2000 - 2001 - Central Manchester University Hospitals - NHS ...

The Trust Board
A Statement from Chairman and Chief Executive
Redevelopment of Children’s and Adults Services on the Central Manchester Site
Central Manchester Healthcare NHS Trust Annual Report:
Introduction
Medical Director’s Report
Acute Medicine and Accident & Emergency
Acute Surgery
Clinical Radiology
Critical Care
Dental
Facilities
Human Resources and Organisational Development
Information Management & Technology
Laboratory Medicine
Manchester Heart Centre
Nursing and Midwifery
Ophthalmology
Pharmacy
Rehabilitation
Renal Medicine
Saint Mary’s Hospital for Women and Children
Surgical Specialties
Theatres (MRI), Anaesthesia and Sterile Services
Research & Development
Resolving Complaints
Performance Figures
Finance Director’s Summary
Summary Financial Accounts
Manchester Children’s Hospitals NHS Trust Annual Report:
Introduction
Medical Director’s Report
Anaesthesia and Theatres/Sterile Services Directorate
Child and Adolescent Mental Health Services
Clinical Governance
Facilities
Human Resources
Information Technology
Medical Directorate
Nursing Services
Pathology & Radiology Directorate
Professional Allied to Medicine Directorate
Resolving Complaints
Research & Development
Surgical Directorate
Performance Figures
Finance Director’s Report
Summary Financial Accounts
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Annual Report 2000 ~ 2001

Peter Mount
Chairman
Mike Deegan
Chief Executive
Sheila Jones
Non-Executive Director
Bob Johnson
Acting Medical Director
Anthony Leon
Non-Executive Director
John Scampion
Acting Director of Finance
Bill Shaw
Non-Executive Director
Hussein Khatib
Acting Director of
Children’s Services
Jo Somerset
Non-Executive Director
Marian Carroll
Acting Director of Nursing
Two further Non-Executive Directors are yet to be appointed
Annual Report 2000 ~ 2001 1

Following a comprehensive public consultation exercise, the
Manchester Children’s Hospitals and Central Manchester
Healthcare NHS Trusts were brought together to form the Central
Manchester and Manchester Children’s University Hospitals NHS
Trust, which was established on the 1st April 2001. The merger
has provided the best opportunity for the £250m adult and
children’s services re-development in central Manchester to be
successfully delivered through the Government’s Private Finance
Initiative.
In addition to the preparatory work undertaken by the Trust
Merger Project Team, we should recognise the leadership
provided by the acting Directors and the contribution made by all
staff in continuing to maintain and develop services whilst
making the merger as seamless as possible. The development of
organisational arrangements will continue through 2001/2002.
The Trust will face some exciting challenges in delivering the
Government’s modernisation agenda, the national NHS Plan,
implementation of National Service Frameworks and we look
forward to working closely with the newly formed Primary Care
Trusts.
During 2001, three short-listed bidders were identified to
progress the development of the new adult and children’s
hospital facilities. A decision on the preferred partner will be
made by the Trust Board in early 2002. Work will then begin on
what will eventually become one of the most comprehensive and
exciting healthcare facilities in Europe.
The Children’s Hospital and the Medical wing should be
completed in 2006, with the Eye Hospital and women’s health
facilities finished two years after that.
The Commission for Health Improvement will visit the Trust
during September and we welcome the opportunity of working
with them to develop and improve our services.
The year ahead will see a number of major service developments
and improvements. On the Central site in September, to
accommodate the transfer of services from Withington Hospital,
a £9.7m acute medical unit with twin day-case theatre suite will
open; a £6m, 706 space multi-storey car park will be completed
in December to ease the car park congestion caused through
increased activity and site development.
Work has commenced on the £6.2m extension to the Clinical
Sciences Building to re-provide an automation laboratory,
Cytology Services transferred from The Christie Hospital and the
Public Health Laboratory from Withington Hospital. This is
scheduled to open in August 2002. Booth Hall Children’s
Hospital has successfully bid for a state-of-the-art CT Scanner
from the Government’s Modernisation monies which will be
operational in November. By 2002 a £750k replacement
cardio-catheterisation laboratory will have been installed at
the Royal Manchester Children’s Hospital.
These new developments will enable our excellent and dedicated
staff to continue to deliver a first class service. We are proud
that throughout this busy period of change they have continued
to deliver such high standards of care to our patients.
Peter W. Mount
Chairman
Mike Deegan
Chief Executive
2
Annual Report 2000 ~ 2001

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Evaluation of initial responses from the private sector and
the identification of 6 bidders.
Completion of the issue of Preliminary Invitation to Negotiate
(PITN) documentation – the response to which the Trust shall
evaluate in order to identify a shortlist of bidders.
Evaluation of PITN responses and the identification of a
shortlist of 3 bidders.
Further development and completion of Final Invitation to
Negotiate (FITN) documentation – the response to which the
Trust shall evaluate in order to identify a preferred bidder.
Continued development of medical briefing packs to embrace
the Government’s Modernisation Agenda.
Key Milestones 2001/02
Following the Secretary of State’s approval to the Trust’s Outline
Business Case in May 2000, the procurement process for the new
hospital development is now well underway.
Scheme content, progress during 2000/01 and key milestones to
be achieved within the year 2001/02 are outlined below:
The Scheme includes:
● A new Children’s Hospital.
● New adult medical facilities, replacing the current medical
corridor facility.
● Reprovision of St. Mary’s Hospital and the tower block in
new purpose-built accommodation.
● New Eye Hospital facilities to replace the Royal Eye Hospital
main buildings and out-patients department.
An undertaking of this size requires a huge amount of
preparatory work. Over the last 18 months, the clinical
specification for the new hospital has now been developed.
This has been prepared by the Private Finance Initiative (PFI)
Project Office in close consultation with clinicians and other
healthcare professionals. The clinical specification sets out the
requirements for the new hospital on a department by
department basis and has been used within the Project to
develop an outline design which will be used by the private
sector to prepare their detailed design proposals.
Progress 2000/01
● Issue of FITN documentation to the selected shortlist (3
bidders), completed on 30th April 2001.
● Continued development of the medical briefing packs to reflect:
- re-configuration of Adult Services – includes growth
and impact of the National Beds Enquiry.
- finalisation of the enabling schemes business case –
required in order to bring the Children’s development
forward to 2005.
- service developments.
● Evaluation of FITN responses, which will look to the
identification of a preferred bidder.
● Following the identification of a preferred bidder, a process
of negotiation with the selected preferred partner (January
2001 – June 2002)
Acute Medical Centre
Construction of the new Acute Medical Centre is due to be fully
operational by 3rd September 2001.
The new unit provides ward based accommodation on the
ground and first floors, comprising four wards, each containing
28 beds (112 in total). Second floor accommodation includes a
small suite of offices with two day-case theatres with the
associated ancillary facilities.
Primary access to the new unit is afforded through the first floor
links from the existing MRI buildings and the Phase II link
corridor at first and second levels.
Nesta Wells
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Outline Business Case approved.
The start of the procurement process and private sector
involvement in the Project.
Following completion of the main construction programme, the
ward opened two weeks in advance of the original programme
dates – 3rd October 2000.
Annual Report 2000 ~ 2001 3

Staff, patients and the Trust are delighted with the new
surroundings and Manchester City Council have awarded the
scheme a “Build in Quality” Award.
Multi-storey Car Park
Following detailed evaluation, the Trust awarded the contract to
construct the new car park to Messrs Wates Construction Ltd.
Work commenced on site on 8th February and the expected date
of completion is 21st December 2001.
This new car park will provide 706 spaces of which 35 have been
designated disabled parking. The ground floor elevation to
Oxford Road provides retail accommodation, thus attracting
income generation to the Trust.
Laboratories Development
Cytology Screening Services from Christies and also the Public
Health Laboratory Service from Withington Hospital.
Following Regional Office approval the Trust undertook a
tendering exercise. Work has now started with a completion date
of August 2002.
PFI Enabling Schemes
The scope of the enabling scheme is currently being finalised and
a business case has been submitted to the Regional Office.
A large element of this work will involve the re-use of Sparshott
House, on a temporary basis, for the provision of Estates
workshops and displaced office accommodation from Lorne
Street and the Facilities building.
The new building provides accommodation on four levels to
house the existing Automation Laboratory, the transferred
New Acute Medical Centre
4
Annual Report 2000 ~ 2001

Trust Board Sub-Committees
There are several Trust Board Sub-Committees which are
accountable to the Trust Board. These include:
Audit Committee – Responsible for the internal control of all
aspects and activities of the Trust. Membership: Non-executive
directors and in attendance, chief executive, executive directors,
auditors.
The Trust was set up in April 1991 and is recognised as a
national centre of excellence for healthcare and research and has
an outstanding reputation for teaching and training and is linked
closely with the University of Manchester Medical School.
It comprises:
Manchester Royal Infirmary Est. 1752
Manchester Royal Eye Hospital Est. 1814
Saint Mary’s Hospital for Women & Children Est. 1790
The University Dental Hospital of Manchester Est. 1884
Aims of the Organisation:
● To provide the highest quality acute and chronic care for
those who live and work in and around Manchester.
Remuneration Committee – Responsible for the control of
terms and conditions of employment, including all aspects of
remuneration. Membership: Chairman, non-executive directors
and in attendance, chief executive and director of human
resources.
Register of Interests of Board Members
The Trust Board requires all Board members to declare any
relevant interests. The register of Directors’ interests is available
to the public.
Controls Assurance Statement
●
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To provide a range of comprehensive specialist services.
To be a major centre for teaching and research.
The Board acknowledges and accepts its responsibility for
maintaining a sound system of internal control including risk
management and for reviewing its effectiveness.
Openness and Accountability
Trust Board meetings have been held in public for a number of
years and are regularly attended by the Community Health
Council. The Trust welcomed the renewed emphasis on the
values of Corporate Governance to ensure openness and
accountability in the public service.
Non-Executive Directors (as at 31.3.01)
Professor Sam Moore, Chairman
Councillor Kath Fry
Professor Bill Shaw
Mrs Gita Conn
Councillor Roy Walters
Ms Jo Somerset
As part of the NHS Controls Assurance Project, I as Chief
Executive, confirm that for the year ending 31 March 2001 and in
accordance with NHS Executive circulars HSC2001/05 and HSC
1999/123 and supporting guidance, the Board has reviewed and
endorsed an action plan resulting from an organisation-wide selfassessment
against relevant risk management and organisational
control standards produced by the NHS Executive. The Board will
oversee implementation of the action plan.
I confirm that in the Board’s judgement Central Manchester
Healthcare NHS Trust has achieved Level 1 of the NHS Executive’s
“control and risk maturity matrix”.
Executive Directors (as at 31.3.01)
Mr David Woodyatt, Chief Executive
Mr John Scampion, Director of Finance
Mr Bob Johnson, Medical Director
Mr Tim Gilpin, Director of Human Resources
Mrs Marian Carroll, Director of Nursing & Midwifery (from 11th
September 2000)
Mrs Marion Lambert, Director of Nursing & Service Development
(until 4th August 2000)
Signed:
Date: 7th August 2001
Acting Chief Executive
Annual Report 2000 ~ 2001 5

The Wellcome Clinical Research Centre is opening in October
which will provide a very significant improvement and incentive
to develop research on this site and offer opportunities to
collaborate with other research workers from our sister Trusts in
South Manchester and Salford.
Following completion of the merger with the Children’s Hospital
Trust new temporary management arrangements have been put
in place and a number of Clinical Directorates have been
restructured. A serious attempt has been made to minimise
changes in the structure in either of the two organisations and a
common Clinical Governance process has been agreed. Helen
Donovan has been appointed as Clinical Governance Manager
for the Trust and the post of Risk Manager has been advertised.
A process of in-house appraisal training for all consultants has
been set up and the documentation for appraisal has been
received from the NHS Executive. We expect a visit from the
Commission for Health Improvement, in September. The process
of which began on 28 May and will last approximately 6 months.
The purpose of the Commission’s visit will be look at our Clinical
Governance arrangements and we have been briefing individual
Directorates on the nature of the visit and analysing their
progress as far as Clinical Governance is concerned.
The Private Finance Initiative continues to progress. Clinicians
are now actively involved with architects and planners in
developing the new site plan in anticipation of the selection of
our favoured partner for a building start in the Spring of next
year.
During the course of the past year we have had excellent support
and collaboration from our clinical directors and directorate
managers to overcome the many difficulties associated both with
the merger and the pressures of the Withington transfer. I should
like to thank them formally for all of their help and dedication.
The Trust has established a new Clinical Practice Group, which
includes Clinical Ethics, to be chaired by an Associate Medical
Director (to be appointed). The purpose of this group will be to
collate evidence-based medicine from the National Institute of
Clinical Excellence and from the Commission for Health
Improvement, to audit current practices and to evaluate new
medicines and therapies as they come on stream. It will liaise
with Research & Development and the University and generally
provoke innovation and reorganisation of patients care.
The consequence of the closure of the Withington Accident and
Emergency Department has had far-reaching effects on our
emergency services and these in turn have had a knock-on effect
on our planned elective work. There has been a very significant
increase in the amount of orthopaedic trauma and in acute
medical admissions to the Trust. We have been seriously
stretched in coping with this extra demand. With the opening of
the new Withington transfer block in September we anticipate
that much of this pressure will be relieved and we are already
advertising for new appointments at consultant and nursing level
to staff this new facility.
Clinical Director: Dr R R Davies
Directorate Manager: Miss M Roberts
Budget: £8 million
Staff: 300
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The creation of this new directorate has enabled closer links
to be forged between General Acute Medicine, Respiratory
Medicine, the Accident & Emergency (A&E) Department and
the Bed Management Team.
The closure of Withington Hospital’s A&E department
resulted in a significant rise in Accident & Emergency
attendance, followed by General Acute Medicine admissions,
which is ongoing. The transfer of in-patient services from
Withington to both Wythenshawe and Manchester Royal
Infirmary has resulted in the planning and provision of a new
Acute Medical Centre.
Following a review of processes in A&E and Acute Medicine
a recommendation to expand the Bed Management Team
has been actioned, strengthening their role in the admissions
procedure. Expansion of the Medical Assessment Unit is also
in the planning stages. A Discharge Lounge is being used to
assist in speeding up the discharge process.
6
Annual Report 2000 ~ 2001

●
Julie Flaherty has been appointed as a Nurse Consultant
Paediatrician in A&E. There has also been an establishment
of a Nurse Practitioner Training programme. Together with
the senior nurses in the A&E Department, the Nurse
Consultant has ensured the successful opening of a
dedicated Children’s Unit within the A&E Department
ensuring that all children, between the hours of 9.00 am and
11.00 pm, will be cared for in a child centred and friendly
environment.
workload increase with the relocation of the service from
Withington Hospital, two additional surgeons (one colorectal
and one upper gastrointestinal) will be appointed along with
two additional senior nurses. There will also be an additional
10 in-patient beds.
Vascular Surgery
● Two surgeons currently provide the service and we expect to
appoint a further consultant in the autumn. They are
supported by a Vascular Laboratory, Vascular Radiology and a
research department. They are currently expanding the leg
ulcer service and aim to introduce a nurse-led Claudication
clinic within the next 12 months. The Vascular Team
continues to be involved in a national clinical trial in
Endoluminal surgery.
Urology
●
Incorporates kidney stone management/lithotripsy, children’s
and reconstructive surgery, impotence and infertility and
specialised cancer surgery.
Renal Transplantation
●
This services not only includes renal transplantation, but also
access surgery for dialysis. It is supported by the Tissue
Typing Laboratory, transplant co-ordinators and specialist
nurses. To meet the increasing workload an additional
transplant surgeon will be in post by the autumn. Since the
recent appointment of a joint transplant and endocrine post
the renal unit will re-launch its pancreatic transplant
programme later this year.
Clinical Director: Mr R C Pearson
Directorate Manager: Mr A Stevens
Budget: £9.2 million
Staff: 260
General Surgery
Clinical Director: Dr P Taylor
Directorate Manager: Mr G Bramall
Budget: £4.1 million
Staff: 120
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Incorporates the following specialist services: Colorectal,
Hepato-Biliary, Upper Gastrointestinal and Endocrine surgery
and is supported by an Oesophageal Investigations Unit.
The unit has recently achieved recognition as a Colo-rectal
Cancer Centre and is now working towards accreditation as
a centre for Upper Gastrointestinal Cancer. To meet the
The Directorate provides a comprehensive imaging service for
Central Manchester including state-of-the-art facilities in
magnetic resonance, ultrasound, vascular and interventional
radiology. Activity continues to increase and over 190,000
patient examinations were performed during the year.
Annual Report 2000 ~ 2001 7

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Among several international visitors, Professor Hervé
Deremond performed one of the first vertebroplasty
procedures in the UK in December 2000.
The Manchester Regional Training Scheme in Radiology is
one of the largest in the country with, at any one time, up to
14 Specialist Registrars in Radiology working within the Trust.
Clinical Director: Dr J Eddleston
Directorate Manager: Mr J Logan
Budget: £4.7 million
Staff: 145
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They were visited by the Royal College of Radiologists
Training Accreditation Committee who commented
favourably on several aspects in the department including
an innovative computer based training log book.
Trials of voice recognition for reporting have commenced in
order to enhance report through-put times and it is intended
to develop this programme further in the coming year. A pilot
study of radiographers and senior nurses performing
peripheral angiography was extremely successful resulting in
three members of staff becoming accredited to undertake
these procedures.
They were pleased to welcome Dr Janet Stringfellow, who
was appointed as a consultant, with a special interest in
paediatric and obstetric radiology.
The Critical Care Directorate provides an integrated service for all
critically ill patients and cares for approximately 450 patients per
year in the Intensive Therapy Unit (ITU) - 4,000 bed days and 603
patients per year in the High Dependency Unit (HDU) – 1,326
bed days. There are currently 13 beds in the ITU and 8 beds in
HDU.
The service is supported by an extensive laboratory and
comprehensive data management system and has an active
research programme.
New Services for 2000/01
The following services have been introduced which are in-keeping
with the current Department of Health Modernisation Agenda:
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During the year the department was one of four in Europe
chosen as a seed site for a trial of the latest generation of
computed radiographic systems.
As part of the ongoing implementation of Picture Archiving
and Communication Systems (PACS) the Directorate, in
conjunction with the IT Department, was successful in
integrating the digital radiographic equipment within the
department with the Trust network. This allows transition of
digital images from the department to remote sites within
the Trust.
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Introduction of an Early Warning System to the Trust. The
purpose of this is to educate both medical and nursing staff
on how to identify patients who are developing critical illness
early in their disease and to introduce a structured
framework which ensures that such patients are identified at
an appropriate point in time.
During the past year there was a significant investment in
critical care beds – 2 additional ITU and 4 additional HDU
beds were added to the bed compliment.
The Follow-up Service after ITU discharge consolidated the
previous 5 years experience and supplemented the provision
of follow-up care on the wards, thereby reducing readmission
rates.
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A comprehensive multi-disciplinary rehabilitation programme
has also been developed. This is based on a randomised
controlled blinded study which has been undertaken by
Critical Care.
New consultant appointments:
Dr M Parker
Dr D Conway
8
Annual Report 2000 ~ 2001

The NHS Plan published in the summer of 2000 outlined plans
for future investment and reform of the NHS it also represents a
new approach for delivering healthcare in the 21st century.
Clinical Director: Professor A S Blinkhorn
Director of Dental Services: Mrs M Attrill
(until June 2001)
Budget: £6 million
Staff: 223
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The University Dental Hospital continues to be acknowledged
as a prestigious centre of dental education, research and
service provision.
The past year has seen the establishment of the first BSc
course in Oral Health Sciences in Britain. This new 3 year
degree course offers training in dental hygiene and dental
therapy for 12 students each year.
The training course for Dental Nursing is to become an NVQ
level 3 qualification. The School of Dental Nursing has
received approval for this new course.
The Plan set out the need for modernisation and change and one
of the major challenges currently facing all hospitals is to ensure
that healthcare environments are capable of meeting the
demands of the modern health service. This means providing
buildings which are energy-efficient, sustainable, accessible and
capable of accommodating changes brought about by advances,
particularly in medical technology.
The NHS Plan also identified areas, such as food quality and the
patient environment, as essential elements in the healing process.
It is clear from the plan that raising and maintaining standards in
both these areas is of paramount importance. In addition, a new
24 hour Trust menu will be required to meet the NHS Plan it
must be healthy, nutritious, tasty and provide good value for
money. There is also a need to develop ward housekeepers in
hospitals who will ensure that meals are delivered on time and
that minor ward maintenance is carried out quickly and
efficiently.
New appointments:
Dr M N Pemberton, Consultant in Oral Medicine
Mr R J Middlehurst, Consultant in Maxillofacial Surgery
In respect of hospital food the method of providing the food
service to patients has been changed during the year. This now
enables the quality of food provided to exceed Patient Charter
standards and enhance compliance with the NHS Plan.
Following the production of a Trust-wide action plan for
improving the patient environment we have began to deliver
improvements on fourteen key areas with particular emphasis on:
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entrance and reception area cleanliness.
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internal appearance of wards and other high profile areas.
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external signage and wayfinding.
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car parking.
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hospital food.
Director: Mr J Foster
Budget: £14 million
Capital Programme: £11 Million
Staff: 637
The Directorate is made up of the Property and Capital
Development Department and the Hotel and Estate Operational
Department.
Following a number of NHS Executive audit visits to assess
performance the Trust received an amber classification which
reflects a satisfactory level of performance, but one where some
areas can be improved. These further improvements will be made
during the year and through the major capital development
taking place at the site between now and 2007.
Annual Report 2000 ~ 2001 9

- carer and compassionate leave
●
Work has been undertaken on harmonising the employment
policies leading up to the merger with the Manchester
Children’s Hospital NHS Trust. These policies underpin the
employment strategy and represent the fruition of joint
working with staff organisations at both the Children’s
Hospitals and Central Manchester.
●
In Partnership with the Crown Prosecution Services and the
Police, a strategy aimed at tackling the harassment of staff
by service users has been implemented.
●
Equal opportunities and diversity have again featured heavily
in the work of the Trust. The participation in mentorship
programmes and work placements for students from local
schools form a part of this approach. Other actions have
resulted in an increase of people from black and minority
ethnic groups as a proportion of the Trust’s workforce.
●
Local Pay Bargaining - The Trust has not extended any local
pay bargaining initiatives over the last year. Following its
long-term pay deal in 1999/2000 it decided to await
national developments with ‘Agenda for Change’.
Director: Mr T Gilpin
● Over the last year the single, most important issue which has
faced the Trust has been the shortage of staff in a range of
professional groups, but most particularly in nursing.
This reflected the national shortage which many Trusts
experienced. International recruitment has featured strongly.
● The Trust has continued to be involved in the reconfiguration
of services in Manchester, with the successful transfer of
Mental Health Services to the Manchester Health Partnership
and the reprovision of the Nesta Wells Unit from Withington
Hospital to St Mary’s Hospital. Preparations are taking place
for the transfer of services from Withington Hospital.
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A work place scheme for people with disabilities has been
successfully introduced. The Trust has developed a policy in
relation to disabled employees and has been awarded the
‘two tick’ symbol for its commitment to the employment of
people with disabilities.
In collaboration with Unison and the Workers Education
Authority, a programme started last year aimed at
developing the basic skills of ancillary staff. The individual
learning accounts framework is to be developed in the
coming year to further establish NVQs at higher levels for
clinical support staff.
During the year the Trust has been part of the Greater
Manchester Education and Training Consortium. From the
1st April 2001 it became the Greater Manchester Workforce
Development Confederation.
●
In line with the National Human Resource Strategy the Trust
has developed plans to implement the “Improving Working
Lives Initiative”. A range of policies have been developed
on:
- flexible working
●
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Together with the Children’s Trust, work commenced on the
re-accreditation of the Investor in People (IIP) Award, which
the Central Trust had held for a number of years.
The Trust has continued to consult with staff and seek their
views through:
- job share
- annual staff survey
- anti-harassment and bullying
- staff newsletter
10
Annual Report 2000 ~ 2001

- intranet
- team brief
faster data transfer to the desktop (PC). It has improved access
to the intranet and internet services as well as providing an
overall improvement in administrative services such as e-mail.
- joint consultation committees.
senior
managers
- 2.7%
other
(ancillary)
- 12.6%
scientific,
therapeutic
& technical
- 18.1%
admin &
estates
- 18.7%
nursing - 40.1%
Chart showing staffing levels
medical & dental
consultant staff
- 4.9%
other medical &
dental staff - 2.9%
The security of the network has been enhanced with more
sophisticated firewalls on the Internet and NHSNet and a
comprehensive anti-virus strategy implemented across the
Trust.
Service Improvements
The rollout of clinical workstations (CWS) for providing access
to the Order Communications and Results Reporting functions
continued throughout the year, in particular CWS became
functional in all the out-patient suites within MRI and in the
Accident & Emergency Department. In order to improve the
speed of reporting results the laboratory computer used by
biochemistry and haematology was upgraded. The Patient
Administration System was enhanced to enable it to support
the service changes being introduced as part of the Booked
Admissions programme and elements of the Out-patient
Improvement Plan.
Modernisation of Out-patient Services
In line with the recommendations put forward by the National
Patients Access Team (NPAT) in their November 1999 report
the Patient Services Department embarked upon a programme
of modernisation.
Director: Mr R Tunnicliffe
Joint IM&T Strategy
The main themes of the modernisation, or improvement plan,
included the introduction of patient choice in the booking of
out-patient appointments and improvements to the outpatient
facilities at the Manchester Royal Infirmary.
The year saw the development and adoption of the Joint IM&T
Strategy by Central Manchester Healthcare NHS Trust and
Manchester Children’s Hospitals NHS Trust
The Strategy has been derived from the wider contexts of the
National Information Strategy “Information for Health” and “The
NHS Plan” and describes progress towards an Electronic Patient
Record. The aim of which is to demonstrate that it can be
effective in directly contributing to improvements in patient care
by supporting clinicians, clinical practice and administrative
processes. All relevant information is to be available at the point
of need to support individual patient care.
Infrastructure Upgrades
The data communications network has been upgraded to enable
This has been achieved by:
● The adoption of a partial booking process for
appointments in 9 specialities and development of a
rolling plan to introduce the system in all specialties with
a waiting time of over 13 weeks for a first appointment.
● The establishment of a centralised telephone
appointments centre.
● Refurbishment and extension of the existing reception and
appointments facility with the Manchester Royal Infirmary.
(pictured on page 12).
● The redecoration of clinic suite areas within the
Manchester Royal Infirmary.
Annual Report 2000 ~ 2001 11

The introduction of “partial booking” has given the patients a
choice in booking an out-patient appointment at a date and time
that is convenient to them.
Traditionally out-patient departments have unilaterally allocated
appointment dates with little regard to patients’ preferences.
This has encouraged a very high did not attend (DNA) rate in
many specialties which has had the effect of creating longer
waiting times for patients.
Health Records Library
During the year the Health Records library staff implemented a
document imaging system, which replaced the obsolete
microfilming equipment. Many of the staff are now trained to
use the system, which allows the imaged case notes to be stored
on CD.
National Booked Admissions Project
The Trust has successfully completed the 2nd wave of the
National Booked Admissions Programme. The project involved
patients deciding the date of their out-patient appointment when
they are with their GP and the date of in-patient admission
during the out-patient consultation.
Fifteen practices, with a total of 50 GPs, are now booking to over
30 clinics in 8 specialties across the Trust. These include colorectal
surgery, neurology, urology, paediatrics, gynaecology, general
medicine and obstetrics. Over 1,000 appointments have been
booked electronically by the participating GPs. In excess of
12,000 admissions have been booked during out-patient
consultations.
In addition to booking appointments the GPs are able to see
admission history, waiting list information, out-patient
appointments, recent A&E attenders, current in-patients and
recent discharges for patients registered with their practice.
An added benefit has been a reduction in queries received by the
practices as electronically booked patients leave the surgery with
all the information they need. Communication between the
hospital, GP practices and the Health Authority has improved due
to regular focus meetings with GPs, practice managers, health
authority IT staff and hospital staff.
Patient surveys were undertaken in gynaecology, urology, day
surgery unit and the endoscopy unit. Results showed that around
95% of patients are satisfied with the service they receive.
Clinical Director: Professor J McClure
(until June 2001)
Deputy Director: Dr K Hyde
Budget: £6 million
Staff: 230
The past year has been one of very intense activity in Laboratory
Medicine. The planning of the new laboratory complex to house
Autolab, Manchester Cytology Centre and the Public Health
Laboratory Service has taken considerable time and effort by all
concerned. In parallel to this has been the planning and
development of the new Manchester Molecular Diagnostics
Centre, the planning for the clinical transfer from Withington,
increased GP activity and the Organ Retention work resulting
from the Alder Hey report. These, and improvements in service
delivery include:
Project 2000
- Transfer of Autolab, Manchester Cytology Centre and
Manchester Public Health Laboratory Service (PHLS).
- Cytology service amalgamated with Christie Hospital.
Organ Retention
- 330 enquiries on the helpline which was set up by the Trust.
- Validation inspection by Manchester Health Authority/Regional
Office.
- Organ, block and slide cataloguing.
GP Service
- Seven general practices transferred to Central from another
local provider.
12
Annual Report 2000 ~ 2001

- Laboratory Medicine provides a regular pathology service to 28
GP surgeries from Irlam, through Manchester, to Tameside.
Pathology Modernisation Fund
- Funding of £965,000 was awarded for a project to develop
services in Molecular Laboratory Medicine from the Department
of Health’s Pathology Modernisation Fund.
- The bid, represented a partnership between the Directorate of
Laboratory Medicine, the Manchester Public Health Laboratory
Service, the Royal Manchester Children’s Hospital and
the Infectious Diseases Unit at North Manchester General
Hospital.
- Funding is being used to create a purpose-designed, state-ofthe-art
Molecular Diagnostics Service to the City of Manchester
and surrounding areas. The new laboratory will also provide a
high-class facility for molecular biology research.
- The new “Manchester Molecular Diagnostics Centre,” opened in
June 2001.
Quality
- Quality assessment of near Patient Testing scheme e.g. glucose.
- Extension of electronic results reporting.
- All departments are CPA accredited ie. Clinical Pathology
Accreditation (UK) Ltd.
Pneumatic Tube
- Increased number of clinical stations.
- New auto-return system in Autolab.
- Increased number of carriers.
New appointments:
Dr G Ayers, Clinical Biochemistry
Dr R McVey, Histopathology
Dr L McWilliam, Histopathology
Dr J Burthem, Haematology
Clinical Director: Mr D J Keenan
Directorate Manager: Mrs J Youart
Budget: £10.6 million
Staff: 200
The Manchester Heart Centre consists of an 8 bedded Cardiac
Surgery Intensive Care Unit, a 27 bedded Cardiothoracic Surgery
Ward incorporating a 6 bedded Progressive Care Unit, an 8
bedded Coronary Care Unit, adjacent to an acute 16 bedded
Cardiology Ward and a 17 bedded 5 Day Cardiology Ward which
is located opposite the Cardiac Catheter Laboratories. The third
Catheter Laboratory was re-opened in November 2000 having
been refurbished at a cost of £1m (pictured below).
New Services Introduced/Service Reviews:
●
●
●
●
A Rapid Access Chest Pain Clinic was set up in November.
A Cardiology Activity Co-ordinator has been appointed to
manage the Cardiology beds. This was considered necessary
after seeing the benefits of having a Cardiac Surgery Coordinator,
who has increased the number of procedures,
reduced the number of cancellations and reduced the
waiting list with no extra beds.
The Aortic Balloon Pump is now being used.
An increased number of surgical procedures were carried out
either “Off by-pass” or by using a minimally invasive
technique.
NHS Plan
●
More investment has been put into Audit, Research, IT
developments and hardware upgrades and training and
development of all grades of staff.
●
Multi-disciplinary Laboratory Leaders have been introduced in
the Cardiac Catheter Laboratories. A nurse, technician and a
radiographer all take equal responsibility for the daily
running of their laboratory.
New Appointments:
Dr Faz Ordoubadi, Consultant Cardiologist (Interventionalist)
Mr Brian Prendergast, Consultant Cardiothoracic Surgeon
Annual Report 2000 ~ 2001 13

that the Trust accommodates an expected increased number of
students in line the NHS Plan.
Nursing Audit
Clinical Benchmarking
The Trust has been preparing nursing and midwifery staff to
utilise the process of clinical benchmarking, with the sole aim of
improving the quality of patient care. The eight initial clinical
benchmarking areas are:
● Principles of self-care
● Food and nutrition
● Personal and oral hygiene
● Continence and bladder and bowel care
● Pressure ulcers
● Record keeping
● Safety of clients/patients with mental health needs in acute
mental health and general hospitals settings
● Privacy and dignity
A Trust-wide Nursing Audit which began in August 1999 was
completed in September 2000. Each clinical area have action
plans to implement the recommendations made.
NHS Direct
An NHS Direct service was opened within the Trust in December
1999, the call centre is a satellite site based at MRI, in
partnership with Greater Manchester Ambulance Service NHS
Direct national site. The call centre is staffed with registered
nurse advisors who are all experienced nurses from a variety of
clinical backgrounds and deals with between 800-1200 calls per
day. It is anticipated that the demand of calls to NHS Direct is
set to grow in the coming years.
Recruitment and Retention
Nurse Consultants
In December 2000 the Trust appointed its first Consultant Nurse.
The post is a Paediatric Accident and Emergency Nurse
Consultant and the post holder is a joint appointment with The
Manchester Children’s Hospitals NHS Trust. A Midwife
Consultant was appointed on the 1st April 2001 to care for
women who use drugs, alcohol and other substances. The post
has been developed through a multi-agency collaboration
between this Trust and Community Health and Resource Centres,
Ltd., Hulme, Manchester, Salford and Trafford Health Action Zone
(HAZ) and Manchester Drugs Service.
The Midwife Consultant will be working in the area of public
health to:
Recruitment has been highlighted as a major issue within the
Trust and certain initiatives have been implemented to help
reduce the number of vacancies.
In September 2000 a Recruitment Initiative Manager was
appointed to organise, manage and implement the strategic
approach to nurse recruitment. Thus far various initiatives have
been implemented including:
● Revising Trust recruitment literature
● Introducing rotational placements for nurses
● Implementing ‘D’ Grade Development programme
● Recruitment campaigns
● Radio advertising
● Open Days/Recruitment Fairs
● Student lunches.
●
●
●
Improve outcomes for a particularly vulnerable, sociallyexcluded
client group, which involves collaboration across a
wide range of health and social agencies.
Provide an opportunity to develop strong leadership.
Build on existing innovative and evidence-based practice and
lead on introducing fresh approaches.
As well as recruiting from the local community the Trust has
shown a commitment to international recruitment.
By the end of March 2001, 178 nurses have been appointed to
work throughout the Trust (79 are in post with the remainder
arriving later in the year).
Increased Training of Student Nurses/
Midwives
The Trust has been working closely with the University of
Manchester on a new curriculum for nurse education and
training, to commence in September 2001. This should ensure
The majority of the nurses (167) have come from India and
others have been recruited from Spain.
In order to ensure that the international nurses’ transition runs
smoothly an Educational Support Worker (International Nurses)
has been appointed.
14
Annual Report 2000 ~ 2001

Quality Issues
Apart from the quality issues and patient satisfaction addressed
at a ward or departmental level, the past year has seen work
begin on some larger Trust-wide projects:
●
An undertaking by Out-patient Services to ensure that all
nursing staff are qualified to a minimum of NVQII has
started. This year has seen the successful completion of
NVQII for the first member of staff to embark on this
programme.
●
●
●
●
Ensuring that the Trust is in line with the requirements of the
Disability Discrimination Act
Review of catering provision
Review of signposting and maps
Work towards the “Investors in People” and “Charter Mark”
standards.
Director of Pharmacy: Mr R Hey
Staffing Budget: £1.5 million
Medicines Expenditure: £8 million
Staff: 70
The aim of the pharmacy services is to ensure the safe and
effective use of medicines throughout the Trust and consists:
Acting Clinical Director: Mr I C Lloyd
Directorate Manager: Mrs K Partington
Budget: £9.6 million
Staff: 331
The Directorate undertook 8,806 main theatre procedures over
the year and held 77,791 (doctor-led) out-patient consultations.
A further 41,613 attendances took place within the Visual Fields
service, Retinal Photography, Orthoptics and other areas.
Events over the past year have included:
●
●
●
●
●
The purchase of additional sets of patient positioning
equipment to help patients posture face down following
macular hole surgery. Posturing face down for a period of
4-6 weeks enables the “bubble in the eye” to support the
healing/sealing process of the retinal hole.
The integration of positioning in the pre-operative
assessment in the Vitreo-retinal clinic with the Vitreo-retinal
Nurse Practitioner.
The commencement of Photodynamic Therapy for the
treatment of specific types of age related macular
degeneration.
The purchase of five new phacoemulsification machines for
cataract surgery.
The Local Anaesthetic Nurse Practitioner role based in
theatre has gained worldwide recognition and the current
postholder has been invited to speak at National and
International conferences.
● Clinical pharmacy; delivering pharmaceutical care for patients
and supporting clinicians in rational prescribing. Provided to
most areas through a team of Directorate and Clinical
pharmacists.
● Medicines Management activities are involved in developing
and maintaining the Medicines Formulary, policies and
guidelines and in the managed introduction of new
medicines both within the Trust and across Manchester.
● Aseptic dispensing services support safe use of parenteral
medicines in neonatal intensive care, parenteral nutrition and
the provision of cytotoxic chemotherapy.
● Medicines Information services respond to medicines queries
from Trust and primary care clinical staff and the general
public.
● Medicines procurement - dispensing and distribution.
● Training, Education and Research in association with local
Universities.
New Services/Service Reviews:
● Development of Medicines Formulary.
● Improved service to Critical Care and the High Dependency
Unit.
● Improved service to A&E and the Medical Assessment Unit.
● Review of chemotherapy services to Clinical Haematology.
● Review of Medicines Information services.
● Review of dispensing services including use of automation.
● Development of patient-centred pharmacy services.
NHS Plan/Modernisation Agenda
The NHS Plan and The National NHS Plan for Pharmacy identify a
challenging agenda for hospital pharmacy - work has started on
the following key areas:
Annual Report 2000 ~ 2001 15

●
●
●
●
●
●
●
●
Re-engineering the way patients’ medicines are dealt with in
hospitals.
Application of the principles of Clinical Governance.
Correct use of skills.
Use of automated technology.
Improving recruitment and retention.
Performance management of hospital pharmacy services.
Involvement in multi-disciplinary working across primary and
secondary care.
Development of services to support delivery of the standards
of care identified in National Service Frameworks and
national Cancer Service Standards.
community services. Directorate based paramedical and palliative
care staff provide a Trust-wide service.
New Services Introduced/Service Reviews:
● Home Stroke Team with Social Services and Central Primary
Care Trust.
● Cardiac Rehabilitation – expanded programme enabling
patients fitted with cardiac defibrillator and high risk patients
access to the service.
● Development of extended scope physiotherapy practitioner
posts with orthopaedics and rehabilitation medicine.
● Development of musculo-skeletal service at Manchester
Clinic.
● Expansion to ITU and HDU service.
● District Audit Appliances/Wheelchair Service.
Achievements/Awards:
●
●
●
●
Commitment for joint development proposal for an Acute
Stroke Unit.
Development of Manchester Stroke guidelines.
Evaluation of Rehabilitation Assistant developments
completed.
Securing funding from Education and Training consortium to
pilot an Undergraduate Clinical Co-ordinator post with
Paramedical Services.● Education and Training
Consortium grant to develop work-based education for
Stroke Unit and Neurology Service.
NHS Plan/Modernisation Agenda:
Reconfiguration of Cardiac Rehabilitation Service in response to
Cardiac National Service Framework.
Clinical Director: Mrs E Birchall
Directorate Manager: Mrs O White
Budget: £8.8 million
Staff: 290
The Rehabilitation Directorate has four in-patient rehabilitation
wards. These wards provide rehabilitation services to elderly,
general, orthopaedic, vascular, stroke and neuro-rehabilitation
patients with associated specialist outreach, out-patient and
Clinical Director: Dr A Hutchison
Directorate Manager: Mr G Roberts
Budget: £6.4 million
Staff: 120
●
Renal Medicine provides a medical service for patients with
all forms of renal disease and renal replacement therapy for
those with end stage renal failure. The services include
haemodialysis, peritoneal dialysis, assessment of suitability
for renal transplantation, in-patient and out-patient services,
drop-in clinics and a team of community nurses. Renal
transplant surgery is provided within the Acute Surgery
Directorate.
16
Annual Report 2000 ~ 2001

●
●
●
●
●
The service is currently undergoing major changes resulting
from the Greater Manchester Renal Project and the merger
with the Renal Unit at Withington Hospital. The merger will
involve the opening of a new dialysis unit at Wythenshawe
Hospital and all other renal services transferring to
Manchester Royal Infirmary. This will result in the opening of a
third renal medicine ward, the doubling of facilities for home
dialysis training, the transfer of two consultant Nephrologists
and two renal Senior House Officers, as well as a large
number of nursing and administrative staff. The whole service
will be staffed and managed from MRI.
During 2000/01 Ward 23 was refurbished to allow patients
with acute renal failure to be treated in a high dependency
area. The existing renal dialysis unit, laboratories and
administrative offices are scheduled for demolition,
commencing January 2003, to clear the site for construction
of a new Children’s Hospital. Plans for a new facility are
complete, with the intention of it being in use by dialysis
patients and staff in December 2002.
The Greater Manchester Renal Project recommended the
creation of a Renal Managed Clinical Network, with
Manchester Royal Infirmary as the centre, to bring together
the renal services at the South Manchester, Tameside,
Stockport, North Manchester and Macclesfield Trusts.
The Network started work during the year and has begun
to develop the renal services as a whole rather than as
individual units.
Staff development has always been a cornerstone of the unit
and this year has again proved to be very successful for our
staff with a number obtaining first and post-graduate degrees
and NVQ qualifications.
In September 2000, Professor Sir Netar Mallick retired from
the unit. Having worked in Manchester since 1967, Professor
Mallick has been a source of inspiration for the staff and
patients. We wish him a long and happy retirement.
Clinical Director: Dr M Maresh
Acting Directorate Manager: Mr A Hughes
Budget: £23 million
Staff: 755
Founded over 200 years ago, Saint Mary’s Hospital provides a
unique range of inter-related services for women and children.
Key services within the directorate include Obstetrics,
Gynaecology, Clinical Genetics, Neonatal Medicine, Neonatal
Surgery, General Paediatrics (Medical & Surgical),
Radiology/Ultrasound and a Sexual Assault Referral Centre.
Saint Mary’s Hospital was exposed to close scrutiny from the
general public, politicians, religious bodies, legal & ethical bodies
and several patient interest groups following the birth
and eventual separation of the conjoined twins from Malta
(Jodie & Mary). The directorate was the focus of world-wide
press & media attention for many months. This national and
international attention has continued to the present day.
The directorate received a visit from the Duchess of York in
October 2000 who was invited to formally launch the Tommy’s
Campaign to establish a new Chair in Maternal and Fetal Health
in Manchester.
Saint Mary’s Hospital, together with the Christie Hospital, carried
out a world-first, pioneering fertility operation which will bring
hope to women suffering from cancer throughout the world.
Surgeons at Saint Mary’s successfully grafted back sections of
ovarian tissue (previously removed and frozen from a patient
receiving chemotherapy treatment for lymphoma) which
functioned normally for two months following re-implantation.
New Services Introduced/Service reviews
●
Establishment of the Whitworth Clinic – a ‘one-stop’
unplanned pregnancy service for women within the city of
Manchester.
●
The Gynaecology Unit was successful in attracting funding
under the Cancer Services Collaborative (Phase II
Annual Report 2000 ~ 2001 17

●
Programme) to support an ‘Ovarian Cancer Improvement
Project’.
The Nesta Wells Unit successfully transferred from the
Duchess of York, Withington Hospital to a new, purpose
built facility.
● Following a successful bid with Barnados to the Department
of Health, a Teenage Pregnancy Midwife has been appointed
to work across boundaries with pregnant teenagers to
reduce the risk of social exclusion.
New Appointments
●
The numbers of beds within the children’s wards in St Mary’s
were increased to accommodate extra patients following the
closure of the Paediatric Unit at the Duchess of York
(Withington Hospital).
●
Earlier this year, The Tommy’s Campaign established a new
Chair in Maternal and Fetal Health in Saint Mary’s Hospital,
in collaboration with the University of Manchester.
●
●
The quality of service provided to children and families who
have been referred by their local GP was greatly enhanced by
the development of a dedicated assessment area within the
Acorn Ward.
The St Mary’s Centre (Sexual Assault Referral Centre) was
successful in attracting significant funding and support from
the Home Office (Crime Reduction Programme) for two key
national, high-profile projects:
-Lead partner in a National Evaluation & Understanding of
Attrition Study.
-Establishment of a pioneering Forensic Nurse Examiner pilot
project.
●
●
●
●
The Obstetric service was further strengthened by the
welcome appointment of Dr Phil Bullen, Consultant
Obstetrician.
The Paediatric service warmly welcomed the appointment of
a fourth Consultant Paediatrician, Dr Sarah Dixon.
The Neonatal & Paediatric Services also welcomed the
appointment of two Consultant Paediatric Surgeons,
Mr James Morecroft, and Miss Gill Humphreys, and a
Consultant Anaesthetist, Dr Nicola Anders.
The Genetics service continued to develop and strengthen its
links with the University section of Genetics and welcomed
the appointment of three new Consultant Geneticists:
Dr Fiona Lalloo, Dr Kay Metcalfe and Dr Graeme Black.
Achievements/Awards
●
The Maternity Unit achieved the ‘Certificate of Commitment’
award as part of the national ‘Baby Friendly Initiative’.
●
The first midwife to be trained in ultrasound at St Mary’s
successfully completed her examinations and is now
practicing both disciplines routinely.
NHS Plan/Modernisation Agenda
●
Haemoglobinopathy Service: The Maternity Unit was
involved in the successful development of a multi-forum,
pan-city approach to the care of women affected by
haemoglobinopathies, with active involvement of users of
the service.
●
The Gynaecology Unit was successful in attracting funding
from the Cancer Services Collaborative to support an
innovative ‘Ovarian Cancer Improvement Project’. The
project aims to improve access to care for ovarian cancer
patients which will ultimately lead to a reduction in the time
from diagnosis to treatment.
18
Annual Report 2000 ~ 2001

Clinical Director: Mr P Hirst
Directorate Manager: Mrs J Edwards
Budget: £6.4 million
Staff: 173
The Surgical Specialties Directorate was formed in November
2000 and comprises: Trauma and Orthopaedic Surgery and the
Head and Neck Surgical Unit (ENT, Maxillo-Facial Surgery,
Audiology and Cochlear Implantation).
Trauma & Orthopaedic Surgery
●
The Department recently introduced the role of Trauma Coordinator.
The purpose of this role is to co-ordinate all
orthopaedic trauma activity, ensuring it is managed in an
efficient and effective manner, by liaising with A&E, Bed
Bureau, Theatres, ward staff and clinicians in order to
manage the patient's journey following admission.
Clinical Director: Professor B J Pollard
Directorate Manager: Mrs J Alexander
(until June 2001)
Budget: £9.8 million
Staff: 250
●
●
●
The purchase of replacement washer disinfectors for Sterile
Services has been agreed, delivery due in September 2001.
Two new sterilizers were installed in the St. Mary’s
department during August 2000 which has enabled
improvements to the service in that area.
During the year, staffing requirements for Sterile Services
were reviewed and this resulted in an extension of opening
hours and the creation of a new post to cover training and
quality issues.
● The department welcomed Mr David Ellis, Consultant
Orthopaedic Surgeon. Mr Ellis, who replaced Mr Maltby,
took up post in April 2000.
● The Department of Trauma and Orthopaedic Surgery has
joined the North West Regional Orthopaedic Collaborative.
The Collaborative, is focused on Joint Replacement Surgery
and forces units to critically review their service and work
towards improvement. We aim to look specifically at
reducing out-patient waiting times, making more efficient
use of theatres and reducing waiting times for patients listed
for Joint Replacement Surgery and categorised as urgent.
The Orthopaedic Collaborative forms part of the
Modernisation Agenda.
The Head & Neck Surgical Unit
● During 2000/2001, 20 adults and 27 children underwent
Cochlear Implantation.
●
●
●
Practices associated with successful decontamination are
under close scrutiny by Central Government and the
publication of HSC 2000 (32) summarised the basic
requirements. Significant changes were requested and a
major programme of renovation and re-equipping of the
three Sterile Service departments began and will continue
throughout 2001/02.
A new purpose-built day surgery unit with two theatres is to
open in September 2001. Extra staff to cope with the
increased workload are being recruited.
When Withington Hospital closes, some of its services will
transfer to Central Manchester and some to Wythenshawe
Hospital. In order to deal with the increased elective surgery
at MRI, both within main theatres and also within the day
surgery unit, there has been major changes to the theatre
operating schedule. The planned rota for September 2001 is
a 2-week rotation with some surgeons working in day
surgery one week and in main theatres the next. To manage
the complexity of this an IT package has been developed for
the directorate.
●
●
Mr Philip Flanagan, Consultant ENT Surgeon joined in June
2000. Mr Flanagan, who replaces Mr Canty, has a special
interest in Paediatric ENT surgery and rhinology.
The ENT Out-patient Department successfully introduced the
partial bookings appointment system in November 2000.
Patients are given more choice in arranging clinic
appointments, thus reducing the number of re-bookings and
DNA’s (Did Not Attends).
●
Another project that the Directorate has been involved in is
run by the Teaching Company Scheme (TCS). The aim of this
project is to examine the theatre business processes and
identify areas where improvements can be achieved.
New Consultant Anaesthetist Appointments:
Dr J Stokes
Dr N Anders
Dr S Monaghan Dr L Winslow
Dr D Conway
Dr M Parker
Annual Report 2000 ~ 2001 19

NHS Trust. The R&D exhibition gives the Trust’s researchers the
opportunity to present their research to both the internal and
external research community. Researchers from both
organisations presented their research via poster displays and
presentations, a total of 74 research posters were displayed.
This year was the last year of the Trust’s Portfolio contract, for
which the Trust receives funding (£5.5 million) to support its R&D
activities. The researchers in the Trust are currently involved in
501 projects, which attracted £15.3 million in funding from
research sponsors for the year.
The Trust Research areas are: Cardiovascular disorders, Genetics,
Health Services Research, Imaging, Laboratory Medicine
(Technology, Transfer and Development), Musculoskeletal
Disorders, Ocular Health, Oncology, Oral Health, Rehabilitation,
Renal Disease and Transplantation and Women's and Children's
Health.
The Trust also supported research through it’s Research Grants
programme. The awards provide pump-priming funding to
projects which are likely to attract further external funding. This
year 33 applications were made, all of a very high standard, and
11 grants were awarded totalling £71,000. This is the third year
that Trust Research Grants have been awarded and the track
record of previous grants has been excellent with approximately
£1.1 million in total external grant funding being generated,
including funding from the Medical Research Council, the Human
Trust, Birth Defect Foundation, Biotechnology and Biological
Science Research Council and the Wellcome Trust.
The Trusts seventh R&D exhibition in November 2000 was jointly
held between this Trust and the Manchester Children’s Hospitals
Although there are many experienced researchers within the
Trust, there are also many new and aspiring researchers, who
wish to improve or learn research skills. The Health Services
Research Unit is a newly developed unit within the Trust, and
aims to provide support to all staff involved in research.
The construction of the Wellcome Trust Clinical Research Facility
(CRF), near the main entrance to the Central site, is well
underway and is due to open in October 2001. This will be a
dedicated research facility with experienced research nurses who
will conduct the research. The facility is gearing up to carry out
projects from researchers in Central Manchester and Manchester
Children’s University Hospitals NHS Trust, South Manchester
University Hospitals NHS Trust, Salford Royal Hospitals NHS Trust
and the University of Manchester.
Education
The Trust continues to support a wide range of educational
activities for all professions as a major teaching organisation.
Library Services
The three separate libraries have been brought together under
the ‘umbrella’ of one co-ordinated library service. Work has
already began on improving this service.
Undergraduate Medical Education
This year has seen further improvement to the facilities and
resources available to the Undergraduate medical students to
support their education.
Skills Laboratory: Skills teaching for medical
undergraduates has vastly increased with the opening of the
skills laboratory with a dedicated skills co-ordinator and this led
to a high demand for placements at our Trust from pre-clinical
students.
Communication Skills: A new communications initiative
has been introduced to cover such areas as “taking a history”,
“giving information” and “breaking bad news”.
20
Annual Report 2000 ~ 2001

IT Facilities: A new PC cluster system has been set up for
the medical undergraduates in the Undergraduate Centre and
various seminar rooms with PCs donated by the University. This
has led to much improved access for the students and a large
library of interactive CDs for the students to aid their learning.
Postgraduate Medical Education and
Postgraduate Education Centre
The Postgraduate Centre has hosted a variety of national and
international conferences on behalf of organisations such as the
Royal College, British Heart Foundation and the Manchester
Medical Society.
out-patient appointments and surgery.
The remaining complaints referred generally to dissatisfaction
with communication, staff attitude, treatment, amenities and
in-patient food service.
Action taken as a result of complaints
The Trust recognises that quality issues are an essential element
of the service. Complaints provide a positive means of identifying
weaknesses and anomalies within the organisation which allows
the Trust the opportunity to monitor and improve the service.
The most recent improvement that has taken place as a result of
complaints is the provision of a wider choice of menu for ethnic
minorities.
The Postgraduate Team has continued to provide a wide variety
of professional teaching programmes covering junior medical
staff, local GPs and multi-professional events. The annual MRCP
Part II Clinical Course was held in October 2000 and was heavily
oversubscribed due to the success of the previous year.
Considerable advancements and improvements have been made
in the working conditions and educational value of the House
Officer posts within the Trust which has resulted in the reaccreditation
of valuable posts.
A number of new appointments have been made to enhance the
postgraduate medical education infrastructure:
- Dr Mike Cheshire, Director of Postgraduate Medical Education;
this is new post and encompasses the role of Postgraduate
Clinical Tutor.
- Dr Ian Bruce and Mr Richard Napier-Hemy to newly created
Pre-registration House Officers Tutor posts.
Change of Approach
The Patient Representative Department has adopted a much
more proactive approach to complaints handling. This is due to a
change in philosophy in response to the changing Health Service
environment of Customer Care.
Of the 920 complaints, 23% [206] were resolved by the
Department, usually within a day. Instead of playing just the
traditional role of go-between (between complainant and
Directorates) the Department, when possible, acts as a broker for
the complainant. This benefits all parties by allowing the Trust to
respond more effectively, which in turn reduces complainants’
anxieties and frustrations.
Taking complaints further
Unfortunately the Trust is not able to resolve matters to
complainant’s satisfaction on every occasion. On these occasions
patients may request that an Independent Review Panel consider
their complaints.
Independent Panel Reviews
Panels Requested 17
Panels Held 1
The number of complaints received = 920
(29% increase on 1999 – 2000)
(34% increase on 1998 – 1999)
Number of Formal Complaints = 683
Number of Formal Complaints Resolved = 663
Number of complaints resolved by front line staff = 31
Number of complaints resolved by Patient Representative
Department = 206
Number of complaints ongoing = 20
Nearly 30% of all complaints related to cancelled or delayed
Panels being convened 2
Panels refused on clinical advice 7
Panels under consideration 4
Panels returned to Trust for resolution 3
The Year Ahead
The complaints database is now fully operational. During the
coming year this will allow the Trust to quickly identify trends and
correct any adverse elements.
Annual Report 2000 ~ 2001 21

90000
80000
70000
60000
50000
40000
30000
20000
1998 - 1999
1999 - 2000
2000 - 2001
Day Case Activity
1998/99 1999/00 2000/01
Day Cases as a % of
Elective Activity 70.0% 73.0% 74.2%
Day Cases as a % of
Total Activity 43.7% 44.3% 44.2%
10000
0
450000
In Patients ~ Elective
In Patients Emergency Day Cases Total
In-patient/Day Case Activity
(excludes private patients and well babies)
Out-patient Waiting Times Percentage of
patients seen within 30 minutes
1998/99 1999/00 2000/01
1st Quarter 81.00 71.91 76.35
2nd Quarter 83.00 78.68 79.88
3rd Quarter 77.30 83.00 73.57
4th Quarter 80.31 76.14 70.00
Total average for Year 80.40 77.43 74.95
400000
350000
300000
1998 - 1999
1999 - 2000
2000 - 2001
Waiting Lists – as at 31st March 2001
250000
In-patient
Day Case
200000
150000
Total on Waiting List 4,741 6,001
100000
50000
Patients waiting
12-18 months 598 379
0
First attendances (new)
Follow-up
Total
Patients waiting
over 18 months 0 0
Out-patients
Bed Usage
200000
1998 - 1999
1999 - 2000
2000 - 2001
Average In-patient length of stay = 6.3 days
Average bed occupancy rate = 86%
100000
80000
60000
Other Totals for 2000/01:
40000
Babies Born 4,043 Cochlear Implants 49
Renal Transplants 143 Operations 30,119
20000
0
First attendances (new)
Follow-up
Total
Coral Implants (eye) 46 Implantable Defibrilators 18
Open Heart Episodes 1,002
A&E Attendances
22
Annual Report 2000 ~ 2001

Introduction
Income and Expenditure
The summary financial statements for the year ended 31st March
2001 are included later in this report. These are an extract of the
full audited accounts adopted by the Trust Board on 7th August
2001, which are available from the Finance Directorate on
0161 276 4936.
The Trust’s income continues to rise each year and in 2000/2001
totalled £222m. In particular the Trust received additional income Capital Absorption Rate
for critical care and coronary heart disease. As a major teaching
Trust the income comes from many different sources as the
diagram below illustrates.
Income Analysis
External Financing Limit
2% 2% 1% Manchester
Greater
13%
Manchester
Levy
10%
Other Health
Authorities
35%
Management costs
Other
13%
Provider to
Provider
24%
Private Patient
Distinction
Awards
Capital Expenditure
Pay Analysis
The provision of healthcare is labour intensive and approximately
60% of expenditure was used to pay staff salaries. The majority
of this is for Medical and Nursing staff, as set out in the following
diagram:
Nursing Staff
4% 4% Medical Staff Senior Manager Pay Awards
5%
Professional &
Technical
7%
10%
12%
27%
31%
Admin &
Clerical
Ancillary Staff
Professions
Allied to
Medicine
Senior
Managers
Agency
The Trust was set a target to break-even in the year, this required
the Trust to implement savings of £1.25m as part of an ongoing
financial plan. In fact the Trust has produced a surplus of £857k
for the year. This has offset deficits made in previous years and
the Trust now has a cumulative deficit of £2,694k, since the
introduction of the revised break-even performance by the NHS
Executive in 1997/98.
The Trust made a surplus before interest and dividends were paid,
of £9,991k. A dividend of £9,041k was paid, which is 5.6% of
net relevant assets, which is within the materiality range set by
the in the NHS financial regime.
The Trust was allowed to borrow an additional £5,549k during
the year. In fact it borrowed £5,539k which is well within the
£50k tolerance set by the NHS Executive. The borrowing
facilitated the financing of the £17m capital programme.
The management costs of the organisation have shown a slight
increase over the last financial year to £7,167k, which is 3.53%
of income. This is well within the target figure of £7,625k.
Details of management and administration costs are given on
page 31.
Capital expenditure for the financial year 2000/2001 totalled
£17.3m and sees the continuation of major capital work in
respect of redevelopment of the site. The largest item of
expenditure was £6.7m on the building of four wards and two
theatres to assist with the transfer of services form Withington
Hospital. Other major expenditure included the purchase of
clinical equipment, health and safety expenditure and the
commencement of the building of a multi-storey car park.
The Secretary of State Health requires Trusts not to have pay rises
for senior managers of more than 3.25% in total. This Trust
complied with this requirement.
Public Sector Payment Policy
The Trust aims to pay all its suppliers on time. The NHS Executive
set a target to pay at lease 95% of all invoices within 30 days.
In 2000/01 it achieved 94% against the target. Full details of
compliance with the code are given on page 31.
Annual Report 2000 ~ 2001 23

Statement of the Chief Executive’s responsibilities as the Accountable Officer of the Trust
The Secretary of State has directed that the Chief Executive should be the Accountable Officer to the Trust. The relevant responsibilities of
Accountable Officers, including their responsibility for the propriety and regularity of the public finances for which they are answerable,
and for the keeping of proper records, are set out in the Accountable Officers’ Memorandum issued by the NHS Executive.
To the best of my knowledge and belief, I have properly discharged the responsibilities set out in my letter of appointment as an
accountable officer.
Acting Chief Executive 7th August 2001
Statement of directors’ responsibilities in respect of the accounts
The directors are required under the National Health Services Act 1977 to prepare accounts for each financial year. The Secretary of
State, with the approval of the Treasury, directs that these accounts give a true and fair view of the state of affairs of the Trust and of the
income and expenditure of the Trust for that period. In preparing those accounts, the directors are required to:
- apply on a consistent basis accounting policies laid down by the Secretary of State with
the approval of the Treasury.
- make judgements and estimates which are reasonable and prudent.
- state whether applicable accounting standards have been followed, subject to any
material departures disclosed and explained in the accounts.
The directors confirm they have complied with the above requirements in preparing the accounts.
The directors are responsible for keeping proper accounting records which disclose with reasonable accuracy at any time the financial
position of the trust and to enable them to ensure that the accounts comply with requirement outlined in the above mentioned direction
of the Secretary of State. They are also responsible for safeguarding the assets of the Trust and hence for taking reasonable steps for
the prevention and detection of fraud and other irregularities.
By order of the Board
Acting Chief Executive 7th August 2001
Acting Finance Director 7th August 2001
24
Annual Report 2000 ~ 2001

The Chief Executive as Accountable Officer, together with the other directors, has a responsibility for ensuring that an effective (*) system
of internal financial control is maintained and operated in connection with the organisation’s resources. To be effective the system must
provide reasonable assurance of:
a) the safeguarding of assets against unauthorised use or disposal,
b) the maintenance of proper accounting records; and
c) the reliability of financial information used within the organisation or for external publication.
No system can provide absolute assurance against material mis-statement or loss but the system should provide reasonable assurance
that material errors; irregularities or fraud are either prevented or would be detected within a timely period.
The Chief Executive, as Accountable Officer, together with the other directors, have a responsibility for reviewing the effectiveness (*) of
the organisation’s system of internal financial control. In carrying out the review in accordance with EL(97)55. Directors are required to
confirm that the “minimum control standards” laid down by the NHS Executive (appended to this statement) have been in existence
within the organisation throughout the financial year.
The directors confirm that they have undertaken the review and the above requirements have been met.
By order of the Board.
Acting Chief Executive 7th August 2001
*The judgement on “effectiveness” is informed by the work of the internal auditors and managers who have responsibility for the
development and maintenance of the financial control framework and by the comments made by the external auditors in their annual
audit letter and other reports.
Annual Report 2000 ~ 2001 25

Key Financial Controls 2000/01: The Minimum Control Standards
1. The Control Environment
Minimum Control Standards
1.1. Standing Orders are in place.
1.2. Standing Financial Instructions are in place.
1.3. There is compliance with the Secretary of State’s Directions on fraud and corruption.
1.4. There is an Audit Committee in place.
1.5. There is a Remuneration Committee in place.
1.6. There is an adequate Internal Audit Function.
1.7. There is a mechanism in place to facilitate control over the acquisition, use, disposal
and safeguarding of assets.
1.8. There is a budgetary control system in place.
2. Identification and Evaluation of Business Risks
Minimum Control Standards
2.1. There is an annually produced Business Plan.
3. Information and Communication
Minimum Control Standards
3.1. There are systems in place which produce reliable financial information
and proper accounting records.
3.2. There are controls in place concerning the security of financial systems
and data.
4. Control Processes
Minimum Control Standards
4.1. Procedure notes are in place for all significant and fundamental financial systems.
4.2. Financial systems are subject to Internal Audit coverage.
4.3. There has been adherence to the mandatory requirements contained within the
current NHS Executive costing guidance.
5. Monitoring
Minimum Control Standards
5.1. The Audit Committee reviews and monitors internal financial control and the
implementation of agreed control improvements.
5.2. The Board regularly receive and review financial and performance reports.
26
Annual Report 2000 ~ 2001

Central Manchester Healthcare NHS Trust
We have examined the summary financial statements set out on pages 28 to 32 and the directors’ statement on internal financial
control.
Respective responsibilities of Directors and Auditors
The directors are responsible for preparing the Annual Report. Our responsibility is to report to you our opinion on the consistency
of the summary financial statements and the directors’ statement on internal financial control with the statutory financial statements.
We also read the other information contained in the Annual Report and consider the implications for our report if we become aware of
any mis-statements or material inconsistencies with the summary financial statements.
Basis of Opinion
We conducted our work in accordance with Bulletin 1999/6 ‘The auditors statement on the summary financial statements’ issued by the
Auditing Practices Board for use in the United Kingdom.
Opinion
In our opinion the summary financial statements and the directors’ statement on internal financial control are consistent with the
statutory financial statements of the Trust for the year ended 31 March 2001 on which we have issued an unqualified opinion.
Signature: 9th August 2001
S Sunderland, District Auditor
District Audit, 3rd Floor, Sumner House, St Thomas's Road, Chorley, Lancashire, PR7 1HP
Annual Report 2000 ~ 2001 27

Restated*
1999/00
£000 £000
Income from activities:
Continuing operations 158,065 141,898
Other operating income 64,478 162,576
Operating expenses:
Continuing operations (214,546) (199,212)
OPERATING SURPLUS
Continuing operations 7,997 5,262
Profit on disposal of fixed assets 1,994 3
SURPLUS BEFORE INTEREST 9,991 5,265
Interest receivable 514 365
Interest payable (607) (2,860)
SURPLUS FOR THE FINANCIAL YEAR 9,898 2,770
Public Dividend Capital dividends payable (9,041) (7,429)
RETAINED SURPLUS (DEFICIT) FOR THE YEAR 857 (4,659)
*Restated: The previous years accounts have been restated where there has been an amendment to the current years guidance.
Such restatement ensures comparability of the information provided.
28
Annual Report 2000 ~ 2001

Restated
31 March 2000
£000 £000 £000
Fixed Assets
Intangible assets 117 130
Tangible assets 181,719 171,531
181,836 171,531
Current Assets
Stocks and work in progress 2,805 2,764
Debtors 25,673 24,024
Investments - -
Cash at bank and in hand 190 180
28,668 26,968
28,668 26,968
Creditors:
Amounts falling due within one year (26,252) (23,412)
Net Current Assets 2,416 3,556
Debtors:
Amounts falling due after more than one year 4,671 3,574
TOTAL ASSETS LESS CURRENT LIABILITIES 188,923 178,661
PROVISIONS FOR LIABILITIES AND CHARGES (11,239) (9,676)
TOTAL ASSETS EMPLOYED 177,684 168,985
FINANCED BY:
CAPITAL AND RESERVES
Public dividend capital 131,125 125,576
Revaluation reserve 48,041 49,037
Donated asset reserve 6,403 6,175
Income and expenditure reserve (7,885) (11,803)
TOTAL CAPITAL AND RESERVES 177,684 168,985
Signed on behalf of the Trust Board
Acting Chief Executive 7th August 2001
Acting Finance Director 7th August 2001
Annual Report 2000 ~ 2001 29

Restated
31 March 2000
£000 £000 £000
Operating Activities
Net cash inflow from operating activities 15,784 10,132
Returns on investments and
servicing of finance:
Interest received 458 359
Interest paid - (2,110)
Net cash inflow/(outflow) from returns on
investments and servicing of finance 458 (1,751)
Capital Expenditure
Payments to acquire tangible fixed assets (15,284) (5,745)
Receipts from sale of tangible fixed assets 2,568 3
(Payments to acquire) intangible assets (24) (138)
Net cash (outflow) from capital expenditure (12,740) (5,880)
Dividends Paid (9,041) (7,429)
Net cash (outflow) before management of
liquid resources and financing (5,539) (4,928)
Management of Liquid Resources
Purchase of investments - (11,367)
Sale of investments - 11,367
Net cash inflow (outflow) from management of
liquid resources - -
Net cash (outflow) before financing (5,539) (4,928)
Financing
Public dividend capital received 5,549 4,928
Net cash inflow from financing 5,549 4,928
Increase in cash 10 -
30
Annual Report 2000 ~ 2001

Restated
1999/00
£000 £000
Surplus for the financial year before dividend payments 9,898 2,770
Fixed asset impairment losses - (18,395)
Unrealised surplus on fixed asset revaluations/indexation 2,153 18,794
Increase in the Donated Asset reserve due to receipt of donated asset 576 489
Reduction in the Donated Asset reserve due to depreciation, impairment
(loss of economic benefits), and/or disposal of donated assets (436) (441)
Total recognised gains and losses for the financial year 12,191 3,217
Prior period adjustment (2,320) 4,071
Total gains and losses recognised in the financial year 9,871 7,288
The prior period adjustment relates to FRS11 reversal of impairments due to price changes.
Management Costs
Restated
1999/00
£000 £000
Management Costs 7,167 7,058
Income 203,069 184,431
Management costs as a percentage of Income 3.53% 3.83%
Income for management costs is defined as income from activities and other operating income less exceptional items, contracted out
services or consortium arrangements and NMET levy monies. NMET monies of £19,474K (£20,043K 1999/00) have, therefore, been
excluded from the calculation.
Public Sector Payment Policy
Better Payment Practice Code - measure of compliance
1999/00
Number £000 £000
Total bills paid in the year 84,763 95,638 69,604
Total bills paid within target 79,484 89,395 63,606
Percentage of bills paid within target 93.77% 93.47% 91.38%
Annual Report 2000 ~ 2001 31

Salary/fees Benefits Pensions Total
Name Status 2000/01 1999/00 2000/01 1999/00 2000/01 1999/00 2000/01 1999/00
£ £ £ £ £ £ £ £
D Woodyatt Chief Executive 106,599 97,850 3,073 3,795 5,330 3,914 115,002 105,559
J Scampion Director of Finance & Contracting 95,762 54,245 - - 4,322 2,067 100,084 56,312
T Gilpin Director of Human Resources 81,850 48,968 3,387 3,431 3,780 1,859 89,017 54,258
RWG Johnson Medical Director 135,268 - - - 6,544 - 141,812 -
M Lambert Director of Nursing & Service 30,849 66,112 3,787 6,209 3,584 2,610 38,220 74,931
Development
M Carroll Director of Nursing & Midwifery 39,329 - - - 1,967 - 41,296 -
J Wilbraham Director of Finance & - 25,247 - - - 1,010 - 26,257
Contracting
L Bartlett Director of Human Resources - 21,859 - 516 - 874 - 23,249
Prof. N Mallick Medical Director - 12,500 - 6,177 - - - 18,677
Sub total Executive Directors 489,657 326,781 10,247 20,128 25,527 12,334 525,431 359,243
S A Moore Chairman 14,464 14,464 - - - - 14,464 14,464
R Walters Non Executive Director 5,140 5,140 - - - - 5,140 5,140
K Fry Non Executive Director 5,140 5,140 - - - - 5,140 5,140
G Conn Non Executive Director 5,140 5,140 - - - - 5,140 5,140
J Somerset Non Executive Director 5,140 5,140 - - - - 5,140 5,140
W Shaw Non Executive Director - - - - - - - -
C A Butterworth Non Executive Director - 2,998 - - - - - 2,998
Sub total Non Executive Directors 35,024 38,022 - - - - 35,024 38,022
Total for all Directors 524,681 364,803 10,247 20,128 25,527 12,334 560,455 397,265
Notes:
-The value of benefits in kind are taken from the P11D, and are, therefore, net of any personal contributions, these include a lease vehicle.
-The lease vehicle scheme is available to all employees of the Trust.
-The Directors pensions contributions are made to NHS Superannuation scheme which is available to all NHS employees.
-The Trust does not operate a performance related pay scheme.
-Professor Mallick resigned as Medical Director with the effect from 31st March 2000.
-Professor Mallick was an employee of the University of Manchester the fee shown is for the Directors fee only.
-Mr Johnson took up the post of Medical Director with the effect form 1st April 2000. He is a full time employee of the Trust.
-Professor Shaw became a non-executive director with the effect from 1st May 2000. He waives the right to receive a fee personally, however an equivalent sum is paid to the University
of Manchester to support the loss of teaching time.
-Mrs M Lambert took up secondment at South Manchester University Hospitals Trust with effect form 6th August 2000.
-Mrs M Carroll was seconded from Trafford Healthcare Trust with effect from 11th September 2000.
-Mr J Wilbraham was Acting Director of Finance for the period 1st April 1999 to 9th August 1999.
-Mrs L Bartlett was Acting Director of Human Resources for the period 31st January 1999 to 1st August 1999.
-Professor Butterworth resigned as non-executive director on 30th November 1999.
32
Annual Report 2000 ~ 2001

Annual Report 2000 ~ 2001 33

and incentive, of all executive directors and senior management
staff of the Trust.
Members: Dr Amar Sabberwal, Mrs Pamela Barnes, Mr Paul
Brearley, Prof Tim Eden, Mrs Sheila Jones and Mrs Susan Loudon.
Manchester Children’s Hospitals NHS Trust comprised Booth Hall
Children’s Hospital and Royal Manchester Children’s Hospital.
The Trust provided a wide range of local healthcare services at
both hospitals for children from Manchester, Salford and the
surrounding districts, for example Bolton, Bury, Oldham,
Rochdale, Stockport, Tameside, Trafford and Wigan. Specialist
healthcare services were provided for children from throughout
the North West as well as nationally and internationally.
Audit Committee
This Committee was responsible for considering systems and
standards of internal control over all aspects and activities of the
Trust. It had the power to investigate through the Trust’s
internal auditor and, if necessary, through the Trust’s external
auditors.
Members: Mr Paul Brearley, Mrs Sheila Jones and Mrs Susan
Loudon.
During the year we treated many children from abroad including
such countries as France, Italy, Belgium, Kuwait and Malta.
The Trust employed over 1800 staff ranging from doctors and
nurses to clerical and maintenance staff.
Relevant Interests of Board Members
The Trust Board required all Board Members to declare interests
that were relevant and material to the Board. The register of the
Directors’ Interests is available to the public.
An Open Approach
The Trust Board remained committed to an open approach and
continued to hold its meetings in public.
Our mission statement will always be
foremost in our minds:
Non-Executive Directors
Dr Amar Sabberwal (Chair)
Mrs Pamela Barnes
Mr Paul Brearley
Professor Tim Eden
Mrs Sheila Jones
Mrs Susan Loudon
“Together we will
provide the best possible
healthcare for children”
Executive Directors
Mr Stuart E Smalley (Chief Executive)
Mr Ray Goodier (Director of Planning and Performance)
Mr Mick Guymer (Director of Finance until 14.8.00)
Dr Garry Hambleton (Medical Director)
Mrs Rebecca Howard (Director of Nursing until 14.8.00)
Mr Hussein Khatib (Director of Nursing from 14.8.00)
Mr Mike Pye (Director of Finance from 14.8.00)
Remuneration Committee
This Committee was responsible for considering the terms and
conditions of employment, including all aspects of remuneration
The year was dominated by the preparatory work around merging
Manchester Children’s Hospitals NHS Trust with Central
Manchester Healthcare NHS Trust to form a new Trust.
The merger of the two Trusts will allow positive progress on
significant areas of co-operation and harmonisation ahead of the
opening of the new children’s hospital in 2006.
34
Annual Report 2000 ~ 2001

Staff from a variety of disciplines have been involved in
discussions about parallel developments in Secondary Paediatric
Services in Greater Manchester, a recognition of the important
place the new children’s hospital will have in North West
England.
- Strategic Theatre Management
- Operational Theatre Management
- Human Resources Management
- Medical Staff Issues
- Risk Management
Within the hospitals an important development is the Paediatric
Intensive Care Services. The split site provision between Booth
Hall and Royal Manchester Children’s Hospitals proved
increasingly difficult to sustain during the year in terms of
medical staff cover and certain clinical governance issues.
In December 2000, it became necessary to rationalise the
Paediatric Intensive Care service on to the Royal Manchester
Children’s Hospital site. Funding was made available to establish
a Critical Care Service at Booth Hall Children’s Hospital to
provide essential support to clinical services.
● Centralisation and recommissioning of the Sterile Services
Department onto the Booth Hall Children’s Hospital site. This
department provides the Central Sterile Services Department
(CSSD) and Theatre Sterile Services Unit (TSSU) for both
children’s hospitals. The unit is in the process of assessment
for accreditation for the quality standard ISO9002.
● Actively recruiting Theatre staff of all grades, using all
available sources including overseas.
The priorities for 2001/02 are:
Consultant appraisal has been successfully introduced for the first
time and will continue to develop around the needs of
revalidation.
●
Purchasing and implementing a combined theatre and TSSU
IT system.
A notable academic development concerned the conferral by the
University of Manchester of a personal professorial chair upon Dr
Peter Clayton, Consultant Paediatric Endocrinologist.
● Purchasing state-of-the-art anaesthetic machines for the
theatres across both sites.
New Appointments:
Dr H Hack, Consultant Anaesthetist
Dr D Prosser, Consultant Anaesthetist
Clinical Director: Dr D Patel
General Manager: Mr S McCallum
Budget: £5.0 million
Staff: 105
The Directorate was newly formed in November 2000 having
previously been part of the Surgical Directorate.
Developments following the formation of the Directorate
included:
●
Commencing the implementation of the Strategic Theatre
Action Plan. This was drawn together following a Theatre
service review. The plan covers the following areas:-
Annual Report 2000 ~ 2001 35

Clinical Governance is the national framework through which we
are accountable for continuously improving the quality of our
services and safeguarding high quality standards of care.
Clinical Directors: Dr H Lloyd
and Dr C Verduyn
General Manager: Mrs G Saker
Budget: £3.9 million
Staff: 103
The Trust was awarded responsibility for managing the
Manchester city-wide Child & Adolescent Mental Health Service.
The Child & Adolescent Mental Health Service (CAMHS)
Directorate was formed on 1 January 2001, through the merger
of the services provided by South Manchester University Hospitals
NHS Trust, Central Manchester Healthcare NHS Trust and
Mancunian Community Healthcare NHS Trust, with services
provided by Manchester Children’s Hospitals NHS Trust.
The Directorate provides district Child and Adolescent Clinical
Psychology Services in Manchester and Salford, and a Greater
Manchester inpatient service for children and young people up to
the age of 14 years. The University of Manchester’s Academic
Department of Child Psychiatry is located within the Directorate.
The Academic Department attracts substantial grant income and
is an internationally renowned centre of excellence. Clinical and
academic departments play a major role in teaching and training.
The priorities for the coming year include:
●
●
Developing a Directorate Clinical Governance Strategy.
Recruiting to key posts: Family Therapist and Senior Nurse.
The fundamental issue of the clinical governance agenda is the
implementation of a culture, which allows staff to continually
improve the clinical quality of services provided for children.
It requires a combination of the right environment, appropriate
education and the involvement of staff, patients and their families.
The Trust’s strategy was led jointly by the Medical Director and
the Director of Nursing through the Clinical Governance Coordinating
Group. This group brought together all the essential
elements of clinical governance into one consolidated body.
There was also a Clinical Governance Forum which provided an
opportunity for all clinical staff in the multi-disciplinary
professions to come together to examine, explore, challenge and
advise on core clinical quality issues.
During 2000/01 the Trust:
● Developed a Consultant appraisal manual, which will be
reviewed in the light of national advice.
● Continued to develop information for patients and their
families. A consumer satisfaction survey was carried out to
measure parents/carers’ satisfaction with the explanation of
proposed treatment, risks and alternatives given to them by
our healthcare professionals.
- 97% of respondents were satisfied with the
explanation of proposed treatment.
- 98% of respondents felt they had made an informed
decision.
● Submission of bids with partner agencies for Children’s Fund
monies.
New appointment:
Dr R Refaat, Consultant Child & Adolescent Psychiatrist.
The key priorities for 2001/02 include:
● The further development of a clinical risk management
framework.
● A Children’s National Service Framework is being produced
and this will drive the clinical priorities for children’s issues.
The formation of the new Trust will require a change in
organisational arrangements for clinical governance.
36
Annual Report 2000 ~ 2001

Director: Mr C Fitzpatrick
Budget: £4.3 million
Capital Programme: £2.06 million
Staff: 91
As part of a consumer satisfaction survey measuring the level of
privacy and dignity awarded to patients and their families,
parents were asked to comment on the issue of single sex wards.
Of the 69 parents whose children were on the main wards, only
2 (2.89%) of parents stated that their child would have been
more comfortable on a single sex ward.
The NHS Plan requires all hospitals to provide a healthcare
environment, which is capable of meeting the demands of the
modern health service. This means that buildings should be
energy-efficient, sustainable, accessible and capable of
accommodating changes brought about by medical advances.
To deliver the Plan we started to make significant improvements.
Following an audit by the NHS Executive Patient Environmental
Action Team, we were given an amber traffic light for both the
children’s hospitals. This indicates satisfactory performance.
We received £100,000 from the NHS Cleanliness in Hospitals
initiative. This was invested in a number of patient flow areas
including the main corridor at Royal Manchester Children’s
Hospital and the Outpatient Department at Booth Hall
Children’s Hospital.
●
The capital investment programme included:
- A major upgrading of Theatre 3 at Booth Hall
Children’s Hospital.
- “Electricity at Work” improvements, fire precautions
and health and safety,
- We received one of the highest awards in the North
West, £660,000, as part of the NHS modernisation
programme, to upgrade the Accident & Emergency
Department at Booth Hall Children’s Hospital.
Key developments in 2000/01 included:
● Developing plans in line with the ‘Improving Working Lives’
initiative.
● Preparing for ‘Investor in People’ accreditation.
●
We are moving towards a 24-hour catering service and have
made many improvements to our menus.
●
As an accredited centre, we had many successes in the
achievement of NVQ qualifications:
●
●
●
We have started to develop ward housekeepers whose duties
include ensuring that meals are delivered on time.
We will be reviewing car parking facilities.
Single Sex Wards: within the limitation of resources there is
an attempt to segregate children by age and sex. At present,
Ward 15, the Child & Adolescent Psychiatric Unit, is the only
ward within the Children’s Hospitals to provide single sex
rooms. Focus Group work undertaken in 1999 reconfirmed
that children prefer to be segregated according to age rather
than sex. Whenever possible, adolescents are offered
cubicles on request, subject to availability.
●
- Levels 3/4 in Management were offered for the first time.
- 6 candidates successfully completed Level 3 in Acute Care,
with a further 12 commencing in March 2001.
- We continued to offer Assessor/ Verifier awards to support
the whole NVQ process.
- We trained 50 clinical staff from across the North West, in
Advanced Paediatric Life Support.
Preparing for the merger with Central Manchester Healthcare
NHS Trust by jointly reviewing and developing Human
Resource policies and procedures for the new Trust. Working
closely with staff organisations, agreed policies were
transferred over and plans are now being made to deliver
joint training.
Annual Report 2000 ~ 2001
37

●
Successfully transferring staff from other hospitals, to form a
city-wide Child & Adolescent Mental Health Services
(CAMHS).
●
Local Pay Bargaining: The Trust has not pursued any local pay
bargaining initiatives during the year.
30.3
●
●
The many service developments and reconfigurations over
future years will need to be matched by robust workforce
plans. Thus the Trust continued to participate in the work of
the Greater Manchester Workforce Development
Confederation in securing both pre and post registration
training places and funds.
Continuing our commitment to promote equal opportunities
in all aspects of employment and service delivery.
242.6 300.5
87.2
109.3
679.6
●
●
●
●
●
●
Launching the Trust’s new Anti-Harassment and Bullying
Policy, supported by awareness training.
Successfully implementing the Zero Tolerance campaign,
which has been supported by comprehensive training.
Consulting staff and seeking their views through:
- An annual survey, which has highlighted issues to be
addressed over the next twelve months.
- The local staff Joint Consultation Committee.
- Looking to build on traditional mechanisms, through wider
initiatives.
Equal opportunities and diversity have been incorporated
into regular courses provided by the Trust, for example,
recruitment and selection, and anti-harassment courses. A
bid for ‘Improving Working Lives’ monies has been submitted
so that additional training in equal opportunities can be
provided. The Trust continued its commitment to attracting
more ethnic minority staff into our hospitals.
The Trust continued to hold the ‘Two Ticks’ award for
achieving high standards in both the employment and
treatment of disabled people. A new job application form has
been implemented which provides information on our
guaranteed interview scheme.
Staff organisations continued to participate in the Private
Finance Initiative (PFI) project as we work towards the
selection of a preferred partner to build our new hospital.
Administration & Estates
Medical & Dental Consultant Staff
Other Medical & Dental Staff
Nursing
Scientific, Therapeutic & Technical
Senior Managers
Number of staff by whole time equivalent employed at March
2001.
In October 2000, a joint IM&T Strategy for the Manchester
Children’s Hospitals and the Central Manchester Hospitals was
approved by the two Trust Boards. The IM&T Strategy includes a
major procurement for Trust-wide clinical systems.
A Business Case to support a £550,000 investment in the two
Children’s Hospitals local networks was supported and approved.
The network includes:
● A high-speed cabling backbone at each hospital site with
network access points available in Wards and Offices.
● A direct link between the two Children’s Hospitals, which has
been installed, along with a link from each hospital to
Manchester Royal Infirmary.
● The new network will support data, telemedicine and video
conferencing and will provide a robust and resilient network
infrastructure, which will facilitate delivery of hospital
services to Clinicians and support staff.
In addition to the network investment, a number of computers
have been purchased which will provide additional E-mail and
NHSnet access for clinical staff. This will help us to achieve the
first target outlined in the national NHS policy, Building the
Information Core - Implementing the NHS Plan.
38
Annual Report 2000 ~ 2001

Clinical Director: Dr J Walter (until 31.3.01)
Dr M Bone (from 1.4.01)
General Manager: Mrs J Shaw
Budget: £16.75 million
Staff: 512
2000/01 was a successful year with significant achievements.
These included:
● Developing new nursing roles with the aim of improving the
quality of services provided for children. We appointed:
Key developments in the Medical Directorate in 2000/01
included:
● Centralising the Paediatric Intensive Care services on to the
Royal Manchester Children’s Hospital site, where 15 beds are
provided.
● Establishing a Critical Care Unit at Booth Hall Children’s
Hospital to ensure the safety of patients admitted to Booth
Hall.
● Opening a day unit for cancer patients at Royal Manchester
Children’s Hospital. This will reduce the incidence of cancer
patients having to be admitted to other wards in the hospital
and will ensure day patients can receive their chemotherapy
as required.
● Funding our third Macmillan Nurse.
● Developing a multidisciplinary nutritional care team at Booth
Hall Children’s Hospital. This team supports the
gastroenterology patients and their families.
● Developing home intravenous therapy for children with cystic
fibrosis. This reduces the number of hospital admissions for
children with this disease.
● Developing a managed clinical networking arrangement with
Alder Hey Children’s Hospital for children requiring
interventional cardiology procedures. New recommendations
made by the British Paediatric Cardiac Association prevent
interventional cardiac catheterisation procedures being
performed at Royal Manchester Children’s Hospital. Children
requiring these procedures are now admitted to Alder Hey
Children’s Hospital and treated there by their consultant from
Royal Manchester Children’s Hospital.
New appointments:
Dr A Akobeng, Consultant Paediatric Gastroenterologist
Dr E Estlin, Macmillan Cancer Relief Consultant in Paediatric Oncology
Dr C Hall, Consultant Paediatric Endocrinologist.
●
●
●
- A Nurse Consultant/Head of Nursing Practice. This post
spans the Paediatric Accident & Emergency Services at
both Manchester Children’s Hospitals and Manchester
Royal Infirmary.
- Two Surgical Nurse Practitioners to establish a preoperative
assessment service for surgical patients. Prior to
admission, children are assessed by the Nurse Practitioners
to reduce pressure on the junior doctors.
- A Practice Placement Nursing Officer with the aim of
supporting nursing students in their clinical placements.
This supporting role will assist in reducing the number of
students who drop out of the nurse training programme.
- A Practice Educator who supports newly recruited ‘D’ and
‘E’ grade nurses to develop individual portfolios.
- Ten full time Nurse Practitioner Teachers, who are ward or
unit based, to look specifically at continuing professional
development of registered nurses and student nurses.
- One of our Clinical Nurse Managers to lead the
development and implementation of the National Booked
Admissions programme. This involves agreeing prearranged
appointments for children for outpatient
attendances and elective surgical admissions at a date that
is convenient for the child and the family.
The Department of Clinical Practice went on line on lst
September 2000. This Department will support the
development and expansion of the clinical governance and
shared governance agendas.
A new drug error framework was introduced to manage drug
errors. This will support the investigation of drug errors with
the aim of learning from any mistakes.
The leadership programme ‘Thinking Leadership’ which we
developed in partnership with the University of Leeds, and
which our Continuing Education Department is licensed to
Annual Report 2000 ~ 2001
39

offer, has now successful achieved the throughput of 6
groups of professional staff.
This programme aims to provide delegates with new and
innovative ways to improve efficiency, effectiveness and
creativity skills.
In 2001/02 a Family Support service will be established to
provide advice to parents/carers and staff.
The Trust was the lead organisation for non-medical education
and training for the Child Health Special Interest Group
throughout Greater Manchester.
●
●
●
●
Clinical Biochemistry introduced ward-based testing on both
the Intensive Care and Critical Care wards. This means that
doctors can have faster access to patient tests, particularly
out of normal working hours.
Clinical Biochemistry now provides specific haemoglobin
tests in the Diabetic Clinics. This means that test results can
be received whilst the patient is still in the clinic.
Histopathology extended its Perinatal Pathology Service to
hospitals across the North West Region and undertook extra
work from Coroners across the Region.
The Consultant Pathologists continued to be closely involved
in the United Kingdom Childhood Cancer Study Groups and
hosted meetings with Pathologists from around the world.
●
Haematology purchased a new IT system. This system is
used at both children’s hospitals and encompasses
Haematology and Blood Transfusion.
●
New blood analysers have been purchased for both sites.
●
Microbiology has implemented changes in its IT system and
now offers an improved result reporting service to its users
with automatic faxing of blood culture results.
●
The identification of M.R.S.A. is now undertaken “in house”,
allowing a significant reduction in time to reporting.
2001/02 will see the continued development of plans for the
transfer of the Children’s Pathology Services to the new hospital
when it is built on the Central Manchester site.
Radiology
Clinical Director: Dr A Kelsey
General Manager: Mr A Milford
Budget: £5.1 million
Staff: 114
There have been some major improvements in the Radiology
Department. These included:
● Introducing a CT Scanner service at Royal Manchester
Children’s Hospitals.
Pathology
During 2000/01 there have been some significant changes that
have affected Pathology both as a whole and some which are
specific to the individual specialties within Pathology. These
included:
● Applying for Clinical Pathology Accreditation. This involved a
major inspection of the laboratories in March 2001 to verify
our compliance.
●
●
Involving the Magnetic Resonance Imaging Department as a
pilot site for the implementation of the National Booked
Admission Project, with plans to expand this to the whole
Radiology Department.
Being award, as a part of the national CT Scanner
replacement programme, a state-of-the-art multi-slice
replacement CT Scanner for Booth Hall Children’s Hospital.
This will take images in the quickest possible time and will
result in many children having scans on an outpatient basis
40
Annual Report 2000 ~ 2001

instead of having to be admitted as a day case. It is planned
to install the Scanner during 2001/02.
●
Following a successful business case for funding, a new
Cardiac Catheterisation suite will be installed at Royal
Manchester Children’s Hospital during 2001/02.
●
A business case is being completed for the replacement of
the Fluoroscopy Rooms at both Booth Hall Children’s
Hospital and Royal Manchester Children’s Hospital.
New appointment:
Dr U Hughes, Consultant Paediatric Radiologist.
●
Involvement of one of our Dietitians in a large research
project investigating different types of gastrostomy feeds.
●
Developing a Nutrition Screening Tool so that patients can
be screened on admission.
The Trust ensured that all complainants, written and verbal,
received full explanations and an apology where necessary.
Clinical Director: Mr A Gibson
General Manager: Ms L Thompson
Budget: £5.4 million
Staff: 132
There was a reduction in the number of complaints received
during the year. We aimed to resolve verbal complaints at an
informal level through our front line staff who received training in
managing complaints.
The Directorate comprises the following services:
● Audiology
● Chiropody
● Medical Illustration
● Nutrition & Dietetics
● Occupational Therapy
● Optical Services
● Pharmacy
● Physiotherapy
● Speech & Language Therapy
Achievements during the year included:
The Trust’s overall response time increased, one of the reasons for
this was the complexity of some of the cases we investigated.
During the year we received a total of 128 complaints compared
with 142 in 1999/2000. This is a reduction of 10%.
We resolved 81 (63%) of complaints within 4 weeks and the
remainder within 13 weeks.
Three requests for Independent Review were received in 2000/01
compared with two in 1999/2000. Two requests were refused
and the third request was accepted for Independent Review, a
decision is awaited from the panel.
●
Developing a drug expenditure report by specialty.
●
Introducing a 7-day Pharmacy Aseptic Service.
●
Ongoing development of a Macmillan physiotherapy post,
which has gained national interest.
Annual Report 2000 ~ 2001
41

Types of Complaints received in 2000/01
5%
1%
12%
23%
●
●
Reviewing the training needs of administrative staff including
communication skills.
Establishing parents’ accommodation on Ward 6 at Booth
Hall Children’s Hospital.
15%
9%
●
Reviewing the outpatient system. We worked with
Consultants to try and ensure the smooth running of clinics.
12%
23%
Inpatient waits
Clinical treatment
Attitude of staff
Admissions
Outpatient waits
Communication
Consent to treatment
Other
Types of Complaints received 1999/2000
Director of Research and Development:
Dr M Lewis
Research and Development plays an important role in
20%
24%
maintaining our reputation as a centre of excellence and forms
part of our Clinical Governance framework. It ensures that
6%
patient healthcare is evidence-based and therefore clinically
effective.
12%
19%
The five current activity areas (themes) are:
Inpatient waits
Clinical treatment
Communication
19%
Outpatient waits
Staff Attitude
Other
●
●
●
●
●
Cancer and Haematology
Cardiovascular, Respiratory and Trauma
Clinical and Biochemical Genetics
Growth Nutrition and Excretion
Mental Health and Neurosciences
All complainants were offered the opportunity to meet with staff
involved in investigating their complaint when they received the
final written response from the Chief Executive.
In 2000/01 external funding research rose by over a million
pounds to just over £3 million.
Key activities during the year included:
Some of the improvements we made as a result of complaints
received during 2000/01 included:
● Improving the information sent to parents whose child is
being admitted for surgery.
●
Re-aligning our activity areas to the five research themes,
each of which have two theme leaders. The aim of this
process was to stimulate high quality research in particular
areas.
●
●
Improving the use of the Named Nurse philosophy.
Ensuring that parents are aware of the time their child will
go to theatre.
● Continuing to support the National Research Register, which
is a national database of all NHS research projects. We
submitted 114 research projects, all of which were accepted.
Over the next few months the research databases of the two
former Trusts, Manchester Children’s Hospitals and Central
Manchester Healthcare NHS Trusts will be merged.
42
Annual Report 2000 ~ 2001

Clinical Director: Mr J Bruce (until 31.1.01)
Miss G Humphrey (from 1.2.01)
General Manager: Mrs F Williams
Budget: £9.8 million
Staff: 386
During 2000/2001 there were a variety of service improvements,
developments and changes that included:
●
Appointing two new Consultant Paediatric Surgeons, thus
enabling an increase in the number of Consultant Paediatric
Urologists.
●
Developing two ENT Nurse Practitioner posts which have
responsibility for pre-admission clinic work, providing support
and care to children in the speciality; thus helping to improve
the care of children, whilst at the same time reducing junior
doctor duties.
During the early part of 2001/02, the Directorate has been
involved in discussions about developing the following major
services:
●
Extending the service provided for babies, who have bladder
extrophy, through the development of a national service in
conjunction with Great Ormond Street Children’s Hospital.
●
Preparing a service case for developing the Burns Unit at
Booth Hall Children’s Hospital as a supra-regional centre.
●
The ongoing development of the limb correction services has
been formally evaluated, and as a consequence, has enabled
the appointment of an External Fixator Sister.
●
Appointing two additional Orthopaedic Surgeons, one of
which is proleptic, to meet the increasing demands on this
speciality.
●
Evaluating the possibility of transferring paediatric plastic
surgical cases from Withington Hospital to Booth Hall
Children’s Hospital.
New appointments:
Mr J Morecroft, Consultant in Paediatric Surgery
Miss G Humphrey, Consultant in Paediatric Surgery
Mr J Thorne, Consultant Neurosurgeon.
Annual Report 2000 ~ 2001
43

45000
40000
35000
30000
25000
20000
15000
10000
5000
0
1998 - 1999
1999 - 2000
2000 - 2001
In Patients ~ Elective In Patients Emergency Day Cases Total
In-patient/Day Case Activity
1998/99 1999/00 2000/01
In-patients-Elective 7,594 7,128 6,720
In-patients-Emergency 12,953 12,252 12,681
Day Cases 8,518 9,653 10,631
Total 29,065 29,033 30,032
In-patient/Day Case Activity
90000
80000
70000
60000
50000
40000
30000
20000
10000
1998 - 1999
1999 - 2000
2000 - 2001
Out-patients
1998/99 1999/00 2000/01
First attendances (new) 18,897 19,356 19,736
Follow-up attendances 60,302 61,602 63,872
Total 79,199 80,958 83,608
0
First attendances (new)
Follow-up attendances
Total
Out-patients
1998 - 1999
50000
1999 - 2000
2000 - 2001
A&E Attendances
40000
30000
20000
10000
1998/99 1999/00 2000/01
First attendances (new) 21,751 21,837 23,451
Follow-up attendances 3,804 4,171 4,359
Total 25,555 26,008 27,810
5000
0
First attendances (new)
Follow-up attendances
Total
A&E Attendances
44
Annual Report 2000 ~ 2001

Day Case Activity
1998/99 1999/00 2000/01
Day Cases as a % of Elective Activity 52.8% 57.5% 61.3%
Day Cases as a % of Total Activity 29.3% 33.2% 35.4%
Out-patient Waiting Times
Percentage of patients seen within 30 minutes
1998/99 1999/00 2000/01
1st Quarter - 90.5% 76.1%
2nd Quarter - 90.8% 63.6%
3rd Quarter - 91.1% 64.4%
4th Quarter - 90.1% 63.7%
Total average for Year - 90.6% 67.0%
Waiting Lists – as at 31st March 2001
In-patient
Total on Waiting List 1,894
Patients waiting 12-18 months 216
Patients waiting over 18 month 0
Cancelled Operations
1998/99 1999/00 2000/01
Operations cancelled on day of operation 238 220 167
Number of cancelled operations performed within one month 193 182 140
Operations cancelled for a second time 2 3 6
Emergency Admissions
1998/99 1999/00 2000/01
Number of patients admitted as emergencies through the
A&E Department 264 232 285
Number of patients admitted within 2 hours of the
decision to admitted 258 221 282
Number of patients admitted after 2 hours 6 11 3
Bed Usage
Average In-patient length of stay days = 2.3
Average bed occupancy rate = 70%
Other Totals for 2000/01:
Bone Marrow Transplants 27
Renal Transplants 12
Titanium Implants 7
Annual Report 2000 ~ 2001
45

I am pleased to be able to report that the financial statements,
which follow, demonstrate that in 2000/2001 the Trust once
again achieved all three of its required financial duties.
Taking each of the Trust’s main financial duties in turn:
1. To at least break-even
The Trust is required by statute to ensure that its income is at
least sufficient to cover its expenditure “taking one year with
another”. With total income of £69,378,000, operating
expenditure of £67,233,000 and other costs (principally net
financing costs) of £2,141,000, the out-turn for the year was a
small surplus of £4,000.
2. To remain with the approved External
Financing Limit.
days and therefore over-achieved the current 95%
compliance target. Performance for the year maintained the
compliance achieved in 1999/2000. (full details are provided
on page 55).
ii) Management and Administration Costs
The NHS Executive set the Trust a management cost target
of £2,717,000 for financial year 2000/2001. The actual
management and administration costs were £2,700,700,
which represents 3.9% of the Trust's total income.
(full details are provided on page 55).
The Trust has a further duty to ensure that it uses the resources
provided to best effect. This is achieved through the active
participation of clinical staff at all levels of decision and policy
making.
The External Financing Limit is a control set by the NHS Executive
on the net cash outflow of the Trust. The Trust is set a target,
which is either positive or negative, depending on whether the
Trust has to borrow funds, or has sufficient cash balances to meet
its capital expenditure commitments. Either way this target must
not be exceeded. The Trust's financing limit for 2000/2001 was
positive £39,000. The actual financing requirement was negative
£3,000 and therefore the Trust undershot its target by £42,000,
which was within the permitted tolerance.
3. To achieve a Capital Cost Absorption
Rate of 6.0%
The Trust is required to absorb the cost of capital at a rate of 6%
of average relevant net assets. The Trust paid in cash a total of
£2,207,000 in respect of dividends on Public Dividend Capital.
The average relevant net assets for the year were £36,155,000,
which therefore produces a capital cost absorption rate of 6.1%.
In addition to those duties described above, the Trust must also
report on its performance against the Public Sector Payment
Policy target and the level of its Management Costs.
i) Public Sector Payment Policy
In addition to the main financial statements that follow, full
details of directors’ remuneration are provided on pages 53
and 54.
The Trust participates in the Greater Manchester Education and
Training Consortium. Trafford Healthcare NHS Trust, as lead trust
for the consortium, accounts for the consortium’s income and
expenditure.
The financial performance in 2000/2001 continues the pattern of
firm financial control established since the inception of the Trust
in 1995. The sound financial position has allowed the Trust to
finance significant developments in clinical services whilst
continuing to maintain the estates infrastructure and replace
medical equipment. This has been achieved in collaboration with
Health Commissioners, Primary Care Groups, Primary Care Trusts
and the NHS Executive North West, each of whom plays an
important role in making available the resources necessary for
the provision of health care services and capital investment.
In conclusion, therefore, I would like to thank all Trust staff for
their continued efforts to deliver increased levels of patient care
at consistently high standards, along with a demanding
management agenda, within the resources available to the Trust.
The NHS Executive requires that Trusts pay their non-NHS
trade creditors in accordance with the CBI (Confederation of
British Industries) prompt payment code and Government
accounting rules. The Trust's performance demonstrates that
97% of its invoices were paid within agreed terms or 30
J. Wilbraham
Acting Director of Finance
46
Annual Report 2000 ~ 2001

Statement of the Chief Executive’s responsibilities as the Accountant Officer of the Trust.
The Secretary of State has directed that the Chief Executive should be the Accountable Officer to the Trust. The relevant responsibilities
of Accountable Officers, including their responsibility for the priority and regularity of the public finances for which they are answerable,
and for keeping of proper records, are set out in the Accountable Officers’ Memorandum issued by the NHS Executive.
To the best of my knowledge and belief, I have properly discharged the responsibilities set out in my letter of appointment as an
Accountable Officer.
Acting Chief Executive
August 2001
Compliance Statement on NHS Managers’ Pay
The Chief Executive of the NHS Executive’s letter of 16th March 2000 to Chief Executives about NHS managers’ pay in 2000/01 has
been complied with. Pay rises for senior managers at the trust did not exceed 3.25%.
Statement of Directors’ Responsibilities in respect of the Accounts
The Directors are required under the National Health Services Act 1977 to prepare accounts for each financial year. The Secretary of
State with the approval of the Treasury, directs that these accounts give a true and fair view of the state of affairs of the Trust and of the
income and expenditure of the Trust for that period. In preparing those accounts, the directors are required to:
●
Apply on a consistent basis accounting policies laid down by the Secretary of State with the approval of the Treasury;
●
Make judgements and estimates which are reasonable and prudent;
●
State where applicable accounting standards have been followed, subject to material departures disclosed and explained in the
accounts.
The directors confirm they have complied with the above requirements in preparing the accounts.
The directors are responsible for keeping proper accounting records which disclose with reasonable accuracy at any time the financial
position of the Trust and to enable them to ensure that the accounts comply with requirements outlined in the above mentioned
direction of the Secretary of State. They are also responsible for safeguarding the assets of the Trust and hence for taking reasonable
steps for the prevention and detection of fraud and other irregularities.
Acting Chief Executive
August 2001
Annual Report 2000 ~ 2001
47

Statement of Directors’ Responsibility in respect of Internal Financial Control
The Chief Executive as Accountable Officer, together with the other directors, has a responsibility for ensuring that an effective system of
internal financial control is operated in connection with the organisation’s resources. To be effective the system must provide reasonable
assurances of:
a) the safeguarding of assets against unauthorised use or disposal;
b) the maintenance of proper accounting records; and
c) the reliability of financial information used within the organisation or for external publication.
No system can provide absolute assurance against material mis-statements or loss but the system should provide reasonable assurance
that material errors, irregularities or fraud are either prevented or would be detected within a timely period.
The Chief Executive, as Accountable Officer, together with the other directors, have a responsibility for reviewing the effectiveness(*) of
the organisation’s system of internal financial control. In carrying out the review in accordance with HSG(97)17 and EL(97)55 directors
are required to confirm that the “minimum control standards” laid down by the NHS Executive (appended to this statement) have been
in existence within the organisation throughout the financial year.
The directors confirm that they have undertaken the review and the above requirements have been met.
By order of the Board.
Acting Chief Executive
August 2001
*The judgement on “effectiveness” is informed by the work of the internal auditors and managers who have responsibility for the
development and maintenance of the financial control framework and by the comments made by the external auditors in their
management letter and other reports.
48
Annual Report 2000 ~ 2001

Key financial Controls 2000/2001.
The Minimum Control Standards
1. The Control Environment
Minimum Control Standards
1.1. Standing Orders are in place
1.2. Standing Financial Instructions are in place.
1.3. There is compliance with the Secretary of State’s
Directions on fraud and corruption.
1.4. There is an Audit Committee in place.
1.5. There is a Remuneration Committee in place.
1.6. There is an adequate Internal Audit Function.
1.7. There is a mechanism in place to facilitate control
over the acquisition, use, disposal and safeguarding
of assets.
1.8. There is a budgetary control system in place.
2. Identification and Evaluation
of Business Risks
Minimum Control Standards
2.1 There is an annually produced Business Plan.
3. Information and Communication
Minimum Control Standards
3.1 There are systems in place which produce reliable
financial information and proper accounting records.
3.2 There are controls in place concerning the security of
financial systems and data.
4. Control Processes
Minimum Control Standards
4.1 Procedure notes are in place for all significant and
fundamental financial systems.
4.2 Financial systems are subject to Internal Audit coverage.
4.3 There has been adherence to the mandatory
requirements contained within the current NHS
Executive costing guidance.
5. Monitoring
Minimum Control Standards
5.1 The Audit Committee reviews and monitors internal
financial Control and the implementation of agreed
control improvements.
5.2 The Board regularly receives and reviews financial and
performance reports.
Independent Auditors Report to the Directors of Manchester Children’s Hospitals
Summary Financial Statements
We have examined the summary financial statements set out on pages 50 to 55 and the director’s statement on internal financial
control.
Respective responsibilities of Directors and Auditors
The directors are responsible for preparing the Annual Report. Our responsibility is to report to you our opinion on the consistency of the
summary financial statements and the directors’ statement on internal financial control with the statutory financial statements. We also
read the other information contained in the Annual Report and consider the implications for our report if we become aware of any
misstatements or material inconsistencies with the summary financial statements.
Basis of Opinion
We conducted our work in accordance with Bulletin 1999/6 ‘The auditor’s statement on the summary financial statements’ issued by the
Auditing Practices Board for the use in the United Kingdom.
Opinion
In our opinion the summary financial statements and the directors’ statement on internal financial control are consistent with the
statutory financial statements of the Trust for the year ended 31 March 2001 on which we have issued an unqualified opinion.
Mick Waite:
District Audit, Sumner House, St. Thomas’s Road, Chorley, Lancashire PR7 1HP
8th August 2001
Annual Report 2000 ~ 2001
49

2000/2001 1999/2000
£000 £000
Income from activities:
Continuing operations 57,299 51,884
other operating income 12,079 11,301
Operating expenses:
Continuing operations (67,233) (60,999)
OPERATING SURPLUS/(DEFICIT)
Continuing operations 2,145 2,186
Cost of fundamental reorganisation/restructuring 0 0
Profit/(loss) on disposal of fixed assets 2 0
SURPLUS/(DEFICIT)BEFORE INTEREST 2,147 2,186
Interest receivable 106 119
Interest payable (42) (287)
SURPLUS/(DEFICIT) FOR THE FINANCIAL YEAR 2,211 2,018
Public Dividend Capital dividends payable (2,207) (1,977)
RETAINED SURPLUS (DEFICIT) FOR THE YEAR 4 41
Above is a summary of the Trust’s financial performance for the year ended 31st March 2001. For a full set of the Trust’s audited annual
accounts please write to Mr J Wilbraham, Acting Director of Finance, Central Manchester and Manchester Children’s University Hospitals
NHS Trust, Cobbet House, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL.
A prior period adjustment has been made in respect of downward revaluations of fixed assets which were previously treated as
impairments. The adjustment removes their effect on the Income and Expenditure Account; instead charging them in the Revaluation
Reserve. The associated accruals for income and repayment of Public Dividend Capital and for transfers between the Revaluation Reserve
and the Income and Expenditure Reserve have also been written back. The prior period adjustments are:
For the changed approach to the revaluation:
- a reduction in the Revaluation Reserve
- an increase in the Income and Expenditure Reserve
Write back of the associated accurals:
- a reduction in the Income and Expenditure Reserve
- a reduction in debtors
- a reduction in creditors
- an increase in Public Dividend Capital
Each of the above adjustments is for £843,000.
50
Annual Report 2000 ~ 2001

31 March 2001 31 March 2000
£000 £000
Fixed Assets
Intangible assets 59 0
Tangible assets 43,594 42,964
43,653 42,964
Current Assets
Stocks and work in progress 882 900
Debtors:
Amounts falling due after one year 0 929
Within one year 5,908 3,553
Investments 0 0
Cash at bank and in hand 176 134
6,966 5,516
Creditors:
Amount falling due within one year (5,896) (5,454)
NET CURRENT ASSETS/(LIABILITIES) 1070 62
TOTAL ASSETS LESS CURRENT LIABILITIES 44,723 43,026
Creditors:
Amount falling due after more than one year (32) (27)
PROVISIONS FOR LIABILITIES AND CHARGES (2,491) (1,194)
TOTAL ASSETS EMPLOYED 42,200 41,805
FINANCED BY: CAPITAL AND RESERVES
Public dividend capital 30,862 30,823
Revaluation reserve 5,557 5,741
Donation reserve 5,285 5,359
Realised donation reserve 0 0
Other reserves 7 7
Income and expenditure reserve 489 (125)
TOTAL CAPITAL AND RESERVES 42,200 41,805
Annual Report 2000 ~ 2001
51

31 March 2001 31 March 2000
£000 £000
Operating Activities
Net cash inflow from operating activities 4,221 3,721
Returns on investments and
servicing of finance:
Interest received 106 120
Interest paid 0 (242)
Interest element of finance leases 0 0
Net cash (outflow) from returned on
investments and servicing of finance 106 (122)
Capital Expenditure
Payments to acquire tangible fixed assets (2,307) 1,780
Receipts from sale of tangible fixed assets 3 0
(Payments to acquire)/receipts from sale of tangible assets (59) 0
Net cash (outflow) from capital expenditure (2,363) (1,780)
Dividends Paid (2,207) (1,977)
Net cash inflow(outflow) before management of
liquid resources and financing (243) (158)
Management of Liquid Resources
Purchase of investments 0 0
Sale of investments 0 0
Net cash inflow(outflow) from management of
liquid resources 0 0
Net cash (outflow) before financing (243) (158)
Financing
Public dividend capital received 39 0
Public dividend capital repaid (not previously accrued) 0 (100)
Public dividend capital repaid (accrued in prior period) 0 0
Loans received 0 0
Loans repaid 0 0
Other capital receipts 246 330
Capital element of finance leases 0 0
Cash transferred from/to other NHS bodies 0 0
Net cash inflow(outflow) from financing 285 230
Increase/(decrease) in cash 42 72
52
Annual Report 2000 ~ 2001

31 March 2001 31 March 2000
£000 £000
Surplus/(deficit) for the financial year before dividend payments 2,211 2,018
Fixed asset impairment losses 0 (3,863)
Unrealised surplus/(deficit) on fixed asset revaluations/indexation 511 5,804
Increases in the donation reserve due to receipt of donated asset 246 443
Reduction in the donation reserve due to depreciation/ disposal of donated assets (405) (771)
Additions/(reductions) in other reserves’ 0 0
Total recognised gains and losses for the financial year 2,563 3,631
Prior period adjustment (843) 338
Total gains and losses recognised in the financial year 1,720 3,969
DIRECTORS’ REMUNERATION
Remuneration Other 2000/2001 1999/2000
as Director Remuneration Total £000
£000 £000 £000 £000
Non-Executive Directors’ Remuneration 44 0 44 45
Executive Directors’ Remuneration:
Basic Salaries 237 89 326 301
Benefits 6 0 6 7
Performance related bonuses 21 0 21 25
Pensions contributions paid 15 0 15 12
279 89 368 345
Compensations for loss of office 0 0 0 0
Pensions for Directors and former Directors
(other than from the NHS Pension Scheme) 0 0 0 0
Total Directors’ Remuneration 323 89 412 390
Performance related bonuses were calculated in accordance in with the guidance contained in Health Circular HC(90) issued by the
Department of Health.
Annual Report 2000 ~ 2001
53

THE REMUNERATION OF THE CHAIRMAN, CHIEF EXECUTIVE AND (WHERE THE CHIEF EXECUTIVE IS
NOT THE HIGHEST PAID MEMBER) THE HIGHEST PAID DIRECTOR, ARE AS FOLLOWS:
Remuneration Other 2000/2001 1999/2000
as Director Remuneration Total £000
£000 £000 £000 £000
Chairman
Basic Remuneration 18 0 18 18
Benefits 1 0 1 0
19 0 19 18
Chief Executive
Basic Salary 67 0 67 67
Benefits 3 0 3 3
Performance related bonuses 13 0 13 9
83 0 83 79
Pensions contributions 4 0 4 3
87 0 87 82
Highest Paid Director*
Basic Salary 12 89 101 92
Benefits 0 0 0 0
Performance related bonuses 0 0 0 0
12 89 101 92
Pensions contributions 1 3 4 3
13 92 105 95
*Where Chief Executive is not the highest paid member.
DIRECTORS’ REMUNERATION (EXCLUDING PENSION CONTRIBUTIONS) FELL WITHIN THE
FOLLOWING RANGES:
2000/2001 1999/2000
£0 - £5,000 - -
£5,001 - £10,000 5 5
£10,001 - £15,000 - -
£15,001 - £20,000 1 1
£20,001 - £25,000 1 1
£25,001 - £30,000 1 -
£30,001 - £35,000 1 -
£35,001 - £40,000 1 -
£40,001 - £45,000 - 1
£45,001 - £50,000 - -
£50,001 - £55,000 - 1
£55,001 - £60,000 1 -
£60,001 - £65,000 - -
£65,001 - £70,000 - 1
£70,001 - £75,000 - -
£75,001 - £80,000 - 1
£80,001 - £85,000 - 1
£85,001 - £90,000 1 -
£90,001 - £95,000 - -
£95,001 - £100,000 - -
£100,001 - £105,000 - -
£105,001 - £110,000 1 -
£110,001 - £115,000 - -
More than £120,001 - -
Total 13 12
For 2000/01 NHS Trusts have been granted exemption by HM Treasury from following the requirements of Greenbury.
54
Annual Report 2000 ~ 2001

SENIOR EMPLOYEES’ REMUNERATION (EXCLUDING PENSION CONTRIBUTIONS) FELL WITHIN THE
FOLLOWING RANGES:
2000/2001 1999/2000
Medical
£40,001 - £45,000 10 7
£45,001 - £50,000 6 2
£50,001 - £55,000 8 9
£55,001 - £60,000 8 7
£60,001 - £65,000 6 8
£65,001 - £70,000 10 7
£70,001 - £75,000 5 3
£75,001 - £80,000 4 2
£80,001 - £85,000 5 1
£85,001 - £90,000 1 5
£90,001 - £95,000 4 1
£95,001 - £100,000 2 2
More than £100,001 4 1
Administration
£40,001 - £45,000 2 3
£45,001 - £50,000 1 3
Other
£40,001 - £45,000 2 2
£45,001 - £50,000 - 0
£50,001 - £55,000 3 3
Total 81 66
Management Costs 1999/2001 1999/2000
£000 £000
Management Costs 2,701 2,626
Income 69,378 63,185
Management costs as a percentage of Income 3.89% 4.15%
Public Sector Payment Policy - Measure of Compliance
2000/2001 1999/2000
Number £000 Number £000
Total bills paid 27,609 19,428 27,322 17,698
Total bills paid within target 26,832 18,706 26,837 17,251
Percentage of bills paid within target 97.19% 96.28% 98.22% 97.47%
Annual Report 2000 ~ 2001
55