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Annual Report and Accounts 2003/2004 - Homerton University ...

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From the Chairman <strong>and</strong> Chief Executivephoto right:Chairman <strong>and</strong> chiefexecutive welcomeJohn Reid, Secretaryof State for Healthphoto far right:Our Chairman <strong>and</strong>executive teamP2This year brought to a close onestage in the history of <strong>Homerton</strong>Hospital. We have chosen in this<strong>Annual</strong> <strong>Report</strong> to look back over thehistory not just of <strong>Homerton</strong> but ofsome of the other hospitals that haveserved Hackney.Hospitals have existed for hundreds of years,providing not just places of health care butalso focal points for the communities theyserve. There is something both reassuring<strong>and</strong> humbling in the knowledge that ahospital has stood on the <strong>Homerton</strong>’s sitesince the 1700s. Many of the buildings whichhoused Hackney’s other hospitals in bygoneyears still exist, serving the community indifferent ways now.The core of the current <strong>Homerton</strong> Hospitalwas built nearly twenty years ago to providegeneral services for the people of Hackney. Amajor extension was added five years ago tohouse new developments. It was not until1994 that <strong>Homerton</strong> gained its ownmanagement board, having until that timebeen part of other health bodies. This Boardstood down at the end of March this year toallow for the new NHS Foundation Trust tobe established. We were one of the firsthospitals in the country to be granted thisindependent status, allowing us for the firsttime to elect members of the public <strong>and</strong> staffto become governors of the Trust.People rightly have strong views about theirhospital <strong>and</strong> how it should serve itspopulation. It is of course the care <strong>and</strong>treatment they receive from their hospitalthat matters most, not how <strong>and</strong> by whom itis managed. We hope though that as theBoard responsible for managing <strong>Homerton</strong><strong>University</strong> Hospital NHS Trust, we have beenable to demonstrate that our foremostconcern was always the people we serve.As the Board responsible for <strong>Homerton</strong><strong>University</strong> Hospital NHS Foundation Trustwe will continue with our mission – “to bethe hospital for Hackney; keeping the peopleof Hackney in the best of health, caring forour community, our staff <strong>and</strong> our hospital”.Our backward look in this <strong>Annual</strong> <strong>Report</strong>shows how important hospitals have beenin the history of Hackney. We, at <strong>Homerton</strong>are pleased <strong>and</strong> proud to be part ofHackney’s future.Andy Windross, ChairmanNancy Hallett, Chief Executive


A guide to our clinical servicesDirectorate of Medicine<strong>and</strong> RehabilitationDirectorate of Medicine<strong>and</strong> RehabilitationDirectorate of Surgery, Anaesthesia& Critical CareDirectorate of Services for Children,Women & Sexual HealthGeneral MedicineOutpatient ServicesCardiologyDermatologyGastroenterologyEndocrinology & Diabetes ServiceHypertensionMedicine for the ElderlyNeurologyNeurorehabilitationRespiratory MedicineRheumatologyStroke UnitTherapy Services- Physiotherapy- Speech & Language Therapy- Dietetics- Occupational TherapyPatient AppliancesPharmacyRadiologyMedical PhotographyHealthcare RecordsPathology- Microbiology & Infection Control- Haematology- Chemical Pathology- Histology, Virology & ImmunologyAccident & Emergency Services- Adult Majors- Injuries Unit- Children’s A&EClinical Site ManagementMortuary ServicesBereavement ServicesDischarge LoungeGeneral SurgeryCritical Care ServicesAnaestheticsEar, Nose & Throat ServicesMaxillo-facial SurgeryPlastic SurgeryPodiatryTrauma & OrthopaedicsUrologyInpatient Operating TheatresDay Surgery UnitEndoscopy ServicesSterile SuppliesCancer & Palliative CareChronic Pain & Acute Pain ServicesMaternity & ObstetricsGynaecology & Emergency AssessmentEarly Pregnancy AssessmentColposcopySexual Health & Family PlanningHIV ServicesFertility ServicesFetal MedicineNeonatal Unit- Intensive Care- Special Care- Transitional CareChildren’s ServicesRP3IM: 1Ex: 14285SE: 1


Health in Hackneymap left:1913 map of Hackney,Hackney UnionWorkhouse <strong>and</strong> EasternHospital sites are shown.<strong>Homerton</strong> <strong>University</strong>Hospital now st<strong>and</strong>swhere the EasternHospital is.OCTOBERmap right:1913 map of Dalston,showing the site of theGerman Hospital.P4We realise that many ofyou may remember the“old” hospitals inHackney - St Leonards,St Matthews, theMothers’, QueenElizabeth Hospital forChildren, theMetropolitan, theGerman, the Eastern<strong>and</strong> Hackney.Here we look moreclosely at just four ofthem-those whichclosed at a similar timeto <strong>Homerton</strong> opening;remembering thoughthat all havecontributed to<strong>Homerton</strong> becomingwhat it is today.Hackney was first recorded in 1198 <strong>and</strong>for 400 years remained as a farmingcommunity in Middlesex; districts weknow today including <strong>Homerton</strong>,Dalston, Clapton <strong>and</strong> Shacklewell werehamlets in the parish of Hackney.It quickly established itself as an area ofdiversity; as well as nonconformistworshippers in the 1600s <strong>and</strong> 1700s, therewere a number of immigrants from Europe.The communities we know today can alsotrace their roots back to the 17th Century;Jewish people have lived here since 1684,there has been a black presence since1630 (although the Afro-Caribbeancommunity did not fully develop until the1950s), <strong>and</strong> Asian nurses for Britishchildren have been staying in the area sincethe early 1900s. As you will see from thehistory of the hospitals in this area therewas a strong German community from the1800s.Hackney’s first hospital was founded in1280, called the Kingsl<strong>and</strong> Leper Hospital(based on Kingsl<strong>and</strong> Road). It was one often leper hospitals set up in London; it waseventually closed in 1760. Although thearea was very diverse, in terms ofhealthcare Hackney conformed to theEnglish system.By the 1800s there were two kinds ofhospital in Engl<strong>and</strong>: the voluntary hospitals,which were funded by donations fromprivate benefactors who were then ablenominate patients for treatment by writingletters of introduction; or the workhouseinfirmaries, public fever <strong>and</strong> mentalhospitals. All hospitals were used only bythe poor; patients had a higher chance ofrecovery if they were nursed at home <strong>and</strong>so those who could afford to would pay fora nurse to tend to them there.


OktoobarOCTOBEROct <strong>2004</strong>M T W T F S SOCTOBERHealth in HackneyP5View of Hackney in 1831,including the site ofHackney Union Workhouse1 2 34 5 6 7 8 9 1011 12 13 14 15 16 1718 19 20 21 22 23 2425 26 27 28 29 30 31


Hackney Hospital1750 - 1995NOVEMBERP6Hackney register ofdeaths 1879 – showingsome of the illnessesat that timeOver 250 years ago, in 1750, a room wasopened in the Hackney Union Workhouse on<strong>Homerton</strong> High Street, to allow sick paupers tobe treated away from other residents. Thisroom became known as Hackney Hospital <strong>and</strong>was run by one matron <strong>and</strong> one nurse; by1751 a larger room was needed <strong>and</strong> thehospital started to look after what was termedat that time as the ‘insane’ as well as the sick.By 1801 the dem<strong>and</strong>s for healthcare due tothe poor social conditions of the area hadsoared; l<strong>and</strong> was purchased on <strong>Homerton</strong>High Street but nothing was built orNurses signing upnew traineesA less electronictelephoneexchangeDiagnosticsmodernised until 1834 when the Guardians ofthe Poor took over the management of poorrelief from the Trustees of the parish of St John,who had previously managed the workhouse.Known primarily at this time as the workhouseinfirmary, the building was quickly filled waybeyond its capacity due to a cholera epidemic,which was worsened by overcrowding, poordrainage <strong>and</strong> the resignation of the parishMedical Officer in 1849.Although the Guardians continually exp<strong>and</strong>ed<strong>and</strong> improved the buildings, workhouses wereseen as miserable, depressing places; thereX-ray in actionLaundry servicesthe large wayHealthcare recordsin the 1970sA typical ward1950were very few comforts <strong>and</strong> the decorationconsisted of brown <strong>and</strong> white walls <strong>and</strong> barelyany ornaments. There were hardly any booksor games (cards were strictly forbidden), <strong>and</strong>patients had to sleep on flock beds withwooden or iron bedsteads. Food wasunappetising, consisting of mutton, bread <strong>and</strong>beer with no fruit or vegetables; it was alsogenerally cold from being carried a longdistance from the kitchens. Nurses weresparse <strong>and</strong> many had not been trained; inaddition, with beer <strong>and</strong> gin being used tosupplement their wages, many nurses werealso prone to being drunk.


NoofembarNOVEMBERNov <strong>2004</strong>NOVEMBERHackney Hospital 1750 - 1995P7M T W T F S S1 2 3 4 5 6 78 9 10 11 12 13 1415 16 17 18 19 20 2122 23 24 25 26 27 2829 30


Hackney Hospital1750 - 1995DECEMBERPrincess Alex<strong>and</strong>raopening the Oncologyunit in 1976P8Further rebuilding took place at HackneyHospital following the Metropolitan Poor LawAct in 1867 <strong>and</strong> the hospital became aseparate building from the workhouse. By theend of the 1800s this building, which startedas a small room, now housed 606 beds <strong>and</strong>the nursing staff (who were now completingtraining programmes) had risen to a matron,her assistant, 11 staff nurses, 26 students<strong>and</strong> six maids.Nurses at this time worked 57 hours perweek or 72 hours if on night duty.Today the average nurse works 37 hoursper week.Lab staff at work Works department Operating theatreIn 1930, London County Council gainedcontrol of the workhouse, now known as theHackney Institute; within four years theworkhouse had closed <strong>and</strong> the building wasused for hospital accommodation, with itformally coming under the management ofHackney Hospital in 1938. With the creation ofthe NHS in 1948, further funds were madeavailable allowing the hospital to build a newoutpatients department in 1956 <strong>and</strong>physiotherapy rooms in 1957. In addition, anew Oncology unit was opened in 1976. Bythis time Hackney Hospital was one of thelargest general hospitals in London <strong>and</strong> wasthe first hospital in the country authorised toaccept male nurses for training.Invitation to the openingHackney register of birthsThe Department of Health restructured servicesin 1974 <strong>and</strong> created a number of healthauthorities to oversee the hospital <strong>and</strong> servicedevelopments within their designatedboroughs. The City <strong>and</strong> Hackney HealthAuthority opened <strong>Homerton</strong> Hospital in 1986<strong>and</strong> over time services from Hackney Hospitalwere transferred there.You can now see the original buildings ofHackney Hospital being restored as part ofEast London <strong>and</strong> the City Mental Health Trust.


DiisembarDECEMBERDec <strong>2004</strong>DECEMBERHackney Hospital 1750 - 1995P9At work on the wardM T W T F S S1 2 3 4 56 7 8 9 10 11 1213 14 15 16 17 18 1920 21 22 23 24 25 2627 28 29 30 31


German Hospital1845 - 1987Outpatients departmentJANUARYP10In October 1845 the German Hospital,on the site of the former Dalston InfantOrphan Asylum on Dalston Road, wasopened with only 12 beds, later exp<strong>and</strong>ingto four wards of ten beds each. It was ahospital for German immigrants, staffed byGerman nurses recruited from theKaiserworth Institute in Germany; at this timeGermans were the largest immigrantcommunity, with approximately 30,000 livingin Engl<strong>and</strong>. Many lived <strong>and</strong> worked in verypoor conditions in east London; thiscombined with poverty <strong>and</strong> the inabilityto speak English properly left the Germancommunity unable to use the medicalresources available. A German pastor <strong>and</strong>a doctor made it their mission to build ahospital to meet the needs of theircommunity, enlisting the help of the richin Engl<strong>and</strong>.Children's wardIt was the work that the nurses did atthe German Hospital that inspiredFlorence Nightingale to visit twice<strong>and</strong> then enrol for training at theInstitute in Germany in 1851.Not conforming to the other foreignhospitals which were being opened, theGerman Hospital followed the traditionalEnglish system of healthcare by being runas a voluntary general hospital i.e. nonteaching hospital. The hospital was primarilyfor those who ‘spoke with German tongue’,Floorplan 1864but it did also see English speaking peopleas outpatients. In addition, it boasted asanitorium for the more affluent patientswho could afford treatment but couldn’t benursed at home (e.g. young singleprofessional men or those with no family).New hospital buildings, meeting the highestst<strong>and</strong>ard in hospital design, were opened in1864, which proved invaluable during thefever epidemics raging across Londonduring the 1860s <strong>and</strong> ‘70s.


JannaayoJANUARYJan 2005M T W T F S SJANUARYGerman Hospital 1845 - 1987P111 23 4 5 6 7 8 910 11 12 13 14 15 1617 18 19 20 21 22 2324 25 26 27 28 29 3031


German Hospital1845 - 1987FEBRUARYP12During the First World War, the hospitalremained open <strong>and</strong> was still run byGerman doctors <strong>and</strong> nurses despiteanti-German feeling in Engl<strong>and</strong> <strong>and</strong> theshortage of medical staff back home inGermany to treat war casualties.Between the First <strong>and</strong> Second WorldWars, the hospital undertook a number ofimprovements <strong>and</strong> extensions to thebuildings. At this time there was a declinein the German population in London <strong>and</strong> aneed for more beds for Londoners.The main building, opened in 1936, wasprimarily for maternity <strong>and</strong> children wards,<strong>and</strong> was seen as a leading architectural<strong>and</strong> medical development; particularly withthe introduction of roof gardens withHospital gardensMain entrancepanoramic views across London.After the outbreak of the Second WorldWar, staff of the German Hospital werearrested <strong>and</strong> confined on the Isle of Man.From this point on the hospital wasGerman by name only.The hospital became part of the NHS in1948, ceasing its function as a voluntaryhospital. Then in 1974 it became part ofthe City <strong>and</strong> Hackney Health Authority. TheDay roomTypical patient notes, 1897focus of the German hospital shifted afterthis time, providing care for psychiatric <strong>and</strong>elderly mentally ill patients; this includedemergency night shelter facilities for theelderly. These services were transferred to<strong>Homerton</strong> Hospital in 1987, when theGerman closed its doors.More recently the building was redevelopedas housing.


FebraayoFEBRUARYFeb 2005FEBRUARYGerman Hospital 1845 - 1987P13Hospital gardensM T W T F S S1 2 3 4 5 67 8 9 10 11 12 1314 15 16 17 18 19 2021 22 23 24 25 26 2728


Eastern Hospital1870 - 1982MARCHP14In December 1870 a fever hospital (laterknown as the Eastern Hospital) was openedon the site of where <strong>Homerton</strong> Hospital istoday; this hospital housed six typhus wards,two scarlet fever wards, two wards forpatients with enteric fever <strong>and</strong> two wards forany special cases. Before the fever hospitalwas opened there were a number ofepidemics throughout London - particularlypeople with relapse fever (where theyseemed to recover but relapsed after aweek). The Metropolitan Asylums Board wasin charge of all fever cases <strong>and</strong> designatedthe site as a fever <strong>and</strong> smallpox hospital.When the fever hospital opened, all 200beds were immediately taken up. Thebuilding of a smallpox hospital next doorwas still taking place to prevent the spreadof the epidemic, which between 1870 <strong>and</strong>1871 killed 8000 people in London. Thesmallpox hospital opened in February 1871<strong>and</strong> was made up of fourIsolation block1935Cubicle in isolation ward1935blocks, each with eight wards of 12 beds.In the first three days 60 patients wereadmitted <strong>and</strong> by the next month thehospital was filled to capacity. The overflowwent to the fever hospital, which by thistime housed 600 beds. Recoveringpatients stayed in corridors or in tents inthe hospital’s garden, some were evensent to stay in a hospital ship moored atGreenwich. By July the epidemic hadnearly ended <strong>and</strong> by 1873 the smallpoxhospital was practically empty.Babies cubicle in isolation block1938The first inoculation for smallpox was madein Engl<strong>and</strong> in 1721 <strong>and</strong> a vaccine wasintroduced in 1796; it was not until 1853however that infant vaccinations weremade compulsory, although they were notreceived by everyone. The 1870s epidemicshowed that the vaccinations worked, asno patient who had been vaccinated died.Following the smallpox decline, it was nolonger feasible to keep the hospital open<strong>and</strong> in 1921 it merged with the Eastern‘fever’ Hospital.


MaarsoMARCHMar 2005M T W T F S S1 2 3 4 5 6MARCHEastern Hospital 1870 - 1982P15Site map19307 8 9 10 11 12 1314 15 16 17 18 19 2021 22 23 24 25 26 2728 29 30 31


Eastern Hospital1870 - 1982Day roomEastern closing<strong>and</strong> demolitionright <strong>and</strong> belowFamous clock tower, which now st<strong>and</strong>sin a park near Hoxton MarketAPRILP16The 1920s saw the Eastern Hospitaltreating mainly scarlet fever <strong>and</strong> diphtheriain children. Patients were made to wearrough flannel nightdresses <strong>and</strong> black boots,<strong>and</strong> breakfast consisted of weak cocoa <strong>and</strong>marmalade s<strong>and</strong>wiches. They were put intoisolation facilities until they had beendiagnosed, at which time they would bemoved to a general ward.During the Second World War, St John’sHospital for Diseases of the Skin in LeicesterSquare lost all of its inpatient facilities due tothe bombing. Patients were moved to theEastern <strong>and</strong> the relationship between the twohospitals continued until their closure. Afterthe war the Eastern played an important partin the fight against TB <strong>and</strong> polio. With thesediseases under control at this time, thewards were then used to care for the elderly<strong>and</strong> mentally h<strong>and</strong>icapped children.In 1974 the Eastern was bought under themanagement of the City <strong>and</strong> HackneyHealth Authority; it was closed in 1982 <strong>and</strong>most of the buildings were demolished.<strong>Homerton</strong> Hospital was built on the sitewhere the Eastern Hospital stood, openingin 1986. The only remaining building of thisera is Chatsworth House.


AbriilAPRILApr 2005M T W T F S S1 2 34 5 6 7 8 9 10APRILEastern Hospital 1870 - 1982P1711 12 13 14 15 16 1718 19 20 21 22 23 2425 26 27 28 29 30


Mothers’ Hospital1884 - 1986Front elevation1958The front façade neverchanged despite hopesIn 1884 the Salvation Army opened a refugeehome at Ivy House on Mare Street, Hackney.Many of the women arriving at the housewere pregnant <strong>and</strong> unmarried. To be so atthis time would mean becoming a socialoutcast, with employers <strong>and</strong> parentsdisowning the women; so in 1888 theSalvation Army decided to dedicate Ivy Houseto the care of pregnant, unmarried women.Patient temperature chart1898MAYP18The house was the first to look afterunmarried mothers, previously all hospitalswould only cater for those who were married.The house was also used as a midwives’training school; the first student midwife wastrained in 1889 <strong>and</strong> for the 18 years thehospital was based at Ivy House, where morethan 250 student midwives graduated.Whilst based at Ivy House the hospitalexp<strong>and</strong>ed <strong>and</strong> more l<strong>and</strong> was bought,including a mother <strong>and</strong> baby home calledCotl<strong>and</strong> based on Springfield Road, UpperClapton. Eventually the Salvation Army builta hospital solely for unmarried mothers basedConveyance of the freeholdon Lower Clapton Road. Opened in 1913 byQueen Victoria’s daughter, Princess Louise,the hospital was officially called the Mothers’for the first time.The hospital particularly catered for the poor<strong>and</strong> unmarried; during the First World War italso began to look after a large numberof women who had become widowed ordestitute <strong>and</strong> from this point on agreed totake married or unmarried mothers. Thehospital was originally built to caterfor 600 births per year, but it was soonexp<strong>and</strong>ed upon as this number increased.As part of the developments to the hospital,a new nurses’ home <strong>and</strong> theatre wasopened by Queen Mary in 1921.By the 1930s the number of births peryear had risen to 2,000. The hospital alsocontinued to train midwives <strong>and</strong>encouraged research <strong>and</strong> innovation.


MayMAYMay 2005M T W T F S S12 3 4 5 6 7 8Artist’s impression of the hospital9 10 11 12 13 14 15MAYMothers’ Hospital 1894 - 1986P1916 17 18 19 20 21 2223 24 25 26 27 28 2930 31


Mothers’ Hospital1884 - 1986Mothers’ hospitalin the 1980sWalkway insidethe hospitalJUNEP20During the Second World War, the hospitalsuffered some damage; plans were made toevacuate to Willersley Castle in Matlock,Derbyshire <strong>and</strong> to Bragborough Hall inNorthamptonshire, but the hospital remainedopen for those who did not leave Londonduring the war. Between 1939 <strong>and</strong> 1945,6587 babies were born.In 1948 the Mothers’ Hospital became partof the NHS, although it was agreed that anumber of staff could be Salvation ArmyDuring the wartime period, mothers weremade mobile on the second day afterdelivery, to ensure that transfers to airraid shelters were orderly (<strong>and</strong> alsoallowing more space due to less bedsbeing taken down). This was contrary tonursing techniques at that time, howeveris a method used in modern medicine.members – this relationship between theNHS <strong>and</strong> the Salvation Army continued untilthe Mothers’ closure. Further growth allowedthe hospital to open a training centre <strong>and</strong>home for 24 nurses in 1952. At this time, thehospital also started to provide a service formothers giving birth in their own homes.In 1974, the hospital became part of the City<strong>and</strong> Hackney Health Authority. The hospitalwas closed in 1986 when <strong>Homerton</strong> Hospitalopened <strong>and</strong> all the maternity <strong>and</strong> obstetricservices were transferred.During 1912 <strong>and</strong> 1986 the Mothers’ Hospitaldelivered 124,000 babies <strong>and</strong> trained 3,000nurses through its Midwifery Training School.


JuunJUNEJun 2005M T W T F S S1 2 3 4 56 7 8 9 10 11 1213 14 15 16 17 18 19JUNEMothers’ Hospital 1894 - 1986P21Interior of ward for six patients191520 21 22 23 24 25 2627 28 29 30


<strong>Homerton</strong> Hospital1986 - present09I512 % 256R0: 270MF: 2.0<strong>Homerton</strong> Hospitallaying the first stoneRThe hospital we see today in <strong>Homerton</strong> Row,London, E9 opened its doors on Sunday 5thJuly 1986, exactly 38 years after theestablishment of the NHS.IM: 1Ex: 14285SE: 1JULYP22Long before this, the site was home to the“new” <strong>Homerton</strong> College, founded in 1694as a non-conformist teaching academy. Thecollege moved to Cambridge in the mid19th century <strong>and</strong> in 1870 the site becamethe Eastern Fever Hospital. Adjacent to thehospital was the City of London Institutionwith its own infirmary, <strong>and</strong> nearby wasHackney Union Workhouse <strong>and</strong> Infirmary.Construction began on the new <strong>Homerton</strong>Hospital in 1982. By this time, no newhospital had been built in Hackney for over70 years but the new hospital broughttogether general hospital services from acrossHackney. It was officially opened by thePrincess Royal in March 1987, <strong>and</strong> remainstoday as the hospital for Hackney.In 1986 the borough had a population of185,000. Building the new hospital cost£20 million. There were 800 members ofstaff, 15 wards, 444 beds <strong>and</strong> 89,000pieces of equipment to install.


JuulaayJULYJul 2005M T W T F S S1 2 34 5 6 7 8 9 1011 12 13 14 15 16 17JULY<strong>Homerton</strong> Hospital 1986 - presentP23Hackney’s new hospital198618 19 20 21 22 23 2425 26 27 28 29 30 31


Our WardsAUGUSTP24Our wards are named after famouspeople or institutionsof Hackney. Here we take a closerlook at a selection of these:AlbionThe ancient name of Britain wassometimes thought to derive fromAlbus, a mythical refugee from Troy, butthe real meaning was probably “whiteisl<strong>and</strong>”, due to the chalk cliffs of thesouthern coast. The original Albion wardis now our medical admissions unit.CassSir John Cass (1666-1718) founded theSir John Cass Institute <strong>and</strong> Charity.Cass, who was born in Hackney, was amember of thelocal vestry <strong>and</strong> MP for the City.CoxA pioneer of X-ray therapy, WilliamCharles Cox died in Hackney in 1910from the effects of exposure to radiation.DefoeDaniel Defoe, author of ‘RobinsonCrusoe’, was born in 1660 <strong>and</strong> went toschool in Hackney, later living at 95Stoke Newington Church Street on thecorner of the now Defoe Road.Edith Cavell - photo 1From 1903-06 Edith Cavell wasAssistant Matron at ShoreditchInfirmary - St Leonards Hospital -where she pioneered follow up workby visiting patients after theirdischarge. She is best known for herwork in the First World War. Sheassisted over 200 allied soldiers toescape from Belgium until she wascaught <strong>and</strong> executed in 1915.GeffryeSir Robert Geffrye (1613-1703) was aprominent merchant <strong>and</strong> member ofthe Ironmongers Company, becomingLord Mayor in 1686. He bequeathedmoney to the Company foralmshouses, 14 of which were built inKingsl<strong>and</strong> Road. In 1910 these becamethe Geffrye Museum.Halley - photo 2Astronomer Royal <strong>and</strong> mathematician,friend of Wren, Flamsteed <strong>and</strong> Newton,Edmond Halley was born atHaggerston in 1656. Halley’s Cometwas seen in the year of <strong>Homerton</strong>Hospital’s completion.HowardPrison reformer John Howard was bornin Clapton on 2nd September 1726<strong>and</strong> later lived in Stoke NewingtonChurch Street.In 1756 he was imprisoned by theFrench <strong>and</strong> was so shocked that hiswork turned to prison reform.In 1775 he toured foreign prisons<strong>and</strong> died of typhus whilst visiting aRussian military hospital on 20thJanuary, 1790.1 2LloydMarie Lloyd, famous Victorian musichall entertainer, was born in PlummerStreet <strong>and</strong> is honoured with a plaque inGraham Road.LambThe Lamb <strong>and</strong> Flag was the badge ofthe Knights of St John of Jerusalemwho owned the estate of <strong>Homerton</strong> inthe 14th century. It was also a famouscoaching inn, which stood adjacent tothe site of the hospital.PriestleyJoseph Priestley (1733-1804),theologian, chemist <strong>and</strong> politician,discovered oxygen <strong>and</strong> the oxygencycle. He was appointed preacher at theGravel Pit Chapel in Clapton in 1792<strong>and</strong> lectured on science <strong>and</strong> history atthe radical new protestant college on thesite of the present <strong>Homerton</strong> Hospitalbefore moving to America in 1774.PictonJames Picton (1832-1910) was pastorof St Thomas’ Square Chapel, Hackneywhere he gave lectures on history <strong>and</strong>politics to the working classes thatbegan the Pleasant AfternoonMovement. He represented Hackneyon the London School Board from itsfoundation in 1879.Mary SeacolePioneering black nurse <strong>and</strong> heroine ofthe Crimea war, Mary Seacole wasborn in Jamaica in 1805 before movingto London in 1854. Our nursing homein Shoreditch is named after her.TemplarThe Knights Templar were establishedin the 12th century to protect pilgrimstravelling to Jerusalem. They were wellestablished in London by the middle ofthe 12th century <strong>and</strong> were the originalholders of the manor of Hackney. In1312 their l<strong>and</strong> <strong>and</strong> rents, includingthose in Hackney, were transferred tothe Knights of St John.TurpinDick Turpin (1706-1739), highwayman,was apprenticed to a butcher inWhitechapel before turning to robbery.The Kingsl<strong>and</strong> Road <strong>and</strong> StokeNewington High Street are reputed tohave been his most lucrative ‘hunting’grounds. He is said to have frequentedthe White House public house onHackney Marshes.


OgostoAUGUSTAug 2005M T W T F S S1 2 3 4 5 6 7AUGUSTOur WardsP25AskeRobert Aske was a silk merchant <strong>and</strong> liveryman of the Worshipful Companyof Haberdashers. In the 1690s he left £20,000 to the Haberdashers’Company for an almshouse for 20 poor single freemen <strong>and</strong> a school for 20sons of poor freemen. Aske’s school opened in 1692 in Pitfield Street <strong>and</strong>remained there until 1902.8 9 10 11 12 13 1415 16 17 18 19 20 2122 23 24 25 26 27 2829 30 31


<strong>Homerton</strong>Hospital 1986 - presentSEPTEMBERFoundation status helpsus to carry out our vision:“Keeping the people of Hackney in the best of health,Caring for our community, our staff <strong>and</strong> our hospital.P26Today we see a modern, innovative threestar NHS foundation hospital, going fromstrength to strength.In 1995 the hospital became an NHS Trust<strong>and</strong> in 2001 it was granted universityhospital status in recognition of the medicalstudent training undertaken here. Followingtwo years of successful three star“performance rating, the Trust was awardedNHS Foundation Trust status, one of thefirst hospitals in Engl<strong>and</strong> to achieve this.Since April the hospital has again achieveda three star rating.Foundation status brings us additionalresponsibilities <strong>and</strong> we believe that it willhelp us to combine our traditionally strong09RIM: 1IEx: 14285SE: 1512 % 256R0: 270MF: 2.0focus on the local community with agreater ability to manage our own affairs.Our foundation hospital has members<strong>and</strong> an elected body of governors to helpensure the patients’ voice is heard.


SebtembarSEPTEMBERSEPTEMBER<strong>Homerton</strong> Hospital 1986 - presentP27<strong>Homerton</strong> todaySep 2005M T W T F S S1 2 3 45 6 7 8 9 10 1112 13 14 15 16 17 1819 20 21 22 23 24 2526 27 28 29 30


Financial Review <strong>2003</strong>/4We met allfinancialtargetsIncome received £111, 300, 000Expenditure £111, 300, 00039, 483 cases171, 766 outpatientsOCTOBERP2879, 624 patients in the A&E departmetFinancial ReviewTotalincome£111.3mINCOMECity & Hackney TeachingPrimary Care Trust £78.6mOther primary care trusts £6.4mOther health authorities £8.7mRegional Office £7.7mOther £9.9mTotalpay£73.2mTotal ExpenditurePAYNON-PAYDrugs £4.8mNurses <strong>and</strong> Midwives £31.8mMedical equipment £7.3mHotel Services £4.3mReturn on capital £2.9mDoctors £20.2mEstate services £5.4mServices from other trusts £4.3mProfessional staff £7.7mDepreciation £3.8mEstablishment £2.0mOther staff £13.5mOther £3.3mTotalnon-pay£38.1m


OktoobarOCTOBEROct 2005M T W T F S SOCTOBERP29<strong>Annual</strong> <strong>Report</strong> statistics 19151 23 4 5 6 7 8 910 11 12 13 14 15 1617 18 19 20 21 22 2324 25 26 27 28 29 3031


Activity & Performance Review <strong>2003</strong>/4NOVEMBERP30Outpatients waiting over 13 weeks<strong>2003</strong>/42002/32001/22000/11999/00<strong>2003</strong>/42002/32001/22000/11999/00936231,0901,9361,3350 500 1,000 1,500 2,000Inpatient admissions39,48333,60032,00030,<strong>2003</strong>0,1000 10,000 20,000 30,000 40,000Accident & Emergency attendances<strong>2003</strong>/42002/32001/22000/11999/00<strong>2003</strong>/42002/32001/22000/11999/000 20,000 40,000 60,000 80,000Outpatient attendances63,40065,00069,30066,000136,200152,700147,20079,624161,800171,7660 50,000 100,000 150,000 200,000Over 70% of our outpatients were seen within 30 minutes.RIM: 1Ex: 14285SE: 1As at 31 March <strong>2004</strong> there were902 patients waiting for surgery,with only one patient waitingover six months. Throughoutthe year 90% were treatedwithin three months <strong>and</strong> onlythree patients had theiroperations cancelled <strong>and</strong> notre-booked within 28 days.


NoofembarNOVEMBERNov 2005NOVEMBERP31<strong>Annual</strong> <strong>Report</strong> statistics1915M T W T F S S1 2 3 4 5 67 8 9 10 11 12 1314 15 16 17 18 19 2021 22 23 24 25 26 2728 29 30


Our StaffDECEMBERP32Nurses & Midwives 692Nursing Assistants 179Consultants & Other Medical Staff 274Allied Health Professionals 86Scientific & Technical Staff 95Scientific & Technical Support Staff 52Clinical & Other Managers 109Admin & Clerical 364Estates & Ancillary 54Total 1905There are hundreds of different jobs available in theNHS for every level of experience <strong>and</strong> qualification.Whatever your background or experience, a careerin the NHS could be the best step for you.Our recruitment line is 020 8510 7219or human.resources@homerton.nhs.ukWhite 47.7%Bangladeshi 0.8%Pakistani 1.4%Other Asian 7.8%Other 3%Mixed 0.9%Indian 6.1%Chinese 1.2%Black Other 8.5%Black Carribean 9.2%Black African 13.4%


DiisembarDECEMBERDec 2005DECEMBERP33By Paul ClementsM T W T F S S1 2 3 45 6 7 8 9 10 1112 13 14 15 16 17 1819 20 21 22 23 24 2526 27 28 29 30 31


Staff - Our Most Valuable Resource<strong>2003</strong>/4 was an extremely busyyear for the Human Resources(HR) Department.P34EmploymentWe now employ more people thanever - 1,853.04 whole timeequivalents (at 31st March <strong>2004</strong>),or 1,905 in actual staff numbers -an increase of 10.7%.Vacancies continue to decrease innursing from 16% to 11%. This wasdue to decreasing turnover rates(down to 14.4%, compared to17.8% in 2002) <strong>and</strong> strong levels ofrecruitment.Sickness absence fell to 4.1% from4.8% in <strong>2003</strong>.Supporting localemploymentWe have focused on helping localpeople into employment. Workingwith Ground Work – Hackney, weprovide work placements, training<strong>and</strong> work experience. In addition,we have a volunteer programme,giving local people opportunities.Improving Working LivesA number of initiatives have takenplace, including the extension ofnursery provision <strong>and</strong> childcareadvice, <strong>and</strong> working with managersto ensure staff can identify <strong>and</strong> takeflexible working opportunities.Pay mattersPreparation for changes to the NHSpay systems, known as theConsultant Contract <strong>and</strong> Agenda forChange, have been underway aswell as service changes to ensurecompliance with the EuropeanWorking Time Directive for doctors<strong>and</strong> other staff.Training & Development<strong>Homerton</strong> is a major training centrefor clinical staff, working closely withQueen Mary College, City <strong>University</strong><strong>and</strong> <strong>University</strong> of East London, inparticular. The hospital activelysupports personal <strong>and</strong> professionaldevelopment for staff. In the lastyear we have established amultiprofessional Learning Board tolead training in the Trust. We hostan extensive range of inhousecourses including NVQs, BTEC <strong>and</strong>IT qualifications, as well as ourinnovative leadership programme.Equalities & DiversityOur Equalities Steering Group playsa key role in implementing our RaceEquality Scheme. They also assistedin commissioning <strong>and</strong> providinginformation for the AuditCommission’s review of progressagainst this scheme.We support the local Black <strong>and</strong>Minority Ethnic Network <strong>and</strong> staffhave benefited from the leadership<strong>and</strong> mentoring programmes arisingfrom it. Five harassment advisorshave been recruited to support staffon issues relating to bullying <strong>and</strong>harassment in the workplace.The Trust is “Positive About DisabledPeople” ensuring that they aresupported in their efforts to gainemployment here <strong>and</strong> that currentstaff are supported back to work,should they become disabled.Consulting with staffFrom the National Staff Survey <strong>2003</strong>our staff told us that they have agood quality of work life balance,job design, senior managementleadership <strong>and</strong> a high level ofpositive feeling in the organisation.They also told us <strong>and</strong> we will befocusing on: improving the overallresponse rate to the survey; tacklingharassment, bullying <strong>and</strong> abuse;increasing access to health <strong>and</strong>safety training; <strong>and</strong> improvingperceptions of action towardsviolence <strong>and</strong> harassment.We have consulted widely with staffon other issues during the year suchas our Foundation Trust application<strong>and</strong> HR strategy for the future.We also work actively in partnershipwith Staff side on developmentssuch as Agenda for Change <strong>and</strong>the establishment of a PolicyDevelopment subgroup of the JointStaff Council.


Improving Your CareNew <strong>and</strong> more servicesQuality mattersWe all have a responsibility tomaintain <strong>and</strong> improve the clinicalcare we offer to our patients, <strong>and</strong>in the health service this is knownas clinical governance. To us thismeans that our work concentrateson the areas of:patient <strong>and</strong> public involvementeducation, training, personal<strong>and</strong> professional developmentstaffing <strong>and</strong> staff managementlearning lessons from incidents<strong>and</strong> complaintsclinical risk managementclinical audit <strong>and</strong> effectiveness.P35This year again we have seennew services <strong>and</strong> new buildings.These have included:building a fifth main operating theatreestablishment of an onsite MagneticResonance Imaging (MRI) servicereopening of our refurbished shortstay surgical wardopening of a new colposcopy unit.We continue to work on manymore major projects including:a new hospital computer systemallowing health records to be storedelectronically <strong>and</strong> accessed from anycomputer terminal in the hospital <strong>and</strong>helping to manage patients’ carebuilding a new lecture theatre to trainour doctors, nurses <strong>and</strong> other staffdeveloping a specialist mother <strong>and</strong>baby centre, including more intensivecare cots to care for premature babiesfacilities to further improve the careof emergency patientsdeveloping pharmacy services,including the use of high technologyroboticsestablishing a mammographyservice.This work is led by the Director ofNursing & Quality <strong>and</strong> the MedicalDirector <strong>and</strong> overseen by theClinical Governance &Modernisation Committee, whichreports regularly to the Board.Each directorate has a lead clinicianfor clinical governance <strong>and</strong> a clinicalgovernance facilitator as well asdesignated leads for clinical audit &effectiveness, clinical risk <strong>and</strong>patient <strong>and</strong> public involvement.Groups within directorates monitorclinical governance activity, sharelearning <strong>and</strong> good practice <strong>and</strong>implement changes to improve thecare of patients.Further details can be found inour Clinical Governance <strong>Annual</strong><strong>Report</strong> <strong>and</strong> Development Plan.Research <strong>and</strong> developmentR&D continues to strengthen, withmore externally funded projects,better reporting <strong>and</strong> compliancewith the research governanceframework.The budget was £654,230,supporting 122 projects, in areassuch as cancer, rehabilitation,perinatal services, respiratorymedicine, <strong>and</strong> women’s <strong>and</strong> familyhealth.


Listening to YouP36PALS - here to help,here to listenOur patient advice & liaisonservice (PALS) aims to:• provide information <strong>and</strong> support topatients, their families <strong>and</strong> carers• help sort out problems, oftenproviding on-the-spot help• listen to concerns, suggestions orqueries to learn about what thehospital gets right, what it getswrong <strong>and</strong> what could beimproved• be a gateway for patient <strong>and</strong>public involvement.In <strong>2003</strong>/4 we assisted 775 clients,an increase of 24%.The team can be contacted on020 8510 7315 orvia email pals@homerton.nhs.ukYour complaints <strong>and</strong>suggestionsMany of our service improvementsdevelop from actions taken followingsuggestions <strong>and</strong> complaints.Out of nearly 300,000 patients wesaw <strong>and</strong> treated during the year, wereceived 116 formal complaints,compared with 183 in 2002/3.Each issue is investigated <strong>and</strong>, likeall hospitals, we are required torespond to complainants within 20working days. 68% were respondedto within this timescale butsometimes the investigation takeslonger depending on the complexity.Resolved by letter: 85 (73.27%)We offer complainants a meeting withsenior staff, 19 meetings were held.Resolved following meeting:19 (16.38%)If a complainant remains dissatisfied,he or she may request anIndependent Review panel (IRP).This is led by an independent LayChair (appointed by NE LondonStrategic Health Authority) <strong>and</strong> theTrust Convenor, who considerrequests, examine records <strong>and</strong> files<strong>and</strong> request independent clinicalassessments before decidingwhether to convene a panel.From 1 July this stage will becomethe responsibility of the HealthcareCommission.Requests for independent review:12 (10.34%)Independent reviews agreed: 1The final stage is referral to the HealthService Ombudsman. TheOmbudsman requested documentsrelating to four complaints previouslyinvestigated by the Trust during 2001-03 <strong>and</strong> has confirmed that none ofthese will be investigated further.One complaint originally received in2000 will be investigated <strong>and</strong> we arecurrently awaiting decisions on twofurther complaints.Helping us to improveMany of our service improvementsarise as a result of a complaint orsuggestion.This year:- In Patient Safety & Falls PreventionSystems have been developed tosimplify the assessment of apatient’s mobility <strong>and</strong> need forassistance.- In MaternityChanges have been put in placeregarding the support <strong>and</strong> care ofwomen having a stillbirth.- Privacy <strong>and</strong> DignityThe Trust has developed a stafftraining DVD to address attitude <strong>and</strong>communication issues. Our patientscontinue to be nursed in single sexbays with single sex toilets.- InformationWe have revised our complaintsleaflet, used in all our departments.If you have any commentsor feedback on our services,please direct them to the ChiefExecutive at <strong>Homerton</strong><strong>University</strong> Hospital NHSFoundation Trust, <strong>Homerton</strong>Row, London E9 6SR


Our BoardP37The Board consists of the chairman,executive <strong>and</strong> non executivedirectors. All executive directors areappointed on permanent contracts inaccordance with formal NHS <strong>and</strong>Trust recruitment procedures.Termination of executive directors’appointments would be throughsimilar procedures. In <strong>2003</strong>/4 nonexecutivedirectors were appointedon fixed term basis through the NHSAppointment Commission.In <strong>2003</strong>/4 our executivedirectors were:Nancy HallettChief ExecutiveJohn CoakleyMedical DirectorCaroline ClarkeDirector of Finance & InformationFrom August <strong>2003</strong>Pauline BrownFoundation Project DirectorFrom June <strong>2003</strong> to March <strong>2004</strong>(formerly Director of Nursing & Quality)Guy YoungActing Director of Nursing & QualityFrom June <strong>2003</strong>Tracey FletcherDirector of Planning & ServiceDevelopmentAndrew PannikerDirector of Estates & FacilitiesSusan AcottDirector of Redesign From April <strong>2003</strong>Mark BriceActing Director of Finance &Information Until July <strong>2003</strong>Frank McKennaDirector of Human ResourcesUntil April <strong>2003</strong>Our chairman is Andy Windross.Andy was appointed as chairman inJuly 2000 after being on the Boardsince 1995. He has lived in Hackneyfor over twenty years <strong>and</strong> has beena member of Hackney BoroughCouncil. During <strong>2003</strong>/4 he sat onthe Trust’s Human ResourcesCommittee.Our non-executive directors(<strong>2003</strong>/4):Ian Luder was appointed to theBoard in June 2002. A CharteredAccountant <strong>and</strong> Chartered TaxAdvisor, he was President of theChartered Institute of Taxation in1994/95. Ian chaired the HumanResources Committee of the Trustduring this year, <strong>and</strong> also served onthe Audit <strong>and</strong> RemunerationCommittees. From April <strong>2004</strong>, Ian hasserved on the Finance Committee.Omar Faruk is a Barrister <strong>and</strong>employed by the Government LegalService. He was born in London<strong>and</strong> for 20 years has had extensiveinvolvement in the local community<strong>and</strong> voluntary sector. He graduatedwith an MBA from Cranfield<strong>University</strong>. He was appointed inJune 2002 <strong>and</strong> has chaired theAudit Committee. He sits on theTrust’s Remuneration Committee.Kate Costeloe is Professor ofPaediatrics at St Bartholomew's<strong>and</strong> the Royal London School ofMedicine <strong>and</strong> Dentistry, SeniorLecturer & Honorary Consultant inNeonatal Paediatrics <strong>and</strong> ClinicalLead for the North East LondonPerinatal Clinical Network.She is a member of theRemuneration Committee, Audit<strong>and</strong> Clinical Governance &Modernisation Committees <strong>and</strong> isDirector of Research <strong>and</strong>Development for the Trust.Gillian Borrie retired from the Boardin March after eight years as anon-executive director. In April shewas elected to serve as a Governorof the new Foundation Trust.Pippa McNichol <strong>and</strong> ValerieAbdulsalem also served as nonexecutivedirectors during <strong>2003</strong>/4.Register of Directors’ InterestsThe following interests have beendeclared as currently relevant bymembers of the Board:Ian LuderPartner, Grant ThorntonNo other director declared anyrelevant interests.


Financial review <strong>2003</strong>/4In <strong>2003</strong>/4 the Trust continued to grow. All statutoryfinancial <strong>and</strong> performance targets were met for theyear, <strong>and</strong> in terms of overall performance, many ofthe national targets were exceeded.A summary of the Trust’s financial performance over the last five years is:<strong>2003</strong>/042002/030 100 200 300 400 500232<strong>2003</strong>/040 100 200 300 400 5000 1 2 3 4 5 6 7 82002/030 1 2 3 4 5 6 7 8In financial terms, the Trust facedpressures that were common to manyother hospitals:6 overspends relating to risingunfunded patient activity in A&E,intensive care, diagnostic services<strong>and</strong> facilities management;6 pressure to pay budgets as a resultof difficulty in recruiting key staffgroups;In terms of non financial targets:6 no patients were waiting longerthan 9 months for electiveprocedures;6 no outpatients were waiting longerthan 17 weeks;6 90% of patients were seen inAccident <strong>and</strong> Emergency within4 hoursOur performances against these targets are:TargetBreak EvenRequirementAvoiding a deficitThe Trust achieved a break-even positionby using deferred income accumulatedin previous years, <strong>and</strong> with furtherfunding from commissioners for specificprojects.Income Sources, Expenditure Incurred<strong>and</strong> Patient ActivityIncome was £111.3 million (2002/3- £99.9 million) whilst expenditure was£108.4 million (2002/3 - £95.4 million).£2.8 million was required to fund thereturn on capital leaving a surplus of£2,000.As can be seen by the increase in incomethe Trust continues to grow in size withdevelopment funding received forcancer, waiting times <strong>and</strong> access.Performance£2K surplus2001/020 100 200 300 400 5002000/010 100 200 300 400 5001999/000 100 200 300 400 500Surplus (£000)The charts on pages 28 <strong>and</strong> 30 show:6 Income sources6 Where expenditure was spent6 Changes in activity, <strong>and</strong> waiting lists<strong>and</strong> waiting timesOther Financial TargetsOther key financial targets include:6 Paying suppliers within therequirement that Trusts pay theircreditors within 30 days of receipt ofgoods or on receipt of valid invoice(which ever is later) unless otherterms are agreed.6 To reduce spend on management<strong>and</strong> administration.41334872001/020 1 2 3 4 5 6 7 82000/010 1 2 3 4 5 6 7 81999/000 1 2 3 4 5 6 7 8Rate of return (%)<strong>2003</strong>/040 20 40 60 80 100 1202002/030 20 40 60 80 100 1202001/020 20 40 60 80 100 1202000/010 20 40 60 80 100 1201999/000 20 40 60 80 100 120Income (%)<strong>2003</strong>/040 20 40 60 80 100 1202002/030 20 40 60 80100 1202001/020 20 40 60 80 100 1202000/010 20 40 60 80 100 1201999/000 20 40 60 80 100 120Expenditure (%)<strong>2003</strong>/040 2000 4000 6000 8000 100002002/030 2000 4000 6000 8000 10000111.399.988.682.173.2111.399.988.682.173.29,3495,531Capital cost absorption rate3.5% Rate of return on assets*3.5%2001/020 2000 4000 6000 8000 100002,843P38External Finance Limit (EFL)Capital Resource Limit (CRL)Borrowing at target or below, up to £250KBorrowing at targetor below, up to £50K£0k below target£1K below target2000/010 2000 4000 6000 8000 100001999/000 2000 4000 6000 8000 100001,8641,864* Previous year rate of return was 6%CRL (%)


Financial review <strong>2003</strong>/4The Trust performance against these targets was:Financial StatementsSummary financial statements are shownon pages 41. These have been extractedfrom the audited statutory finalaccounts. A full set of financial accountscan be obtained by written request to:Caroline ClarkeDirector of Finance, Trust Offices,<strong>Homerton</strong> <strong>University</strong> Hospital NHSFoundation Trust<strong>Homerton</strong> Row, London E9 6SRFinancial GovernanceFinancial probity is tested through <strong>and</strong>supported by:6 internal audit6 the work of the Audit Committee6 certification of the accounts by theexternal auditor.In addition, the Trust formed a FinanceCommittee (comprising 2 Non ExecutiveDirectors, the Chief Executive, 3 ExecutiveDirectors <strong>and</strong> 2 Clinical Directors) in<strong>2003</strong>/4 to ensure that the long termfinancial strategy of the trust is viable.The external auditor has given anunqualified opinion on the <strong>2003</strong>/4accounts. There were no changes inaccounting policy during <strong>2003</strong>/4.ConclusionThe Trust achieved all its financialduties in <strong>2003</strong>/4, <strong>and</strong> met its key NHSperformance targets, resulting in theaward of three stars for the third yearin a row. Foundation status granted inApril <strong>2004</strong> will give the organisation thechance to develop services more quickly,<strong>and</strong> with greater reference to thecommunity than would otherwise havebeen possible. We will need to workclosely with our PCTs, <strong>and</strong> theIndependent Regulator for FoundationTrusts to ensure that we make the mostof our new status.Caroline ClarkeDirector of FinanceStatement of internal control <strong>2003</strong>/4A copy of the Trust’s statement ofinternal control is available in the full setof financial accounts, available from theDirector of Finance.<strong>2003</strong>/04Payments to Suppliers<strong>2003</strong>/040 10,000 20,000 30,000 40,0002002/030 10,000 20,000 30,000 40,000Bills paid within 30 days<strong>2003</strong>/040 10,000 20,000 30,000 40,0002002/030 10,000 20,000 30,000 40,000Total Number of Bills paid<strong>2003</strong>/0489.5 90 90.5 912002/0389.5 90 90.5 91Percentage paid within targetManagement Costs<strong>2003</strong>/040 20 40 60 80 100 1202002/030 20 40 60 80 100 120Total Management costs (£ Million)<strong>2003</strong>/040 20 40 60 80 100 1202002/030 20 40 60 80 100 120Trust income (£ Million)<strong>2003</strong>/044.4 4.6 4.8 5 5.2 5.4£5.4m £5.3m£111.3m £99.9m4.8%34,491 31,73538,264 35,01090% 91%P392002/034.4 4.6 4.8 5 5.2 5.4Management costs (% of income)5.3%


Independent auditors report to directors ofthe board of <strong>Homerton</strong> <strong>University</strong> HospitalNHS Trust on the summary Financial StatementIndependent Auditors’ <strong>Report</strong> to theDirectors of <strong>Homerton</strong> <strong>University</strong>Hospital NHS Trust on the SummaryFinancial StatementsWe have examined the summaryfinancial statements set out on pages38 to 41.This report is made solely to the Boardof <strong>Homerton</strong> <strong>University</strong> Hospital NHSTrust in accordance with Part II of theAudit Commission Act 1998 <strong>and</strong> for noother purpose, as set out in paragraph54 of the Statement of Responsibilitiesof Auditors <strong>and</strong> of Audited Bodies,prepared by the Audit Commission.Respective responsibilities of directors<strong>and</strong> auditorsThe directors are responsible for preparingthe <strong>Annual</strong> <strong>Report</strong>. Our responsibility is toreport to you our opinion on theconsistency of the summary financialstatements with the statutory financialstatements. We also read the otherinformation contained in the <strong>Annual</strong><strong>Report</strong> <strong>and</strong> consider the implications forour report if we become aware of anymisstatements or material inconsistencieswith the summary financial statements.Basis of opinionWe conducted our work in accordancewith Bulletin 1999/6 ‘The auditor’sstatement on the summary financialstatements’ issued by the AuditingPractices Board for use in the UnitedKingdom.OpinionIn our opinion the summary financialstatements are consistent with thestatutory financial statements of theTrust for the year ended 31 March <strong>2004</strong>on which we have issued an unqualifiedopinion.Suresh M Patel, Audit ManagerAugust <strong>2004</strong>The Audit Commission, 1st floor,Millbank Tower, Millbank,London SW1P 4HQP40Salary <strong>and</strong> PensionEntitlements of Senior ManagersAge Salary Real increase in Total accrued pensionRemuneration pension at age 60 at age 60 at 31(b<strong>and</strong>s of £5000) (b<strong>and</strong>s of £2500) (b<strong>and</strong>s of £5000)£000 £000 £000Hallett N Chief Executive 48 100 -105 2.5 - 5 25 - 30McKenna F Director of Human Resources 37 10-15Brown P Director of Nursing 45 80- 85 2.5 - 5 20 - 25Coakley J Director of Medicine 48 110 -115Clarke C Director of Finance 36 45-50 0 - 2.5 10 - 15Brice M Director of Finance 37 65 -70Windross A Chairman 54 15-20Fletcher T Dir. of Service Development 34 75 - 80 0 - 2.5 5 - 10Acott S Director of Redesign 39 65-70 0 10 - 15Young G Director of Nursing 45 60- 65 0 - 2.5 15 - 20Panniker A Dir of Estate&Facilities 41 75- 80Abdulsalam V Non Executive Director * *Borrie G Non Executive Director 63 5 -10Costeloe K Non Executive Director 56 0 -5McNichol P Non Executive Director 36 0 - 5Faruk O Non Executive Director 34 5 -10Luder I Non Executive Director 52 5 -10Remuneration for the Executive Directors is determined annually by the Remuneration Committee. Pay rises for senior managers were in accordance withthe NHS Chief Executive’s letter of 27.3.03.* 'Consent to disclose withheld'The post of Director of Financewas occupied by Mark Brice <strong>and</strong>Caroline Clarke during <strong>2003</strong>/4.The post of Director of Nursingwas occupied by Pauline Brown<strong>and</strong> Guy Young during <strong>2003</strong>/4.The following officers left during<strong>2003</strong>/4: Mark Brice (11.8.03), FrankMcKenna (16.5.03). The followingNon-Executive Directors left during<strong>2003</strong>/4: Gillian Borrie (31.1.04),Pippa McNichol (31.10.03),Valerie Abdulsalam (30.9.03).


Summary Financial StatementsCash flow statements as at 31 March <strong>2004</strong><strong>2003</strong>/4 £m 2002/3 £mBalance sheet as at 31 March <strong>2004</strong>31/3/04 £m 31/3/03 £mFixed Assets:L<strong>and</strong> 15.1 14.3Buildings 72.6 66.1Plant & equipment 5.6 4.0Transport Equipment 0.2 0.2IT Equipment 1.6 0.7Furniture & Fittings 0.6 0.5Assets in the course of construction 3.3 0.399.0 86.1Intangible Assets 0.1 0.0Total fixed assets 99.1 86.1Net Cash Inflow from operating Activities 5.2 6.6Returns on investments <strong>and</strong>servicing of finance:Interest received 0.1 0.1Interest paid - -Dividends paid (2.9) (4.5)Capital spend (7.9) (6.0)Net Cash Flow before Financing (5.5) (3.9)Financed by:• New public dividend capital 5.5 3.9• Public dividend capital repaid - -• Loan repaid - -• Finance lease capital - -P41Current Assets:Stock 0.5 0.4Debtors 6.0 3.8Cash 0.2 0.2Total current assets 6.7 4.4Current Liabilities (Creditors):Due within 1 year (14.5) (12.0)Due after 1 year (0.0) (0.1)Provisions (0.5) (0.5)Total liabilities (15.0) (12.6)Total assets employed 90.8 77.9Financed by:Public dividend capital 77.2 71.6Revaluation reserve 13.4 6.1Donation reserve 0.6 0.6Other reserves – –Income/expenditure reserve (0.4) (0.4)Total Capital <strong>and</strong> Reserves 90.8 77.9Net Cash Inflow from Financing 5.5 3.9Income <strong>and</strong> expenditure account for financial year <strong>2003</strong>/4:<strong>2003</strong>/4 £m 2002/3 £mIncome:Income from patient services 92.6 83.9Other operating income 18.6 16.0Total income 111.3 99.9Operating Expenses:Total expenses 108.4 95.4Operating Surplus 2.8 4.5Interest: receivable 0.1 0.1Interest: payable 0.1 0.1Public dividend capital (2.8) (4.5)Retained Surplus 0.02 0.32Return on Assets 3.5% 6.5%


<strong>Homerton</strong> - the hospital for Hackney<strong>Homerton</strong> - Cisbitaalka HackneyCisbitaalku waxa uu sannadkii saddexaad kuguulaystay in la siiyo darajada saddexda xiddigoodoo ay siisay Waaxda La-socodka iyo WaxqabadkaCaafimaadka sannadka <strong>2003</strong>/4. Waa darajada ugusarraysa ee suurtogalka ah in la helo waxana sababu ah shaqada adag ee dhammaan shaqaalahayagacisbitaalka iyo bulshada dhexdeeda kuwaasooadeegga habboon siinaya bukaanka.Sannadka <strong>2003</strong>/4 waxaan daweynay ku dhowaad:- 39,500 xaaladood- 172,000 bukaan oo lagu daweeyey qaybtabukaan-socodka- 80,000 bukaan oo lagu daweeyey QaybtaShilka iyo Xaaladaha Degdegga (Accident& Emergency Department)Liiska sugitaanku waxa uu hoos ugu dhacay 902bukaan; kuwaasoo badankkood lagu qaabilo 3-6bilood gudohood. Qaybta bukaan-socodka 93bukaan keliya ayaa ballantii ugu horreysay sugaywax ka badan 13 usbuuc, waana ka shaqaynaynaain muddadaas hoos loo dhigo. Hawlahaas oo dhanwaxa la qabtay iyadoon laga bixin miisaaniyaddiinaloogu talogalay oo ah £111.3 milyan.Waxaan aaminsanahay muhiimadda in lagudhagaysto, waxaana sannad kasta fikradaha iyocabashadaada loo isticmaala sii wanaajintaadeegga. Sannadkii tagay waxaa nasoo gaaray116 cabasho oo rasmi ah kuwaas oo nagacaawiyey inaan hagaajino adeegyada sidaqaybaha shilka iyo xaaladaha degdegga,dhalmada iyo wanaajinta xiriirka guud ahaan.P42Lakiin si kasta oo shaqo badan loo qabto, waxamarkasta jira qaab lagu sii wanaajin karoadeegga. Haddii aad jeclaan lahayd inaadtilmaan bixisid, fadlan nala socodsii adigoo soomarsiinaya qaybta Xiriirinta Adeegga iyoTalosiinta Bukaanka (Patient Advice <strong>and</strong> LiaisonService). Waxay, iyaga oo adeegsanayaKormeerayaasha Caafimaadka, halkaas ujoogaan inay ku caawiyaan.Gujarati Somali Turkish Vietnamese


Looking aheadP43The future holds newchallenges. Some of theseare linked to national policyinitiatives: patient choice,payment by results,changes to the medicalworkforce (the EuropeanWorking Time Directive,<strong>and</strong> the new consultantcontract in particular), <strong>and</strong>Agenda for Change. Eachpresent operational <strong>and</strong>financial risks to all NHSorganisations.There are also some localchallenges that are unique to<strong>Homerton</strong> - foundation status, theimplementation of the ElectronicPatient Record, <strong>and</strong> the joint workthat the Trust <strong>and</strong> City & HackneyTeaching Primary Care Trust areengaged in, on Chronic DiseaseManagement <strong>and</strong> the shift of activityinto the community.In addition, the hospital is at theedge of the Thames Gateway areawhere the population is expected toincrease by over 30% in our threemost local Primary Care Trust areas.Foundation status will help us tomanage this complex agenda byensuring that we have strongcorporate governance, robustbusiness planning <strong>and</strong> forecasting,improved risk managementprocesses <strong>and</strong> more effectiveengagement with the community.In addition, we will be able to borrowadditional funding in order to investin new buildings, technology <strong>and</strong>equipment. We therefore plan toinvest in our infrastructure over thenext three years to ensure that wehave a strong, modern local hospitalthat patients choose to come to,<strong>and</strong> that staff want to work in.Our visionWe have an overall vision for aunique hospital based in a uniquelocal community which:• Is the “hospital for Hackney”with services directly targeted atthe specific needs of the localpopulation, <strong>and</strong> which plays itspart in the local community.• Provides specialist services inparticular areas for a widerpopulation in North East London<strong>and</strong> beyond – these services willbe those where we have built upa specific expertise because ofthe needs of local people.New uniforms for frontline admin staff• Is thriving <strong>and</strong> sustainable.A fundamental element of beingable to provide the core servicespeople need is for us to provide acomprehensive range of servicesthat will give us the critical masswe need for service excellence.• Continuously improves itsperformance. We are now aFoundation Trust because ofgood performance in the past.We will sustain this <strong>and</strong>consistently do better.• Has modern, high qualitysystems <strong>and</strong> processes,supported by excellent technology.• Has an infrastructure of services,training <strong>and</strong> education resources<strong>and</strong> buildings which enables usto meet the needs of ourpopulation <strong>and</strong> contribute to thewider development of the NHS.


The year aheadIn the short term, this yearwe have the followinggoals:Our vision1. To improve or maintainperformance against allHealthcare Commissionperformance indicators <strong>and</strong>actions set out in the ClinicalGovernance <strong>and</strong> DevelopmentPlans.2. To implement phase 1 of ourElectronic Patient Recordprogramme <strong>and</strong> achieveprogress for 2005.3. To establish <strong>Homerton</strong> as aFoundation Trust.4. To commence implementation ofthe <strong>Homerton</strong> service development<strong>and</strong> related Human Resourcesstrategy.5. To implement the Trust’s revisedbusiness planning <strong>and</strong> riskmanagement arrangements.OurCommunityServicesA unique hospitalfor a uniquecommunityOur StaffP44Fitting it all togetherOur vision for NHS Foundation Truststatus has three core <strong>and</strong> totallyinter-related planks.For services we want to ensure weoffer “The best of health” meaninghigh quality, accessible servicesbased on the needs of the localpopulation, provided without delay,courteously <strong>and</strong> at a timeconvenient for the patient.We are firmly rooted in thecommunity of Hackney. FoundationTrust status means that we caninvolve the people we serve muchmore closely in the Trust, helping usto shape our future <strong>and</strong> make ourdecisions. We also want to ensurethat we play our part in developingthe local community, <strong>and</strong> contributingto social inclusion <strong>and</strong> its widerhealth <strong>and</strong> well beingOur high quality staff arefundamental to all our achievements<strong>and</strong> we have a Human Resourcesstrategy which sets out our detailedplan to ensure that we continue tohave an excellent workforceproviding excellent, patient focusedservices.“Your hospital, your health, yourfoundation”As a Foundation Trust we aim forpatients <strong>and</strong> local residents interestedin health <strong>and</strong> healthcare to becomeinvolved by becoming a member –a way of supporting your localhospital.Before applying for FoundationTrust status, we undertook acomprehensive consultation with thelocal community.Members receive regular news <strong>and</strong>updates on services <strong>and</strong> plans forthe hospital. So please get involvedby joining us as a member now by:writing to the Foundation Office,<strong>Homerton</strong> <strong>University</strong> Hospital,<strong>Homerton</strong> Row, London, E9 6SRcalling us on 020 8510 5221or emailing us atmembers@homerton.nhs.uk


Acknowledgements:BBC History ‘Historic Figures, Edmond Halley’ (11 August <strong>2004</strong>)BBC History ‘Historic Figures, Mary Seacole’ (11 August <strong>2004</strong>)Elizabeth McKellar (1991) The German Hospital Hackney –A social <strong>and</strong> architectural history, The Hackney Society<strong>Homerton</strong> College Cambridge ‘<strong>Homerton</strong> College Archive’ (11 August <strong>2004</strong>)Ian Wylie (1987) <strong>Homerton</strong> Hospital, <strong>Homerton</strong> HospitalLondon Borough of Hackney ‘Hackney Archives’ (1 July <strong>2004</strong>)Peter Higginbotham ‘Hackney Workhouse <strong>and</strong> Poor Law Union’ (1 July <strong>2004</strong>)Spartacus Educational ‘Joseph Priestley’ (11 August <strong>2004</strong>)The City <strong>and</strong> Hackney Health Authority (June 1987)Newsletter: The German HospitalThe Learning Curve ‘Local History, Hackney’s First Hospital’ (15 June <strong>2004</strong>)Our thanks to the following for their assistance in the research<strong>and</strong> production of this report:City <strong>and</strong> Hackney Teaching Primary Care TrustCorporation of London, London Metropolitan ArchivesLondon Borough of Hackney ArchivesMedical Photography Department, <strong>Homerton</strong> <strong>University</strong> HospitalSt Bartholomew’s Hospital Archives <strong>and</strong> MuseumSt Bartholomew’s Hospital Medical Illustration DepartmentThe Newcomb Library, <strong>Homerton</strong> <strong>University</strong> Hospital<strong>and</strong> the many staff who contributed to this publicationResearched <strong>and</strong> written by <strong>Homerton</strong> <strong>University</strong> Hospital’sPress <strong>and</strong> Communications DepartmentDesigned <strong>and</strong> printed by Good Impressions.www.goodimpressions.co.ukIf you would like to receive further copies of this reportplease contact the Press <strong>and</strong> Communications Departmenton 020 8510 7112R0: 270MF: 2.0512 % 256I90P45


<strong>Homerton</strong> <strong>University</strong> Hospital NHS Foundation Trust<strong>Homerton</strong> RowLondonE9 6SRT: 020 8510 5555F: 020 8510 7608Email: enquiries@homerton.nhs.ukwww.homerton.nhs.ukR0: 270MF: 2.0512 % 256I90

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