June Team Briefing

							June - Team Briefing                                                            >
   Standards of care and service
    Performance
    The trust continues to make progress on numbers of inpatients and outpatients
    waiting. The next set of inpatient and outpatient targets are to be achieved by
    December 2005. As there are no new targets within 2004/05, other than ensuring no
    breaches of the 9 month and 17 week waits, specific plans will derive from Service
    Agreement discussions with PCTs.

    The A&E target still remains extremely challenging with our overall Trust
    performance still averaging 88% of patients seen within 4 hours.


    Key Targets

     Number of Inpatients waiting greater than 9 months during the year
    (Target 0). 6 months at the end of December 05.

    There have been no breaches of the 9 month target in April. There has been a
    consistent reduction in patients waiting over 6 months.

       Number of Outpatients waiting greater than 17 weeks during the year
        (Target 0). NHS Plan target 13 weeks at the end of December 05.

    There have been no breaches of the 17 week target in April.

    We are within the plan at the moment. Agreement on further reductions is dependent
    on commissioner's recognition of the activity levels required for consistent progress
    towards December 2005 NHS Plan targets.

       Number of patients waiting more than 12 hours for emergency admission
        via A&E (Target 0)

    There were no 12-hr Trolley Wait breaches during April.

       Total time in A&E - % patients waiting less than 4 hours (Target 90%)

    Achieving the A&E Wait target has throughout last year been the Trust’ s most
challenging area. The end of year figure for patients waiting under four hours for the
period July-March fell just under 84%. The performance figures for April do show an
improvement, at 88.2%

   Two week cancer waits

The Trust achieved 100% for patients seen with two weeks of referral.

   Outpatient and elective (inpatient and day case) booking

The target is for 100% of first outpatient appointments and 100% of elective
admissions to be prebooked with the patient by December 2005. For elective
booking we have achieved 93% for April 2004 whilst outpatients is currently at 90%.

   Improving Working Lives

The Trust continues to work towards Practice Plus status in 2006 and it is expected
that performance for 2003/04 will be measured on the self-assessment document
and action plan the Trust is completing.


   Hospital Cleanliness

The PEAT inspection for the Trust took place at the beginning of February 2004 and
although we do not find out our final score from NHS Estates for sometime, overall
the feedback was positive with some areas identified in which we need to improve.


 Financial Management
See below


Finance
The draft final accounts show a Trust in the red by £986,000. This deficit includes
the additional income levied against the PCT for extra work beyond the service
agreement and the income and costs relating to the new consultant contacts.

We are having develop an additional approach this year to face up to our target to
save £20m this year, allocated budgets currently only bear the burden of only half
(5%) of this savings target.

Atos KPMG consulting have been commissioned by this trust and our local PCTs
to look at ways that the whole Brent and Harrow health economy can deal with the
financial challenge.

The Trust has also commissioned Secta Consulting Group to carry out some
focussed work in three areas.

Project 1- Temporary Staffing resource management review
Project 2: Medicines Management
Project 3: Clinical Activity Modelling

In a six step process the team programme will start by looking at areas such as
source management practices within Central Park office function, a diagnostic
assessment of medicines management practices within the Trust and how
wards/directorates use and control their budgets.

Reporting Milestones

It is proposed that Project 1 and 2 will have a reporting deadline the end of June
subject to the completion of the fieldwork programme.
Project 3 will have a target final reporting deadline of mid July.

A model to save money will be presented to an agreed steering group of the lead
managers for validation, before being subsequently submitted to the Executive
Management Team and the Board.

The Secta teams will consult with, information analysts and directorate managers/
clinical service leads, where appropriate.

If you contacted by a member of the project team please help the Trust by
being as co-operative as you can with the team.

For further information contact Don Richards on (1) 2712

Report from NHS CEO
In May NHS Chief Executive, Sir Nigel Crisp produced his annual report 2003/4,
which highlighted activity and performance in the NHS over the year and since the
publication of the NHS Plan

Under the headlines of:
1. Improvement are coming quicker
2. The NHS is working more effectively and more efficiently
3. There is more to do

The Official figures confirm that - with a handful of exceptions – the NHS has hit the
Government's NHS Plan target of ensuring that no patients wait more than nine
months for an operation. Waiting times have fallen faster and further this year than
ever before and the maximum waiting time is now half what it was in 1997.

 Death rates from the major killers, cancer and coronary heart disease, are falling
quickly.

More staff have been recruited, and more buildings and equipment brought into use.

In the report Sir Nigel thanked the staff for all their hard work and set out the
challenges for the future including listening to patients, and involves the public
wherever possible.
If you would like a copy of the report visit www.doh.gov.uk or email
doh@prolog.uk.com and quote 40123/chief executive’s report.

Workforce Development
ACAD staff changes
The Trust is looking into ways of increasing the number of patients that use ACAD.

The need to increase activity is due to a reduction in the amount of patients being
channelled to ACAD via the London Patient Choice Project. And as part of DOH
policy to extend Choice for its patients, this year 2004/5, the DOH has
commissioned a number of operations to the private sector. ACAD bids alongside a
private sector partner for this work was not successful.

Last year it was anticipated that approximately 5000 cases would be completed.
This year we are working on the basis that approximately 1500 cases will be
completed.

The reduction in workload means that the Trust will have to redeploy up to 20 staff
from ACAD to other areas of the organisation.

There will be no compulsory redundancies at this time. The relevant staff and their
representatives are being consulted and are being kept fully informed at every stage
of the process.

The ACAD management and the NWLH Hospital Trust Executive are eager and
committed to proactively secure the future of ACAD

For further information contact Nicky Bloom on (6) 8857

Agenda for Change (AFC)
Training on role profiling, appraisal and personal development planning under the
Knowledge & Skills Framework is due to take place during June and July. One of the
aims of the training is to ensure that all job descriptions for non-medical posts have
been updated by the end of August in preparation for Job Evaluation.

A draft Terms & Conditions of Service handbook has been made available to Trusts,
to support preparatory work in mapping current Whitley or local terms and conditions
of service against proposed Agenda for Change Conditions of Service. The Trust’s
working group has started to collect and map the data regarding staff terms and
conditions and assessing the impact on costs.

The review of data emerging from the 12 Early Implementer (EI) sites is due to be
completed by the end of June. Nationally, a number of unions are due to hold
secondary ballots following the review. The ballots are due to take place in the
autumn and in the meantime Trusts are being urged to carry out as much
preparatory work as possible.
Alistair Stinson has been appointed as the Assistant Director, Workforce
Modernisation and will jointly lead the implementation of Agenda for Change and the
KSF with Colleen Sherlock.

Consultant contracts
The job planning exercise needed for changing consultant contracts is almost
complete so we are technically in a position to offer contracts to those consultants
who have expressed an interest.

The reviewing of Clinical Directors contracts along with consultant colleagues is
also ongoing. There will be some job plans which will referred to the Strategic Health
Authority for assessment.

There is not enough funding to meet the costs of the new contracts and The Trust is
making representation via the Strategic Health Authority to the Department of Health
about the shortfall. We have also arranged to meet with the national Consultant
Contract Implementation Team to raise the concerns of our consultant body.


Leading innovation
Speech and Language therapy welcome royal visitor
The Countess of Wessex made a visit to NWLH last month. She met patients who
have benefited from the innovative work of one of our speech and language therapists
Claire Wells and Graham Williamson, a consultant from Sedgefield PCT the joint recipients
of the 2003 Sternberg Award for Clinical Innovation.

The Countess also made an impromptu visit to our new Children’s Unit, Jack Place.

Lab tests on line
On June 16th The DOH and the Association of Clinical Biochemists is launching a
website called "LabTests Online".

The purpose of this site is to give individuals and health carers a better
understanding of the many clinical laboratory tests that are now part of routine
healthcare, as well as information on the diagnosis and treatment of a wide range of
conditions and diseases.

Derek Edgerton is the link co-ordination for the Trust. Information packs will be made
available to all GP surgeries and phlebotomy areas during the first two weeks of
June.

For further information contact Derek Edgerton on (6) 2299
   Imperial College Undergraduate Expansion
   A business case has been put forward to expand and develop undergraduate
   teaching across the Trust. The business case proposes NWLH forms a strategic
   partnership with Imperial College School of Medicine and local Primary Care Trusts
   in providing innovative, modern clinical placements to an increased number of
   medical undergraduates.

   The five key benefits to the Trust for expansion include:
    NWLH becomes the 4th main teaching campus in Imperial College Medical
      School
    Expansion of multi-professional education and opportunity to re-develop clinical
      placements
    Ability to attract qualified staff to difficult to fill posts
    Opportunity to develop teleconference teaching across sites reducing manpower
      demands and increasing access to education
    Opportunity to develop purpose built undergraduate facilities

   The Trust has agreed to go ahead with the project confirmation of the budget and
   with a formal agreement from Imperial college and the Strategic Health Authority.

   Site developments
   ACAD
   Cardiology have settled into the ground floor of the extension. A grand opening of
   the new cardiology dept, 'The GlaxoSmithKline Cardiology Centre' is planned for
   24th June.

   Ophthalmology have moved to their 'permanent' new home in the 1st floor of the
   extension. On the whole the move went very well and they resumed their clinics as
   planned on Monday 17th May.

   A 'walk-around' (with the architect and relevant / key users) prior to the formal
   handover of the extension is scheduled for Friday 28th May.

   BECaD
   A “Start of Site” ceremony held last with Paul Boateng (MP) and the Managing
   director of Bouygues in attendance.

The work is galloping at such a pace that staff can now book tours of the new hospital the
site with the BECaD team.

To organise a tour or for further information contact Liz Dominique on (6) 2510

   Maternity
   We are commissioning the equipment for the birthing Centre at CMH over the next
   two weeks. It will also be handed over the Trust during this period.
   The refurbishment of the Maternity Unit at NPSM is making steady progress. The
   work is slightly behind schedule but the contractors are putting in place a project
   plan to make up the lost time.

   For further information contact Doug Charlton on (1) 2885

   Bus Interchange Project
   Work on the new bus interchange at NPSM on front of maternity this month. The
   interchange will increase capacity improve access, facilities and safety at the front of
   the hospital. It is anticipated that the work will take three months.

The work also includes two further new stops, for route 186 to/from Harrow, on the ring
road outside the Medical Education & Training Centre, and opposite the Staff
Residences.

If you have any ideas on how the service can be developed further please let us know - a
consultation event is being discussed to coincide with the opening of the new facility in
the autumn.

For further information contact Philip Sutcliffe on (1) 2003

   Opening up – Freedom of Information
   The Freedom of Information Act was passed in November 2000. It will allow
   members of the public, including the press, access to information stored by this
   organisation from January 1st 2005. It is essential that all staff are aware of the
   following key points:

      Any information held by this Trust in theory could be asked for, including emails
       and minutes of meetings. It is therefore essential that these are written and
       stored in a professional, coherent way.
      We are currently developing our policy, which will detail information held by the
       Trust and how it can be accessed. It will be in place over the coming months and
       will be the first port of call for the public.
      Any written request for information comes under the Act and must be responded
       to within 20 working days.

   For further information contact Sue Edwards or visit www.foi.nhs.uk

   RPST Assessment
Further to last month’s report, it is pleasing to note that the Trust has received
confirmation that it has now passed its Level One RPST assessment, improving its
Controls Assurance profile and qualifying for a discount on its NHS Litigation Authority
premium. As previously mentioned, one of the next actions will be a review of our risk
management committees’ structure and interrelationships. The next RPST assessment
will take place in 2005-06.
Staff summer ball
Friday 2nd July
New Connaught Rooms, Great Smith Street, London
£35 per person
Drinks reception, three course meal, coffee & chocolates
Live band and disco
Black tie/evening dress/traditional dress or smart suits

Tickets available from the Trust offices at NPSM and General Office at Central
Middlesex

Future forums
NPSM – Wednesday 7th July, 12pm – 1pm
CMH – Friday 9th July, 1pm - 2pm