AH ANNUAL REPORT 2018

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Local Audit Has the introduction of Plasmalyte as the routine IV (Intravenous) maintenance fluid therapy reduced the risk of iatrogenic metabolic disturbances? (Disruption to the normal metabolic processes following medical intervention) Actions The audit was presented to the Alder Hey Pharmacy Department lunchtime meeting in April 2018. Action/Recommendation: • Feed results back to a wider range of healthcare professionals involved in the switch to Plasmalyte. • Update existing training to emphasise the importance of using fluid guidelines. • No changes to practice are required as Plasmalyte has been well received by prescribers and patients and can continue to be prescribed. • Further audit required to look at other electrolytes as a result of the switch to Plasmalyte • Re-audit in 12 months. 2.2.5 Participation in Clinical Research 2017/18 The number of patients receiving NHS services provided or subcontracted by Alder Hey Children’s NHS Foundation Trust in 2017/18 that were recruited to participate in NIHR Portfolio adopted clinical research was 9,184, the largest number in Alder Hey history. All research is governed by the EU Clinical Trial Directive, UK ethics committees and the Trusts Clinical Research Division who carry out safety and quality checks to provide organisational permission. This is a highly robust mechanism that ensures oversight of every research study in the organisation. International Research, Education and Innovation is one of the Trust’s four strategic pillars and as such elicits full support of the Board of Directors. All three areas are undergoing expansion and the creation of the Alder Hey Academy will further link research with education. Furthermore, the Alder Hey/University of Liverpool refreshed ten year research strategy states that “Every child (should be) offered the opportunity to participate in a research study / clinical trial”. The strategy is patient focused and supports research from all disciplines. The Trust is a member of Liverpool Health Partners (LHP), a consortium of seven hospitals, the University of Liverpool and the Liverpool School of Tropical Medicine working together to provide a world class environment for research and health education across a regional footprint. As a significant stakeholder in LHP, Alder Hey demonstrates a strong commitment to contributing to evidence-based, cutting edge healthcare aimed at improving quality of care whilst holding patient safety, dignity and respect at the centre of everything we do. A clinical research review for Liverpool Health Partners took place in 2018 that made several recommendations and Alder Hey has a strong influence over this and the emergent strategy for child health. One of the main strengths of Liverpool is that of pharmacology – developing better safer medicines for children and young people and contributing to the personalised medicine agenda. LHP is developing an Industry Gateway Office that will boost the region’s ability to conduct more research into new medicines. Being an organisation undertaking high quality patient centred research means that Alder Hey contributes to the health and wealth of Liverpool and the UK as a whole as well as having an international impact on treatments developed for children. The infrastructure of expertise available at Alder Hey for setting up and successfully delivering clinical research is led and managed by a dedicated team who form the Clinical Research Division (CRD). The CRD employs 40 research nurses, supports approximately 260 studies at any one time and rigorously manages performance to ensure high quality delivery to time and target. Alder Hey has an excellent track record of recruiting the first patient globally to clinical trials, demonstrating that the organisation is at the forefront of drug development in paediatrics. Over the last 10 years Alder Hey has achieved this for 16 of its patients. Our clinical staff and associated academics lead and contribute to studies of the latest and newest treatment options, genetic profiling of diseases and research looking at drug safety including adverse drug reactions (side effects). Alder Hey was involved in recruiting patients to 152 open, non-commercial NIHR portfolio adopted clinical research studies, 37 commercial trials and 29 nonportfolio studies during 2017/18, which is significant for a Trust of its size. Whilst some studies report outcomes fairly quickly most will not be ready for publication for a few years. The majority were research in the area of medical specialties reflecting the prevalence of available research studies locally and nationally. Alder Hey Children’s NHS Foundation Trust 96 Annual Report & Accounts 2017/18
01/04/2017 to 31/03/2018 NIHR Studies Number of Participants Non-NIHR Studies Number of Participants SG1 (Oncology, Haematology, Palliative Care) 33 118 9 2 SG2 Nephrology, Rheumatology, Gastroenterology, Endocrinology, Dietetics) SG3 (Respiratory, Infectious Diseases, Allergy, Immunology, Metabolic Diseases) SG4 (A&E, General Paediatrics, Diabetes, Dermatology, CFS/ME) SG5 (CAMHS Tier 3 & 4, Psychological Services and Dewi Jones) SG6 (Community Child Health, Safeguarding, Social Work Dept., Community Clinics, Neurodisability Education, Fostering, Adoption, Audiology) 36 349 10 29 24 7460 3 0 10 568 3 0 6 34 1 0 1 0 3 0 SG7 (PICU, HDU, Burns) 3 53 3 0 SG8 (Theatres, Daycase Unit, Anaesthetics, Pain Control) 1 0 0 0 SG9 (General Surgery, Urology, Gynaecology, Neonatal) 10 33 0 0 SG10 (Cardiology, Cardiac Surgery) 0 0 0 0 SG11 (Orthopaedics, Plastics) 3 132 3 0 SG12 (Neurology, Neurosurgery, Craniofacial, Long Term Ventilation) SG13 (Specialist Surgery, Ear Nose and Throat, Cleft Lip and Palate, Ophthalmology, Maxillofacial, Dentistry, Orthodontics) 20 90 6 0 6 70 0 0 SS1 (Radiology) 0 0 0 0 SS2 (Pathology) 0 0 0 0 SS3 (Pharmacy) 0 0 0 0 SS4 (Therapies, EBME, Central Admissions, Bed Management, Medical Records, Generic Outpatients) 0 0 0 0 NON-CBU 3 0 2 0 CNRU 0 0 1 0 Non Classified 3 5 1 0 TOTAL 169 9139 74 169 Alder Hey Children’s NHS Foundation Trust 97 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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Page 48 and 49: SALARY AND PENSION ENTITLEMENTS OF
Page 50 and 51: STAFF REPORT Analysis of Trust staf
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Page 54 and 55: EXIT PACKAGES 2016/17 Exit Package
Page 56 and 57: As in 2016, we surveyed all staff i
Page 58 and 59: NHS FOUNDATION TRUST CODE OF GOVERN
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Page 66 and 67: External Audit In April 2017 new re
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Page 70 and 71: STATEMENT OF THE CHIEF EXECUTIVE’
Page 72 and 73: During the year the Trust sustained
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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/
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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 98 and 99: The Quality Account deals with rese
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Page 102 and 103: • A Data Quality dashboard is emb
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Page 106 and 107: Clinical Incidents Reported 2013/14
Page 108 and 109: Reducing Hospital Acquired Infectio
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Page 114 and 115: • Improved the quality of room bo
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Page 118 and 119: The awards and review schedule is h
Page 120 and 121: F. The Alder Play App Aims: • To
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Page 126 and 127: • Working with external organisat
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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
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Target or Indicator (per 2013/14 Ri
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I would recommend the Trust’s app
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Commentary from Clinical Commission
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STATEMENT OF DIRECTORS’ RESPONSIB
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• feedback from local Healthwatch
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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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