One Message from the chief executive
We must be part of the solution
Dear colleague,
April saw the start of a new financial year
for the trust and with it has arrived warmer
weather, a definite sign that spring is here.
The heat is certainly on when it comes
to NHS finances and we can take some
consolation in knowing that we are not
alone.
Across London there has been a steady
stream of efficiency announcements in
recent weeks which indicate the scale of
the challenge that the NHS faces across the
capital.
For St George’s Healthcare, our £55 million
efficiency target is made up of a £40 million
cost reduction programme (CRP) and
£15 million related to quality, innovation,
productivity, prevention (QIPP) targets.
In facing up to this challenge it is important
that the trust is seen as part of the solution
rather than the problem. Although we have
successfully delivered a surplus in each of
the past four years our financial position
is still not as robust as it needs to be. Our
clinical and governance standards are not
in question but we do need to focus on our
financial performance and this will require
a commitment across the organisation and
the introduction of new ways of working.
I am aware that the decision to delay our
Our values foundation trust (FT) application to 2013
has disappointed many staff and it was
certainly not an easy one for the board to
make. However, as I explained in my March
One Message, patient safety must always
remain our priority and we cannot take
unnecessary risks in order to chase the
financial targets that are required for FT
status.
Recognising our achievements
While it is important that we look to the
future we should also take time to reflect
on the past and recognise our successes
over the financial year 2010/11.
April 2011
During that time we became operational
as both a major trauma centre and hyper-
acute stroke unit. In August our stroke
services were named the best in the
country in a national audit conducted by
the Royal College of Physicians.
Our cancer services also achieved earned
autonomy, removing the need for peer
review and we have increased surgical
capacity at the trust by 20 per cent by
opening new facilities. Infection control
rates at the trust remain among the best of
any London teaching hospital and this is
something we can all take pride in.
Our consultation to become a FT was
launched in May 2010 and with it our
membership recruitment drive. So far we
have recruited over 4,000 patient and
public members together with some 7,000
staff.
Last but by no means least, in October
2010 we successfully integrated with
community services Wandsworth, which
means that we now provide a wide range
of community services to children, adults
and older people provided at Queen Mary’s
Hospital (Roehampton), HMP Wandsworth,
health centres and clinics, GP surgeries,
schools and in people’s homes throughout
Wandsworth.
Quality and improvement will
drive success
However, as I explained earlier everything
hinges on our finances. In 2011/12
colleagues will be hearing a lot about the
Commissioning for Quality and Innovation
(CQUIN) payment framework. Put simply,
a proportion of the trust’s income is
conditional on our meeting quality
improvement and innovation goals. CQUINs
are objectives agreed between NHS trusts
in England and their commissioners and
are designed to support the shift towards
a vision where quality is the organising
principle.
 CQUINS are important because they
reward good clinical practice but equally
penalise poor practice. The trust has
CQUIN objectives for acute, specialised and
community services and in financial terms
these total around £6million so there is a lot
to win and also lose.
Key CQUINs for the trust this year
include Venous Thromboembolism
(VTE), patient experience and
outpatient experience.
Staff survey shows progress
The annual staff survey results were
published in March. The results are
important as they provide a snapshot
of what it is like to work at the trust.
It also indicates where we can make
improvements.
Over 3,000 members of staff received a
questionnaire with 40 per cent responding.
The results show that staff are satisfied with
the quality of work and patient care that
they are able to deliver and believe that
their role makes a difference to patients.
Staff also feel satisfied with their jobs
and believe they get support from their
immediate managers.
We have some areas to improve on and
some of the problems outlined in the
survey results are already being addressed.
We have more work to do around bullying
and harassment; an issue highlighted in
previous years and one that the trust takes
very seriously.
We also need to continue work around
Our values
Our values staff appraisals and MAST training. Revised
policies for both have been introduced
by the human resources directorate this
month, and we will work with managers to
successfully implement these in line with
our trust values.
Positive inpatient survey results
The results of the national inpatient survey
2010 have just been published and I am
pleased to announce that the scores for St
George’s Healthcare have improved in a
number of areas compared to 2009.
The results show that we now score
in the top 20 per cent of trusts in the
country in nine categories, which is a clear
improvement compared to just three
categories in 2009. Although still scoring
in the bottom 20 per cent in 11 categories,
this is also a marked improvement on 2009
when we scored in the bottom 20 per cent
in 30 categories. Our scores were about the
same as other trusts in the remaining 44
categories.
Initiatives introduced following
disappointing results in the 2009 survey
have really made a positive impact. I’d
like to congratulate colleagues across the
trust who have worked hard to implement
changes that have delivered real
improvements.
The survey also identified some aspects
of care and customer service where the
trust still needs to do better. As we move
forward we will need to communicate
more clearly with our patients and service
users, broaden patient choice and provide
services in a more patient-centred way. I
believe that together we can achieve these
things by being true to our values and
ensuring that patients are at the heart of
everything we do.
Thank you
I would like to end this One Message
by acknowledging the dedication and
commitment of our team of 7,000 staff who
I know are working hard across the trust to
deliver change and improve patient care. St
George’s Healthcare has a proud reputation
for quality and innovation and, by working
together, I am confident that the trust will
continue to go from strength to strength.
David Astley
Chief executive