SECTION 2: TRUST PROFILE

SECTION 2: TRUST PROFILE

Section Summary

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2.

TRUST PROFILE

2.1

Overview

Hereford Hospitals NHS Trust (HHT) operates within two distinct health economies – Herefordshire (England) and Powys (Wales) – although clinically/operationally they are part of a single secondary care system spanning Herefordshire and the eastern part of central Wales.

HHT provides routine secondary care (District General Hospital) services to a core catchment population of X and an extended catchment population of Y.

Reproduced from Ordnance Survey map data by permission of the Ordnance Survey © Crown copyright 2001.

The Trust provides inpatient and ‘hi tech’ services from The County Hospital in Hereford. Ambulatory ‘lo tech’ services are provided on a decentralised basis from the following community hospitals (none of which are owned or operated by the organisation): • Ledbury • Bromyard • Ross-on-Wye • Leominster • Llandrindod Wells.

Table 1 below provides details of the Trust’s main commissioners: Commissioner Population % of HHT elective

income (07/08) % of HHT non elective income (07/08)

Herefordshire Primary Care Trust Powys Local Health Board

Others TOTAL

Table 2 below provides details of the Trust’s turnover, staffing levels and bed base Turnover (2007/08)

Staff Headcount as at 1/2/2008 WTE staff as at 1/2/2008

Bed base* as at 1/2/2008 323

*

2.2

Services and workloads

HHT provides the full range of services traditionally associated with a smaller county District General Hospital : A&E, emergency and elective surgery, inpatient medicine, women’s and children’s services, ambulatory, diagnostic and therapeutic services. Table 3 below profiles planned activity in 2007/08 across the Trust’s main services Speciality/

service New outpatients Follow up outpatients Non elective cases Inpatient elective cases Day surgery cases Day care cases Other attendances A&E Paediatrics/ neonates Cardiology Rheumatology Diabetic Medicine Gastroenterology Respiratory medicine Palliative Care Dermatology Geriatric Medicine Oncology ENT Oral surgery/ orthodontics Ophthalmology Obstetrics & gynaecology Trauma & orthopaedics General surgery (inc. GI, vascular, urology) Pathology

Radiology

Therapy services

In recognition of its size, HHT has developed an extensive network arrangement for the local provision of services which would not be viable on a ‘stand alone’ basis. These services include

• Neurology (outreach service from University Hospital Birmingham NHSFT) • Nephrology (outreach service from Worcester Acute NHS Trust)

• Cardio-thoracic surgery (outreach service from University Hospital Birmingham NHSFT)

• Vascular surgery (joint service with Worcester Acute Trust check title)

• ENT (joint service with Worcester Acute Trust)

• HHT is a member of the Three Counties Cancer Network, cancer services being provided in partnership with Gloucestershire Hospitals NHSFT.

Others??? Eg Herefordshire and Worcestershire Cardiac Network

2.3

Assets and facilities

The County Hospital was opened in 2002 as a first wave PFI scheme. The building is owned and operated by Mercia Healthcare on the basis of a thirty year contract with the Trust. The land remains within the ownership of the Trust as do a number of (primarily administrative) buildings with a total value of £Xm @ Y date which

constitute the retained estate.

The retained estate includes three ‘hutted’ wards housing 67 beds dating from World War II. This is not sustainable beyond the very short term.

Powys Local Health Board Herefordshire Health Steering Group Neurology, Nephrology and Cardio Thoracic surgery University Hospital Birmingham NHS Foundation Trust Vascular surgery, ENT and Oral Cancer Services , Three Counties Cancer Network

Hereford

Hospitals

Trust

The various components of the retained estate will be classified as Protected Assets under the Terms of Authorisation.

Add in something about the use of other sites for ambulatory care and the terms of any use

2.4

Key financial data

• Turnover and profile of commissioner income • Asset base

• RCI and changes over time 2003/4 onwards • Track record in delivering financial balance • Track record on EFL

• Track record on return on capital • Other KPIs?

Commentary on HHT perception of its financial robustness

2.5

Key performance data

• Key national targets 2003/04 onwards • 2 week cancer wait

• 31 day cancer wait • 62 day cancer wait • Hospital cleanliness

• Elective patients waiting longer than target • Outpatients waiting longer than standard • A&E

• Booking • Other KPIs?

Table from Annual Report

CHI (star ratings 2002/03, 03/04 and 04/05)

Healthcare Commission annual performance ratings 05/06 and 06/07

Commentary on HHT perception of its performance against non financial targets.

2.6

Key contractual data/key commercial relationships

The Trust’s most significant commercial relationship is with Mercia Healthcare Ltd in relation to The County Hospital and associated facilities management. Mercia Healthcare is a Special Purpose Vehicle established specifically to support the PFI scheme. 75% of the shares are held by SMIF (Secondary Investment Market Fund) and 25% by Sodexho. Mercia subcontracts with Sodexho for ‘soft’ FM services and with Atkins for ‘hard’ FM services. The 2007/08 unitary charge paid by the Trust will total £XXm or XX% of total income. HHT is putting in place a Deed of Safeguard as part of the FT process. The contract with Mercia will run until 20??

Input from Anthony Wheaton

HHT also has a significant commercial relationship with the Healthcare Purchasing Consortium (HPC). HPC is a DoH established collaborative procurement hub for the provision of a procurement/supplies service to the Trust. The value of the contract which runs until 20YY is £Xm per annum.

HHT provides a number of services (eg pharmacy) to Herefordshire PCT. HHT and the PCT also ‘share’ a number of services (eg IT). These services are covered by annual Service Level Agreements. The total value of the 2007/08 SLA is £Zm.

Powys