Here for patients,

here for each other

Our virtual Annual General Meeting Wednesday 15 July 2020

Here for patients,

here for each other

Ellen Schroder

Chair

Welcome to our AGM

Our virtual AGM week

Monday: Supporting patients, families and carers: the family clinician liaison service

Tuesday: Work, grow, thrive & care together: supporting our workforce

Wednesday: A cancer service for the future at ENHT

Wednesday: East and North Hertfordshire NHS Trust Annual General Meeting

Thursday: Celebrating the year of the nurse and midwife

Friday: Digital innovation to support patient care

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Our agenda

Welcome

Ellen Schroder, Chair

Review of the year

Nick Carver, Chief Executive

Martin Armstrong, Deputy Chief Executive and Director of Finance and Information

Julie Anne Smith, Chief Operating Officer

Rachael Corser, Chief Nurse

Dr Michael Chilvers, Medical Director

A patient’s story – recovering from COVID-19

Chris and Mary Goward

Reflections on a pandemic

Nick Carver, Chief Executive

Operation: Restart

Julie Anne Smith, Chief Operating Officer

Q&A

Thank you

to all of our

volunteers

Congratulations to our Butterfly service

Our student

nurses in a

socially

distanced

induction

Amanda Radford, who came out

of retirement to support the trust

as a senior sister and nurse

educator, working in critical care

Our new staff wellbeing

area – created with your

donations.

Tablets helped patients

keep in touch with loved

ones

“It was so very lovely to see

his face, even though he

was very ill. He died the

following day.”

Dr Abdy Sedghi

Review of the year

Nick Carver

Chief Executive

Our financial health:

Final accounts 2019/20

Martin Armstrong

Deputy Chief Executive, and Director of Finance and Information

Moving in the right direction

18/19

Deficit

£13.5m

19/20

Surplus

£0.8m

3.0 2.9 1.0 0.5

-3.6

-16.0

-29.5

-25.8

-13.5

0.8

-35

-30

-25

-20

-15

-10

-5

0

5

10/11 11/12 12/13 13/14 14/15 15/16 16/17 17/18 18/19 19/20

Trust Surplus / (Deficit)

The long road to recovery

• The Trust has worked hard to develop and follow a consistent financial

strategy

• We’ve sought to achieve financial sustainability in balance with quality and

performance

• We’ve improved the quality of the data and information we use to make

business decisions

• Enhanced the accuracy of our appropriate capture and coding of activity

• Established an expert and innovative improvement function to help make

savings in a safe and sustainable way

• We’ve built a finance and information team that is expert, passionate and

committed

Why has our financial delivery improved?

Investing in our trust £'000

Building Maintenance

Fire Safety Works 1,266

Refurbishment of aseptic unit 869

ClO2 Plant Replacement 231

Backlog Maintenance - Building 1,515

3,881

Investment on medical equipment

Theatre Monitors 311

Anaesthetic Machines 240

Donated medical equipment (X-ray Machine) 280

Other medical equipment 1,311

2,142

IT Infrastructure

IT Hardware / PC refresh 1,817

Digital programme - Lorenzo 714

Renal IT System 291

Other IT Infrastructure 660

3,482

Strategic Investment

Renal Dialysis and Vascular 710

Total Capital Investment 19/20 10,215

Performance against our statutory duties

Classification Target Actual Rating

I&E 0.0 0.8 Missed

External financing limit

(EFL) * 3.0 -8.7 Achieved

Capital resource limit

(CRL) * 10.5 9.1 Achieved

Capital cost absorption

rate 3.5% 3.5% Achieved

Our auditor’s view

• Financial statements are true and fair in accordance with accounting policies of Secretary of State

• The part of the remuneration report to be audited has been properly prepared

• Information which comprises the commentary on financial performance within the annual report is consistent with the accounts

• Summary of opinion on economy, efficiency and effectiveness:

– Satisfied, in all significant respects, the Trust made proper arrangements to secure EEE

The year ahead – 2020 / 2021

• An emergency financial framework is in place across the first four

months of the new financial year across the NHS.

• This framework ensures that sufficient financial resources are in place to

help NHS providers to manage the impact of COVID-19.

• Normal contracting arrangements with commissioners have been

suspended during this period, as has the requirement to generate

savings.

• Revised financial guidance for the remainder of the 20/21 financial year

will come into place from 1 August.

Performance

Julie Anne Smith

Chief Operating Officer

556, 527

outpatient

attendances

205, 491

occupied

bed days

156,439

A&E

visits

65,202

day

cases

49,412

emergency

inpatients

26,471 chemo

attendances

57,987

radiotherapy

attendances

75,146

dialysis

attendances

5,241 births

6,783 elective

inpatients

Scale of activity

80.6% 81.7%

84.6% 83.8% 86.1%

85.1% 85.8%

81.5%

78.9%

81.5%

85.3%

80.2%

50%

55%

60%

65%

70%

75%

80%

85%

90%

95%

100%

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

% 4

hr

Perf

orm

an

ce

Emergency department 4-hour target

141,260

149,799 148,894

152,992

156,439

130,000

135,000

140,000

145,000

150,000

155,000

160,000

15/16 16/17 17/18 18/19 19/20

Nu

mb

er

of

A&

E a

tten

dan

ces

Emergency department - attendances

Emergency department 4-hour target

Type 3 minors and paediatrics

94%

95%

96%

97%

98%

99%

100%

4-h

ou

r p

erf

orm

an

ce

Type 3 (Minors) performance

94%

95%

96%

97%

98%

99%

100%

4-h

ou

r p

erf

orm

an

ce

Paediatrics 4-hour performance

Cancer performance

Standard

Target

Mar-19

Mar-20

Two week waits

Suspected cancer

93%

97.00%

98.77%

Two week waits

Breast symptomatic

93%

94.00%

97.14%

31-day

First definitive treatment

96%

94.47%

97.89%

31-day subsequent treatment

Anti-cancer drugs

98%

98.26%

99.50%

31-day subsequent treatment

Radiotherapy

94%

95.68%

98.06%

31-day subsequent treatment

Surgery

94%

78.79%

95.83%

62-day

GP referral to treatment

85%

67.52%

89.27%

62-day

Specialist screening service

90%

95.24%

66.67%

Cancer performance

62-day performance against all other trusts

ENHT (127th) 67.52%

Target = 85%

National performance = 79.72%

50%

60%

70%

80%

90%

100%

Performance at March 2019

Performance at March 2020

ENHT (15th) 89.27%

Target = 85%

National performance = 78.79%

50%

60%

70%

80%

90%

100%

70%

75%

80%

85%

90%

95%

100%

Apr-19 May-19 Jun-19 Jul-19 Aug-19 Sep-19 Oct-19 Nov-19 Dec-19 Jan-20 Feb-20 Mar-20

Elective waiting time performance

Treatment within 18 weeks of referral

91%

92%

93%

94%

95%

96%

97%

98%

99%

100%

Apr-19 May-19 Jun-19 Jul-19 Aug-19 Sep-19 Oct-19 Nov-19 Dec-19 Jan-20 Feb-20 Mar-20

Elective waiting time performance

Diagnostic tests undertaken within 6 weeks of referral

Quality

Rachael Corser, Chief Nurse

Dr Michael Chilvers, Medical Director

Quality Strategy 2019 - 2024

Quality

Care Quality Commission – July 2018

Care Quality Commission – December 2019

Quality Strategy 2019 - 2024

Quality

Positioned just outside the upper quartile

HSMR national peer comparison

Hospital standardised mortality rate (HSMR)

Positioned second in our peer group

HSMR peer comparison

Hospital standardised mortality rate (HSMR)

A patient’s story –

recovering from COVID-19

A short film featuring Chris and Mary Goward

Reflections on a pandemic

Nick Carver

Chief Executive

At the heart of the response

Initial projection – mitigated early peak

0

50

100

150

200

250

Critical care General & acute beds

Revised projection – mitigated early peak

shifted to right

0

50

100

150

200

250

16-Mar 23-Mar 30-Mar 06-Apr 13-Apr 20-Apr 27-Apr 04-May 11-May 18-May 25-May 01-Jun 08-Jun 15-Jun

Critical care General & acute beds

Patients who tested positive for COVID-19

0

5

10

15

20

25

Daily total Rolling 7-day average

Critical care beds occupied by date

0

5

10

15

20

25

30

Occupied beds Rolling 7-day average

Patient deaths due to COVID-19

0

1

2

3

4

5

6

Rolling 7-day average

Level 4 national incident

Level 4 national incident

Discharges to care homes – tested and not tested

0

5

10

15

20

25

30

35

Tested Not Tested

Our staff response

A new social contract

A new social contract

Operation: Restart

Julie Anne Smith

Chief Operating Officer

Operation: Restart

Provide the best care for all our patients; changes required in the hospital

Support our staff as they responded to change and worked through one of the hardest times

Cancer

operations

and cancer

therapies

sustained

throughout

the

pandemic

Emergency

Department

– triage pod

and

potential

Covid and

Non –Covid

departments

set up

Diagnostics

maintained to

support our

urgent and

cancer

patients

Outpatients

transformed

via innovative

digital

solutions –

Attend

Anywhere

Maternity

services

adapted to

ensure

access to

maternity

care

Operation: Restart

Provide the best care for all our patients; changes required in the hospital

Support our staff as they responded to change and worked through one of the hardest times

• We need to restart services for patients and meet the needs of our local

populations

• We need to maintain capacity for potential future surges in COVID-19 in our

populations

• We must be able to accommodate COVID-19 inpatients within the hospital –

in a way which keeps all of our patients, and staff, as safe as possible

• We must restart our services in a way which supports progress towards our

medium and long-term strategic priorities.

Operation: Restart - services today

Preventing

admission Frailty

Post-COVID

rehab and

support

Same-day

emergency care

and ambulatory

care

Discharge

home to

assess

Working as a health system

The way forward

Questions

• Ellen Schroder, Chair

• Nick Carver, Chief Executive

• Martin Armstrong, Deputy Chief Executive and Director of

Finance and Information

• Julie Anne Smith, Chief Operating Officer

• Rachael Corser, Chief Nurse

• Dr Michael Chilvers, Medical Director

Thank you for watching.