Annual Report - Central Manchester University Hospitals - NHS ...

Annual Report
and
Summary Financial Statements
2008/09

Contents
Message from the Chairman
and Chief Executive . . . . . . . . . . . . . . . . . . . . . .1
All about the Organisation . . . . . . . . . . . . . . . .2
Highlights of the Year . . . . . . . . . . . . . . . . . . . .3
Research & Innovation . . . . . . . . . . . . . . . . . . . 14
Infection Control . . . . . . . . . . . . . . . . . . . . . . . 15
Working at the Trust . . . . . . . . . . . . . . . . . . . . 16
Working with our Patients and Visitors. . . . . . . 17
The New Hospitals Development . . . . . . . . . . .20
Activity and Performance . . . . . . . . . . . . . . . . . 21
Trust Board . . . . . . . . . . . . . . . . . . . . . . . . . . . .22
Statement on Internal Control . . . . . . . . . . . . . 24
Report of the Director of Finance . . . . . . . . . . . 26
Summary Financial Statements . . . . . . . . . . . . .28
Independant Auditor’s Report . . . . . . . . . . . . .37
This report covers 1st April – 30th December 2008. We became Central Manchester University
Hospitals NHS Foundation Trust on 1st January 2009 and there is a separate report covering
1st January – 31st March 2009.
Mission Statement
The Trust aims to become the leading integrated health,
teaching, research and innovation campus in the NHS and
to position itself on an international basis alongside the
major biomedical research centres, as part of the thriving
city region of Manchester – with its strong emphasis on
economic regeneration, science and enterprise.

Annual Report and Summary Financial Statements 2008/09
page 1
Message from the Chairman
and Chief Executive
Welcome to our eighth annual report of Central
Manchester and Manchester Children’s University
Hospitals NHS Trust. We would like to begin this
report by thanking our staff for all their hard
work and dedication over the year, particularly
in preparation of our application to become a
Foundation Trust.
On 17th December 2008 we were pleased to announce that
our Foundation Trust (FT) application had been successful
and that we would become an FT from 1st January 2009.
This report will focus on our nine months as Central
Manchester and Manchester Children’s University Hospitals
NHS Trust and a separate report is available which covers the
new organisation from 1st January.
Our main challenge has been preparing for the opening of
our four new hospitals, including the UK’s largest children’s
hospital in summer 2009.
Our research continues to go from strength to strength
following us becoming one of the nationally renowned
Biomedical Research Centre last year. The Biomedical
Research Centre brings together all the research work going
on at this Trust and University, creating a truly world class
clinical academic campus.
The Health Academy which is to open a year earlier in
September 2009, is the first NHS sponsored Health Academy
to be given the go-ahead.
The Health Academy will be at the site of Brookway High
School in Baguley (Wythenshawe). The original intention
was to open the new Health Academy in new purpose-built
premises in September 2010. Work completing the brand
new £19 million health academy, which includes a new £1
million community library on this site, will continue.
The Academy has already received support from Manchester
United Foundation, which will be working with us to develop
and promote healthy living through sport and the association
with Manchester United, its players and philosophy.
The New Children’s Hospital Appeal which was launched
in May 2006, aims to raise £20 million to support children’s
services across the new hospitals development. The Appeal
has already announced reaching £18 million and work
continues to reach the target. We would like to thank all the
supporters of the Appeal for their hard work in achieving this
amount.
There have been many more developments and
achievements which are highlighted throughout the report.
We are indebted to our staff, for without whom our
achievements would not have been possible.
Peter W Mount CBE
Mike Deegan
Chairman
Chief Executive
Together with our co-sponsors Manchester City Council and
The Manchester College, the Health Academy will provide
600 places for 11-16 year olds with an additional 120 post 16
places from September 2010.

All about the Organisation
Central Manchester and Manchester Children’s
University Hospitals NHS Trust was established on 1st
April 2001 following the merger of Central Manchester
Healthcare NHS Trust and Manchester Children’s
Hospitals NHS Trust.
Our Trust is located in Manchester, just two miles outside the
city centre. It is the leading Trust for teaching, research and
specialist services in the North West of England. We provide
an extensive range of district general hospital services to
the local population of 166,000 residents within central
Manchester and tertiary and specialist services to patients
from across the North West and beyond.
We are a centre of excellence for healthcare research with a
long standing and extremely successful academic partnership
with The University of Manchester. The success of this
partnership now sees the Trust as one of a small number
of organisations in England who have attained Biomedical
Research Centre (BRC) status. We collaborate closely with
other NHS organisations in Greater Manchester and have
strong links with institutions within Manchester such as
the City Council and across the North West and beyond
including the Northwest Regional Development Agency.
We are made up of six hospitals:
■ Booth Hall Children’s Hospital (BHCH)
■ Manchester Royal Eye Hospital (MREH)
■ Manchester Royal Infirmary (MRI)
■ Royal Manchester Children’s Hospital (RMCH)
■ Saint Mary’s Hospital (SMH)
■ University Dental Hospital of Manchester (UDH)
Due to the large size of the organisation, the Trust is
managed by grouping together those departments who
work closely. There are called Divisions and are as follows:
■ Children’s (incorporating Booth Hall and Royal
Manchester Children’s Hospitals)
■ Clinical and Scientific Services
■ Ophthalmic (Eye Hospital)
■ Dental Hospital
■ Medical
■ Saint Mary’s Hospital
■ Surgical
■ Research & Innovation
Highlights of
the year
Sarah Brown Visited The New
Children’s Hospital
Prime Minister’s wife Sarah Brown
visited the new children’s hospital on
22nd September 2008, to see how
the development was progressing
and how money raised by The New
Children’s Hospital Appeal will make a
difference to the lives of children and
their families who will utilise this new
hospital.
Sarah, was joined by Appeal
Chairman Maurice Watkins and
Appeal Patrons Philip and Julie Neville.
(September 2008)
See page 3-15 for all of this year’s highlights
page 2
Central Manchester and Manchester Children’s University Hospitals NHS Trust

Annual Report and Summary Financial Statements 2008/09
page 3
Highlights of the Year
Test Aims to Make Pregnancy Safer
Research midwife Suzanne Moody and her colleagues announced
that they are investigating ways to identify women who are at risk of
developing complications in pregnancy.
By looking at ultrasound scans and markers that show up in blood
tests, they can identify the signs that women may be at risk of
conditions like pre-eclampsia or pre-term birth. These conditions can
be life-threatening to both mother and baby.
The next step is to develop a simple test for all pregnant women, so
that those at risk can receive extra monitoring and treatment to help
stop these conditions developing. It will also mean we can reassure
low risk mums, and make the best use of specialist facilities.
Thanks to extra resources available through the new Manchester
Biomedical Research Centre, the project to identify mums at risk is
being extended, and the scientific development of the blood test will
also take place in Manchester. (May 2008)
Major Investment By BRC Boosts
Disability Diagnosis
Children in the North West with a range of genetic
conditions including learning disabilities now have access
to faster and improved diagnosis, thanks to the new
Manchester Biomedical Research Centre (BRC).
The BRC invested £250,000 in a high resolution chip
analyser. This analyses samples of DNA from patients and
can identify tiny genetic changes which indicate the cause
of a child’s developmental problems.
Each year over a thousand children and their parents are
referred to our clinical genetics department in order to
provide an explanation and a diagnosis for a range of
developmental conditions such as learning disability. These
can now be analysed very quickly using the new chip
analyser in our DNA laboratory.
Conditions such as Downs syndrome are fairly easy to
identify because they have a recognisable pattern of
problems and can be diagnosed by simply looking down a
microscope to count the number of chromosomes a child
has. Other birth defects are extremely varied and we may
not recognise an obvious genetic pattern just from looking
New Facilities for
Manchester Centre for
Sexual Health
A new £3 million sexual health centre
opened on 27th May as a one-stop
for sexual health services. The exciting
new purpose-built NHS facility provides
improved access to advice, treatment,
screening, testing and counselling on
a wide range of sexual health issues
including contraception, pregnancy,
sexually transmitted infections and HIV.
The Hathersage Centre as it is known, is a
drop-in service and provides a new home
for the Manchester Centre for Sexual
Health and the Palatine Contraceptive
and Sexual Health Services (part of NHS
Manchester). (May 2008)
at the patient’s symptoms – this makes a genetic cause
much harder to detect as we have to look at all the genetic
information in detail rather than just focusing on one area.
The high resolution chip analyser means very small changes
can be detected quickly and easily.
Once we have diagnosed the problem, we can work with
the family to explain why such problems have occurred
as well as to look at treatment options for the child. If the
problem is inherited, we can also counsel parents about the
implications if they decide to have another baby.
The new chip analyser is one of very few in the North
West and has a wide range of capabilities. In addition
to diagnosing genetic learning disabilities, scientists and
researchers at the BRC will also use it to diagnose other
inherited conditions as well as to help identify genes
underlying more common conditions such as arthritis.
Some of the families who have already started to benefit
from this resource have been known to the department
for many years and have previously undergone many other
investigations. Now that we have the chip analyser many
children will be diagnosed much earlier and will be spared
the need to have other tests. (May 2008)

page 4
IMPS and Children Join Forces To
Recognise Child Safety Week
The Child Accident Prevention Trust (CAPT) designates one
week every year in the UK as Child Safety Week.
The theme of the most recent campaign was ‘Make a change.
Make a difference’ which sent out the message that even small
changes in our everyday lives can make a big difference to
children’s safety.
Manchester IMPS (Injury Minimisation Programme for Schools)
supported the initiative by running a competition for all
schools who attended IMPS hospital visits to Manchester Royal
Infirmary and Booth Hall.
As well as interactive injury minimisation, first aid activities and
tours of A&E, the IMPS children, aged 10 and 11, from Oswald
Road, Crossacres and Abbott primary schools were asked to
think of small changes that they could make to their routine or
environment that would help to improve safety for all children.
Child Safety Week which ran from 23rd to 27th June aimed
to raise awareness of the impact and consequences that
accidental injury plays in the lives of children, young people
and their families.
It helps the community to better understand and manage the
real risks to children and young people so that t they can enjoy
safer, healthier and more active lives. (June
2008)
Central Manchester and Manchester Children’s University Hospitals NHS Trust
Saint Mary’s Get Involved
In National Breastfeeding
Awareness Week
As part of Breastfeeding Awareness Week, Saint
Mary’s launched their first group of Peer Supporters.
The Peer Supporters are breastfeeding mums
who have volunteered to offer help and advice
to other breastfeeding woman on all aspects
of breastfeeding. They have been successfully
trained by the midwives at Saint Mary’s Hospital
in accordance with the La Lache League of Great
Britain who are an internationally recognised
breastfeeding organisation.
Saint Mary’s Hospital positively supports women
who choose to breastfeed. All mothers are
encouraged and given the opportunity to have
skin to skin contact with their babies from birth.
Breastfeeding is a healthy choice for both mother
and baby. Breast milk is a health food for babies.
It helps to prevent ear infections, chest infections,
tummy upsets, asthma, eczema, diabetes, and heart
disease. (May 2008)
National Kidney Transplant Forum
Returns
Manchester again hosted the National Kidney Transplant Forum after
its successful launch last year. Led by Consultant Nephrologist Dr
Faieza Qasim, the event was held on 28th June.
The forum was launched in 2007 by a team of patients and staff
at the Manchester Royal Infirmary’s Renal Unit. They decided to
organise a day where transplant patients, their families and
carers could come together and talk about their needs and
wants.
The forum enables them to have an opportunity to put
ideas forward on a national scale.
This is a unique event which puts the needs and
voices of kidney transplant patients and their carers
at the centre of the day. Kidney transplantation can
transform lives for the better but we need to find
ways for patients to access the help they need to live
long, healthy and fulfilling lives with a functioning
transplant.
More than 60 patients and their carers/spouses from
all around the country attended the Forum. (June 2008)

Annual Report and Summary Financial Statements 2008/09
page 5
Midwife Goes Back To The Lab
For Answers
Midwife Tracey Mills swapped the maternity unit for the lab
to try to find out why some babies don’t develop well in the
womb – and gained a PhD in the process.
A midwife at Saint Mary’s Hospital in Manchester since
1993, Tracey has spent four years studying blood vessels in
placentas, with the help of around a hundred new mothers
at the hospital.
The placenta transfers oxygen and nutrients from the
mother to help the baby grow. Tracey discovered that
reactive oxygen species chemicals which are thought to
cause heart disease and cancers also affect the function of
tiny blood vessels in the placenta. Reactive oxygen species
are increased in the placenta in pregnancy complications
such as pre-eclampsia and fetal growth restriction, and
may be the cause of reduced blood flow which impairs the
transfer of oxygen and nutrients to the baby compromising
its growth and development in the womb.
In the next stage of her research at the Maternal and Fetal
Health Research Group, The University of Manchester,
Tracey will try to identify the exact causes of reduced blood
flow in the placenta in pregnancy complications such as
fetal growth restriction, and ways to prevent or treat the
problem.
While continuing with the next stage of her research, Tracey
plans to return to Sainy Mary’s part-time so she can also
spend time delivering babies and helping mums-to-be. (July
2008)
Key Role for Manchester In
Beating Bugs
The Trust is playing an important part in a major NHS
project to develop and test new infection-beating
products in hospitals, and then provide support to roll
them out across the NHS.
We are one of seven Showcase Hospitals across England
participating in the Healthcare Associated Infections
(HCAIs) Technology Innovation Programme. The aim is to
help further reduce levels of infection, especially MRSA
and C. difficile, through the use of new products and
technologies.
The Showcase Hospitals provide facilities in which frontline
NHS staff can put new products and equipment designed
to combat bugs like MRSA into practice. Evidence of
how effective each product or technology is being
collected, along with the views of staff on how easy they
are to use, and this information will be shared among
hospitals around the country. The NHS Purchasing and
Supply Agency (PASA) will then work with the Showcase
Hospitals to make successful products more widely
available.
Developing an infection in hospital is a worry for many
patients and infection control is a top priority for the six
hospitals in our Trust. We’ve worked very hard over the
past year to significantly reduce infections. As a result, we
are one of the best performing trusts in the North West,
and this expertise in infection control has been reinforced
by our selection as a Showcase Hospital. (July 2008)
MRI First to Achieve 1,000
Cochlear Implants
Manchester Royal Infirmary successfully fitted its 1,000th
Cochlear Implant as part of their Cochlear Implant
Programme and in doing so became the first in the UK to
reach the milestone.
To mark the occasion they invited all 1,000 patients
and their families to attend a special event at Old
Trafford Football Club on 5th July. The event included
family activities and entertainment, and formed part of
Manchester Royal Infirmary’s NHS 60 celebrations.
As well as celebrating their 1,000th success, they also
celebrated the 20th Anniversary of Cochlear Implants in
Manchester. Since the Programme started in 1988 by
Professor Ramsden, they have seen their success grow
and the number of patients they’ve treated has increased
steadily. The programme has treated both children and
adults alike with their youngest recipient being just six
months old and their oldest being 81 years old.
A cochlear implant helps those who are severe or
profoundly deaf to regain some hearing. This works
by stimulating the nerve that allows us to hear. With
approximately 7,000 current users in the UK, Manchester
Royal Infirmary is the largest programme and helping to
provide increasing numbers of people with the opportunity
to hear again. For the past few years they have fitted
approximately 100 implants every year, a figure which
looks certain to be sustained if not increased. (July 2008)

Research Team Helps Children With MPS
A stem cell research laboratory for mucopolysaccharide (MPS) diseases
is investigating treatments which may help around 400 children in
Manchester - and many more nationally. The lab was set up at the Royal
Manchester Children’s Hospital by Drs Rob Wynn, Ed Wraith and Brian
Bigger.
The nine-strong research team is using a multidisciplinary approach
to investigate stem cell and gene therapies to improve bone marrow
transplantation in MPS and related diseases.
MPS diseases are genetic disorders which affect 1 in 26,000 people,
mainly children. In each type of the disease, the patient lacks a specific
enzyme needed to break down glycosaminoglycans (GAGs), types of
carbohydrate that are essential in connective tissues and are used by the
body to help cells to communicate with each other.
These GAGs are essential for the body to work normally, but when too
many build up, as happens in cells from patients with MPS diseases,
they cause severe progressive mental decline, heart and other problems
as well as bone and joint disease in some cases. Severe forms of MPS
usually result in death in early childhood.
Milder forms of MPS can be treated with weekly injections of the
missing enzyme. However, most severe forms of MPS are currently
untreatable as the enzyme supplied in the blood is not able to cross into
the brain or to correct bone defects. The exception is Hurler syndrome
(MPS IH) which can be treated with a bone marrow transplant. Our
team is looking at ways to reduce the risks and side effects involved in
bone marrow transplants and to increase success rates. We’re also trying
to develop gene therapies for untreatable forms of MPS.
Funded by the UK MPS Society and other national MPS and children’s
charities, the research group is based in dedicated laboratory facilities at
the Royal Manchester Children’s Hospital. (July 2008)
Manchester Royal
Infirmary Performs First
Chimney Procedure In
The UK
T
The Manchester Royal Infirmary became
the first hospital in the UK to perform
a Chimney (or Periscope) Endovascular
aneurysm repair (EVAR).
A patient, aged 69, suffered an aortic
aneurysm which is when the aorta, the
largest artery in the body, balloons or
widens. The aneurysm weakens the wall of
the artery and can lead to it rupturing which
can have fatal consequences.
The four hour operation involved a team
of three consultants, in addition to many
support staff, fitting a ‘chimney’ or
‘periscope’ graft to repair the weakening,
instead of the usual stent graft. This had to
be used as the area around the aneurysm
wasn’t big enough to support the standard
stent graft. If they had placed it further up
the artery, the blood flow to the patient’s
kidneys may have been affected resulting
in kidney failure. Without this type of stent,
The patient would have had to wait for a
minimum of two months for a specially
made ‘Branch’ graft from Australia as she
was not fit for full conventional surgery.
The patient would have been an
exceptionally high risk for conventional
surgery and because of this new technology
they have not only had their aneurysm
repaired but their kidney function preserved.
Only a few of these chimney grafts have
been done world-wide and this was the first
in the UK.
This new and advanced technique enabled
this patient to have the life-saving procedure
without a need for a large abdominal
incision, therefore reducing the risk of
infection and also meaning that a postoperative
stay on Intensive care wasn’t
needed. Instead, two, much smaller incisions
were made in the groin and one in the
patient’s armpit. (July 2008)
page 6
Central Manchester and Manchester Children’s University Hospitals NHS Trust

Annual Report and Summary Financial Statements 2008/09
page 7
Trust Staff Help Celebrate
60 Years of The NHS
To celebrate the NHS 60th Birthday we held an
open day which offered not only a look back
at yesteryear, but a glance into tomorrow.
There was an exhibition highlighting the
work and development of all six hospitals
within the Trust over the years since they were
established and since the beginning of the
NHS in 1948.
The exhibition not only consisted of an in
depth history of the six hospitals in the Trust,
but also had features such as the ward diary
of a ward sister from 1948 which is a startling
contrast to how they work today, 60 minutes
in the day of several jobs within the Trust and
what was in the news as the NHS reached
several milestones.
There was also the opportunity to explore
the past with the Magical History Tour which
look at the existing buildings, which date
back over 100 years. It took in interesting
features of the old MRI, Saint Mary’s and
Eye Hospital site and those on the tour heard
about how the hospitals came about and
what special events have occurred during the
years.
The tour of the New Hospitals Development
took more than 100 people round the £500
million new hospitals site where they saw how
the scheme is progressing.
The exhibition and tours were both well
attended and the day was a great success.
Parrs Wood High School performed a specially
commissioned drama production and Chanje
Kunda, the Trust’s new Artist in Residence
performed some of her own poetry, both to
great acclaim.
Two large banners hung from the ceiling with
the faint outline of a six and a zero. Visitors to
the exhibition and those attending the tours
were asked to fill in a postcard with their
thoughts on what the NHS means to them.
(July 2008)
Inspirational Leader Appointed For
Manchester Health Academy
An inspirational head teacher whose leadership resulted in his school
being named as the fifth most improved secondary school in England,
was appointed as head of one of Manchester’s new academies.
Barry Burke, from Chorley, was appointed as the Principal Designate for
Manchester Health Academy.
The academy, which will be based in Brooklands, Wythenshawe, is one
of seven across the city and will provide 600 places for 11-16 year olds
and 120 places for 16-19 education.
It will specialise in health and will be aimed at students interested in
careers in the medical, clinical, nursing and technical health services.
The Academy will also develop networks to help further support and
influence the health agenda at other schools across the city.
Manchester is leading the way with its academy programme in that not
only is it ensuring children gain the skills and qualifications demanded
by employers, but it is also supported by a comprehensive regeneration
programme that is on a scale unlike anywhere else in the country.
The Academy is sponsored by the Trust with co-sponsorship from
Manchester City Council and The Manchester College.
The Academy will differ from existing schools in that sponsors will
work alongside teachers to design learning and assessment materials.
All students will have personal mentors as well as round the clock
access to materials and support to encourage ‘anytime, anywhere
learning.’ (July 2008)

Trust Joins Forces With
Manchester Academic Health
Centre
Greater Manchester has ambition to become one of
the world leaders for health research, and as such the
Trust has joined forces with six research-active NHS
organisations in Greater Manchester and the University
of Manchester to form the Manchester Academic
Health Science Centre (MAHSC).
This venture will offer great benefits to the health of
the people of the region as well as contributing to
enterprise, innovation and economic developments, by
networking existing research activity and promoting
new research partnerships. MAHSC is the first Academic c
Health Science Centre in the UK to cover the full
spectrum of care – acute, specialist, mental health,
primary care and commissioning. (July 2008)
RMCH Says ‘Wilkommen’ To
German Nurses
Staff at the Royal Manchester Children’s Hospital said
willkommen to two student nurses from Germany. The
two nurses, who were in the second year of their studies,
spent a month on general medical ward, Sillivan. This is
the second year that the Trust has welcomed German
nursing students.
The pair observed the differences between the German
and English health system and nursing as English nurses
have more responsibilities than the German nurses, for
example administering intravenous antibiotics and blood
transfusion.
The visit also prompted the University of Salford to
discuss a partnership with the University of Mainz, where
the two study, to organise future educational exchange
visits. (July 2008)
Manchester Dental Hospital reached
a major milestone in July, as it
celebrated its 125th anniversary
Opened in 1883 at 98 Grosvenor Street in Chorlton-upon-
Medlock, the hospital’s principal objective was to relieve the
suffering of the poor, with many practitioners working without
financial reward.
The building was originally a private residence, with all the facilities
for a fully functioning dental hospital crammed into the three
storey terrace. Extractions took place on the ground floor, fillings
on the first and a top storey was reserved for committee rooms,
professional lectures and meetings.
The first dental students were not able to enrol until 1885, and
even then, there was only enough room for three students at a
time.
The current building was purpose built as the University Dental
Hospital in 1939, and is now one of the key specialist dental
hospitals in the UK. Around 90,000 patients attend for treatment
every year. It is one of the major teaching hospitals in the UK,
undertaking the training of postgraduate and undergraduate
dental students, student dental nurses and hygienist therapists. In
all, a dental team of around 300 staff work in the hospital.
The 125th Anniversary was also marked with the construction of
a new £1 million laboratory complex at the site. The state of the
art facilities replace a service that was previously scattered across
the Hospital, and provide a more suitable home for clinicians,
technicians and students undertaking lab work and research for
the Trust. The Grosvenor Street birthplace of the Hospital is now
but a very distant memory. (July 2008)
New Partnership Helps Manchester
Researchers Beat Information
‘Overload’
The Manchester Biomedical Research Centre (BRC) launched a new
partnership with a unique national service which filters the millions
of pages of scientific data published worldwide every year.
To help scientists faced with ‘information overload’, the BRC joined
forces with the National Centre for Text Mining (NaCTeM), based at
The University of Manchester.
Text mining involves using advanced analysis and search tools to
extract specific information from a wide range of scientific and
medical sources. These can range from books, journal articles, news
stories and conference papers to case studies, surveys and drug
company data.
The system works like a kind of super search engine, identifying all
material linked to the researcher’s area of study and then narrowing
it down to focus on key areas and automatically extract relevant
nuggets of information. (September 2008).
page 8
Central Manchester and Manchester Children’s University Hospitals NHS Trust

Annual Report and Summary Financial Statements 2008/09
page 9
Trust Announces The
Appointment of 12 New
Academic Chairs
Manchester aims to be the source of major advances in
medical research during the next decade, following an
unprecedented drive to recruit some of the world’s top
academics.
The city’s Biomedical Research Centre (BRC), run by the
Trust and The University of Manchester, announced the
recruitment of 12 new academic chairs.
Based at the University and carrying out clinical work at
the Trust, the 12 professors will be recruited in the fields
of Paediatrics, Bone Metabolism, Reproductive Medicine,
Renal Medicine, Maternal and Fetal Health, Vascular
Medicine, Hearing, Cardiology, Chemical Pathology,
Lipids/Obesity, Dentistry and Pharmacology.
The BRC can offer all the technical support and facilities
needed to deliver major research programmes, working
as part of a close-knit team of surgeons, doctors, nurses
and scientists. (September 2008)
Manchester Hospital Showcases Its
Productive Ward Successes On A
Global Scale
The Trust played host to 20 Canadian and New Zealand clinical
staff as part of the Releasing Time to Care Productive Ward
programme.
The productive approach to hospital ward management has
been developed by the NHS Institute with support from a
number of acute trusts across England. The result is a series
of learning modules that empower ward staff to review and
improve their care processes such as meal and medicine
rounds, admission and discharge arrangements, and patient
observations.
The 20 visiting staff, including nurse managers, doctors and
nurse leaders, took part in a one-day event which included
visiting wards, talking to staff and listening to those who have
helped to introduce the programme.
For this Trust, it’s not about productivity and cost saving, it is
about efficiency in releasing time to care. This is about nurses
being able to deliver a better standard of care to their patients.
Manchester Eye Bank 20th
Anniversary Celebration
Established in 1988, the Manchester Eye Bank, is one of two
National eye banks in the country (Manchester and Bristol),
which constitute the Corneal Transplant Service in the UK.
For the organisation, this has been a 16 month journey and
after starting on four wards, they now have 23 areas on the
programme. They work on a 12-week roll out process covering
six to eight areas each time. They aim to have all 82 wards and
departments using the programme by June 2010. (September
2008).
The Manchester Eye Bank plays a crucial part in the transplant of
corneas. In the last year the Eye Bank issued 1,409 corneas and 259
sclerae for transplant.
At present, the only substitute for a human cornea is another human
cornea donated at the time of death. Transplantation involves
replacing the diseased or damaged cornea with a healthy one from a
donor, via an eye bank.
The Eye Banks process donated eyes from across the country,
preparing corneas for graft surgery, which helps to restore sight.
Virtually anyone can donate his or her eyes, even patients that have
suffered from solid malignant tumors. However, there is a donor
selection process to guarantee the tissue is safe to use in a transplant.
To mark the 20th Anniversary an event was held which looked at:
Origins of the Corneal Transplant Service; Organ Culture and its Role
in European Eye Banking; Corneal Transplantation. Past, Present and
Future; Research and Eye Banking and The Manchester Eye Bank Now
and Future. (September 2008)

Valuing Older People Event
On 2nd October the Patient and Public Involvement Service
held a Valuing Older People’s Awareness Session. The
event was held in conjunction with the Cardiac and Stroke
Department and had a focus on older people’s health and
getting involved. (October 2008)
National Award For Manchester
BRC Researcher
The Blair Bell Lectureship 2009 was awarded to Dr Jenny
Myers, in recognition of her research work on pre-eclampsia,
a serious condition affecting pregnant women and their
babies.
Based at the Manchester Biomedical Research Centre (BRC),
Jenny is the lead clinical investigator for a project which is
trying to identify indicators, known as biomarkers, in blood
which may show that a woman is at risk of pre-eclampsia.
She is part of a team at Saint Mary’s Hospital, Manchester,
working on the Make Pregnancy Safer (MAPS) research
project, supported by the baby charity Tommy’s.
MAPS is part of an international study which is investigating
how to predict and prevent the major diseases of late
pregnancy. With 10,000 women taking part worldwide, the
UK MAPS study aims to develop tests that will predict the
likelihood of pregnant women developing major pregnancy
diseases including pre-eclampsia.
The prestigious national Blair Bell Lectureship award
is presented by the Royal College of Obstetricians and
Gynaecologists (RCOG) to a young researcher within two
years of passing their College membership exam. It is named
after William Blair Bell, the first President of RCOG. (October
2008)
OUR KID: Medical Manchester
1948 – 2008
A larger than life size figure was unveiled at a
glittering launch event on 20th October, revealing
the dramatic changes in Manchester’s medical history
like never before. A new installation, with a multimedia
exhibition at its heart, traces the regions past
medical breakthroughs and blows the lid on what
healthcare could be like in the future.
‘Our Kid’ is a 7ft high steel sculpture in human
form and the centerpiece of an innovative, new
multimedia exhibition that charts changes in
healthcare over the last 60 years.
Our Kid is made up of several digital screens, packed
with facts, figures and short films which follow the
changes in healthcare over the last 60 years, and
look to the possibilities of healthcare in the future.
Our Kid also incorporates films made by young
people from Manchester who worked with local
experts to imagine what healthcare might be like in
2048.
Some of the futuristic ideas include a brain clinic
where bad memories can be hidden from your
consciousness; growing replacement body organs
from stem cells, and a GP appointment via an
interactive video wall.
Our Kid includes a selection of memorable public
information films from ‘Coughs and Sneezes’ in
1948 to the unforgettable AIDS campaign of 1987,
a drama from Parrswood High School looking at
healthcare in Manchester over the last 60 years, and
interviews with scientific experts who look to the
amazing advancements that might become possible
in neuroscience, skin regeneration and psychiatry
over the coming decades.
Manchester is known as the place where the NHS
was announced and the North West region is
home to several medical firsts – first NHS patient in
1948; first hip replacement in 1962; first test tube
baby in 1978 and the first NHS IVF Clinic in the
UK in 1982. Today the city is home to the first and
only Biomedical Research Centre in the country to
specialise in Genetics and Developmental Medicine.
(October 2008)
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New Development Reaches Major
Milestone
All eyes were on our new hospital development when a 38
tonne centre section of a bridge was lowered into place to
complete the 110 tonne foot bridge linking two state-of-theart
buildings.
The 74 metre foot bridge was built and transported in three
sections. The two end sections were initially installed, leaving
the final centre section to be hoisted into place, suspended
from a 500 tonne crane.
The installation of the new bridge was seen as a key milestone
for the project.
The bridge was constructed offsite by Corus Northern
Engineering Services in Scunthorpe. Each section was
transported from Yorkshire to Manchester and lifted into place.
The modular construction and short installation was relatively
rare in the construction industry. (October 2008)
Manchester Royal Infirmary Pilot Is a
Huge Success
Manchester Royal Infirmary became one of only two hospitals in
the region to have taken part in a highly successful pilot study to
help heart attack patients. The National Infarct Angioplasty Project
officially published their findings in October to national media,
findings which revealed that around 240 more lives would be saved
every year.
These findings were discussed at an event hosted by Manchester
Royal Infirmary and Wythenshawe Hospital in association with
Greater Manchester & Cheshire Cardiac and Stroke Network and the
Department of Health.
Primary angioplasty otherwise known as Primary PCI (percutaneous
coronary intervention) is a key-hole technique which uses a balloon
followed by metal scaffolding called a stent to unblock a coronary
artery. Primary PCI when performed without delay has been
proven to be superior in preventing death following a heart attack
compared to current practice of giving a clot-busting drug.
At our Manchester Heart Centre we are dedicated and working
hard with Greater Manchester and Cheshire Cardiac Stroke
Network, Wythenshawe and other hospitals to develop a
comprehensive 24/7 primary angioplasty programme that would
not just cater for our local patients but as a tertiary referral centre
for the rest of the greater Manchester population.
Patients who are treated in this way are not only more likely to
survive a heart attack but also have much less damage to their
heart muscle. They are less likely to have subsequent cardiac events
and less likely to be readmitted to the hospital. (October 2008)
Vegan Awards 2008
Saint Mary’s Hospital was voted the ‘Best Vegan Hospital or
Care Home’ by The Vegan Society. The award is voted for by
members of the society and they vote on their experiences,
whether as a patient, relative or visitor to the hospital.
(November 2008)
Ambitious i Arts Project For Our
New Hospitals – Creating A
Vision
When the Trust put out a call for artists to get involved
with our new hospitals we didn’t expect the 1,074
expressions of interest.
Artists from across the globe, including Thailand,
Norway and USA got in touch to find out more
about what we were looking for to support our new
development.
The artwork projects are split into nine categories and
we now have the artists agreed for all of these except
for the Iconic artwork project where three shortlisted
artists will battle it out during an interview process.
We were delighted with the response and are confident
that we have chosen artists who will provide excellent
and creative artwork for all the areas identified. It is
an important part of our new hospitals which not only
improves the environment of our buildings, but research
shows that inspirational and eye pleasing artworks
can help patients deal with pain and anxiety better.
(November 2008)

MRI Celebrates 100 Years On Oxford Road
1st December 2008 marked the 100th anniversary of when Manchester Royal
Infirmary moved from Piccadilly Gardens in the centre of Manchester to the present
site on Oxford Road.
The Manchester Royal Infirmary was established on 27th July 1752 in a small house
in the centre of Manchester. In 1755 a new infirmary was built on the site of what we
now know as Piccadilly Gardens. The new building cost £2,587. The new infirmary
on this site expanded over the years with new wings being added.
In 1902 a debate broke out as to whether or not to re-build a new hospital on the
existing site or on a new site further out of town as the city centre was noisy and
unhealthy.
The plans for the new hospital were formally approved at a special meeting of the
Trustees on 27th July 1904. By the end of 1905 the excavations and foundations had
been completed and work was proceeding up to the level of the ground floor.
By the end of 1906 there were 700 men at work on the new building and such
excellent progress had been made that it was clear that the work would be
Avenue Are Right Up
Booth Hall’s Street!
A promising boy band visited Booth
Hall Children’s Hospital to spread a
little festive cheer in the run up to
Christmas. Avenue proved they are
right up the kids’ street when they
wowed them with a stunning acoustic c
set fresh from supporting McFly on
their arena tour.
Avenue took time out of their
busy schedule to visit Booth Hall
to entertain patients, performing
their debut single ‘Can You Feel It?’
before meeting and greeting the
children.
Young patients, their parents and
carers, and the staff were thrilled
as Avenue arrived laden down
with goodie bags before the
down-to-earth band took the
time to sign photos, have a chat
and pose for photos. Not only did
Avenue perform several of their
own songs, but they also got
into the festive sprit by leading
the children in several Christmas
songs. (December 2008)
completed to schedule and that the total cost would be £500,000. The new hospital
had capacity for 600 beds.
On 24th November 1908 The Board of Management met for the last time at the
Piccadilly site – the Minutes end as follows: This being the last meeting of the Board
of Management in the present building, as the removal of patients would take place
on 1st December, the Chairman referred in feeling terms to the work of the Infirmary
during the last 150 years and to the still greater sphere of usefulness which lay before
it.
Resolved, that the cordial thanks of the Board be given to Mr Cobbett for his services
as Chairman and that the Board look forward to his occupying the chair of the New
Infirmary for many years to come.
On 1st December 1908 the great day arrived. The work of transferring the patients to
the new building was carried out with ease and smoothness that won the admiration
of the patients themselves and said much for the care with which the whole business
had been planned. The number of patients had been reduced to a minimum. Still
there were few short of a hundred to be conveyed from the old building to the
new. The raw December morning with fog hanging all about the streets was not
an ideal one for the purpose. There were five horse ambulances and Salford’s new
motor ambulance in the use together with horse drawn carriages and taxis and the
Infirmary’s own omnibus that usually transported convalescent patients to Cheadle.
The patients, warmly wrapped up, were carried down the hospital steps on chairs
and stretchers and placed in waiting vehicles. The journey took half an hour from
bed to bed and there were doctors, nurses and hot drinks to welcome them to their
new wards.
When King Edward VII and Queen Alexandra formally opened the building on 6th
July 1909 King Edward was so impressed with the new facilities that he knighted
hospital Chairman William Cobbett on the spot.
It seems a strange co-incidence that 100 years later we are planning moving patients
from our other hospitals to the Oxford Road site! (December 2008)
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Annual Report and Summary Financial Statements 2008/09
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Success For The Trust on NHSLA
Assessment
The Trust was successful in attaining Level 2 compliance against
the NHSLA Risk Management Standards for Acute Trusts.
This assessment took place on 9th – 10th December and
involved staff from every Division and corporate service.
The Risk Management Standards for Acute Trusts have 5
standards each having 10 criteria, the 5 standards are:
1. Governance
2. Competent and Capable Workforce
3. Safe Environment
4. Clinical Care
5. Learning from Experience.
At Level 2 the Trust had to demonstrate that all relevant
policies were adequately disseminated and implemented and
compliance to the minimum requirements of the 50 criteria,
the Trust scored 44 out of that possible 50.
This is an immense achievement and demonstrates that the
organisation continues to improve in the safety and quality of
services delivered. (December 2008)
Trust Employee Voted One Of The
Most Influential Nurses Of The
Last 60 Years –
Janet Marsden, a part time nurse practitioner at the
Emergency Eye Centre, was voted by her peers among the
20 most influential nurses of the last 60 years.
The top 20 ‘thinkers, writers and doers’ from the world of
nursing were nominated by the readers of Nursing Times.
A passionate ophthalmic nurse, Janet developed advanced
practice roles in the specialty including the first nurse led
ophthalmic emergency department, here in Manchester.
She has written extensively about ophthalmic and
emergency care and taught the subject all over the world.
One of her recent books – Ophthalmic Care – is widely used
by ophthalmic professionals as a reference across the world.
She is also an editor of Emergency Triage, a consensus
and now evidence based triage system, developed by
Manchester’s senior emergency physicians and nurses,
which is now used extensively in the UK and internationally.
(December 2008)
Manchester United Players
Visit Children’s Hospitals
On 4th December 2008 players from
Manchester United took part in their
annual Christmas visit to Booth Hall
and Royal Manchester Children’s
Hospitals. The two children’s
hospitals were visited on the
same day by their top players
who gave out presents to the
children on the wards. This
visit was particularly special
as it would be the last time
the players would visit the
two hospitals which were
due to close in Summer
2009. At Booth Hall a
special party was held
with guest star Bobby
Charlton. (December 2008)

Research & Innovation
Clinical research is the cornerstone of first-class
healthcare for the people of Greater Manchester and
the Trust has a research portfolio to be proud of.
With excellent facilities and internationally renowned
researchers, we are gaining a global reputation for
pioneering research in areas such as experimental
therapeutics, genetics and developmental medicine
and tissue injury and repair. In partnership with The
University of Manchester and other collaborators we
are rapidly making Manchester the centre of cuttingedge
research to improve healthcare worldwide,
benefitting from the award of the Manchester
Biomedical Research Centre by the National Institute
of Health Research.
The £35 million Manchester Biomedical Research Centre
(BRC) was set up by the National Institute for Health
Research (NIHR) on 1st April 2008, and is one of 12 elite
centres of medical research excellence across the UK.
Bringing together researchers and clinicians from the Trust
and The University of Manchester, we have created a truly
world-class clinical academic campus in the city.
This BRC harnesses the academic and clinical expertise
of its partners to conduct high-quality, patient-focused
translational research. This involves taking research from the
laboratory to the patient’s bedside.
Led by Professor Phil Baker (Consultant Obstetrician, Saint
Mary’s Hospital), the Manchester BRC’s vision is to deliver a
broad range of ‘health and wealth’ benefits. Our research
projects will tackle some of the highest priority disease areas
of the Manchester population, and will enable patients
to access leading edge clinical treatments, both through
participating in clinical trials and through the early adoption
of new treatments across Greater Manchester.
In line with the Department of Health ‘Best Research for
Best Health’ strategy, the BRC partners are focusing on three
areas of excellence in translational research:
■ Experimental Therapeutics
■ Genetic & Developmental Medicine
■ Tissue Injury & Repair
Our partners
The Manchester BRC works closely with local and national
partners to help improve healthcare through collaborating
on research and innovation programmes. More
information about our partners can be
found in the Foundation Trust
annual report (1st January –
31st March 2009).
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Annual Report and Summary Financial Statements 2008/09
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Infection Control
The prevention and control of infection is a top
priority for the Trust.
All NHS organisations must ensure that they have effective
systems in place to control healthcare associated infection
and we are fully committed to ensuring resources are
allocated to effectively protect patients, their relatives, staff
and visiting members of the public.
Nothing has had higher priority for the Trust than improving
our performance in tackling hospital-acquired infections such
as MRSA and Clostridium difficile.
Infection Control Team
A dedicated Infection Control Team has been created
headed by the Director of Infection Prevention and Control.
A Consultant Medical Microbiologist is designated as the
Infection Control Doctor and team also includes specialist
nurses, a clinical scientist involved in surveillance and
microbiologists specialising in adult medicine and paediatrics.
The Infection Control Team is committed to preventing and
minimising the spread of infection. This includes:
■ Constantly improving practice to reduce the incidence of
infections acquired in hospital
■ Robust surveillance on targeted infections reporting all
results back to the frontline staff
■ Education and training of all staff via the Trust’s
Induction and mandatory training programmes and
locally at ward and department level
■ Producing Infection Control Policies in line with
government guidelines, which are readily available to all
staff in hard copy and via the Trust’s intranet
■ Audit of policies and guidelines to ensure that best
practice is followed
■ Supporting and reassuring patients and their families
using our services.
What are we doing as an Organisation?
Showcase Hospital Project
The Trust was one of only seven in the country to be invited
to take part in the Showcase Hospital Trust Project. The
six-month initiative is a key element of the Department
of Health’s strategy within ‘Clean Safe Care – Reducing
Infections and Saving Lives 2008.’
‘Clean Your Hands’! We are actively taking part in the
Government’s ‘Clean Your Hands’ Campaign and are
currently in the third year of the campaign. This involves:
■ Removing the practical barriers faced by staff maintaining
a supply of alcohol gel throughout all clinical areas so
that hand hygiene can happen immediately before any
direct patient contact
■ Using highly visible posters to raise awareness of the
importance of good hand hygiene amongst staff,
patients and visitors
■ Encouraging patients and visitors to challenge staff if
they feel that we need reminding
Audit
We carry out regular hand washing audits on the wards
to assess whether staff and visitors are following Trust
guidelines and washing their hands or using the alcohol gel
when they should.
PEAT
The Patient Environment Action Team (PEAT) carries out
inspections across the National Health Service looking at a
range of environmental factors from general cleanliness and
upkeep to clear signage and quality patient food.
Staff Training
We provide training to staff on hand washing and the
principles of infection prevention and control annually
through the Trust’s Mandatory staff training programmes.
Surveillance
We test patients for MRSA who are transferred from other
hospitals and who have been in hospital any time during
the last 6 months. We also test patients admitted to certain
outpatient pre-admission clinics prior to some elective
surgery and are planning to extend this to cover other groups
of patients in both the adult and paediatric areas.
Isolation
We isolate in cubicles/siderooms where possible patients
with infections.
Standard Precautions
‘Barrier nursing’ patients with infections includes carrying
out certain precautions to prevent the spread of infection to
others.
Uniform Policy
We are working hard to ensure that all staff adhere to the
revised Uniform Policy, which states that uniforms should be
covered when staff are not in the hospital and theatre staff
must change when they leave the operating theatre area.

Working at
the Trust
Staffing
Staffing - the Trust’s staff in post totals 7554.6 whole time
equivalents (w.t.e.) and 8504 staff on a headcount basis as at
April 2008.
Age profile – an age profile analysis of our workforce
indicates that the majority (81%) of the workforce are below
age 50 and does not reveal any age-related hot spots.
Ethnicity profile – 17.5% of our staff are from BME groups
compared with 19% in the City of Manchester, and 7.9%
nationally (source 2001 census).
Investors in People (IIP) – The organisation
became the largest NHS Trust in Greater
Manchester to achieve the new Investor’s in
People standard. The IIP assessment meant
that the Trust underwent a vigorous assessment
process which involved a series of interviews
and focus groups with individuals across
the organisation representing all Divisions
and all staff groups, including staff side
representatives.
Staffing numbers and skill mix are constantly reviewed to
ensure appropriate grade mix to deliver a quality service but
ensuring that efficiencies and productivity improvements are
delivered.
One of our HR principles is to prevent discrimination, value
diversity and provide equality of opportunity for all our
employees and potential employees. As a result the Trust
benefits from a rich diversity in its workforce. The Trust sees
the development of this approach as key to the delivery of its
objectives over the next five years.
Staff group profile of the Trust (Whole Time Equivalent)
1443.8
1479.8
526.1
154.3
714.9
696.8
2538.9
Admin and Clerical
Senior Managers
Medcial Staffing
Professional & Technical
Nursing Professionals
Nursing Support
Ancilliary and Maintenance
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Annual Report and Summary Financial Statements 2008/09
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Working with our
Patients and Visitors
Patient and Public
Involvement Service
The Patient and Public Involvement (PPI) Service has focused
on engaging with our local communities and involving
patients in our service changes this year, in particular the
area of Transition of young people from our Children’s
services to Adult Services, the new hospital build, the new
Youth Forum and the PPI Bank.
The PPI service has facilitated Transition Seminars for service
specific events to allow young people, parents and carers
as well as staff to discuss transition pathways and ways to
improve the process for all involved. The Dental Hospital held
an event and has subsequently employed a Consultant to
specialise in adolescent transitional care. The Trust has also
employed another Consultant based in Children’s Division to
focus on transitional care arrangements across the Trust.
The Youth Forum, part of the Foundation Trust constitution,
is now running and has taken part in a variety of work
including the policy design of an Age Policy linked with
Transition and the design of the adolescent out-patients area
for the New Children’s Hospital. The two youth governors
for the Council of Governors sit on this forum and there is a
positive response to their involvement.
The focus for the coming year is experience based design to
look in more detail at the patient experience.
Complaints and Patient Advice and
Liaison (PALS) Services
The Complaints and PALS Services continue to strive to
effectively manage concerns and complaints about the
services and/or facilities provided by the Trust.
Throughout the year the team has invested in sound
quality assurance frameworks to reflect the changes in
the way complaints are to be responded to across health
and social care from April 2009. The new approach aims
to foster a culture of openness and encourages feedback
about our services. It aims to encourage staff at all levels –
especially frontline staff – to respond quickly, sensitively and
effectively to people who have concerns. Complaints will be
investigated thoroughly in order to resolve issues identified.
As part of their response to complaints, services will ensure
they remedy any problems and improve service delivery, to
prevent poor experiences recurring.
The Trust’s fundamental objective of complaint management
has always been to facilitate effective handling at local level
and to encourage organisational learning.
The Trust’s PPI Bank has also had a very successful year.
Its members have been involved in a variety of projects
including the Patient Environment Action Team assessments,
comments on the PPI website, opinions about various leaflets
before publication for patients and a food tasting event.
In addition to this they helped to undertake consultation
within the Out Patients Department on Health improvement
and also went into the wards to consult upon the possible
developments of a patient charter
In March 2009, the service held a Community Engagement
Week Event which invited patients, public and community
groups to come and talk to staff from all the Divisions to
learn more about the services we provide. The event was
a success with over 1,100 people attending throughout
the week. Feedback showed that the patients and public
felt it was beneficial to learn about services and staff
found the event a good opportunity to network with
other professionals form the Trust

ongoing training as they undertake more and varied roles
across the Trust.
We have had very successful specific recruitment drives
to areas such as Chaplaincy and Spiritual Care, Maternity
Services and Paediatric Psychology. In addition to this the
service is also involved in the recruitment of volunteers to
Radio Lollipop which operates in the evenings within the
Children’s Hospitals.
In addition to the above the volunteers have supported many
projects and assessments across the Trust.
General Principles of Complaint
Management
The Principles of Remedy published by The Parliamentary
and Health Service Ombudsman (PHSO) supports our core
work – to investigate and resolve complaints, effectively and
efficiently. The basis for an effective complaints process is:
■ Getting it right
■ Being customer-focused
■ Being open and accountable
■ Acting fairly and proportionately
■ Putting things right
■ Seeking continuous improvement
Volunteer Services
The Volunteer Service has gone from strength to strength
over recent months. There are currently 73 volunteers in a
Hospital Welcoming role. This is a vital ‘front of house’ role
that is proving to be very successful as many patients and
visitors to the Trust benefit from the time and dedication
given by the volunteers. There are also an additional 20
volunteers supporting and enhancing the patient experience
in both clinical and non-clinical areas.
Volunteers are recruited from a wide range of ethnic
and cultural backgrounds from within the community,
including local schools and colleges. This year there has
been an increase in older people becoming involved in the
service. This has been really positive for the service as the
young people are very transient as they move onto further
education.
The Volunteers receive training to prepare them for the
various roles they will undertake. This has proved to be very
advantageous to the volunteers, helping them to carry out
their roles to the maximum. Volunteers will also receive
One of our younger volunteers has been elected as a Youth
Governor as part of the Foundation Trust and a number of
them are part of the Youth Forum that supports the Youth
Governors who represent the views of young people forming
part of the Council of Governors as part of the structure for
the Foundation Trust.
As the service looks towards the future, we are embarking
on a very exciting and historic time for the Trust. The
volunteers will play a very pivotal role in supporting the
opening of the New Hospitals Development and beyond in
to 2010.
Service Equality Team
The Service Equality Team is responsible for leading the Trust
work on promoting equality and diversity. It does this by
supporting the clinical divisions and corporate services to
improve services to meet the needs of the Trust’s diverse
patients and other service users.
Each of the Trust’s clinical divisions is required to produce an
annual Equality and Diversity Action Plan. The action plan
sets out the work that the division intends to undertake to
promote equality and manage diversity during the next 12
months. Action plans consist of Trust-wide priorities and
local priorities set by the divisions themselves. The work of
divisions included:
■ Improving information and communication.
■ Improving the quality of information on who uses our
services and how.
■ Improving the information to patients and carers so they
can find their way to service without requiring help.
■ Reviewing services and policies to ensure that they
promote equality and do not discriminate against anyone
(Equalities Impact Assessment).
■ Promoting equal opportunities in employment.
The team was involved in a number of areas of work. The
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Annual Report and Summary Financial Statements 2008/09
page 19
team produced the Annual Equality and Diversity Planning
guidance to assist divisions to produce their equality and
diversity action plans. One of the largest areas of work was
supporting the divisions and corporate service to carry out
Equalities Impact Assessments (EqIA).
Interpretation and Translation
Service
The Interpretation and Translation Service (ITS) exists to
facilitate communication between healthcare professionals
and patients or carers who have difficulty speaking or
understanding English. The Service also provides British Sign
Language.
The service is provided by in-house interpreters (employed by
the Trust) and supplemented by services provided by external
agencies. The in-house service provides 17 languages.
Other languages required are provided by agencies as
necessary.
It has been a very busy year for the service. The demand
for interpreting services has increased during the year. The
Trust has seen year-on-year increases in demand for several
years now. During 2008/09 the service delivered 22,634
interpreting sessions in 67 different languages. This
compares to 19,650 sessions in 54 languages for 2007/08.
The majority of interpreting sessions were face-to-face.
Telephone interpreting was also provided.
During the year the Trust also contributed to the work
of the NHS North West Collaborative Procurement Hub’s
work on developing a regional contact for interpreting and
translation services. This work has lead to a new contract
being available for NHS organisations in the North West of
England. The Trust is considering how to make the best of
use of this contract.
Coptic Church of Egypt, the Baha’i faith and the Unitarian
Church. We support them as a team by offering time to
debrief at the end of their sessions and by supervision on a
weekly basis.
Throughout the year, we have organised four Memorial
Services held at Salford Cathedral for families of those who
have lost loved ones and these have been attended by over
1,500 people. We are also involved in holding staff memorial
services in the chapel, and have remembered six members
of staff who have died during the year. We have continued
our contributions to various multi-disciplinary teams in
Palliative Care, Renal Department and Saint Mary’s Hospital,
and have offered guidance about spiritual care through
clinical governance meetings and training sessions for nurses,
doctors and allied health professionals.
Bereavement Care Team
The service continues to grow to accommodate the needs
of the newly bereaved by providing continuing support
for families, including support at the time of death, and
aftercare with follow-up telephone calls and assessment for
formal counselling.
The team is continually looking at ways to improve the
services for bereaved people by updating their knowledge
and skills, such as Coroner’s procedures and requirements
for registering a death. In the past year, the team has taken
part in ‘job swaps’ with members of the Coroner’s staff and
Registrar’s Office, gaining invaluable experience and ensuring
that information given to families is relevant and accurate.
The Patient Advice and Liaison Service can be
contacted on Tel: 0161 276 8686 Fax: 0161 276 4971
e-mail: pals@cmft.nhs.uk.
Chaplaincy-Spiritual Care
The Chaplaincy–Spiritual Care Department provides a multifaith
service to patients, carers, families, visitors and staff
across the Trust. In the year from February 2008 to February
2009, we made over 17,000 visits to patients, accepted over
1,400 referrals, took 130 funerals and 86 baptisms, and
responded to over 500 emergency call outs.
Our work has been enhanced by the introduction of ten
chaplaincy volunteers. After their initial induction, a
period of ten weeks training and a commissioning
service, the volunteers have become a valuable
resource in the work of Chaplaincy. They have come
from a wide variety of backgrounds, including the

The New Hospitals
Development
The Trust has nearly completed its six year construction
agreement to deliver state-of-the-art healthcare and
research facilities on the Oxford Road site.
Specifically, the benefits include:
■ For children’s services, all hospital based treatment to be
provided from one site in conjunction with new service
models to enable children to be cared for as close to their
home as their condition allows.
■ The bringing together of children’s and neonatal services
on one site.
■ Replacement of outdated facilities, for adults, women’s
and ophthalmic specialist care currently dispersed across
the site, with facilities designed to enable the provision
of medical, therapy and nursing care in an appropriate
manner and environment for the twenty first century.
■ Dedicated facilities for elective (planned) surgery for both
adults and children protecting both the elective and
emergency capacity.
■ Patients and visitors will have the benefits of a reordered
site with facilities designed for the patient.
■ Access to a wide range of state-of-the-art clinical
and support services on a single site so that patients
with multiple problems do not have to travel between
different hospitals.
■ Expertise concentrated on a single site means more
professionals available to ensure high standards of safety
throughout the 24 hours.
■ The strong research and teaching base in the new
development means that patients will benefit from
modern and proven treatments and they will be cared for
by staff who are trained to understand the wider needs
of patients.
■ In addition to the core development, there are a number
of stand-alone buildings for clinical sciences (pathology
services), rehabilitation and education.
The following phases have already been completed and
handed over:
■ Multi-storey car park
January 2006
■ Rehabilitation Unit
May 2006
■ New Manchester Royal infirmary Wing (Phase 1)
December 2006
• Renal Services
• Heart Centre
• Neurophysiology Department
• Elective Treatment Centre
■ Education facilities
September 2007
■ Endoscopy facilities
January 2008
■ Clinical Sciences Building
April 2009
The highlight of our development has been the opening of
four new hospitals:
■ Children’s Hospital - 11th June 2009
■ New wing for Manchester Royal Infirmary -
11th July 2009
■ Saint Mary’s Hospital - 13th July 2009
■ Manchester Royal Eye Hospital - 8th August 2009
For further details log onto:
www.borninmanchester.co.uk
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Central Manchester and Manchester Children’s University Hospitals NHS Trust

Annual Report and Summary Financial Statements 2008/09
page 21
Activity and Performance
Accident and Emergency Attendances
Out-patient Activity
2008/09 2007/08
First Attendances 201,627 194,705
Follow-up attendances 1,396 1,449
Total 203,023 196,154
In-patient/Day case Activity
2008/09 2007/08
In-patient (emergency) 61,794 62,095
In-patient (elective) 19,461 23,760
Day cases 49,314 34,766
Total 130,569 120,621
Day cases as a % or elective activity 71.7% 59.4
Day cases as a % of total activity 37.8% 28.8%
2008/09 2007/08
Out-patients first attendances 163,868 170,047
Out-patients follow-up
attendances
441,708 422,378
Total 605,576 592,425
General Information
2008/09 2007/08
Number of Babies Born 5,167 5,168
Total number of Operations/
Procedures
Renal Transplants (including
kidney/pancreas)
127,294 109,223
168 144
Number of Cataract Procedures 10,504 9,290
In-patient Waiting List
31st March 2009 31st March 2008
In-patient Day case Total In-patient Day case Total
Total on Waiting List 2,605 3,619 6,224 2,639 3,824 6,463
Patients Waiting 0-3 months 2,224 3,404 5,628 2,139 3,378 5,517
Patients Waiting 3-9 months 381 215 596 500 446 946
Patients Waiting over 9 months 0 0 0 0 0 0
Bed Usage
2008/09 2007/08
Average in-patient stay 3.0 days 2.9 days

Trust Board
Peter W Mount CBE,
Chairman
Mike Deegan,
Chief Executive
Professor Rod
Coombs,
Non-executive
Director
Anthony Leon,
Non-executive
Director
Jo Somerset,
Non-executive
Director
Brenda Smith,
Non-executive
Director (from 10th
November 2008)
Lady Rhona Bradley,
Non-executive Director
(from 10th November
2008)
Stephen Mole,
Non-Executive
Director (from 10th
November 2008)
Robert Pearson,
Medical Director
Gill Heaton,
Director of Patient
Services/Chief Nurse
Derek Welsh,
Director of Human
and Corporate
Resources
Adrian Roberts,
Director of Finance
Martin Hodgson,
Director of Children’s
Services
Clare Nangle
Non-executive
Director (until 9th
November 2008)
Sheila Jones
Non-executive
Director (until 9th
November 2008)
Blaise
Nkwenti-Azeh
Non-executive (until
31st July 2008)
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Central Manchester and Manchester Children’s University Hospitals NHS Trust

Annual Report and Summary Financial Statements 2008/09
page 23
Register of Interests
Peter W Mount, Chairman: Chairman Provider Advisory
Group on Health Regulation (for NHS and Independent
Sector); Member of the Data Streamling Board Department
of Health Information Centre; Member of the Department of
Health Data Reference Group; Chair of NHS Confederation
project working to assist integration of Refugee Health
professionals; Member of General Assembly – The University
of Manchester; Chairman, Trustee and Founder of Charity
called Helping Uganda Schools (HUGS); Board Member
Manchester Knowledge Capital.
Mike Deegan, Chief Executive: Non-executive Director for
the NHS Institute of Innovation and Improvement.
Professor Rod Coombs, Non-executive Director: Vice-
President, The University of Manchester and Non-executive
Directorships for: The University of Manchester Intellectual
Property Ltd; The University of Manchester Incubator
Company Ltd; Manchester Technology Fund Ltd; One Central
Park Ltd; Cityco Ltd; MIDAS Ltd; MBS Worldwide Ltd.
Anthony Leon, Non-executive Director: Non-executive
Director – Mercury Re-Cycling Group PLC; Consultant –
Horwich Cohen Coghlan (Solicitors); Non-executive Director
EXC PLC; Non-executive Director Cleardebt Group PLC.
Jo Somerset, Non-executive Director: Director, Infrastruct
Ltd (Business Consultancy); Trustee of the William Walter
(Will Trust) Saint Mary’s Hospital; Director; Director,
Bikeright! Ltd (Cycle Training Company).
Brenda Smith, Non-executive Director (from 10th
November 2008): Non-executive Board Member for: North
West Development Agency; Manchester Airport Group;
Manchester International Festival and Member of the Board
of Governors, The University of Manchester.
Lady Rhona Bradley, Non-executive Director (from 10th
November 2008): Chief Executive and Company Secretary,
ADS (Addictions Dependency Solutions).
Stephen Mole, Non-executive Director (from 10th
November 2008): Executive Director of Filtronic PLC.
Claire Nangle, Non-executive Director: (until 9th November
2008): Employed by Opal Property Group.
Sheila Jones, Non-executive Director: (until 9th November
2008): Research and Information Officer, British Fluoridation
Society; Co-ordinator, National Alliance for Equity in Dental
Health.
Blaise Nkwenti-Azeh, Non-executive Director (until 31st
July 2008): Partner is Chief Executive of Black Health Agency
and Non-executive Director of Trafford Primary Care Trust.
Robert Pearson, Medical Director: Trustee: National
Association of Assistants in Surgical Practice; Chair, National
Technology Adoption Hub.
Derek Welsh, Director of Human and Corporate
Resources: Director Manchester Health Academy (non paid
appointment).
No interests to declare: Gill Heaton, Director of Patient
Services/Chief Nurse; Adrian Roberts, Director of Finance;
Martin Hodgson, Director of Children’s Services.
Emergency Preparedness
The Trust has a major plan in place detailing how we prepare for and
respond to an incident or special emergency. Staff receive training
in their roles and responsibilities in the event of a Major Incident
and the procedures are exercised and reviewed annually.
Throughout the year the Trust has enhanced its existing
Business Continuity Management arrangements, detailing
the management of disruptions to services at our Trust
sites.
The Trust will continue to train, exercise and review its
Emergency Planning arrangements to ensure we are
prepared to respond to internal or external incidents and
emergencies.

Statement on
Internal Control
Scope of Responsibility
The Trust Board is accountable for internal control. As
Accountable Officer, and Chief Executive of this Trust Board, I
have responsibility for maintaining a sound system of internal
control that supports the achievement of the organisation’s
policies, aims and objectives. I also have responsibility for
safeguarding the public funds and the organisation’s assets
for which I am personally responsible as set out in the
Accountable Officer Memorandum.
The Trust’s management structure has established
accountability arrangements through a scheme of delegation
covering both corporate and clinical division arrangements.
This is reflected in the corporate and divisional work
programmes/objectives and the governance arrangements
within the Trust.
The purpose of the System of
Internal Control
The system of internal control is designed to manage risk to
a reasonable level rather than to eliminate all risk of failure
to achieve policies, aims and objectives; it can therefore
only provide reasonable and not absolute assurance of
effectiveness. The system of internal control is based on an
ongoing process designed to:
1st April – 31st December 2008 (Summary)
■ Trading Gap Plans – Financial
An annual efficiency requirement of over 3% removed
from tariff uplifts each year will require significant
efficiencies over the next five years. The Trust is
proactively identifying, developing and implementing
plans in advance of need. Budgetary control measures
closely monitor the delivery of the trading gap across
each Division of the Trust.
■ New Hospitals Development (PFI Project) -
Organisational
The Trust recognised that a number of key issues need
to be managed through the construction phase of the
New Development, including the maintenance of the
site, clinical activity and delivery of access targets and
the development of integrated service models to match
capacity.
Work has been particularly focused this year on
workforce requirements for the move of the Children’s
hospital to the central site in 2009 and the mobilisation
of support services staff.
The Trust has an established internal implementation
group to manage the issues arising during the
construction phase. An operational group meets weekly
to monitor risks.
■ Identify and prioritise the risks to the achievement of the
organisation’s policies, aims and objectives.
■ Evaluate the likelihood of those risks being realised and
the impact should they be realised, and to manage them
efficiently, effectively and economically.
■ The system of internal control has been in place in the
Central Manchester and Manchester Children’s University
Hospitals NHS Trust for the year ended 30th December
2008 and up to the date of approval of the Annual
Report and Annual Accounts.
Significant Internal Control Issues
The Trust has identified the following significant internal
control issues which have been or are being addressed:-
Robust operational plans have been developed for all
hospital moves, which detail at ward and department
level the processes which will be implemented.
Communication plans both internally and externally
have been prepared and a publicity campaign has been
commenced to ensure the public are well informed
regarding the moves. The operational plans have been
assessed and approved by external experts.
■ Increased Referrals and Activity – Organisational
Unprecedented increases in GP and self referrals to A&E
has affected the Trust’s ability to deliver the four hour
A&E access target in 2008/09.
The Trust is working with our host Primary Care Trust
to identify and implement alternative service models for
urgent care which will address the rise in demand. In
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Central Manchester and Manchester Children’s University Hospitals NHS Trust

Annual Report and Summary Financial Statements 2008/09
page 25
addition work is underway to identify additional capacity
in the Trust and in the Health Economy.
■ Workforce - Organisational
The Trust recognises that to achieve its strategic aims, it
needs to ensure the provision of an adequately skilled
and flexible workforce.
The Trust has produced a Workforce Strategy linked to
its business planning process that ensures that we are
well prepared to meet the demands for a skilled and
flexible workforce to deliver continued improvements in
the health and care services it provides. Much work has
taken place to ensure following the hospital moves that
staff with the required skills are in place.
Delivering the European Working Time Directive for
Doctors in training targeted for August 2009 is a
significant risk to the Trust. New models of care delivery
are being considered alongside strenuous recruitment.
■ Adult Critical Care Capacity – Clinical
Increasing demands on adult critical care services
particularly for specialist referrals has necessitated the
Trust to develop increased capacity for critical care
beds. Before further planned capacity is provided, other
measures are in place to mitigate the risk.
■ Infection Control – Clinical
The Trust has continued to demonstrate significant
improvement during 2008/09 on all aspects of infection
prevention and control. The MRSA target was achieved
and the Trust was under trajectory; in addition the target
for managing C.Difficile was also achieved and the Trust
was under trajectory.
The Trust continues to adopt a zero tolerance approach
to infection prevention and control and is continually
improving services to meet these challenges.
■ Information/Data
The Trust has undertaken audits of transfers of personal
data and reviewed all transfers of personal data in or out
of the Trust. The risks identified in the audits related to
faxes, bulk mailing and e-mail. Resolutions included for
faxes, the use of safe haven fax or a fax authentication
process. Courier services were used for bulk mailings and
only NHS mail is used for emails with emails encrypted.
The following are a summary of the serious incidents of
data loss reported:
● Theft of a laptop from office - person
identifiable information for 22 persons
No further actions were required and all Trust laptops
are being encrypted under the Trust IT Security policy.
● Theft of fifteen laptops from the University
offices - one hundred records contained patient
identifiable data
Data Sharing Agreements between the Trust and
University have been developed and all laptops are
now encrypted.
An action plan to reduce the occurrence of these
incidents was developed which involved raising
staff awareness through mandatory and induction
training, regular team briefings, information on the
Trust intranet and meetings with the staff involved.
Systems and processes are now in place to ensure
that all patient and staff information is now being
stored and shared in a secure manner in accordance
with Department of Health guidance and Information
Governance Good Practice.
■ Annual Declaration on Standards for Better Health
The Trust has completed its self assessment exercise
against the seven domains of the Standards for Better
Health. The organisation has declared compliance against
all standards of all seven domains.
Therefore the target compliance for 2008/2009,
according to our self assessment, has been met.
The Trust is fully compliant with the core Standards for
Better Health.
Mike Deegan, Chief Executive
5th June 2009

Report of the
Director of Finance
The nine months of 2008/09 to 31st
December 2008 proved to be another
challenging period for the Trust. We
worked hard to deliver the part year
effect of an annual £24m trading gap/
savings programme to ensure the
Trust achieved the statutory duty to
at least breakeven. The period saw
the continued implementation of the
new NHS funding system; Payments
by Results, which remunerates Trusts
at nationally set price levels for a wide
range of services. The Trust continues
to benefit from this new regime as it
is phased in and is testimony to the
enormous efforts we have made in
the past few years to improve our
operational efficiency.
Turning to the formal issues, I am pleased to be able to report
on the Trust’s performance against its financial duties during
the nine months to 31st December 2008. Taking each of the
Trust’s main financial duties in turn:
1. To balance income with expenditure
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 £454.8 million
and expenditure of £450.1 million (including the payment
of Public Dividends) the Trust made a surplus of £4.7
million for the Financial Period 1st April 2008 to 31st
December 2008 therefore achieving the target.
2. To remain within the approved External
Financing Limit
The external financing limit is a control set by the
Department of Health upon the net cash position of
the Trust. The Trust is set a target, which can be either
positive or negative, depending on whether the Trust
has to borrow funds, or has sufficient cash balances to
meet its capital expenditure commitments. The Trust’s
financing limit for the period 1st April 2008 to 31st
December 2008 was a negative £3.5 million. The Trust
remained within this limit.
3. To achieve a Capital Cost Absorption Rate of 3.5%
The Trust is required to recognise the cost of capital at a
rate of 3.5% of average net relevant assets. This amount
is paid to the Treasury in the form of a dividend, which
was £6.0 million for the period 1st April 2008 to 31st
December 2008. The average relevant net assets for the
year were £190.5 million, which equates to a capital cost
absorption rate of 3.6%, which is within the target limits
set by the Department.
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Central Manchester and Manchester Children’s University Hospitals NHS Trust

Annual Report and Summary Financial Statements 2008/09
page 27
4. To remain within the approved
Capital Resource Limit
The Trust is required to stay within
a capital resource limit set by the
Department of Health. The Capital
Resource Limit (CRL) is the gross capital
expenditure for the period less the book value
of assets disposed of and capital grants and
donations received. The CRL set for the period 1st
April 2008 to 31st December 2008 was £8.9 million. The
Trust capital spend exactly matched the CRL.
In addition to those duties described above, the Trust must
also report its performance against the Better Payments
Practice Code and also the level of its management and
administration costs.
i) Better Payments Practice Code – this is a target to pay
all NHS and non-NHS trade creditors within 30 days of
receipt of goods or a valid invoice (whichever is later)
unless other payment terms have been agreed. The Trust
paid 84% of its invoices (on value) within those agreed
terms.
ii) Management and Administration Costs - these costs
were £14.0 million and represent 3.1% of total income
for the period.
In addition to the main financial statements that follow, full
details of Senior Managers remuneration are also provided
on page 35.
The Trust has insurance which is purchased through the NHS
Litigation Authority (NHSLA) to cover both liabilities to third
parties and clinical negligence. In addition, the Trust also
purchases commercial insurance for some risks not covered
by the NHSLA.
In conclusion, 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, whilst remaining within the resources
available to the Trust.
Adrian Roberts, Executive Director of Finance
29th April 2009

Summary
Financial Statements
The Summary Financial Statements on the following
pages are key extracts from the accounts of the Trust for
the period ended 31st December 2008.
A full copy of the accounts is available by written
application to Chief Accountant, Central Manchester
University Hospitals NHS Foundation Trust, Wilmslow
Park, K Block, 211 Hathersage Road, M13 9OJ.
We certify that the Summary Financial Statements on
pages 28 to 36 are extracts from the accounts of the
Trust as approved by the Trust Board.
M Deegan
A D Roberts
Chief Executive
Director of Finance
5th June 2009 5th June 2009
INCOME AND EXPENDITURE ACCOUNT
FOR THE PERIOD ENDED 31st December 2008
9 months to
2007/08
31st December
2008 £000
£000
Income from activities 376,079 432,404
Other operating income 78,756 135,048
Operating expenses (443,870) (559,001)
OPERATING SURPLUS/(DEFICIT) 10,965 8,451
Cost of fundamental reorganisation/restructuring 0 0
Profit/(loss) on disposal of fixed assets 0 0
SURPLUS/(DEFICIT) BEFORE INTEREST 10,965 8,451
Interest receivable 689 920
Interest payable 0 (11)
Other finance costs - unwinding of discount (60) (61)
SURPLUS/(DEFICIT) FOR THE FINANCIAL YEAR 11,594 9,299
Public Dividend Capital dividends payable (6,879) (8,963)
RETAINED SURPLUS/(DEFICIT) FOR THE YEAR 4,715 336
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Central Manchester and Manchester Children’s University Hospitals NHS Trust

Annual Report and Summary Financial Statements 2008/09
page 29
BALANCE SHEET
AS AT 31st DECEMBER 2008
FIXED ASSETS
31st December 2008
£000
31st March 2008
£000
Intangible assets 3,067 3,606
Tangible assets 123,445 166,486
Investments 0 0
126,512 170,092
CURRENT ASSETS
Stocks and work in progress 8,338 7,826
Debtors 49,888 38,546
Investments 0 0
Cash at bank and in hand 4,998 1,500
63,224 47,872
CREDITORS: Amounts falling due within one year (72,806) (63,736)
NET CURRENT ASSETS/(LIABILITIES) (9,582) (15,864)
DEBTORS: Amounts falling due after more than one year 121,828 122,874
TOTAL ASSETS LESS CURRENT LIABILITIES 238,758 277,102
CREDITORS: Amounts falling due after more than one year (7,350) (12,090)
PROVISIONS FOR LIABILITIES AND CHARGES (8,252) (7,150)
TOTAL ASSETS EMPLOYED 223,156 257,862
FINANCED BY:
TAXPAYERS’ EQUITY
Public dividend capital 169,355 169,355
Revaluation reserve 15,482 57,650
Donated asset reserve 2,800 3,391
Government grant reserve 195 295
Income and expenditure reserve 35,324 27,171
TOTAL TAXPAYERS’ EQUITY 223,156 257,862

STATEMENT OF TOTAL RECOGNISED GAINS
AND LOSSES
FOR THE PERIOD ENDED 31st December 2008
9 months to
2007/08
31st December 2008
£000
£000
Surplus for the financial year before dividend payments 11,594 9,299
Fixed asset impairment losses 0 0
Unrealised surplus on fixed asset revaluations/indexation (38,811) 8,909
Increases in the donated asset and government grant reserve due to
receipt of donated and government grant financed assets
0 506
Total recognised gains and losses for the financial year (27,217) 18,714
Prior period adjustment 0 (48,013)
Total gains and losses recognised in the financial year (27,217) (29,299)
page 30
Central Manchester and Manchester Children’s University Hospitals NHS Trust

Annual Report and Summary Financial Statements 2008/09
page 31
CASH FLOW STATEMENT
FOR THE PERIOD ENDED 31st December 2008
9 months to 31st
2007/08
December 2008
£000
£000
OPERATING ACTIVITIES
Net cash inflow from operating activities 18,780 34,360
RETURNS ON INVESTMENTS AND SERVICING OF FINANCE:
Interest received 689 920
Interest paid 0 (11)
Interest element of finance leases 0 0
Net cash inflow from returns on investments and servicing of finance 689 909
CAPITAL EXPENDITURE
(Payments) to acquire tangible fixed assets (11,380) (17,764)
Receipts from sale of tangible fixed assets 0 232
(Payments) to acquire intangible assets (5) (2,772)
Receipts from sale of intangible assets 0 0
(Payments to acquire)/receipts from sale of fixed asset investments 0 0
Net cash (outflow) from capital expenditure (11,385) (20,304)
DIVIDENDS PAID (4,586) (8,963)
Net cash inflow before management of liquid resources and financing 3,498 6,002
MANAGEMENT OF LIQUID RESOURCES
(Purchase) of investments with Department of Health (DH) 0 0
(Purchase) of other current asset investments 0 0
Sale of investments with DH 0 0
Sale of other current asset investments 0 0
Net cash inflow/(outflow) from management of liquid resources 0 0
Net cash inflow before financing 3,498 6,002
FINANCING
Public dividend capital received 0 20,956
Public dividend capital repaid (not previously accrued) 0 (26,946)
Loans received from DH 0 0
Other loans received 0 0
Loans repaid to DH 0 0
Other loans repaid 0 0
Other capital receipts 0 0
Capital element of finance lease rental payments 0 0
Cash transferred (to)/from other NHS bodies 0 0
Net cash (outflow) from financing 0 (5,990)
Increase in cash 3,498 12

Better Payment Practice Code - measure of compliance
9 Months to 31st December 2008
Number £000
Total Non-NHS trade invoices paid in the nine months to 31st December 2008 112,565 184,290
Total Non NHS trade invoices paid within target 99,657 157,802
Percentage of Non-NHS trade invoices paid within target 89% 86%
Total NHS trade invoices paid in the nine months to 31st December 2008 5,126 55,607
Total NHS trade invoices paid within target 3,595 44,087
Percentage of NHS trade invoices paid within target 70% 79%
The Better Payment Practice Code requires the Trust to aim to pay all undisputed invoices by the due date or within 30 days of
receipt of goods or a valid invoice, whichever is later.
The Late Payment of Commercial Debts (Interest) Act 1998
The Trust made no payments under The Late Payment of Commercial Debts (Interest) Act 1998 in the nine months to 31st
December 2008 (£11k 2007/08).
Management costs
9 Months to
2007/08
31st December 2008
£000
£000
Management costs 14,023 15,452
Income 454,835 567,451
Management costs as a proportion of income (%) 3.08% 2.72%
Management costs are defined as those on the management costs website at www.dh.gov.uk/PolicyAndGuidance/
OrganisationPolicy/FinanceAndPlanning/NHSManagementCosts/fs/en..
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Central Manchester and Manchester Children’s University Hospitals NHS Trust

Annual Report and Summary Financial Statements 2008/09
page 33
Breakeven Performance
The Trust’s breakeven performance for the 9 months to 31st December 2008 is as follows:
2003/04
£000
2004/05
£000
2005/06
£000
2006/07
£000
2007/08
£000
9 Months
to 31st
December
2008
£000
Turnover 396,832 432,633 483,340 510,848 567,452 454,835
Retained surplus/(deficit) for the year 128 (7,727) 6,481 1,317 336 4,715
Adjustment for:
• Timing/non-cash impacting distortions
• Use of pre - 1.4.97 surpluses [FDL(97)24 Agreements]
0 0 0 0 0 0
• 2004/05 Prior Period Adjustment (relating to
0 0 0 0 0 0
1997/98 to 2003/04)
• 2005/06 Prior Period Adjustment (relating to
0 0 0 0 0 0
1997/98 to 2004/05)
• 2006/07 Prior Period Adjustment (relating to
0 0 0 0 0 0
1997/98 to 2005/06)
• 2007/08 Prior Period Adjustment (relating to
(160) (107) (284) (44) 0 0
1997/98 to 2006/07)
• 2008/09 Prior Period Adjustment (relating to
0 0 0 0 0 0
1997/98 to 2007/08)
• Other agreed adjustments 0 0 7,727 0 0 0
Break-even in-year position (32) (7,834) 13,924 1,273 336 4,715
Break-even cumulative position (10) (7,844) 6,080 7,353 7,689 12,404
Materiality test (I.e. is it equal to or less than 0.5%):
• Break-even in-year position as a percentage of (0.01%) (1.81%) 2.88% 0.25% 0.06% 1.04%
turnover
• Break-even cumulative position as a percentage
of turnover
(0.00%) (1.81%) 1.26% 1.44% 1.36% 2.73%
Capital cost absorption rate
The Trust is required to absorb the cost of capital at a rate of 3.5% of average relevant net assets. The rate is calculated as
the percentage that dividends paid on public dividend capital, totalling £6,879k, bears to the average relevant net assets of
£190,480k, on an annualised basis, that is 3.6%.
The annualised basis has been calculated by pro-rating, for 9 months to 31st December 2008, both the public dividend capital
and average net relevant assets. This maintains comparability with the annual calculation.

External financing
The Trust is given an external financing limit which it is permitted to undershoot.
9 Months to 31st
December 2008
2007/08
£000
£000
£000
External financing limit (3,498) (5,990)
Cash flow financing (3,498) (6,002)
Finance leases taken out in the year 0 0
Other capital receipts 0 0
External financing requirement (3,498) (6,002)
Undershoot/(overshoot) 0 12
Capital Resource Limit
The Trust is given a capital resource limit which it is not permitted to overspend
9 Months to 31st
2007/08
December 2008
£000
£000
Gross capital expenditure 8,974 20,852
Less: book value of assets disposed of 0 (232)
Plus: loss on disposal of donated assets 0 0
Less: capital grants 0 (152)
Less: donations towards the acquisition of fixed assets 0 (354)
Charge against the capital resource limit 8,974 20,114
Capital resource limit 8,974 23,038
Underspend against the capital resource limit 0 2,924
For 2007/08 the Department of Health issued an instruction that expenditure incurred as part of the PFI transfer can not be
capitalised and therefore is not to be charged against the Capital Resource Limit (CRL). As a consequence the Trust had a technical
under-spend against its CRL of £2,924k, as shown above, since the CRL value could not be adjusted post year end. This
has not affected either the availability or use of resources for the Trust’s ongoing capital programme.
Trust External Auditors
The Trust’s external auditors are the Audit Commission. During 2008/09 they performed audit work to the value of £113,000.
page 34
Central Manchester and Manchester Children’s University Hospitals NHS Trust

Annual Report and Summary Financial Statements 2008/09
page 35
Salary and pension entitlements of senior managers
(a) Remuneration
Name and title
2008-09 for the Nine Months to
31st December 2008
Salary
(bands of
£5000)
£000
Other Remuneration
(bands of
£5000)
£000
Benefits in
kind
(Rounded to
the nearest
£100)
Salary
(bands of
£5000)
£000
2007-08
Other Remuneration
(bands of
£5000)
£000
P Mount, Chairman 15-20 20-25
S Jones, Non-Executive Director 0-5 5-10
A Leon, Non-Executive Director 0-5 5-10
W Shaw, Non-Executive Director* (to 09/09/07) - -
J Somerset, Non-Executive Director 0-5 5-10
C Nangle, Non-Executive Director 0-5 5-10
B Nkwenti-Azeh, Non-Executive Director
0-5 5-10
(to 31/07/08)
R Coombs, Non-Executive Director 0-5 0-5
R Bradley, Non-Executive Director (from 10/11/08) 0-5 -
S Mole, Non-Executive Director (from 10/11/08) 0-5 -
B Smith, Non-Executive Director (from 10/11/08) 0-5 -
M Deegan, Chief Executive 145-150 190-195
D Welsh, Executive Director of Human & Corporate 85-90 110-115
Resources
G Heaton, Executive Director of Patient Services/ 110-115 150-155
Chief Nurse
M Hodgson, Executive Director of Children’s Services 75-80 100-105
J Scampion, Executive Director of Finance, Information,
- 15-20
Capital & Planning (to 18/05/07)
R Pearson, Medical Director 70-75 95-100 95-100 125-130
L Readman, Acting Executive Director of Planning (to 15-20 100-105
01/06/08)
A Roberts, Executive Director of Finance 100-105 110-115
Benefits in
kind
(Rounded to
the nearest
£100)
Notes
* Professor Shaw waived the right to receive a Non-Executive Directors fee.

(b) Pension Benefits
Name and title
Real
increase
in pension
at age 60
(bands of
£2,500)
Real
increase
in pension
lump sum
at aged 60
(bands of
£2,500)
Total
accrued
pension at
age 60 at
31 March
2008
(bands of
£5,000)
Lump sum
at age 60
related to
accrued
pension at
31 March
2008
(bands of
£5,000)
Cash
Equivalent
Transfer
Value at
31 March
2008
Cash
Equivalent
Transfer
Value at
31 March
2007
Real
increase
in Cash
Equivalent
Transfer
Value
£000 £000 £000 £000 £000 £000 £000
M Deegan, Chief Executive 0-2.5 5-7.5 25-30 75-80 427 322 70
G Heaton, Executive Director of Patient Service/Chief
0-2.5 5-7.5 30-35 100-105 639 501 89
Nurse
M Hodgson, Executive Director of Children’s 0-2.5 2.5-5 15-20 55-60 256 199 37
Services
R Pearson, Medical Director 0-2.5 5-7.5 70-75 210-215 1,502 1,159 225
D Welsh, Executive Director of Human & Corporate
0-2.5 2.5-5 45-50 145-150 1,036 805 151
Resources
L Readman, Acting Executive Director of Planning
- - 30-35 95-100 508 495 7
(to 01/06/08)
A Roberts, Executive Director of Finance 0-2.5 5-7.5 35-40 105-110 573 442 86
A Roberts, Executive Director of Finance (from
21/05/07)
2.5-5 10-12.5 30-35 100-105 442 358 53
The above table gives pension benefits up to 31st December 2008.
As Non-Executive members do not receive pensionable remuneration, there will be no entries in respect of pensions for Non-
Executive members.
A Cash Equivalent Transfer Value (CETV) is the actuarially assessed capital value of the pension scheme benefits accrued by
a member at a particular point in time. The benefits valued are the member’s accrued benefits and any contingent spouse’s
pension payable from the scheme. A CETV is a payment made by a pension scheme, or arrangement to secure pension
benefits in another pension scheme or arrangement when the member leaves a scheme and chooses to transfer the benefits
accrued in their former scheme. The pension figures shown relate to the benefits that the individual has accrued as a
consequence of their total membership of the pension scheme, not just their service in a senior capacity to which the disclosure
applies.
The CETV figures, and from 2005-06 the other pension details, include the value of any pension benefits in another scheme or
arrangement which the individual has transferred to the NHS pension scheme. They also include any additional pension benefit
accrued to the member as a result of their purchasing additional years of pension service in the scheme at their own cost.
CETVs are calculated within the guidelines and framework prescribed by the Institute and Faculty of Actuaries.
Real Increase in CETV - This reflects the increase in CETV effectively funded by the employer. It takes account of the increase
in accrued pension due to inflation, contributions paid by the employee (including the value of any benefits transferred from
another pension scheme or arrangement) and uses common market valuation factors for the start and end of the period.
page 36
Central Manchester and Manchester Children’s University Hospitals NHS Trust

Annual Report and Summary Financial Statements 2008/09
page 37
INDEPENDENT AUDITOR’S REPORT TO THE
BOARD OF DIRECTORS
Opinion on the financial
statements
I have audited the financial statements of Central
Manchester and Manchester Children’s University
Hospitals NHS Trust for the period ended 31st
December 2008 under the Audit Commission Act 1998.
The financial statements comprise the Income and
Expenditure Account, the Balance Sheet, the Cashflow
Statement, the Statement of Total Recognised Gains and
Losses and the related notes. These financial statements
have been prepared in accordance with the accounting
policies directed by the Secretary of State with the
consent of the Treasury as relevant to the National Health
Service set out within them. I have also audited the
information in the Remuneration Report that is described
as having been audited.
This report is made solely to the Board of Directors of
Central Manchester University Hospitals NHS Foundation
Trust (the successor body) in accordance with Part II
of the Audit Commission Act 1998 and for no other
purpose, as set out in paragraph 36 of the Statement
of Responsibilities of Auditors and of Audited Bodies
prepared by the Audit Commission.
properly prepared in accordance with the accounting
policies directed by the Secretary of State as being
relevant to the National Health Service in England. I also
report to you whether, in my opinion, the information
which comprises the commentary on the financial
performance included within the message from the
Chairman and Chief Executive and the Report of the
Director of Finance, included in the Annual Report, is
consistent with the financial statements.
I review whether the directors’ Statement on Internal
Control reflects compliance with the Department
of Health’s requirements, set out in ‘Guidance on
Completing the Statement on Internal Control 2008/09’
issued 25th February 2009. I report if it does not meet
the requirements specified by the Department of Health
or if the statement is misleading or inconsistent with
other information I am aware of from my audit of the
financial statements. I am not required to consider, nor
have I considered, whether the directors’ Statement on
Internal Control covers all risks and controls. Neither am
I required to form an opinion on the effectiveness of the
Trust’s corporate governance procedures or its risk and
control procedures.
Respective responsibilities of
Directors and auditor
The directors’ responsibilities for preparing the financial
statements in accordance with directions made by
the Secretary of State are set out in the Statement of
Directors’ Responsibilities.
My responsibility is to audit the financial statements
in accordance with relevant legal and regulatory
requirements and International Standards on Auditing
(UK and Ireland).
I report to you my opinion as to whether the
financial statements give a true and fair view in
accordance with the accounting policies directed
by the Secretary of State as being relevant to
the National Health Service in England. I report
whether the financial statements and the part of
the Remuneration Report to be audited have been

I read the other information contained in the Annual
Report and consider whether it is consistent with the
audited financial statements. This other information
comprises message from the Chairman and Chief
Executive and the report of the Director of Finance. I
consider the implications for my report if I become aware
of any apparent misstatements or material inconsistencies
with the financial statements. My responsibilities do not
extend to any other information.
Basis of audit opinion
I conducted my audit in accordance with the Audit
Commission Act 1998, the Code of Audit Practice issued
by the Audit Commission and International Standards on
Auditing (UK and Ireland) issued by the Auditing Practices
Board. An audit includes examination, on a test basis, of
evidence relevant to the amounts and disclosures in the
financial statements and the part of the Remuneration
Report to be audited. It also includes an assessment of
the significant estimates and judgments made by the
directors in the preparation of the financial statements,
and of whether the accounting policies are appropriate
to the Trust’s circumstances, consistently applied and
adequately disclosed.
I planned and performed my audit so as to obtain all
the information and explanations which I considered
necessary in order to provide me with sufficient evidence
to give reasonable assurance that:
■ the financial statements are free from material
misstatement, whether caused by fraud or other
irregularity or error; and
■ the financial statements and the part of the
Remuneration Report to be audited have been
properly prepared.
In forming my opinion I also evaluated the overall
adequacy of the presentation of information in the
financial statements and the part of the Remuneration
Report to be audited.
Opinion
In my opinion:
■ the financial statements give a true and fair view,
in accordance with the accounting policies directed
by the Secretary of State as being relevant to the
National Health Service in England, of the state of the
Trust’s affairs as at 31st December 2008 and of its
income and expenditure for the period then ended;
■ the part of the Remuneration Report to be audited
has been properly prepared in accordance with the
accounting policies directed by the Secretary of State
as being relevant to the National Health Service in
England; and
■ information which comprises the commentary on
the financial performance included within the report
of Director of Finance, included within the Annual
Report, is consistent with the financial statements.
Certificate
I certify that I have completed the audit of the accounts
in accordance with the requirements of the Audit
Commission Act 1998 and the Code of Audit Practice
issued by the Audit Commission.
Jackie Bellard
Officer of the Audit Commission
Audit Commission
Aspinall House
Aspinall Close
Middlebrook
Bolton
BL6 6QQ
8th June 2009
page 38
Central Manchester and Manchester Children’s University Hospitals NHS Trust

We would like to thank everyone who has contributed to producing
this Annual Report.
For further information contact:
Director of Corporate Services • Telephone: 0161 276 6262
For further information about the organisation visit our website: www.cmft.nhs.uk
Produced by: Communications Unit
Designed and printed by: Niche Communications Ltd • Tel: 0161 430 7771 • Email: pat@nichecommunications.co.uk