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					ANNUAL REPORT
AND ACCOUNTS
2006/2007
Presented to Parliament pursuant to Schedule 1

of the Health and Social Care (Community

Health and Standard) Act 2003, Schedule 1,

paragraph 25 (4)




                                                 3
                                                    I am pleased to present the first Annual            Over the past seven months we have taken an


chairman’s                                          Report of Northumbria Healthcare NHS
                                                    Foundation Trust. This report summarises our
                                                    work and achievements from becoming a
                                                    Foundation Trust in August 2006 to the end of
                                                                                                        active and varied approach to increasing and
                                                                                                        engaging our membership and our efforts
                                                                                                        have paid off. We now have some 15,000
                                                                                                        members throughout our patch, who will be


statement
I believe our Governors will increasingly help us
                                                    March 2007. It demonstrates strong
                                                    performance both financially and in terms of
                                                    the delivery of activity, waiting times and other
                                                    targets. Northumbria Healthcare has a strong
                                                    track record for financial performance, having
                                                                                                        essential to the success of our future
                                                                                                        direction. We will continue to build on this
                                                                                                        progress and to look for opportunities to use
                                                                                                        our financial and other freedoms as a
                                                                                                        Foundation Trust to make a real difference to
                                                    met all the required financial targets. On our      the services provided for our patients, their
                                                    operational performance this has been               families and the local community.
tailor our services to meet the needs of our        another successful year. In October 2006 the
                                                    Healthcare Commission confirmed our quality         Since being awarded Foundation Trust status
communities and Foundation Trust members.           rating as “good” and we anticipate this rating      the Board of Directors has had to address
                                                    being enhanced to “excellent”.                      new ways of working as well as major
                                                                                                        financial concerns. During this time we have
                                                    As a NHS Foundation Trust, we are                   benefited from a period of stability with no
                                                    accountable through our 69 Governors to             changes of membership in the Board of
                                                    local people. Since August our Governors            Directors. Our executive management team is
                                                    Body has developed considerably and I am            one of considerable talent and ability and they
                                                    impressed by the commitment our Governors           continue to provide strong leadership and
                                                    have shown to their local hospitals. Our            manage all of the changing scenarios with
                                                    Governors have contributed to the work of the       commitment and efficiency. Likewise my non-
                                                    Trust in a number of different ways: they have      executive colleagues also give much support
                                                    participated in key clinical service reviews,       to the Trust. Their knowledge of their local
                                                    participated in patient environment action          communities and expertise is particularly
                                                    team visits, appointed the Trust’s auditors and     valuable to the Board’s discussions
                                                    actively contributed to the development of our
                                                    Annual plan. This group of public, staff and        It can never be said often enough that our
                                  Brian Flood
                                  Chairman          nominated partner Governors is acquiring            success is entirely dependent upon the
                                                    vital knowledge and experience, which will be       dedication of staff at every level in the
                                                    of increasing importance. I am grateful for         organisation, from doctors and nurses, to
                                                    their patience and support as we learn to           therapists, laboratory, catering, portering and
                                                    work together. I believe our Governors will         administrative staff. Their dedication and hard
                                                    increasingly help us tailor our services to         work which often goes beyond the call of duty
                                                    meet the needs of our communities and               has allowed us to report the successful
                                                    Foundation Trust members.                           performance and many achievements that
                                                                                                        are described throughout this report.
                                                                                                                                                      5
chief executive’s
                                                 Becoming a Foundation Trust last August was       We’ve also introduced new services into
                                                 a major milestone for all of us at Northumbria.   Berwick Infirmary so patients don’t have to
                                                 It marked a new era for the Trust, as we          make the long journey to a general hospital.



report
                                                 worked closely with our local communities,        A new outreach respiratory clinic is provided
                                                 through our 69 governors and 15,000               by one of our Respiratory Physicians who
                                                 members, to provide healthcare that meets         travels 53 miles north from Wansbeck
                                                 the needs of our patients.                        General to see patients with respiratory
                                                                                                   disorders     and    a    new       nurse-led
                                                 On behalf of the Board of Directors, I take
                                                 great pride in reporting that the Trust           chemotherapy service will get underway in
                                                 continues to perform extremely well both in       the summer.
The Trust continues to perform extremely well
                                                 terms of our financial and our operational
                                                 performance. This has been another busy and       Service improvements have also been
both in terms of our financial and our           successful year for the Trust, and one in which   introduced into our General Hospitals. In
                                                 we again met our key performance targets. At      December a new state-of-the-art scanner was
operational performance.                         the end of the first period as a Foundation       installed at Wansbeck General Hospital. This
                                                 Trust we have achieved excellent performance      scanner, one of the most advanced in the
                                                 that gives us a firm platform to move on to our   region, speeds up the scanning process for
                                                 first full year as a Foundation Trust.            patients, potentially saving lives.

                                                 Despite this success we would all                 Jonny Wilkinson OBE, Newcastle and
                                                 acknowledge it has been an extremely              Falcons rugby fly-half marked the start of
                                                 demanding year. The focus has been very           work on the new £25 million development at
                                                 much on improving the patient experience.         Hexham hospital by laying a foundation
                                                 We are aware our continued success is             stone. This new facility will bring local GPs
                                                 entirely dependent on the quality of care we      onto the site improving access to healthcare
                                                 deliver and on our patients’ satisfaction. We     services for Tynedale patients.
                                                 are pleased to have made significant
                                                 reductions in the waiting times for elective      Our Emergency Care teams came in above
                                                 admissions and diagnostic testing, improved       the national average at 99% for patients seen
                                                 our referral to treatment times for cancer        within four hours, despite a 2% increase in
                               James Mackey      services whilst at the same time treating an
                               Chief Executive                                                     patients. This was thanks to the teams who
                                                 increasing number of patients.
                                                                                                   streamlined services in the department.
                                                 One of the main highlights of the year has to
                                                 be our work to improve services and facilities    Across the Trust cleanliness is important to
                                                 in our community hospitals. In October the        us and we have invested £40,000 in new
                                                 new hospital at Rothbury opened, this saw         cleaning equipment to help our domestic
                                                 physiotherapy,      occupational      therapy,    staff maintain high standards on our wards
                                                 outpatients, minor injuries, a day hospital and   and departments.
                                                 rehabilitation service all being provided
                                                 under one roof.
6
chief executive’s
                                                   We are particularly proud of our staff, over the   Our Trust is committed to working with our
                                                   past year they continued to gain national          partner organisations, together we can tailor
                                                   recognition for their work. Some of the            services to better meet the needs of our local



report
We are particularly proud of our staff, over the
                                                   notable achievements include; in December
                                                   the Special Care Baby Unit at Wansbeck
                                                   General were voted the best in the country by
                                                   the Royal College of Midwives, our team of
                                                   Advanced Neonatal Nurse Practitioners won
                                                   the “outstanding contribution to newborn
                                                                                                      communities and can improve the patient
                                                                                                      experience by providing seamless healthcare
                                                                                                      as patients move from one NHS provider to
                                                                                                      another. Over the past year we have worked
                                                                                                      closely with our Commissioners. We have
                                                                                                      sought their views on the future of community
                                                   care award” for their professional excellence      hospitals in Northumberland. We have also
                                                   in the care of new born babies, our Stroke         worked with them to hold public
past year they continued to gain national          team at North Tyneside General was rated as        consultations and more generally to plan
                                                   the leading hospital in the region for stroke      future service provision. We have also
recognition for their work.                        services and was ranked in the top 20% in          established productive relationships with
                                                   the country, the Parkinson’s Disease Team at       local practice based commissioning groups.
                                                   Northumbria is the only neurological team in       We now maintain a regular dialogue with our
                                                   the country to be asked to work with the           local GPs through regular meetings, it’s early
                                                   Parkinson’s Disease Society to provide good        days for Practice Based Commissioning GPs
                                                   quality information prescriptions for patients     and we expect to develop stronger, more
                                                   and their carers. The Radiography Team             effective working relationships in the future.
                                                   were also recognised for their hard work in
                                                   relation to a patient discharge scheme and         We have also worked closely with statutory
                                                   our Infection Control Team for the first           and voluntary sector organisations. These
                                                   infection control course for the public and        include our main academic partners, the
                                                   private sector.                                    universities of Newcastle, Northumbria and
                                                                                                      Sunderland, with whom we provide a wide
                                                   All of these staff are worthy winners, but there   range of training and education for future
                                                   are others who deserve recognition too. I          health care professionals.
                                                   receive many letters from grateful patients
                                                   who praise our staff for treating them with        Many of our relationships have been
                                                   good quality care and kindness. This level of      strengthened by our Foundation Trust status
                                                   care is the most important thing for me and        and involvement of our Governors Body
                                                   we will build on this strong platform in the
                                                   coming year, our first full year as a              I do hope you find this report informative, if
                                                   Foundation Trust.                                  you have any feedback I would be delighted
                                                                                                      to hear from you.

                                                                                                                                                   7
introduction
                                                     Northumbria Healthcare NHS Foundation               innovative, forward thinking NHS Trust
                                                     Trust is a successful top performing Trust          working in partnership with others to deliver
                                                     providing healthcare to over 550,000 people.        excellent services for patients, creating a
                                                     Our geographical spread is the largest of any       relationship with patients where they are
                                                     Trust in England, stretching from Tyneside in       central to the decisions that affect them and
We are recognised regionally and nationally as       the south and east, to the Scottish Border in       their carers.”
                                                     the north, and to Hexham and Haltwhistle in
having very strong clinical services in a range of                                                      To deliver this strategy, we have a vision of an
                                                     the west of the county. We are recognised
                                                                                                        integrated local NHS where we have earned
                                                     regionally and nationally as having very
specialties.                                         strong clinical services in a range of
                                                                                                        the confidence of patients and we have
                                                                                                        enabled them to control their own care and
                                                     specialties, excellent clinical leadership, a
                                                                                                        therefore we are their first choice of hospital
                                                     track record of delivery with limited resources,
                                                                                                        for first class care. We have named this vision
                                                     an innovative approach to service delivery
                                                     and excellent relationships with primary care.     Personalising Healthcare.
                                                     We also have a first class reputation for
                                                     teaching, being a key unit of Newcastle            We deliver patient centred care where
                                                     Medical School and having partnerships with        services are designed with the needs of
                                                     Northumbria and Sunderland Universities for        patients in mind. Patients are placed at the
                                                     nurses and other professionals.                    centre, and the service is designed and
                                                                                                        incentivised to provide the highest quality of
                                                     We achieved NHS Foundation Trust status on         appropriate care which is coordinated,
                                                     1st August 2006 under the Health and Social        integrated and provides value for money. To
                                                     Care (Community Health and Standards) Act          deliver our vision we have developed five
                                                     2003.                                              strategic objectives and these are shown left.
                                                     Over 350,000 patients per year are cared for       The annual report for 2006/07 describes how
                                                     in our hospitals. We have a wide range of          we have delivered these objectives in our
                                                     services including accident and emergency,         local hospitals:
                                                     maternity care, children’s services, elective      • North Tyneside General Hospital
                                                     surgery and intensive care. We provide our         • Wansbeck General Hospital
                                                     services from three general hospitals and six
                                                                                                        • Hexham General Hospital
                                                     community hospitals.
                                                                                                        • Haltwhistle Memorial Hospital
                                                     Our Vision                                         • Rothbury Community Hospital
                                                     Our strategic purpose is about:                    • Berwick Infirmary
                                                                                                        • Alnwick Infirmary
                                                      “Helping people to attain the quality of
                                                      health they choose and aspire to throughout       • Morpeth Cottage Hospital
                                                      their life by striving for the continuous         • Blyth Community Hospital
                                                      development of the organisation as an             • Sir G B Hunter Memorial Hospital
8
our operational
                                                   We were rated in the top 30% of hospitals in                      Healthcare                                  Assumed
                                                                                                                                                    Annual
                                                   the  country     when     the    Healthcare                      Commission                   Performance
                                                                                                                                                                   Annual
                                                   Commission rated the quality of our services                                                                 Performance
                                                                                                                     Standards                   Rating 05/06
                                                                                                                                                                Rating 06/07


performance
                                                   and our use of resources as “Good” in
                                                   October 2006.                                            2 Quality of services

                                                                                                             2.1 Core standards                  Almost met      Fully met
                                                   Since then, we have further improved our
                                                   ‘Quality of Services’ and we anticipate being             2.2 Existing targets                 Fully Met      Fully Met
We were rated in the top 30% of hospitals in the   rated as excellent in the Healthcare
                                                   Commission Annual Performance Ratings to                  2.3 New national targets             Fully Met      Fully met
country when the Healthcare Commission rated       be published in October 2007. This is subject             2.4 Improvement reviews/acute
                                                   to no further amendments to the definitions of                hospital portfolio
the quality of our services and our use of         the rating system.                                        Services for children in hospital       Fair           n/a

resources as “Good” in October 2006                The overall Quality of Services rating is                 Admissions management                Excellent         n/a
                                                   awarded by assessing how good the                         Diagnostic services                    Good            n/a
                                                   systems in place are at ensuring patients
                                                                                                             Medicines management                 Excellent         n/a
                                                   receive a minimum quality standard of care
                                                   which is in line with statutory requirements              2.5. Developmental standards
                                                   and best practice standards, corporate and                (shadow form)

                                                   clinical. For example, patient safety, meeting            Patient safety                          n/a         Excellent
                                                   the national service frameworks, risk                     Clinical & cost effectiveness           n/a           Good
                                                   management,       hospital     food,    waste
                                                                                                            Overall quality of services             Good         Excellent
                                                   management, recruitment and training of
                                                   staff.


                                                           Healthcare                         Assumed
                                                                                 Annual
                                                                                                Annual
                                                          Commission          Performance
                                                                                             Performance
                                                           Standards          Rating 05/06
                                                                                             Rating 06/07

                                                   1 Use of resources
                                                    1.1 Use of resources
                                                                                 Good           Good
                                                    (key lines of enquiry)
                                                    1.2 Balanced year end
                                                                                 Good           Good
                                                    position
                                                   Overall use of resources      Good           Good


                                                                                                                                                                             9
our operational                                   Core Standards: Statutory and
                                                  Mandatory Training
                                                  We achieved a rating of ‘Almost Met’ for our
                                                                                                                                                  Existing Targets
                                                                                                                                                  The Trust successfully met all of its existing
                                                                                                                                                  targets in 06/07. Some examples of these


performance                                       core standards in October 2006 because we
                                                  declared in March 2006 that we had a system
                                                  for all staff to receive training in fire and
                                                  manual handling however, the Board of
                                                                                                                                                  are:

                                                                                                                                                  • A maximum wait of four hours for 98.8%
                                                                                                                                                    of patients who attend our Accident and
                                                  Directors considered that the evidence of the                                                     Emergency service
The Trust successfully met all of its existing
                                                  training standards to be in need of                                                             • 99.9% of suspected cancer patients seen
targets in 06/07.                                 development. During 06/07, the Trust made                                                         within two weeks.
                                                  this change a priority. This was a significant                                                  • 100% of breast cancer patients treated
                                                  challenge however, it was achieved by March                                                       within 31 days.
                                                  2007. The Board of Directors was satisfied                                                      • 95.9% of cancer patients treated within
                                                  that in 06/07 the system in place to evidence                                                     62 days. The remaining patients had
                                                  that statutory and mandatory training was                                                         more complex treatment pathways
                                                  satisfactory. At the end of the year, 90% of                                                      appropriate to their needs.
                                                  staff in high risk areas had received the
                                                  appropriate training.

                                                   Accident and Emergency total wait 2005/06 and 2006/07

                                                                                                                             % departing within 4 hours of arrival
                                                           Total attTotdlaatcendances   100%



                                                                                        99%
                                                                    ena n t es




                                                                                        98%



                                                                                        97%



                                                                                        96%
                                                                                               Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar
                                                                                               05 05 05 05 05 05 05 05 05 06 06 06 06 06 06 06 06 06 06 06 06 07 07 07
                                                 Total No. of attendances 13806 15104 15105 15184 14453 14149 14381 12842 13613 13063 12162 13645 14396 14519 14590 16195 14195 13903 13734 12624 13278 12969 11717 13448
                                                       % Seen < 4hrs                           98.6 98.3 98.5 98.5 98.9 98.8 98.7 99.2 98.9 98.8 98.4 97.9 98.6 98.5   99   98.7   99   99   99   98.9 98.9 97.6 98.1 98.5

                                                       Profiled Target                         98   98   98   98   98   98    98   98   98   98   98   98   98   98    98   98     98   98   98   98   98    98   98   98




10
                                                                                                                                              MRSA Monthly Reports - 2006/07
                                                                                                            12
                                             12


our operational                              10

                                                                           8


performance                                  8

                                             6
                                                        7

                                                              5
                                                                    6            6

                                                                                         4
                                                                                                   5
                                                                                                                              6


                                                                                                                                    4    4           4
                                                                                                                                                             7



                                                                                                                                                                     4                   4
                                                                                                                                                                                                  7
                                                                                                                                                                                                       6


                                             4
The trust achieved a 34% reduction in the                                                                                                     3
                                                                                                                      2
                                             2
                                                                                                                                                                               1
number of MRSA cases on the previous year.
                                             0




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                                                                        Monthly Actual                            LDP Trajectory                    Recovery Plan Trajectory

                                                                                             Apr       May       Jun      Jul     Aug   Sep   Oct    Nov Dec             Jan       Feb       Mar Total

                                                  2006/07 Trajectory target                   2         6         4       4        3     2     2         4       4        4         2         4       41

                                                  06/07 Actual No. of MRSA                    2         6         4       4        3     4     7         4       1        4         7         6       52
                                                  bacteraemia

                                                  06/07 MRSA bacteraemia isolated             1         0         2       2        0     0     1         1       1        2         4         1       15
                                                  < 48 hours after admission

                                                  06/07 MRSA bacteraemia isolated             1         6         2       2        3     4     6         3       0        2         3         5       37
                                                  > 48 hours after admission


                                             New National Targets                                                                 The Board of Directors were disappointed
                                             The Trust successfully met most of the new                                           not to achieve a month-by-month reduction
                                             national targets apart from one and that is to                                       in the MRSA bacteraemia number during the
                                             reduce the number of MRSA bacteraemia to                                             winter months. The clinical teams have
                                             a maximum of 41 per year by March 2007.                                              developed an enhanced plan that will
                                             The Trust achieved 52 by March 2007, a                                               introduce the same standards for emergency
                                             reduction of 34% on the previous year. This                                          patients that are in place for elective patients
                                             was a significant challenge for the Trust and                                        and that is:
                                             was made a very high priority by the Board of                                        • Screening of patients in accident and
                                             Directors. The Board received a monthly                                                 emergency should the patient be
                                             report on the implementation plan which was                                             planned for admission
                                             led by the clinical team in infection control                                        • An eradication policy for high risk
                                             and by the clinicians working in the high risk                                          emergency patients
                                             clinical areas.                                                                      • Faster roll-out of root cause analysis

                                                                                                                                                                                                           11
our operational                                                           Outpatients waiting for a consultant first appointment:

performance                                                        8000

                                                                   7000
                                                                          GP referrals only
                                                                                                                         Trust Total




                                                 Number W aiting
                                                                   6000
We have achieved a reduction in our diagnostic
                                                                   5000
waiting times.                                                     4000

                                                                   3000

                                                                   2000

                                                                   1000

                                                                    0




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                                                                                                                                                                                           M
                                                                                   M
                                                                                                  Apr     May    Jun    Jul      Aug         Sep      Oct     Nov    Dec    Jan     Feb        Mar

                                                                              13 + wks             0       0      0      0        0           0           0    0      0      0       0          0

                                                                              10 < 13 wks         462     556    410    554      628         508      504      221   300    131     96          27

                                                                              8 < 10 wks          728     825    642    595      683         694      490      473   513    454     261        356

                                                                              6 < 8 wks           1054    920    1128   950      1142        1068     916     1124   956    904     583        678

                                                                              0 < 6 wks           5370    5002   5234   4968     4798        4463     5075    4936   4556   4238    4682       4754

                                                                           Total                  7614    7303   7414   7067     7251        6733     6985    6754   6325   5727    5622       5815



                                                         An example of our successful achievement of                           maximum of 13 weeks. To do this we
                                                         a new national target is that we achieved a                           investigated over a 1000 additional patients.
                                                         maximum wait of 11 weeks for a first out-                             Some of the patients who benefited were
                                                         patient appointment.                                                  those waiting for a first assessment for a
                                                                                                                               hearing aid and those waiting for an MRI or
                                                         We have achieved a reduction in our                                   CT scan.
                                                         diagnostic waiting times from 26 weeks to a
12
                                                                                                                                                  Waiting times for Magnetic Resonance Imaging:
                                                                                                                                                  Number waiting 0- <20 weeks, 20- <26 weeks, and 26+ weeks
                                                                                                                                         1000

                                                                                                                                         900




                                                                                                              Number w aiting for M RI
                                                                                                                                         800
                                                                                                                                                                                                      as at end of month:


our operational                                                                                                                          700

                                                                                                                                         600




performance                                                                                                                              500

                                                                                                                                         400

                                                                                                                                         300

              Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar                                                                200
              06 06 06 06 06 06 06 06 06 06 06 06 07 07 07
                                                                                                                                         100
26 + wks       1     0     0     3     0     0     0     0     0     0     0     0     0     0     0
                                                                                                                                          0




                                                                                                                                                                                      06




                                                                                                                                                                                                                         6




                                                                                                                                                                                                                                                    6
                                                                                                                                                                                                                                          06
                                                                                                                                                                                                                6
                                                                                                                                                             6




                                                                                                                                                                                                                                                                      7
                                                                                                                                                                      6




                                                                                                                                                                                                                                                                               7
                                                                                                                                                                                               6




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                                                                                                                                                                                                                                                             7
                                                                                                                                                                             6




                                                                                                                                                                                                       6




                                                                                                                                                                                                                          0




                                                                                                                                                                                                                                                     0
                                                                                                                                                                                                                 0
                                                                                                                                                              0




                                                                                                                                                                                                                                                                       0
                                                                                                                                                                    -0




                                                                                                                                                                                                                                                                             -0
                                                                                                                                                                                                0




                                                                                                                                                                                                                                  -0
                                                                                                                                                     0




                                                                                                                                                                                                                                                              0
                                                                                                                                                                            r-0




                                                                                                                                                                                                      l-0
20 < 26 wks




                                                                                                                                                                                     -
              201   57    35     0     0     0     0     0     0     0     0     0     0     0     0




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                                                                                                                                                                                                                              O
                                                                                                                                                                                  M
0 < 20 wks    696   880   567   587   375   452   334   314   212   174   211   175   100   92    217




                                                                                                                                                  Waiting times for Computer Tomography:
                                                                                                                                                  Number waiting 0- <20 weeks, 20- <26 weeks, and 26+ weeks
                                                                                                                                                  • A maximum wait of 20 weeks for in-patients.
                                                                                                                                         600
                                                                                                                Number w aiting for CT
                                                                                                                                         500                                                                                  as at end of month:

                                                                                                                                         400



                                                                                                                                         300

                    Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar
                    06 06 06 06 06 06 06 06 06 06 06 06 07 07 07                                                                         200


26 + wks             0    0     0     0     0     0     0     0     0     0     0     0     0     0     0
                                                                                                                                         100

20 < 26 wks          0    0     0     0     0     0     0     0     0     0     0     0     0     0     0
                                                                                                                                          0
                                                                                                                                                                                      06




                                                                                                                                                                                                                          6




                                                                                                                                                                                                                                                    06
                                                                                                                                                                                                                                           6
                                                                                                                                                                                                                 6
                                                                                                                                                              6




                                                                                                                                                                                                                                                                       7
                                                                                                                                                                      6




                                                                                                                                                                                                                                                                               7
                                                                                                                                                                                               6




                                                                                                                                                                                                                                   6
                                                                                                                                                    6




                                                                                                                                                                                                                                                             7
                                                                                                                                                                              6




                                                                                                                                                                                                        6




                                                                                                                                                                                                                          0




                                                                                                                                                                                                                                            0
                                                                                                                                                                                                                 0
                                                                                                                                                              0




                                                                                                                                                                                                                                                                       0
                                                                                                                                                                    -0




                                                                                                                                                                                                                                                                             -0
                                                                                                                                                                                                0




                                                                                                                                                                                                                                  -0
                                                                                                                                                     0




                                                                                                                                                                                                                                                              0
                                                                                                                                                                            r-0




                                                                                                                                                                                                      l-0
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0 < 20 wks
                                                                                                                                                                  ar




                                                                                                                                                                                                                                                                           ar
                                                                                                                                                                                                                              ct
                    345   412   417   390   392   442   576   487   425   406   390   399   380   347   362
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                                                                                                                                                                                                                                                                                   13
our operational                                                                                                                                        Patients waiting for elective admission

performance                                                                                                                                     4000
                                                                                                                                                                                                         Trust Total

                                                                                                                                                3500




                                                                                                      Number W aiting
                                                                                                                                                3000

                                                                                                                                                2500
                      Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar
                                                                                                                                                2000
     26 + wks          0    0         0   0      0     0     0      0     0       0   0         0

     20 < 26 wks      261   170   176     188    227   203   172   124   55       7   6         0
                                                                                                                                                1500

     8 < 20 wks       1322 1350 1267 1196 1375 1268 1024           994   1104 1205    994       996                                             1000
     0 < 8 wks        1958 1808 1905 1906 1608 1653 1980 2016 1939 1997 2034 1805
                                                                                                                                                500
Total                 3541 3328 3348 3290 3210 3124 3176 3134 3098 3209 3034 2801
                                                                                                                                                 0
Profile 26 + wks       0    0         0   0      0     0     0      0     0       0   0         0




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                                                                                                                                                                   M
Profile 20 < 26 wks   279   222   169     138    138   79    38     0     0       0   0         0




                                                                                                                                                       Reduction in waiting times for admissions:
                                                                                                                                                       Number waiting 5- <6 months, 6- <9 months, and 9- <12 months
                                                                                                                                                900

                                                                                                                                                800
                                                                                                                Number w aiting for admission


                                                                                                                                                700

                                                                                                                                                600

                                                                                                                                                500

                                                                                                                                                400

                                                                                                                                                300
                            March March March March March March
                            2002 2003 2004 2005 2006 2007                                                                                       200

     20 < 26 wks                183        187         218         196        102           0                                                   100

     20 < 26 wks                187        129          0          0          0             0                                                    0
                                                                                                                                                               2




                                                                                                                                                                                 3




                                                                                                                                                                                                    4




                                                                                                                                                                                                                        5




                                                                                                                                                                                                                                          6




                                                                                                                                                                                                                                                             7
     20 < 26 wks
                                                                                                                                                              -0




                                                                                                                                                                                 -0




                                                                                                                                                                                                    -0




                                                                                                                                                                                                                      -0




                                                                                                                                                                                                                                          -0




                                                                                                                                                                                                                                                             -0
                                477        461         212         47         0             0
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                                                                                                                                                                                                                                                       M
                                                                                                                                                                        Please note: for Mar 07, 5 months equates to 20 weeks
14
our operational                                            Children’s Service                                 The Board of Directors held a development
                                                           The Board of Directors is committed to             day in January 2007 to consider the patient
                                                           achieving the new developmental standards          safety culture and used the Institute of


performance                                                set by the Healthcare Commission. The              Healthcare Improvement framework. The
                                                           Healthcare Commission awarded the Trust            result was a series of recommendations to
                                                           ‘Fair’ following a national review of children’s   enhance our culture, systems and processes
                                                           hospital services. 71% of hospitals were also      and these are described in detail in our Annual
                                                           allocated this rating. The Trust has worked        Plan 07/08 at www.northumbria.nhs.uk
                                                           with clinical teams to produce a plan to
The main areas of improvement are increasing               improve the service to aim for a Good              Monitor
                                                           standard and this will be presented to the         Monitor is our Regulator and since
the number of staff trained in advanced patient            Trust Board in June 2007. The main areas of        Authorisation, has awarded the Trust the
                                                           improvement are increasing the number of           rating shown in the table left.
life support and advanced paediatric life                  staff trained in advanced patient life support
                                                                                                              The amber rating was awarded because the
                                                           and advanced paediatric life support.
support.                                                                                                      Trust could not guarantee achievement of the
                                                           Developmental Standards                            maximum number of 41 MRSA bacteraemia
                                                           The Healthcare Commission introduced two           by March 2007. The Board of Directors has
                                                           new developmental standards for acute              enhanced the improvement plan for 07/08
                                                           hospitals. These were published in January         and this was described in our declaration to
                                                           2007 and are concerned with patient safety         Monitor on 30th April 2007.
                                                           and progress made with the implementation          Comprehensive Financial and
                                                           of the national service frameworks and             Operational Performance Measures
  Monitor’s Self-certification                31.3.07      National Institute for Clinical Excellence
                                                                                                              We also have a comprehensive range of
                                                           guidance. The Trust self-assessment was
                                                                                                              financial and non-financial measures to
                                                           ‘Good’ and the actions to achieve excellence
                                                                                                              assess delivery of our five strategic
                                                           focus on improving:
Healthcare Commission Quality Standards and                                                                   objectives and these are reported each
Governance
                                              Almost Met   • the system of audit to meet the higher           month in our reports from our sub-
                                                             audit standards                                  committees to the Board, available on our
Finance                                          Met       • systems to allow us to meet higher               website at www.northumbria.nhs.uk
                                                             patient safety standards. This is in line
                                                             with our plan to achieve Clinical
Mandatory Services                               Met
                                                             Negligence Scheme for Trusts Level 2
                                                             and 3 by March 2008 and March 2009
Other Items                                      Met         respectively.

                                                                                                                                                           15
personalising
                                            A look back at 2006/07 demonstrates another         The Trust’s performance was assessed in
                                            successful year. Our staff have worked hard to      2006 by the Healthcare Commission as part
                                            continue to personalise the healthcare              of an Acute Hospital Portfolio review. The
                                            provided in all of our 10 hospitals. We are         assessment was made against several

our healthcare                              committed to providing the highest quality of
                                            appropriate care, as efficiently as possible,
                                            ensuring the hospital environment meets the
                                            needs of patients, carers and staff. A number
                                                                                                elements including an independent audit of
                                                                                                outpatient supply, an audit of the timeliness
                                                                                                and quality of inpatient drug history taking
                                                                                                and medication review and the effectiveness
                                            of major programmes of change are underway          of the Pharmacy service and other medicines
                                            and have involved listening to the views of our     management systems. Their assessment
                                            patients, carers, staff and governors.              ranked Northumbria as ‘excellent’; a rating
The stroke team were commended as the top                                                       achieved by only 18 acute trusts within the
                                            Highest Quality of Appropriate Care                 UK.
performing team in the North East.          Many of our clinical teams have won
                                            prestigious awards this year. The Trust was         Stroke Service
                                            awarded Excellence in the Acute Hospital            Results of a national stroke audit show that
                                            Portfolios for medicine management and              North Tyneside General Hospital is now rated
                                            admissions management. The stroke team              as the leading hospital for stroke services in
                                            were commended as the top performing team           the region and one of the top performing
                                            in the North East in the national audit of Stroke   units in the country placed at 12 out of the
                                            Services led by the Royal College of                224 units audited.
                                            Physicians. The laparoscopic surgeons were          Hexham General Hospital similarly achieved
                                            commended by the National Institute of              excellence for clinical care and is placed in
                                            Innovation and Learning.                            the top 20% off all NHS hospitals. Wansbeck
                                                                                                General Hospital performed above the
                                            Medicines Management                                national average.
                                            Over the last few years significant
                                            improvements have been made in the way              The audit, which is run by the Royal College
                                            that medicines are prescribed, handled,             of Physicians, covers 100% of hospital sites
                                            dispensed and administered within the Trust.        across England and Wales and assesses
                                            Progress has been made against the Trust’s          both clinical and organisational standards in
                                            Medicines Management Strategy with                  how patients with stroke are cared for. The
                                            leadership provided by the Pharmacy                 audit provides nationally acclaimed insight
                                            service, the multi disciplinary Medicines           into how well stroke is being managed at
                                            Management Committee and the local Drug             local level. The results showed that
                                            and Therapeutics Committee, with excellent          Northumbria’s model of care is working
                                            representation from across the health               ensuring a consistent approach that delivers
                                            economy.                                            excellence at each hospital and places
                                                                                                Northumbria in the top 10% nationally for the
                                                                                                way care is organised.
16
personalising
                                                     Laparoscopic Surgeons                             orthopaedic service to operate in the top
                                                     Our laparoscopic surgeons received a              percentile in the country. The benchmarking
                                                     glowing report from the NHS Institute for         resulted in the following improvement
                                                     Innovation and Improvement.                       programme:

our healthcare                                       The surgical team, whose specialist expertise
                                                     means patients spend less time in hospital
                                                                                                       • improve the in-patient length of stay from
                                                                                                         8.5 day to 6.5 days
                                                                                                       • improve the cost of prosthesis
                                                     and suffer less pain after the operation, has
                                                     been held up as the best in the country for       • all patients to be admitted on the day of
                                                     gall bladder surgery.                               surgery
We have significantly reduced the average
                                                     The NHS Institute spent two days at Hexham        A review of our performance against the best
length of stay for patients. In 2005/06 48% of our                                                     is planned for May 2007.
                                                     General Hospital and North Tyneside General
                                                     Hospital listening to patients and speaking to    Emergency Care
patients had an average length of stay of two        staff. They found that the services Northumbria   We have significantly reduced the average
                                                     provides in upper gastro-intestinal surgery and   length of stay for patients. In 2005/06 48% of
days or less.                                        daycase laparoscopic operations for gall          our patients had an average length of stay of
                                                     stones and hiatus hernias are some of the best    two days or less, this is now 56% of our
                                                     clinically and most patient focussed in the       patients. The revised pathway in accident and
                                                     country.                                          emergency and the medical admissions unit
                                                                                                       has resulted in a higher quality of care and
                                                     Some of the country’s leading surgeons have       more efficient processes. Assessment is
                                                     joined the Trust since new state-of-the-art       undertaken by senior clinical staff within two
                                                     operating theatres with voice activated           hours and the diagnostic service responds
                                                     laparoscopic equipment was installed at           within one day. The result is more clinical
                                                     Wansbeck and Hexham General Hospitals.            decisions by senior staff.
                                                     Gall bladder operations are carried out each
                                                     year at Hexham, Wansbeck and North                Inpatient Wards
                                                     Tyneside General Hospitals.                       There is a need to focus on the planned
                                                                                                       discharge arrangements for patients. An
                                                     Orthopaedic Service                               audit has demonstrated that 4% of patients
                                                     Our Orthopaedic surgeons worked in                have a planned day of discharge on the day
                                                     partnership with McKinsey’s and the               of admission.
                                                     Foundation Trust Network to develop a             We aim to improve this standard during
                                                     benchmarking tool to gain a better                06/07. This will involve a major shift in our
                                                     understanding of the service and its              culture,   processes      and   partnership
                                                     associated costs. The aim was for the             arrangements with social care.
                                                                                                                                                   17
personalising
                                                  A 21st Century Hospital Environment             • Berwick Infirmary
                                                  The Trust has invested significantly to         • Haltwhistle Memorial Hospital
                                                  enhance our diagnostic services and our         • Morpeth Cottage Hospital
                                                  ward environment. Examples of these

our healthcare                                    investments are listed below:
                                                  • £600,000 for a new CT scanner at
                                                    Wansbeck General Hospital which opened
                                                                                                  Information Technology
                                                                                                  The need for accurate and up-to-date
                                                    in January 2007.                              information at the patient’s bedside and in
The Trust has invested significantly to enhance   • A new hospital at Rothbury was opened in      other clinical areas is increasingly an
                                                    October 2006 at a cost of £3,500,000.         essential component of good quality and
diagnostic services and the ward environment.     • An extension to Hexham General Hospital       efficient care. Our information and
                                                    started in August 2006 and is due to be       technology departments have worked hard
                                                    completed in the summer of 2008. This         this year to develop systems. We already
                                                    extension will cost £24.255 million. Two      have digital x-rays available in our clinical
                                                    General Practitioner practices will be re-    areas and on the wards and electronic results
                                                    located onto the site enabling more           of radiology and pathology. We have started
                                                    patients to experience a “one-stop” visit     to develop the following:
                                                    for a GP appointment and diagnostic           • A system to implement e-pathology and
                                                    services. Other services planned are an          radiology requesting
                                                    integrated chronic disease centre, a North    • A business case for e-prescribing
                                                    East Laparoscopic Surgery Institute, and      • A pilot for e-hospital at night (an
                                                    additional bed capacity.                         integrated record of high risk patients)
                                                  • We opened two new wards at North
                                                    Tyneside General Hospital. One ward           Environmental Management
                                                    provides a stroke rehabilitation service      The Trust Estates and Facilities Advisory
                                                    and the second ward has enhanced              Board agreed, at its January meeting, to
                                                    intermediate care capacity for North          identify three priority areas for action and set
                                                    Tyneside Primary Care Trust. These            up sub-committees to take them forward. The
                                                    developments cost £4,500,000.                 priorities identified are:
                                                                                                  Priority 1     Energy Management
                                                  The Board of Directors has continued with its
                                                                                                  Priority 2     Waste Management
                                                  commitment to the long-term success of
                                                  local community hospitals. The Board has        Priority 3     Transport
                                                  commissioned business cases for the re-
                                                  development of:

18
personalising
                                                               This is seen as an important area for action, the   work has provided evidence of how we can
                                                               membership of the sub-committees will include       develop our organisation to provide a higher
                                                               members of our Governors Body, who will work        standard of clinical care and productivity. This
                                                               closely with Estates department staff to            is explained in section 2.

our healthcare                                                 produce strategic action plans which focus on:
                                                               reducing energy consumption, reducing and
                                                               recycling waste and transportation.
                                                                                                                   Vulnerable Adults
                                                                                                                   Northumbria Healthcare NHS Foundation
                                                                                                                   Trust has demonstrated its commitment to its
                                                               Improved Productivity                               role as a partner organisation in safeguarding
We are operating in the top 25% nationally                     We are operating in the national top quartile       adults and plays a key role by working with
                                                               (ie top 25%) compared to other general              the other agencies. To do this we have a
compared to other general hospitals of this size               hospitals of this size and complexity. The          steering group with executive leadership. We
                                                               table below confirms the comparison.                have developed the Trust’s policy on
and complexity.                                                                                                    safeguarding adults which was ratified at the
                                                               However, we are not complacent. We worked
                                                                                                                   Trust wide Governance Committee (TWGC) in
                                                               with three external companies that specialise
                                                                                                                   February 2007. The most significant
                                                               in healthcare benchmarking in the UK and the
                                                                                                                   development last year was to commence
                                                               USA, that is, McKinsey Consulting, Jonathan
                                                                                                                   awareness training. This is being rolled out
                                                               Bailey    Associates    and     International
                                                                                                                   across the Trust over three years.
                                                               Healthcare Advisory Board. This development


             Strategic Performance Indicator     Base-line period              Base-line data         05/06           Current position         Target March 08

Referrals for outpatient visit                      Apr-Dec 2005                    64842               —               62395 (-3.8%)                0%

Trust elective mean length of stay (days)         2004/05 (England)                  4.7               5.4                   4.8                     4.4
                                                     2006/07 qtr 1
Basket of 25 day case rate                                                          76.5%              74%                   76%                     84%
                                                 (National top quartile)
Trust non-elective mean length of stay (days)*    2004/05 (England)                  7.4               6.1                   5.4                     5.7

Patients with a planned discharge                     Audit 06/07                    4%                n/a                   4%                      50%

Patients discharged by 11am                           Audit 07/08                    n/a               n/a              Starts in 07/08              50%

Bed Occupancy (General and Acute)                       2005/06                     86%                86%                79% (Dec)                  90%

Utilisation of ITU/HDU: number of ward stays        Apr–Dec 2005                     956                —               1036 (+8.4%)                 956

Emergency readmissions within 28 days                   2004/05                      8%                 9%                   8%                      8%

*Includes patients with a stay in the Rapid Access Treatment Unit
                                                                                                                                                                 19
personalising
                                                   Service Investment                                Capital Investment and Borrowing
                                                   The Trust has delivered on its commitments        There has been significant capital investment
                                                   to invest in clinical services. The investments   in clinical services, with expenditure of
                                                   were:                                             £9.742 million. This investment enabled us to

our healthcare                                     • Additional staff to provide a children’s
                                                     ambulatory service at Wansbeck General
                                                     Hospital at a cost of £200,000
                                                                                                     enhance our patient services and
                                                                                                     environment by:
                                                                                                     • Starting the re-development of wards 5
There has been significant capital investment in   • Improved patient information leaflets to          and 7 at North Tyneside General Hospital
                                                     meet the Clinical Negligence Scheme for           to provide an enhanced patient
clinical services, with expenditure of £9.742        Trusts (CNST) Level 2 standards at a cost         environment and patient flow at an initial
                                                     of £50,000                                        cost of c£500,000. The total cost rising to
million.                                           • Increased staff numbers to provide faster         £2,000,000 by 2009
                                                     access to our diagnostic services at a cost     • The purchase of ward medical and
                                                     of £250,000                                       surgical equipment at a cost of £1,546,000
                                                   • £170,000 set aside to implement a               • Enhancing our clinical information
                                                     strategic review of our catering service          technology by developing electronic
                                                   • Additional nursing and domestic staff             radiology and pathology requesting and
                                                     appointed to enable our trained nursing           reporting. This is the first step in an
                                                     staff to give more time to our patients.          electronic patient record. £1,500,000 was
                                                     This will cost £300,000 when fully                allocated
                                                     implemented                                     • Starting the building of a local renal
                                                   • Establishing a local sleep apnoea service         dialysis service at Wansbeck General
                                                     at a cost of £250,000                             Hospital at a cost of £500,000
                                                   • Supported our local ambulance service by        • Purchasing furnishings and fittings for the
                                                     investing £120,000                                new Rothbury Hospital at a cost of
                                                                                                       £130,000
                                                   • Establishment costs of NHS Foundation
                                                     Trust to support the enhanced                   • Increasing the electrical capacity at
                                                     governance arrangements at a cost of              Wansbeck General Hospital to support
                                                     £150,000                                          current and future service needs at a cost
                                                                                                       of £750,000
                                                   • Set aside resources for our planned
                                                     depreciation costs to improve our patient       • Investing in the Central Sterile Services
                                                     environment – £1,050,000.                         department to meet latest regulatory
                                                                                                       requirements. This the final year of a
                                                                                                       three-year investment plan. £600,000 was
                                                                                                       allocated. The total cost was £3,000,000.
20
our financial
                                                   Northumbria Healthcare has a strong track          months accounts covering the period 1
                                                   record in terms of financial performance,          August 2006 to 31 March 2007 which are
                                                   having broken even and met all the required        published here and begin on page 63.
                                                   financial targets in every year since
                                                                                                      The table below sets out the actuals for both

performance
                                                   becoming a NHS Trust. We have built on this
                                                   success in the past year.                          of these accounting periods, as well as the
                                                                                                      year overall. When the financial year 2006/07
                                                   In the year 2006/07, we have produced two          is taken as a whole, the Trust achieved a
                                                   sets of annual accounts to reflect the fact that   surplus of £620,000.
                                                   we officially became a NHS Foundation Trust
Northumbria Healthcare has a strong track          on 1 August 2006. We will therefore publish a      In our first accounting period as a NHS
                                                   four month set of accounts for the period          Foundation Trust, the eight months to 31
record in terms of financial performance, having   prior to becoming a Foundation Trust (1 April      March 2007, the Trust made a surplus of
                                                   to 31 July 2006), in addition to the eight         £618,000.
broken even and met all the required financial

targets in every year since becoming a NHS

Trust.
                                                                                     Apr 1–Jul 31          Aug 1–Mar 31
                                                                                                                                      Total
                                                                                         2006                  2007
                                                                                                                                     £000s
                                                                                        £000s                 £000s

                                                   Income                                   85,966                167,644               253,610

                                                   Expenditure                              -83,690              -165,603              -249,293

                                                   Operating Surplus                         2,276                 2,041                 4,317

                                                   Profit on disposal of Assets                  0                  2,961                 2,961

                                                   Interest etc                                 51                   266                   317

                                                   PDC                                       -2,325                -4,650                -6,975

                                                   Surplus/(deficit)                             2                   618                   620




                                                                                                                                                  21
our financial
                                               Financial performance                             Trends in activity, income and
                                               The £620,000 surplus is primarily due to          expenditure
                                               increased activity leading to an increase in      The charts 1 to 5 overleaf show activity,
                                               income from Primary Care Organisations            income and expenditure growth over a three

performance                                    (PCOs). The increase in activity and related
                                               income was largely offset by the increased
                                               costs associated with providing this
                                               additional work, hence the increase in
                                                                                                 year period from April 2004 to March 2007.
                                                                                                 The Trust has seen sustained demand for its
                                                                                                 services and consequential income and
                                                                                                 expenditure increases over this period.
The Trust launched a service development       expenditure during the year.                      Looking forward we predict similar levels of
                                                                                                 demand to continue. We have submitted
                                               The Trust made a gain in the year due to a        detailed plans to Monitor, the independent
strategy designed to imporve the quality,      land swap transaction. This gain was offset       regulator for Foundation Trusts, which
                                               by the impact of Agenda for Change. Both of       include forecasts to this effect. These are also
efficiency and effectiveness of services for   these items were non-recurring and will not       described in the Trust’s Annual Plan 2007/08.
                                               be an issue for 2007/08.
patients.                                                                                        Patient activity was broadly in line with the
                                               In 2006/07 the Trust launched its service         Trust’s forecasts. However, it was
                                               development strategy designed to improve          substantially higher than Commissioner
                                               overall efficiency both in financial terms, for   forecasts. The Trust has received the income
                                               example through better use of Trust assets,       from Commissioners in line with the patient
                                               and operationally, for example by reviewing       activity and our contracts with them.
                                               and redesigning organisational processes to
                                               increase effectiveness. The overall aim is to
                                               improve the quality, efficiency and
                                               effectiveness of services for patients, and to
                                               make the Trust a better and more efficient
                                               place for staff to work. Underpinning the
                                               programme is a determination to reduce the
                                               overall cost base of the Trust and to reinvest
                                               the resources saved into more effective
                                               service delivery and other improvements. In
                                               order to achieve this financial headroom going
                                               forward, challenging savings plans are linked
                                               to the service development strategy.

                                               In 2006/07 the Trust’s plans to save £6.2
                                               million were achieved.
22
                                                     Chart 1 Finished Consultant Episodes ’000s

                                                                         2004 - 05




                                                        Financial Year
                                                                         2005 - 06



our financial                                                            2006 - 07



performance                                                                          0

                                                                                         Day Cases
                                                                                                    20           40           60

                                                                                                                Elective In-patients
                                                                                                                                          80             100

                                                                                                                                               Non-elective In-patients
                                                                                                                                                                       120




Inpatient and day case activity was slightly
                                                     Chart 2 Outpatient Attendances ’000s
down on the previous year in terms of volume
                                                                         2004 - 05
but this was in line with the annual plan agreed




                                                       Financial Year
with commissioners and over-performed in                                 2005 - 06


monetary terms due to a more complex case
                                                                         2006 - 07
mix.

                                                                                     0              50          100         150         200        250           300

                                                                                         New             Follow up
Outpatient attendances continued to show an

increase and significantly over-performed            Chart 3 A&E Attendances ’000s

against the contract with commissioners.                                 2004 - 05
                                                       Financial Year




                                                                         2005 - 06
Accident    and     Emergency       attendances

remained in line with the previous year’s activity
                                                                         2006 - 07

and the annual plan.
                                                                                     0         50         100         150         200    250       300         300

                                                                                                                                                                             23
our financial
                                                     Chart 4 Total Income (£000,000)
                                                     Chart 4 shows the growth in income over the three year period April 2004 to March 2007.




performance                                                            2004 - 05




                                                     Financial Year
                                                                       2005 - 06
Income has grown at an average of nine
percent per year, which is around four percent
above NHS inflation funding increases. The                             2006 - 07


increase is as a result of the additional activity
                                                                                   190   200   210   220   230   240   250   260
and more complex case mix referred to above.

                                                     Chart 5 Total Expenditure (£000,000)
Expenditure has grown at an average rate of          Chart 5 shows the growth in expenditure over the three year period.
nine percent per year. This was in the main as a
result of additional staff and non pay
                                                                       2004 - 05
consumable costs required to deliver the
                                                      Financial Year




additional activity referred to above.
                                                                       2005 - 06


There have been a number of significant
                                                                       2006 - 07
changes in the Trust’s balance sheet and
working capital during the year. The Trust ended                                   190   200   210   220   230   240   250   260
the year with £5.8 million cash in the bank,
against a plan of £3.7 million.


24
our financial
                                                   Capital Expenditure 2006/07
                                                                                4 months                  8 months                       Total
                                                                                1.4.06–31.7.06           31.7.06–31.3.07             1.4.06–31.3.07



performance
                                                                                     £000                     £000                        £000
                                                                            NHS Funded      Donated   NHS Funded     Donated    NHS Funded       Donated


                                                   Buildings                     312              0        971              0        1,283             0
Capital expenditure in 2006/07 was on
                                                   AUC                          1,453             0       2,091             0        3,544             0

protected assets and included backlog              Plant/Machinery               176             90       2,987            89        3,163           179

maintenance to the Trust estate, medical           IT                            227              0       1,024            13        1,251             13

                                                   Furniture/Fittings                0            0          3              6            3             6
equipment and investment in new IT projects.
                                                   Software                      300              0          0              0          300             0

                                                                               2,468             90      7,076            108        9,544           198

Pay for the Trust’s most senior managers is        WGH land swap value – not cash                         2,900                      2,900

determined by the Trust’s Remuneration                                                                    9,976                     12,444


Committee, which consists of the Chairman and      Management Costs
the   Non-Executive    Directors.   Details   of                                4 months                   8 months                       Total
                                                               --               1.4.06–31.7.06            31.7.06–31.3.07             1.4.06–31.3.07
remuneration, including the salaries of the                                              £000                     £000                    £000
                                                   Management Costs                 2,818                   6,094                       8,912
Board of Directors, are published in the annual
                                                   Income                        85,157                   165,984                     251,141
accounts.                                          Management costs as a
                                                   percentage of adjusted                3.31%                    3.67%                      3.55%
                                                   income

                                                   Management costs are defined in the document ‘NHS Management
                                                   Costs 2002/03’ which can be found on the internet at
                                                   http://www.dh.gov.uk/PolicyAndGuidance/Organisation/Policy/FinanceAndPlanning/NHSManagementCosts/fs/en
                                                                                                                                                            25
our financial
                                                    Private patient cap                                  ensure independence has not been
                                                    In accordance with Foundation Trust                  compromised. For 2006/07 in addition to the
                                                    legislation, the Trust’s private patient income is   statutory audit, PricewaterhouseCoopers, the
                                                    to be capped at 0.09 per cent of income from         Trust’s external auditors, also provided tax

performance                                         patient care activities, based on the Trust’s
                                                    2002/03 financial outturn. The Trust remained
                                                    within the private patients cap during 2006/07.
                                                    Our plans assume that private income will
                                                                                                         advice on salary sacrifice schemes for
                                                                                                         £21,561 and carried out an 'Auditors Local
                                                                                                         Evaluation' assessment for £15,000.
Total value of what the Trust borrows must be                                                            Directors audit statement
                                                    remain constant in real terms, and will
                                                    therefore remain within the required limit.          So far as Directors are aware, there is no
within it’s Prudential Borrowing limit. The trust                                                        relevant audit information of which the
did not need to borrow against it’s limit during    Prudential Borrowing Limit                           auditors are unaware and the Directors have
                                                    A Prudential Borrowing Limit (PBL) for the           taken all of the steps that they ought to have
2006/07                                             Trust is set by Monitor, and is to be reviewed       taken as Directors in order to make
                                                    at least once a year. The total value of what        themselves aware of any relevant audit
                                                    the Trust borrows must be within this                information and to establish that the auditors
                                                    Prudential Borrowing Limit. Monitor sets the         are aware of this information.
                                                    limit with reference to financial ratios and the
                                                    Trust’s working capital facility. As expected,       Audit Committee
                                                    the Trust did not need to borrow against its         The Audit Committee, as a sub committee of
                                                    Prudential Borrowing Limit during 2006/07.           the Board, is responsible for ensuring that
                                                    Performance against the PBL indicators is            robust systems of internal control and
                                                    described in note 24 of the final accounts.          integrated governance are in operation, this
                                                                                                         includes a review of financial controls,
                                                    External audit services                              financial information and compliance with
                                                    The     Governors     Body     agreed      that      law, guidance and codes of conduct. It deals
                                                    PricewaterhouseCoopers should be the                 with issues arising from the work of the
                                                    Trust’s external auditor for 2006/07. The            external auditors and internal audit service.
                                                    provision of external audit services for future
                                                    years was recently the subject of a tender           During 2006/07, the Trust’s Audit Committee
                                                    exercise and it was agreed by the Governors          was formed from the following members:
                                                    Body that from 2007/08 onwards these                 Non-Executive Directors:
                                                    services would be provided by KPMG.
                                                                                                         N Mundy (Audit Committee Chair)
                                                    The Trust manages work done by the                   I McMinn
                                                    external auditors outside of the audit code to       L Garrett
                                                                                                         D Thompson
26
our financial
                                                 Going concern                                       present both opportunities and threats to our
                                                 After making enquiries, the Directors have a        future operation. These are:
                                                 reasonable expectation that the NHS                 • The national Patient Choice initiative;
                                                 Foundation Trust has adequate resources to          • Demand and Referral Management

performance                                      continue in operational existence for the
                                                 foreseeable future. For this reason, they
                                                 continue to adopt the going concern basis in
                                                 the preparation of the accounts.
                                                                                                     • Potential Changes to Payment by Results;
                                                                                                     • Increases in independent sector provision.

The Trust has set itself challenging financial                                                       Using an economic model developed as part
                                                 Monitoring Trust performance                        of the Trust’s strategy work, it was concluded
targets for the next three years. These aim to                                                       that, on balance, the threats associated with
                                                 The Trust has developed a balanced
                                                                                                     this rapidly changing external environment
deliver a cumulative surplus of £6.4 million     scorecard      to    review    and      monitor
                                                                                                     generally outweighed the potential gains.
                                                 performance at a Trustwide, divisional and
which would then be available to reinvested in   service     delivery    unit   (SDU)       level.   Responding to potential financial
                                                 Incorporated within this are the metrics used       risks
development opportunities.                       by Monitor to assess the financial risk rating      In responding to these potential risks, in
                                                 of the Trust. Monitor uses four criteria to         particular the change and uncertainty we
                                                 assess the Trust’s financial risk rating;           face in terms of the external environment, the
                                                 underlying        financial      performance,       Trust set itself challenging financial targets for
                                                 achievement of the financial plan, financial        the next three years. These aim to deliver a
                                                 efficiency, and liquidity. Overall the Trust        cumulative surplus of £6.4 million which we
                                                 achieved a risk rating of three, within a range     would then be able to reinvest in
                                                 of one to five, where five is the best              development opportunities.
                                                 performance.

                                                 Identifying potential financial risks
                                                 In assessing the financial risks faced by the
                                                 Trust, we have assessed the external factors
                                                 which are likely to impact on the
                                                 organisation. The external environment in
                                                 which the Trust, along with all other NHS
                                                 organisations, must operate is changing in
                                                 an unprecedented way. Through our
                                                 strategic    development       work,    senior
                                                 managers and clinical leaders in the Trust
                                                 have identified four key drivers of change that

                                                                                                                                                    27
our financial
                                              Strategy                                       Better Payment Practice Code (BPPC)
                                              As part of the work to develop the Trust’s     The Trust is working towards compliance with
                                              service strategy, the agreement of a high      the Better Payment Practice Code target,
                                              level vision and strategic themes has been     which is payment of all non NHS creditors

performance                                   complemented by detailed service planning
                                              at a specialty level. 2007/08 will see the
                                              implementation of Service Line Reporting
                                              (SLR) across all Business Units within the
                                                                                             within 30 days of receipt of goods or a valid
                                                                                             invoice (whichever is the later) unless other
                                                                                             payment terms have been agreed with the
                                                                                             supplier. For 2006/07 the Trust paid 61% of
The Trust is committed to promoting and                                                      invoices to this timescale.
                                              Trust.
maintaining an absolute standard of honesty                                                  No payments were made by the Trust in
                                              Countering fraud and corruption
                                              The Trust is committed to promoting and        respect of claims made by small businesses
and integrity in dealing with our assets.                                                    under the Late Payment of Commercial
                                              maintaining an absolute standard of honesty
                                              and integrity in dealing with our assets. We   Debts (Interest) Act 1998.
                                              are committed to the limitation of fraud or
                                              illegal acts within the Trust, and ensure
                                              rigorous investigation and disciplinary or
                                              other action as appropriate. The Trust uses
                                              best practice, as recommended by the NHS
                                              Counter Fraud and Security Management
                                              Service (CFSMS), and is also involved in the
                                              National Fraud Initiative, led by the Audit
                                              Commission.

                                              Over the year we have widely publicised our
                                              procedure for staff to report any concern
                                              about potential fraud and corruption, and
                                              reinforced this with awareness training. Any
                                              concerns are investigated by our local
                                              counter fraud specialists or CFSMS as
                                              appropriate, and all investigations are
                                              reported to the Audit Committee.
listening
                                                   The Trust is committed to listening to all      and explaining how the operation or
                                                   forms of feedback from patients concerning      procedure had gone afterward. Patients
                                                   their experiences as service users. This        know about medication side effects to
                                                   Feedback from patients and service users is     watch for and receiving copies of letters
                                                   then used in a continual improvement            sent between hospital doctors and the GP  .
                                                   process. This is achieved in a number of

to our patients                                    ways:
                                                   • learning from surveys
                                                   • improving communication and information
                                                                                                 Action taken from the survey:
                                                                                                 • Over 98% of patients wait a maximum of four
                                                                                                   hours for admission; however, in our survey
                                                                                                   results, patients have suggested that this is
                                                   • listening to informal feedback                too long a wait. The trust intends to
The Trust is committed to listening to all forms
                                                   • involving volunteers, support groups and      undertake a patient survey of patients’
of feedback from patients concerning their           the community                                 experiences and determine what more could
                                                   • learning from incidents, complaints and       be done to improve the waiting time.
experiences as service users.                        claims                                      • We do well to provide single sex sleeping
                                                                                                   areas, but the use of bathrooms by the
                                                   Learning from the National Patient’s            opposite sex is being reviewed and we
                                                   Survey                                          need to enhance our cleanliness
                                                   The national inpatient survey demonstrated      standards, which is being tackled through
                                                   that we are in the top 20% of hospitals for     a review of Domestic Services and Internal
                                                   • Privacy and dignity, such as when being       PEAT inspections involving the Patient and
                                                     examined in the Emergency Department,         Public Involvement Forum and our Public
                                                     and in discussing their condition or          Governors.
                                                     treatment generally, as well as providing   • Patients do not rate our food well and a
                                                     single sex sleeping areas.                    strategic review of our catering service
                                                   • Not changing admission dates and              was undertaken. The outcome was a
                                                     ensuring discharges are not delayed.          recommendation to invest £1,000,000 in a
                                                   • Doctors washing or cleaning their hands       complete overhaul of the system,
                                                     between touching patients                     providing higher quality of food and more
                                                   • Giving information in a range of areas,       choice. This was approved by the Board
                                                     such as about the patient’s condition or    • Patients want more time to talk to nursing
                                                     treatment, explaining what would be done      staff. The review of our nursing staff
                                                     during the operation or procedure,            numbers on acute wards was completed
                                                     answering questions about it, telling         in March and the outcome is an increase
                                                     patients how they would expect to feel        in the planned investment of £500,000 to
                                                                                                   £1,035,000.
                                                                                                                                             29
                                            We received positive feedback from patients        • protected mealtimes being introduced



listening                                   about our discharge arrangements. However,
                                            we recognised the service could be
                                            enhanced and improved by the involvement
                                            of former patients, the local community and
                                            volunteer representatives
                                                                                               • car parking signage being amended to
                                                                                                 clarify arrangements for specific groups of
                                                                                                 patients and visitors such as those
                                                                                                 attending the chemotherapy unit.


to our patients                             Improving Communication and
                                            Information
                                                                                               The Patient Advice and Liaison Service which
                                                                                               is run independently as part of a consortium
                                                                                               arrangement with local trusts, is incorporated
                                            We are committed to improving patient and          in the Trust’s governance processes. Hospital
Patient leaflets have been revised with     carer information. The Trust invested £50,000      volunteers also liaise closely with staff on a
                                            to meet the higher standards of the NHS            range of practical issues, from the need to
involvement from patients and our Patient   Litigation Authority. Patient leaflets have been   improve information, to commenting on Trust
                                            revised with involvement from patients and         initiatives and problems, such as patients
Information Advisory Group which includes   our Patient Information Advisory Group which       waiting in outpatient departments and
                                            includes both public and staff governors. We       involvement in focus groups about managing
both public and staff governors.            have seen the improvement in patient               medicines.
                                            experience reflected in the results of the
                                            national inpatient survey. We are in the top       There are many examples available to
                                            20% for patient information: 63% of patients       demonstrate how the Trust has changed the
                                            said they received a copy of their consultant      way services are provided in response to
                                            discharge letter sent to their GP Our provision
                                                                              .                patient feedback. This includes: the opening in
                                            of interpreting and translation has also           October of a new locally provided respiratory
                                            demonstrably improved with a 24% increase          outpatient clinic in Berwick, which has reduced
                                            reflecting the implementation of ideas             the need for patients to travel to Ashington; the
                                            received from patients and the local deaf          introduction in February of evening and
                                            community.                                         weekend orthopaedic clinics in North Tyneside
                                                                                               and Ear Nose and Throat (ENT) clinics being
                                            Listening to Informal Feedback                     held on Saturday mornings. All of these
                                            A range of informal feedback opportunities         innovations have proved popular with patients
                                            are available to patients and visitors.            because they involve either less travel, time off
                                            Feedback from our suggestion schemes has           work, or fit with caring commitments.
                                            resulted in improvements such as:

                                            • website information being updated and
                                              improved

30
                                                    Involving Volunteers, Support Groups                There is a comprehensive programme to



listening                                           and the Community
                                                    There are now over 500 volunteers registered
                                                    with the Trust. The Trust liaises with and
                                                    provides contact and support for patient
                                                    groups in a range of different services for
                                                                                                        involve local schools in the Trust’s arts
                                                                                                        programme. Berwick High School has been
                                                                                                        supporting the Trusts International Link with
                                                                                                        Kilimanjaro Christian Medical Centre in
                                                                                                        Tanzania and other schools have helped with

to our patients                                     example:
                                                    • The Hospital Volunteer Service, and
                                                      associated groups
                                                                                                        design projects which are now on display.
                                                                                                        Hexham High School has designed new flags
                                                                                                        for the hospital and 3 local schools in Rothbury
                                                                                                        have worked with a professional artist to
                                                    • the Total Hip User Group                          design glass art in the new community
The Trust has many volunteers who generously
                                                    • Prostate and Breast Cancer Support                hospital.
give up their time to provide support by              Groups
                                                    • Inflame (Rheumatology)                            Learning from Incidents, Complaints
fundraising,    supporting      patients    with    • League of Friends
                                                                                                        and Claims
                                                                                                        INCIDENTS
information, providing a listening ear or helping   The Trust has many volunteers generously            a) Serious Untoward Incident
                                                    giving up their time to provide support by          A serious untoward incident generally is an
staff improve patient experience.                   fundraising,     supporting      patients    with   incident or accident occurring on health
                                                    information, providing a listening ear or helping   service premises or in relation to health
                                                    staff improve patient experience. This includes     services provided in other settings, resulting
                                                    providing a trolley service to wards, a meet and    in death, serious injury or harm to patients,
                                                    greets service and informational help in            staff or the public, significant loss or damage
                                                    Outpatients. Volunteers at North Tyneside have      to property or the environment, or otherwise
                                                    been involved throughout the year in the            likely to be of significant public concern. The
                                                    design and planning of a new cafe in North          Trust takes all incidents seriously and a full
                                                    Tyneside General Hospital, for which they           investigation is undertaken for those of a
                                                    raised in excess of £250,000.                       serious nature or those where there may be
                                                    We continue to work closely with the North          significant learning. Two examples of
                                                    Tyneside Coalition of Disabled People,              incidents that resulted in learning are:
                                                    particularly in relation to the equality schemes    A. Following three incidents of power failure
                                                    and the Trust accessibility programme. An              at Wansbeck General Hospital over five
                                                    audit of Trust hearing loop systems was                years the Trust has invested £800,000 in
                                                    initiated as a result of feedback from the             a new generator.
                                                    Coalition and patients.

                                                                                                                                                      31
                                                   B. A patient was given incorrect blood (the       year and the following changes have been



listening                                             patient suffered no harm). This happened
                                                      during a power cut with no apparent light
                                                      available in the blood bank and the
                                                      correct procedure for checking the
                                                      patient’s identity was not adhered to. As a
                                                                                                     made in order to help reduce and eliminate
                                                                                                     the risk of falls to patients.

                                                                                                     A Project Development Manager (NSF for
                                                                                                     Older People) has been working on a fall

to our patients                                       result of this incident a number of
                                                      changes have been implemented to
                                                      including:
                                                                                                     project focusing on in-patient management
                                                                                                     and links to work already occurring in out
                                                                                                     patient clinics and the community. The aim is
                                                      - nurses reminded of the importance of         to promote a seamless package of care
                                                                                                     which is patient focused, starting at point of
The aim is to promote a seamless package of             carrying out correct blood
                                                        administration procedure                     admission through to discharge.
care which is patient focused, starting at point      - Porters have been reminded of                A pilot project was established on four wards
                                                        procedures for collecting blood              at Morpeth and Blyth with the following aims:
of admission through to discharge.                    - Review of emergency lighting provision       • Use of the Newcastle fall risk assessment
                                                        with porters                                 • Assess the efficiency of the falls risk
                                                      - Trust wide awareness of “E” (emergency         register
                                                        lighting) switches in risk management        • Determine the strategies appropriate in an
                                                        newsletter to all staff and discussed at       acute setting
Accidents                          4130   42%           Health and Safety meetings
including slips, trips and falls                                                                     • Assess the training needs of staff and
Clinical Incidents                 4076   41.5%    b) General Incidents                                support them in the use of the tool and
Including pressure ulcers
                                                   Last year, staff reported 9,800 incidents. The      management of patients
Violence and Abuse                  964   10%
                                                   table on the left gives a summary of these        • Analyse the pilot data and evaluate the
Security incident                   333   3.3%     incidents:                                          impact of the project on fall rate
Complaint                           116   1.3%
                                                   Incidents by Type                                 Two Falls Nurse specialists were appointed.
Other                                63   0.72%    The following section highlights some             Each ward and department is identifying links
                                                   specific examples of how patient care has         to these nurses. At Berwick Hospital falls risk
Fire incident                        49   0.50%
                                                   benefited from our learning from these            assessments are undertaken on admission
Vehicle incident                     34   0.34%    incidents.                                        and relevant care plans are put in place. A
Ill health                           31   0.30%                                                      Falls Prevention Group has also been set up
                                                   c) Slips, Trips and Falls                         at Morpeth and is being led by a Modern
Incidents                             4   0.04%                                                      Matron.
                                                   Out of all incidents reported, 3,629 (37%)
                                                   were as a result of a slips, trips or fall. The
Totals:                            9800   100%     Trust has focused on this area throughout the
32
                                                  d) Pressure Ulcers                                 2006/07 the Trust received 455 formal



listening                                         Some patients arrive in hospital with pressure
                                                  ulcers and some develop these whilst in
                                                  hospital. Pressure ulcers and their severity are
                                                  reported within the Trust and are identified
                                                  where patients are admitted with ulcers. This
                                                                                                     complaints all of which are taken seriously
                                                                                                     and a full investigation is carried out for every
                                                                                                     case. We are open and honest about details
                                                                                                     and share this information with patients,
                                                                                                     carers and families. If a complaint highlights

to our patients                                   year there have been 181 pressure ulcers
                                                  reported. Following an Essence of Care pilot
                                                  it was highlighted that there was a
                                                                                                     the need for change this is actioned, for
                                                                                                     example a patient at North Tyneside General
                                                                                                     Hospital was prescribed medication in error.
                                                  requirement for enhanced staff training. This      This was due to her test results being mixed
We are open and honest about the details of a     has been completed and staff continue to           up with another patient's results. A new
                                                  administer pressure area care and refer            computerised system has now been
complaint and share this information with         patients to dieticians where necessary.            introduced and a medical records audit has
                                                  Essence of Care audits have also been              been carried out to check that the system is
patients, carers and families. If a complaint     completed. The audit tool has now been             working correctly.
                                                  redesigned to ensure adequate feedback is
highlights the need for change this is actioned   gained and a further audit is planned for          CLAIMS
                                                  October 2007.                                      The Trust received 106 claims last year. Of
                                                                                                     the 106 claims, 76 related to clinical
                                                  COMPLAINTS                                         negligence, 25 employer’s liability and 5
                                                  Our performance for formally responding to         public liabilities.
                                                  complaints within 25 working days is still         All claims by Business Unit are summarised
                                                  below 90%. We aim to improve our response          in the table on the following page.
                                                  rate to a minimum of 90% in 2007/08. In




                                                                                                                                                   33
listening
                                                               ALL CLAIMS BY BUSINESS UNIT
                   Emergency Surgery            Emergency Care
                                                                           Clinical Support        Children’s Services         Non Clinical
                    and Elective Care            and Medicine
                             61                         36                        4                        0                           5




to our patients   A breakdown of clinical negligence claims by Business Unit specialty and subject is as follows:

                              CLINICAL NEGLIGENCE CLAIMS BY BUSINESS UNIT/SPECIALTY AND SUBJECT

                                                              Emergency Surgery Elective       Emergency Care        Clinical Children’s
                                                                       Care                      Medicine            Support Services
                                                              General Orthopedic Gynecolog        General
                  Subject                                                                     ECC Medicine     ITU   Radiology Obstetric   Totals
                                                              Surgery      s         y                                            s
                  Failure/delay to diagnose or treat/wrong                                                                                    30
                                                                5         4           0       16       3       0         1         1
                  diagnosis/unexpected death
                  Problems related to Operations                14        4           6        0       1       0         0         2          27
                  Birth defects/problems with delivery/ante                                                                                   7
                                                                0         0           0        0       0       0         0         7
                  and postal natal care
                  Nursing care/treatment                        1         2           1        0       0       1         0         0          5
                  Medication Errors                             0         2           0        0       2       0         0         1          5
                  Other                                         1         0           0        0       0       0         1         0          2
                  Totals                                        21       12           7       16       6       1         2        11          76


                  As part of our continuous learning process                          • carry out regular audits of nursing
                  the Trust aims to introduce changes which                             documentation to ensure patient
                  will benefit patient care. One of the claims                          observations are recorded and acted
                  resulted in an inquest and the lessons learnt                         upon.
                  included:
                  • the need to introduce an enhanced                                 This has been implemented.
                    surgical referral system
                  • implement ALERT training for healthcare
                    assistants

34
working in
                                                    Relationships with local                         b. North of Tyne Commissioners
                                                    commissioners and key stakeholders               95% of our business is commissioned by the
                                                    We believe our long term vision can be           North of Tyne Commissioning Consortium.
                                                    achieved by this Trust working in partnership    There is a structured system in place to
                                                    with our key partners and those about to join    manage and monitor the legally binding


partnership
                                                    the local economy in the next five years. A      contract. This essentially constitutes monthly
                                                    new entrant is the independent sector for        and ad-hoc meetings.
                                                    diagnostics (radiology) and elective care
                                                    from 2005. A general view of our relationship    There are no new service developments
                                                    and interventions in 2006/07 is described        proposed by the Commissioners and there
                                                    below:
We believe our long term vision can be                                                               were no significant revisions to our service
                                                    a. Practice Based Commissioners                  portfolio.
achieved by this Trust working in partnership       A system has been established to engage the      c. North East of England Strategic Health
                                                    executive team with local clinical practice
                                                                                                     Authority (SHA)
with our key partners and those about to join the   based commissioners at regular intervals
                                                    during the year. An initial first round of       The North East of England Strategic Health
local economy in the next five years.               discussions with each of the 11 Practice         Authority was established in 2006 and is one
                                                    Based Commissioners by our Chief                 of our key stakeholders. There have been two
                                                    Executive and one of our Medical Directors       examples of development work with the SHA.
                                                    has confirmed a generally positive               Firstly embedding the SHA Vision, Passionate
                                                    satisfaction with the quality of care. We are    about Health, by acknowledging the fit
                                                    viewed as their first choice of secondary care   between our five core strategic objectives and
                                                    provider. There were two significant             the seven strategic aims of the SHA which
                                                    suggested improvements. These are being          are; no avoidable deaths, injury or illness; no
                                                    taken forward by the Trust and are:              avoidable suffering or pain; no barriers to
                                                    • discharge summaries for out-patient and        health and well-being; no helplessness; no
                                                      in-patient attendances to be received by       inequality; no waste and no unnecessary
                                                      the General Practitioner and patient within    waiting or delays
                                                      48 hours of discharge. Detailed                The second area of partnership work was
                                                      implementation plans are being                 benchmarking clinical care performance in a
                                                      developed to ensure that by December           joint venture with McKinsey’s Consulting. The
                                                      2008 100% of inpatient and outpatient          Acute Hospitals in the SHA area worked in
                                                      summaries will be sent to GPs within 48
                                                      hours                                          partnership to learn from each other about
                                                                                                     areas of excellence in orthopaedics and
                                                    • browsable electronic radiology and
                                                      pathology requesting and reporting in use      general medicine.
                                                      in all wards and general practitioner
                                                      surgeries by early 2009.
                                                                                                                                                  35
working in
                                                    Our Patients and Public                           provided locally, particularly in rural
                                                    We have a track record of engaging with           communities. The focus this year has been
                                                    patients and the public to re-design our          on the developing obesity strategy and the
                                                    services and listen to their views. Last year     strategic reviews of our community hospitals.
                                                    we invited our elected governors to be
                                                                                                      North East Chamber of Commerce

partnership                                         involved in our strategic reviews. There were
                                                    a total of 10 strategic reviews and there
                                                    comments       have     been     taken
                                                    consideration when deciding the solution.
                                                                                              into
                                                                                                      We are delighted that the North East
                                                                                                      Chamber of Commerce has agreed to be one
                                                                                                      of our co-opted partners at a time when we
                                                                                                      are seeking to strengthen our links with the
Acute Hospitals in the Strategic Health Authority   University of Newcastle upon Tyne                 commercial sector. We look forward to
                                                    Medical School                                    developing our relationship to market our
                                                    In the past 10 years we have built up an          vision and support the business community
area worked in partnership to learn from each
                                                    enviable relationship with the Medical School     achieve healthier workplaces.
other about areas of excellence in orthopaedics     and the University. This has enhanced our
                                                    reputation as an excellent place of learning
                                                                                                      Patient and Public Involvement Forum
                                                    for pre and post-graduate teaching and            The Trust Board views the Patient and Public
and general medicine.                                                                                 Involvement Forum as equal partners. We
                                                    education. We have received strong support
                                                    from the Dean to important changes we have        have worked together on reviewing maternity
                                                    made to our systems of care and also our          services and developing infection control
                                                    strategic vision. We have built on this           standards. They have been actively involved
                                                    relationship by two of our co-opted partners      in the strategic review of the GP out-of-hours
                                                    being from both the Medical School and the        service, nurse staffing levels and our
                                                    University of Northumbria.                        response to Coroner 43 requests, car
                                                                                                      parking, Patient Environment Action Team
                                                    Local Authorities and Local Strategic             (PEAT) inspections and our cleanliness
                                                    Partnerships                                      standards.
                                                    The Trust has a strong track record of working    Newcastle Upon Tyne Hospitals NHS
                                                    closely with North Tyneside Council, North        Foundation Trust
                                                    Tyneside Strategic Health Partnership,            The Chief Executives and Chairmen meet at
                                                    Northumberland County Council, and District       regular intervals to discuss issues of mutual
                                                    Councils: Wansbeck, Tynedale, Castle              interest and seek potential opportunities to
                                                    Morpeth, Berwick, and the Council Overview        work in partnership to deliver improved
                                                    and Scrutiny Committees. Local Authorities        standards of care North of Tyne. Recent
                                                    support the concept of whole systems              opportunities were the use of Hexham
                                                    working given the strategic advantages to         Hospital by Newcastle Consultants to
                                                    maximise efficiency of delivery of care and for   provide orthopaedic services.
                                                    an increased range of services to be
36
risk
                                                The main trends and factors underlying the       reports were provided to the Board at
                                                development, performance and position of         quarterly intervals.
                                                the business are:
                                                                                                 The reports to the Board are available at
                                                • increasing patient activity                    www.northumbria.nhs.uk.
                                                • steady stake in our market share for
                                                  elective and emergency care                    The key constraints on Trust activities are:
                                                • increasing financial headroom                  • the ability to influence the increasing
                                                • increasing local community engagement            regulatory environment
                                                  influencing our strategic and operational      • the ability to maximise integrated care for
Strategic and operational risks were managed      decision making                                  patients and provide more seamless care
                                                                                                   that is more appropriate and value for
by the executive leads working in partnership   The main trends and factors likely to affect       money
                                                future development, performance and
with staff.                                     position are:                                    Review of economy, efficiency and
                                                • improving our reputation for providing         effectiveness of the use of resources
                                                  good customer care                             Our Internal Audit programme agreed by the
                                                • increase in patient choice                     Trust Audit Committee is our main assurance
                                                • starting to conduct patient surveys –          mechanism for ensuring that resources are
                                                  survey at least 7,000 patients and link this   used economically, efficiently and effectively.
                                                  feedback to strategic decision making and      The Audit Committee reports to the Board of
                                                  our appraisal system                           Directors.
                                                • increasing regulatory environment, such
                                                  as patient safety
                                                • increasing emphasis on information,
                                                  management and technology

                                                The relevant strategic and operational risks
                                                were outlined in our Trust Annual Plan
                                                2006/07 which is available on our website at:
                                                www.northumbria.nhs.uk.        These    were
                                                managed by the executive leads working in
                                                partnership with staff to develop appropriate
                                                action plans at the start of the year. These
                                                plans were considered and approved by the
                                                Board of Directors and regular progress

                                                                                                                                              37
valuing
                                                  Our Workforce                                             Choice and to maintain an excellent dialogue
                                                  Our reputation for high quality services                  with staff and to work in partnership The table
                                                  depends on the skill and commitment of our                below explains our staff by professional
                                                  staff. During the year we have continued in               group and the number employed.
                                                  our determination to be an Employer of



our staff
Our reputation for high quality services
                                                              Staff Group

                                                  Medical and Dental
                                                                                           Full Time Equivalent

                                                                                                   409.19
                                                                                                                      Controlled Hours

                                                                                                                            9,941.12
                                                                                                                                            Headcount

                                                                                                                                                 465


                                                  Nursing and Midwifery Registered               1,394.15                  52,275.58            1838
depends on the skill and commitment of our
                                                  Additional Professional Scientific and
                                                  Technical                                         85.36                   2,995.51             113
staff. During the year we have continued in our
                                                  Additional Clinical Services                     793.37                  29,597.56            1448
determination to be an Employer of Choice.
                                                  Administrative and Clerical                    1,099.61                  40,799.43            1494


                                                  Allied Health Professionals                      244.61                   8,797.67             326


                                                  Estates and Ancillary                            439.66                  16,465.00             817


                                                  Healthcare Scientists                            179.10                   6,625.59             196


                                                  NULL                                               1.00                     37.50                1


                                                                                                 4,646.04                167,534.96             6698


                                                  Based on January 2007




38
valuing
                                                    Investments in our Workforce                       Training and Development
                                                    We have invested in our trained nurse staffing     90% of staff in high risk areas are now trained
                                                    numbers and our untrained nurse staffing           in statutory and mandatory training (fire and
                                                    numbers. In 2003/04, we invested £2,000,000        manual handling) compared to 30% of staff in
                                                    in 49 trained nursing staff and 33 untrained       April 2006.



our staff
We have invested in our nurse staffing levels. In
                                                    nursing staff. In 2006/07, we allocated
                                                    £500,000 for investment in trained nursing staff
                                                    posts and staff that would directly support
                                                    nursing staff. The highest priorities were a
                                                    range of specialist trained nursing posts to
                                                    support regulatory training standards, and
                                                                                                       Appraisals
                                                                                                       We have commenced appraisals using the
                                                                                                       new Knowledge and Skills Framework (KSF)
                                                                                                       and are tracking appraisal completion via the
                                                                                                       Human Resource system.
                                                    improved domestic cleaning specifications.
2003/04 we invested £2 million and in 2006/07                                                          Agenda for Change
                                                    The specialist nursing posts were:                 Assimilations under Agenda for Change are
we allocated £500,000.                              • Child protection nurse                           now virtually complete and the Agenda for
                                                    • Blood transfusion nurse                          Change team have now returned to their
                                                                                                       substantive posts.
                                                    • Tissue viability nurse
                                                                                                       Staff Survey
                                                    The     enhanced      domestic    cleaning
                                                                                                       The 2005/2006 staff survey highlighted the
                                                    specification has resulted in £100,000 per
                                                                                                       following issues that were addressed:
                                                    annum for additional domestic hours at
                                                    Wansbeck General Hospital and a similar            a To improve the working relationships
                                                    sum has been carried forward to 2007/08 for           within the team and provide a mediation
                                                    North Tyneside General Hospital.                      service where relationships in the
                                                                                                          workplace have broken down.
                                                    Our investment priorities for nurse investment     b To improve access to training and
                                                    in 2007/08 are acute medical and surgical             improve our attendance rates at statutory
                                                    wards and the community hospitals and this            and mandatory training.
                                                    is explained in detail in section 2.               c To continue to emphasis that zero
                                                                                                          tolerance in terms of harassment and
                                                    Actual ward nursing staff hours have
                                                                                                          abuse from patients and/or relatives is the
                                                    increased further by a reduction in our
                                                                                                          most appropriate standard.
                                                    average sickness absence rate from 12.10%
                                                    in December 2005 to 7.5% in November
                                                    2006. We are determined to drive this down
                                                    further.

                                                                                                                                                    39
valuing
                                                   d To continue to work in partnership with        Significant partnership working has existed
                                                     the staff side representatives on key          over large scale workforce changes such as
                                                     strategic issues. The next few months will     Agenda for Change. Our Partnership Board is
                                                     focus on their involvement in the Trust        well attended by Trade Unions and Executive
                                                     Annual Plan and seeking their views. The       Directors. A non-Executive Director also



our staff
                                                     focus during the year will be to engage        attends on a frequent basis. The agenda for
                                                     staff side in the major change                 this board focuses on change initiatives and
                                                     management programmes to deliver the           strategic issues as well as a regular updates
                                                     Trust Annual Plan.                             on key performance indicators such as
                                                   e Develop the 18 staff governors into a pro-     financial position, sickness absence levels
Consultation with our staff has been a continual     active team to express their ideas and the     and labour turnover.
                                                     views of members to enhance patient
focus during the last year due to the level of       care and support to staff. An event with       As part of the development of Agenda for
                                                     the staff governors is planned in the          Change the Trust have recently established a
organisational change that has been ongoing.         spring to empower the staff governors to       Terms and Conditions sub committee which
                                                     agree their development objectives.            is a partnership meeting to agree those areas
                                                                                                    of local terms and conditions that are not
                                                   f To reduce the incidence of work related        governed by the Agenda for Change
                                                     stress by a number of interventions that       handbook.
                                                     are included in the stress management
                                                     plan. This includes the training of staff in   Consultation with our staff has been a
                                                     the Health and Safety Executive stress         continual focus during the last year due to
                                                     risk standards, the completion of stress       the level of organisational change that has
                                                     risk audits and assessments in areas that      been ongoing. Consultation has included:
                                                     appear to be experiencing difficulties.        • re-development of Morpeth and Berwick
                                                     This is in addition to the support service       Hospitals
                                                     for staff in difficulty that is already in
                                                     place.                                         • introduction of staff car parking charges
                                                                                                      on hospital sites
                                                   Partnership Agreement with Staff                 • re-configuration of catering services at
                                                   Side                                               North Tyneside and Wansbeck Hospitals
                                                   As part of the move to a Foundation Trust        • improvement of domestic cover at
                                                   considerable effort was put into developing a      Wansbeck and North Tyneside Hospitals
                                                   partnership agreement with the 16                • the move to maternity led services at
                                                   recognised Trade Unions and professional           North Tyneside Hospital
                                                   associations that are recognised on the site.


40
valuing
                                                   Examples of consultations currently                workplace stress in the health sector and will
                                                   underway are:                                      benefit from its results and consequent
                                                   • move from weekly to monthly pay for              training later this year.
                                                     approximately 1000 staff
                                                                                                      Disability Equality Scheme
                                                   • movement of the monthly pay date



our staff
                                                                                                      As a Trust we are proud of the support we
                                                   • potential change to staffing levels in           afford to disabled employees, visitors and
                                                     theatres                                         patients.
                                                   • implementation of voice recognition
                                                     dictation systems in clinical areas.             On December 4th 2006 the Trust published
                                                                                                      its first Disability Equality Scheme aimed at
The Disability Equality Scheme will raise the      We are also planning to hold focus groups          promoting disability equality and eliminating
                                                   with a cross section of our staff in the coming    disability discrimination.
awareness amongst our managers and staff of        weeks to develop action plans to improve
                                                                                                      The Disability Equality Scheme contains an
                                                   issues raised in the recent staff survey.
the benefits of working with disabled colleagues                                                      action plan that will enable the Trust to work
                                                   Occupational Health                                towards a culture where people feel safe to
in a mutually supportive environment.              Occupational Health has continued to               disclose their disability. We try to make
                                                   support the organisation during a period of        reasonable adjustments that are necessary to
                                                   rapid change. The implementation of a              attract potential employees and retain existing
                                                   computerised management system will                employees, and celebrate the achievements
                                                   enable the function to analyse referrals by        of our disabled staff thereby highlighting the
                                                   type and area to assist in the identification of   Trust as an Employer of Choice. The Disability
                                                   areas that require specific interventions on       Equality Scheme will raise the awareness
                                                   matters such as work related injuries, stress      amongst our managers and staff of the
                                                   management etc.                                    benefits of working with disabled colleagues
                                                                                                      in a mutually supportive environment.
                                                   The Trust invested in training several staff in
                                                                                                      The scheme was a result of joint partnership
                                                   mediation skills to assist in issues of
                                                                                                      working between the Trust, North Tyneside
                                                   workplace conflict and this service is
                                                                                                      Council, Northumbria Police and North
                                                   managed by the Trust Occupational
                                                                                                      Tyneside PCT. We have developed close
                                                   Psychologist. This new service has been well
                                                                                                      links with North Tyneside Coalition for
                                                   received and has resulted in the successful
                                                                                                      Disabled People and they were central to the
                                                   resolution of a number of conflict issues over
                                                                                                      process of developing the scheme.
                                                   the past 12 months. The Trust participated in
                                                   a Health and Safety Executive research study
                                                   completed by Goldsmiths College into
                                                                                                                                                   41
valuing
                                                All of the policies of the Trust are underpinned   • A quarterly Trust magazine to keep staff
                                                by the principles of equality and fairness and       informed of new services and
                                                we make reasonable adjustments where                 developments across our patch, including
                                                required to ensure disabled colleagues have          information from the Governors
                                                equal access to training and promotion             • A monthly staff briefing which gives the



our staff
                                                opportunities.                                       news in brief
                                                The Trust continues to be accredited with the      • One-off indepth briefings on particular
                                                Two Tick guaranteed interview scheme                 topics of importance to staff
                                                symbol from Job centre plus and we                 • When necessary important messages
                                                guarantee interviews to any candidate who            attached to payslips
We understand the importance of keeping our     has a disability and who meets the minimum         • Newsletters with more in-depth information
                                                requirement for the post.                            from individual Business Units
staff informed of changes and developments on   The Trust Recruitment and Selection training
                                                                                                   • An electronic on-line ‘Message board’ for
                                                                                                     staff to raise issues with Executive
                                                programme for managers contains a section            Management Team and a Staff Message
a regular basis.                                on Equality and stresses the legal                   Board to share messages with other staff
                                                responsibilities of recruiting managers in
                                                terms of discrimination legislation.               • A Trust internal website with extensive
                                                                                                     links to enable staff to fast access to
                                                Staff who may become disabled receive                information on policies / training /
                                                extensive support from the organisation,             vacancies and the latest news via press
                                                particularly the Occupational Health                 releases
                                                department. The Trusts Health at Work policy       • Publication of our annual plan summary
                                                has a section specifically aimed at advising         for 2007/2008
                                                managers on dealing with disability issues.
                                                We have numerous examples of reasonable            This year we introduced:
                                                adjustments being made, of links with access       • Chief Executive’s walkabout – James
                                                to work and of actively redeploying staff to         Mackey and other members of the
                                                other roles in order to retain their services.       Executive Team went out and about
                                                                                                     meeting and engaging with staff at their
                                                Communication with staff                             place of work. This has enabled an open
                                                We understand the importance of keeping              forum to be created where staff can speak
                                                our staff informed of changes and                    face-to-face with the Chief Executive.
                                                developments on a regular basis.                   • Open meetings where Foundation Trust
                                                                                                     Members, staff and public, can air their
                                                We do this by providing information in both          views and join in the discussions that form
                                                electronic and paper format that can be              future strategic developments.
                                                easily distributed across our 10 hospital sites.
                                                We do this by:
42
                                                    The Trust has a national and local reputation       the R&D functions will be taken over by the

teaching and                                        for high quality training of pre and post
                                                    graduate training for medical, nursing and
                                                    professional staff. We aim to attain the same
                                                                                                        recently established topic specific, and
                                                                                                        comprehensive local research networks but
                                                                                                        the reality will be that there will still be a lot of


research &                                          reputation for training (statutory and
                                                    mandatory) training for all staff. During
                                                    2006/07, we have put considerable effort into
                                                    improving this training from below 30% to
                                                                                                        functions required of an in-house R&D
                                                                                                        department.

                                                                                                        The Trust continues to perform well above

development                                         over 90% of staff. A radical review of the
                                                    system and processes is underway to make
                                                    this sustainable.
                                                                                                        the national average for Trusts of a similar
                                                                                                        size for research output. There are more than
                                                                                                        40 registered ongoing pharmaceutical trials
                                                                                                        within the Trust, as well as many other
The Trust has a national and local reputation for   We have an Education and Training Board,            research projects. The R&D department
                                                    led by Professor Roger Barton, Clinical Sub-        provides support for researchers in areas
high quality training of pre and post graduate      Dean, University of Newcastle Medical               such as funding, and ethical, applications,
                                                    School. This Board has recommended that             research methodology and statistical
training for medical, nursing and professional      the Trust invest a further £120,000 to              analyses. We have 4 programmes of
                                                    enhance training opportunities. The Board           research registered with the Department of
staff.                                              intend to measure the percentage of                 Health in relation to the Cullyer funding
                                                    additional staff that benefit from the extra        (gastrointestinal, child health, stroke and
                                                    training opportunities, and this will be            Parkinson’s disease), all of which continue to
                                                    reported in the Annual Report 2007/08.              be very productive. The Teaching and
                                                                                                        Research Fellow programme still continues
                                                    Research and Development                            to be highly successful with a greater than
                                                    Since achieving Foundation status the Trust         90% higher degree completion rate. The
                                                    has continued to regard Research and                research success has a positive knock on
                                                    Development (R&D) as a priority area. The           effect for clinical care and enables the Trust
                                                    R&D department is going through a                   to attract high calibre clinical and academic
                                                    transitional period in relation to future funding   staff
                                                    and good news is that the Cullyer funding for
                                                    2007/2008 will be 80% of the previous
                                                    funding (£158,000) rather than the expected
                                                    50%.

                                                    However Cullyer funding will disappear
                                                    altogether over the next couple of years and
                                                    alternative funding for the R&D department is
                                                    therefore a high priority. In principle, many of
                                                                                                                                                          43
                                                In January 2006, the Government launched a        We plan to develop a clinical trials support

teaching and                                    new research and development strategy,
                                                Best research for best health. The R&D
                                                strategy group has focused a lot of attention
                                                                                                  facility within the Trust to support the LRNs
                                                                                                  and encourage mutual support of staff
                                                                                                  working within the different LRNs. The aim is


research &                                      on the challenges, and opportunities, that
                                                this creates, and an R&D strategy document
                                                for the next 5 years will be produced for
                                                autumn 2007.
                                                                                                  for Northumbria to be a popular, and
                                                                                                  productive, site for LRN involvement such
                                                                                                  that our patients have the opportunity to
                                                                                                  partake in the latest research, should they so

development                                     As the core funding for R&D from Cullyer
                                                decreases, and disappears, over the next 2
                                                years we will need to look towards other
                                                                                                  wish, locally.

                                                                                                  We will make use of the training opportunities
                                                                                                  provided by the research networks for
Trust staff are already influencing local and   sources of income, such as overheads for          Northumbria staff and will continue to provide
                                                clinical trials and funding from grant giving     our own “in-house” training as necessary. We
national research through their involvement     bodies which allow full economic costing. As      will continue to be highly responsive to
                                                part of this we aim to increase collaborative     minimise delays in providing project
with the research networks.                     work with the university.
                                                                                                  approvals and, where necessary, honorary
                                                Trust staff are also actively involved with the   contracts, while continuing to provide a high
                                                recently established topic specific Local         level of research governance to protect staff,
                                                Research Networks (LRN) in diabetes,              patients, and the reputation of the Trust.
                                                stroke, and dementia and neurodegenerative
                                                diseases, and we aim to have an active, and
                                                influential, role in the soon to be established
                                                comprehensive research network. Trust staff
                                                are already influencing local and national
                                                research through their involvement with the
                                                research networks.




44
our organisational                              Governors Body
                                                As an NHS Foundation Trust we established
                                                                                                    membership by members to serve for three
                                                                                                    years. Elections for the 54 positions originally
                                                                                                    took place in March 2006. However, to


structure
                                                a Governors Body (our equivalent of the
                                                Board of Governors as described in the              manage the number of elections held in any
                                                legislation) that met for the first time in April   one year half of these positions will come up
                                                2006. The Governors Body has met on six             for re-election in March 2008. There were no
                                                occasions between 1st August 2006 and 31st          elections held during the year. See Appendix
                                                March 2007.                                         1 for details of the membership of our
The Governors Body provides support and                                                             Governors Body during the year.
                                                The Governors Body provides support and
advice to the Trust to ensure that we deliver   advice to the Trust to ensure that we deliver       Our Governors Body supports the work of the
                                                services that best meet the needs of patients       Trust outside of its formal meetings. Governors
services that best meet the needs of patients   and the communities we serve. It comprises          have the opportunity to concentrate on
                                                36 public and 18 staff governors elected by         specific issues in greater detail than is
and the communities we serve.                   foundation trust members together with 15           possible at a full meeting of the Governors
                                                co-opted representatives nominated from our         Body. Governors play an important role
                                                local partner organisations. The composition        through participation in service reviews and
                                                of the Board of Governors and their                 working groups. They bring their individual
                                                attendance at each meeting is set out in            skills and experiences to these meetings and
                                                Appendices 1 to 3.                                  provide a valuable asset to the Trust. The
                                                                                                    following working groups were active this
                                                The Governors Body fulfils a number of              year:
                                                formal functions such as the appointment of         Estates and Facilities Advisory Board – this
                                                external auditors and the appointment, re-          group reviewed catering and domestic
                                                appointment and removal of the Chair and            services and made recommendations on
                                                other Non-Executive Directors for 3 year            how the Trust could improve service delivery.
                                                terms. The Governors Body may, at a general
                                                meeting, appoint or remove the Chairman             Membership Committee – this group
                                                and the other Non-Executive Directors of the        considered the membership development
                                                Trust, although the decision to remove a Non-       strategy, including initiatives to increase staff
                                                Executive Director would require the support        and public members.
                                                of three quarters of the Governors Body.
                                                                                                    MRSA Steering Group – this group focused
                                                Elections to the Governors Body                     specifically on developing strategies to
                                                The public and staff governors of the               reduce the incidence of hospital acquired
                                                Governors Body are elected from the                 infection.

                                                                                                                                                  45
our organisational                                Board of Directors
                                                  We are recognised as having one of the
                                                  highest quality leadership teams in the NHS
                                                                                                  Executive Directors and the Chief Executive
                                                                                                  leads Director appraisals.




structure                                         such as:                                        All Directors must have an understanding of
                                                                                                  the work of the Trust and of the local and
                                                  • Brian Flood, Chairman, has served for         national health economy to enable then to
                                                    eight years and prior to this was a Non-      properly direct the business of the NHS
                                                    executive Director of the Trust and Leader    Foundation Trust. The Board development
                                                    of the North Tyneside Council.                programme has led us to revise our
                                                  • James Mackey, Chief Executive, has an         membership of the Board to ensure the
All Directors must have an understanding of the     exemplary track record. Jim was               required balance of skills to meet the
                                                    previously the NHS Regional Director of       requirements of a NHS Foundation Trust
work of the Trust and of the local and national     Finance.
                                                  • The Non-Executive Directors on our Trust      Communication of Governors and
health economy to enable then to properly           Board bring a wealth of experience in         Members to Trust Board
                                                    managing large complex public and             Trust Board members are committed to
                                                    private sector organisations and as active    building    effective   engagement      with
direct the business of the NHS Foundation           leaders in the North East community. Our      Governors and foundation trust members.
                                                    Non-Executive Directors provide a well        The challenge is to develop local
Trust.                                              balanced Board which offers the capacity      accountability which has real meaning.
                                                    and capability to lead a successful NHS       Board members apply an open and frank
                                                    Foundation Trust.                             approach in their dealings with Governors
                                                                                                  and members. The following provides a
                                                  We are a unique Trust Board with three          summary of the steps they have taken to
                                                  Medical Directors and Executive Directors.      understand the views of governors and
                                                  They bring substantial NHS clinical and         members:
                                                  management experience as a result of their      • attended governors body meetings
                                                  contributions      to    the   wider    NHS
                                                  improvements, such as, assessors of the         • attended governors and members
                                                  Regional Cancer Peer Review Team,                 constituency meetings
                                                  involvement in the Tynedale GP Multi-fund       • consulted on the content of the Trust
                                                  pilot, involvement in the Kaiser Permanente       Annual plan
                                                  national pilot site, a member of the National   • involved governors in constitutional
                                                  Clinical     Assessment      Authority   and      committees
                                                  participating in national reviews and           • involved governors in a wide range of
                                                  inquiries.                                        service reviews
                                                  All Directors have had an individual            • involved governors in Patient Environment
                                                  performance review carried out this year. The     Action Team visits
                                                  Chair appraises the performance of non-         • Provided timely communication on areas
                                                                                                    of media interest
46
our
                                                 Our Trust is unique covering one of the           each public and staff constituency. Members
                                                 largest geographical areas in England. We         can stand for election and elect
                                                 employ 6,708 staff and operate over eight         representatives to the Governing Body. They
                                                 distinctive and diverse geographical localities   receive information about developments and


membership
                                                 including Berwick, Alnwick, Blyth Valley,         services within the Trust and are able to
                                                 Tynedale, Ashington, North Shields, Whitley       contribute their ideas and suggestions.
                                                 Bay and Hexham. The Trust has two
                                                 membership constituencies:                        Membership Recruitment Strategy
                                                                                                   The Governance Strategy submitted for the
                                                 Public membership constituency – open to          foundation application set out the Trust’s
the Trust is committed to active engagement of   residents over 12 years of age who live in the    approach to increasing its membership. A
                                                 parliamentary constituencies of Berwick           variety of different methods have been used
the local population and its staff in the        upon Tweed, Blyth Valley, Wansbeck and            to recruit members including:
                                                 Tynedale in Northumberland and in the local       • Use of an external company
development and delivery of services.            authority wards of North West Tyneside,
                                                                                                   • Election of governors
                                                 North Shields, Wallsend and Whitley Bay in
                                                 North Tyneside.                                   • Attending voluntary and community
                                                                                                     group meetings
                                                 Staff membership constituency – open to           • Governor get member campaign
                                                 all staff and volunteers employed by the          • Presentations at schools
                                                 Trust. Northumbria Healthcare operates              Northumberland and North Tyneside
                                                 across 10 hospital sites, to ensure members
                                                                                                   • Member get member campaign
                                                 are adequately represented; we have a
                                                 minimum of one staff governor per hospital        • Staff road shows
                                                 site.                                             • Use of key managers to recruit staff
                                                                                                   • Advertising on the website
                                                 Our Membership Community – the
                                                 Heart of our vision                               In October 2006 the Governors Body
                                                 The large geographical area covered by            approved a revised member recruitment
                                                 Northumbria Healthcare clearly presents a         strategy. It was recommended that:
                                                 challenge in the construction of a                1. A staff opt out scheme be introduced.
                                                 membership community. However, the Trust
                                                                                                   2. All new employees be confirmed as an
                                                 is committed to active engagement of the
                                                                                                      NHS Foundation members and are given
                                                 local population and its staff in the
                                                                                                      the option to opt out.
                                                 development and delivery of services. To
                                                 achieve this aim the Trust intends to recruit a   3. Students for work placements, vocational
                                                 large and representative membership for              education, to be confirmed as members.

                                                                                                                                            47
our
                                                    From an initial recruitment of 10,000            Members can contact Governors or
                                                    members in August 2006 the Trust has             Foundation Trust Directors via:
                                                    significantly increased the number of
                                                    members. By 31st March 2007 membership           Telephone: Foundation Membership Office
                                                                                                     on 293 4102


membership
                                                    had reached 15,000. This steep increase has      Post: Foundation Membership Office at
                                                    mainly been achieved through the                 Northumbria Healthcare NHS Foundation
                                                    introduction of the staff-opt out scheme.        Trust, Unit 7/8 Silver Fox Way, Cobalt
                                                    Information on the number of members and         Business Park, Newcastle upon Tyne NE27
                                                    number in each constituency is set out in        OQJ.
                                                    Appendix 8.
                                                                                                     E-mail:
Developing an engaged membership is very                                                             foundation@northumbria-healthcare.nhs.uk.
                                                    Developing the membership
important to both the Governors Body and the        The Trust has revised the total membership       Internet:
                                                    recruitment target from 30,000 to 100,000        www.northumbria-
Board of Directors. Membership is seen as one       members by 2011. The main focus of activity      healthcare.nhs.uk/foundation.
                                                    will centre on recruitment of new outpatients.
way of encouraging people to help us to put         The foundation Trust Membership Committee
                                                    oversees the implementation of the
patients at the forefront of everything the Trust   membership strategy on behalf of the
                                                    Governors Body. Developing an engaged
does.                                               membership is very important to both the
                                                    Governors Body and the Board of Directors.
                                                    Membership is seen as one way of
                                                    encouraging people to help us to put patients
                                                    at the forefront of everything the Trust does.
                                                    The Trust is committed to developing a
                                                    diverse and representative membership
                                                    which recognises and values the variety and
                                                    richness of the life experiences of the public
                                                    we serve. The Trust seeks to use the
                                                    opportunity given to it as a member
                                                    organisation to hear the voices of the people
                                                    who reflect this diversity. An analysis of the
                                                    current membership is set out in Appendix 8
                                                    and demonstrates that this broadly reflects
                                                    the communities we serve.

48
                                                The remuneration of the Executive Directors     All Executive Directors and Directors

remuneration                                    continues to be managed by the
                                                Remuneration Committee (see Appendix 3
                                                                                                completed a performance appraisal with the
                                                                                                Chief Executive. The policy on remuneration




reports
                                                and 5 for membership details). The              does require reference to performance
                                                remuneration of the Non-Executive Directors     appraisal. All Executive Directors and
                                                and Chair is managed by two sub-committees      Directors have permanent contracts of
                                                of the Governing Body.                          employment. Notice periods vary with
                                                                                                seniority, rising from three months to twelve
                                                Trust Board Remuneration                        months. Notice periods are clearly stated in
                                                Committee                                       written particulars of employment. There were
                                                The membership consists of the Chairman,        no termination payments made to Executive
The move to a Foundation Trust increased the    the Chief Executive Officer and non-Executive   Directors or Directors during the financial year.
                                                Directors. During the last financial year a
responsibilities of the Board and Governing     review of Executive Director and Director       Governing Body Remuneration
                                                salaries was carried out. This review took      Committee
Body in relation to managing the remuneration   guidance from a national salary survey on       The membership consists of Staff and Public
                                                NHS Board remuneration completed by             Governors, the Chief Executive Officer, the
of Non-Executive Directors and the Chair.       Income Data Services and reference to other     Human Resources Director. The Chair of the
                                                Trusts.                                         Trust sits only on the Non-Executive Director
                                                                                                Remuneration committee and Non-Executive
                                                During the past twelve months the               Directors sit on the committee relating to
                                                Committee have conducted the following          remuneration of the Chair. During the last
                                                major pieces of business.                       financial year, a review of the remuneration for
                                                                                                the Chairman and Non-Executive Directors
                                                • Review of salaries – Executive Director       remuneration was completed. This review was
                                                  and Chief Executive Officer                   based on guidance issued by the Foundation
                                                • Approval of Local Clinical Excellence         Trust Network and local market comparisons
                                                  Awards and Discretionary Points for           with other NHS Foundation Trusts. The
                                                  Associate Specialists/Optional Points for     recommendations were put forward and
                                                  staff grades                                  accepted at a full meeting of the Governing
                                                • Revision of the Terms of Reference and        Body.
                                                  Process in line with Monitor Governance
                                                  Framework                                     Non-Executive Directors and the Chairman
                                                • Business Unit Director and Medical            hold a service contract which clearly
                                                  Director remuneration levels.                 stipulates that there is no employment
                                                                                                relationship.

                                                                                                                                              49
remuneration
                                                       There is no compensation for loss of office.               Executive and Non Executive
                                                       Periods of office are generally for a period of            Directors:
                                                       three years (as a Foundation Trust). These
                                                                                                                                                                  Period in




reports
                                                       posts are eligible for re-appointment at the               Executive Directors             Name             Office
                                                       end of their period of office but there is no
                                                       absolute right to be re-appointed. A range of              Chief Executive               Jim Mackey      1/8/06–31/3/07

                                                       reasons for termination of appointment are                 Chief Operating Officer        Ann Farrar     1/8/06–31/3/07
                                                       stated in the written particulars. No                      Director of Nursing and        Rosemary       1/8/06–31/3/07
                                                       termination payments have been made in the                 Patient Services              Stephenson
                                                       financial year.                                            Director Of Finance            Paul Dunn      1/8/06–31/3/07

                                                       The remaining term of appointment is shown                 Director of Human             Ann Stringer    1/8/06–31/3/07
                                                                                                                  Resources
                                                       as follows:
                                                                                                                  Director of Elective Care      Ann Wright     1/8/06–31/3/07
Nomination Committee                                                                              Expiry Date     Director of Emergency
                                                            Name               Position           of Contract     Care                          Steve Russell   1/8/06–31/3/07
The Nomination Committee as a sub-committee of
the Board of Governors is responsible for carrying     Brian Flood               Chair             January 2008
                                                                                                                  Medical Director             Michael Weaver   1/8/06–31/3/07
out the process of recruitment and appointment of                                                                 Medical Director             Derek Thomson    1/8/06–31/3/07
the Chairman and Non-Executive Directors. The          Ian Swithenbank         Vice-Chair          January 2008
membership consists of the Chief Executive, Director                                                              Medical Director              David Evans     1/8/06–31/3/07
                                                                         Non-Executive Director
of Human Resources, Governors, and the Chairman        Neil Mundy         Senior Independent       January 2008
                                                                                Director
for   Non-Executive      Director     appointments.                                                                  Non Executive               Name            Period in
Membership and attendance is detailed in               Lorna Garrett     Non-Executive Director   October 2008         Directors                                  Office
Appendices 3 and 5 of this report. There were no new   David Thompson    Non-Executive Director   December 2008   Chairman                      Brian Flood     1/8/06–31/3/07
appointments in 2006/07.
                                                       Ian McMinn        Non-Executive Director    January 2008
                                                                                                                  Non Executive Director        Neil Mundy      1/8/06–31/3/07
Signed:
                                                       The membership and attendance at these                     Non Executive Director       Lorna Garrett    1/8/06–31/3/07
                                                       sub-committees can be found in Appendices
                                                                                                                  Non Executive Director      Ian Swithenbank   1/8/06–31/3/07
                                                       3 and 5 of this report. Details of
                                                       remuneration, including the salaries and                   Non Executive Director        Ian McMinn      1/8/06–31/3/07
                                                       pension entitlements of the Board of
James Mackey                                           Directors are published in the annual                      Non Executive Director      David Thompson    1/8/06–31/3/07
Chief Executive                                        accounts.
4th June 2007



50
audit
                                                This report provides details of the role of the    During 2006/07 the Audit Committee met on
                                                Audit Committee and the work it has                five occasions and presented a report to the
                                                undertaken during 2006 to 2007. The Audit          next Board meeting summarising the key
                                                Committee currently comprises the following        issues discussed. The terms of reference



committee
                                                non-executive directors nominated by the           were reviewed during the year and approved
                                                Board:                                             by the Board. The Chair of the Audit
                                                                                                   Committee also attended the Trust-wide
                                                Neil Mundy (Chair)
                                                                                                   Governance Committee in March 2007.



report
                                                Ian McMinn
                                                Lorna Garrett                                      Key developmental objectives arising from
                                                David Thompson                                     the terms of reference for 06/07 are as
                                                                                                   follows:
                                                The Chair is a qualified accountant. In            • Working towards a standard that would
                                                addition executive and senior managers,              achieve full assurance for key systems
The role of the Audit Commity is to provide     internal auditors and external auditors have all     by March 2008
                                                attended meetings. A summary of the number         • Delivering 100% of the Audit Committee
assurance to the Trust Board that the commity   of meetings and attendance rates of Audit            Handbook recommendations.
                                                Committee members is detailed in Appendix
has met it’s key responsibilities.              5 of this report.
                                                                                                   • Achieving an improved score in the “Use
                                                                                                     of Resources” (KLOE)
                                                The role of the Audit Committee is to provide
                                                                                                   The Audit Committee is asked to endorse this
                                                positive assurance to the Trust Board that the
                                                                                                   draft report for submission to the Board.
                                                committee has met its key responsibilities in
                                                line with its terms of reference and the           Governance, Risk Management and
                                                requirements of the Audit Committee                Internal Control
                                                Handbook for 2006/07. These can be                 The Audit Committee has reviewed the
                                                summarised as follows:                             effective system of governance, risk
                                                • Ensure effective systems of governance,          management and internal control across all
                                                   risk management and internal control            activities (clinical and non clinical) that
                                                • Monitor and review effectiveness of the          support the achievement of the Trust’s
                                                   internal audit function                         objectives. Key achievements include:
                                                • Review the independence and objectivity
                                                                                                   Statement on Internal Control – The Head of
                                                   of external audit
                                                                                                   Internal Audit opinion statement has been
                                                • Monitor the integrity of the financial           received on the effectiveness of the system of
                                                   statements and review internal financial        internal control.
                                                   control systems
                                                                                                                                               51
audit
                                                 The overall opinion is that significant             the operation of the Committee including the
                                                 assurance can be given that there is a              operation of the Risk Register and Assurance
                                                 generally sound system of internal control,         Framework, the HCC Standards and Annual
                                                 designed to meet the organisation’s                 Declaration. In addition, this has helped to



committee
                                                 objectives, and that controls are generally         assure the Audit Committee that the process
                                                 being applied consistently.                         of the Governance Committee is operating
                                                                                                     effectively to identify, assess and action risks.
                                                 There were no significant internal control          In summary the Chair commented that the



report
The Audit Committee has a responsibility to
                                                 issues or gaps in control identified in the
                                                 period 1st April 2006 to 31st March 2007.

                                                 Risk Management – The Audit Committee
                                                 has a responsibility to ensure that the overall
                                                 risk management system is in place and
                                                                                                     system of risk management in the Trust is
                                                                                                     adequate in identifying risks and also allows
                                                                                                     the Board to understand the appropriate
                                                                                                     management of those risks. Points for action
                                                                                                     in respect of risk registers have been
                                                                                                     rectified.
                                                 effective, leaving the operational management
                                                 of risk to the Trust wide Governance                Assurance Framework – the Audit
ensure that the overall risk management system   Committee. This committee has operational           Committee uses the Assurance Framework
                                                 management responsibility for overseeing all        as a key tool for planning its work, to ensure
is in place and effective.                       risk activity including clinical, financial and     that this provides a complete coverage of the
                                                 corporate risk. The Governance Committee            Trust’s objectives at a strategic level and that
                                                 (core team) meets monthly with general              the listings of controls/assurances within it are
                                                 managers, heads of service etc to discuss           reasonable. The Committee business is
                                                 progress with the Standards for Better Health,      focused on compliance with the financial and
                                                 NHSLA risk standards and quarterly to               internal controls aspects of the current service
                                                 discuss risk registers/clinical governance risk     development strategy. The Assurance
                                                 reports. Any emerging high risk issues which        Framework includes the key risks: strategic;
                                                 would have a significant impact on the Trust’s      financial; clinical and operational (including
                                                 strategic     objectives    i.e.   where      the   Standards for Better Health), controls and
                                                 consequence/impact risk score is a 4 or 5           related assurances that underpin the delivery
                                                 (and the likelihood is 3 or greater i.e. coloured   of the Trusts objectives. The Committee has
                                                 brown or red) have been subsequently                reviewed the Assurance Framework and
                                                 referred to the Audit Committee as part of the      believes that it is fit for purpose.
                                                 updated Assurance Framework.

                                                 The Chair of the Audit Committee attended
                                                 the Trust wide Governance Committee on 6th
                                                 March 2007 to gain a better understanding of
52
audit
                                                                Following the Head of Internal Audit Opinion    should assess whether the assurance is
                                                                for the year ended 31 March 2006 a number of    adequate given what is included in the
                                                                changes to develop the Assurance Framework      Assurance Framework.
                                                                further were implemented, namely:
                                                                                                                Standards for Better Health Final


committee
                                                                • The need for the process of identifying and
                                                                  reporting assurance to become                 Declaration – The Audit Committee has
                                                                  prospective rather than retrospective –       reviewed the adequacy of all risk and control
                                                                                                                related disclosure statements (in particular



report
                                                                  some progress has been made and further
                                                                  improvements will continue during             declarations of compliance with the
                                                                  2007/08.                                      Standards for Better Health), together with
                                                                                                                appropriate independent assurances, prior
                                                                • The need for the process to include           to endorsement by the Board.
                                                                  consideration of what is an acceptable
                                                                  level of assurance – this is done via the     The Trust’s final declaration for 2006/07 was
Overall, the Trust achieved full compliance                       quarterly Assurance Framework reports to      submitted in May 2007. Overall, the Trust
                                                                  the Audit Committee and Trust Board           achieved full compliance against each of the
against each of the core standards.                             • The need to include consideration of          core standards and “good” for the
                                                                  whether management assurance is               developmental standards as shown in the
                                                                  sufficient or should independent              table to the left.
                                                                  assurance be sought and at what
                                                                  frequency – as above                          The current self assessment by the Trust
                                                                                                                against the Standards for Better Health is
                                                                • Consideration should be given to how key
                                                                                                                consistent with the Audit Committee’s
                                                                  controls are specified as there are
                                                                                                                understanding gained through the Assurance
                                                                  instances where the assurances listed do
  Trust’s Final Declaration         1st Apr 06 to 31st Mar 07                                                   Framework.
                                                                  not easily or precisely map the assurance
                                                                  to the control – this has been rectified.     Duplications/omissions – The Committee
                                                                                                                has reviewed the underlying assurance
                                                                The Assurance Framework is a developing
                                                                                                                processes that indicate the degree of the
Core Standards                              Fully Met           process and the Audit Committee continues
                                                                                                                achievement of corporate objectives, the
                                                                to work to enhance its effectiveness. In
                                                                                                                effectiveness of the management of principal
                                                                particular the Head of Internal Audit has
                                                                                                                risks and the appropriateness of the above
Developmental Standard – Safety              “Good”
                                                                suggested that Board reports should be
(shadow assessment)                                                                                             disclosure statements. In carrying out this
                                                                more closely aligned to the assurance
                                                                                                                work the Committee has utilised the work of
                                                                framework in that they should include a
                                                                                                                Internal Audit, External Audit and other
Developmental Standard – Clinical
                                                                reference to the appropriate entry on the
                                             “Good”                                                             assurance functions, but is not limited to these
Effectiveness (shadow assessment)                               Assurance Framework and be more specific
                                                                                                                audit functions.
                                                                about the assurances provided. The Board
                                                                                                                                                              53
audit
            It also seeks reports and assurances from          External Audit
            directors and managers as appropriate,             The Committee has reviewed the work and
            concentrating on the overarching systems of        findings of external audit and considered the
            integrated governance, risk management and         implications and management responses to


committee
            internal control, together with indicators of      their work. Key achievements have included:
            their effectiveness. This is evidenced through     • Review of all external audit reports,
            the Committee’s use of an effective Assurance         including agreement of the annual audit
            Framework to guide its work and that of the



report
                                                                  letter before submission to the Board
            audit and assurance functions that report to it.
                                                               • Undertaking a review of the
            There have been no areas of significant               independence, objectivity and
            duplication or omission in the systems of             effectiveness of External Audit
            governance in the Trust that have come to          • Acute Hospital Portfolio reports have been
            the Committee’s attention and not been                received for: admissions management;
            adequately resolved.                                  medicines management (both compared
                                                                  favourably with other Trusts with many
            Internal Audit                                        examples of good performance) and
            The Committee has ensured that there is an            diagnostics (overall good practice
            effective Internal Audit function that meets          arrangements in place and some areas
            mandatory NHS Internal Audit standards and            that require additional
            provides appropriate independent assurance.           investigation/review). Action plans are in
            This has been achieved by:                            place for all three new reports.
            • Review and approval of the Internal Audit        • Annual accounts for 2005/06
               Strategy, operational plan, detailed
               programme of work and annual report             Financial areas of review
            • Undertaking a review of the independence,        The Committee has ensured that the systems
               objectivity and effectiveness of Internal       for financial reporting to the Board, including
               Audit                                           those of budgetary control, are subject to
            • Consideration of the major findings of           review as to completeness and accuracy of
               internal audit work including continued         the information provided to the Board. The
               emphasis on securing and maintaining full       Committee has reviewed the following main
               assurance on all key systems. The focus is      areas:
               on working towards a standard that would        • The financial position and financial
               achieve full assurance for key systems by         reporting systems of the organisation
               March 2008


54
audit
            • Whether there have been any major             • Benchmarking to confirm our risk
              break-downs in control leading to a             management position with comparable
              significant loss in one form or another         Trusts in the Strategic Health Authority
              (e.g. a delay in the processing of RTA          (July 2006)



committee
              claim forms)                                  • Review of the Terms of Reference to
            • Whether there have been any major               include Foundation status from 1st August
              weaknesses in the governance systems            2006




report
              that have exposed, or continue to expose,     • Process for the tender and award of
              the organisation to an unacceptable risk        contract for External Audit Services
                                                              (September 2006)
            Other areas of action and review by the
            Committee:                                      • Audit Committee annual self assessment
                                                              in line with the Audit Committee
            • The Audit Committee has received                Handbook (December 2006)
              quarterly reports from the Local Counter
              Fraud Service including action to raise       • Independent meetings have been held
              awareness and proactive investigation of        between the Non Executive Audit
              incidents                                       Committee members and Internal and
                                                              External Audit
            • Quarterly review of action plans for
              existing Acute Hospital Portfolio reports
              (e.g. ward staffing, day surgery, therapies
              and facilities)
            • Annual report of the Remuneration
              Committee (July 2006)




                                                                                                     55
audit
            Key Performance Indicators 2006/07

                                         Details                                                      Achieved 06/07




committee
                                                                               Actual 93 % (13% full assurance: 80% significant assurance: 7%
            Achieve significant assurance for 100% of internal audit reports   limited assurance)


            A turnaround of 4 weeks for a management response to draft IA      Actual was 4.5 weeks




report
            reports via EMT:


            Delivering 100% of the Audit Committee Handbook                    Fully Achieved
            recommendations.



            Develop a plan for the implementation of Integrated Governance     Fully Achieved
            by March 2008 (Integrated Governance handbook – Feb 2006)


                                                                               Financial Reporting
                                                                               – To be confirmed in July 2007
                                                                               Financial Management
                                                                               – To be confirmed in July 2007
            Achieve at least three on all our KLOEs.                           Financial Standing
                                                                               – To be confirmed in July 2007
                                                                               Internal Control
                                                                               – To be confirmed in July 2007
                                                                               Value for Money
                                                                               – To be confirmed in July 2007


            Prompt implementation of the recommendations from the Audit        Fully achieved
            Committee as agreed in the minutes.


            Review of the Assurance framework/SFBH declaration
            (including a forward plan for gaining positive assurances) by Sep Partially achieved (ongoing)
            06.



            These key performance indicators have
            influenced the development objectives for
            2006/07 which are described in the next
            section.

56
audit
            Developmental Objectives 2007/2008
            The key developmental objectives are as
            follows:
            • Local Counter Fraud Specialist (LCFS)


committee     Annual Plan - Achieve the compound
              indicators outlined in the LCFS plan.
            • Reaching a standard that would achieve



report
              full assurance for key systems by March
              2008
            • Maintaining at least three on all Key Lines
              of Enquiries (KLOEs)
            • Internal Audit Plan – Ensure that that the
              plan reflect the high risks in the
              Assurance Framework/risk register
            • Assurance Framework – Board reports to
              be more closely aligned to the Assurance
              Framework

            The Audit Committee wishes to record its
            thanks to the External and Internal Auditors
            for their invaluable work during 2006/07.
            Thanks are also extended to the Directors and
            staff of the Trust for their continued
            commitment to the principles of strong
            governance




                                                       57
                                                 The Trust receives support in its activities      streams. For example supporting new



charitable
                                                 from the registered charity ‘Northumbria          initiatives and treatment methods, improving
                                                 Healthcare Charitable Fund’ (charity number       the patient experience arts and improved
                                                 1083122). The Board members of the                furnishings and purchasing additional capital
                                                 Foundation Trust also serve as Trustees of        equipment. The charity does not contribute



funds
                                                 the charity. The Trustees meet on a quarterly     to staff salaries (other than certain fixed term
                                                 basis to review charity activities and finances   research posts) and everyday medical
                                                 and to set the policies and objectives for the    consumables.
                                                 charity.
                                                                                                   One of the main activities of the charity is to
                                                 The charity’s funds are a result of donations,    support volunteering across hospital sites –
The charity’s main objective is to ensure that   legacies, mainly from members of the public,      the Hospital Volunteer Service. The café and
                                                 as well as fundraising activities. The income     retail outlet at North Tyneside General
donations enhance patient care in ways that      is given to improve services for patients, to     Hospital which is staffed mainly by volunteers
                                                 support staff in their work and to fund           raises around £120,000 each year which
would not be possible within usual revenue       research and development projects.                goes directly to improve patient care at the
                                                                                                   hospital.
streams.                                         The Trustees ensure that where donors have
                                                 placed a restriction on the use donations the     Overall during the period August 2006 to
                                                 funds are used in accordance with these           March 2007 year the charity contributed
                                                 wishes. Other donations are used in               £503,000 to the Trusts activities.
                                                 accordance with the overall objectives of the
                                                 charity.

                                                 The charity’s main objective is to ensure that
                                                 donations enhance patient care in ways that
                                                 would not be possible within usual revenue




58
annual
                                              1. Scope of responsibility                        internal control has been in place in
                                              This statement of internal control covers the     Northumbria Healthcare NHS Foundation
                                              period 1st August 2006 to 31st March 2007.        Trust for the year (from 1st August 2006)
                                              As Accounting Officer, I have responsibility      ended 31 March 2007 and up to the date of



accounts                                      for maintaining a sound system of internal        approval of the annual report and accounts.
                                              control that supports the achievement of the
                                              NHS foundation trust’s policies, aims and         3. Capacity to handle risk
                                              objectives, whilst safeguarding the public        The accountability arrangements for the
                                              funds and departmental assets for which I am      Chief Executive Officer, Board of Directors,
                                              personally responsible, in accordance with        Business Unit Directors, Clinical Directors,
Northumbria Healthcare NHS Foundation Trust   the responsibilities assigned to me. I am also    General Managers, Department Heads,
                                              responsible for ensuring that the NHS             Operational Service Managers and all staff
Statement on Internal Control                 foundation trust is administered prudently        are set out in the Trust’s Risk Management
                                              and economically and that resources are           Strategy/Policy, which was reviewed and
1st August 2006 to 31st March 2007            applied efficiently and effectively. I also       approved by the Board of Directors in
                                              acknowledge my responsibilities as set out in     October 2006. In addition, there are clear
                                              the NHS Foundation Trust Accounting Officer       terms of reference for the key committees
                                              Memorandum.                                       involved with risk. The Trust appointed the
                                                                                                chair of the Audit Committee as Senior
                                              2. The purpose of the system of                   Independent Director in November 2006 to
                                              internal control                                  be available to members if they have
                                              The system of internal control is designed to     concerns which contact through the normal
                                              manage risk to a reasonable level rather than     channels of Chairman, Chief Executive or
                                              to eliminate all risk of failure to achieve       Finance Director has failed to resolve or for
                                              policies, aims and objectives; it can therefore   which such contact is inappropriate.
                                              only provide reasonable and not absolute
                                              assurance of effectiveness. The system of         The Trust employs key staff who specialise in
                                              internal control is based on an ongoing           risk management and health and safety
                                              process designed to identify and prioritise       matters. Risk management awareness/health
                                              the risks to the achievement of the policies,     and safety training is delivered to all new
                                              aims and objectives of Northumbria                members of staff on the first day of
                                              Healthcare NHS Foundation Trust, to               employment and to existing staff through
                                              evaluate the likelihood of those risks being      mandatory training programmes. Relevant
                                              realised and the impact should they be            policies are specific in accountabilities and
                                              realised, and to manage them efficiently,         responsibilities for all staff groups.
                                              effectively and economically. The system of

                                                                                                                                          59
annual
           Systems and procedures are in place to              exceeded the national target. Operational
           support staff in managing risk and carrying         Boards, the Health and Safety Steering Group
           out their duties. All staff have specific risk      and the Trust wide Governance Committee
           management and health and safety sections           play key roles in evaluating and prioritising risk.



accounts
           in their job descriptions. Quarter/annual           It is accepted that all risks cannot be
           reports and risk management newsletters as          eliminated. An acceptable risk is one which
           well as managers, communicate lessons               has been appropriately risk assessed and the
           learnt from good practice across the                risks reduced to the lowest possible level.
           organisation and national learning.
                                                               The Trust has worked closely with partner
           4. The risk and control framework                   organisations to explore, understand, quantify
           Risks are identified proactively through risk       and minimise potential risks which may
           assessment processes and reactively through         impact upon other organisations and public
           identifying risks associated with delivering        stakeholders. Issues raised through the
           key business objectives/incidents/complaints/       Trust’s risk management process that impact
           claims. These risks are evaluated through the       on partner organisations and public
           use of a risk assessment matrix and controlled      stakeholders will be discussed in the
           through a risk register system. This links into     appropriate forum so that action can be
           the Assurance Framework process. The Trust’s        agreed.
           Assurance Framework sets out the principal
           risks to deliver key priorities and objectives.     As an employer with staff entitled to
           The Assurance Framework identifies the              membership of the NHS Pension Scheme
           assurances available to the Board of Directors      control measures are in place to ensure all
           in relation to the achievement of the Trust’s key   employer obligations contained within the
           priorities and objectives. The principal risks to   Scheme regulations are complied with.
           the delivery of these objectives are mapped to
                                                               5. Review of economy, efficiency and
           key controls. The Board of Directors requires
                                                               effectiveness of the use of resources
           both the assurance that the Assurance
           Framework identifies, those actions required to     The Trust has robust arrangements in place for
           address gaps in control and assurance, and          setting objectives and targets on a strategic
           the development and implementation of action        and annual basis. These arrangements
           plans. In this period there were no strategic,      include ensuring the financial strategy is
           operational or financial risks identified,          affordable, scrutiny of cost savings plans to
           however there was one clinical residual risk        ensure achievement, compliance with terms of
           relating to the MRSA target. Although actions       authorisation and coordination of individual
           on hygiene and enhanced clinical practice           objectives with corporate objectives as
           reduced incidents by 34 percent these still         identified in the Annual Plan.
60
annual
           Performance against objectives is monitored       This is used for the risk management
           and actions identified through a number of        process and to identify where
           channels:                                         improvements can be made.
           • Approval of annual budgets by the Board       • Healthcare Commission information that



accounts     of Directors.
           • Monthly reporting to the Board on key
             performance indicators covering finance,
             activity, patient safety and human
             resources targets and IM&T bi-monthly.
                                                             identifies key performance indicators and
                                                             measures these over time to focus
                                                             attention on areas for improvement.
                                                           • Value for money is an important
                                                             component of the internal and external
           • Monthly review of financial and                 audit plans that provides assurance to
             performance targets by the Finance and          the Trust of processes that are in place
             Performance Committee, which is a sub           to ensure effective use of resources.
             committee of the Board.
                                                           The Trust has a standard assessment
           • Weekly reporting to Executive Team on         process for future business plans to ensure
             key influences on the Trust’s financial       value for money and full appraisal processes
             position.                                     are employed when considering the effect on
           • Monthly reporting to Business Units           the organisation.
             through the budgetary control and risk
             system.                                       Procedures are in place to ensure all strategic
           • Periodic performance management of            decisions are considered at Executive and
             Business Units by the Executive Team          Board level.
             covering performance on against key
                                                           The emphasis in Internal Audit work is
             objectives.
                                                           providing assurances on internal controls,
           • Quarterly reporting to Monitor and            risk management and governance systems to
             compliance with terms of authorisation.       the Audit Committee and to the Board. Where
                                                           scope for improvement, in terms of value for
           The Trust also participates in initiatives to
                                                           money was identified during an Internal Audit
           ensure value for money for example:
                                                           review, appropriate recommendations were
           • Subscribes to a national benchmarking         made and actions were agreed with
             organisation that provides comparative        management for implementation.
             information analysis on patient activity
             and clinical indicators and participation     6. Review of effectiveness
             in the NHS Litigation Authority standards,    As Accounting Officer, I have responsibility for
             working towards achieving level 2 in both     reviewing the effectiveness of the system of
             the general and maternity standards.          internal control. My review of the effectiveness
                                                                                                         61
annual
           of the system of internal control is informed by   management processes, based on an audit
           the work of the internal auditors and the          plan approved by the Audit Committee. The
           executive managers within the NHS                  work included identifying and evaluating
           Foundation Trust who have responsibility for       controls and testing their effectiveness, in



accounts
           the development and maintenance of the             accordance with NHS Internal Audit
           internal control framework, and comments           Standards. Where scope for improvement
           made by the external auditors in their             was found, recommendations were made
           management letter and other reports. I have        and appropriate action plans agreed with
           been advised on the implications of the result     management.
           of my review of the effectiveness of the system
           of internal control by the Board, the Audit        The Head of Internal Audit opinion statement
           Committee and Trust Wide Governance                has been received on the effectiveness of the
           Committee and a plan to address weaknesses         system of internal control. The overall opinion
           and ensure continuous improvement of the           is that significant assurance can be given that
           system is in place.                                there is a generally sound system of internal
                                                              control, designed to meet the organisation’s
           The Board supported by the Audit Committee         objectives, and that controls are generally
           and Trust Wide Governance Committee has            being applied consistently.
           routinely reviewed the Trust’s system of
           internal control and governance framework,         There were no significant internal control
           together with the Trust’s integrated approach      issues or gaps in control identified in the
           to achieving compliance with Standards for         period 1st August 2006 to 31st March 2007.
           Better Health and Clinical Negligence
           Scheme for the Trust. The Assurance                Signed:
           Framework provides the Board with evidence
           that the effectiveness of controls that manage
           the risks to the organisation achieving its
           principal objectives have been reviewed.

           The Audit Committee and Finance and                James Mackey
                                                              Chief Executive
           Performance Committee have also provided           4th June 2007
           the Board with an independent and objective
           review of integrated governance and internal
           financial control within the Trust.

           Internal audit has reviewed and reported
           upon control, governance and risk
62
                                                            Page




contents   Foreword
           Independent Auditor's Report
           Income and expenditure account
           Balance Sheet
           Statement of total recognised gains and losses
           Cashflow statement
                                                            64
                                                            65
                                                            67
                                                            68
                                                            69
                                                            70
           Accounting policies                              71
           Notes to the financial statements                71




                                                                   63
     northumbria healthcare nhs foundation trust - accounts for the eight months ended 31 march 2007




     Foreword to the accounts
                   Northumbria Healthcare NHS Foundation Trust                                         In preparing the accounts, the Accounting Officer is required to
                                                                                                       comply with the requirements of the NHS foundation trust
                   These accounts for the eight months ended 31st March 2007                           Financial Reporting Manual and in particular to:
                   have been prepared on a going concern basis by Northumbria
                   Healthcare NHS Foundation Trust in accordance with paragraphs                         observe the Accounts Direction issued by Monitor, including the
                   24 and 25 of Schedule 1 of the Health and Social Care                                 relevant accounting and disclosure requirements, and apply
                   (Community Health and Standards) Act 2003, (repealed and re-                          suitable accounting policies on a consistent basis;
                   enacted in the National Health Service Act 2006), with the                            make judgements and estimates on a reasonable basis;
                   reporting guidance within the 2006/07 NHS Foundation Trust
                                                                                                         state whether applicable accounting standards as set out in the
                   Financial Reporting Manual.
                                                                                                         NHS foundation trust Financial Reporting Manual have been
                                                                                                         followed, and disclose and explain any material departures in
                   Statement of Accounting Officer's Responsibilities                                    the financial statements; and
                   Statement of the Chief Executive's responsibilities as                                prepare the financial statements on a going concern basis.
                   the Accounting Officer of Northumbria Healthcare NHS
                                                                                                       The Accounting Officer is responsible for keeping proper
                   Foundation Trust
                                                                                                       accounting records which disclose with reasonable accuracy at
                   The Health and Social Care (Community Health and Standards)                         any time the financial position of the Foundation Trust and to
                   Act 2003, (repealed and re-enacted in the National Health Service                   enable him to ensure that the accounts comply with requirements
                   Act 2006), states that the Chief Executive is the Accounting Officer                outlined in the above mentioned act. The Accounting Officer is
                   of the Foundation Trust. The relevant responsibilities of the                       also responsible for safeguarding the assets of the Foundation
                   Accounting Officer, including their responsibility for the propriety                Trust and hence for taking reasonable steps for the prevention
                   and regularity of public finances for which they are answerable,                    and detection of fraud and other irregularities.
                   and for keeping of proper accounts, are set out in the accounting
                                                                                                       To the best of my knowledge and belief, I have properly
                   officers' Memorandum issued by the Independent Regulator of
                                                                                                       discharged the responsibilities set out in Monitor's NHS
                   NHS Foundation Trusts ("Monitor").
                                                                                                       Foundation Trust Accounting Officers' Memorandum.
                   Under the Health and Social Care (Community Health and
                   Standards) Act 2003, (repealed and re-enacted in the National
                   Health Service Act 2006), Monitor has directed the Foundation                       Signed
                   Trust to prepare for each financial year a statement of accounts in
                   the form and on the basis set out in the Accounts direction.
                   The accounts are prepared on an accruals basis and must give a
                   true and fair view of the state of affairs of the Foundation Trust and              Chief Executive
                   of its income and expenditure, total recognised gains and losses                    4th June 2007
                   and cash flows for the financial year.


64
                                                                                  northumbria healthcare nhs foundation trust - accounts for the eight months ended 31 march 2007
Independent Auditor's Report to the Board
of Governors of Northumbria Healthcare
NHS Foundation Trust
We have audited the financial statements of Northumbria Healthcare            We read other information contained in the Annual Report, and consider
NHS Foundation Trust for the eight month period ended 31 March                whether it is consistent with the audited financial statements. This other
2007 which comprise the Income and Expenditure Account, the                   information comprises only the Foreword, the Remuneration Report, the
Balance Sheet, the Statement of Total Recognised Gains and Losses,            Chairman's Statement and the Operating and Financial Review. We
the Cashflow Statement and the related notes. These financial                 consider the implications for our report if we become aware of any
statements have been prepared in accordance with the accounting               apparent misstatements or material inconsistencies with the financial
policies set out therein.                                                     statements. Our responsibilities do not extend to any other information.
Respective Responsibilities of Directors and Auditors                         In addition we report to you if, in our opinion, the NHS foundation trust
                                                                              has not kept proper accounting records, if we have not received all the
The Foundation Trust is responsible for preparing the Annual Report           information and explanations we require for our audit, or if information
and the financial statements in accordance with directions issued by          specified by law regarding directors' remuneration and other
the Independent Regulator of Foundation Trusts ("Monitor") under the          transactions is not disclosed.
Health and Social Care (Community Health and Standards) Act 2003.
Our responsibility is to audit the financial statements in accordance with    Basis of audit opinion
relevant statute, the Audit Code for NHS Foundation Trusts issued by          We conducted our audit in accordance with section 28 and Schedule 5
Monitor and International Standards on Auditing (UK and Ireland).             of the Health and Social Care (Community Health and Standards) Act
This report, including the opinion, is made solely to the Board of            2003 and Audit Code for NHS Foundation Trusts issued by Monitor,
Governors of Northumbria Healthcare NHS Foundation Trust in                   which requires compliance with relevant auditing standards issued by
accordance with paragraph 24(5) of Schedule 1 of the Health and               the Auditing Practices Board.
Social Care (Community Health and Standards) Act 2003 (the Act) and           An audit includes examination, on a test basis, of evidence relevant to
for no other purpose. We do not, in giving this opinion, accept or            the amounts and disclosures in the financial statements. It also
assume responsibility for any other purpose or to any other person to         includes an assessment of the significant estimates and judgements
whom this report is shown or into whose hands it may come save                made by the Foundation Trust in the preparation of the financial
where expressly agreed by our prior consent in writing.                       statements, and of whether the accounting policies are appropriate to
We report to you our opinion as to whether the financial statements give      the NHS Foundation Trust's circumstances, consistently applied and
a true and fair view and are properly prepared in accordance with the         adequately disclosed.
directions issued by Monitor under the Health and Social Care                 We planned and performed our audit so as to obtain all the information
(Community Health and Standards) Act 2003.                                    and explanations which we considered necessary in order to provide us
We review whether the Accounting Officer's statement on internal control      with sufficient evidence to give reasonable assurance that the financial
is misleading or inconsistent with other information we are aware of from     statements are free from material misstatement, whether caused by
our audit of the financial statements. We are not required to consider,       fraud or other irregularity or error. In forming our opinion we also
nor have we considered, whether the Accounting Officer's statement on         evaluated the overall adequacy of the presentation of information in the
internal control covers all risks and controls. We are also not required to   financial statements.
form an opinion on the effectiveness of the NHS Foundation Trust's
corporate governance procedures or its risk and control procedures.
                                                                                                                                                                                    65
     northumbria healthcare nhs foundation trust - accounts for the eight months ended 31 march 2007




     Opinion
     In our opinion:
     • the financial statements give a true and fair view, in accordance with
        the NHS Foundation Trust Financial Reporting Manual, of the state of
        affairs of Northumbria Healthcare NHS Foundation Trust as at 31
        March 2007 and of its income and expenditure for the eight month
        period from 1 August 2006 to 31 March 2007;
     • the financial statements have been properly prepared in accordance
        with the Health and Social Care Act 2003 and the directions made
        thereunder by Monitor.
     Certificate
     We certify that we have completed the audit of the accounts in
     accordance with the requirements of the Health and Social Care
     (Community Health and Standards) Act 2003 and the Audit Code for
     NHS Foundation Trusts issued by Monitor.




     PricewaterhouseCoopers LLP
     Newcastle upon Tyne
     4 June 2007




66
                                                                                northumbria healthcare nhs foundation trust - accounts for the eight months ended 31 march 2007




income and expenditure account
for the eight months ended 31 March 2007
                                                          8 Months ended
                                                           31 March 2007
                                               NOTE                     £000

Income from activities                              3                153,872
Other operating income                              4                 14,145
Operating expenses                                5-7               (165,976)

OPERATING SURPLUS                                                      2,041
Profit on disposal of fixed assets                  8                  2,961

SURPLUS BEFORE INTEREST                                                5,002
Interest receivable                                                      296
Other finance costs - unwinding of discount                              (30)

SURPLUS FOR THE FINANCIAL PERIOD                                       5,268
Public Dividend Capital dividends payable          28                 (4,650)

RETAINED SURPLUS FOR THE YEAR                                            618


All income and expenditure is derived from continuing operations.




                                                                                                                                                                                  67
     northumbria healthcare nhs foundation trust - accounts for the eight months ended 31 march 2007




     balance sheet
     as at 31 March 2007
                                                                                                              31 March 2007           1 August 2006
                                                                                                   NOTE                £000                    £000
     FIXED ASSETS
     Intangible assets                                                                                  10              249                         300
     Tangible assets                                                                                    11          231,238                     225,661
     TOTAL FIXED ASSETS                                                                                             231,487                     225,961
     CURRENT ASSETS
     Stocks and work in progress                                                                        13            7,149                       6,846
     Debtors                                                                                             14          13,848                      24,748
     Cash at bank and in hand                                                                          19.3           5,804                         809
                                                                                                                     26,801                      32,403
     CREDITORS : Amounts falling due within one year                                                    16         (24,010)                     (22,809)
     NET CURRENT ASSETS                                                                                               2,791                       9,594


     TOTAL ASSETS LESS CURRENT LIABILITIES                                                                          234,274                     235,555
     CREDITORS : Amounts falling due after more than one year                                           16          (1,140)                      (1,424)
     PROVISIONS FOR LIABILITIES AND CHARGES                                                             17          (3,347)                      (3,169)


     TOTAL ASSETS EMPLOYED                                                                                          229,791                     230,962
     FINANCED BY:
     TAXPAYERS' EQUITY
     Public Dividend Capital                                                                           18.2         145,417                     147,052
     Revaluation reserve                                                                               18.3          75,467                      75,661
     Donated asset reserve                                                                             18.3           3,822                       3,873
     Other reserves                                                                                    18.3           (551)                       (551)
     Income and expenditure reserve                                                                    18.3           5,636                       4,927
     TOTAL TAXPAYERS' EQUITY                                                                                        229,791                     230,962



     The financial statements were approved by the Board and signed on its behalf by:                                         Chief Executive    4th June 2007

68
                                                                          northumbria healthcare nhs foundation trust - accounts for the eight months ended 31 march 2007




statement of total recognised gains and losses
for the eight months ended 31 March 2007


                                                                          8 Months ended
                                                                           31 March 2007

                                                                                        £000

Surplus for the financial year before dividend payments                                5,268

Fixed asset impairment losses                                                           (103)

Increases in the donated asset reserve due to receipt of donated assets                   108

Reductions in the donated asset reserve due to the depreciation,
impairment and/or disposal of donated assets                                            (159)

Total recognised gains and losses for the financial year                               5,114




                                                                                                                                                                            69
     northumbria healthcare nhs foundation trust - accounts for the eight months ended 31 march 2007




     cashflow statement
     for the eight month period ended 31 March 2007
                                                                                                                        8 Months ended
                                                                                                                         31 March 2007
                                                                                                   NOTE         £000              £000
     OPERATING ACTIVITIES

     Net cash inflow from operating activities                                                         19.1                     12,407

     RETURNS ON INVESTMENTS AND
     SERVICING OF FINANCE:

     Interest received                                                                                           276

     Net cash inflow from returns on
     investments and servicing of finance                                                                                          276

     CAPITAL EXPENDITURE

     Payments to acquire tangible fixed assets                                                                (6,300)
     Receipts from sale of tangible fixed assets                                                                7,222

     Net cash outflow from capital expenditure                                                                                     922

     DIVIDENDS PAID                                                                                                             (6,975)

     Net cash inflow before management of liquid
     resources and financing                                                                                                     6,630

     FINANCING

     Public Dividend Capital received                                                                                               875
     Public Dividend Capital repaid (not previously accrued)                                                                    (2,510)

     Net cash inflow from financing                                                                                             (1,635)

     Increase in cash                                                                                                            4,995




70
Notes
                                                                                northumbria healthcare nhs foundation trust - accounts for the eight months ended 31 march 2007




1 Accounting policies and other information                                           either from its withdrawal from a particular activity or from a
                                                                                      material reduction in income in the NHS foundation trust's
Monitor has directed that the financial statements of NHS foundation                  continuing operations; and
trusts shall meet the accounting requirements of the NHS Foundation
                                                                                  d. the assets, liabilities, results of operations and activities are clearly
Trust Financial Reporting Manual which shall be agreed with HM
                                                                                      distinguishable, physically, operationally and for financial reporting
Treasury. Consequently, the following financial statements have been
                                                                                      purposes.
prepared in accordance with the 2006'07 NHS Foundation Trust
Financial Reporting Manual issued by Monitor. The accounting policies          Operations not satisfying all of these conditions are classified as continuing.
contained in that manual follow UK generally accepted accounting               Activities are considered to be 'acquired' whether or not they are acquired
practice for companies (UK GAAP) and HM Treasury's Financial                   from outside the public sector.
Reporting Manual to the extent that they are meaningful and
                                                                               1.3 Income recognition
appropriate to NHS foundation trusts. The accounting policies have
been applied consistently in dealing with items considered material in         Income is accounted for applying the accruals convention. The main source
relation to the accounts.                                                      of income for the trust is under contracts for commissioners in respect of
                                                                               healthcare services. Income is recognised in the period in which services
As the Trust only attained foundation status on 1 August 2006, the
                                                                               are provided. Where income is received for a specific activity which is to be
accounts are for an eight month period only and there are no prior year
                                                                               delivered in the following financial year, that income is deferred.
comparatives.
                                                                               The NHS foundation trust changed the form of its contracts with NHS
1.1 Accounting Convention                                                      commissioners to follow the Department of Health's Payment by Results
These accounts have been prepared under the historical cost convention         methodology in 2005/06. To manage the financial impact of this change
modified to account for the revaluation of tangible fixed assets at their      on the NHS Foundation Trust and its commissioners, the NHS Foundation
value to the business by reference to their current costs. NHS Foundation      Trust was only able to retain 50% of the gain under PbR. The remainder is
Trusts, in compliance with HM Treasury's Financial Reporting Manual, are       paid back to the Department of Health as part of national clawback rules
not required to comply with the FRS 3 requirement to report "earnings per      in monthly instalments. The clawback figure for the eight months from 1
share" or historical profits and losses.                                       August 2006 to 31 March 2007 was £1,544,000.
                                                                               NHS Bodies are required to record and account for partially completed
1.2 Acquisitions and discontinued operations
                                                                               spells of patient treatment (clinical work in progress) at the year end.
Activities are considered to be 'discontinued' where they meet all of the      The Trust first adopted this accounting policy in its four month NHS
following conditions:                                                          Trust accounts for the period ending 31 July 2006. The value of clinical
    a. the sale (this may be at nil consideration for activities transferred   work in progress in the accounts as at 31 March 2007 is £2,282,000.
       to another public sector body) or termination is completed either
       in the period or before the earlier of three months after the           1.4 Expenditure
       commencement of the subsequent period and the date on                   Expenditure is accounted for applying the accruals concept.
       which the financial statements are approved;
                                                                               1.5 Tangible fixed assets
    b. if a termination, the former activities have ceased permanently;
                                                                               Capitalisation
    c. the sale or termination has a material effect on the nature and
       focus of the reporting NHS foundation trust's operations and            Tangible assets are capitalised if they are capable of being used for a
       represents a material reduction in its operating facilities resulting   period which exceeds one year and they:


                                                                                                                                                                                  71
     northumbria healthcare nhs foundation trust - accounts for the eight months ended 31 march 2007




        individually have a cost of at least £5,000; or                                                Assets in the course of construction are valued at cost and are valued
        form a group of assets which individually have a cost of more than                             by professional valuers as part of the five or three-yearly valuation or
        £250, collectively have a cost of at least £5,000, where the assets are                        when they are brought into use.
        functionally interdependent, they had broadly simultaneous purchase                            Residual interests in off-balance sheet private finance initiative
        dates, are anticipated to have simultaneous disposal dates and are                             properties are included in assets under construction within tangible
        under single managerial control; or                                                            fixed assets at the amount of the unitary charge allocated for the
        form part of the initial setting up cost of a new building or refurbishment                    acquisition of the residual with an adjustment. The adjustment is the net
        of a ward or unit, irrespective of their individual or collective cost.                        present value of the change in the fair value of the residual as
                                                                                                       estimated at the start of the contract and at the balance sheet date.
     Valuation
                                                                                                       Operational equipment is valued at net current replacement cost.
     Tangible fixed assets are stated at the lower of replacement cost and                             Equipment surplus to requirements is valued at net recoverable amount.
     recoverable amount. On initial recognition they are measured at cost
     (for leased assets, fair value) including any costs, such as installation,                        Depreciation, amortisation and impairments
     directly attributable to bringing them into working condition. The                                Tangible fixed assets are depreciated at rates calculated to write them
     carrying values of tangible fixed assets are reviewed for impairment in                           down to estimated residual value on a straight-line basis over their
     periods if events or changes in circumstances indicate the carrying                               estimated useful lives. No depreciation is provided on freehold land,
     value may not be recoverable. The costs arising from financing the                                and assets surplus to requirements.
     construction of the fixed assets are not capitalised but are charged to                           Assets in the course of construction and residual interests in off-
     the income and expenditure account in the year to which they relate.                              balance sheet PFI contract assets are not depreciated until the asset is
     All land and buildings are revalued using professional valuations in                              brought into use or reverts to the trust, respectively.
     accordance with FRS 15 every five years. A three yearly interim                                   Buildings, installations and fittings are depreciated on their current
     valuation is also carried out.                                                                    value over the estimated remaining life of the asset as assessed by the
     Valuations are carried out by professionally qualified valuers in                                 NHS foundation trust's professional valuers.
     accordance with the Royal Institute of Chartered Surveyors (RICS)                                 Leaseholds are depreciated over the primary lease term.
     Appraisal and Valuation Manual. The last asset valuations were
     undertaken in 2004 as at the prospective valuation date of 1 April 2005.                          Equipment is depreciated on current cost evenly over the estimated life
                                                                                                       of the asset.
     The revaluation undertaken at that date was accounted for on 31
     March 2005.                                                                                       Fixed asset impairments resulting from losses of economic benefits are
                                                                                                       charged to the income and expenditure account. All other impairments
     The revaluations are carried out primarily on the basis of depreciated                            are taken to the revaluation reserve and reported in the statement of
     replacement cost for specialised operational property and existing use                            total recognised gains and losses to the extent that there is a balance
     value for non-specialised operational property. The value of land for                             on the revaluation reserve in respect of the particular asset.
     existing use purposes is assessed at existing user value. For non-
     operational properties including surplus land, the valuations are carried                         1.6 Intangible fixed assets
     out at open market value.                                                                         Intangible assets are capitalised when they are capable of being used
     Additional alternative open market value figures have only been                                   in the trust's activities for more than one year; they can be valued; and
     supplied for operational assets scheduled for imminent closure and                                they have a cost of at least £5,000.
     subsequent disposal.                                                                              Intangible fixed assets held for operational use are valued at historical

72
                                                                                northumbria healthcare nhs foundation trust - accounts for the eight months ended 31 march 2007




cost and are amortised over the estimated life of the asset on a straight      trust has contributed land and buildings, a prepayment for their fair value
line basis. The carrying value of intangible assets is reviewed for            is recognised and amortised over the life of the PFI contract by charge
impairment at the end of the first full year following acquisition and in      to the income and expenditure account. Where, at the end of a PFI
other periods if events or changes in circumstances indicate the               contract, a property reverts to the trust, the difference between the
carrying value may not be recoverable.                                         expected fair value of the residual on reversion and any agreed payment
Purchased computer software licences are capitalised as intangible fixed       on reversion is built up over the life of the current contract by capitalising
assets where expenditure of at least £5,000 is incurred and amortised          part of the unitary charge each year, as a tangible fixed asset.
over the shorter of the term of the licence and their useful economic lives.   Where the balance of risks and rewards of ownership of the PFI
                                                                               property are borne by the trust, it is recognised as a fixed asset along
1.7 Donated fixed assets                                                       with the liability to pay for it which is accounted for as a finance lease.
Donated fixed assets are capitalised at their current value on receipt         Contract payments are apportioned between an imputed finance lease
and this value is credited to the donated asset reserve. Donated fixed         service charge and a service charge.
assets are valued and depreciated as described above for purchased
assets. Gains and losses on revaluations are also taken to the donated         1.10 Stocks and work-in-progress
asset reserve and, each year, an amount equal to the depreciation              Stocks and work-in-progress are valued at the lower of cost and net
charge on the asset is released from the donated asset reserve to the          realisable value. Work-in-progress comprises goods and services in
income and expenditure account. Similarly, any impairment on donated           intermediate stages of production.
assets charged to the income and expenditure account is matched by
a transfer from the donated asset reserve. On sale of donated assets,          1.11 Cash, bank and overdrafts
the net book value of the donated asset is transferred from the donated        Cash, bank and overdraft balances are recorded at the current values
asset reserve to the Income and Expenditure Reserve.                           of these balances in the NHS foundation trust's cash book. These
                                                                               balances exclude monies held in the NHS foundation trust's belonging
1.8 Investments                                                                to patients (see "third party assets" below). Account balances are only
Investments in subsidiary undertakings, associates and joint ventures          set off where a formal agreement has been made with the bank to do
are treated as fixed asset investments and valued at market value.             so. In all other cases overdrafts are disclosed within creditors. Interest
Fixed asset investments are reviewed annually for impairments.                 earned on bank accounts and interest charged on overdrafts is
Deposits and other investments that are readily convertible into known         recorded as, respectively, "interest receivable" and "interest payable" in
amounts of cash at or close to their carrying amounts are treated as liquid    the periods to which they relate. Bank charges are recorded as
resources in the cashflow statement. These assets, and any other current       operating expenses in the periods to which they relate.
assets, are valued at cost less any amounts written off to represent any       1.12 Research and development
impairments in value, and are reviewed annually for impairments.
                                                                               Expenditure on research is not capitalised. Expenditure on development
1.9 Private Finance Initiative (PFI) transactions                              is capitalised if it meets the following criteria:
The NHS follows HM Treasury's Technical note 1 (Revised) "How to                  there is a clearly defined project;
account for PFI transactions" which provides definitive guidance for the          the related expenditure is separately identifiable;
application of note F to FRS 5. Where the balance of the risks and                the outcome of the project has been assessed with reasonable
rewards of ownership of the PFI property are borne by the PFI operator,           certainty to its technical feasibility and its resulting in a product or
the PFI payments are recorded as an operating expense. Where the                  service that will eventually be brought into use; and


                                                                                                                                                                                  73
     northumbria healthcare nhs foundation trust - accounts for the eight months ended 31 march 2007




         adequate resources exist, or are reasonably expected to be                                    Clinical negligence costs
         available, to enable the project to be completed and to provide any                           The NHS Litigation Authority (NHSLA) operates a risk pooling scheme
         consequential increase in working capital.                                                    under which the NHS foundation trust pays an annual contribution to
     Expenditure so deferred is limited to the future benefits expected and is                         the NHSLA, which, in return, settles all clinical negligence claims.
     amortised through the income and expenditure account on a                                         Although the NHSLA is administratively responsible for clinical
     systematic basis over the period expected to benefit from the project. It                         negligence cases, the legal liability remains with the NHS foundation
     is revalued on the basis of the current cost. Expenditure which does not                          trust. The total value of clinical negligence provisions carried by the
     meet the criteria for capitalisation is treated as an operating cost in the                       NHSLA on behalf of the NHS foundation trust is disclosed at note 17.
     year in which it is incurred. Where possible, NHS foundation trusts
     disclose the total amount of research and development expenditure                                 Non clinical risk pooling
     charged to the income and expenditure account separately. However                                 The NHS foundation trust participates in the Property Expenses
     where research and development activity cannot be separated form                                  Scheme and the Liabilities to Third Parties Scheme. Both are risk
     patient care activity it cannot be identified and is therefore not                                pooling schemes under which the trust pays an annual contribution to
     separately disclosed.                                                                             the NHS Litigation Authority and in turn receives assistance with the
     Fixed assets acquired for use in research and development are                                     costs of claims arising. The annual membership contributions, and any
     amortised over the life of the associated project.                                                'excesses' payable in respect of particular claims are charged to
                                                                                                       operating expenses when the liability arises.
     1.13 Provisions
     The NHS foundation trust provides for legal or constructive obligations                           1.14 Pension costs
     that are of uncertain timing or amount at the balance sheet date on the                           Past and present employees are covered by the provisions of the NHS
     basis of the best estimate of the expenditure required to settle the                              Pensions Scheme. The scheme is an unfunded, delivery benefit scheme
     obligation. Where the effect of the time value of money is significant,                           that covers NHS employers, general practices and other bodies, allowed
     the estimated risk-adjusted cash flows are discounted using HM                                    under the direction of the Secretary of State, in England and Wales. As a
     Treasury's discount rate of 2.2% in real terms.                                                   consequence it is not possible for the NHS foundation trust to identify its
                                                                                                       share of then underlying scheme liabilities. Therefore, the scheme is
     Contingencies                                                                                     accounted for as a defined contribution scheme under FRS 17.
     Contingent assets (that is assets arising from past events whose                                  Employers pension cost contributions are charged to operating
     existence can only be confirmed by one or more future events not                                  expenses as and when they become due.
     wholly within the entity's control) are not recognised as assets, but are
     disclosed in note 22 unless the probability of a transfer of economic                             Additional pension liabilities arising from early retirement are not funded
     benefits is remote. Contingent liabilities are defined as:                                        by the scheme except where the retirement is due to ill health. The full
                                                                                                       amount of the liability for the additional costs is charged to the income
        Possible obligations arising from past events whose existence will be                          and expenditure account at the time the trust commits itself to the
        confirmed only by the occurrence of one or more uncertain future                               retirement, regardless of the method of payment.
        events not wholly within the entity's control: or
        Present obligations arising from past events but for which it is not                           1.15 Value added tax
        probable that a transfer of economic benefits will arise or for                                Most of the activities of the NHS foundation trust are outside the scope
        which the amount of the obligation cannot be measured with                                     of VAT and in general, output tax does not apply input tax on purchases
        sufficient reliability.                                                                        is not recoverable. Irrecoverable VAT is charged to the relevant

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                                                                               northumbria healthcare nhs foundation trust - accounts for the eight months ended 31 march 2007




expenditure category or included in the capitalised purchase cost of          Relevant net assets are calculated as the value of all assets less the
fixed assets. Where output tax is charged or input VAT is recoverable,        value of all liabilities, except for donated assets and cash held with the
the amounts are stated net of VAT.                                            Office of the Paymaster General. Average relevant net assets are
                                                                              calculated as a simple mean of opening and closing relevant net assets.
1.16 Corporation tax
The Trust has no corporation tax liability as it has no non-core activities   1.21 Going concern
that are subject to it.                                                       After making enquiries, the Directors have a reasonable expectation
                                                                              that the NHS Foundation Trust has adequate resources to continue
1.17 Foreign exchange                                                         in operational existence for the forseeable future. For this reason,
Transactions that are denominated in a foreign currency are translated        they continue to adopt the going concern basis in the preparation of
into sterling at the exchange rate ruling on the dates of the transactions.   the accounts.
Resulting exchange gains and losses are taken to the income and
expenditure account.                                                          1.22 Financial Instruments
                                                                              The Trust may hold any of the following financial assets and liabilities:
1.18 Third party assets
                                                                              – assets: investments, long-term debtors and accrued income, short-
Assets belonging to third parties (such as money held on behalf of               term debtors and accrued income; and
patients) are not recognised in accounts since the NHS foundation trust
has no beneficial interest in them. However, they are disclosed in a          – liabilities: loans and overdrafts, long term creditors, long terms
separate note to the accounts in accordance with the requirements of             provisions arising from contractual arrangements, short term
the HM Treasury Financial Reporting Manual.                                      creditors, short term provisions arising from contarctual
                                                                                 arrangements.
1.19 Leases                                                                   NHS Foundation Trusts can borrow within the limits set by Monitors
Where substantially all risks and rewards of ownership of a leased asset      Prudential Borrowing Code. The Trusts position against its prudential
are borne by the NHS foundation trust, the asset is recorded as a             borrowing limit is set out in note 16.3.
tangible fixed asset and a debt is recorded to the lessor of the              All other financial instruments are held for the sole purpose of manageing
minimum lease payments discounted by the interest rate implicit on the        the cashflow of the Trust on a day-to-day basis or arise from the operating
lease. The interest element of the finance lease payment is charged to        activities of the Trust. The management of risks around these financial
the income and expenditure account over the period of the lease at a          instruments therefore relates primarily to the Trusts overall arrangements
constant rate in relation to the balance outstanding.                         for managing risks to their financial position.
Other leases are regarded as operating leases and the rentals are
charged to the income and expenditure account on a straight-line basis
over the term of the lease.
1.20 Public dividend capital
Public dividend capital (PDC) is a type of public sector equity finance.
A charge, reflecting the forecast cost of capital utilised by the NHS
foundation trust, is paid over as public dividend capital dividend. The
charge is calculated at the real rate set by HM Treasury (currently 3.5%)
on the average relevant net assets of the NHS foundation trust.

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     northumbria healthcare nhs foundation trust - accounts for the eight months ended 31 march 2007




     2 Segmental reporting
     All of the activities of the Trust arise from a single business segment, the provision of Healthcare.

     3 Income from activities
     3.1 Income from activities - by function
                                                                                        8 months to 31.03.07                 The Trust's Terms of Authorisation
                                                                                                        £000                 set out the mandatory goods and
                                                                                                                             services that the Trust is required
     Elective income                                                                                   28,215                to provide ('Protected services').
     Non elective income                                                                               55,847                All income from activities shown
     Outpatient income                                                                                 20,097                left is derived from the provision
     Other type of income activity                                                                     43,116                of protected services.
     A&E income                                                                                          8,033
     PBR (clawback) / relief                                                                           (1,544)
     Private patient income                                                                                108
                                                                                                       153,872

     3.2 Private patient income
                                                                                        8 months to 31.03.07     Base year   Under it's terms of authorisation,
                                                                                                                  2002/03    the Trust must ensure that the
                                                                                                         £000        £000    proportion of patient related
                                                                                                                             income derived from private
     Private patient income                                                                                108        139    patients does not exceed the
     Total patient related income                                                                      153,872    159,637    proportion received as an NHS
     Proportion (as a percentage)                                                                       0.07%       0.09%    Trust in the base year.


     3.3 Income from activities by source
                                                                                        8 months to 31.03.07                 * Road Traffic Act income is
                                                                                                        £000                 subject to a provision for doubtful
                                                                                                                             debts of 7.7% to reflect expected
     NHS Foundation Trusts                                                                                  46               rates of collection.
     NHS Trusts                                                                                            260
     Strategic Health Authorities                                                                          623
     Primary Care Trusts                                                                               147,802
     Department of Health - other                                                                        3,797
     Non NHS : Private patients                                                                            108
     Road Traffic Act *                                                                                    924
     Non NHS : Other                                                                                       312
                                                                                                       153,872
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                                                                           northumbria healthcare nhs foundation trust - accounts for the eight months ended 31 march 2007




4 Other operating income
                                                                                                           8 months to 31.03.07
                                                                                                                           £000
Education and training                                                                                                    5,013
Charitable and other contributions to expenditure                                                                           503
Transfers from donated asset reserve in respect of depreciation, impairment and disposal of donated assets                  159
Non-patient care services to other bodies                                                                                 2,434
Other income                                                                                                              6,036
                                                                                                                         14,145
TOTAL INCOME                                                                                                                            168,017
The main components of other income are lease car fees £574,000, catering income £590,000, income from premises £400,000,
staff creches £406,000 and £316,00 for hosting the North of Tyne PALS service.

5 Operating expenses
5.1 Operating expenses comprise:
                                                                                                                     8 months to 31.03.07
                                                                                                                                     £000
Services from NHS Foundation Trusts                                                                                                   933
Services from NHS Trusts                                                                                                            1,698
Services from other NHS bodies                                                                                                        425
Purchase of healthcare from non-NHS bodies                                                                                            623
Executive Directors' costs                                                                                                            753
Non-Executive Directors' costs                                                                                                         89
Staff costs                                                                                                                       113,768
Drug costs                                                                                                                          8,613
Supplies and services - clinical (excluding drug costs)                                                                            11,340
Supplies and services - general                                                                                                     3,154
Establishment                                                                                                                       4,262
Transport                                                                                                                             268
Premises                                                                                                                           10,952
Bad debts                                                                                                                             234
Depreciation and amortisation                                                                                                       4,179
Audit fees - audit services - statutory audit                                                                                          70
Other auditors remuneration - further assurance services                                                                               15
Other auditors remuneration - other services                                                                                           22
Clinical negligence                                                                                                                 2,360
Other                                                                                                                               2,218
                                                                                                                                        165,976
The main components of other expenditure are charitable contributions to expenditure £395,000, costs of running
on site creches £608,000, internal recharges £396,000 and provisions made for Agenda For Change pay arrears.
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     northumbria healthcare nhs foundation trust - accounts for the eight months ended 31 march 2007




     5.2/1 Operating lease rentals :
                                                                                            8 months to 31.03.07
                                                                                                            £000
     Other operating lease rental                                                                          1,214
                                                                                                              1,214


     5.2/2 Operating lease commitments :
                                                                                            8 months to 31.03.07
                                                                                                            £000

     Annual commitments on leases expiring :                                                           Other Leases   Land and Buildings
     - within one year                                                                                         226                    0
     - between one and five years                                                                             1,398                   0
     - after five years                                                                                          0                1,204
                                                                                                              1,624               1,204

     Operating leases less than 5 years refer to leasing agreements entered into for leased vehicles. All leases are for a period of 3 years
     with 3 equal annual instalments payable. Costs are charged to operating expenses in the year in which payments are made.
     Leases over 5 years are in respect of leased buildings.




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5.3 Salary and pension entitlements of senior managers

A) Remuneration                                                                                        8 months to 31.03.07


Name                              Title                                       Basic salary              Other Remuneration                  Benefits in kind
                                                                          (bands of £5000)                 (bands of £5000)                 To nearest £100
                                                                                      £000                             £000                            £000

Executive Directors
James Mackey                      Chief Executive                                      95-100                                      0                     10,300
Anne Farrar                       Chief Operating Officer                               80-85                                      0                      1,100

Rosemary Stephenson               Director of Nursing & Emergency Care                   70-75                                   0                         2,700
Paul Dunn                         Director of Finance                                    65-70                                   0                         4,300
Anne Wright                       Director of Elective Care                              70-75                                   0                         1,100
Steve Russell                     Director of Emergency Care                             70-75                                   0                         1,600
Ann Stringer                      Director of Human Resources                            70-75                                   0                         2,000
David Evans                       Medical Director, Family Care and Medicine             20-25                               90-95                         1,100
Michael Weaver                    Medical Director - Hexham General Hospital             10-15                               85-90                         2,800
Derek Thomson                     Medical Director - Community Services                  15-20                               15-20                         2,200

Non-Executive Directors
Brian Flood                       Chairman                                               30-35                                     0                       1,000
Neil Mundy                        Non Executive Director                                  5-10                                     0                         300
David Thompson                    Non Executive Director                                  5-10                                     0                         500
Ian McMinn                        Non Executive Director                                  5-10                                     0                           0
Ian Swithenbank                   Non Executive Director                                  5-10                                     0                           0
Lorna Garrett                     Non Executive Director                                  5-10                                     0                         100

Salary for Medical Directors is the payment made in respect of this duty. Other remuneration for the Joint Medical Directors is payment in their
capacity as Medical Practitioners.
Benefits in kind consist of the taxable benefit of leased cars used for business and private purposes and the taxabale benefit of payments made
for the reimbursement of business miles in private vehicles.



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     B) Pension Benefits
                                                                Real increase in                  Total accrued   Cash equivalent    Cash equivalent    Real increase
                                                                pension (a) and                pension (a) and      transfer value     transfer value          in cash
                                                                   related lump              related lump sum         at 31 March          at 31 July       equivalent
                                                              sum (b) at age 60                (b) at age 60 at              2007               2006    transfer value
                                                             since 31 July 2006                 31 March 2007

     Name                                                      (bands of £2500)               (bands of £2500)
                                                                           £000                           £000               £000               £000             £000
     James Mackey                                 a                           (2.5-5)                    25-30                338                377              (39)
                                                  b                        (12.5-15)                     85-90
     Anne Farrar                                  a                             2.5-5                    30-35                454                392                0
                                                  b                          12.5-15                   100-105
     Rosemary Stephenson                          a                             2.5-5                    50-55                 n/a                n/a             n/a
                                                  b                          10-12.5                   160-165
     Paul Dunn                                    a                             2.5-5                    25-30                318                283               35
                                                  b                           7.5-10                     80-85
     Steve Russell                                a                             2.5-5                    10-15                101                 79               22
                                                  b                          35-37.5                     35-40
     Anne Wright                                  a                             2.5-5                    30-35                479                390               89
                                                  b                          15-17.5                   100-105
     Ann Stringer                                 a                               n/a                    20-25                 n/a                n/a             n/a
                                                  b                               n/a                    60-65
     David Evans                                  a                             5-7.5                    60-65               1030                917                0
                                                  b                          15-17.5                   180-185
     Michael Weaver                               a                             2.5-5                    75-80                 n/a                n/a             n/a
                                                  b                          10-12.5                   230-235

     During the year Ann Stringer transferred her pension rights from her previous employer into the NHS Pension Scheme therefore no increase in
     pension rights are reported for this period.
     As Non-executive directors do not receive pensionable remuneration, there are no entries in respect of pensions for Non-Executive Directors.
     A Cash Equivalent Transfer Value is the actuarially assessed capital value of the pension scheme benefits accrued by a member at a particular point in time.
     The benefits are the members accrued benefits and any contingent spouse's pension payable from the scheme. A CETV is a payment made by a pension
     scheme, or arrangement to secure pension benefits in another pension scheme or arrangement when the member leaves a scheme and chooses to
     transfer the benefits accrued in their former scheme. The pension figures shown relate to the benefits that the individual has accrued as a consequence of
     their total membership of the pension scheme, not just their service in a senior capacity to which the disclosure applies. The CETV figures include the values
     of any pension benefits in another scheme or arrangement which the individual has transferred to the NHS pension scheme. They also include any
     additional pension benefit accrued to the member as a result of their purchasing additional years of pension service in the scheme at their own cost.
     CETV's are calculated within the guidelines and framework prescribed by the Institute and Faculty of Actuaries.
     Real increase in CETV reflects the increase in CETV effectively funded by the employer. It takes account of the increase in accrued pension due to
     inflation, contributions paid by the employee (including the value of any benefits transferred from another pension scheme or arrangement) and
     uses common market valuation factors for the start and end of the period.
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                                                                              northumbria healthcare nhs foundation trust - accounts for the eight months ended 31 march 2007




6 Staff costs and numbers
6.1 Staff costs
                                                                                           8 months to 31.03.07
                                                                                     Total        Permanently                                 Other
                                                                                                     Employed
                                                                                     £000                 £000                                 £000
Salaries and wages                                                                94,758                        92,083                         2,675
Social security costs                                                              7,952                         7,473                           479
Employer contributions to NHSPA                                                   11,295                        10,885                           410
Agency/contract staff                                                                605                             0                           605
                                                                                 114,610                      110,441                          4,169
In addition the Trust capitalised £517,000 of salaries as tangible fixed assets. This relates to staff employed to work on specific capital schemes.

6.2 Average number of persons employed
                                                                                           8 months to 31.03.07
                                                                                                  Permanently                                 Other
                                                                                     Total           Employed
Medical and dental                                                                    573                           497                            76
Administration and estates                                                          1,112                         1,102                            10
Healthcare assistants & other support staff                                           658                           658                             0
Nursing, midwifery & health visiting staff                                          2,506                         2,504                             2
Scientific, therapeutic and technical staff                                           672                           670                             2
Total                                                                               5,521                        5,413                             90

6.3 Employee benefits
The Trust incurred no costs in providing employee benefits in the eight months to 31.03.2007

6.4 Retirements due to ill-health
                                                                                       8 months to 31.03.07
                                                                                Number                £000
Number of early retirements agreed on the grounds of ill health                      7
Estimated additional liabilities                                                                       292
The costs of these ill-health retirements will be borne by the NHS Pension Agency.

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     northumbria healthcare nhs foundation trust - accounts for the eight months ended 31 march 2007




     6.5 Management costs
                                                                                                   8 months to 31.03.07
                                                                                                                   £000
     Management costs                                                                                            6,094
     Income                                                                                                    165,984
     Management costs as percentage of adjusted income                                                           3.67%

     Management costs are defined in the document 'NHS Management Costs 2002/03' which can be found on the internet at
     http://www.dh.gov.uk/PolicyAndGuidance/OrganisationPolicy/FinanceAndPlanning/NHSManagementCosts/fs/en


     7 Better Payment Practice Code
     7.1     Better Payment Practice Code - measure of compliance
                                                                                                8 months to 31.03.2007
                                                                                                               Number       £000
     Total Non NHS bills paid in the period                                                                      51,546    34,233
     Total Non NHS bills paid within target                                                                      26,964    19,266
     Percentage of NON NHS bills paid within target                                                             52.31%    56.28%
     The Better Payment Practice Code requires the Trust to aim to pay all valid non-NHS invoices by the due date or within 30 days of receipt of goods
     or a valid invoice, whichever is later.
     Total NHS bills paid in the year                                                                             1,174    11,579
     Total NHS bills paid within target                                                                             570     5,456
     Percentage of NHS bills paid within target                                                                 48.55%    47.12%


     7.2 The Late Payment of Commercial Debts (Interest) Act 1998
     During the eight months to 31 March 2007 no payment was made in respect of claims made by small businesses under this legislation.




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                                                                             northumbria healthcare nhs foundation trust - accounts for the eight months ended 31 march 2007




8 Profit on Disposal of Fixed Assets
During the eight months to 31st March 2007 the Trust received a total of £7,222,000 in respect of the sale of fixed assets.
The net book value of the assets was £4,261,000.
Profit on the disposal of fixed assets is made up as follows:
                                                                              8 months to 31.03.07
                                                                                                £000
Profit on disposal of land and buildings                                                             2,961
                                                                                                     2,961
The profit on assets disposed of was derived from the differential values of land in a land transfer at Wansbeck.


9 Interest Payable
No interest was payable during the eight months to 31 March 2007.


10 Intangible Fixed Assets
10.1 Intangible fixed assets at the balance sheet date comprise the following elements:
                                                                      Software                         Total
                                                                      Licences
                                                                           £000                       £000
Gross cost at 1 August 2006                                                 305                         305
Disposals                                                                   (34)                        (34)
Gross cost at 31 March 2007                                                 271                         271
Amortisation at 1 August 2006                                                 5                            5
Provide during the year                                                      17                           17
Amortisation at 31 March 2007                                                22                           22
Net book value
- Purchased at 1 August 2006                                                300                         300
Total at 1 August 2006                                                      300                         300
Net book value
- Purchased at 31 March 2007                                                249                         249
Total at 31 March 2007                                                      249                         249
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     northumbria healthcare nhs foundation trust - accounts for the eight months ended 31 march 2007




     11 Tangible Fixed Assets
     11.1 Tangible fixed assets at the balance sheet date comprise the following elements:
                                                                      Land       Buildings         Assets under      Plant &    Transport   Information Furniture      Total
                                                                                 excluding          construction   Machinery   Equipment    Technology & fittings
                                                                                 dwellings        and payments
                                                                                                     on account
                                                                     £000             £000                 £000        £000         £000         £000      £000       £000
     Cost or valuation at 1 August 2006                             42,462          146,004                7,126      38,785         164         9,547     3,561    247,649
     Additions - purchased                                           2,900              971                2,091       2,988           0           945         3      9,898
     Additions - donated                                                  0                0                   0          89           0            13         6        108
     Impairments                                                       (39)             (64)                   0           0           0             0         0      (103)
     Reclassifications                                                    0           2,350              (3,123)         316           0           457         0          0
     Disposals                                                         (80)             (83)                   0           0           0             0         0      (163)
     At 31 March 2007                                               45,243         149,178                6,094      42,178          164        10,962     3,570    257,389


     Accumulated depreciation at 1 August 2006                             0               0                  0       17,282         134         3,481     1,092     21,989
     Provided during the year                                              0           1,455                  0        1,734           3           864       106      4,162
     Accumulated depreciation at 31 March 2007                             0           1,455                  0      19,016          137         4,345     1,198     26,151


     Net book value
     - Purchased at 1 August 2006                                   42,103          144,037               7,126       19,998          10         6,066     2,449    221,789
     - Donated at 1 August 2006                                        359            1,968                   0        1,505          20             0        20      3,872
     Total at 1 August 2006                                        42,462          146,005                7,126      21,503           30         6,066     2,469    225,661


     Net book value
     - Purchased at 31 March 2007                                   44,884          145,777               6,094       21,700           9         6,605     2,347    227,416
     - Donated at 31 March 2007                                        359            1,946                   0        1,462          18            12        25      3,822
     Total at 31 March 2007                                        45,243          147,723                6,094      23,162           27         6,617     2,372    231,238




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                                                                          northumbria healthcare nhs foundation trust - accounts for the eight months ended 31 march 2007




11.2 Analysis of tangible fixed assets
                                             Land   Buildings    Assets under         Plant &           Transport        Information         Furniture           Total
                                                    excluding     construction      Machinery          Equipment         Technology          & fittings
                                                    dwellings   and payments
                                                                   on account
                                             £000        £000            £000              £000                £000               £000            £000           £000
Net book value
-Protected assets at 31 March 2007         43,370     142,035                0                0                    0                  0               0       185,405
-Unprotected assets at 31 March 2007        1,873       5,688            6,094           23,162                   27              6,617           2,372        45,833
Total at 31 March 2007                     45,243     147,723            6,094           23,162                   27             6,617            2,372      231,238


11.3 Assets held at open market value
                                                                  31 March 2007                   1 August 2006
                                                                           £000                            £000
Land                                                                       45,243                          42,462
Buildings excluding dwellings                                             147,723                         146,004
                                                                          192,966                         188,466


11.4 Net book value of assets held under finance leases and hire purchase contracts at the balance sheet date:
The Trust held no assets under finance leases and hire purchase contracts.
No depreciation was charged to the income and expenditure in respect of assets held under finance leases and hire purchase contracts.


11.5 The net book value of land, buildings and dwellings at 31 March 2007 comprises:
                                                                  31 March 2007                   1 August 2006
                                                                           £000                            £000
Freehold - Protected                                                      185,405                         180,840
Freehold - Unprotected                                                      7,561                           7,626
                                                                          192,966                         188,466




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     northumbria healthcare nhs foundation trust - accounts for the eight months ended 31 march 2007




     12 Fixed asset investments
     No fixed asset investments were held at 31 March 2007.


     13 Stocks and work in progress
                                                                                      31 March 2007        1 August 2006
                                                                                               £000                 £000
     Raw materials and consumables                                                                 7,149           6,846
                                                                                                   7,149           6,846


     14 Debtors
                                                                                      31 March 2007        1 August 2006
                                                                                               £000                 £000
     Amounts falling due within one year
     NHS debtors                                                                                   6,639         16,580
     Provisions for irrecoverable debts                                                            (701)          (518)
     Prepayments and accrued income                                                                2,540          4,704
     Other debtors                                                                                 2,153          1,105
                                                                                                  10,631         21,871
     Amounts falling due after more than one year:
     NHS debtors                                                                                     163             186
     Other prepayments and accrued income                                                          3,054           2,691
                                                                                                   3,217           2,877
                                                                                                  13,848         24,748

     The reduction in NHS Debtors falling due within one year is due to the balance at 1 August 2006 including a specific sum of £6,998,000 arising from the
     transfer of community healthcare premises.


     15 Current asset investments
     No current asset investments were held at 31 March 2007.

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                                                                              northumbria healthcare nhs foundation trust - accounts for the eight months ended 31 march 2007




16 Creditors
16.1 Creditors at the balance sheet date are made up of:
                                                                         31 March 2007                1 August 2006
                                                                                  £000                         £000
Amounts falling due within one year:
NHS creditors                                                                       5,958                       12,459
Trade creditors - revenue                                                           6,274                        2,567
Trade creditors - capital                                                           1,764                        1,111
Other tax and social security costs                                                 3,584                          342
Other creditors                                                                     2,855                        2,389
Accruals and deferred income                                                        3,575                        3,941
                                                                                  24,010                        22,809
Amounts falling due after more than one year:
Other creditors                                                                     1,140                         1,424
                                                                                    1,140                        1,424
                                                                                  25,150                        24,233
NHS creditors include;
- £40,000 for payments due in future years under arrangements to buy out the liability for early retirements over 5 years.
- £1,938,000 outstanding for pensions contributions at 31 March 2007.
The reduction in NHS creditors is mainly because the balance at 1 August 2006 included a sum of £2,324,999 due to
the Department of Health for dividends due on PDC. Such dividends are repayable in September and March each year.


16.2 Loans
No loans were held at the balance sheet date.




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     northumbria healthcare nhs foundation trust - accounts for the eight months ended 31 march 2007




     16.3 Prudential Borrowing Limit 2006/07
     The Foundation Trust is required to comply with, and remain within, a prudential borrowing limit. This comprises two elements, the maximum
     cumulative amount of long term borrowing and the amount of any working capital facility approved by Monitor. Further information on the NHS
     Foundation Trust's Prudential Borrowing Code and Compliance Framework can be found on the website of Monitor, the Independent Regulator of
     Foundation Trusts.
                                                                                                       £000
     Prudential Borrowing Limit set by Monitor                                                    64,500
     Of which Working Capital Facility (not to exceed)                                            21,000
     During the period covered by the accounts the Trust has not undertaken any borrowing nor has it utilised any of the working capital facility.
                                                                                                  Actual      Plan
     Minimum dividend cover ratio                                                                       1.4    2.1


     16.4 Finance lease obligations
     No finance lease obligations were outstanding at the balance sheet date.


     16.5 Future finance lease obligations
     At the balance sheet date the Trust had no future finance lease obligations.




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                                                                             northumbria healthcare nhs foundation trust - accounts for the eight months ended 31 march 2007




17 Provisions for liabilities and charges
                                                               Pensions             Other          Agenda For                    Other                Total
                                                              relating to            legal            Change
                                                              other staff          claims
                                                                   £000              £000                    £000                 £000                £000
At 1 August 2006                                                   1,406              556                     997                  210               3,169
Arising during the year                                               53                 0                    179                   44                 276
Utilised during the year                                           (106)              (22)                      0                    0               (128)
Unwinding of discount                                                 21                 9                      0                    0                  30
At 31 March 2007                                                  1,374               543                  1,176                   254               3,347

Expected timing of cashflows:
Within 1 year                                                       160                 22                  1,176                   50               1,408
1 - 5 years                                                         640                 88                      0                  204                 932
Over 5 years                                                        574                433                      0                    0               1,007

The provision for 'pensions relating to other staff' is in respect of staff who retired prior to 6 March 1995. Repayment is by quarterly instalment
to the NHS Pensions Agency.
The Agenda for Change provision relates to the estimated costs of fully implementing the new NHS pay system -'Agenda for Change'.
'Other legal claims' relates to employer and public liability claims.
'Other' provisions relates to injury benefit claims. Repayment of claims is made by quarterly repayment to the NHS Pensions Agency.
The NHSLA includes in its accounts at 31 March 2007 a provision for £18,094,625 in respect of clinical negligence claims made against the Trust.


18.1 Movements in taxpayers' equity
                                                                   £000
Taxpayers' equity as at 1 August 2006                           230,962
Surplus for the financial period                                   5,268
Public dividend capital dividends paid                           (4,650)
Fixed asset impairments                                            (103)
New Public Dividend Capital received                                 875
Public Dividend Capital repaid in period                         (2,510)
Reductions in donated asset reserve                                 (51)
Net addition to taxpayers' equity                                (1,171)
Taxpayers' equity as at 31 March 2007                           229,791

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     northumbria healthcare nhs foundation trust - accounts for the eight months ended 31 march 2007




     18.2 Movements in Public Dividend Capital
                                                                                                             £000

     Public Dividend Capital as at 1 August 2006                                                          147,052
     New Public Dividend Capital (cash receipt)                                                               875
     Public Dividend Capital repaid                                                                       (2,510)

     Public Dividend Capital as at 31 March 2007                                                          145,417


     18.3 Movements on Reserves
     Movements on reserves in the period comprised the following :
                                                                                                       Revaluation   Donated       Other   Income and     Total
                                                                                                          reserve       asset   reserves   expenditure
                                                                                                                      reserve                  reserve
                                                                                                             £000       £000       £000          £000     £000

     At 1 August 2006                                                                                      75,661      3,873       (551)        4,927    83,910
     Transfer from the income and expenditure account                                                           0          0          0           618      618
     Fixed asset impairments                                                                                 (103)         0          0             0     (103)
     Transfer of realised profits to the income and expenditure reserve                                       (91)         0          0            91        0
     Receipt of donated assets                                                                                  0        108          0             0      108
     Transfers to the income and expenditure account for depreciation,
     impairment and disposal of donated assets                                                                  0       (159)         0             0     (159)

     At 31 March 2007                                                                                      75,467      3,822       (551)        5,636    84,374




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                                                                            northumbria healthcare nhs foundation trust - accounts for the eight months ended 31 march 2007




19 Notes to the Cash Flow Statement
19.1 Reconciliation of operating surplus to net cash flow from operating activities:
                                                                                     8 months to 31.03.07
                                                                                                     £000
Total operating surplus                                                                                   2,041
Depreciation and amortisation charge                                                                      4,179
Transfer from donated asset reserve                                                                       (159)
Other movements                                                                                           2,325
Increase in stocks                                                                                        (303)
Decrease in debtors                                                                                       3,882
Increase in creditors                                                                                       264
Increase in provisions                                                                                      178
Net cash inflow from operating activities                                                                12,407


19.2 Reconciliation of net cash flow to movement in net funds
                                                                                     8 months to 31.03.07
                                                                           £000                      £000
Increase in cash in the period                                            4,995
Change in net funds resulting from cashflows                                                               4,995
Net funds at 1 August 2006                                                                                   809
Net funds at 31 March 2007                                                                                 5,804


19.3 Analysis of changes in net funds
                                                                                            At 1 August 2006                Cash changes               At 31 March
                                                                                                        2006                     in period                    2007
                                                                                                        £000                         £000                     £000
Commercial cash at bank and in hand                                                                            16                           4                       20
OPG cash at bank                                                                                              793                       4,991                    5,784
                                                                                                              809                       4,995                    5,804

The increase in cash was planned and arose principally to the receipt of £6,998,000 for the transfer of community health premises to North
Tyneside PCT offset in part by a reduction in NHS creditors.
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     northumbria healthcare nhs foundation trust - accounts for the eight months ended 31 march 2007




     20 Contractual capital commitments
     The Trust had no contractual commitments at the balance sheet date.

     21 Post balance sheet events
     There were no post balance sheet events.

     22 Contingencies
                                                                                     £000
     Total estimate of contingent liabilities                                        (236)
     Total estimate of contingent assets                                               113
     Net contingent liability                                                        (123)
     Contingent liabilities at 31 March 2007 are in respect of employer and public liability claims.
     The Trust has received a large number of Equal Pay Claims. As there are no 'test' cases at this stage the Trust is unable to calculate potential costs.

     23 Related party transactions
     Northumbria Healthcare NHS Foundation Trust is a body corporate established by order of the Secretary of State for Health.
     During the year none of the Board Members or members of the key management staff or parties related to them has undertaken any material
     transactions with Northumbria Healthcare.
     The Department of Health is regarded as a related party. During the year Northumbria Healthcare NHS Trust has had a significant number of
     material transactions with the Department, and with other entities for which the Department is regarded as the parent Department, viz:
     Northumberland Care Trust                            Other Strategic Health Authorities and Primary Care Trusts
     North Tyneside Primary Care Trust                    The NHS Litigation Authority
     Newcastle Primary Care Trust                         NHS Logistics Authority
     In addition, the Trust has had a significant number of material transactions with other Government Departments and other central and local
     Government bodies. Most of these transactions have been with the Department for Education and Employment for nurse and other staff training
     and Northumberland County Council and North Tyneside Metropolitan Borough Council in respect of joint enterprises.
     Further the Trust had material transactions with the following local authorities in respect of Business Rates and Community Charges:
     Wansbeck District Council                            Tynedale District Council
     Blyth Valley Borough Council                         North Tyneside Metropolitan Borough Council
     Castle Morpeth Borough Council
     The Trust has also received revenue and capital payments from a number of charitable funds, certain of the Trustees are also members of the NHS
     Trust Board. These totalled £395,000 in respect of revenue contributions and £108,000 in respect of capital contributions (a total of £503,000).
92
                                                                              northumbria healthcare nhs foundation trust - accounts for the eight months ended 31 march 2007




24 Private Finance Transactions
24.1 PFI schemes deemed to be off-balance sheet
Combined Heat and Power Scheme
                                                                                                                                                                   £000
Amounts included within operating expenses in respect of PFI transactions deemed to be off-balance sheet - gross                                                     799
Amortisation of PFI deferred asset                                                                                                                                    nil
Net charge to operating expenses                                                                                                                                     799
The Trust is committed to make the following payments during the next year:
PFI schemes which expires:                                                                                                                                         £000
5th to 10th years (inclusive)                                                                                                                                     1,212
The estimated annual payments in future years are not expected to be materially different from those which the Trust is committed to make during
the next year.
                                                                                                                                            £000
Estimated capital value of the PFI scheme                                                                                                  1,350
Contract start date:                                                                                                                  01/09/1999
Contract end date:                                                                                                                   31/08/ 2014

The scheme is for the provision of combined heat and power on the North Tyneside General Hospital site, including the sale of surplus power.


Phase II Wansbeck General Hospital
                                                                                                                                                                   £000
Amounts included within operating expenses in respect of PFI transactions deemed to be off-balance sheet - gross                                                  1,325
Residual interest capitalised                                                                                                                                     (409)
Amortisation of PFI deferred asset                                                                                                                                   19
Net charge to operating expenses                                                                                                                                     935
The Trust is committed to make the following payments during the next year:
PFI schemes which expires:                                                                                                                                         £000
26th to 30th years (inclusive)                                                                                                                                    2,040




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     24 Private Finance Transactions (contd)
     The estimated annual payments in future years are not expected to be materially different from those which the Trust is committed to make during
     the next year.
                                                                                                                                               £000
     Estimated capital value of the PFI scheme                                                                                                16,669
     Contract start date:                                                                                                                 29/11/2002
     Contract end date:                                                                                                                   15/02/2033
     The scheme is for the provision of Maternity, Gynaecology, Outpatients, Day Surgery and Child Health facilities and associated building
     maintenance.


     Hexham General Hospital
                                                                                                                                               £000
     Amounts included within operating expenses in respect of PFI transactions deemed to be off-balance sheet - gross                          2,410
     Residual interest capitalised                                                                                                              (643
     Amortisation of PFI deferred asset                                                                                                           28
     Net charge to operating expenses                                                                                                          1,795
     The Trust is committed to make the following payments during the next year:
     PFI schemes which expires:                                                                                                                 £000
     26th to 30th years (inclusive)                                                                                                            3,705
     The estimated annual payments in future years are not expected to be materially different from those which the Trust is committed to make during
     the next year.
                                                                                                                                                £000
     Estimated capital value of the PFI scheme                                                                                                29,721
     Contract start date:                                                                                                                 01/04/2003
     Contract end date:                                                                                                                   31/03/2033
     The scheme is for the reprovision of Hexham General Hospital and staff residences on an adjacent site.




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                                                                              northumbria healthcare nhs foundation trust - accounts for the eight months ended 31 march 2007




24 Private Finance Transactions (contd)
Rothbury Community Hospital
                                                                                                                                                                   £000
Amounts included within operating expenses in respect of PFI transactions deemed to be off-balance sheet - gross                                                    195
Residual interest capitalised                                                                                                                                       (29)
Amortisation of PFI deferred asset                                                                                                                                     0
Net charge to operating expenses                                                                                                                                     166
The Trust is committed to make the following payments during the next year:
PFI schemes which expires:                                                                                                                                         £000
26th to 30th years (inclusive)                                                                                                                                      402
The estimated annual payments in future years are not expected to be materially different from those which the Trust is committed to make during
the next year.
                                                                                                                                           £000
Estimated capital value of the PFI scheme                                                                                                                       2,308
Contract start date:                                                                                                                                       01/04/2003
Contract end date:                                                                                                                                         31/03/2033
The scheme is for the reprovision of a community hospital.

24.2 'Service' element of PFI schemes deemed to be on-balance sheet
The Trust has no PFI schemes either in operation or in the planning stage which are deemed to be 'on balance sheet'.




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     northumbria healthcare nhs foundation trust - accounts for the eight months ended 31 march 2007




     25 Financial Instruments
     FRS 13, Derivatives and Other Financial Instruments, requires disclosure of the role that financial instruments have had during the period in
     creating or changing the risks an entity faces in undertaking its activities. Because of the continuing service provider relationship that the NHS
     Foundation Trust has with local Primary Care Trusts and the way those Primary Care Trusts are financed, the NHS Trust is not exposed to the
     degree of financial risk faced by business entities. Also financial instruments play a much more limited role in creating or changing risk that would
     be typical of the listed companies to which FRS 13 mainly applies. Financial assets and liabilities are primarily generated by day-to-day operational
     activities and are not held to change the risks facing NHS foundation trusts in undertaking their activities.
     As allowed by FRS 13, debtors and creditors that are due to mature or become payable within 12 months from the balance sheet date have been
     omitted from the currency profile.
     Liquidity risk
     NHS foundation trusts' net operating expenses are primarily met by income generated under annual service agreements with primary care trusts,
     which are financed from sources voted annually by Parliament. NHS foundation trusts also largely finance their capital expenditure from the funds made
     available from Government under agreed borrowing limits. NHS foundation trusts are not therefore exposed to significant liquidity risks.
     Interest-Rate Risk
     97% of the Trust's financial assets and 99% of its financial liabilities carry nil or fixed rates of interest. Northumbria Healthcare NHS Foundation Trust is not
     therefore exposed to significant interest-rate risk. The following two tables show the interest rate profiles of the Trust's financial assets and liabilities:


     25.1 Financial Assets
                                                                                                                                      Fixed rate
     Currency                                                      Total         Floating Rate         Fixed rate   Non-interest   Weighted ave      Weighted ave
                                                                                                                        bearing         interest        period for
                                                                                                                                            rate      which fixed
                                                                   £000                      £000           £000           £000               %             Years
     At 31 March 2007
     Sterling                                                     5,970                     5,807            163              0            2.2%                    6
     Gross financial assets                                       5,970                     5,807            163              0                                    6
     At 1 August 2006
     Sterling                                                        995                       809           186              0            2.2%                    6
     Gross financial assets                                          995                       809           186              0            2.2%                    6




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                                                                              northumbria healthcare nhs foundation trust - accounts for the eight months ended 31 march 2007




25 Financial Instruments (contd)
25.2 Financial Liabilities
                                                                                                                                     Fixed rate
Currency                                            Total       Floating Rate         Fixed rate          Non-interest          Weighted ave           Weighted ave
                                                                                                              bearing                interest             period for
                                                                                                                                         rate           which fixed
                                                    £000                 £000                £000                   £000                   %                  Years
At 31 March 2007
Sterling                                         147,334                     0              1,917               145,417                     2.2%                         6
Gross financial liabilities                      147,334                     0              1,917               145,417                     2.2%                         6
At 1 August 2006
Sterling                                         149,014                     0              1,962               147,052                     2.2%                         6
Gross financial liabilities                      149,014                     0              1,962               147,052                     2.2%                         6
The Trust's non-interest bearing financial liabilities comprise Public Dividend Capital (PDC). The PDC is of unlimited term.
Foreign currency risk
The Trust has negligible foreign currency income or expenditure.




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     25 Financial Instruments (contd)
     25.3 Fair values
     Set out below is a comparison, by category, of book values and fair values of the NHS Trust's financial assets and liabilities as at 31 March 2007.
                                                                               Book Value            Fair Value       Basis of fair
                                                                                                                          valuation
                                                                                      £000                £000
     Financial assets
     Cash                                                                             5,804               5,804
     Debtors over 1 year:
        - Agreements with commissioners to cover creditors and provisions               163                 163              Note a
     Total                                                                            5,967               5,967

     Financial liabilities
     Provisions under contract                                                                           1,917     1,917       Note b
     Public Dividend Capital                                                                           145,417   145,417       Note c
     Total                                                                                             147,334   147,334
     a These debtors reflect agreements with commissioners to cover creditors over 1 year for early retirements and provisions under contract and their
       related interest charge/unwinding of discount. In line with notes b and c, below, fair value is not significantly different from book value.
     b Fair value is not significantly different from book value since, in the calculation of book value, the expected cash flows have been discounted by the
       Treasury discount rate of 2.2% in real terms.
     c The figure here is the full value of PDC in the balance sheet. Non of the PDC is short term i.e. repayable within a set period.

     26 Third Party Assets
     The Trust held £31,385 cash at bank and in hand at 31 March 2007, which relates to monies held by the Trust on behalf of patients on behalf of
     patients. This has been excluded from cash at bank and in hand figure reported in the accounts.

     27 Pooled budgets
     The Foundation Trust had no pooled budget projects during the eight months to 31 March 2007.

     28 Calculation of Dividend Paid on Public Dividend Capital
     The Foundation Trust is required to absorb the cost of capital at a rate of 3.5% of average relevant net assets. The rate is calculated as the
     percentage that dividends paid on Public Dividend Capital, totalling £,6,975,000, (for the twelve months April 2006 to March 2007) bears to the
     average relevant net assets of £220,787,000. This equates to 3.13%. This level of performance is within the materiality range set.
98
                                                                         northumbria healthcare nhs foundation trust - accounts for the eight months ended 31 march 2007




29 Losses and Special Payments
There were 2,271 cases of losses and special payments totalling £233,938 approved during the eight months to 31 March 2007. Losses and
special payments are charged to the relevant headings on a cash basis, including losses which would have been made good through insurance
cover had NHS Foundation Trusts not been bearing their own risks, (with insurance premiums then being included as normal revenue expenditure).


30 Intra-Government and Other Balances
                                                                            Debtors:             Debtors:             Creditors:            Creditors:
                                                                            amounts              amounts               amounts               amounts
                                                                          falling due          falling due           falling due           falling due
                                                                          within one           after more            within one            after more
                                                                                 year            than one                   year             than one
                                                                                                       year                                        year
                                                                               £000                   £000                  £000                  £000
Balances with other Central Government Bodies                                  6,019                    163                7,358                      0
Balances with Local Authorities                                                  222                      0                   30                      0
Balances with NHS Trusts and Foundation Trusts                                   599                      0                1,936                      0
Balances with Public Corporations and Trading Funds                               21                      0                  248                      0
Balances with bodies external to government                                    3,770                 3,054                14,438                 1,140
At 31 March 2007                                                              10,631                 3,217                24,010                 1,140
Balances with other Central Government Bodies                                 11,321                   186                15,819                     0
Balances with Local Authorities                                                  217                     0                     0                     0
Balances with NHS Trusts and Foundation Trusts                                 1,071                     0                 1,263                     0
Balances with Public Corporations and Trading Funds                               67                     0                    26                     0
Balances with bodies external to government                                    6,504                 2,691                 5,701                 1,424
At 1 August 2006                                                              19,180                 2,877                22,809                 1,424




                                                                                                                                                                           99
appendix 1   Berwick Constituency
             Tony Sandford *
             Edward Smith
                             Northumberland

                                Michael Mason
                                John Davidson *
                                                       Public Governors

                                                               North Shields Constituency
                                                               Alf McManus
                                                               Steve Ratcliffe
                                                                                   North Tyneside

                                                                                   Raymond Anderson

             Peter Herdman
                                                               North West Constituency
             Blyth Valley Constituency                         Peter Latham       Robert Lackenby
             David Pickering      Janet Flynn                  Mike Lowenstein
             Richard Simmons      Simpson Crawford *
                                                               Wallsend Constituency
             Hexham Constituency                               Ian McKee          Mary McGlade until 01.02.07
             Patrick Eavis     Colin Basey
             Lesley Cadwgan    Sheila Robson *                 Whitley Bay Constituency
             Derek Bramley *   Colin Harwood *                 Ian Grayson *       John Ross
                                                               Owen Lumsdon *
             Wansbeck Constituency
             Jean Hedley       Judith Rushmer
             Mike Elphick      Dane Arries
             Katie Stewart     David Wilkinson *


                                                       Staff Governors
                             Northumberland                                        North Tyneside
             Alnwick, Berwick, Rothbury Hospitals              North Tyneside General Hospital
             Wendy McDonaugh *         Glynis Duff             Including Tynemouth Court, GB Hunter and Balliol now Cobalt
                                                               Business Park
             Blyth, Morpeth Community Hospitals                Kerry Watts                     Cas Rodriguez
             Debbie Henderson *       Alison Thompson          David Morris                    Chris Hand *
             Hexham and Haltwhistle Hospitals                  Stephanie Greenwell *           Kevin Craddock *
             Mo Mansour *             Gary Earle               Seif Asaad *

             Wansbeck General Hospital
             Peter Smith             Kim Beeson
             Ahmed Hamad             Quentin Field-Boden *
             Paul Partington *

             *after name denotes term of office of 2 years




100
appendix 1
                                                  Co-opted Partner Governors
                                                  Education representatives                    North East Ambulance Service
                                                  Roger Barton until 01.02.2007                Colin Cessford
                                                  John Bond from 01.02.2007, University of
                                                                                               North East Chamber of Commerce
                                                  Newcastle
                                                                                               Vacant
Nominated Governors – There are 15                Royston Stevens until 01.02.2007
                                                  Margaret Rowe from 01.02.07, University of   Northumbria PPI Forum
co-opted governors nominated by a broad           Northumbria                                  Ken Patterson
range of organisations. The table below details   Local Authority representatives              Newcastle Hospitals NHS Foundation
                                                  Bill Brooks, Northumberland County Council   Trust
the names of co-opted governors and the           Muriel Green, North Tyneside Council         Len Fenwick
organisations they were nominated by:             Local Medical Committee representatives      Northumberland, Tyne and Wear NHS
                                                  Relton Cummings, Newcastle/ North            Trust
                                                  Tyneside                                     Alan Hall/Roy McLachlan
                                                  Alan Dove, Northumberland
                                                                                               PCT representatives
                                                  Local Voluntary Organisations                Chris Reed
                                                  Ian Dougall, VODA
                                                  Cath Carnaby, Women’s Health Advice
                                                  centre




                                                                                                                                    101
appendix 2                                     Public Governors
                                               Berwick Constituency
                                               John Davidson
                                                                      Number of meetings attended in year


                                                                           4
                                                                               North West Tyneside
                                                                               Constituency
                                                                               Rob Lackenby              2
                                                                                                              N. Tyneside Gen Hospital
                                                                                                              Seif Asaad
                                                                                                              Kevin Craddock
                                                                                                                                         4
                                                                                                                                         5
Governor’s attendance at Governors Body        Peter Herdman               2   Peter Latham              4    Stephanie Greenwell        3
                                               Michael Mason               4   Mike Lowenstein           6    Chris Hand                 4
Meetings                                       Tony Sandford               5                                  David Morris               5
                                               Eddie Smith                 3   Wallsend Constituency          Cas Rodriguez              3
                                                                               Mary McGlade              1    Kerry Watts                5
01.08.06 to 31.03.07                           Blyth Valley Constituency       Ian McKee                 3
                                               Simpson Crawford            4                                  Wansbeck General Hospital
                                               Janet Mary Flynn            3   Whitley Bay Constituency       Kim Beeson              4
                                               David Pickering             4   Ian Grayson              2     Quentin Field-Boden     4
Six meetings held between 1st August 2006 to   Richard Simmons             4   Owen Lumsdon             4     Ahmed Hamad             1
                                                                               John Ross                5     Paul Partington         0
31st March 2007                                Wansbeck Constituency                                          Peter Smith             4
                                               Dane Arries                 1
                                                                               Staff Governors
                                               Mike Elphick                5   Alnwick Infirmary              Nominated Co-opted
                                               Jean Hedley                 4   (inc Coquetdale)               Partner Governors
                                               Judith Rushmer              5   Wendy McDonaugh           3    Alan Hall/Roy McLachlan    2
                                               Katie Stewart               2                                  Colin Cessford             2
                                               David Wilkinson             5   Berwick Infirmary              Relton Cummings            1
                                                                               Glynis Duff               1    George Rae                 1
                                               Hexham Constituency                                            Len Fenwick                3
                                               Colin Basey                 3   Blyth Community Hospital       Andrew Sugden              1
                                               Derek Bramley               6   Debbie Henderson         3     Muriel Green               3
                                               Lesley Cadwgan              5                                  Mike Guy                   2
                                               Patrick Eavis               3   Morpeth Community Hospital
                                                                               Alison Thompson         2      Chris Reed                 1
                                               Colin Harwood               4                                  Bill Brooks                1
                                               Sheila Robson               6   Hexham General Hospital        Alan Dove                  1
                                                                               Mo Mansour                 0   Royston Stephens/
                                               North Shields Constituency
                                                                               Gary Earle (from November) 1   Margaret Rowe              3
                                               Raymond Anderson         3
                                                                                                              Ken Patterson              4
                                               Alf McManus              6
                                                                                                              Roger Barton/John Bond     1
                                               Steve Ratcliffe          3
                                                                                                              Ian Dougall
                                                                                                              Cath Carnaby               5
102
appendix 3
                                                     Governors Body Committee attendance during year ended 31st March 2007
                                             Number of meetings held from 1st             4               1             6              5
                                             August in year
                                                                                                                      Chair/
                                             Number of meetings attended in year Selection of Trust                Non Executive   Membership
                                                                                                      Nomination
                                                                                     Auditors                        Directors     Committee
                                                                                                                   Remuneration
Governors Body Committee attendance during   PUBLIC GOVERNORS
                                             Blyth Valley Constituency
                                             Simpson Crawford                                             1                            3
year ended 31st March 2007                   Richard Simmons                                                                           1
                                             Janet Flynn                                                                               1
                                             Wansbeck Constituency
                                             Jean Hedley                                                                3              1
                                             David Wilkinson                                                            2              4
                                             Mike Elphick                                                                              2
                                             Hexham Constituency
                                             Colin Basey                                  3
                                             Derek Bramley                                4
                                             Patrick Eavis                                                1                            1
                                             Colin Harwood                                                              2
                                             Sheila Robson                                                                             4
                                             North Shields Constituency
                                             Raymond Anderson                                                           3
                                             Alf McManus                                                                               1
                                             Whitley Bay Constituency
                                             John Ross                                    4                                            2
                                             Owen Lumsdon                                                                              1
                                             North West Tyneside Constituency
                                             Mike Lowenstein                              4
                                             Peter Latham                                                                              2
                                             STAFF GOVERNORS
                                             North Tyneside
                                             Kevin Craddock                               1               1             3              3
                                             Chris Hand                                                                 2
                                             Stephanie Greenwell                                                                       2
                                             Ahmed Hamad                                                                               1
                                             CO-OPTED GOVERNORS
                                             Cath Carnaby                                                                              4
                                             (letters after name indicate committee membership) * indicates committee chairman
                                                                                                                                                103
Board of Directors 2006/07
appendix 4
         Brian Flood, Chairman                                     Ann Farrar, Chief Operations Officer
         BSc (ENG), Hons.Upper2, Diploma in Nuclear Engineering,   MBA
         M.I.MECH.E, C.ENG                                         Joined the NHS in 1980. Northern and Yorkshire
         Mr Brian Flood has a background in engineering            Cancer Peer Review Team member, 2001. Acting
         working in his early career for Rolls Royce and           Director of Planning, Darlington and Durham Acute
         British Gas. Elected leader of North Tyneside             Hospitals Trust, June 2002-June 2003.
         Council 1984–1996. Started the economic                   Executive Director of Performance and
         development policy that caused Siemens to build           Governance, 2003-2004; Acting Chief Operating
         in North Tyneside, thereby starting considerable          Officer, November 2004.
         growth in jobs and industry.
         Has held current post since l998.
                                                                   Rosemary Stephenson, Executive
                                                                   Director of Nursing
         Jim Mackey, Chief Executive                               RGN 1970, BTA 1972, DMS 1995, Executive Development
         CIPFA                                                     Programme l997 – Durham University
         A qualified accountant who joined the NHS in 1990         Executive Director of Nursing 1997 – North
         becoming Director of Finance at North Tyneside            Tyneside Healthcare Trust
         Healthcare NHS Trust and then Deputy Chief                Executive Director of Patient Services/Elective
         Executive for the new Northumbria Healthcare              Care 1998
         NHS Trust.
                                                                   Executive Director of Nursing/Emergency Care 2004
         Spent 18 months on secondment as Regional
                                                                   Northern Regional Member of NPAT 1997–1999
         Director of Finance before returning to
         Northumbria as Chief Operating Officer in the
         summer of 2002. Appointed Joint Chief Executive           Paul Dunn, Executive Director of Finance
         in November 2003.                                         CIPFA
         Jim was also interim Chief Executive of                   Head of Finance, Northgate and Prudhoe NHS
         Northumberland Care Trust returned however to             Trust from January 1990 to May 2000.
         Northumbria Healthcare NHS Trust full-time from 1         Joined Northumbria Healthcare as Head of
         August 2005.                                              Finance June 2000 to December 2003.
                                                                   Executive Director of Finance from January 2004

104
Board of Directors 2006/07
appendix 4
         Steve Russell, Executive Director of                 Ann Stringer, Executive Director of
         Emergency Medicine and Community                     Human Resources and Organisational
         Hospitals                                            Development
         Steve has worked for the NHS for 9 years, starting   BA (Hons) Upper    Second   Sociology   and   Social
         as an NHS Management Trainee in 1997, having         Administration
         graduated in Industrial Economics.                   Ann Stringer joined the NHS in June 2005 from the
         He trained in Northumbria Healthcare and has         private sector and was Human Resources
         worked with the Trust ever since. He currently has   Manager with Nestle Food Division from
         responsibility for the management and                1994–1999.
         development of all medical specialities, emergency   Director of Human Resources , Findus Ltd –
         and critical care and the Trust's 5 community        1999–2005
         hospitals.                                           Executive Director of HR/OD, Northumbria
                                                              Healthcare from June 2005


         Ann Wright, Executive Director of Elective           Derek Thomson, Medical Director
         Care                                                 GP in Haltwhistle, Northumberland
         MBA 1995, DMS 1994, Diploma in Health Service        Medical Director for Northumbria Healthcare since
         Management 1986                                      2002
         Joined the NHS June 1979                             Medical Director for Long Term Conditions
         Started operational management in 1984 in            Part of Tynedale GP Fund holding Pilot Site
         Durham
                                                              Involved in Kaiser Permanente National Pilot Sit
         Newcastle Hospitals
         Regional Office
         Newcastle Hospitals
         Cheviot and Wansbeck in 1996
         Above posts all operational posts in acute trusts
         with the exception of Regional Office which was
         headquarters management job including servicing
         the Regional Health Authority Board
                                                                                                              105
Board of Directors 2006/07
appendix 4
         Dave Evans, Medical Director                            Regional Health Authority employees to complete
         Consultant in Obstetrics and Gynaecology                the part-time MBA Course at Durham University
         MBBS FRCOG                                              Business School
         Medical Director for Northumbria Healthcare since       Medical Director for Northumbria Healthcare since
         2002                                                    1998
         Medical Director of Surgery
         Previously Clinical Director for Obstetrics and         Ian Swithenbank, Non Executive Director
         Gynaecology                                             Member of Northumberland County Council (NCC)
         Caldicott Guardian                                      1977 to present.
         Lead for Risk Management                                Leader of NCC 1989-98
                                                                 Chairman of NCC 2002-2003
         Member of National Clinical Assessment Authority
                                                                 Member of Blyth Valley District Council 1986-89 and
                                                                 2001 to present
         Mike Weaver, Medical Director                           Chair of Association of County Councils(ACC)
         FRCS, MBA                                               International Affairs Committee 1992-1994
         Consultant Surgeon at Hexham General Hospital           Chair of ACC Policy Committee 1994-1996 Chair of
         for 20 years, specialising in colorectal and            ACC 1996-1997
         laparoscopic surgery, and also gastrointestinal         Deputy Chair of Local Government Association
         endoscopy.                                              1997 to present
         Currently Medical Director for Hexham General           Chair of Local Government Employers Organisation
                                                                 1999-2004
         Hospital.
                                                                 Chair of Local Government Improvement and
         Chairman of the Trust Medical Devices Advisory and      Development Agency 2004 to present
         Core Groups, and Hexham General Hospital’s
                                                                 Senior Vice Chair of the Council for National Land
         Clinical Governance Committee.                          and Property Information Services 2005 to present
         Previously Medical Director for Trust Surgical Board.   Member of "Central/Local Partnership" between
         Previously (Hexham General Hospital) Clinical           Central Government and Local Government
         Tutor, Clinic Audit Chairman, Medical Advisory          Trustee of Northumberland Local Government
         Committee Chair and Theatre Users Group Chair.          Pension Scheme
         Previously member of the first cohort of Northern       Non Executive Director for Northumbria Healthcare
                                                                 since 1998
106
Board of Directors 2006/07
appendix 4
        Lorna Garrett, Non Executive Director           Ian McMinn, Non Executive Director
        SRN 1971                                        BSc (Hons) Mathematics, Post-grad Diploma in Operational
        Staff Nurse until 1994                          Research

        Local Authority Involvement:                    Management grounding with Proctor and Gamble
                                                        Ltd where he worked in company statistician, IT
        Prudhoe Town Council 1976 - present
                                                        development, internal management consultancy
        Tynedale District Council 1991 -present         and line management roles for 8 years. At Tyne
        Mayor of Prudhoe 1990-91                        and Wear County Council became one of the first
        Mayor of Prudhoe 1997                           performance review officers in local government,
        Member of Prudhoe Community Partnership since   serving on the national advisory group on P    .R.
        1994 and currently Vice-Chairman.               before moving to position of Manpower Officer in
                                                        charge of organisational change and recruitment.
        Tynedale Council, Chairman of Economic and
                                                        During 20 years of self-employment from 1980,
        Community Development 1997
                                                        chaired local town council, regeneration
        Non Executive Director for Northumbria          partnership and social welfare charity for several
        Healthcare since 2000.                          years and was chair of finance and performance
                                                        review committee at Northumberland C.C. for 8
                                                        years. Presently undertakes social research for
                                                        various government and local government
                                                        departments.
                                                        Non Executive Director for Northumbria
                                                        Healthcare since l998




                                                                                                               107
Board of Directors 2006/07
appendix 4
         Neil Mundy, Non Executive Director                             David Thompson, Non Executive Director
         Chartered Institute of Public Finance and Accountancy          BA (Hon) Geography
         Associate of the Institute of Revenues, Rating and Valuation   MA Applied Geography
         Diploma in Municipal Administration                            Diploma in Education
         Fellow of the Royal Society of Arts
                                                                        1968–2003: Teacher, Deputy Head, High School
         Current Business interests:
                                                                        Headteacher
         • Retailing    catering,    Property,     Computer
           Visualisation and software development                       1994–2003: Secondary Heads Association –
                                                                        National Council Member and Northumberland
         • Partner Ellingham Associates
                                                                        Branch Secretary
         Current Appointments
                                                                        1997–2006: Member of DFES Headteachers’
         • Chairman of UK MNT Group
                                                                        Reference Group (until 2003), Rural Schools
         • Member of the Casino Advisory Panel
                                                                        Group and Federation Advisory Group
         • Port of Tyne Authority Chair of Audit Ctte
                                                                        1993–2003: Chairman of Tynedale Sports Council
         • Northumbria Healthcare NHS Trust
                                                                        2004–2005: Joint Co-Ordinator of Tynedale Virtual
         • Trustee: Age Concern
                                                                        College
         Recent full time appointments:-
                                                                        2003–Present: Chairman of North Country Leisure
         • Director of Finance, Director of Integration
                                                                        and Board Member of Leisure Tynedale, Leisure
         One North East (RDA) – 2004                                    Alnwick and Leisure Copeland
         • Group Finance Director DCWM Group – 1999
                                                                        2006–Present: Field Officer of Association of
         • Director of Finance and then Chief Executive of              School and College Leaders
           Tyne and Wear Development Corporation – 1997
         • Senior Consultant KPMG – 1987                                Non Executive Director with Northumbria
                                                                        Healthcare since 2003
         Recent Directorships:
         • Northern Defence Industries
         • Bioscience North Ltd
         • Genetics Knowledge Park
         • Process Industries Innovation Centre Ltd
         • Member of the National Strategic Advisory Board
         Non Executive Director with Northumbria
         Healthcare since l998
108
appendix 5                   Directors’ attendance at Board and Constitutional Committees
                                                   during year ended 31 March 2007

             Number of meetings held from 1st August 2006 to 31 March 2007     7             3          5             6               1             6      5




                                                                                                                   Governors Body




                                                                                                                                                 Non Executive
                                                                                                    Remuneration




                                                                                                                                                 Remuneration
                                                                                                                                                  Membership
                                                                                                                                    Nomination
                                                                             Trust Board




                                                                                                                                                  Committee
                                                                                                      Directors




                                                                                                                                                   Directors
                                                                                                                                                    Chair/
                                                                                            Audit
             Number of meetings attended in year



             Executive Board Directors
             Jim Mackey                                                        7                        4             5             *1             *6
             Paul Dunn                                                         5             2                        4
             Ann Farrar                                                        7             3                        4                                    2
             Ann Stringer                                                      7                        5             3               1             6
             Rosemary Stephenson                                               7             2                        4
             Ann Wright                                                        7                                      4
             Steve Russell                                                     4                                      3
             David Evans                                                       5                                      2
             Derek Thomson                                                     6                                      3
             Brian Griggs                                                      6                                      3
             Mike Weaver                                                       3                                      1

             Non Executive Board Directors
             Brian Flood                                                     *6              1          3          *6                 1             3     *5
             Neil Mundy                                                        6           *3**         2             4               1             1
             Ian Swithenbank                                                   6             1          5             3               1             3
             David Thompson                                                    6           3**          2             6                                    3
             Ian McMinn                                                        6           3**        *4              6
             Lorna Garrett                                                     7           2**          4             5                             2

             * denotes Board/Committee Chair
             ** denotes Committee member




                                                                                                                                                           109
appendix 6
             Director’s Interests
             Director’s are required to declare any                    None of these interests resulted in
             interest, such as a directorship of a company             transactions, financial or otherwise, with the
             or membership of a council they, or close                 Trust during the period.
             family members may have, which could
             potentially give rise to a conflict of interest in
             their duties as a Director of Northumbria
             Healthcare NHS Foundation Trust.

             Directors declared the following interests for
             the period of this report:


                             Director                                               Interest
             Jim Mackey                         None
             Ann Farrar                         None
             Rosemary Stephenson                None
             Paul Dunn                          None
             Ann Stringer                       None
             Ann Wright                         None
             Steve Russell                      None
             Michael Weaver                     None

             Derek Thomson                      North East Strategic Health Authority – GP Advisor on procurement

             David Evans                        None
             Brian Flood                        None
                                                Port of Tyne Authority – Non Executive Director, Age Concern (Northumberland) –
             Neil Mundy                         Trustee and Treasurer, Creative North Ltd – Associate Director, Ellingham Associates –
                                                partner, Celtic Crafts – partner, Ellingham Parish Council – councillor.

             Lorna Garrett                      Tynedale Council – Councillor, Prudhoe Community Partnership – Vice Chairman

             Ian Swithenbank                    None
             Ian McMinn                         None

                                                Leisure Tynedale – Chairman, Leisure Alnwick District – Board Member, North County
             David Thompson                     Leisure – Chairman.

110
appendix 7
             Governors’ Register of Interests
             Governors are required to declare all interests            Governors declared the following interests
             which they or their spouse or partner, have                for the year 2006/07:
             which would be considered relevant and
             material to the Governors Body such as a                   None of the declared interests resulted in
             directorship of a company or any connection                transactions which may have given rise to a
             with a voluntary or other organisation                     conflict of interest.
             contracting for Trust services which could
             potentially give rise to a conflict of interest.


                Public Governor               Declared Interest                                  Organisation
             Simpson Crawford      Unpaid Treasurer of a charity            Contract with Northumberland Care Trust

             Richard Simmons       Chairman of Charity with care contract   Northumberland Care Trust

             Michael Mason         Consultant                               GVA Lamb & Edge Newcastle upon Tyne

             Derek Bramley         Self employed trainer                    Provides training for NHS Trusts
                                                                            Teesside and Wear Valley NHS Trusts

             Colin Harwood         Director and Honorary Treasurer          The Society for General Microbiology.
                                   (Registered Charity 264017)              Business is four scientific journals in Microbiology and it
                                                                            is possible that the NHS is a customer.

             Owen Lumsdon          Board Member                             - Stepney Banks Stables
                                   Generalist Advisor                       - Citizens Advice Bureau

             Jean Hedley           Trustee of Charity                       - Women's Health Advisory Centre Ashington
                                   Daughter                                 - Staff Nurse NHCT

               Co-opted/Partner
                  Governors
             Chris Reed            Chief Executive                          North of Tyne Primary Care Organisations

             Alan Dove             Senior Partner                           Brockwell Medical Group
                                   Chairman Governing Body                  Burnside First School

             Margaret Rowe         Member of groups                         - Sunderland Education Forum City Hospitals
                                                                              Sunderland.
                                                                            - Service Education Partnership (NE SHA)
                                                                            - Nursing and Midwifery Education sub-group Newcastle
                                                                              upon Tyne Hospitals

                                                                                                                                    111
appendix 8
             Public membership                                        The Trust has achieved its target to recruit 1%
             The membership in the majority of                        of the total population as members in each
             constituency areas is representative in terms            constituency. The Trust plans to recruit
             of the number of members. Table 1 provides               further from its constituencies by introducing
             the number of public members split by                    an opt-out scheme for patients attending
             constituency as at 31 March 2007.                        Trust outpatient departments in May 2007.


             Table 1

             Public membership and percentage of local population by constituency

                            Foundation Constituency Area                       Members        Population       %
                                                         Berwick-upon-Tweed       1,828          70,345       2.60
                                                             Blyth Valley         1,771          81,265       2.18
             Northumberland (Parliamentary                    Hexham              1,293          74,981       1.72
             Constituencies)
                                                             Wansbeck              948           80,599       1.18
                                                              TOTAL               5,840         307,190       1.90
                                                             North West            691           47,414       1.46
                                                              Wallsend             709           42,842       1.65
             North Tyneside (Forum Areas)                   North Shields         1,089          55,759       1.95
                                                             Whitley Bay           943           45,644       2.07
                                                              TOTAL               3,432         191,659       1.79
             Unknown                                                               31
             Northumberland/North Tyneside Grand Total                            9,303         498,849       1.86




112
appendix 8
 Table 2 shows the number of staff members         Table 2
 at each constituency by 31st March 2007.          Staff constituency membership and % of staff employed
 The Trust has achieved its target of recruiting
 99% of the overall staff population in all of 7                  Staff Constituency Base                 Members             All Staff              %
 of the staff constituencies. This achievement
                                                   Staff constituency membership
 followed the introduction of the Staff opt out    and % of staff employed                                 2,838               2,845             45.60
 scheme in January 2007.
                                                   Wansbeck General Hospital                               1,761               1,768             28.29

 Representative membership                         Hexham, Haltwhistle                                      535                 542              8.60
 The Trust monitors ethnicity, gender and age
                                                   Morpeth Cottage Hospital                                 128                 135              2.06
 distribution of its membership population
                                                   Blyth Community Hospital                                 163                 170              2.62
 Ethnicity mix – Our membership is
                                                   Alnwick, Coquetdale                                      220                 227              3.53
 representative within each constituency with
 regard to ethnicity. 98% of our public            Berwick Infirmary                                        173                 180              2.78
 members are White British which reflects the
                                                   Unknown                                                  350                 357              5.62
 average ethnic composition of the total
 population in Northumberland and North            Northumbria Healthcare NHS Trust Total                  6,169               6,224             99.12
 Tyneside. Although the diversity of the
 ethnicity of the membership reflects the
 overall population statistics, the actual
 numbers of members who do not class                              Ethnicity           Number of Members     Eligible Membership           Population %
 themselves as White British are very small.
                                                   White                                    9125                    492,199                  1.85%
 Gender – The membership represents 1.5%
 of the total male population and 2.3% of the      Mixed                                     10                      1,855                   0.54%
 total female population. To be representative
 in terms of gender split, the number of           Asian or Asian British                    18                      2,689                   0.67%
 members who are male will need to be
                                                   Black or Black British                     1                      587                     0.17%
 increased.
                                                   Other                                      8                      1,691                   0.47%
 Age distribution – Young people are under
 represented within the age ranges 12–15 and
 16–19 within the membership. For 2007/08          *Ethnicity not stated or recorded as unknown excluded
 the Trust will be identifying opportunities to
 target recruitment in these age ranges.


                                                                                                                                                         113
appendix 8
             Disability – Less than 1% of members have           Some adjustments have been necessary to
             recorded an interest in disability and further      take account of ward boundary changes.
             data needs to be collected in this respect, to      Analysis of the current data confirms the Trust
             include these hard to reach groups. The Trust       is under represented in some local authority
             published a Disability Equality Scheme in line      wards based on the index of deprivation for
             with existing equality legislation and will be      that ward.
             consulting on the action plan. This will
             include active recruitment during the               Over the next year it is expected that the
             consultation with voluntary and community           introduction of the revised membership
             groups with an interest in disability, as well as   recruitment plan and the anticipated
             disabled residents identified through local         significant increase in our public membership
             councils.                                           could possibly result in a more representative
                                                                 membership in terms of age, gender and
             Socio-economic groupings – The Trust                socio – economic groups. Plans are in place
             membership reports currently provide data on        to monitor this on a monthly basis and the
             socio-economic groupings. By linking public         results will be reported to our Membership
             member’s postcodes to a local government            Committee. This committee has responsibility
             ward of residence an index of deprivation can       to ensure membership of each constituency
             be obtained. This is based on data extracted        is representative.
             from the Office of National Statistics Website.



              Socio-Economic groupings Number of Members            Eligible Membership        Population %
             Least deprived                         1547                    79041                  1.96%
             Below average                          1347                    74788                  1.80%
             Average                                1572                    84752                  1.85%
             Above average                          1576                   105731                  1.49%
             Most deprived                          1783                   114738                  1.55%




             • Groupings derived from member’s postcode to allocate local government ward. The
               wards grouped into quintiles according to their Index of Multiple Deprivation score.
             • Wards where deprivation quintiles are unknown are excluded from this analysis and
               represent 10% of the overall population

114
appendix 9
Committee Structure Chart                                                               BOARD OF DIRECTORS




                                                   Community Engagement Committee                                      Executive Team
                                                   Chair: Mrs Lorna Garrett                                            Chair: Chief Executive
                                                   Deputy Chair Mr Ian McMinn
                                                   Chief Officer: Ann Farrar




 Clinical Policy Group                         Audit Committee *                     Finance and Performance                Human Resources/OD Committee                Trustwide Governance Committee
 Chair: David Evans                            Chair Neil Mundy                      Committee                              Chair: David Thompson                       Chair: Lorna Garrett
 Chief Officer - Rosemary Stephenson           Deputy Chair - Ian McMinn             Chair: Ian Swithenbank                 Deputy Chair - Ian Swithenbank              Deputy Chair - David Thompson
                                               Chief Officer - Paul Dunn             Deputy Chair – Ian McMinn              Chief Officer - Ann Stringer                Chief Officer – Ann Farrar
                                                                                     Chief Officer – Ann Farrar



                         Remuneration Committee *                  IT Committee                             Charitable Funds Committee                Estates & Facilities Advisory Board
                         Chair: Ian McMinn                         Chair: Brian Flood                       Chair: Ian McMinn                         Chair: David Thompson
                         Deputy Chair - Lorna Garrett              Deputy Chair – vacant                    Deputy Chair - David Thompson             Deputy Chair: Ian McMinn
                         Chief Officer – Jim Mackey                Chief Officer - Ann Farrar               Chief Officer - Paul Dunn                 Chief Officer: Brian Griggs
                                                                   Clinical Lead: Mike Bradburn




                         Emergency Care and                        Emergency Surgery and                    Clinical Support Business Unit            Child Health Clinical Directorate
                         Medicine Business Unit                    Elective Care Business Unit
                                                                                                            Chair: Dr Colin Doig                      Chair: Dr Neela Shabde
                         Chair: Dr R Curless                       Chair: Dr Jeremy Rushmer
                                                                                                            Chief Officer – Rosemary Stephenson       Chief Officer - Rosemary Stephenson
                         Chief Officer - Steve Russell

                                                                                                                                                                                                     115
notes




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notes




        117
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