1. Homerton University Hospital NHS Foundation Trust Tracey Fletcher Chief Executive

2. Who we are: Hackney and Homerton
Population of Hackney in the region of 310,000
Provide secondary and community care, education and training
440 beds on the hospital site plus a 50 bed nursing home and many community facilities
c.3,800 staff
2016/17 Income of £307m

3. Review of the year…2016/17
Striving to meet the challenges of providing care as effectively and efficiently as possible
Responding to feedback from patients
Improving staff health and wellbeing, and responding to feedback
Continuing our focus on transforming care we offer through technology, with our EPR and RiO projects.
Working together with local and regional partners

4. Effective and efficient working – Care Quality Commission (CQC) reports
Community services
The inspection visits took place from 31st January to 3rd February 2017
First full inspection that had taken place for community services
Rated ‘Good’ overall with ‘Good’ for each of the domains (Safe, Effective, Caring, Responsive, Well led)
Children & Young People Services: + systems for identifying, reporting and managing risk + policies were easily available to staff + professional from across different teams worked well with each other + locations were clean and tidy, child friendly + services provided patient centred care + service leaders were described as supportive, accessible by staff - paediatric basic life support (PBLS) training - infection prevention training needs to be improved - terminology ‘duty of candour’ - Friends and Family test
Adult services: + good process for identifying and managing risks + demonstrated evidence based care and good multi-disciplinary working + integrated care and responsive to patients needs + local understanding of risks and where improvement is needed + managers supportive and patients involved in service development - Mental Capacity Act and DoLS training and awareness - online appraisal system does not provide satisfactory data - separate electronic systems for hospital and community teams - need for greater out of hours community nursing input

5. Mary Seacole Nursing Home
The Home has been inspected under the CQC approach in April 2016 and June 2017
The first inspection visit rated the Home as ‘Requires Improvement’
The second inspection Rated ‘Good’ overall with ‘Good’ for each of the domains (Safe, Effective, Caring, Responsive, Well led)
April June 2017

6. Effective and efficient working – access to services
Waiting for services:
A&E (target 95%)
RTT (target 92%)
Cancer (target 85%)

7. Effective and efficient working – access to services
Health visiting
IAPT
Community services

8. Feedback – Patients & Staff
Feedback from patients – Inpatient Survey
25% (35%) response rate compared to 44% (47%) nationally from a cohort of patients admitted during July (2015)
Based on a comparison to other trusts, there has been a small, overall improvement.
For the 72 questions that were asked in both 2015 and 2016, the Trust scored ‘worse’ on 6 questions in 2016 compared to ‘worse’ on 11 questions in 2015
In 2016, the Trust made a statistically significant improvement in one question (Trust and Confidence in Doctors).
There were no sections where the Trust was significantly worse compared to other trusts. In 2015, the Trust was significantly worse in two questions.
Staff Wellbeing and Engagement
Staff Survey 2016: 55% response rate which was a significant increase on the 34% response rate of
The external benchmarking compares the Trust to 39 other acute and community organisations or 98 acute Trusts. HUH had 64% of questions ranked in the top 20% for a positive response
Staff Survey 2016 findings (by decile)
Top 10% - satisfaction with quality of care able to deliver, staff agree their role makes a difference, good communication between management and staff and quality of non-mandatory training appraisals
Top 20% - able to contribute to improvements, recommend as a place to work/get treated, confidence in reporting unsafe practice
Bottom 10% - Equal opportunities and career progression, discrimination at work, % of appraisals,

9. Transforming care through technology
There are a number of transformational projects the Trust has embarked upon to deliver better and more effective care through the use of better technology:
Acute system enhancement – July 2015
Community system replacement – June 2015
Health Information Exchange expansion – 2016/17
Use of system technology in outpatients
Use of technology in the community

10. Working with local and sector partners
Hackney Devolution pilot / development of Accountable Care System thinking
Brings stakeholders together across Hackney
Offers the opportunity to make the case for devolved responsibility
Sustainability & Transformation Planning (STP)
Plan across north east London
Focus of STP on areas where there is a benefit to plan across a wider geographical area
Retaining the locality focus where appropriate

11. Looking to the future - Local Context
There are a number of strategic challenges and opportunities within our local environment:
Being aware of a future acute visit from the CQC and following up on the recommendations of existing reports as well as focusing on the issues arising from staff and patient surveys
Increased financial constraints against predicted population growth
Increased focus on clinical standards, 7 day working, staffing numbers and service accreditation

12. Looking to the future – key developments
Work with other partners within Hackney to develop service provision to patients in the community
Build on the partnerships within north east London to improve clinical pathways and offer solutions to assist in the sector working as effectively as it can
Environmental improvements:
Fire resilience work in the roof space above Neonatal Unit
Ward improvement programme
Pathology department

13. Strategic Priorities and Values
There are three broad key priorities for the Trust:
Quality – safe, effective, positive patient experience
Integration – pathways, prevention, partnerships
Growth – turnover, scale, reputation
There are four key Values for the Trust:
Safe
Respectful
Personal
Responsibility