms and
conditions.
No awards have been made to past senior managers of the PCT.
The PCT undertakes its recruitment in line with its recruitment policy.
This process is used when employing Directors. All individuals employed
on a senior managers or Medical Consultant contract are required to
give a minimum of 12 weeks notice in order to terminate their contract.
Termination payments are made on grounds of ill health retirement or
redundancy on the same basis as for all other NHS employees as laid
down in national terms and conditions and/or NHS Pension scheme
procedures. There were no early terminations in 2009/10 and therefore
no provisions are necessary.
The PCT’s liability in the event of an early termination will be in
accordance with the senior manager’s terms and conditions. The Chief
Executive and Director of Finance are employed via arrangements
made by the Secretary of State. Any termination payments are paid in
accordance with the Secretary of State’s directions. The Chairman and
Non Executive members of the Trust Board are office holders and as
such are not employees. Their appointment process is managed by the
Appointments Commission.
The Audit Committee
The PCT’s Audit Committee is a Sub Committee of the Trust Board. Its
role is to provide the Board with an assurance and scrutiny function. Its
key duties are to ensure that the organisation has effective corporate and
clinical governance in order to effectively deliver its corporate objectives,
and to identify and manage the risks facing the organisation through
internal control processes.
For the Period 1 April 2010 to 31 March 2011, the Audit Committee
Membership comprised of the following Non Executive Directors:
Malcolm Noyce (Chair)
Brian Mansbridge
Tom Morton
Andy Silvester
The Non Executive Directors are supported by Executive Directors,
External and Internal Audit and the Local Counter Fraud Specialist who
may be in attendance at these meetings.
Register of Interests
The PCT maintains a register of interests whereby members of the
Board, Executive Committee and Senior Managers of the PCT declare
any interests that they believe should be in the public domain. During
2010/11, none of these were related to any company directorships,
with the exception of GP Board and Executive Committee members
who are partners in local GP Practices that undertook or sought to
undertake business with the PCT, and PCT Board Members who are also
Directors or Governors of Portsmouth University.
Related Party Transaction Statement
Four of the Board / Professional Executive Committee Members of
the PCT are also Partners in local GP practices, where practices have
undertaken transactions with the PCT. The total transactions relating
to each practice ranged from £459k to £1.496m.
Two Board Members are also members of the Board of Governors of
the University of Portsmouth. In 2010/11, the PCT made total payments
of £1.7m to the University, of which £558k related to the dental
academy and £1.1m related to the dental outreach capital grant.
68

Private Finance Initiative (PFI)
Although the PCT does not directly have responsibility for any PFI
schemes, it is an active partner in Portsmouth Hospital NHS Trust’s
scheme to reprovide Acute Services at Queen Alexandra Hospital. The
reprovided Queen Alexandra Hospital opened during 2009.
External Auditor
The PCT’s External Auditor is the Audit Commission. During the
financial year, the PCT paid £229k for services from the Audit
Commission covering the audit of financial statements and the PCT’s
arrangements for delivering value for money (economy, efficiency and
effectiveness) in the use of its resources. All audit work was statutory
and undertaken under the Audit Code of Practice.
Summarised Financial Statements
The following pages show the summarised financial statements for the
Revenue Accounts for Portsmouth City Teaching Primary Care Trust. The
financial statements may not contain sufficient information to gain a full
understanding of the PCT’s financial position and performance. A full set
of accounts, complete with an explanation of the organisations principle
methods of financial control, are set out in detail in a separate document
(available free of charge). If you would like a copy of the accounts please
contact the Director of Finance, telephone 023 9268 4844, or contact
Trust Headquarters, St James Hospital, Locksway Road, Portsmouth,
Hampshire, PO4 8LD
Statement of Boards Responsibility in respect of Internal Control
The Board is accountable for Internal Control, which encompasses the
maintenance of sound systems that support the achievement of the
organisations policies, aims and objectives. The Chief Executive as
Accountable Officer is personally responsible for safeguarding public
funds and the organisations assets. The Board has prepared a detailed
statement which provides the PCT with the assurances necessary in
order to sign off the statement. The statement itself is produced in
full in the Full Annual Accounts for the PCT which can be obtained on
request.
69

Statement of Comprehensive Net Expenditure
31 March 2011 Restated 2
2010-11 2009-10 2009-10
£000 £000 £000
Commissioning
Employee benefits 18,639 18,644 17,841
Other costs 396,931 285,067 366,256
Income (33,320) (22,034) (33,745)
Provider
Employee benefits 0 63,805 0
Other costs 0 31,631 0
Income 0 (27,821) 0
PCT net operating costs before interest 382,250 349,292 350,352
Investment income 0 0 0
Other (Gains)/Losses 4 0 0
Finance costs 483 744 744
Net operating costs for the financial year 382,737 350,036 351,096
Other Comprehensive Net Expenditure
Net (gain) on revaluation of property, plant & equipment (1,528) (2,881) (2,881)
Net (gain) on revaluation of intangibles 0 0 0
Net (gain) on revaluation of available for sale financial assets 0 0 0
Receipt of donated or government granted assets 0 0 0
(Gain)/loss on other reserves 0 0 0
Impairments and reversals through revaluation reserve 1,626 11,080 11,080
Transfers from donated and government grant reserves 0 0 0
Adjustment for nominal cost of capital charge 0 (3,054) (3,054)
Transfers (to)/from other bodies within the Resource Account Boundary 0 0 0
Net actuarial (gain)/loss on pension 1 0 - -
Total comprehensive net expenditure for the year 382,835 355,181 356,241
70
1
Reported for the first time in 2010-11
2
The restated columns relate to Merger Accounting adjustments in respect of the transfer of Provider Services
to Southampton City PCT. Note 1.28 in the annual accounts provides more detail on the restatement.

Statement of Financial Position
STATEMENT OF FINANCIAL POSITION AS AT
31 March 2011 Restated
31 March 2011 31 March 2010 31 March 2010
£000 £000 £000
Non-current assets:
Property, plant and equipment 114,606 119,366 119,366
Intangible assets 0 0 0
Other financial assets 0 0 0
Trade and other receivables 0 0 0
Total non-current assets 114,606 119,366 119,366
Current assets:
Inventories 46 252 49
Trade and other receivables 3,617 9,912 7,015
Other financial assets 0 0 0
Other current assets 0 0 0
Cash and cash equivalents 16 63 63
3,679 10,227 7,127
Non-current assets held for sale 920 0 0
Total current assets 4,599 10,227 7,127
Total assets 119,205 129,593 126,493
Current liabilities
Trade and other payables (23,913) (22,187) (20,105)
Other liabilities 0 0 0
Provisions (775) (1,860) (1,045)
Borrowings 0 (10,795) (10,795)
Other financial liabilities 0 0 0
Total current liabilities (24,688) (34,842) (31,945)
Non-current assets plus/less net current assets/liabilities 94,517 94,751 94,548
Non-current liabilities
Trade and other payables 0 0 0
Provisions (1,051) (1,125) (1,125)
Borrowings 0 0 0
Other financial liabilities 0 0 0
Other liabilities 0 0 0
Total non-current liabilities (1,051) (1,125) (1,125)
Total Assets Employed: 93,466 93,626 93,423
FINANCED BY:
TAXPAYERS' EQUITY
General fund 87,209 86,978 86,775
Revaluation reserve 6,257 6,648 6,648
Donated asset reserve 0 0 0
Government grant reserve 0 0 0
Other reserves 0 0 0
Total Taxpayers' Equity: 93,466 93,626 93,423
71

Statement of Changes in Taxpayers’ Equity
STATEMENT OF CHANGES IN TAXPAYERS' EQUITY
For the year ended 31 March 2011
General
Fund
Revaluation
Reserve
Donated Asset
Reserve
Govt. Grant
Reserve
Other
Reserves
Total
Reserves
Changes in taxpayers’ equity for 2010-11 £000 £000 £000 £000 £000 £000
Balance at 1 April 2010
86,775 6,648 0 0 0 93,423
Net operating cost for the year (382,737) (382,737)
Net gain on revaluation of property, plant, equipment 1,528 0 0 1,528
Net gain on revaluation of intangible assets 0 0 0 0
Net gain on revaluation of financial assets 0 0
Receipt of donated or government granted assets 0 0 0
Movements in other reserves 0 0
Impairments and reversals (1,626) 0 0 (1,626)
Release of reserves to SoCNE 0 0 0 0
Non-cash charges – cost of capital 0 0
Transfers between reserves 293 (293) 0 0 0 0
Transfers to/(from) other bodies within the Resource Account Boundary 0 0 0 0 0
Net actuarial gain/(loss) on pension 0 0 0
Total recognised income and expense for 2010-11 (382,444) (391) 0 0 0 (382,835)
Net Parliamentary funding 382,878 382,878
Balance at 31 March 2011 87,209 6,257 0 0 0 93,466
72

Statement of Cash Flows
STATEMENT OF CASH FLOWS FOR THE YEAR ENDED
31 March 2011
2010-11 2009-10
£000 £000
Cash flow from operating activities
Net operating cost before interest (382,250) (349,292)
Other cash flow adjustments 20,821 16,976
Movements in Working Capital 8,123 3,407
Provisions utilised (578) (1,078)
Interest paid (460) (716)
Net cash outflow from operating activities (354,344) (330,703)
Cash flows from investing activities
Payments to purchase property, plant and equipment (18,336) (36,688)
Payments to purchase intangible assets 0 0
Proceeds of disposal of assets held for sale 264 0
Purchase of financial investments (LIFT) 0 0
Sale of financial investments (LIFT) 0 0
Loans made in respect of LIFT 0 0
Loans repaid in respect of LIFT 0 0
Payments for other financial assets 0 0
Proceeds from disposal of other financial assets 0 0
Interest received 0 0
Rental Revenue 0 0
Net cash inflow/(outflow) from investing activities (18,072) (36,688)
Net cash inflow/(outflow) before financing (372,416) (367,391)
Cash flows from financing activities
Net Parliamentary Funding 382,878 367,790
Other capital receipts surrendered 0 0
Capital grants received 0 0
Capital element of payments in respect of finance leases, on-SoFP PFI and LIFT (10,509) (409)
Cash transfers (to)/from other NHS bodies 0 0
Net cash inflow/(outflow) from financing 372,369 367,381
Net increase/(decrease) in cash and cash equivalents (47) (10)
Cash (and) cash equivalents (and bank overdrafts) at the beginning of the financial
year 63 73
Effect of exchange rate changes on the balance of cash held in foreign currencies 0 0
Cash and cash equivalents (and bank overdrafts) at the end of the financial year 16 63
73

Senior Managers Remuneration Report
2010-11 2009-10
Salary
(Bands of
£5,000)
Other
Remuneration
(Bands of £5000)
Benefits in Kind
(nearest £’00)
Salary
(Bands of
£5,000)
Other
Remuneration
(Bands of £5000)
Benefits in Kind
(nearest £’00)
Name and Title
£000 £000 £’00s £000 £000 £’00
Dalton, Robert (Director of Corporate Affairs) 90-95 - - 85-90 - -
Dinapala, Dr Leslie (Executive Committee Member) 5-10 - - 5-10 - -
Edmondson-Jones, Dr Paul (Director of Public Health & Primary Care) 90-95 65-70 - 90.95 65-70 -
Fellows, Dr Elizabeth GP (Executive Committee Member) 5-10 - - 5-10 - -
Gooch, Joanne (Director of Finance) 2 75-80 20-25 - - - -
Griggs, Edward (Director of Estates & Facilities Management) 85-90 - - 35-40 35-40 -
Hayward, Christine (Executive Committee Representative on Board) 5-10 - - 5-10 65-70 -
Hibbert, Richard (Chair and Non Executive Director) 30-35 - - 30-35 - -
Hobbs, Pamela (Director of Finance) 1 25-30 75-80 - 35-40 65-70 -
Hogan, Dr Jim GP (Vice Chair, Executive Committee) 4 10-15 - - 10-15 - -
Hovenden, Katie (Executive Committee Member) 5-10 75-80 - 5-10 70-75 -
Jack, Rosalyn (Director of Workforce and Training) 85-90 - - 80-85 - -
Loughran, Fiona (Non Executive Director) 5-10 - - 5-10 - -
Mansbridge, Brian (Non Executive Director) 5-10 - - 5-10 - -
Meikle, Margaret (Executive Committee Member) 5-10 - - 5-10 75-80 -
Morton, Tom (Non Executive Director) 5-10 - - 5-10 - -
Noyce, Malcolm (Non Executive Director & Chair of Audit Committee) 10-15 - - 10-15 - -
Parke, John (Executive Committee Member) 3 0-5 - - 5-10 75-80 -
Powell, Jacqueline (Non Executive Director) 5-10 - - 5-10 - -
Richens, Innes (Director of Strategy and System Management) 90-95 - - 85-90 - -
Sanders, Tracy (Chief Executive) 130-135 - - 130-135 - -
Silvester, Andrew (Non Executive Director) 5-10 - - 5-10 - -
Wilkinson, Dr Tim GP (Chair, Executive Committee) 4 30-35 - - 30-35 - -
1 Pamela Hobbs is Director of Finance, but is on secondment from 1st July 2010 to Southampton City
PCT
2 Joanne Gooch seconded from Southampton City PCT to Director of Finance from 1st July 2010
3 John Parke retired 31st July 2010
4 Voting member of the Board
Signed: Debbie Fleming, Chief Executive SHIP PCT Cluster:
__________________________ Date: 08/09/2011
74

Senior Managers Pension Benefits Report 2010/11
Real
Increase /
(Decrease)
in Pension
at Age 60
(Bands of
£2500)
Real Increase
/ (Decrease)
in Pension
lump sum at
Age 60
(Bands of
£2500)
Total
Accrued
Pension at
age 60 at
31 March
2011
(Bands of
£5000)
Lump Sum
at age 60
related to
accrued
pension at
31 March
2011
(Bands of
£5000)
Cash
Equivalent
Transfer
Value at
31 March
2011
Cash
Equivalent
Transfer
Value at
31 March
2010
Real
Increase /
(Decrease)
in Cash
Equivalent
Transfer
Value 4
Employer’s
contribution
to
stakeholder
pension
Name and Title
£000 £000 £000 £000 £000 £000 £000 £000
Dalton, Robert (Director of Corporate Affairs)
Edmondson-Jones, Dr Paul (Director of Health and
0.0-2.5 2.5-5.0 20-25 70-75 450 446 (13) 0
Wellbeing) 0.0-2.5 2.5-5.0 15-20 50-55 374 354 7 0
Gooch, Joanne (Director of Finance) 2,3 N/A N/A 20-25 70-75 306 N/A N/A 0
Griggs, Edward (Director of Estates & Facilities Management) (0.0-2.5) (0.0-2.5) 35-40 115-120 726 773 (78) 0
Hobbs, Pamela (Director of Finance) 1 (0.0-2.5) (7.5-10.0) 35-40 115-120 701 743 (71) 0
Hovenden, Katie (Executive Committee Member) 0.0-2.5 2.5-5.0 20-25 65-70 339 345 (19) 0
Jack, Rosalyn (Director of Workforce and Training) 0.0-2.5 5.0-7.5 35-40 105-110 585 596 (35) 0
Richens, Innes (Director of Strategy & System Management) 0.0-2.5 2.5-5.0 15-20 50-55 210 218 (17) 0
Sanders, Tracy (Chief Executive) 0.0-2.5 0.0-2.5 35-40 110-115 417 481 (83) 0
Signed: Debbie Fleming, Chief Executive SHIP PCT Cluster:
__________________________ Date: 08/09/2011
1
Pamela Hobbs is Director of Finance, but is on secondment from 1st
July 2010
2
Joanne Gooch seconded to Director of Finance from 1st July 2010
3
2009/10 Pension information is unavailable for Joanne Gooch
4
Following the emergency budget of 22 June 2010 when it was
announced that the uprating of the majority of state benefits and the
Second State Pension would be changed from the Retail Prices Index
(RPI) to the Consumer Prices Index (CPI) the Cash Equivalent Transfer
value is now calculated using the CPI (previous years were calculated
using the RPI)
75

Independent Auditors Statement to the Board of Directors of
Portsmouth City Teaching Primary Care Trust
I have examined the summary financial statement for the year ended
31 March 2011 which comprises the Statement of Comprehensive Net
Expenditure, the Statement of Financial Position, the Statement of
Changes in Taxpayers’ Equity, the Statement of Cash Flows, the Senior
Managers Remuneration Report and the Senior Managers Pension
Benefits Report.
This report is made solely to the Board of Directors of Portsmouth City
Teaching PCT in accordance with Part II of the Audit Commission Act 1998
and for no other purpose, as set out in paragraph 45 of the Statement of
Responsibilities of Auditors and Audited Bodies published by the Audit
Commission in March 2010.
Respective responsibilities of directors and auditor
The directors are responsible for preparing the Annual Report.
My responsibility is to report to you my opinion on the consistency of
the summary financial statement within the Annual Report with the
statutory financial statements.
Opinion
In my opinion the summary financial statement is consistent with the
statutory financial statements of Portsmouth City Teaching PCT for the
year ended 31 March 2011. I have not considered the effects of any
events between the date on which I signed my report on the statutory
financial statements, 9 June 2011, and the date of this statement.
Stephen Taylor
District Auditor
Audit Commission, Collins House, Bishopstoke Road, Eastleigh SO50 6AD
September 2011
A copy of this Annual Report, signed by Mr Taylor in September 2011, is
held in the NHS Portsmouth registry.
I also read the other information contained in the Annual Report
and consider the implications for my report if I become aware of any
misstatements or material inconsistencies with the summary financial
statement.
I conducted my work in accordance with Bulletin 2008/03 “The auditor’s
statement on the summary financial statement in the United Kingdom”
issued by the Auditing Practices Board. My report on the statutory
financial statements describes the basis of my opinion on those financial
statements.
76

Glossary
Glossary
Capital Charges
Capital Expenditure
Capital charges reflect the cost associated with
using a capital asset. A charge is made to the
income and expenditure account comprising
depreciation, together with a 3.5% charge
based on the average net book value of the
asset over the course of the year.
Expenditure on land, buildings and equipment
exceeding £5,000 deemed to have a useful life
greater than one year.
General Fund
GMS/PMS/APMS/
PCTMS
Represents the total assets and liabilities of the
PCT, other than those represented by other
reserves and financing items.
There are four different routes for discharging
PCTs’ duty to secure the provision of primary
medical services, to “the extent that they
consider it necessary to meet all reasonable
requirements” of their populations. These are
known as GMS, PMS, APMS and PCTMS.
Capital Resource
Limit (CRL)
Cash Limit
This represents the allowed maximum level of
capital expenditure that the PCT has been set
by the Department of Health.
This represents the maximum level of
cash drawings allocated to the PCT by the
Department of Health to support its Revenue
Resource Limit and Capital Resource Limit.
GMS - General Medical Services - Medical
Services provided by a General Practitioner (as
opposed to ophthalmic and pharmaceutical
services provided by other clinical professions)
who is subject to the GMS contract, negotiated
by the NHS Confederation and GP Committee
of the British Medical Association and
published in February 2003.
Donation Reserve
ELS
GDS
Market value of assets donated to the Trust
e.g. from charities.
The Existing Liability Scheme relates to the
guidance and funding for clinical negligence
incidents which occurred between 1st April
1994 and 31st March 1995.
General Dental Services. These are services
provided by NHS Dentists working under the
nationally negotiated contract for dental
services.
PMS - Personal Medical services - Medical
Services provided by a General Practitioner (as
opposed to ophthalmic and pharmaceutical
services provided by other clinical professions)
who is subject to terms and conditions of a
local contract, negotiated with the PCT but
subject to the same regulatory framework as
GMS.
PCTMS - Primary Care Trust (PCT) Medical
Services - PCTMS are medical services provided
directly by PCTs, i.e by directly employing staff,
under the PCTMS route. The PCT may wish to
employ full time staff to provide a full range
77

Glossary
Glossary
GMS/PMS/APMS/
PCTMS
of services, or employ staff on a sessional
or part time basis. When providing services
directly, through PCTMS, the PCT must comply
with the National Guidelines. In addition, the
PCT must comply with its standing orders and
financial instructions, and will want to take
into consideration its general duty of care.
APMS - Alternative Provider Medical Services
- PCTs can enter APMS contracts with any
individual or organisation that meets the
provider conditions set out in directions. This
includes the independent sector, voluntary
sector, not-for-profit organisations, NHS Trusts,
other PCTs, Foundation Trusts, or even GMS
and PMS practices. If PCTs contracts with GMS
/ PMS practices via APMS, the practice would
hold a separate APMS contract alongside their
GMS / PMS contract. APMS in particular offers
substantial opportunities for the restructuring
of services to offer greater patient choice,
improved access and greater responsiveness to
the specific needs of the community. It provides
a valuable tool to address need in areas of
historic under-provision, enable re-provision
of services where practices opt out, and
improve access in areas with problems with GP
recruitment and retention.
Intangible Assets
Internal Control
NHSLA
Operating Cost
Statement (OCS)
Operating Costs
OPG
Goodwill, brand value or some other right,
which although invisible is likely to derive
financial benefit (income) for its owner in
future, and for which you might be willing
to pay.
Is the whole system of controls, financial and
otherwise, established by management to
ensure the business of the Trust is performed
in an efficient manner, to ensure adherence
to management policies, to safeguard assets
and ensure complete and accurate records.
The NHS Litigation Authority manages the
clinical negligence scheme for Trusts under a
Risk Sharing Scheme which commenced 1st
April 1995.
A statement showing the resources
consumed during the year covering the
administration cost and the cost of services
commissioned less miscellaneous income
Expenditure relating to staff, suppliers etc.
Office of Paymaster General
Income from
Activities
Clinical income from Strategic Health
Authorities, NHS Trusts etc.
78

Glossary
PDS
Revenue
Expenditure
Revenue Resource
Limit (RRL)
Personal Dental Services - These are services
provided by NHS Dentists under a local
NHS contract known as PDS. PDS contracts
provide an opportunity for dentists and PCTs
to work in partnership to meet local needs
determined through commissioning plans.
Income and expenditure relating to the
current years activity only, as opposed to
capital items which extend over a number of
years.
This represents the allowed maximum level
of revenue expenditure the PCT has been set
by the Department of Health.
79

Contacts
Management Offices
Trust Headquarters
St James’ Hospital
Locksway Road
Portsmouth, PO4 8LD
Tel: 023 9282 2444
Fax: 023 9268 4801
Your Health
Registering with a family doctor - 01962 853 361or www.nhs.uk
GP Out of Hours - call your own surgery number and you will be
automatically re-directed to the service or call 023 9237 7921
Finding an NHS Dentist or emergency dental service -
Dental Helpline 0845 050 8345 or www.hampshiredentalhelpline.nhs.uk
NHS Direct - 0845 4647
Help to stop smoking - 023 9236 9234 or www.solent.nhs.uk
Healthy lifestyle information - www.healthypompey.com
How can we improve this annual report
Thank you for taking the time to look at this annual report. We
hope you have found it interesting and informative. We would really
welcome any feedback you have on this, or any of our other main
documents. We would be particularly interested in your views on this
report and any thoughts you may have on how we could improve the
content, or presentation, in future years.
All our documents, including a summary of this report, are available
from our website:
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You can do this by:
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Trust Headquarters
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Portsmouth
PO4 8LD
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81

NHS Portsmouth
Trust Headquarters
St James’ Hospital
Locksway Road
Portsmouth PO4 8LD
www.portsmouth.nhs.uk
82
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