Item 8 - Sheffield Health and Social Care

2.0 Directors’ Report2.1 Foundation Trust Chair’s statementIt is a great pleasure to introduce SheffieldHealth and Social Care NHS FoundationTrust’s Annual Report and Accounts for2012/13. The Trust has now completedfive years as an NHS Foundation Trust (FT)and has made further substantial progresstowards delivering the improved serviceuser outcomes that were the main reasonfor applying to become an FT.I apologise for the fact that this Annual Report islooking more and more like a doorstep as eachyear passes. However, there are many aspects thatwe are legally obliged to report on. Also there arenumerous excellent service developments that wesimply must draw attention to. Please take sometime to examine the information summarised hereabout the Trust’s performance (as assessed byexternal regulators). The overall picture is extremelypositive and, in the third quarter of the financialyear, SHSC was awarded Monitor’s top ratings forboth finance and governance.Like the rest of the NHS, this Trust faces a hugelychallenging financial context. The Governmentexpects the NHS, nationally, to save some £20billionfrom its budget by 2014/15. For SHSC, this meansaround £16million over this period, or just over£5million per year. The Trust’s total annual incomefor 2012/13 was £128 million which means thatthis has to be reduced by approximately 13%.I hardly need to say that this is very difficult to dowhen most of that expenditure is on staff and thesereductions come on top of more than a decadeof annual efficiency savings targets. In addition,the demand for the Trust’s services is increasingconstantly, for example, because of populationageing and the survival of more babies with highlycomplex disabilities. Responding to these hugechallenges takes a great deal of effort on the part ofthe Trust Board, Clinicians and Managers. The viewtaken by the Board of Directors is that this circle canonly be squared by reconfiguring services, with theprimary aim of improving recovery for service userswhile trying to save money at the same time.Despite the scale of the challenge faced by the Trust,I am confident that it is possible to deliver improvedservices while reducing costs in some areas. Thisconfidence is based, first, on the track record of thisTrust. We have overcome previous obstacles becauseof strength of purpose, dedication to patients andservice users and sheer quality of staff throughoutthis organisation. Secondly, our partnership withservice users and carers gets stronger and stronger.It is this, above all else, that will guarantee theresponsiveness and quality of the Trust’s services.Third, I expect a close partnership to developbetween SHSC and the new Clinical CommissioningGroup (CCG) in Sheffield. Many staff in the Trustalready work closely with primary care and we willseek to extend that as much as possible. Breakingdown barriers between primary and secondary care,and between health and social care, is essential tomaintain and strengthen SHSC services. Therefore,I am confident that this Trust can combine majorservice improvements with a sound financialbalance, as it has done in the past.This Annual Report contains a great deal ofinformation about the quality of the Trust’s services.To most members this will be the main point ofinterest and rightly so. SHSC is required to beregistered with the Care Quality Commission (CQC)and, unlike some other Trusts, is registered withoutconditions. During 2012/13 the CQC did not takeany enforcement actions against the Trust, nor hasit taken part in any special reviews or investigationsby the CQC. The CQC does monitor and reviewthe Trust’s services as it does for all Trusts. During2012/13 the CQC visited seven service locations toreview their compliance with essential standardsof quality and safety. All but one of the servicesinspected were fully compliant and the exceptionhad two relatively minor compliance actions toaddress. Action plans were put in place, reviewedby the CQC and full compliance was achieved.During 2012/13 the CQC also undertook nine visitsto inspect the delivery of care and treatment topeople detained under the Mental Health Act. Theyreview care processes, the environment in whichcare is delivered and meet privately with inpatients.No undue areas for concern relating to compliancewith essential standards have been identified.(There is also a team of Associate Mental HealthAct Managers who review the reasons for detentionunder the Mental Health Act). As noted above,in the third quarter of 2012/13, the FT RegulatorMonitor awarded SHSC its top ratings for financialrisk and for governance risk.As a Foundation Trust we are committed to a constantincrease in membership and this now totals 12630excluding staff. The Trust is very keen to hear fromand be responsive to its members. This helps us to beresponsive to the needs of the communities we serveand to represent those needs to the commissionersof services. Also important is the representation ofmembers provided by the Council of Governorsbecause they speak on behalf of the membershipwhen they contribute to the development of theTrust’s plans (and they do so actively). One of themain opportunities for members to interact withGovernors is the Annual Members’ Meeting, heldeach September. Last year’s meeting again brokeprevious records with over 280 participants.Governors play a crucial role in the life of the Trust.They hold the Board of Director’s to account for themanagement of the Trust and the achievement of itsobjectives, which they also play a big role in setting.We are very fortunate to have a tremendous groupof Governors who are all highly committed to thevalues of the Trust and, especially, to improving thelives of service users and carers. They do criticisethe Trust on various fronts but they do so in a veryconstructive and ultimately supportive way. Atits best this is a highly effective partnership andI am proud of the way that SHSC works with itsGovernors. No praise can do justice to the role thatSam Stoddart plays in achieving this partnership.During 2012/13 we said goodbye to 11 Governorswhose terms of office had expired or who resignedfor other reasons. I want to express the thanks ofthe whole Trust for their contributions to improvingthe quality of SHSC services.Also during 2012/13 one of the NHS’s andSheffield’s most outstanding health servicesmanagers, Mick Rodgers retired after 42 years ofservice. It is impossible to summarise the immensecontribution that Mick made to the NHS in Sheffieldas both a manager of Mental Health and LearningDisability Services, and as a Finance Director. Heserved with distinction in every post he workedin and always put service users and carers first.He ended his NHS career as Finance Director andDeputy Chief Executive. He was crucial in the Trustbecoming an FT in 2008. His leaving event wasvastly oversubscribed and, as speaker after speakerpaid tribute to his professionalism and personalqualities, it was a fitting tribute to this very specialperson. The history of the NHS in Sheffield willalways have to have a chapter devoted to MickRodgers. Thousands and thousands of service users,who have never heard of him, have cause to bethankful for the compassion that led Mick into theNHS in the first place and which made him striveconstantly to improve services. As a Finance Directorhe never lost sight of what the finance is for.During 2012/13 three Non Executive Directorswere reappointed following external competitionand a competitive selection process. They are TonyClayton, Sue Rogers and Mervyn Thomas, and theymake major contributions to the work of the Trust.I have indicated that the next few years are going tobe extremely difficult for this Trust, for its staff andfor the service users and carers it serves. There willbe less funding and increasing demand. We knowthat at times of economic downturn, the numbersof people with mental health and substance misuseproblems increases. In partnership with primary careand the local authority, we will have to try hard torespond to this demand while also balancing ourbudget. We will do it but only with the hard workand dedication of staff and with the continuedsupport of service users and carers. The ability torise above adversity is the defining spirit of the NHSand this Trust in particular. It is this spirit that willprevail and ensure that the Trust is able to respondimaginatively to the challenges it faces.Professor Alan WalkerChair910