1. Staff Meetings May 2012

2. Agenda 1.How we did in 2011/12 2.The Financial Challenge this year 3.BEH Clinical Strategy

3. How did we do? 2011/12 in Summary 1.Targets A&E 96% for the year Infection control: 1 above target in MRSA, CDiff 23/60 18 weeks: achieved 62 day cancer treatment waits (80% rather than 85%). 2.Of 4,000 patients who have provided feedback since January 2011 97% rate their care as good or excellent. 3.Statutory and Mandatory Training and Appraisal- we need to improve 4.Staff survey- this year’s results similar to last year 5.Patient survey- one improved area, mixed sex accommodation, rest same as 2010 6.Ended year with £2.2m surplus, £800k behind plan.

4. 2012-13 Will be Difficult Financially Contract income this year is £10m less than last year because of a combination of national tariff price reductions, acute demand management and efficiency requirements from commissioners. Commissioners wanted to reduce our contract further- the final figure reflects the outcome of arbitration which largely went in our favour. BCF Trust Income

5. What Does This Mean for You as a Member of Staff and How Can You Help? 1.We believe you have ideas to improve our efficiency and reduce waste. We shall be establishing some focus groups to capture staff ideas and you can also raise things with your manager or email feedbackbcf@nhs.net feedbackbcf@nhs.net 2.A major issues we need to tackle is reducing our use of bank and agency staff. Last year we spent £32m on short term staff. We need to bring this down by: Recruiting permanent staff Making sure we roster staff efficiently using e-rostering Follow the staff sickness and absence policies 3.Think about how you can do more with less: do you really need to order that test, place that order. Would you do it this way with your money? 4.This is not about reducing quality or safety. We have to maintain standards while cutting waste and inefficiency.

6. BEH creates two sites with complimentary roles Chase Farm Planned Care Outpatients Elective surgery Cancer services Day surgery Rehabilitation UCC –Paediatric Assessment Unit –Elderly Assessment Unit Enhanced Recovery Barnet Emergency Care, Maternity & Paediatrics A&E Emergency surgery Day surgery Maternity (inc. Midwife Led Unit) Paediatrics Outpatients ITU & HDU

7. BEH Activity Shifts – Post Transfer Barnet HospitalChase Farm BCF Activity @ other sites NMH Transfer 2010/11Post BEHChange2010/11Post BEHChange2010/11Post BEH In Patient Medicine26,34128,6672,32614,9995,804-9,1950 4,888 Surgery22,56622,039-52722,73419,176-3,55802,855 Maternity4,9308,6063,6764,9660-4,9664212,889 Paediatrics5,0267,8912,8654,9241,783-3,141602,002 Total58,86367,2038,34047,62326,763-20,86048112,634 Out Patient First Attendance82,444 077,268 021,624 0 Follow up Attendance151,334 0149,274 032,9540 A&E Attendances - Major31,26239,754849229,3511619-27,732014,572 Attendances - Minor + Walk in 46,89450,863396944,02730,868-13,15906,993 Total78,156 90,61712,461 73,378 32,487 -40,891 021,565

8. Event OBC Approval by NHS London April 2012 OBC approval of NMUH Business case by TreasuryJuly 2012 FBC Approval by NHS LondonAugust 2012 FBC approval of NMUH Business case by TreasuryNovember 2012 Works to increase capacity at BH beginSeptember 2012 Works to expand capacity of BH for additional activity, complete October 2013 Transfer activity from CFH to BH and NMUHNovember 2013 EAU and UCC services at CFH beginNovember 2013 All CFH works complete and new OPD configuration begins operation October 2014 BEH Timeline

9. OBC Barnet Capital Works to support BEH ~ £18m Barnet Hospital –Relocation of Genito Urinary Medicine to allow conversion of template for ward use –Works to A&E to include sufficient resus. and paediatric facilities; –Expansion of ITU/HDU capacity –Increase in single room accommodation –CT scanner –Changes to paediatric in- and out-patient areas –Remodelling of Women’s outpatients –New and remodelled maternity and neonatal facilities

10. But What About Car Parking at Barnet? Car Parking proposals have been submitted to Barnet Council there are now 375 marked spaces for use by patients and visitors, and 570 marked spaces for use by staff (945 in total) in practice around 980 parking spaces are currently available Following BEH visitor numbers are expected to increase by 6%, and staff by 3% Temporary parking areas will be provided for contractor staff within a compound proposed north of the access road on fallow land total of around 40 additional spaces for visitors would appropriate to ensure equivalent parking provision in the future. About 28 further spaces can be created by better organisation of space. Can make improvements via encouraging care sharing, public transport improvements and green travel. Awaiting Barnet Council Response

11. OBC CFH Investment ~ £12m Refurbish the Maternity Block to create Modern Out Patient facilities Refurbish Highlands Wing to include new Elderly Assessment Unit Refurbish A&E to include UCC and PAU

12. OBC Loan Funding Funded through Interest Bearing Loan –Standard 5% interest –24 year term

13. Further CFH Investment- Stage 2 Follow on Business case –Further modernisation of Highlands Wing –Relocation of Pathology and Pharmacy –Modernisation of infrastructure to significantly improve site energy efficiency –Relocation of Admin and Support Services –Clearing of land for sale Plan to fully/partially fund through land sales

14. Chase Farm Final Configuration

15. BEH Workforce Changes  Workforce changes: Strategy implementation will require some staff to relocate from the Chase Farm Hospital site to Barnet Hospital and North Middlesex Hospital sites. The Trust aims to retain affected staff by redeploying into suitable vacancies where possible. Workforce plans are being developed to determine exact numbers and staff affected.  Financial implications: The strategy has around £30m of workforce reductions post BEH in 2013/14. We currently have 574 vacancies and 12% turnover.  Change management: The Trust will adopt robust change management principles in accordance with the Trust’s Policy, legislation and best practice including: –Timely and meaningful communication and consultation –Regular meetings with union representatives –Mechanisms to support staff through the change

16. Timeline for Workforce Changes ActionTimescales Internal communication to all staff and union representatives on the implementation of the BEH Strategy via FAQs, staff bulletins, intranet and letters reflecting timelines and the impact on staff and services. Ongoing Identification of future staffing numbers at specialty, staff group and grade levels to meet BEH requirements By Jul 2012 Development of detailed workforce change plans and proposed changes and staff consultation processes to be discussed with union representatives By Dec 2012 Hold suitable vacanciesFrom Feb 2013 Consultation papers to be issued.From Apr 2013 Commencement of redeployment of displaced staffFrom Jul 2013 Transfer of staff.By Nov 2013

17. Finally, on the Secretary of State’s Feasibility Study The SoS asked NHS London to undertake a feasibility study, on the creation of “Enfield Hospitals” that is merger of North Middlesex Hospital and Chase Farm Hospital A report was submitted in December SoS has accepted conclusion of NHS London that “there is little merit in pursuing this option” NHS London has said it will continue to support BCF and NM to develop further options for ensuring clinically and financially viable hospitals for this part of London

18. Questions?