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Annual Report 200506 - Welcome

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Annual Report 200506 - Welcome  Powered By Docstoc
					Our vision statement

“Our NHS Foundation Trust will
work in partnership to provide
innovative, leading edge care services
for our community which promote
recovery and well being, maximise
individual choice and enable people to
live as independently as possible.”




Acknowledgements

Editor Maxine Forrest
Food preparation Phil Johns
Design and food photography Peter Bolton



www.southessex-trust.nhs.uk
Table of contents

                                      PAGE                          PAGE
Aperitif	
Introduction by Jai Tout, Chairman,    1
                                             Main Course
                                             About the Trust         33
                                                                           TABLE OF
                                                                           CONTENTS
and Dr Patrick Geoghegan OBE,
Chief Executive                              Operating Review        43
                                             • Performance           43
Starter                                      • People                49
Recipes for good mental health         3     • Community             51
                                             • Emergency Planning    52
• Pasta with chicken and               5     • Environment           53
  mushrooms
• Pan fried salmon with tuna           7     Financial Review        57
  and salsa
• Clean and green salad                9     Dessert
• Grilled tuna nicoise                 11    Remuneration Report     71
• Vegetable rissotto                   13
• Turkey and cabbage casserole         15    The Bill
• Pasta and broccoli and               17    Summary Accounts        77
  red pesto
• Cinnamon and raisin porridge         19
• Refreshing fruit salad               21
• Brain boosting smoothie              23

Keep active - exercise to promote      25
mental wellbeing

Good news, new hospitals,              27
better environments
Introduction


APERITIF   From Jai Tout, Chairman, and
           Dr Patrick Geoghegan OBE,
                                                       reputation of ground breaking,
                                                       innovative service development and a
           Chief Executive                             champion for mental health, we worked
                                                       diligently to achieve this milestone. We are
                                                       extremely proud to be one of the first
           Welcome to the Annual                       mental health and learning disability trusts
           Report for 2005 – 2006

           May Day Was Our Day!

           Monday 1 May 2006 was the
           day we received the news we
           had been waiting for all year.
           We were officially authorised
           as a NHS Foundation Trust.
           This excellent news was the
           culmination of a tremendous
           amount of work brought
           together by our Foundation
           Trust Project Group with help
           from colleagues in Finance,
           Performance, Human
           Resources, Business
           Development, Patient and
           Public Involvement (PPI) and
           Communications. As well as colleagues       to be authorised. We join with only two
           within the Trust, we must recognise the     other organisations in the country to pave
           immense contribution from our partners,     the way for other mental health and
           services users, carers and all the people   learning disability NHS Foundation Trusts.
           from the community who
           supported our application.                  Since becoming a NHS Foundation Trust
           In keeping with this organisation’s         we have been concentrating on our future

 1
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planning. We also recognise that our past
triumphs and successes have contributed
                                                 continuing to provide the excellent care for
                                                 all the people who come into contact with
                                                                                                APERITIF
to us achieving this feat, and we are            our services.
determined not to lose this sense of energy
and passion.                                     “The care, the listening, the
                                                 understanding I’ve had from you all, you
This year we have been delighted with our        can never put a price on.”
continued success in relation to patient care    Compliment received from a service user.
and staff development. We have also been
extremely pleased with the progress of our  We have chosen the ‘cook book’ design this
short term and strategic plans. None of thisyear so that we can share with you the
would be possible without the support of    latest information about diet and exercise
our partners, service users, carers and staff.
                                            and the impact they can have on your
Details of these achievements and plans are mental health. We hope that these health
contained in the pages that follow.         promotion facts combined with sections
                                            on our major achievements, performance,
Attaining NHS Foundation Trust status gives environment and finance really do give you
us the opportunity to plan and develop      ‘Food for Thought’.
services knowing we have the support of
almost 9,000 staff and public members who
we have recruited over the past year. We
have an elected Board of Governors that is
actively involved in taking forward the     Jai Tout
recruitment of more public members as       Chairman
well as carrying out mental health
awareness and anti-stigma campaigns.

We want to take this opportunity to thank
all our staff, service users, carers, partners,
stakeholders and the public of south Essex
for their support over the last year. A special Dr Patrick Geoghegan OBE
thank you goes to our staff for                 Chief Executive

                                                                                                       2
                                                                                                      __
Eat Well – recipes for good mental health


STARTER   We are very grateful to the Mental
          Health Foundation for allowing us to
                                                       disability services in south Essex, we are
                                                       here to help you if you need it. For more
          reprint the recipes in this section of our   information about our services please
          annual report. Thank you.                    visit our website www.southessex-trust.
                                                       nhs.uk.
          The Mental Health Foundation (www.
          mentalhealth.org.uk) has put forward
          recommendations on how to look after
          your mental health. The ten positive
          steps are:


          • Talk about your feelings
          • Keep active
          • Eat well
          • Drink sensibly
          • Keep in touch with friends and loved
            ones
          • Ask for help
          • Take a break
          • Do something you’re good at
          • Accept who you are
          • Care for others


          We endorse and support all of these
          and highlight diet and exercise in this
          year’s annual report. As the main
          provider of mental health and learning

 3
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STARTER




      4
     __
     Lean meat, for example, chicken, turkey or lamb
     are good sources of vitamin B12, Tryptophan and
     Tyrosine. They may be lacking in people with
     depression.




                                                       It is best to have chicken or turkey
                                                       without the skin and to choose lean
                                                       cuts of meat.

 5
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Pasta with Chicken
and Mushrooms
                                            Ingredients
                                            (serves four)

                                            4 skinless chicken breasts – cut into chunks
                                            220g button mushrooms – cut into quarters
                                            4 cloves garlic – finely chopped
Method                                      1 red onion – finely diced
                                            1 red pepper – finely diced
Heat oil in a medium size pan. Add onions   1 small tin chopped tomatoes
and garlic, cook until golden brown.        250g butterfly pasta
Stir in mushrooms and peppers and cook
                                            30 g grated parmesan cheese
for a further 2-3 minutes, stirring         1 teaspoon rosemary – dried or fresh
continuously.                               1 tablespoon parsley - chopped
                                            285mls water
Add the tomatoes, salt, pepper, rosemary    1 tablespoon olive oil
and water. Bring to the boil and then add   salt
the chicken. Cook for approximately 20      pepper
minutes.

Season to taste.

Meanwhile add pasta to boiling water and
cook for approximately 10 minutes or to
your liking.

Drain well and add to chicken mixture.

Serve on a suitable platter and garnish
with parmesan cheese and chopped
parsley.
                                                                                            6
                                                                                           __
     Salmon and other oily fish such as mackerel,
     sardines, trout and herring are good sources
     of omega 3 fatty acids.




                                                    Omega 3 fatty acids may help with
                                                    depression. Aim for 1 - 2 portions
                                                    of oily fish per week.

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Pan Fried Salmon with
Tomato Salsa
Method                                        Ingredients
                                              (serves two)
Cook the potatoes and keep hot.

Heat half the oil in a pan and place salmon
                                              2 salmon fillets – skin on
fillets skin side down and cook for 3-4       3 tablespoons olive oil
minutes.                                      Juice of 1 lemon
                                              2 small onions – finely chopped
Turn fish over and cook for a further 2-3     2 large tomatoes – skinned* and diced
minutes.                                      8 small new potatoes
                                              200g mixed salad leaves
In another pan heat the remaining oil and     2 g basil – finely shredded
add the onion and cook until they soften.     5 g sunflower spread
Add the tomatoes and cook for a further       balsamic vinegar – to taste
2-3 minutes. Add the lemon juice, salt,
                                              salt
pepper and a dash of balsamic vinegar.
                                              pepper
Season to taste.

Mix the potatoes with the basil and melted
sunflower spread.

Serve the salmon on a bed of the tomato
salsa accompanied with mixed salad leaves
and the potatoes.

*To skin tomatoes, make a cross on the top
of the tomato and plunge into
boiling hot water for 30 seconds. Remove
and place into a bowl of ice cold water
which will allow the skins to be removed.
                                                                                       8
                                                                                      __
     Salads are an excellent way to help us to get our five
     portions of fruit and vegetables a day. We get most of
     our folate from fruit and vegetables and studies show
     that people with depression have low levels of this
     vitamin. Increasing folate is known to improve mood.




       Dressing
       Olive oil
       Balsamic vinegar
       Mustard
       Salt
       Pepper

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Clean and Green Salad

                                                Ingredients
                                                (serves four)

                                                1 small bunch coriander
Method                                          5 g sliced fresh ginger
                                                1 bulb of garlic – split in half horizontally
Place the coriander, ginger, garlic, chillies   2 hot dried chillies
and onion along with the chicken into a         1 medium onion – roughly chopped
suitable saucepan. Add salt and                 1 teaspoon salt
pepper and enough cold water to cover           1 pinch paprika
the chicken.                                    1.5kg free range chicken
                                                2 baby gem lettuces – leaves separated
Bring to the boil and simmer for 45
minutes ensuring that the chicken is
                                                1 pack spinach leaves
cooked. Allow it to cool in its own liquid.     1 pack rocket leaves
                                                1 bunch spring onions – thinly sliced
Once cooled take the chicken and peel off       85g frozen peas
the skin and remove the bone.                   125g broccoli florets
                                                85g sugarsnap peas
Cut into chunks or finely shred, coat with      125g asparagus tips
half of the dressing and set aside.
Arrange the lettuce, spinach and rocket
leaves onto a suitable serving platter.          Place the peas, broccoli florets, sugarsnap peas
                                                 and asparagus into boiling water and allow to
Toss the cooked vegetables in the                return to the boil. Cook for 2 minutes. Drain off
remaining dressing, check the seasoning          the hot water and rinse with cold water until
and arrange over the salad leaves. Scatter       cooled. Drain into a colander.
the chicken over the vegetables and
garnish with the spring onions and
paprika.
                                                                                                     10
                                                                                                     __
     Fresh tuna is an example of an oily fish, rich in omega 3
     fatty acids. Studies show that countries where there is
     a lot of fish consumption have correspondingly lower
     levels of depression. Aim for 1 - 2 portions
     of oily fish per week.




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Grilled Tuna Nicoise

                                               Ingredients
                                               (serves four)

                                               Marinade
                                               3 tbs balsamic vinegar
                                               135 mls olive oil
Method                                         2 teaspoons parsley – chopped
                                               2 teaspoons chives – chopped
Make a marinade by using the vinegar,
                                               2 cloves garlic – chopped
olive oil, parsley, chives, garlic, salt and
                                               ½ teaspoon salt
pepper. Whisk together thoroughly in a
bowl.                                          ½ teaspoon pepper

Pour half of the marinade over the tuna        Recipe
steaks which have been put into a suitable     4 tuna steaks – 1” thick
dish. Chill for 2 hours.                       2 little gem lettuces – leaves separated
                                               16 pitted black olives – halved
Heat an oiled griddle pan and cook the         3 plum tomatoes – cut into ¼
drained tuna for 1-3 minutes each side.        115 g french beans – topped and tailed –
                                               cooked for three minutes and plunged into
This will depend on how well you wish the
                                               cold water.
fish to be cooked.

Toss together the lettuce, olives, tomatoes,   1 red onion – finely diced
beans, onion, anchovies and potatoes with      6 anchovy fillets – chopped
the remaining marinade.                        8 small new potatoes – cooked – cut in halves
                                               3 eggs – hard boiled – cut into ¼
Arrange the salad on a suitable serving        8 basil leaves – ripped
dish and place the tuna on the top.
Garnish with the hard boiled eggs and
basil.
                                                                                               12
                                                                                               __
     Brown rice and other wholegrains, for example,
     wholegrain bread, oats, barley and fresh pasta
     are good sources of vitamin B1, B6, magnesium
     and selenium. They are also good sources of
     fibre. They will help with anxiety, depression,
     poor memory and irritability.




13
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Vegetable Rissotto

                                              Ingredients
                                              (serves four)

                                              3 teaspoons olive oil
                                              1 cup brown rice
                                              3 cloves garlic – chopped
                                              2 cups vegetable stock
                                              ¼ cup chopped parsley
Method                                        1 cup carrots – diced small
                                              ½ bunch spring onions – chopped
Heat the oil in a suitable pan and add the
                                              1½ cups fine green beans – cut into 1” pieces
rice and garlic. Cook for 3-4 minutes on a
medium heat, stirring occasionally.           ¾ cup parmesan cheese – grated
                                              1 small tin chick peas
Add the vegetable stock, water, parsley,      1 large bunch of spinach
salt and pepper.                              salt
                                              pepper
Bring to the boil and cook on a low heat      300mls water
for approx 35 minutes or until the rice is
nearly cooked.

Add the carrots, green beans, chick peas
and spring onions and cook for a further
15 minutes until the rice is cooked and the
liquid has been absorbed.

Stir in the parmesan cheese and check the
taste for any further seasoning.

Serve on a bed of fresh spinach leaves.
                                                                                              14
                                                                                              __
     Cabbage and other green leafy vegetables are good
     sources of folate, magnesium, vitamin B1, vitamin B6
     and are all important in helping people cope with
     anxiety, depression, stress and insomnia.




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Turkey and cabbage
Casserole
Method
                                               Ingredients
Preheat oven to 160 o c                        (serves two)
Place shredded cabbage into medium size        2 turkey fillets
ovenproof dish.                                ½ small cabbage - shredded
                                               1 red onion – diced
Heat oil in pan and brown the turkey on
both sides.
                                               2 cloves garlic – finely chopped
                                               ½ teaspoon oregano
Place turkey on top of the cabbage.            1 cup tomato sauce
                                               1 cup brown rice
Add onions and garlic to the turkey pan        2 tablespoons olive oil
and cook for 2-3 minutes stirring              1 tablespoon parsley – chopped
occasionally.                                  1 cup water
                                               salt
Add the rice and cook for a further 2-3        pepper
minutes. Pour into the dish with the turkey.

Combine the oregano, tomato sauce,
water, salt and pepper and pour over the
rice and turkey.

Cover and bake for approximately 1 hour.
If the liquid evaporates and the rice is not
cooked just add a little water.

Season to taste.

Serve on a bed of the cabbage and rice
topped with the turkey and garnish with
chopped parsley.
                                                                                  16
                                                                                  __
     Green leafy vegetables such as broccoli, spinach,
     asparagus and brussel sprouts are good sources of
     folate. Folates or folic acid is often lacking in people with
     depression or anxiety. Increasing the folate intake may
     improve mood.




                                                                     Aim for six portions of fruit and
                                                                     vegetables per day.
17
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Pasta with Broccoli
and Red Pesto
                                               Ingredients
                                               (serves four)

                                               1 bunch basil
                                               2 cloves garlic
                                               2 tablespoons tomato puree
                                               ½ cup water
                                               200g penne/fusilli pasta
                                               300g small broccoli florets
                                               2 large red peppers – cut into strips
Method                                         3 medium tomatoes – skinned and diced
                                               25g grated parmesan cheese
Combine basil (retain a little for garnish),
garlic, tomato puree and water in a            salt
blender until a puree.                         pepper

Add pasta to boiling water and cook for
                                                To skin tomatoes, make a cross on the top of the
approx. 10 minutes. Add broccoli and
peppers and cook for a further 3 minutes.       tomato and plunge into boiling hot water for
                                                30 seconds. Remove and place into a bowl of
Drain into a colander.                          ice cold water. The skin can then be peeled quite
                                                easily.
Meanwhile, mix tomatoes and pesto and
place in saucepan on a medium heat.
When hot, add pasta and vegetables along
with the parmesan cheese, salt and
pepper.

Season to taste and serve on a suitable
Check seasoning and serve on a suitable
plate garnished with shredded basil leaves.
                                                                                                18
                                                                                                __
     Brown rice and other wholegrains, for example, wholegrain bread,
     oats, barley and fresh pasta are good sources of
     vitamin B1, B6, magnesium and selenium. They are also good
     sources of fibre. They will help with anxiety and depression.




19
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Cinnamon and
Raisin Porridge
                                              Ingredients
                                              (serves two)

                                              2 ¼ cups water
                                              1 cup rolled oats
                                              ½ teaspoon cinnamon
                                              ½ cup raisins
                                              ¼ cup chopped walnuts
                                              salt to taste
                                              soya or skimmed milk
                                              honey
Method
Boil the water and gradually add the rolled
oats.

Turn to low heat and allow the oats to be
absorbed whilst stirring continuously.

Add the salt, cinnamon, walnuts (retain a
little of both for garnish) and raisins.

Cover the pan and allow to stand for 5
minutes.

Serve in a suitable dish and garnish with
the cinnamon and walnuts.

Accompany porridge with a jug of milk
and a jug of honey.
                                                                      20
                                                                      __
     Bananas, kiwi fruit, blackberries, strawberrries and oranges are good
     sources of magnesium which may be lacking in people with anxiety,
     depression and stress. Having more fruit in your diet could help
     people cope with these problems. Try substituting sweets and
     chocolate with fruit.




21
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Refreshing Fruit Salad
Method
All fruit should be washed prior to
preparation.                                  Ingredients
                                              (serves two)
Peel the pear, mango, kiwi fruit and
banana and cut into small pieces and place
in a bowl.                                    1 apple
                                              ½ small honeydew melon
Cut the grapes and strawberries into          1 pear
halves and add to the bowl.                   10 white and red grapes
                                              1 mango
Cut off the tops and tails of the cumquats    5 cumquats
and thinly slice ensuring you remove any      1 kiwi fruit
pips.                                         250 gms strawberries
                                              1 banana
Cut melon in half and remove pips and
                                              1 small pineapple
inner brown contents. Slice flesh from the
                                              1 lime
outer skin and cut into same size pieces as
the other fruit.                              sprig of mint

Cut away outer skin from the pineapple
and again cut into pieces ensuring that the
core is removed.

Finely chop mint leaves and add to the
bowl. (Retain a few leaves for garnish.)

Squeeze juice from the lime and any juice
from all of the fruits into the bowl.

Place in the chiller for an hour and serve
in a suitable dish garnished with the mint
leaves.
                                                                        22
                                                                        __
     Flax oil is a vegetable source of omega 3 fatty
     acids and is helpful in managing depression
     and schizophrenia. Peanuts are a good source
     of magnesium and may help with irritability,
     insomnia, stress and depression.




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Brain Boosting Smoothie

                                              Ingredients
                                              (serves two)

                                              3 cups skimmed milk
                                              1 ½ cups plain low fat yogurt
                                              1 banana
                                              1 cup blueberries
                                              ½ cup mixed fruits in season
                                              2 tablespoons flax oil
                                              2 tablespoons peanut butter
                                              1 tablespoon cinnamon




Method
Blend all of the ingredients but save a
small amount of the cinnamon for garnish.

Allow to chill.

Serve in a suitable glass and sprinkle with
remaining cinnamon.
                                                                              24
                                                                              __
Keep active – exercise to
promote mental wellbeing
STARTER   Regular physical activity can make you feel
          better and is therefore good for your
                                                        Physical activities that can have a positive
                                                        effect on your mental wellbeing include
          physical health, but it can also make you     rhythmic aerobic exercise such as walking,
          feel better about yourself, making it
          great for your mental wellbeing.

          Not only can regular exercise alleviate
          some symptoms of mental ill health, it
          can also improve your mood and reduce
          anxiety as well as improving
          self-esteem.

          The positive effects of exercise on self
          perception can be experienced by men
          and women and all age groups, and
          evidence is greatest for children and
          middle aged adults.

          “Physical self-worth carries mental
          well-being properties in its own right
          and should be considered as a
          valuable endpoint of exercise
          programmes,” explained Rob Read,
          Fitness Coach at Runwell hospital.

          Exercise is also extremely effective in the
          treatment of clinical depression,
          particularly in the long term, and make       jogging, cycling or swimming to name just
          as much of a contribution to recovery as      a few. You don’t have to pay out to join a
          physiotherapy or medication.                  gym to feel the benefits of exercise. A brisk
                                                        walk around your local park can be just as
                                                        beneficial as an hour on the treadmill.

25
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                                                 ten minutes, three times a day is just as
                                                 beneficial as a 30 minute stint in the gym.
                                                                                                STARTER
                                                 Rob added, “Physical activity and exercise
                                                 have consistently been associated with
                                                 positive mood, and moderate intensity
                                                 exercise has a positive effect on
                                                 psychological well-being.”

                                                 With this in mind, the Trust has a
                                                 programme of exercise for our adult
                                                 inpatients. Patients can work out in a well
                                                 equipped gym in the grounds of Runwell
                                                 hospital, or in ward grounds.

                                                 Jeff, a patient who uses the gym said,
                                                 “I can control my weight even when
                                                 taking medication with exercise. I have
                                                 been encouraged to take part in all
                                                 activities despite limited ability due to
                                                 physical problems. I’ve enjoyed it so much
Around a third of all adults in Britain report   I intend to join a gym/health club when I
sleep problems or feelings of fatigue, but,      leave hospital to keep myself in good trim!”
did you know that regular physical activity
can reduce physiological reactions to stress     Darren, another patient, added,
and may improve sleep patterns?                  “Exercise gives me more motivation and
                                                 keeps me in good health. I am looking at
The Department of Health recommends              eating more healthily and continuing this in
that adults get at least 30 minutes of           the community.”
activity a day for general health.
However, this can be built up throughout
the day – three bouts of brisk walking for

                                                                                                     26
                                                                                                     __
Good news, new hospitals,
better environments
STARTER   Summer 2005                                   branch of the Alzheimer’s Society, in
                                                        recognition of his dedication to the mental
          PPI	Forums	and	Trust	launch	Crisis	Cards      health needs of older people in the
          This handy credit-card sized card comes in    community. The centre supports older
          its own plastic wallet that protects the      people in the community with
          important information contained inside. It    comprehensive services tailored to their
          was designed specifically for people who      needs.
          have mental health problems and
          occasionally experience a crisis. The         Birthday	cake	for	CDAS
          Crisis Card                                   21st birthday celebrations took place in
                                                        Southend for the Trust’s Community Drug
                                                        and Alcohol Services. This service started in
                                                        1984 in Benfleet then moved to the Roche
                                                        Unit at Rochford Hospital in 1987 and after
                                                        moving in 2004 is now based at the Taylor
                                                        Centre in Southend.

                                                         Afternoon	anniversary	tea	at	Weymarks
                                                          Staff and residents at Weymarks
                                                        Rehabilitation unit in Basildon celebrated
                                                        the 10th anniversary of this excellent
                                                        community rehabilitation facility which
          gives contact details of the Trust’s out-     helps clients improve their quality of life
          of-hours service available 24 hours a day,    through participation in a range of
          seven days a week.                            therapeutic activities. Staff and service
                                                        users, past and present, came together to
          Harland	Centre	opens	its	doors                celebrate a decade of care at the unit.
          Sir Teddy Taylor was the guest of honour at
          the opening of the Harland Centre,            Business	Breakfast	supports	anti-stigma	
          Westcliff. This resource and treatment        campaign	
          centre for older people was named after       Essex businesses and support groups got
          Harland Bateson, Chair of the Southend        together for breakfast in Basildon to

27
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explore prejudice and discrimination in the   Autumn 2005                                    STARTER
workplace and offer advice on how to help,
support and enable service users to enjoy     Art	Exhibition	and	Quality	Awards	
fulfilling employment.                        The Trust’s annual Art Exhibition is a
                                              showcase for the many talents of service
Dame	visits	Trust                             users, staff, schools and professional local
Dame Gillian Morgan, Chief Executive of the   artists with a spectacular variety of
NHS Confederation, visited the Trust and      paintings, sculptures and sketches on
opened the newly refurbished Gloucester       display. The Quality Awards is also an
ward at our mental health unit in Basildon.   annual event where staff present and
The ward cares for older people with          celebrate their achievements for the past
mental health problems from Basildon,         year. This year’s winners were the Southend
Wickford, Billericay and Thurrock.




                                                                                                  28
                                                                                                  __
STARTER   Scorchers, a mixed gender football team
          made up of staff and service users.
                                                       take - it said:
                                                       The Patrick Geoghegan Recovery Unit.

          Surprise	Treat	for	Chief                     The	Rt.	Hon	Lord	Hanningfield	DL,	
          Executive                                    Leader	of	Essex	County	Council,	opened	
          To celebrate his ‘special’ birthday, his     Oakview	ward	at	Runwell	hospital
          unswerving commitment to mental health       The ward was completely refurbished and
          and the recent honour of being awarded an    offers homely, therapeutic environment for
          OBE, the Trust officially opened the         patients. With rehabilitation on the top of
          Recovery Unit at Basildon hospital. Our      the agenda, staff organise creative
          unsuspecting Chief Executive took part in    activities, cooking, budgeting skills,
          the ceremony and when Angela Smith MP        shopping, self-care and education to help
          unveiled the plaque, Patrick took a double   understand their own mental health issues.




29
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Nurses	vote	SEPT	their	favourite	dish!
The Trust’s nurses voted South Essex
                                              Assessment	Unit	in	Basildon	
                                              nominated	for	national	award
                                                                                          STARTER
Partnership NHS Trust the top mental          This unit based in the mental health
health and learning disability trust for      unit at Basildon hospital was shortlisted
nurses to work for in the UK. The Trust was   for one of the prestigious 2005 Health
named in the Nursing Times Top 100 as the     Service Journal Awards in recognition
top mental health and learning disability     of their contribution to innovation and
Trust in the country and was ranked third     improvement for the development of
best employer out of 100 short listed         mental health services.
finalists.
                                              Winter 2005
                                              Top	Staff	Vote	SEPT	Top	Trust
                                              The outcome of this year’s NHS Staff




                                                                                               30
                                                                                               __
STARTER   Attitude Survey shows that South Essex
          Partnership NHS Trust was the top
          mental health and learning disability trust
          in the country.

          Hampers	of	Christmas	Cheer
          Members of the Trust’s Assertive
          Outreach Teams in Southend, Basildon,
          Brentwood, Billericay, Wickford, Rayleigh
          and Castle Point gave up their Christmas
          day to deliver food hampers, a small gift
          and lots of Christmas cheer to their patients
          who were alone during the festive season.       turf at the site of the brand new £21 million
                                                          hospital development at Rochford.
          Harman	ward                                     The plans include:
          Mark Francois MP visited the Trust in
          February and opened the upgraded                • Assessment suite
          Harman ward at Runwell hospital. The Trust      • 2 x 24 beds adult admission
          believes that as well as clinical care the        wards
          environment has therapeutic contribution        • 1 x 15 beds adult rehabilitation
          to make to recovery. We are constantly            ward
          upgrading and modernising our hospital          • 2 x 24 beds older people
          and community facilities. We listen to our        assessment wards
          service users and consult with them
          whenever we are planning building and           The new Rochford hospital is expected to
          refurbishing.                                   open and be fully operational by March
                                                          2008.
          Spring 2006                                     Sandra Hillier, Chair of Basildon District
                                                          Council, turned the turf for the new
          Icing	on	the	cake
                                                          Psychiatric Intensive Care Unit in Basildon.
          Rosie Winterton MP Minister of State for
                                                          The new purpose built psychiatric intensive
          Health visited south Essex and turned the

31
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care facility house15 beds for adults
between 16 and 65 years old. There will be
                                             Making	your	mind	up!
                                             Cheryl Baker of Bucks Fizz, television and
                                                                                          STARTER
separate bedrooms for men and women          stage fame joined the Trust at their
and include a bedroom specially designed     Foundation Trust Public Governor elections
for a person with a physical disability.     in March. After announcing the names of
                                             the elected governors, Cheryl released
                                             1,000 balloons into the sky above Basildon
                                             each carrying a positive mental health
                                             message.




                                                                                               32
                                                                                               __
About the Trust


 MAIN    South Essex Partnership NHS Foundation         to people in their own homes and from a
COURSE   Trust (SEPT) is located 30 miles to the east
         of London on the northern bank of the
                                                        range of hospital and community based
                                                        premises. The Trust delivers 4,300 finished
         River Thames and provides mental health        consultant episodes (appointments with
         and learning disability services.              consultant psychiatrists) and over 250,000
                                                        attendances and contacts (out-patient or
         SEPT has a budget of £100 million and          home visits with clinicians) each year.
         employs approximately 2000 people. We
         operate across six district council            In line with national policy the Trust has
         boundaries with a total population of          developed a range of modern community
         715,000. Unlike acute hospital services,       based resource centres and community
         mental health and learning disability          facilities to provide local services wherever
         services are mainly provided in community      possible.
         settings and defined geographical
         localities. SEPT operates from 49 locations    Key	Strategies	and	Objectives
         across south Essex.
                                                        Over 300 staff, service users and other
         The Trust is the main NHS provider of a
                                                        stakeholders were involved in developing
         wide range of specialist health and social
                                                        the Service Development Strategy (SDS) for
         care services within south and north Essex
                                                        2005/2006. Six key priorities were identified
         including:
                                                        for the Trust. All of these ensure that local
                                                        mental health and learning disability
         • mental health services for adults
                                                        services continue to be developed in line
           and older people;
                                                        with national priorities for the NHS and
         • Essex-wide forensic services;
                                                        in line with what our staff and our service
         • low secure services;
                                                        users believe are the areas where further
         • specialist children’s services;
                                                        improvement is required.
         • learning disability services;
         • drug and alcohol services;
                                                        On 30 March 2005, the Trust Board
         • other specialist services.
                                                        approved that our priorities for 2005/2006
                                                        were:
         The Trust works with a range of partner
         organisations to provide care and support

33
__
                                                     standards set out in national guidance;
                                                                                                    MAIN
 • the health of the local community;
 • the care of people with long term
                                                   • all of our older people’s community
                                                     mental health teams offer fully integrated
                                                                                                   COURSE
   conditions;                                       health and social care services;
 • access to services;                             • 83% of our inpatient and community
 • the service user experience;                      patient records have a valid ethnic code;
 • modernisation of local services;                • 83% of drug misusers ( total = 681 )
 • developing the infrastructure of the              entering treatment in 05/06 were retained
  Trust to support the delivery of our               in treatment more than 12 weeks.
   objectives.                                     • leadership, action planning and
                                                     monitoring arrangements in respect of
A range of actions was agreed to ensure              infection control were put in place in line
that these key priorities were delivered             with national requirements;
by the end of March 2006. These actions            • new policies and procedures were put in
included the achievement of a range of key           place to improve the management of
targets that the Healthcare Commission set           obesity amongst our client group and
for mental health service providers (please          excellent progress was made to introduce
refer to www.healthcarecommission.org.uk             a ‘smoke free’ environment for our staff
for more details of these targets). The Trust        and service users.
Board monitored progress with achieving
our objectives and targets throughout the          Key	Developments	and	Performance	
year and we are delighted to report that:          Management

• we achieved a 16% increase in staffing           We are very proud of the progress we made
   levels and a 6% increase in activity in Child   during the year to take forward many
   and Adolescent Mental Health Services;          service improvements and developments
• five Crisis Resolution and Home Treatment        that will ensure that local services continue
 Teams were fully established in south             to be effective and efficient.
  Essex that met all of the Department of
  Health policy implementation guidance;           The Trust has completed a range of action
• a comprehensive audit of suicide                 plans, audits and training to facilitate
  prevention was undertaken against                improvements to the health and well

                                                                                                        34
                                                                                                        __
 MAIN    being of the people of Essex. Mental health      Additional investment in children’s
COURSE   promotion is a key development area for
         our new NHS Foundation Trust and will be
                                                          services, nurse prescribing, improved
                                                          access to therapy services and for people
         developed further over the next five years,      with a dual diagnosis as well as increased
         led by our Board of Governors and the            uptake in Direct Payments were some of
         Membership of our NHS Foundation Trust.          the key achievements in delivering the
                                                          Trust’s third priority area; improving access
         During the year the Trust worked closely         to our services.
         with Primary Care Trusts (PCTs) to meet
         objectives detailed in the National Service      During the last year SEPT has worked
         Frameworks. The Trust successfully               alongside accident & emergency
         delivered specialist community teams             departments at Basildon and Southend
         including Crisis Resolution and Home             hospitals to reduce waiting times for
         Treatment, Gateway workers, Early                people presenting with mental health
         Intervention Teams, Assertive Outreach           related conditions to less than four hours.
         Teams and Support, Time Recovery Workers.        The Trust also achieved 100% compliance
                                                          with following up people within seven days
          Actions to improve service user experience:     of their discharge from hospital.

         • initiatives to avoid transferring patients
            for out of area treatments because there      Preparing	for	Foundation	Trust	status
            are no local beds available;
          • developing an assessment and recovery         2005/2006 was an exciting year for our Trust
            unit to prevent avoidable admissions to       as we undertook extensive preparation for
            hospital and to facilitate early discharge.   NHS Foundation Trust status. Our
                                                          application process started in October 2004
         This has led to a reduction in the average       and we were successfully authorised as an
         number of bed days to 8%. As a result of a       NHS Foundation Trust on 1 May 2006.
         lower demand for inpatient services and an
         increased investment in community                The preparations for NHS Foundation Trust
         services, the Trust has reduced its bed          status included a complete review of the
         complement by 33.                                Trust’s strategic direction which in turn has

35
__
led to the development of our new vision         of Governors. Our track record of responding
                                                                                                   MAIN
statement.                                       to change, modernising services and being
                                                 innovative is excellent and we believe that
                                                                                                  COURSE
“Our NHS Foundation Trust will work in           as a NHS Foundation Trust we can build on
partnership to provide innovative,               our successes and secure further real
leading edge care services for our               benefits for local people.
community which promote recovery and
well being, maximise individual choice           The Trust has identified 13 priority areas for
and enable people to live as                     the next five years. Many objectives focus
independently as possible.”                      on the delivery of a range of existing
                                                 commitments such as:
This new statement is supported by the
following organisational values:                   The	completion of the Runwell hospital
                                                   closure and modernisation programme
 • To uphold the principles of the NHS             which will deliver:
 • To provide person centred care                • a new 96-bedded secure facility for
 • To deliver high quality integrated              people who require medium and low
   services                                        secure care;
 • To create an inclusive and supportive         • the re-development of Rochford hospital
   culture                                         to deliver 111 beds for adults and older
 • To ensure excellent performance                 people;
  and efficiency                                 • the closure of Runwell hospital.

As a NHS Foundation Trust, we re-examined        The	delivery of new mental health
local priorities and aligned future objectives   services for the Brentwood locality.
to the new statement of purpose. NHS             The	transformation	of therapy and
Foundation Trusts are a completely new           rehabilitation services and the
kind of organisation known as a public           development of employment, social
benefit corporation. They remain firmly          inclusion, primary care mental health
part of the NHS but are run locally and are      services and physical and mental health
more accountable to the local community          promotion.
through an active membership and a Board

                                                                                                       36
                                                                                                       __
 MAIN    The	transformation of training and          culture and prepare staff to meet the
COURSE   learning services.
         The	implementation of national and local
                                                     new challenges of foundation trust status.
                                                     The	development and delivery of the
         Information Management & Technology         Trust’s Human Resource, Governance and
         strategies.                                 Marketing Strategies.
         The	development	of the membership of        Focus	on achieving best value, effective
         the new NHS Foundation Trust to promote     resource utilisation and quality
         a positive mental health message and help   management plans.
         the Trust plan for the future changing                     The	ability	to respond to
         the Trust’s                                                future changes in mental
                                                                     health legislation.

                                                                   The Trust also intends to
                                                                   build upon successful
                                                                    partnerships with the
                                                                    statutory and voluntary
                                                                    sector to deliver
                                                                    multi-agency solutions for
                                                                     health, social care,
                                                                     employment and health
                                                                     promotion.

                                                                        Resources
                                                                        The NHS uses whole time
                                                                         equivalents as a
                                                                         workforce measure
                                                                         which examines the
                                                         hours worked by each person and
          Rochford hospital (artist’s impression)    converts this to a single measure based
                                                     on full time employment (i.e. one full-time
                                                     employee working 37.5 hours equals 1.00
                                                     WTE).

37
__
Although the Trust employs 2000 people,       develop a range of advanced practitioner
                                                                                               MAIN
this equates to 1829 WTEs. The total
workforce employed by the Trust is detailed
                                              and associate practitioner roles particularly
                                              in services where recruiting staff remains
                                                                                              COURSE
in Table 2 below.                             difficult.

Table	2:	Current	Workforce	Numbers (by        The table overleaf details changes to staff
whole time equivalent)                        groups during the next five years for the
The Trust does not intend to significantly    respective professional groups. The average
increase staffing levels over the medium      rate for leavers included within the
term and will look to utilise existing        calculations underpinning this table
manpower capacity to deliver a range of       decreases by an anticipated 5%, for each
objectives over this period. A significant    year of the plan. This assumption arises
investment in training and development        from the anticipated improvements that
will be made during this timeframe to         will accrue from the implementation of the
increase competencies and maximise            Trust’s recruitment and retention strategies
flexibility. A key aim of the Trust is to     as outlined in the Human Resources
                                              Strategy. Our workforce plan models the
    Professional Group              WTE       effect of the 5% reduction in the number of
                                              leavers and this provides a recruitment
    Admin & Clerical               214.3      advantage. The numbers of staff are
    Medical                         89.7      relatively low and have no material impact
    Qualified – AHP                 61.0      on the Trust’s financial plans and
    Unqualified – AHP               54.8      assumptions.
    Ancillary & Maintenance         92.9
    Qualified Nurses               640.6      Our turnover figures together with
    Unqualified – Nurses           578.7      retirements, service development
    Senior Managers                 97.2      information and efficiencies have been
   	TOTAL	        	      												1829.1   used within the workforce plan to calculate
                                              the level of recruitment required by staff
                                              group for each year of our five year plan as
                                              a NHS Foundation Trust.


                                                                                                   38
                                                                                                   __
 MAIN     Turnover Rates by Service Group
COURSE
          Professional Group         2006/7     2007/08 2008/09 2009/10 2010/11

          Admin & Clerical           9.5%        9.4%      8.9%      10.7%      9.6%
          Medical                   12.8%       13.2%     11.9%       9.7%      9.3%
          Qualified - AHP           15.1%       10.3%     11.2%      10.7%     10.3%
          Unqualified - AHP         10.5%        7.1%      8.4%       9.6%      6.3%
          Ancillary & Maintenance    7.7%        5.8%      8.3%       5.5%      4.5%
          Qualified Nurses           8.4%        9.4%      8.1%       8.1%      8.4%
          Unqualified – Nurses       9.1%        9.0%      8.9%       9.9%      8.7%
          Senior Managers*           2.3%        2.7%      3.1%       2.2%      2.4%

          * Adjusted due to management restructure


         The	Management	of	Risk	and	                     objectives of the Trust and any
         Uncertainty                                     significant risks that could materialise
                                                         during 2005/2006. This new framework
         Managing risk is an inherent part of the        was developed to ensure that the Trust
         Trust’s systems of internal control. It is      Board was kept up-to-date with progress in
         crucial that the organisation is aware of the   managing these risks. This framework was
         risks facing our organisation and whether       presented on seven separate occasions
         those risks have the potential to prevent       during the financial year and the Trust
         us from achieving our objectives. We have       Board was satisfied that adequate action
         put in place robust systems that ensure that    was being taken to manage all of the
         risks are identified, we take steps to          identified risks.
         manage them and we look at ways that we
         can evidence that this has taken place.

         The Board Assurance Framework was
         developed to focus on the principle

39
__
The significant risks identified for the next    making in the short term and for
                                                                                                  MAIN
five year planning period are:                   competition with other providers in the
                                                 longer term.
                                                                                                 COURSE
Achieving	Cash	Releasing	Efficiency	
Savings	(CRES)                                   Implications	of	new	Mental	Health	Act
The Trust is required to achieve a significant   The revised Mental Health Act has the
CRES target in 2005/2006. Achieving this         potential to impact significantly on the
target puts considerable pressure on the         Trust’s services, although it is
Trust’s ability to continue to achieve           acknowledged that this risk is dependent
financial balance and to provide existing        on the Act being passed.
levels of service.
                                                 Runwell	Hospital	Modernisation	
Vulnerability	of	Future	Income                   Programme
The Trust needs to be aware of and prepare       The scheme must be completed on time
for the potential for a future reduction in      and within agreed resources to ensure
income as a result of financial pressures        service modernisation plans are achieved.
within the local health economy and              Developing	Capacity	Through	
potential for changes in commissioning           Modernisation
intentions. In addition, during 2005/2006        Delivering spare capacity to provide
the Essex Strategic Health Authority agreed      additional services and generate additional
an Essex wide Recovery Plan to manage            income is a key mitigating strategy for
in-year cost pressures that require the          achieving CRES targets and reducing risk of
Trust to achieve a non-recurring saving of       vulnerability of future income.
£983,000 in 2005/2006 in addition to
existing CRES target.                            Lesser risks are recorded in the Trust
                                                 Risk Register and directorate risk registers.
Impact	of	CHOICE	Agenda                          The Trust’s Integrated Governance Steering
Although the impact of the CHOICE agenda         Committee has delegated responsibility for
on mental health is still dependant on the       managing corporate risks and Service
development of Department of Health              Management Boards have delegated
policy, the Trust must prepare for CHOICE in     responsibility for managing operational
the treatments available and decision            risks.

                                                                                                      40
                                                                                                      __
 MAIN    An	independant	view	of		our	systems	for	
         managing	risk
                                                         the design or inconsistent application of
                                                         controls; put the achievement of
COURSE                                                   particular objectives at risk.”
         The Head of Internal Audit provides the
         Trust Board with an opinion on the systems      In addition, as Accountable Officer, the
         for managing risks. The Head of Internal        Chief Executive has a statutory
         Audit Opinion is based upon:                    responsibility to prepare annual financial
                                                         statements for the Trust and a Statement of
         • an assessment of the design and               Internal Control (SIC). The SIC is designed
           operation of the Trust Assurance              to confirm that effective risk management
           Framework and supporting processes;           systems are in place and would be used for
                                                         Chief Executives to disclose any significant
         • an assessment of the range of individual      internal control issues. The Trust Board
           opinions arising from risk based audit        confirmed that the System of Internal
           assessments contained with internal audit     Control has been in place for the year
           risk based plans that have been reported      ended 31March 2006 and up to the date
           throughout the year;                          of the approval of the Annual Report and
                                                         Accounts.
         • an assessment of the process by which the
           organisation has arrived at its declaration   The SIC for 2005/2006 confirms that there
           in respect of the national standards for      are no significant internal control issues
           better health; and any relevance that is      that have been identified during the year
           being placed upon third party assurances.     that require disclosure within the Annual
                                                         Report and Accounts. A copy of the SIC can
         The Head of Internal Audit Opinion was          be obtained from the Trust Secretary (01375
         issued on the 5 May 2006 and confirms:          364650).
         “Significant assurance can be given that
         there is a generally sound system of
         internal control, designed to meet the
         organisation’s objectives, and that
         controls are generally being applied
         consistently. However, some weakness in

41
__
 MAIN
COURSE




     42
     __
Operating Review


 MAIN    Performance                                     Community services teams saw an
COURSE   During 2005/2006 the Trust provided nearly
                                                          increased number of patients referred.
                                                         Adult services received 16% more referrals
         72,000 occupied bed days in hospital wards      and Older People services received 25%
         across south Essex for adult mental health      more referrals than in the previous year. The
         services. Over the same period, almost          following table summarises their activity
         81,000 occupied bed days were provided          across south Essex.
         for older people (ages 65+) requiring
         inpatient care. The Trust was able to treat     Consultants in adult mental health received
         all but one of our acute admission patients     1,673 GP referrals during the year and 786
         within its own facilities, which represents a   other referrals. To meet this demand 1,522
         significant improvement in access for local
         residents. In part this has been achieved        	        																								Adult				Older	People
         by the opening of the Assessment Unit at         	        	               							Teams									Teams
         Basildon hospital which has admitted 1,115
         patients this year and discharged 670 of         Referrals Received 3944                  1501
         these to the care of our community
                                                          Assessments              1114             653
         services.
                                                          performed
         The successful care and treatment of             Average waiting           16.4           20.4
         patients outside of a hospital setting is        time from referral        days           days
         a key aim for the services we provide. To        to assessment
         measure this the percentage of patients
                                                          Cases on Standard 975                     410
         returning to hospital within 28 days of
                                                          Care Programme
         being discharged is regularly monitored
                                                          Approach ( year end )
         and we can report that it fell to an annual
         rate of 3.9% from 10.5% in 2004/2005.            Cases on Enhanced 1621                    568
         Closer management of discharges from             Care Programme
         hospital has also been achieved during the       Approach ( year end )
         year to help keep patients out of hospital
         and by the end of the year 98% of all            Care Programme Approach (process whereby
         discharges are followed by a face-to-face        clinicians assess, plan, coordinate and review the
                                                          care of patients).
         contact or a telephone call within
         seven days.
43
__
new patients attended outpatient clinics
                                                In summary we:                            MAIN
and a further 12,529 follow-up
appointments were held. Consultants in
                                                                                         COURSE
older people’s mental health received a         • treated more people locally;
total of 656 referrals and saw 569 new
patients and 3,656 patients as follow-up        • provided better crisis services as
attendances. In line with Department of           less people needed readmission to
Health targets, no patient referred by a GP       hospital;
waited more than 13 weeks for their first
appointment.                                    • met our targets and all consultant
                                                  referrals were seen within 13 weeks;
Substance Misuse services received just
over 1,700 referrals, which is a 52% increase   • we increased the number of substance
on the previous year. 76% of these referrals      misuse patients that remained in
were assessed within 20 days of referral. The     treatment.
effectiveness of the services was enhanced
during the year and patients attending the      All of which are significant
four teams in south Essex benefited from        improvements for mental health in
increased lengths of contact with the           south Essex.
service. In 2005/2006 83% of patients
stayed in contact with services for longer
than 12 weeks compared to 65% during the
previous year.

Child and Family Consultation services
received over 3,200 referrals during the
year, an increase of 13% on the previous
year. The service performed 982 referral and
474 full assessments. Although 15.1% of
patients did not attend their appointment,
the service provided over 10,700
attendances during the year.

                                                                                              44
                                                                                              __
 MAIN    Complaints and Compliments
COURSE   Complaints and compliments enable the
         Trust to examine and improve the services
         we provide. They give us an opportunity to
         strengthen our ‘customer service’ and
         clinical practice which in turn ensures that
         our patients receive the best of care at all
         times.

         Over the last year we received a total of 147
         formal complaints and all of these were
         acknowledged within two working days
         and thoroughly investigated. 81% of
         complaints were resolved within 20
         working days, 76 of which were completed
         within ten days (51.7%) and 43 within 20
         days (29.3%). 11.6% of complaints were
         investigated within 30 days and 7.5% of
         complaints (11) took longer than 30 days
         to investigate. The average time taken to
         respond to complaints was 16 days.              PALs
                                                         The PALs (Patient Advice and Liaison
         The Trust like all other NHS organisations is   Service) gives patients and carers an
         bound by a national timetable for               alternative to making a formal complaint.
         responding to complaints. Please contact        PALs is contactable between 09.00 and
         our PPI (Patient and Public Involvement)        17.00 Monday to Friday and also through
         Team (01375 364650) for details of this         the Trust’s website by email. If you are a
         procedure.                                      patient or carer and have a question, a
                                                         concern or just want to find out more about
                                                         our services, please contact PALs on
                                                         freephone 0800 0857935.

45
__
Complaints PALs and Compliments for 2005/2006
                                                                               MAIN
    Older	People’s	Mental	Health	&	         Community	Services	(1/2/06)
                                                                              COURSE
    Learning	Disabilities
                                            Total Complaints              7
    Total Complaints              10        Total PALs                   10
    Total PALs                    18        Total Local Resolution        0
    Total Local Resolution         2
                                            Partnerships	&	Specialist	
    Inpatient	&	Rehabilitation	             Services(1/2/06)
    Mental	Health	Services
                                            Total Complaints             6
    Total Complaints              48        Total PALs                   9
    Total PALs                    91        Total Local Resolution       1
    Total Local Resolution        29
                                            Support	Services/Other/Etc
    Adult	Mental	Health	
    Community	Services                      Total Complaints              4
                                            Total PALs                   63
    Total Complaints              33        Total Local Resolution        1
    Total PALS                    64
    Total Local Resolution         1        Medical	Directorate
                                            Total Complaints          37
    Forensic	Services                       Total PALs                21
    Total Complaints               2        Total Local Resolution     0
    Total PALs                    22
    Total Local Resolution         3        TRUST TOTALS
                                            Total Formal Complaints   147
                                            Total PALs                298
                                            Total Local Resolution     37
                                            Total Compliments          88


                                                                                   46
                                                                                   __
 MAIN    Things you said….what we did!
COURSE   These are just a few examples of the kind
                                                          if relatives are unable to take these items
                                                          home. No further complaints regarding
         of complaints and compliments we receive         missing clothing have been received.
         during the course of a year. We hope they
         give you a flavour of what our patients and     “What can I say except a huge thank you. If
         their carers were unhappy with and what         it wasn’t for you I’m sure I wouldn’t be here
         they liked.                                     writing you this card. Your understanding
                                                         and encouragement kept me going.”
         Older	People’s	Mental	Health	&	Learning	        Sydervelt Centre, Canvey Island
         Disabilities	Services
                                                         “To the staff on Gloucester ward, I would
         “It makes such a nice change in this day        like to express my thanks to each and
         and age for someone to be so excellent at       everyone that has cared for my mother
         their job and do it with such compassion.”      during her stay in your ward. You have
         Leigh Centre                                    treated her with kindness and dignity. I
                                                         have had peace of mind knowing that her
         “I just wanted to write and say a sincere       every need was met, and promptly at that.
         thank you to all of you for the care and        Wherever my mother moves on to, I only
         consideration you gave Bill whilst he was in    hope it will be of the high standard you
         your care. I cannot imagine how you all do      provide.” Gloucester ward, Basildon
         what you do every day, it is amazing. You       “My wife has nothing but praise for all of
         really do make a difference in people’s lives   you who made her stay in the ward very
         and that is not always easy to do. I hope you   pleasant. You showed care and
         know that you are not taken for granted.        compassion and did everything possible
         Thank you all” Cherrydown ward, Basildon        to make everyone comfortable and happy.
                                                         Cleanliness was constant. Food was
         Following complaints regarding                  plentiful and of excellent quality – even
         clothing going missing from Ashingdon           choice of menu. You often have a hard time
         Ward, a washing machine/tumble drier            and deserve the utmost praise for your
         was installed. This enables staff to wash       behaviour. Keep it up!” Ashingdon ward,
         personal items of clothing on the ward          Runwell

47
__
“My purpose in writing is to express my       “All doctors and staff, we wish to
                                                                                               MAIN
thanks for all the care and attention my
wife is receiving. I am particularly aware
                                              acknowledge and thank you all on
                                              Hullbridge ward for all the kind and
                                                                                              COURSE
of the excellent facilities at Rawreth        beneficial treatment given and shown to
Court.” Rawreth Court, Rayleigh               our son. As his parents and family we are all
                                              sure he himself appears to be thinking
Adult	Inpatient	&	Community	Mental	           positive.” Hullbridge ward, Runwell
Health	Services
“The Team on the ward were very good          “Thank you all so much for all your help and
to my father. They are an excellent group     kindness, being here has given me a new
of people who helped us during a difficult    lease of life.” Boleyn ward, Runwell
time.” Westley ward, Basildon
                                              “I’ve waited 27 years for help with my
 A patient complained about being kept        problems and when I was referred to the
 waiting to see the Consultant at ward        Recovery Unit I could not have asked for
 round. An appointment system was put         better. You are fantastic people and
 in place and is displayed on the notice      doing a fantastic job. I just can’t thank you
 board so that each patient has an            all enough for everything.” Recovery Unit,
 allocated slot during the ward round for     Basildon
 themselves and relatives/carers.
                                              We received a complaint about the lack of
“Everything, the food and cleanliness of      patient information at a patient’s first
the ward couldn’t have been better and        Consultant appointment. The Trust is
the facilities were very good. I take this    working with service users to improving
opportunity of saying it was the best         information that is given to patients who
ward I have been on.” Chalkwell ward,         are referred, enabling them to have a
Runwell                                       better understanding of what to expect at
“To all the staff on Laburnum who have        a first consultation.
given me so much kindness, help and
compassion from their hearts throughout
my illness. I will be coming back to see
you all. I will never forget you.” Laburnum
ward, Runwell
                                                                                                   48
                                                                                                   __
 MAIN    People                                         • quicker response times;
COURSE   The Trust has enjoyed an extremely
                                                        • instant advertisement of post.

         successful year in terms of its staff and      The implementation of e-recruitment and
         employee relations.                            advertising posts within the service has
                                                        achieved substantial savings on our
         New staff pay systems have been                recruitment costs of over £258,000 within
         implemented within the Trust and all staff     the last financial year.
         have now been through the assimilation
         process. Excellent partnership with staff      Essex Mental Health Professionals is a
         side representatives has been evident          dedicated, non-profit making organisation
         throughout the process and relevant            based within the Trust. Our purpose is to
         policies and procedures have been              reduce rising agency administration costs
         adopted. We are also pleased to report         to a minimum. In the past year we have
         that our implementation met all national       reduced our Trust’s agency spend from 14%
         targets.                                       to 4%. We are already committed to
                                                        providing nursing staff to mental health
         Recruitment                                    wards in Essex at a cost effective price
         The Trust recognises that modern health        with plans to extend the service to include
         services require modern employment             administration and clerical staff in the near
         practices. It accepts a joint responsibility   future.
         with staff to develop a range of working
         arrangements that balance the needs of         This service currently provides temporary
         patients and services.                         staffing to 15 hospitals and 46 wards across
                                                        both North and South Essex Partnership
         Our new electronic recruitment system aids     Trusts.
         the advertising of posts within the NHS
         Jobs Website. The e-recruitment service has    The Trust is engaged in an on-going
         many benefits including:                       recruitment campaign with colleagues in
                                                        Italy and is building academic links with an
         • providing a no fee service;                  Italian university. Such has been the success
         • web based national and internal coverage;    of this endeavour that the Trust has been

49
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asked to co-ordinate the recruitment of          • percentage of staff having well structured
                                                                                                 MAIN
Italian doctors on behalf of other NHS
Trusts in the UK.
                                                   appraisal reviews within the previous 12
                                                   months;
                                                                                                COURSE
                                                 • quality of work life balance;
Top	Employer	/	Top	Staff                         • support from immediate managers;
The Trust is committed to the principles of      • perceptions of effective action from
work-life balance for all of our staff             employer towards violence and
regardless of their age, race or gender. The       harassment.
Trust recognises that staff work best for
patients when they can strike a healthy          This was further reinforced by the Nursing
balance between work and other aspects of        Times Award for the top NHS mental health
their life outside work. A number of             employer within the UK.
policies such as the flexible working, special
leave and parental ensure that staff are able    Staff have worked with the Trust in its
to manage a healthy workplace balance            preparation for NHS Foundation Trust
between their work and home-life                 status. They have been actively involved in
commitments.                                     the development of the HR Strategy and
                                                 have been keen to engage as members and
The Trust operates a childcare voucher           governors of the new organisation.
scheme that is available to all staff. By
operating the voucher scheme the Trust           Staff sickness remains at 4.6% which is low
enables staff to save as much as 11% on          compared with other mental health
their childcare costs. In the last year staff    organisations and staff turnover is well
saved over £10,000 on their annual               within average at 12.3 %.
childcare costs.

The feedback from this year’s Healthcare
Commission NHS Staff Attitude Survey
placed the Trust as the top mental health
employer, with particular emphasis on the
following:


                                                                                                     50
                                                                                                     __
 MAIN    Community                                        who have gained or retained employment
COURSE   People with mental health problems are
                                                          or education with our help – at the present
                                                          time this is a total of 21 people.
         one of the most excluded groups in society.
         Although many want to work, only a
         quarter actually do – the lowest
         employment rate for any category of
         disabled people. Too often people do not
         have other activities to fill their days and
         spend their time alone.

         Community engagement is known to
         greatly assist people in recovering from a
         mental health problem.
         To enable people to play a full and
         active part in the life of their community
         the Trust has taken the lead in developing
         an employment strategy that has achieved
         significant success in helping people to
         take up opportunities in employment and
         education.

         ‘Working It’ is the Trust’s vocational service   The Trust has achieved significant success in
         which is a specialist intervention introduced    supporting direct payments to people who
         over the last year. Our team of employment       use mental health services within south
         specialists provide support in the majority      Essex. These payments are provided so that
         of the Trust’s Community Mental Health           people can choose how their needs are met
         Teams. Plans are in place to extend this         and to take control of the process.
         service right across all mental health teams
         in south Essex and to our forensic services.     In addition the Trust is piloting a Social
         The effectiveness of the service is evident      Inclusion Project in Rochford and Castle
         in the personal successes of the people          Point aimed at helping people to engage in

51
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community life through involvement in art,     Emergency Planning                                MAIN
leisure, health and fitness activities.
                                               The Trust participates in major incident
                                                                                                COURSE
Looking to the future the Trust is excited     management and is an active member of
about the involvement from the                 the South Essex Strategic Health Authority/
community with our governors and               Primary Care & Mental Health Trusts’
members. At the time of writing this report    Emergency Planning Forum hosted by
our membership is at 9,000 with a Board        Essex Ambulance NHS Trust. The Forum
of Governors numbering 51. We have set a       ensures county-wide uniformity and
target of 10,000 members by 31                 co-operation in the management of such
December 2006 ensuring that our                situations.
membership is representative of the
population of the community we serve.          Dedicated Trust policy and procedures have
Our governors and members are already          been approved and implemented
taking an active role in our strategic plans   covering the management and recovery
for mental health and learning disabilities    from major incidents as well as local
services. At their recent development event    emergencies. These plans are reviewed
the governors identified some projects for     annually to ensure that they remain
consideration as follows:                      relevant to the organisation. Our plans are
                                               designed to enable the Trust to continue to
• employment;                                  provide its clinical services as well as being
• anti stigma campaign;                        able to respond to the major incident. This
• social inclusion;                            includes a major review of the Trust
• fundraising;                                 emergency contingency strategy. The Trust
• volunteering;                                has developed an internal Emergency
• membership communication.                    Planning Committee to enhance its existing
                                               arrangements.
The Trust looks forward to supporting our
governors in these activities.                 The Trust is also collaborating with partner
                                               agencies in developing appropriate
                                               responses in the case of a flu pandemic. Our
                                               Trust’s Consultant in Public Health has

                                                                                                     52
                                                                                                     __
 MAIN    developed a forum to ensure the                Reducing	the	Environmental	Impacts
COURSE   organisation is prepared in the event of an
         outbreak.                                      In providing its service to the local
                                                        community the Trust is aware that its
         Environment                                    consumption of resources and production
                                                        of waste has a significant cost as well as an
         DDA	–	ensuring	the	Trust	is	compliant          environmental impact. This is considered in
                                                        formulating its corporate business strategy
         We have been working with service user         and policies. In considering these impacts
         and staff groups to ensure that the Trust is   a number of themes have been identified
         complying with the legislation                 together with related issues as follows:

                                                        • air quality;
                                                        • transport;
                                                        • ecology and landscape;
                                                        • energy and resources;
                                                        • waste;
                                                        • water;
                                                        • procurement;
                                                        • contaminated land;
                                                        • noise;
                                                        • legal compliance.
         surrounding the Disability Discrimination
         Act (DDA). Adjustments have been made to       In addressing these key environmental
         our buildings to provide easy access. We are   themes, the Trust has set out its
         working with staff to provide an               environmental policy and procedural
         understanding so that everyone is treated      guidelines. In addition, the implementation
         equal regardless of whether or not they        of the policy, and the awareness raising of
         have a disability. In addition, we have been   the issues is being progressed through the
         developing our Disability Equality Scheme      formulation of a number of action plans
         which will be published in the Autumn          including:
         2006.

53
__
• environmental impact assessment;            part of its modernisation programme. All
                                                                                              MAIN
• procurement;
• energy conservation;
                                              of these buildings and systems will be
                                              designed to achieve an ‘excellent rating’ in
                                                                                             COURSE
• ecology and landscape;                      terms of low energy use and low
• transport strategy.                         environmental impact.

                                              Raising	Awareness	of	Environmental	
                                              Issues	across	the	Trust

                                              This has been achieved through
                                              communication, training, improvement
                                              action and measurement.

                                              Communications
                                              We have used existing Trust newsletters
                                              and media that are made available to all
                                              employees. This was the most cost effective
                                              way of delivering the Trust’s message about
                                              energy and environmental issues.

                                              Training
                                              Training is provided for everyone on the
                                              staff induction programme with emphasis
                                              on the Trust’s environmental policies and
                                              energy saving initiatives as well as
                                              introducing ways that all staff can
                                              contribute to waste minimisation and waste
In addition to the range of action plans      reduction.
listed above, the Trust is currently in the
process of replacing most of its most         Improvement	Action
energy inefficient buildings and systems      Improvement action has been a key
with new facilities and infastructure as      element of the Trust’s approach. Two

                                                                                                  54
                                                                                                  __
 MAIN    examples of stories of improvement action          reduction of 641,000 KWh the value of this
COURSE   are detailed below.                                energy saving is around £30,000.

         As a result of leak repairs and controls           Measurement
         modifications at Runwell hospital the              There is an old adage that ‘you can’t
         Trust has burnt 1,471,103 litres less oil          manage what you can’t measure’. The
                                                                            measurement of energy
                                                                            and water consumption
                                                                            has been a key component
                                                                            of measuring the effect
                                                                            of raising environmental
                                                                            awareness. As a result of
                                                                            these initiatives, the Trust
                                                                            has achieved year-on-year
                                                                            reductions in actual energy
                                                                            usage.

                                                                            PEAT	Patient	
                                                                            Environment	Action	Team
                                                                            PEAT is a NHS initiative
                                                                            managed by the National
                                                                            Patient Safety Agency. The
                                                                            initiative, which is in its fifth
                                                                            year, ensures that the
         than would have been the case and saved            environment for patients and visitors is
         around £264,000.                                   maintained to the highest standard. The
                                                            initiative concentrates on a number of set
         At ‘The Lodge’ Runwell, the complete steam         areas of inspection which includes
         heating system was replaced with gas fired         cleanliness, infection control, decoration,
         boilers and at the same time a full building       lighting, furnishings, access, safety and
         energy management system of control was            security and patient food.
         installed. The first full year of use has seen a

55
__
The Trust continues to improve the care
                                                MAIN
environment for our patients. We have
received national recognition for our food
                                               COURSE
and cleanliness for two years running. The
PEAT (Patient Environment Action Team)
assessment in December 2005 gave the
Trust a score of ‘excellent’ for cleanliness
– the highest accolade possible at these
sites:

•	Mental	Health	Unit,	
			Basildon	hospital
•	Clifton	Lodge,	
			Southend-on-Sea
•	Rawreth	Court,	Rayleigh	
•	Runwell	hospital,	Wickford
•	Thurrock	Community	hospital,	
			Thurrock.




                                                    56
                                                    __
Financial Review


 MAIN    Overview                                      Although the Essex health economy has
COURSE   In reviewing the financial performance of
                                                       generally performed well in comparison
                                                       with elsewhere, there has still been a need
         the Trust for the 2005/2006 financial year,   during 2005/2006 to reduce expenditure
         there were a number of factors which when     levels where possible. As part of this
         taken together have led to a year that,       process the Trust agreed to achieve a target
         although ultimately successful, proved to     surplus by the end of March 2006 of around
         be highly challenging with a significant      £1.1 million. This was largely achieved
         agenda for management. These challenges       through savings from transitional funding
         and successes are outlined further below.     derived from temporary delays around our
                                                       major projects relating to the
         2005/2006 was also the third year of the      modernisation of services from Runwell
         Department of Health’s three-year             hospital.
         spending plan. This plan has provided a
         good deal of certainty around funding         The Trust also provided further cash
         levels and has seen substantial new           support to the Essex Strategic Health
         investment across the NHS including           Authority by transferring £3.6 million to the
         mental health services.                       Health Authority during March 2006. It is
         However, pressures across the NHS             anticipated that these cash resources will
         particularly in relation to acute hospital    be returned to the Trust during the current
         services have given rise to significant       financial year.
         deficits across most health economies.
                                                       The Trust was funded for an additional four
         “The Trust’s arrangements for financial       Crisis Resolution and Home Treatment
         management are good and there are a           Teams giving us a total of five. An Early
         number of examples of notable practice        Intervention Service was also planned for
         where the Trust is able to demonstrate that   implementation during 2005/2006.
         the arrangements for managing                 However, in view of the financial difficulties
         performance against budgets are working       facing the Essex health economy,
         well. “                                       agreement was reached with local
         2005/2006 Annual Audit Letter                 commissioners to delay full implementation
                                                       until 2006/2007. Despite these delays the

57
__
Trust was successful in providing these new    having to deliver a substantial programme
                                                                                                MAIN
services to the target level agreed with the
Strategic Health Authority.
                                               of efficiency measures with significant
                                               savings coming from management
                                                                                               COURSE
                                               restructuring, procurement and other back
The Trust’s application for NHS Foundation     office functions.
Trust status gave rise to a significant
additional workload throughout 2005/2006.      The range of efficiency measures
The detailed preparations for FT status        implemented enabled the Trust to remain
included the successful implementation         on course and continue with an ambitious
of a new finance and purchasing system,        programme of refurbishing patient areas
extensive changes to the Trust’s               and staff facilities throughout the year. By
internal financial reporting arrangements      the end of the financial year work had also
and the development of detailed financial      begun on a new psychiatric intensive care
plans providing forecasts over a five-year     unit based at the Trust’s Mental Health Unit,
planning period. In addition, the Trust’s      Basildon hospital, and a new 12-bedded
finance function has given a greater focus     learning disability facility located at the
to the development of its cash                 Heath Close complex in Billericay. Work has
management and forecasting                     also started on the first phase of the
arrangements which is an essential              redevelopment of Rochford hospital.
requirement for the operation of a NHS
Foundation Trust.                              During the course of the year careful
                                               monitoring of all the Trust’s financial
Despite the financial difficulties facing      arrangements by the Trust management
the NHS, the Trust received a reasonable       team enabled the Trust to end the year with
financial settlement for 2005/2006. As         a surplus in excess of the target required by
in previous years, however, much of this       the Strategic Health Authority and with all
financial settlement has been eroded by a      other statutory duties achieved.
range of financial pressures relating to the
cost of pay awards including the agenda for    Summary of Accounts
change process, additional drugs               Table 1 (see page 77) is a summary of the
expenditure and a cash efficiency reduction    Trust’s annual accounts for the year which
of 1.7% of income. This left the Trust with    ended on the 31 March 2006. The table

                                                                                                    58
                                                                                                    __
 MAIN    shows extracts from income and                 Comparative information is provided in
COURSE   expenditure, cashflow, balance sheet and
         statement of recognised gains and losses.
                                                        relation to the 2004/2005 financial year
                                                        both within the Trust’s main accounting
         Other extracts from the Trust’s accounts are   documents and within the summary of
         provided in tables 2-7 and figures 1 and 2.    accounts included within the Annual
                                                        Report. In reviewing the accounting entries
         “Engagement with users, patients and other     with the previous year the following four
         stakeholders is extremely strong and has a     key issues need to be taken into
         clear impact on the operation of the Trust.”   consideration:
         2005/2006 Annual Audit Letter
                                                        Fixed	Assets
         With the Trust’s NHS Foundation Trust          The value of the Trust’s fixed assets has
         authorisation effective from the 1 May         increased significantly in 2005/2006 to £86
         2006, the Trust has also been required to      million compared to only £63 million at the
         complete a further set of annual accounts      end of 2004/2005. This reflects additional
         covering the one month period of April         capital expenditure of £23 million
         2006 and therefore covering the period in      during the year of which just over £19
         which the Trust retained NHS Trust             million relates to the transfer of land and
         status. This set of accounts covering the      buildings within the NHS. This relates to:
         one month period together with a full set
         of accounts covering the first 11 months of    • the transfer of The Lodge and land
         Foundation Trust status will be published        at Runwell hospital from the Secretary of
         after the completion of the 2006/2007            State;
         financial year.                                • the transfer of part of the Little
                                                          Highwood hospital site from Billericay,
         In preparing the accounts for the                Brentwood and Wickford PCT;
         2005/2006 financial year, the Trust has
         followed the general accounting policies       • land relating to the periphery homes at
         covered by the Finance Manual for NHS            Brentwood from the North East London
         Trusts. There have been no changes made          Mental Health NHS Trust.
         to these policies in comparison with
         previous years.

59
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The net impact of these changes to the           Working	Capital
                                                                                                    MAIN
Trust’s fixed assets together with a number
of other smaller property transfers has
                                                 As part of the measures agreed across Essex
                                                 to address a potential financial shortfall, the
                                                                                                   COURSE
resulted in an increase in the Trust’s public    Trust was required to contribute £3.6
dividend capital of £18.1 million.               million in cash to the Essex health economy.
                                                 As a result of this action the Trust’s
Depreciation                                     balance sheet position in relation to
The level of depreciation shown in the           debtors and creditors has moved
2005/2006 accounts at £1.7 million is            considerably in 2005/2006 in comparison
significantly lower than the £3.3 million        with the previous year. The Trust’s debtors
relating to 2004/2005. This reduction is         – due within one year, have increased from
due to the inclusion of one off accelerated      £5.4 million in 2004/2005 to £8.1 million
depreciation of £1.66 million in 2004/2005.      in 2005/2006. The increase of £2.7 million
This related to the demolition of buildings      predominately relates to outstanding debts
on the Rochford hospital site in preparation     with the Billericay, Brentwood and Wickford
for the site’s redevelopment.                    PCT.

PDC	Dividends	Payable                            Similarly, the Trust’s creditors have
The 2005/2006 accounts also show a               increased from £6.3 million in 2004/2005 to
significant increase in the level of public      £9.8 million in 2005/2006. This
dividend capital dividends payable from          movement of £3.5 million is largely due to
£1.67 million in 2004/2005 to £2.33              the Trust delaying the payment of
million in 2005/2006. This increase relates to   tax/national insurance during March to
the impact of a five-year asset revaluation      April 2006. This accounts for around £2.3
exercise which was effective in 2004/2005.       million of the movement in creditors.
This revalued the Trust’s asset base by
approximately £12.6 million and thereby          At the end of 2005/2006, a change in
increasing the level of public dividend          accounting practice in relation to Essex
capital dividend payable from 2005/2006          Social Services also resulted in an increase
onwards.                                         to the Trust’s debtor and creditor positions.
                                                 In previous years the county council had
                                                 undertaken the practice of netting together

                                                                                                        60
                                                                                                        __
 MAIN    amounts owed between the two                    The Charitable Funds are administered by
COURSE   respective organisations. At the end of
         2005/2006, however, agreement was
                                                         the Trust’s Finance Department on behalf of
                                                         the Partnership Trust and the Primary Care
         reached to show separate debtor and             Trusts across south Essex.
         creditor entries which follows good
         accounting practice. This change, however,      “Overall, the Trust has excellent
         has increased the Trust’s debtors by £0.4       arrangements for managing and improving
         million and the Trust’s creditors by around     the value for money. “
         £0.6 million in 2005/2006.                      2005/2006 Annual Audit Letter

         A copy of the full set of Annual Accounts for   The Board of the Partnership Trust acts as
         2005/2006 is available free of charge from      Corporate Trustee and meets regularly in
         the Director of Finance and Resources.          the form of a Trustee Board to oversee the
                                                         management of the Charitable Fund. The
         A	large	print	version	of	the	Annual             Trust also operates an Investment Panel
         Accounts	is	also	available	on	                  which has the responsibility of advising the
         request.                                        Trustee Board on matters of investment
                                                         policy.
         Charitable	Funds
         The Trust currently administers the South       The primary care organisations each have
         Essex Partnership NHS Trust General             their own separate Charity Committee
         Charitable Fund (Charity No: 1053793).          and representatives from the primary care
         These funds have resulted from fund             organisations regularly attend meetings of
         raising activities and donations received       the Trustee Board. Representatives from the
         over many years. The charitable funds are       Primary Care Trusts are also members of the
         used to purchase equipment and other            Investment Panel.
         services in accordance with the purpose
         for which the funds were either raised or       The charity currently invests, through the
         donated. The charity also has a General         stockbrokers HSBC and with the charities
         Purpose Fund which is used more widely to       official investment fund. Further
         the benefit of patients and staff.              information regarding the charitable fund
                                                         will be available in January 2007 when the

61
__
Annual Report and Accounts for the funds     Statutory	Duties
                                                                                              MAIN
held on Trust is published. A copy of the
document will then be available free of
                                             The Trust’s annual accounts show that the
                                             Trust achieved its main financial duties of
                                                                                             COURSE
charge from the Director of Finance and      breaking even, target rate of return (capital
Resources.                                   cost absorption duty) and remaining within
                                             the external financing and capital resource
A	large	print	version	of	the	Annual	         limits set by the Department of Health. (see
Report	and	Accounts	for	the	                 Table 2 on page 80).
Charitable	Fund	will	be	available	on	
request.                                     The Trust’s income in relation to continuing
                                             operations for 2005/2006 was just over £99
The Partnership Trust’s move to NHS          million representing an increase of around
Foundation Trust status has no impact on     £8.5 million over the 2004/2005 financial
the operation of the charitable fund.        year. This excludes income relating to the
However, the name of the charitable fund     provision of social services provided by the
will change to the South Essex Partnership   Trust on behalf of our three local
NHS Foundation Trust General Charitable      authorities. This follows agreement with the
Fund.                                        Trust’s external auditors to exclude such
                                             income from the Trust’s accounts with
The reorganisation of Primary Care Trusts    effect from 2004/2005.
across south Essex from the former five
organisations to the new South West          The Trust’s retained surplus at around £1.4
PCT and South East T PCT will not, in the    million exceeded the target of £1.1 million
short term, have any impact on the           set by the Essex Strategic Health Authority.
operation of the charity fund. However,      This surplus was generated largely from
reporting arrangements will change to        the return of prior year underspending and
ensure that the new Primary Care Trusts      non recurrent savings achieved through the
receive information relating to the funds    temporary delays associated with our major
applicable to their location and services    modernisation plans including the transfer
managed.                                     of services from Runwell hospital.

                                             The Trust achieved a capital cost absorption

                                                                                                  62
                                                                                                  __
 MAIN    rate of 3.3% which is within the tolerance      included the establishment of three
COURSE   allowed. The Trust’s achievement against
         a capital resource limit of £22.4 million for
                                                         Assertive Outreach Teams, five Crisis
                                                         Resolution and Home Treatment Teams and
         2005/2006 was £22.3 million which, again,       new Assessment and Recovery Units based
         was within the tolerances allowed.              at the Trust’s Mental Health Unit at Basildon
                                                         hospital. This has led to improved services
         Efficiency	Measures                             for patients and significantfinancial
         The Trust was required to make savings of       efficiencies for our local commissioners
         just over £2.6 million in 2005/2006. This       with the Trust no longer having to send any
         represented a major efficiency programme        patient out of area in relation to the
         resulting from cash efficiency reductions       services provided by the Trust. The success
         imposed by local commissioners, the need        of these new arrangements has also led to
         to generate an additional £750,000 to cover     surplus capacity within the Trust’s inpatient
         costs associated with the implementation        services enabling the closure of two wards
         of agenda for change and other more local       by the end of March 2006.
         cost pressures relating to drugs, domestics
         and utilities.                                  “The Trust’s internal control arrangements
                                                         are strong and there are a number of
         By the end of March 2006, the Trust had         examples of notable practice.”
         achieved the required savings levels            2005/2006 Annual Audit Letter
         through a range of cost saving initiatives
         which primarily related to service              As part of the Trust’s application for NHS
         reconfigurations and management savings         Foundation Trust status a comprehensive
         together with savings from procurement          five-year financial plan which forms part of
         and a variety of other back office functions.   the Trust’s Service Development Strategy
         During 2005/06 non recurrent savings            has been completed. This includes a
         measures totalling around £0.9 million were     detailed cost improvement plan which
         also delivered to cover the period during       generates a total of £8.5 million from
         which the Trust’s major recurrent financial     efficiency measures or contribution from
         savings initiatives were being implemented.     income generation by the end of
         The Trust’s major service modernisation and     2010/2011.
         developments over recent years has

63
__
For the future the Trust intends to complete   Accounting Rules state: “the timing of
                                                                                                MAIN
its programme of management
reorganisation and hopes to benefit from
                                               payment should normally be stated in the
                                               contract. Where there is no contractual
                                                                                               COURSE
technological improvements to our              provision, departments should pay within
communication system enabling a greater        30 days of receipt of goods and services or
proportion of the Trust staff to work from     the presentation of a valid invoice, which
home where this is appropriate. The Trust      ever is the later.”
also anticipates making significant savings
by joining a collaborative Procurement HUB     As a result of this policy, the Trust ensures
for the new East of England Strategic Health   that:
Authority area which should produce
                                               • a clear consistent policy of paying
significant procurement savings for all
                                                 bills in accordance with contracts
health organisations across the east of
                                                 exists and that finance and purchasing
England.
                                                 divisions are aware of this policy;
Management	Costs
                                               • payment terms are agreed at the
Table 4 (see page 81) shows the cost of
                                                 outset of a contract and are adhered to;
management for the Trust. This has been
measured in accordance with the rules
                                               • payment terms are not altered
published by the Department of Health.
                                                 without prior agreement of the
The Trust’s cost of management for the
                                                 supplier;
2005/2006 financial year was £5.9 million
representing around 6% of the Trust’s
                                               • suppliers are given clear guidance
relevant income. This remains competitive
                                                 on payment terms;
for an organisation of the Trust’s size and
complexity.
                                               • a system exists for dealing quickly
                                                 with disputes and complaints;
Better	Payments	Practice	Code
The non NHS Trade Creditor Payment Policy
                                               • bills are paid within 30 days unless
of the NHS is to comply with both the CBI
                                                 covered by other agreed payment terms.
Prompt Payment Code and Government
Accounting Rules. The Government

                                                                                                    64
                                                                                                    __
 MAIN    Table 5 (see Page 82) shows that the Trust       completion of the Harland Centre on the
COURSE   paid around 95% of all bills within the 30
         days target limit.
                                                          former Westcliff day hospital site and the
                                                          start of major schemes in relation to a new
                                                          psychiatric intensive care unit located at
         As a NHS Foundation Trust the Trust will be      Basildon hospital, a new 12-bedded
         applying a more commercial approach to           learning disability unit at the Heath Close
         cash management and will, for the future,        complex in Billericay and the first phase of
         ensure that while continuing to pay all bills    the redevelopment of Rochford hospital
         promptly will want to take full advantage of     which will ultimately provide a state of the
         credit periods, where appropriate.               art environment for adults, older people
                                                          and rehabilitation services. In addition,
         Operating	Expenditure                            there have been a range of smaller capital
         The total operating expenditure for the          projects in relation to the Trust’s
         Trust 2005/06 was £95.5 million. Figure 1        infrastructure and new disaster recovery
         (see Page 85) shows the Trust’s                  software for critical systems.
         expenditure analysed over the type of
         patient care provided. The single                The Trust also incurred further capital
         largest area of expenditure is related to        expenditure of around £19 million
         adult services followed by older people          relating to a number of internal asset
         services and medical services. Within this       transfers within the NHS. This included the
         the single largest area of expenditure is        transfer of land and buildings at Runwell
         related to staff costs and totalled £67          hospital, land in relation to the Little
         million. Figure 2 (See Page 86) provides         Highwood site and land relating to the
         analysis of expenditure of the different staff   periphery homes site located in Brentwood.
         groups.
                                                          Table 6 (see page 83) shows a list of the
         Capital	Expenditure                              capital investments made during
         During 2005/2006 the Trust invested              2005/2006.
         around £4 million in direct service
         improvements through capital expenditure.        Private	Finance	Transactions
         Investments were made across most                As part of the Trust’s modernisation of
         patient service areas including the              services from Runwell hospital, the Trust

65
__
has entered into a privately funded scheme       asset revaluation resulting from the impact
                                                                                                    MAIN
(PFI) for the provision of 70 beds for elderly
mentally ill patients. These new services
                                                 of valuations undertaken by the District
                                                 Valuer and annual indexation (inflation).
                                                                                                   COURSE
were completed and become operational in         The Trust also has a small reserve in relation
June 2004.                                       to donated assets. The total of the Trust’s
                                                 public dividend capital and reserves is
The Trust is also part way through a PFI         equivalent to the tax payer’s equity in the
process for the provision of a medium and        Trust. For the future the Department of
low secure unit to be located on the             Health is considering the introduction of
Runwell hospital site. The Trust has             capital finance in the form of interest
selected a preferred bidder for the scheme       bearing debt. However, the
and it is anticipated that this development      implementation of these arrangements has
will reach financial close in 2007 with the      yet to be finalised. It is possible that future
new unit becoming operational during             financing of NHS Trusts will be in the form
2008/2009.                                       of loans from the Treasury which will attract
                                                 interest payments and may require
Capital	Structure                                repayment on a long term basis.
The Trust’s capital structure reflects the
structure of all NHS Trusts. Capital finance     “Arrangements for monitoring and
is provided by the Treasury in the form of       reviewing performance is very good
public dividend capital. The Trust is required   ensuring that services meet the needs of the
to pay to the Treasury dividends relating to     patients and taxpayers.”
the public dividend capital in September         2005/2006 Annual Audit Letter
and March each year. The dividends
payable are essentially agreed with the          The capital structure of the Trust will not be
Treasury before the start of a financial year    immediately affected by Foundation Trust
and are based on 3.5% of the Trust’s             status. The Trust will continue to benefit
estimated average value of assets during         from public dividend capital and existing
the financial year.                              major schemes which are publicly funded
                                                 will be supported by the Strategic Health
The Trust also has reserves relating to          Authority’s capital programme. The Trust
income and expenditure surpluses and             will receive finance in the form of further

                                                                                                        66
                                                                                                        __
 MAIN    public dividend capital or interest bearing      arrangements. This was a necessary
COURSE   debt should this be introduced. For the
         future, however, Foundation Trust status is
                                                          prerequisite of achieving Foundation Trust
                                                          status. As an NHS Trust, however, the Trust
         likely to provide opportunities to borrow        has a statutory duty to achieve an External
         on a commercial basis. However, the Trust        Financing Limit set by the Department of
         currently has no plans to borrow externally      Health. This is effectively a cash limit which,
         over the next few years.                         in practical terms, limits the amount of
                                                          cash that the Trust can hold at the end of
         Table 1.3 (see page 79) provides a               the financial year. Looking ahead as a NHS
         summary of the Trust’s balance sheet for         Foundation Trust, however, there is no such
         the two years that ended the 31 March            limit and the Trust will have the flexibility to
         2005 and 2006. The Trust’s capital and           manage cash resources on a more
         reserves at the end of March 2006 was            commercial basis. This will greatly assist
         around £82.8 million an increase of              financial planning over the years ahead.
         approximately £22 million since March
         2005. This increase predominately relates        The Trust’s working capital (all debtors
         to additional public finance in the form         minus long term debtors plus cash minus
         of public dividend capital of around £18         short term liabilities) was a negative £1.4
         million which reflects the Trust’s significant   million at the end of March 2006. This
         capital investment programme during              reflects the relatively poor balance sheet
         2005/2006. The remainder of the increase         position that the Trust inherited following
         relates to the Trust’s reserves reflecting the   the merger of the former community trusts
         Trust’s income and expenditure                   covering south Essex. It also reflects,
         surplus for 2005/2006 and a small increase       however, the requirement to transfer £3.6
         to the Trust’s revaluation reserve relating to   million, in cash, at the end of the financial
         indexation (inflation) on the Trust’s major      year to assist the financial position across
         buildings.                                       the Essex health economy. It is anticipated
                                                          this cash will be returned to the Trust
         Working	Capital	and	Liquidity                    during the 2006/2007 financial year and
         During 2005/2006 the Trust gave greater          therefore, in practical terms, this should not
         prominence to the development of its cash        pose any difficulties for the future financial
         management and forecasting                       arrangements of the Trust

67
__
Audit	Committee                                Audit	Services
                                                                                                MAIN
The Trust has established an Audit
Committee to provide the Board with an
                                               The Audit Commission has appointed the
                                               Operations Department of the Audit
                                                                                               COURSE
independent and objective review of:           Commission to be the external auditor of
                                               the Trust. Paul King was the District Auditor
• compliance with statute of                   covering the Trust’s activities for the
  Department of Health guidelines              majority of the 2005/2006 financial year.
  and code of conduct and accountability;      The Audit Commission has now established
• financial systems and information            a ‘Trust Practise’ operation providing
   provided to the Trust Board                 external audit services to Foundation
• the Trust’s process around clinical and      Trusts and those Trusts aspiring to become
  corporate governance and assurance           Foundation Trusts. With effect from April
  framework;                                   2006 the Trust’s engagement lead was Rob
• the Trust’s Audit Arrangements.              Murray. Throughout this period the Trust’s
                                               external Audit Manager has been Geraldine
The Trust’s Audit Committee comprises the      Daly.
Trust’s Non Executive Directors of which the
following were committee members during        “There is evidence of innovative
the 2005/2006 financial year:                  management and robust review of the
                                               Assurance Framework.”
• Joan Holden (Chair)                          2005/2006 Annual Audit Letter
• Janet Wood (From 17 January 2006)
• George Sutherland                            During 2005/2006 the Trust’s external
  (From 15 September 2005)                     auditors have continued to focus on the
• Eileen Greenwood                             significant financial and operating risks
  (Left 17 November 2005)                      facing the Trust. This has included
• Geoff Williams (Until 17 January 2006)       reviewing the Trust’s financial and
• Lesley Cuthbertson                           performance management along with the
  (From 15 September 2005)                     Trust’s accounting processes.
• Tony Skidmore (Until 7 January 2006)         The Trust’s Annual Audit Letter for the
                                               2005/2006 financial year was presented to
                                               the Trust Board in July 2006. Reports issued

                                                                                                    68
                                                                                                    __
 MAIN    during 2005/06 financial year were as           Register	of	Interests
COURSE   follows:                                        The Trust maintains a formal Register of
                                                         Director’s Interest. The register is
         • Audit Plan for 2006/2007                      available for inspection, on request, at the
         • Annual Audit Letter for 2004/2005             Trust Headquarters at Dunton Court, Aston
         • SAS610 Report for those charged with          Road, Laindon, Essex SS15 6NX tel 01375
           governance                                    364666.
         • Review of Financial Statements 2004/2005
                                                         Board members do not hold directorships
         The total fee for external audit services for   in companies with whom the Trust has
         2005/06 was £111,049. This comprises the        done business within this financial year.
         following:                                      However, Geoff Williams, Non Executive
                                                         Director and Vice Chair, is also a trustee
         							Audit	Area	 	          		Audit	Fee       of the Laindon Community Centre. The
                                            £            Trust has entered into an agreement with
             Accounts                     82,993         the community centre to rent additional
             Use of Resources             28,056         car parking spaces. Payments made to the
                                                         Community centre during 2005/2006
         						Total	       																		111,049    amounted to £6,270.

         Shared	Financial	Services                       Future	Financial	Performance
         The Trust continues to provide a range of       Now that the Trust has been authorised as a
         shared support services to the local primary    NHS Foundation Trust with effect from
         care organisations across south Essex. These    1 May 2006, the basis of financial
         services include the provision of Treasury      performance measurement for the Trust will
         Management, procurement and paymaster           change. The Trust will no longer be
         services and the management of related          measured by the achievement of the
         computerised financial ledgers and              statutory NHS Trust duties of breaking even,
         purchasing systems for all organisations.       capital cost absorption and the capital
                                                         resource and External Financing Limits. The
                                                         Trust has been required to demonstrate to


69
__
the satisfaction of Monitor, the                 The Trust is also aware of the significant
                                                                                                 MAIN
Independent Regulator for Foundation
Trusts, that the Trust is financially sound
                                                 financial problems facing the East of
                                                 England Strategic Health Authority area and
                                                                                                COURSE
and has long term stability as well as being     recognises that this may have some impact
able to ensure that it has sufficient cash       on the Trust’s services. The Trust, however,
resources to cover the short term – two          has some degree of spare capacity and
year period.                                     intends to use this to generate additional
                                                 income from commissioners outside of
There will no longer be a prerequisite to        Essex which will help ensure that any
breakeven and the Trust will have the            adverse impact on the Trust’s services to
flexibility to generate potential larger         the local population should be kept to a
surpluses to be reinvested in direct patient     minimum.
care. The Trust will also no longer have an
end of year financing or cash limit. Taken       The Trust has an excellent record of sound
together this will provide the Trust with        financial management and this discipline
more flexibility to manage its resources and     will have helped the Trust achieve
plan for the medium and longer term. The         Foundation Trust status. The Trust’s plans,
Trust will also be able to plan more             governance and monitoring arrangements
successfully and implement significant           will ensure the Trust continues to maintain
restructuring where this is required to          good financial performance together with
benefit patient care.                            first class patient services over the years
                                                 ahead.
For the 2006/2007 financial year the Trust
is planning to deliver a small surplus of
around £0.5 million. This has been assisted
by the financial settlement for mental
health with a net inflation uplift of 4% for
2005/2006 which was a good settlement
for the current year. For the future, however,
the Trust’s plans assume no further growth
in development funding from our local
commissioners.


                                                                                                     70
                                                                                                     __
Remuneration Report


DESSERT   The Trust has an established Remuneration
          and Terms of Service Committee which is a
                                                           to be considered for an individual
                                                           performance bonus which maybe awarded
          key sub committee of the Trust Board. The        at the discretion of the Remuneration
          Committee has delegated responsibility to        Committee up to a maximum of 9% of
          review and set the remuneration and terms        salary. Any bonus payment is made on a
          of service of the Executive Directors. The       non recurrent ‘one off’ basis.
          Committee comprises Non Executive
          Directors, who for the 2005/2006 financial       The Remuneration Committee considers
          year were as follows:                            the performance of the Trust’s Executive
                                                           Directors against the achievement of the
          Jai Tout – Chairman                              Trust’s corporate objectives and individual
          Geoff Williams – Non Executive Director and      personal objectives, where appropriate.
          Vice Chairman                                    Bonus payments, where awarded, are only
          George Sutherland – Non Executive                in respect of performance which is above
          Director                                         and beyond the achievement of normal
                                                           objectives and where a significant
          As a new NHS Foundation Trust the                contribution has been made to the success
          Remuneration Committee is currently in the       of the Trust.
          process of developing a policy on the
          Remuneration of Senior Managers for              The Trust’s Executive Directors are all
          current and future financial years. However,     employed on substantive contracts with a
          for the 2005/2006 financial year, the            standard notice period of six months. The
          remuneration of Executive Directors has          Trust does not make termination payments
          been set following an analysis of current        to Executive Directors which are in excess of
          market conditions and has taken into             contractual obligations. There have been no
          account the performance and experience           such payments made during the 2005/2006
          of individual directors and the portfolio of     financial year.
          service held by each director.
                                                           The Director of Partnerships is currently on
          The Trust’s Executive Directors receive a flat   secondment from Essex County
          rate salary with no other additional ‘fringe’    Council. As a result the gross cost (including
          benefits. The directors, however, are eligible   employer’s superannuation and national

71
__
insurance contributions) paid by the Trust,
to the County Council, was £102,000
                                               DESSERT
during 2005/2006 in relation to this post.
More detailed information in relation to the
remuneration of all Board Executive and
Non Executive Directors is shown on pages
73 to 76.




                                                    72
                                                    __
                                                                                                    2005/06
                                                                                            Other Remuneration
          Salaries and Allowances                                Salary*(bands of £5,000)    (bands of £5,000)
                                                                           £000                      £000
DESSERT

          Patrick Geoghegan Chief Executive                           £130k - £135k
          Michael Lowe          Medical Director                       £25k - £30k            £140k - £145k
          Raymond Jennings Director of Finance &
                           Resources                                   £95k - £100k
          Sally Morris         Director of Operations                  £90k - £95k
          Philip Howe          Director of Partnerships                £75k - £80k
          Oliver Shanley       Director of Integrated
                               Governance                             £85k - £90k
          Jai Tout             Chair                                  £20k - £25k
          Geoffrey Williams    Non-Executive Director                   £5k - £10k
          Joan Holden          Non-Executive Director                   £5k - £10k
          Ahmad Khwaja         Non-Executive Director
                               (left 31st May 2005)                     £0k - £5k
          Eileen Greenwood Non-Executive Director
                           (left 30th November 2005)                    £0k - £5k
          Janet Wood           Non-Executive Director
                               (started 1st November 2005)              £0k - £5k
          George Sutherland Non-Executive Director
                            (started 1st May 2005)                      £5k - £10k
          Tony Skidmore        Non-Executive Director
                               (started 1st May 2005)                   £5k - £10k

          Leslie Cuthbert      Non-Executive Director
                               (started 1st May 2005)                   £5k - £10k

          Christine Nutt       Non-Executive Director
                               (left 30th September 2004)

73        * Salary figures exclude employers superannuation and national insurance contributions.
__
                                      2004/05
Benefits in Kind                                           Benefits in Kind
  (Rounded to      Salary*(bands of   Other Remuneration     (Rounded to
the nearest £00)        £5,000)        (bands of £5,000)   the nearest £00)
     £000               £000                £000                £000
                                                                              DESSERT

                    £125k - £130k
                     £25k - £30k       £150k - £155k

                     £90k - £95k


                     £75k - £80k

                     £70k - £75k
                     £20k - £25k
                      £5k - £10k
                      £5k - £10k

                      £5k - £10k

                      £5k - £10k




                       £0k - £5k

                                                                                   74
                                                                                   __
                                                                                 Real increase in
                                                            Benefits in kind   pension and related
           Pension Benefits                                                    lump sum at age 60
                                                                                      £000
DESSERT




                                                                                       Consent to disclose withheld
          Patrick Geoghegan Chief Executive                       nil
          Michael Lowe        Medical Director
          Raymond Jennings Director of Finance &                  nil
                           Resources
          Sally Morris        Director of Operations              nil
          Philip Howe         Director of Partnerships            nil
          Oliver Shanley      Director of Integrated              nil
                              Governance
          Jai Tout            Chair                               nil                 n/a
          Geoffrey Williams   Non-Executive Director              nil                 n/a
          Joan Holden         Non-Executive Director              nil                 n/a
          Ahmad Khwaja        Non-Executive Director
                              (left 31st May 2005)                nil                 n/a
          Eileen Greenwood Non-Executive Director
                           (left 30th November 2005)              nil                 n/a
          Janet Wood          Non-Executive Director
                              (started 1st November 2005)         nil                 n/a
          George Sutherland Non-Executive Director
                            (started 1st May 2005)                nil                 n/a
          Tony Skidmore       Non-Executive Director
                              (started 1st May 2005)              nil                 n/a
          Leslie Cuthbert     Non-Executive Director
                              (started 1st May 2005)              nil                 n/a




75
__
Total accrued pension
  and related lump                                                                                                   Real increase in
    sumage 60 at                       Cash equivalent value                  Cash equivalent value                  cash equivalent
   31 March 2006                         at 31 March 2006                       at 31 March 2006                      transfer value
        £000                                   £000                                   £000                                £000
                                                                                                                                                          DESSERT
        Consent to disclose withheld




                                               Consent to disclose withheld




                                                                                      Consent to disclose withheld




                                                                                                                           Consent to disclose withheld
        n/a                                    n/a                                    n/a                                  n/a
        n/a                                    n/a                                    n/a                                  n/a
        n/a                                    n/a                                      n/a                                n/a

       n/a                                     n/a                                     n/a                                 n/a

         n/a                                   n/a                                    n/a                                  n/a

       n/a                                     n/a                                       n/a                               n/a

        n/a                                    n/a                                    n/a                                  n/a

        n/a                                   n/a                                        n/a                               n/a

       n/a                                     n/a                                     n/a                                 n/a




                                                                                                                                                               76
                                                                                                                                                               __
Summary Accounts


THE BILL   TABLE 1
           SUMMARY FINANCIAL STATEMENTS
             1.1	    Income	and	expenditure
             For	the	year	ended	31-Mar-06
                                                                     31-Mar-06	        							      31-Mar-05
             	       	       	         	      	          	           		£000’s		        	            			£000’s

             Income from activities                                    90,262                          82,507
             Other operating income                                      9,019                          8,341
             Operating expenses                                       (95,540)                       (88,937)
             Operating surplus                                           3,741                          1,911
             Profit/(Loss) on disposal of fixed assets                         1                          (162)
             Surplus before interest                                     3,742                           1,749
             Interest receivable                                            235                             197
             Interest payable                                                   0                              0
             Other Finance Costs                                           (270)                            (59)
             Surplus for the financial year                              3,707                          1,887
             Public Dividend Capital Dividend                            (2,330)                        (1,670)

             Retained	Surplus	for	the	year		             																					1,377	   																								217




77
__
                                                                                                                                THE BILL
1.2	   Cash	Flow	Statement
For	year	ended	31-Mar-06
                                                                                      31-Mar-06	 									31-Mar-05
	          	           	          	           	           	          		          												£000’s	    													£000’s

Net cash inflow from operating activities                                                  6,555                    4,656
Net cash inflow from returns on
investments and servicing of finance                                                         235                        197
Payments to acquire tangible fixed assets                                              (23,692)                    (3,382)
Payments for Intangible assets                                                               (45)                        (15)
Receipts from sale of tangible fixed assets                                               1,168                            0
Dividends paid                                                                            (2,330)                 (1,670)

Net	cash	outflow	before	financing	                        	          																								(	18,109)	 															(214)


Financed by:
New Public Dividend Capital                                                              18,139                        228
Public Dividend Capital repaid not previously accrued                                            0                        0
Public Dividend (accrued in prior period) capital repaid                                         0                        0

Increase/(decrease)	in	cash	 																																																																				30	    																			14




                                                                                                                                      78
                                                                                                                                      __
THE BILL   1.3	   Balance	Sheet	 		
           For	year	ended	31-Mar-06	
                                           	
                                           	
           		      	         	       	     	       	             	          31-Mar-06	       31-Mar-05
           	       	         	       	     	       	             	          			£000’s	       			£000’s
           Fixed assets                                                        86,035         63,314

           Current assets:
           Stock                                                                    10            26
           Debtors (within 1 year)                                             8,140           5,431
           Debtors (after 1 year)                                               1,292           1,065
           Cash                                                                   304            274
           Creditors less than 1 year                                         (9,832)          (6,326)
           Provision for Liabilities and Charges                               (3,111)         (2,619)

           Total	assets	employed		         	       											   																		82,838	   		61,165

           Financed by:
           Public Dividend Capital                                             50,796         32,657
           Revaluation reserve                                                 28,722         27,328
           Donated Asset Reserve                                                     19            19
           Income and expenditure reserve                                       3,301          1,161

           Total	capital	and	reserves	     	       	             	          		82,838	        		61,165




79
__
1.4	    Statement	of	total	recognised	gains	and	losses
For	the	year	ended	31-Mar-05
                                                                                                               THE BILL
		      	       	        	       	       	          	          									31-Mar-06										31-Mar-05
	       	       	        	       	       	          	          													£000’s	 													£000’s
Surplus for the financial year                                           3,707                  1,887
Fixed Asset Impairment                                                         0                 (50)
Unrealised surplus/(deficit) on fixed asset
Revaluation/indexation                                                   2,157                16,051

Total	gains	and	losses	recognised	in	the	financial	year									5,864	                										17,888



TABLE 2
MAIN FINANCIAL DUTIES

                                                             2005/06																									2004/05
		      		      	        	       	       	          						Target					Actual										Target					Actual
	       	       	        	       	       																							£’000							£’000										£’000							£’000
1. To break even on revenue                              1,100         1,377                0         217
2. To remain within the external financing limit
   set by the NHS Executive                             18,139       18,109               228         214
3. To generate a 3.5% return on assets
  (for 02/03 the target rate of return
    on assets was 5.5% to 6.5%)                         3% - 4%      3.30%           3% - 4%        3.60%
4. Capital Resource Limit                               22,406      22,312              3,562       3,398




                                                                                                                     80
                                                                                                                     __
THE BILL   TABLE 3
           MAIN EFFICIENCY MEASURES
              		           	             	            	             	             																	2005/06	               FYE	of	savings
              		           	             	            	             	             	               	savings	               								plan
              		           	             	            	             	             	            		£’000	 	                 							£’000

              Management Reorganisations                                                             676                            687
              Service Reconfigurations / Ward Closures                                               287                         1,335
              Efficiency Measures                                                                    780                             791
              Non-Recurrent Measures                                                                 897                                0

              Total	 																																																																																			2,640	 																							2,813




            TABLE 4
            MANAGEMENT COSTS

              		           	             	            	             31-Mar-06	                 31-Mar-05
              	            	             	            	             				£’000	                 				£’000

              Management Costs                                           5,925                      5,313
              Income                                                    97,530                    89,042




81
__
TABLE 5                                                                                                                                                                  THE BILL

                                                                                             2005/06							2005/06							2004/05						2004/05
	               																																																																																	Value												No	of													Value												No	of
																																																																																																																					Bills	Paid																													Bills	Paid
	             																																																																																£’000	 		            																		£’000	 	
    Total bills paid                                                                28,418                 25,335                 20,100              24,752
    Total bills paid within 30 days of receipt
    of goods or a valid invoice                                                      26,861                23,763                 19,708             23,957
    % of bills paid within target                                                      95%                   94%                     98%                97%




                                                                                                                                                                               82
                                                                                                                                                                               __
THE BILL   TABLE 6 - CAPITAL
                                                                                 £’000

            Rochford Hospital Development                                        1,754
            Heath Close Development – Learning Disabilities                        590
            Psychiatric Intensive Care Unit (£1,000,000)                           891
            Refurbishment of Harland Centre                                        428
            BYG E Learning Server                                                     5
            Mountnessing Boilers                                                     29
            IP Telephones - Thurrock                                                 13
            Elderly Mental Illness Unitary Charge                                    62
            Boiler House Runwell - New Equipment                                      9
            Disaster Recovery for Critical Systems                                   20
            New Asset Register                                                        8
            Air Conditioning Mental Health Unit                                      10
            E-Mail Server Software                                                   89
            Digital Scanning                                                         49
            On Core Software                                                         12
            Periphery Homes Land                                                 2,675
            Little Highwood Land                                                   531
            Runwell Lodge                                                        5,054
            Runwell Land                                                        11,250

            Total	 	        	        	      	        	     	   	   	   												23,479


83
__
THE BILL




      84
      __
                Figure 0ne - Analysis by pay group

THE BILL


                                                 Speech Therapy
                                 Psychology 4%   less than .5%
                                                                  Administration 21%
           AHP’s 6%
           (Allied Health Professionals)
                                                                        Ancillary 3%



                                                                          Maintenance 1%




                                                            Medical 15%
                     Nursing 50%




85
__
Figure Two - Trust expenditure by service

                                                                                  THE BILL

                                         Psychology 2%
                          Forensic
                          Services 12%
             Drug & Alcohol                        Medical
             Services 4%                           Directorate 12%


Child & Adolescent
                                                              Adult Inpatient
Mental Health 5%
                                                              Services 20%




Learning Disabilty
Inpatient & Community                                    Older People Inpatient
Services 11%                                             Services 13%


                                          Home Treatment &
        Adult Community                   Crisis Resolution 3%
        Services 13%
                          Older People Community
                          Services 5%




                                                                                        86
                                                                                        __
                       www.southessex-trust.nhs.uk

                         South Essex Partnership NHS Foundation Trust
                                 working in partnership with

                          • Face to face interpreters
                          • Document translation into other languages
                          • Signing (at BSL level 3)
                          • Document translation into Braille
                          • Document translation onto audio tapes
                          • Over the telephone translation

                      Contact PALS (Patient Advice and Liaison Service)
                         for more information on 0800 0857 935
                          or email pals@southessex-trust.nhs.uk




Published by

South Essex Partnership NHS Foundation Trust
Trust Head Office, Dunton Court
Aston Road, Laindon, Essex SS15 6NX

Telephone 01375 364650                                                    SE0328

				
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