AH ANNUAL REPORT 2018

Recommendations

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Clinical Incidents Reported 2013/14 to 2017/18 6000 5000 4000 3000 2000 1000 Graph shows year on year increase in incident reporting 2017/18 2013/14 2014/15 2015/16 2016/17 2017/18 0 Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Alder Hey Children’s NHS Foundation Trust 106 Annual Report & Accounts 2017/18
Prompt Recognition and Treatment of Deteriorating Patients Including Implementation of the Sepsis Pathway Aim: To embed the question “Are you concerned this child has sepsis?” in our routine clinical practice Targets: 1. Develop and roll out a sepsis pathway to all our inpatient wards and Emergency Department (ED). 2. Deliver sepsis training to nursing and clinical staff based within Alder Hey. 3. Submit against the CQUIN for 2017/18 Outcomes - 2017/18: 1. 100% of inpatient and ED screened for sepsis. 2. Development of an electronic sepsis pathway. 3. CQUIN submission for Q1-3 of £56k (£66k max). 4. Average time to antibiotic administration for Inpatients 47 mins (Jul17 – Feb18) and ED 64 mins (Jul17 – Feb18). Sepsis is life-threatening infection when it affects the function of an organ or body system and is caused by a dysregulated response by the body’s own defences. Those with ‘septic shock’ are unable to maintain a normal blood pressure without critical care support. Sepsis and septic shock affect children and adults and are major causes of death and lasting complications in those that survive. The priority was to improve the quality of care provided by the Trust in a condition that carries a high morbidity and mortality. Improvements in 2017/18 • Developed electronic sepsis pathway • All ED and inpatient ward nursing staff (excluding Paediatric Intensive Care Unit - PICU) were trained and the new sepsis pathway was implemented. • Enhanced, earlier recognition of children at high risk of sepsis in ED and on the inpatient wards • More timely provision of effective treatment for likely sepsis • Consequent likely reduction in morbidity and mortality • Improved education and training for nurses and doctors in managing sepsis • Compliance with NICE guidance on sepsis management • High quality informatics enabling identification of blocks to rapid, efficient care and allowing feedback to individuals and teams to improve service delivery • Established a Sepsis Team – 1.5 Specialist Nurses and 2 clinical leads. • Developed an e-Learning package to be rolled out in 2018/19. • World Sepsis Day awareness session in the Trust. Future Plans 2018/19 • Roll out of sepsis training to the community setting. • Reviewing the pathways for non-acute setting. • Launch the e-Learning package for 2018/19. • Development of an enhanced IT offer that should facilitate improved clinical management and audit of data. Average Time to Administration of Antibiotics Minutes 80 60 40 20 ED Inpatients 0 Jul Aug Sep Oct Nov Dec Jan Feb Month Alder Hey Children’s NHS Foundation Trust 107 Annual Report & Accounts 2017/18
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A E H E LD Y R ANNUAL REPORT & ACCO
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©2018 Alder Hey Children’s NHS F
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A MESSAGE FROM OUR CHAIR AND CHIEF
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PERFORMANCE REPORT OVERVIEW The fol
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Teenage Cancer Trust Honorary Patro
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OUR CQC RATINGS The Trust’s curre
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• Applied clinical research perfo
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The Trust’s performance against n
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‘Alder Play’ A new approach to
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KEY RISKS TO DELIVERY IN 2017/18 Th
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Regulatory Ratings NHS Improvement
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Expenditure Operating expenses tota
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ALDER HEY USES MRI/ CT DATA TO CREA
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Louise Shepherd CBE - Chief Executi
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Mags Barnaby - Interim Chief Operat
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NHS IMPROVEMENT’S WELL LED FRAMEW
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Clinical Educators The Trust has ag
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All complainants are offered the op
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have resulted in Memoranda of Under
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The Community Cluster Developed wit
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Alder Hey’s collaborative campaig
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accordance with Non-Executive remun
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(R) Indicates that the individual i
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SALARY AND PENSION ENTITLEMENTS OF
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STAFF REPORT Analysis of Trust staf
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approach to internal materials and
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EXIT PACKAGES 2016/17 Exit Package
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Page 58 and 59: NHS FOUNDATION TRUST CODE OF GOVERN
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Page 62 and 63: Throughout our membership activitie
Page 64 and 65: Attendance at Board of Directors an
Page 66 and 67: External Audit In April 2017 new re
Page 68 and 69: Segmentation Alder Hey has been pla
Page 70 and 71: STATEMENT OF THE CHIEF EXECUTIVE’
Page 72 and 73: During the year the Trust sustained
Page 74 and 75: The Divisions report against CQC Fu
Page 76 and 77: organisation’s ability to continu
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Page 80 and 81: THE YOUNG PEOPLE’S CANCER UNIT RE
Page 82 and 83: PART 2: PRIORITIES FOR IMPROVEMENT
Page 84 and 85: 2.1.2 Quality Improvements in 2017/
Page 86 and 87: National Confidential Enquiries Par
Page 88 and 89: 2.2.4 Actions arising from Local Cl
Page 90 and 91: Local Audit Retrospective Audit of
Page 92 and 93: Local Audit How often are high ferr
Page 94 and 95: Local Audit Emollient and bath pack
Page 96 and 97: Local Audit Has the introduction of
Page 98 and 99: The Quality Account deals with rese
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Page 102 and 103: • A Data Quality dashboard is emb
Page 104 and 105: in improved ward to board reporting
Page 108 and 109: Reducing Hospital Acquired Infectio
Page 110 and 111: 3.3.2 PRIORITY 2 - Increase Engagem
Page 112 and 113: Are you: 95 17% 8 1% Parent/Carer P
Page 114 and 115: • Improved the quality of room bo
Page 116 and 117: When a child has an asthma attack t
Page 118 and 119: The awards and review schedule is h
Page 120 and 121: F. The Alder Play App Aims: • To
Page 122 and 123: Developing a System of 7 Day Workin
Page 124 and 125: of staff and governors, assess each
Page 126 and 127: • Working with external organisat
Page 128 and 129: the Tate Exchange programme during
Page 130 and 131: experience. Medication errors are t
Page 132 and 133: • To complete and roll out the ne
Page 134 and 135: 3.3.8 Peri-operative Care The focus
Page 136 and 137: 3.3.9 Best in Operative Care The Be
Page 138 and 139: Improvements: • Increased the Bla
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Page 142 and 143: In November 2017, the National Qual
Page 144 and 145: 3.3.14 Management of Complaints and
Page 146 and 147: Target or Indicator (per 2013/14 Ri
Page 148 and 149: I would recommend the Trust’s app
Page 150 and 151: Commentary from Clinical Commission
Page 152 and 153: STATEMENT OF DIRECTORS’ RESPONSIB
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AN EVENING CELEBRATING THE PASSION,
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STATEMENT OF COMPREHENSIVE INCOME N
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STATEMENT OF CHANGES IN EQUITY FOR
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NOTES TO THE ACCOUNTS 1. ACCOUNTING
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1.6 Expenditure on Other Goods and
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of Financial Position’ by the tru
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through the expected life of the fi
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Exchange gains or losses on monetar
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3.3 Overseas Visitors (Relating to
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5.1 Operating Expenses 2017/18 £00
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7.1 Retirements Due to Ill-Health D
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11. FINANCE EXPENDITURE Finance exp
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15. PROPERTY, PLANT AND EQUIPMENT 1
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15.3 Property, Plant and Equipment
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20. TRADE RECEIVABLES AND OTHER REC
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24. OTHER LIABILITIES 26. FINANCE L
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30. OTHER FINANCIAL COMMITMENTS The
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32.2 Carrying Values of Financial A
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32.5 Maturity of Financial Liabilit
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34. RELATED PARTIES (CONT’D) In a
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KEY AUDIT MATTERS Key audit matters
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AN OVERVIEW OF THE SCOPE OF OUR AUD
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“A matter is significant if, in t
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Alder Hey received visits from both
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AH ANNUAL REPORT 2018

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