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University Hospital Southampton NHS Foundation Trust Constitution
Description
Read our constitution here.
Url
/Media/UHS-website-2019/Docs/About-the-Trust/Trust-governance-and-corporate-docs/University-Hospital-Southampton-NHS-Foundation-Trust-Constitution.pdf
Information for investigators
Description
Expressions of Interest (EOI) We are aware that you may still be receiving EOIs for new studies. Currently we are only processing studies
Url
/Media/Southampton-Clinical-Research/COVID-19/info-for-researchers-and-sponsors/Information-for-investigators.pdf
Papers Council of Governors 20 July 2022
Description
Agenda attachments 1 CoG Agenda - 20.07.2022.docx Date Time Location Chair Agenda Council of Governors 20/07/2022 14
Url
/Media/UHS-website-2019/Docs/About-the-Trust/Trust-governance-and-corporate-docs/2022-Trust-documents/Papers-Council-of-Governors-20-July-2022.pdf
Your cardiac rhythm management device: battery change - patient information
Description
This factsheet explains what you need to know following your operation to have your implanted cardiac device replaced.
Url
/Media/UHS-website-2019/Patientinformation/Heartandlungs/Your-cardiac-rhythm-management-device-battery-change-3344-PIL.pdf
UHS register of interests June 2025
Description
Employee Name Aarvold, Dr Alice Beatrice Rachel Aarvold, Dr Alice Beatrice Rachel Adam, Dr Robert Dhugald (Rob) Adam, Dr Robert Dhugald (Rob) Adam, Dr Robert Dhugald (Rob) Adam, Dr Robert Dhugald (Rob) Adam, Dr Robert Dhugald (Rob) Adam, Dr Robert Dhugald (Rob) Adam, Dr Robert Dhugald (Rob) Afzal, Dr Nadeem Ahmad Afzal, Dr Nadeem Ahmad Afzal, Dr Nadeem Ahmad Afzal, Dr Nadeem Ahmad Afzal, Dr Nadeem Ahmad Afzal, Dr Nadeem Ahmad Afzal, Dr Nadeem Ahmad Afzal, Dr Nadeem Ahmad Afzal, Dr Nadeem Ahmad Afzal, Dr Nadeem Ahmad Afzal, Dr Nadeem Ahmad Akerman, Dr Catherine Mary Elizabeth Akerman, Dr Catherine Mary Elizabeth Akerman, Dr Henry (Harry) Akerman, Dr Henry (Harry) Akerman, Dr Henry (Harry) Al Rawi, Dr Samar Othman Abed Al Baki (Samar) Al Rawi, Dr Samar Othman Abed Al Baki (Samar) Al Rawi, Dr Samar Othman Abed Al Baki (Samar) Al Rawi, Dr Samar Othman Abed Al Baki (Samar) Al Rawi, Dr Samar Othman Abed Al Baki (Samar) Al-Azzawi, Dr Omar Muataz Shnasi Alderton, Dr Mark Vernon Alderton, Dr Mark Vernon Alderton, Dr Mark Vernon Allan, Dr Charlotte Georgina Allan, Dr Charlotte Georgina Allen, Dr David Charles Allen, Dr David Charles Amerasinghe, Ms. Nishani Amerasinghe, Ms. Nishani Amerasinghe, Ms. Nishani Amerasinghe, Ms. Nishani Amerasinghe, Ms. Nishani Amerasinghe, Ms. Nishani Amerasinghe, Ms. Nishani Amerasinghe, Ms. Nishani Amerasinghe, Ms. Nishani Amerasinghe, Ms. Nishani Amerasinghe, Ms. Nishani Amerasinghe, Ms. Nishani Amerasinghe, Ms. Nishani Amerasinghe, Ms. Nishani Amerasinghe, Ms. Nishani Amerasinghe, Ms. Nishani Amerasinghe, Ms. Nishani Amerasinghe, Ms. Nishani Amerasinghe, Ms. Nishani Amerasinghe, Ms. Nishani Amerasinghe, Ms. Nishani Amerasinghe, Ms. Nishani Amerasinghe, Ms. Nishani Amerasinghe, Ms. Nishani Amerasinghe, Ms. Nishani Amerasinghe, Ms. Nishani Amerasinghe, Ms. Nishani Amerasinghe, Ms. Nishani Amerasinghe, Ms. Nishani Amerasinghe, Ms. Nishani Amerasinghe, Ms. Nishani Amerasinghe, Ms. Nishani Amerasinghe, Ms. Nishani Amerasinghe, Ms. Nishani Amerasinghe, Ms. Nishani Amerasinghe, Ms. Nishani Amerasinghe, Ms. Nishani Amerasinghe, Ms. Nishani Amerasinghe, Ms. Nishani Amerasinghe, Ms. Nishani Anderson, Mr. David Frederick Anderson, Mr. David Frederick Anderson, Mr. David Frederick Anderson, Mr. David Frederick Role Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Consultant Interest Declared Y Y Interest Category Financial interests Financial interests Y Financial interests Y Financial interests Y Indirect interests Y Indirect interests Y Indirect interests Y Indirect interests Y Indirect interests Y Financial interests Y Financial interests Y Financial interests Y Financial interests Y Financial interests Y Financial interests Y Financial interests Y Financial interests Y Financial interests Interest Situation Clinical private practice Clinical private practice Outside employment Outside employment Hospitality Outside employment Outside employment Outside employment Sponsored events Clinical private practice Clinical private practice Clinical private practice Clinical private practice Donations Sponsored events Sponsored events Sponsored events Sponsored research Y Financial interests Sponsored research Y Financial interests Sponsored research Y Indirect interests Clinical private practice Shareholdings and other Y Indirect interests ownership interests Y Financial interests Clinical private practice Shareholdings and other Y Financial interests ownership interests Shareholdings and other Y Financial interests ownership interests Y Financial interests Clinical private practice Y Financial interests Clinical private practice Y Financial interests Clinical private practice Y Financial interests Clinical private practice Y Indirect interests Clinical private practice Shareholdings and other Y Financial interests ownership interests Y Indirect interests Clinical private practice Non-financial Y professional interest Outside employment Non-financial Y professional interest Outside employment Non-financial personal Y interests Loyalty interests Y Y Financial interests Clinical private practice Y Indirect interests Donations Y Financial interests Clinical private practice Y Financial interests Clinical private practice Y Financial interests Donations Y Financial interests Hospitality Y Financial interests Hospitality Y Financial interests Hospitality Shareholdings and other Y Financial interests ownership interests Y Financial interests Sponsored events Y Financial interests Sponsored events Y Financial interests Sponsored events Y Financial interests Sponsored events Y Financial interests Sponsored events Y Financial interests Sponsored events Y Financial interests Sponsored events Y Financial interests Sponsored events Y Financial interests Sponsored events Y Financial interests Sponsored events Y Financial interests Sponsored events Y Financial interests Sponsored events Y Financial interests Sponsored events Y Financial interests Sponsored events Y Financial interests Sponsored events Y Financial interests Sponsored events Y Financial interests Sponsored events Y Financial interests Sponsored events Y Financial interests Sponsored events Y Financial interests Sponsored events Y Financial interests Sponsored events Y Financial interests Sponsored events Y Financial interests Sponsored events Y Financial interests Sponsored events Y Financial interests Sponsored events Y Financial interests Sponsored events Y Financial interests Sponsored events Y Financial interests Sponsored research Non-financial personal Y interests Sponsored events Non-financial Y professional interest Hospitality Non-financial Y professional interest Outside employment Non-financial Y professional interest Sponsored events Non-financial Y professional interest Sponsored research Y Financial interests Outside employment Y Financial interests Clinical private practice Y Financial interests Sponsored events Y Financial interests Sponsored events Interest Description I have a private orthopaedic list once per month. I have a private list once a month . - Attended a educational event at the Abbott research facility in Sylmar, California, USA. - All travel cost, accomidation and meals were provided for by Abbott. - During the trip I provided 2.5 hours of feedback on future product development which I recieved a consultation fee for. In September 2022 I was part of the expert panel at the New Evidence based approach to Implementing the Four Pillars of HFrEF training event and I received HCP honorarium fees of £250 from AstraZeneca to participating in the event. On the 15th of November 2022 I attended a dinner/update event at the Harbour Hotel in Southampton that was sponsored by Medtronic LTD. I recieved a consultancy fee from AstraZenaza for speaking of cardiovscualar risk in COPD. I recieved a speakers fee from Astra Zeneca for apprearing at a Cardiometabolic GP Symposium. I recieved a speakers fee from Zoll for giving a presentation at EHRA. In September 2023 I attended a CRT training course in Denmark which was funded by Merit Medical. CANDOVER CLINIC BASINGSTOKE I do private work at Candover clinic, Basingstoke and North Hampshire Hospital, Aldermaston Road, Basingstoke RG24 9NA I have a private practice at Candover Clinic in Basingstoke and Spire Southampton. However, my practice at Spire Southampton is minimal, as it was intended for private endoscopies, which have not been possible due to a lack of support from the Spire hospital team. I practice at the Candover Basingstoke and the Spire A sum of 9,750 £ received from Dana Fry, a parent for purchase of a Paediatric Fibroscan probe. This is to be used for NHS practice. The moneys were deposited in Charity fund I sought sponsorship from Nutricia to organise a regional Wessex Gastroenterology meeting. The aim of this meeting is to maintain effective regional communication, discuss guidelines and standards of practice, and include presentations with key learning points for our day-to-day work. Comments This does not impact on my NHS work This is a regular list that has no impact on my NHS practice. - The trip was approved by to my line manager. - Merit funded all travel, accommodation and hospitality cost Private practice outside working hours for UHS I see patients with paediatric gastroenterology conditions in the clinic The fibroscan probe will be exceptionally useful for managing and treating children with liver fibrosis CoI Date From CoI Date To 16/09/2024 25/07/2022 25/07/2023 20/07/2022 24/09/2022 21/09/2022 21/09/2022 15/11/2022 15/11/2023 12/09/2024 12/09/2024 22/05/2024 22/05/2024 30/03/2025 30/03/2025 16/09/2023 18/09/2023 01/05/2021 04/10/2022 01/05/2021 01/12/2023 18/10/2024 01/12/2022 19/11/2021 27/02/2024 27/02/2024 Talk on national symposium sponsored by Falk, UK. However I haven't received any moneys yet. I declared my conflict of interest at the talk and the sponsorship didn't influence the content of my talk. WESSEX PAEDIATRIC GI NETWORK MEETING CI for The ACTIVE-IBD Study RHM CHI1102 Awarded 400£ for the study by CICRA - Childhood Crohns Research Association PAID TO PROVIDE LUNCH AND TEA FOR DELEGATES ATTENDING MEETING THE NETWORK MEETING IS FOR TEACHING AND DISCUSSION OF NETWORK PROTOCOLS - THIS TIME WE ARE DISCUSSING MANAGEMENT OF GI BLEEDING IN CHILDREN Ethics REC - Sep 2021 Study started - Nov 2021 35/50 recruited into study 19/10/2023 18/10/2022 18/10/2022 01/02/2022 EnablExercise in Crohns: A qualitativE study to uNderstAnd the Barriers and faciLitators to physical activity and Exercise IN children and adolescents with CROHN’S disease – perceptions of patients, caregivers and clinicians The aim of this project is to understand the barriers to and facilitators of physical activity and exercise training in children and adolescents with Crohn’s disease – incorporating the views of young people with Chrohns, their parents/guardians and doctors. Awarded 25K by GUTS UK (national bidding) Principal applicant DR Zoe Saynor - i m co-applicant SPONSORED RESEARCH My husband works as an anaesthetist in private practice moneys not awarded yet still to commence Granted 25K from GUTS UK to conduct research on Crohns in children with IBD 01/02/2022 01/11/2021 04/10/2022 30/11/2023 My husband has developed an app that allocates staff to vacancies in healthcare. Private healthcare providers are using this currently. I undertake private practice in my own at all the local private hospitals I have shares in Zelemiq Life Science Limited which is a local electronics company that helps other companies navigate through regulatory pathways. They also are creating the Ripple- a non invasive continuous glucose and lactate monitor I part own Alloc8tor that is a company linking together healthcare professionals with available outside work. We currently do no business with UHS or with the NHS. We have a contact with the Nuffield Hospital chain nationally and some other smaller contacts with other private hospitals. We have no plans to sell the company currently 30/11/2023 20/01/2022 01/01/2030 18/02/2024 26/02/2030 20/01/2022 01/04/2025 I am a member of SAS partnership and as such provide anaesthesia services locally. I work with a few surgeons closely and may pick up some as hoc sessions when offered to the group 04/01/2022 04/01/2023 I am part of SAS LLP which includes many colleagues from my trust. We provide anaesthetic services individually and as a group to local surgeons as well as other local providers such as ECT for the RSH. 04/11/2024 I have practicing privileges at both the Nuffield and Spire hospitals. In the past this included choose and book NHS patients but more recently the large majority is insured or self funding. Practicing privileges at both the Nuffield and Spire hospitals I continue to work in local private sectors and will occasionally have UHS outsourced patients on some of my lists 01/12/2020 31/12/2021 01/01/2022 01/01/2023 01/01/2023 31/12/2023 I am the sole shareholder and director of two companies. The first one is Al-Azzawi Trading Limited (Company number 13862060), which is an E-Commerce company that trades medical items such as stethoscopes, ophthalmoscopes, and consumer ECG monitors, as well as non-medical items. The suppliers are exclusively dealt with through eBay, Aliexpress, and Alibaba, while buyers are sold to through I would like to state that this is a declaration of interest rather than a declaration of conflict of interest. None of the time spent directing eBay. The second company is Al-Azzawi Businesses Limited (Company number 13829506), which is a property investment company in the form of Buy-To-Let. either of the two companies is part of my contracted time with the trust, nor does it happen on the trust premises. 28/03/2022 I have worked within the joint NHS/Private Palforzia peanut immunotherapy clinic. This is joint with Southampton NHS Trust however the immunotherapy is not offered via NHS services and it was felt best option to be able to offer this to some of our patients within the region. It does not impact on NHS duties running on a weekend and my role is very much supporting the service rather than leading it. I have not really worked in the service this year and will only support if staff sickness 18/01/2024 Designated doctor for child deaths for Hampshire, isle of Wight, Portsmouth and Southampton. Employed via HIOW ICS Potential COI but likely impact more for HIOW ICB 11/02/2020 NHSE SE Long COVID CYP lead No real conflict of interest to the hospital here 18/01/2024 Married to Mr Edward Gardner Consultant Orthopaedic Surgeon at UHS Asked to declare this at previous appraisals I undertake private clinical practice in Clinical Neurophysiology at the Sarum Road (Circle) Hospital Winchester I run one or two clinics per week, lasting 3 hrs each. We previously completed in a sponsored running event and raised money for the Smile for Wessex (Neuro) charity, which donated a few thousand pounds. We are currently potential beneficiaries of the Smile for Wessex charity, with regards to them funding equipment for a second VT bed. Continued work at Wessex Nuffield and Southampton Spire Also ad hoc work at Prema Clinic Portsmouth Do private practice at Southampton Spire and Nuffield wessex and Prema Laservision Educational Grant from Thea Pharmaceuticals £500 Attended list at Western Eye to watch Miniject insertion Moorfields international Glaucoma meeting - delegate iStent meeting - lecture given Hotel room booked by iStar Registration, dinner and hotel room for one night paid by Thea Pharmaceuticals Honorarium from Glaukos 01/11/2008 26/09/2022 26/09/2022 01/01/2010 12/03/2024 03/10/2021 12/03/2024 14/01/2024 08/02/2022 25/06/2023 02/11/2023 27/01/2024 15/09/2023 Paid a refundable deposit to buy shares in a new private non NHS hospital, where I hope to carry out private practice work in the future AbbVie Advisory Board Advisory Board on Durstyra Basic Glaucoma Course - organizer and facilitator - Alcon Basic Surgical Glaucoma Course, held at Alcon Education Centre, Barcelona Booth talk and podcast at European Society of Cataract and Refractive Surgeons Conference on Elios Chair and organiser of Corneal & Glaucoma Southern Meeting Sponsered by Thea Pharmaceuticals Chair of Wessex Glaucoma Forum Chair of Wessex Glaucoma Meeting Chaired Nguenity 1.5 meeting Chaired Southern Glaucoma and Corneal Meeting Educational Grant Elios Advisory Board Glaukos Advisory Board Honoria from Alcon for Advanced Glaucoma Surgical Course Hydrus Meeting Chaired Honorarium received Alcon Eye Care Hydrus Workshop Hydrus Workshop Course facilitator and lecturer International Glaucoma Consortium - participant Interview for Ophthalmologist magazine Interview on Gemini Study for the Ophthalmologist magazine Lecture series x 4 lectures in Singapore Speaker Lecture to Singapore Audience "More than meets the Eye" MIGS unplugged interview On advisory board for AbbVie Allergan for intracameral drugs use Preserflo User Group Meeting Chair of meeting Speaker at Cataract and Glaucoma Update meeting Wessex Glaucoma Meeting Real world data study in Glaucoma Honorarium paid by AbbVie Honoria received from AbbVie Advice on novel drug delivery to NHS Travel Hotel and dinners paid Honoria paid Course organizer and facilitator/lecturer Honorarium paid Course sponsored Accommodation, flights paid Honorarium paid by Elios Conference registration paid by Elios Hotel room & Dinner paid by Thea Pharmaceuticals Honoria paid Educational event for Wessex Glaucoma consultants Honoria received from Thea Pharmatceuticals Honoria received from Thea Pharmaceuticals Honorarium paid by Alcon Honorarium paid by Thea including hotel room for one night Educational Grant from Thea Pharmaceuticals to attend WGC Educational Event Honorarium from Elios travel , hotel and dinner paid Honoria paid Payments on 13th and 20th May 2025 Educational event for new technique being introduced to Trust Attended event registration, travel and accommodation covered by Alcon UK Honorarium paid by Alcon Honorarium paid by ICG Honorarium from Sight Sciences Honorarium paid by Sight Sciences Honorarium , flights , accommodation x 2 nights paid by AbbVie Honorarium received from AbbVie Honorarium paid by International Glaucoma Consortium Honorarium paid by Santen Hotel room booked Honoria received from Scope Chaired meeting Honoria received from Santen Educational event Sponsorship of data analysis and research methodology from AbbVie 12/05/2025 23/04/2024 01/12/2022 01/12/2022 08/01/2025 10/01/2025 17/04/2024 19/04/2024 07/09/2024 14/03/2025 14/03/2025 12/10/2022 12/10/2022 25/11/2022 25/11/2022 07/09/2024 08/12/2023 27/06/2023 01/07/2023 09/09/2023 10/04/2025 11/04/2025 23/04/2025 24/04/2025 06/07/2023 20/04/2023 21/04/2023 14/06/2024 31/05/2024 08/09/2023 07/09/2024 04/03/2024 05/03/2024 16/08/2023 02/06/2024 07/02/2022 21/11/2023 17/05/2023 17/05/2023 16/05/2023 16/05/2023 01/10/2022 Sponsorship of Charitable endeavor - Everest in the Alps to raise money for Glaucoma UK Sponsorship gained from ELIOS Vision; Santen UK; Thea Pharmaceuticals; iStar Medical Benefit to NHS - raises profile of Glaucoma 28/02/2023 03/03/2023 Sight Sciences Dinner WGC 2023 28/06/2023 28/06/2023 President-Elect UK & Eire Glaucoma Society Professional body affiliated to Glaucoma UK charity 04/05/2022 Educational event - Hydrus Workshop Registration , travel and accommodation covered by Alcon UK 20/04/2023 21/04/2023 Real world study of glaucoma data with Medisoft and research sponsored (no direct financial payment) by AbbVie Consultancy agreement between DFA and Leica Microsystems 20/04/2022 on-going private practice as detailed in Job Plan Leica Microsystems Visualization Summit October 2022 Southampton Corneal Meeting sponsored by Thea Pharmaceuticals Standard NDA and consultancy agreement for advice and presentation to Leica Microsystems from 2022Evening lecture 05/12/2021 20/04/2022 27/09/2023 24/07/2024 13/10/2022 13/10/2022 23/03/2023 23/03/2023 Anjum, Mr. Syed Neshat Anjum, Mr. Syed Neshat Anjum, Mr. Syed Neshat Ansell, Dr Gillian Lindsay (Gilly) Antonakis, Dr Serafeim Antonakis, Dr Serafeim Antonakis, Dr Serafeim Antonakis, Dr Serafeim Antony, Mrs. Shaibi Armstrong, Mr. Thomas Armstrong, Mr. Thomas Armstrong, Mr. Thomas Armstrong, Mr. Thomas Armstrong, Mr. Thomas Armstrong, Mr. Thomas Arshad, Mr. Ali Ahmed Osman Ali (Ali) Arshad, Mr. Ali Ahmed Osman Ali (Ali) Ayer, Miss Mavis Grace (Mavis) Ayer, Miss Mavis Grace (Mavis) Ayer, Miss Mavis Grace (Mavis) Ayer, Miss Mavis Grace (Mavis) Ayer, Miss Mavis Grace (Mavis) Ayer, Miss Mavis Grace (Mavis) Ayer, Miss Mavis Grace (Mavis) Ayer, Miss Mavis Grace (Mavis) Ayer, Miss Mavis Grace (Mavis) Ayer, Miss Mavis Grace (Mavis) Ayer, Miss Mavis Grace (Mavis) Ayer, Miss Mavis Grace (Mavis) Ayer, Miss Mavis Grace (Mavis) Ayer, Miss Mavis Grace (Mavis) Ayer, Miss Mavis Grace (Mavis) Ayer, Miss Mavis Grace (Mavis) Ayer, Miss Mavis Grace (Mavis) Ayer, Miss Mavis Grace (Mavis) Ayer, Miss Mavis Grace (Mavis) Ayer, Miss Mavis Grace (Mavis) Ayer, Miss Mavis Grace (Mavis) Ayer, Miss Mavis Grace (Mavis) Ayer, Miss Mavis Grace (Mavis) Ayer, Miss Mavis Grace (Mavis) Ayer, Miss Mavis Grace (Mavis) Ayer, Miss Mavis Grace (Mavis) Ayer, Miss Mavis Grace (Mavis) Ayer, Miss Mavis Grace (Mavis) Ayer, Miss Mavis Grace (Mavis) Ayer, Miss Mavis Grace (Mavis) Ayer, Miss Mavis Grace (Mavis) Ayer, Miss Mavis Grace (Mavis) Ayer, Miss Mavis Grace (Mavis) Ayer, Miss Mavis Grace (Mavis) Ayer, Miss Mavis Grace (Mavis) Ayer, Miss Mavis Grace (Mavis) Ayer, Miss Mavis Grace (Mavis) Ayer, Miss Mavis Grace (Mavis) Ayer, Miss Mavis Grace (Mavis) Ayer, Miss Mavis Grace (Mavis) Ayer, Miss Mavis Grace (Mavis) Ayer, Miss Mavis Grace (Mavis) Ayer, Miss Mavis Grace (Mavis) Ayer, Miss Mavis Grace (Mavis) Ayer, Miss Mavis Grace (Mavis) Ayer, Miss Mavis Grace (Mavis) Ayer, Miss Mavis Grace (Mavis) Ayer, Miss Mavis Grace (Mavis) Ayer, Miss Mavis Grace (Mavis) Ayer, Miss Mavis Grace (Mavis) Ayer, Miss Mavis Grace (Mavis) Ayer, Miss Mavis Grace (Mavis) Baker, Mr. Peter Stuart Balabanidou, Miss Eleni Balabanidou, Miss Eleni Barker, Dr Ruth Emily Barker, Dr Ruth Emily Barker, Dr Ruth Emily Barker, Dr Ruth Emily Barker, Dr Ruth Emily Barker, Dr Ruth Emily Barker, Dr Ruth Emily Barker, Dr Ruth Emily Barratt, Mr. James Matthew Bateman, Dr Andrew Rea Consultant Y Consultant Y Consultant Y Consultant Y Consultant Y Consultant Y Consultant Y Consultant Y Specialist Nurse Practitioner Y Consultant Y Consultant Y Consultant Y Consultant Y Consultant Y Consultant Y Consultant Y Consultant Y Nurse Manager Y Nurse Manager Y Nurse Manager Y Nurse Manager Y Nurse Manager Y Nurse Manager Y Nurse Manager Y Nurse Manager Y Nurse Manager Y Nurse Manager Y Nurse Manager Y Nurse Manager Y Nurse Manager Y Nurse Manager Y Nurse Manager Y Nurse Manager Y Nurse Manager Y Nurse Manager Y Nurse Manager Y Nurse Manager Y Nurse Manager Y Nurse Manager Y Nurse Manager Y Nurse Manager Y Nurse Manager Y Nurse Manager Y Nurse Manager Y Nurse Manager Y Nurse Manager Y Nurse Manager Y Nurse Manager Y Nurse Manager Y Nurse Manager Y Nurse Manager Y Nurse Manager Y Nurse Manager Y Nurse Manager Y Nurse Manager Y Nurse Manager Y Nurse Manager Y Nurse Manager Y Nurse Manager Y Nurse Manager Y Nurse Manager Y Nurse Manager Y Nurse Manager Y Nurse Manager Y Nurse Manager Y Nurse Manager Y Nurse Manager Y Nurse Manager Y Nurse Manager Y Manager Y Consultant Y Consultant Y Manager Y Manager Y Manager Y Manager Y Manager Y Manager Y Manager Y Manager Y Dietitian Specialist Practitioner Y Consultant Y Financial interests Financial interests Non-financial professional interest Clinical private practice Clinical private practice Clinical private practice Indirect interests Financial interests Loyalty interests Clinical private practice Financial interests Financial interests Clinical private practice Shareholdings and other ownership interests Financial interests Non-financial professional interest Financial interests Financial interests Indirect interests Non-financial personal interests Non-financial personal interests Non-financial professional interest Indirect interests Non-financial professional interest Financial interests Financial interests Financial interests Financial interests Financial interests Financial interests Financial interests Financial interests Financial interests Financial interests Financial interests Financial interests Financial interests Financial interests Financial interests Financial interests Financial interests Financial interests Financial interests Financial interests Financial interests Financial interests Financial interests Financial interests Financial interests Financial interests Financial interests Financial interests Financial interests Financial interests Financial interests Financial interests Financial interests Financial interests Financial interests Financial interests Financial interests Financial interests Financial interests Financial interests Financial interests Financial interests Financial interests Financial interests Financial interests Financial interests Non-financial personal interests Non-financial personal interests Non-financial professional interest Non-financial professional interest Non-financial professional interest Non-financial professional interest Non-financial professional interest Sponsored events Hospitality Sponsored events Sponsored events Sponsored events Loyalty interests Sponsored events Clinical private practice Clinical private practice Clinical private practice Hospitality Hospitality Outside employment Outside employment Outside employment Outside employment Outside employment Outside employment Outside employment Outside employment Outside employment Outside employment Outside employment Outside employment Outside employment Outside employment Outside employment Outside employment Outside employment Outside employment Outside employment Outside employment Outside employment Outside employment Outside employment Outside employment Outside employment Outside employment Outside employment Outside employment Outside employment Outside employment Outside employment Outside employment Outside employment Outside employment Outside employment Outside employment Outside employment Outside employment Outside employment Outside employment Outside employment Outside employment Outside employment Outside employment Hospitality Hospitality Hospitality Hospitality Sponsored events Sponsored events Outside employment Financial interests Non-financial personal interests Non-financial professional interest Non-financial professional interest Non-financial professional interest Non-financial professional interest Non-financial professional interest Non-financial professional interest Non-financial professional interest Non-financial professional interest Outside employment Loyalty interests Sponsored posts Sponsored posts Sponsored posts Sponsored posts Sponsored posts Sponsored posts Sponsored posts Sponsored posts Indirect interests Financial interests Sponsored events Clinical private practice I have got private practice privilege in Spire Southampton & Wessex Nuffield Hospitals My private practice mirrors NHS practice I do private practice in Spire & Nuffield hospital and my practice mirrors my NHS practice. I am joint owner of a LLP company with my spouse. His private practice income (HealthShare Winchester, Nuffield Hospital, Chandlers Ford) is paid directly into that company. My spouse also works in industry for a small company called OCG (orthopaedic Consulting Group) as a CMO and this income is also paid directly into the LLP. He does 1 day a week in industry and 1/2 day a week private practice. I have private practice privileges at Spire Southampton Hospital I see patients and do private Vitreoretinal and Cataract surgery through self-referral or/and insured work. Overall Time Commitment: Dedicated session on Job plan or weekends. (Information included in my previous portfolio appraisal documents) I perform cataract surgery un the ICS (NHS pathway) with the following providers: - Newmedica (since October 2020) I stopped working with the following providers: - Optegra (November 2020 - July 2022) - SpaMedica (June 2021 - June 2022) Overall time commitment: Dedicated session on job plan for private work or/and weekends with no on-call commitment or/and non-working time of NHS job plan. (already included in my previous portfolio documents) (14-6-2023: updated status) Service Contract Agreement with New Medical Systems Ltd as Shareholder and Joint Venture Partner in Newmedica Solent OJV. (Contract agreement signed - Newmedica Solent OJV will start offering its services from mid-September 2023) Sponsorship by Alimera to attend American Academy of Ophthalmology (virtual) Congress. As it is stated in the agreement document with Alimera, sponsorship does not constitute an inducement to prescribe, recommend, buy or sell any medicine or product. (Agreement document and details of sponsorship already included in my portfolio appraisal documents.) I have attended MS Trust conference from 23/03/2025 to 25/03 /2025 ENETS Honorarium paid by AAA to lecture at UKINETs symposium Ipsen paid for registration, travel and accommodation to ENETs in Vienna sponsored by AAA Committee member for UKINETs IPSEN Funded attendance at ENETS Conference 2022 and honorarium for supporting an educational event I do private practice in the same clinical sphere private practice I undertake clinical private practice at Spire Hospital Southampton Attending meeting for Merck conference Sponsorship to Conference (CMSC) Roche Ad board Sanofi Advisory Board Novartis Advisory board £420 Advisory board ( Roche) Advisory board Biogen CHARMS steering committee 5-7pm £540 Chairing an evening meeting Roche Chairing and speaking at a Biogen symposium at conference Chairing and speaking at an evening meeting/debate. Novartis Chairing national meeting Chairing sponsored symposium Charing evening meeting ( Merck) Evening Steering committee meeting with Novartis Filming for Merck Interview for market research for Roche paid £100 MS Nursing Connections ad board Meeting for an hour at 2pm Merck Advisory Board Merck Steering Committee Merck Steering committee meeting ( evening) Nursing Practice conference speaker Paid speaking engagement at REALMS Paid speaking engagement ( evening meeting with Novartis) Paid speaking engagement at Get Smart ( Novartis) Paid speaking engagement at INFORM MS Recording of podcast with Biogen Roche Steering committee Roche steering committee meeting ( paid) Roche- chairing a national meeting Roche- promotional material consultancy Roche- sponsorship to attend CMSC ( international conference) and chairing meetings Sanofi advisory board Sanofi- roundtable consultancy Speaker at an evening meeting, sponsored by Novartis Speaker conference Speaking at Biogen meeting for Saudi Nurses. Two separate days 45 mins each Speaking at a conference( Roche) Speaking at a conference, Nurse at the Limits Speaking at a meeting for Merck Speaking at a symposium ( Janssen) Speaking at an evening meeting Steering Committee meeting Steering committee 23rd of March and 27th of March £300 Virtual Advisory Board 5-8pm Biogen £452 ongoing commitment 6pm-7pm 2 hour evening meeting Sponsorship to CMSC Sponsorship to ECTRIMs Milan ( biogen) Sanofi- delegation to ECTRIMS international conference Speaker at conference and hospitality Sponsorship to International Conference Unknown amount Sponsorship to International conference unknown amount 01.05.25: Appointment as Director of YMCA Fairthorne Housing Trustee position of a local charity. I do not consider this to create a conflict of interest with my role at UHS Since the 1st of June 2021 I have started working with Practice Plus Group in Southampton as a Consultant. I hold a part time contract with the company of 20hrs a week. I treat NHS patients there as well. It currently keeps my elective operating skills up to date as my SUHT Contract is purely trauma operating. I am married to another Orthopaedic Hand Surgeon who is currently an employee of Practice Plus Group in Southampton Community Manager: Community Manager (a peer-support and forum) for ‘Healthcare Professionals in Research’ group - unpaid role. Early Career Working Group committee chair: Chair of international committee with American Thoracic Society Pulmonary Rehabilitation Assembly - unpaid role. National co-lead: National co-lead for /AHP's Everywhere’ group - unpaid role. Visiting Fellow: Visiting Fellow contract with UoS - unpaid role. Community Manager: Community Manager (a peer-support and forum) for ‘Healthcare Professionals in Research’ group - unpaid role. Early Career Working Group committee chair: Chair of international committee with American Thoracic Society Pulmonary Rehabilitation Assembly - unpaid role. National co-lead: National co-lead for /AHP's Everywhere’ group - unpaid role. Visiting Fellow: Visiting Fellow contract with UoS - unpaid role. Sponsorship of BIMDG conference by Nutricia Metabolics Private Oncology practice conduct at Spire Southampton and Genesis Southampton private clinical practice mirrors NHS practice i.e. Clinical Oncology for GI cancer Is ongoing 09/11/2024 22/06/2022 22/06/2022 22/06/2022 09/01/2020 20/09/2020 28/10/2020 09/06/2023 12/11/2021 13/11/2021 23/03/2025 25/03/2025 12/03/2024 14/03/2024 04/12/2022 04/12/2022 22/03/2023 24/05/2023 05/02/2022 05/03/2035 09/03/2022 11/03/2022 05/02/2022 16/05/2023 01/01/2021 07/02/2022 26/04/2024 26/04/2024 21/04/2023 22/04/2023 27/05/2024 02/06/2024 11/12/2024 11/12/2024 30/11/2022 30/11/2022 12/05/2022 19/06/2024 19/06/2024 01/12/2022 01/12/2022 08/11/2021 09/11/2021 21/11/2024 21/11/2024 26/03/2023 24/01/2023 24/01/2025 25/01/2025 17/09/2022 17/09/2022 03/04/2025 03/04/2025 21/02/2023 13/08/2024 13/08/2024 13/10/2021 13/10/2021 05/02/2025 05/02/2025 22/10/2024 22/10/2024 27/07/2022 27/07/2022 06/09/2022 06/09/2022 27/02/2025 27/02/2025 09/11/2022 09/11/2022 09/06/2023 09/06/2023 28/11/2023 28/11/2023 11/11/2023 11/11/2023 21/09/2023 21/09/2023 07/02/2023 18/04/2023 18/04/2023 03/10/2023 03/10/2023 20/06/2025 21/06/2025 23/04/2025 23/04/2025 26/05/2025 02/06/2025 28/02/2023 23/04/2025 23/04/2025 28/11/2023 28/12/2023 30/09/2022 01/10/2022 04/03/2023 05/03/2023 10/02/2024 10/02/2024 16/11/2024 16/11/2024 13/11/2024 13/11/2024 19/03/2024 19/03/2024 16/10/2024 16/10/2024 03/09/2024 03/09/2024 23/03/2022 25/11/2021 25/11/2021 29/05/2023 03/06/2023 11/10/2023 13/10/2023 23/09/2025 26/09/2025 17/09/2024 20/09/2024 31/05/2022 04/06/2022 31/05/2022 04/06/2022 01/05/2025 01/05/2028 01/06/2021 30/06/2022 06/05/2012 10/11/2021 01/01/2020 01/04/2022 01/07/2022 19/04/2021 01/01/2020 01/04/2022 01/07/2022 19/04/2021 11/06/2024 12/06/2024 01/10/2007 22/11/2024 Bateman, Professor Adrian Calvin Bateman, Professor Adrian Calvin Bates, Dr Andrew Tom Bates, Dr Andrew Tom Bates, Dr Andrew Tom Bates, Dr Andrew Tom Baxter, Dr Mark Alan Beck, Mr. Nicholas Edward Beecham, Mr. Ryan Christopher Beedle, Mr. Matthew Ian (Matt) Belgi, Dr Geeta Belgi, Dr Geeta Berry, Mrs. Lisa Jane Bevan, Ms. Amanda Bhargava, Dr Vidhi (Vidhi) Bhatnagar, Dr Adityanarayan Bhatnagar, Dr Adityanarayan Birch, Mr. Brian Robert Peter Birkett, Mr. Lewis Terence Blackwell, Ms. Nicola (Nicky) Blackwell, Ms. Nicola (Nicky) Blake, Mrs. Sinead Patricia (Sinead) Boswell, Dr Owen David Boulos, Mr. Nabil Adel Aziz Bowley, Mr. Adam Marcus Haydon Boyce, Dr Sara Rosalind (Sara) Boyce, Dr Sara Rosalind (Sara) Boyce, Dr Sara Rosalind (Sara) Boyce, Dr Sara Rosalind (Sara) Brain, Dr Amanda Rachel Brander, Mr. Matt Lee Breen, Dr David John Breen, Dr David John Breen, Dr David John Briant, Mr. Jason Scott (Jase) Broadbent, Miss Bethany (Beth) Broadley, Dr Rachel Jane Broadley, Dr Rachel Jane Bromby, Mr. Mark David Brooks, Mrs. Julie Bryant, Dr Timothy Bryant, Dr Timothy Bryant, Dr Timothy Bryant, Dr Timothy Bujanova, Dr Jana Bull, Mr. Colin Lawrence Bulters, Mr. Diederik Olivier Bulters, Mr. Diederik Olivier Bulters, Mr. Diederik Olivier Burke, Dr Georgina Burke, Dr Georgina Burke, Dr Hannah Burke, Mr. Martin James Burke, Mr. Martin James Burke, Mr. Martin James Butler, Mrs. Eleanor Mary (Eleanor) Byrne, Dr James Patrick Consultant Y Consultant Y Consultant Y Consultant Y Consultant Y Consultant Y Consultant Y Consultant Y Analyst Y Manager Y Consultant Y Consultant Y Nurse - Advanced Practitioner Y Pharmacist Y Consultant Y Consultant Y Consultant Y Consultant Y Manager Y Occupational Therapy Specialist Practitioner Y Occupational Therapy Specialist Practitioner Y Specialist Nurse Practitioner Y Consultant Y Pharmacist Y Physiotherapist Specialist Practitioner Y Consultant Y Consultant Y Consultant Y Consultant Y Associate Specialist (Closed to new entrants) Y Manager Y Consultant Y Consultant Y Consultant Y Analyst Y Specialist Healthcare Science Practitioner Y Consultant Y Consultant Y Specialist Healthcare Science Practitioner Y Nurse Manager Y Consultant Y Consultant Y Consultant Y Consultant Y Consultant Y Manager Y Consultant Y Consultant Y Consultant Y Consultant Y Consultant Y Consultant Y Manager Y Manager Y Manager Y Physiotherapist Manager Y Consultant Y Financial interests Financial interests Financial interests Financial interests Financial interests Indirect interests Non-financial professional interest Clinical private practice Loyalty interests Clinical private practice Hospitality Hospitality Loyalty interests Clinical private practice Financial interests Clinical private practice Financial interests Outside employment Non-financial professional interest Financial interests Financial interests Financial interests Financial interests Financial interests Financial interests Financial interests Hospitality Clinical private practice Clinical private practice Loyalty interests Sponsored events Clinical private practice Clinical private practice Outside employment Financial interests Non-financial personal interests Sponsored events Gifts Indirect interests Clinical private practice Indirect interests Outside employment Financial interests Indirect interests Outside employment Clinical private practice Non-financial professional interest Sponsored events Financial interests Financial interests Financial interests Financial interests Financial interests Non-financial personal interests Non-financial personal interests Financial interests Financial interests Non-financial professional interest Non-financial personal interests Clinical private practice Outside employment Outside employment Outside employment Sponsored events Outside employment Gifts Sponsored events Sponsored events Sponsored events Gifts Financial interests Financial interests Financial interests Financial interests Non-financial professional interest Financial interests Gifts Outside employment Shareholdings and other ownership interests Clinical private practice Loyalty interests Hospitality Financial interests Financial interests Hospitality Hospitality Financial interests Indirect interests Financial interests Financial interests Financial interests Financial interests Financial interests Non-financial professional interest Financial interests Non-financial personal interests Outside employment Sponsored events Outside employment Clinical private practice Outside employment Outside employment Sponsored events Sponsored events Sponsored events Gifts Non-financial personal interests Hospitality Non-financial personal interests Financial interests Financial interests Hospitality Clinical private practice Outside employment I undertake private practice at the Spire Southampton and Wessex Nuffield Hospitals I am registered with Source Bioscience and Backlogs - which are remote locum companies in cellular pathology I am the Editor in Chief of the journal Diagnostic Histopathology and receive an honorarium for this. Private Practice with admitting rights at UHS, Spire Southampton Hospital and Genesis Care Southampton. 3 hours per week on Wednesday am in Job Plan. Honoraria for talk to Astra Zeneca Sponsored Satellite Symposium at BTOG January 2022. £800 Hospitality from Genesis Care: Dinner Lainston House Hotel 2/12/21 Dinner Ennios Restaurant, Southampton 6/10/22 Mr wife, Claire Walsh (Bates) is a GP Partner at Stockbridge Surgery. Chemotherapy mostly delivered at UHS in Solent Suite. Radiotherapy delivered at UHS and Genesis Care. Most of my Private Practice radiotherapy is now with Genesis Care at Spire Southampton Hospital. Previously most of my Private radiotherapy was delivered at UHS, but the waits are now too long. Patients from Stockbridge Surgery are referred to UHS 05/02/2022 01/09/2024 05/02/2022 01/09/2024 01/06/2006 31/12/2025 27/01/2022 27/01/2022 02/12/2021 06/10/2022 01/01/2010 31/12/2025 I do a weekly private outpatient clinic at Spire/Nuffield. This takes about 4 hours per week This has been ongoing for many years, no change and doesn't impact my NHS practice 25/09/2022 31/03/2023 General and colorectal surgeon including outpatients, endoscopy/colonoscopy, operating. Practicing at: Spire Southampton Hospital, Chalybeate Close, Southampton SO16 6UY Nuffield Health Wessex Hospital, Winchester Road, Chandlers Ford, Eastleigh SO53 2DW Tuesday pm colonoscopy Spire hospital Tuesday evening Outpatients Nuffield hospital (variable/ad hoc surgery) Updated 04.09.24 confirmed private practice as outlined. 01/10/2004 04/09/2024 Looking to be Part Time self employed (weekend work) to be a system analyst for other UK Hospital Sites which use the same software we use in critical care (MetaVision). The skills I have built within my First time filling one of these in so i am happy to reply with more information if needed. I have set the date to a year as i am unsure how the current role within the trust would aide in my Part Time self employment i.e. analysing databases and building reporting solutions I would currently remain as a full time member of UHS. part time self employment will last for in its early stages. 11/05/2023 11/05/2024 Flights, accommodation and conference attendance at the the CPSI (TruBridge) conference in the USA in May 2024. TruBridge are the supplier we partner with to develop My Medical Record. This conference will include an in-person user group (with other TruBridge customers). It will also include meetings with the TruBridge product team, where we will discuss alignment (including potential blockers) of the TruBridge and My Medical Record product roadmaps. I notified my line manger (David Cable) as soon as I received the invite and I also have a approval from Jason Teoh (CIO). I do private work at nuffield. This work is on a wednesday and is documented in the job plan My work at Spire is in NHS hours only. I have private practice to declare I notified my line manger (David Cable) as soon as I received the invite and I also have a approval from Jason Teoh (CIO). I've added this as 'non-financial professional interest' although I'm not sure if that is the correct category? It seemed the best fit from the options. I have private practice to declare. My practice is at the nuffield and Spire hospitals 28/04/2024 03/05/2024 01/06/2022 06/06/2023 01/06/2023 07/06/2024 Advisory Board Member for: DGH Pharma (Europe) Ltd Kemp House 160 City Road London United Kingdom EC1v 2NX Payment received for education session at meeting sponsored by Chiesi. I work for Spire Southampton, Nuffield Wessex hospitals outside of NHS hours. I do remote reporting for Backlogs limited. I work in the private hospital as a consultant oncologist. Private hospitals include Spire Southampton, Genesis radiotherapy, new hall hospital Salisbury. I also undertake private patient work at UHS Southampton Working with GCUK - private radiotherapy provider. Working as a clinical oncologist for approximately 3 to 4 hours a week as MR -Linac specialist. Currently UHS does not have MR Linac therefore there is no direct conflict of interest. have either received research grants, honoraria to speak at, chair and attend meetings or liaised/received educational material from representatives of the following companies over the last 20 years: · Astellas · Pfizer · Ipsen · Glaxo Smith Kline · Sanofi · Lilly · Bayer · Amgen · Ferring · Takeda · Comvita · AstraZenecaJanssen-Cilag · Janssen The latest were from 1. Janssen to attend (as faculty) the prostate cancer summit in the UK (2020) 2. Laborie for providing a presentation to be used at the ICS meeting in Melbourne (20210) (2020) Christmas food box from a supplier - Softcat – of mostly perishable items (crisps, chocolate, cranberry sauce, biscuits, bottle of wine). The market value of the items is estimated at less than £15. Generally thee support provide has been to attend conferences or fund research. I do not hold shares (directly) in any companies providing health care resources of any kind to the NHS or other like companies. I have a Private Practice based at the Wessex Nuffield that might be considered a potential conflict of interest to my work with the NHS and UHS but I manage this along NHS and UHS guidelines and do not perform any procedures there that I do not perform on the NHS other than reversal of vasectomy as this is not generally funded by the NHS. Given the relatively low value, perishable nature, and inconvenience of returning the item to the supplier, it was deemed appropriate for the team to keep this food box. 01/06/2022 31/12/2022 01/04/2021 31/03/2022 20/02/2023 24/03/2025 01/01/2009 31/03/2025 01/04/2024 31/03/2025 07/02/2002 08/07/2022 20/12/2023 20/12/2023 Private OT consultations, on an as and when basis. This is not advertised through verbal or printed advertisements, social media or verbally mentioned, within my current role 27/03/2024 Sole Trade Home/ Mobile Beauty Therapist Case Support/ Brilliant Minds- Epilepsy Teaching (Self Employed) The Grove, North Road Dibden/ Longview, Fryern Court Road Private Epilepsy Awareness and emergency medication training sessions No committed hours/ as and when needed (approx. 4-10 hours per month) Private practice and member of SAS Received sponsorship for flight and hotel accommodation relating to a professional conference in Madrid, Spain. Sponsorship covered only the two days of the conference. Conference details: XLH international conference. Date: 18-19th April 2024. Sponsor: Kyowa Kirin. I prescribe burosumab at UHS, a biological therapy for children with a rare condition (XLH). The therapy is manufactured by Kyowa Kirin. I am an associate of MDT Rehab providing private clinical physiotherapy in an intermittent capacity. 1/ training as AstraZeneca speaker - 19/3/24 £1080 2/talk for AstraZeneca - 16/10/24 £405 Speaker fee- AstraZeneca £500 speaker fee for Sanofi - £760 Advisory board for CSL Behring Sponsorship to attend ISTH congress by Sanofi This is an ongoing Profession before i initially started my first employment at UHS Dec 2008 I will not advertise or provide information about private practice unless specifically asked. If the information is requested I will offer a number of options and not declare which company I am associated with. 17/10/2023 07/06/2022 13/07/2023 14/07/2023 17/04/2024 19/04/2024 01/11/2023 01/01/2024 01/01/2025 21/09/2023 21/09/2023 03/07/2023 03/07/2023 17/01/2023 I have my own business as a sole trader - making and selling dichroic glass jewellery. This is entirely conducted in my own time. Christmas food box from a supplier - Softcat – of mostly perishable items (crisps, chocolate, cranberry sauce, biscuits, bottle of wine). The market value of the items is estimated at less than £15. Proctor and advisory board to Neuwave/Johnson&Johnson. Proctoring for Boston Scientific on image-guided Cryoablation Given the relatively low value, perishable nature, and inconvenience of returning the item to the supplier, it was deemed appropriate for the team to keep this food box. On-site proctoring on image-guided microwave ablation. Payment made to UoS Southampton Charitable fund. Onsite proctoring- payments made to UoS Southampton charitable fund. 04/01/2024 21/12/2023 21/12/2023 07/06/2018 22/06/2022 Advisory panel to Varian/Siemens healthcare systems. Christmas food box from a supplier - Softcat – of mostly perishable items (crisps, chocolate, cranberry sauce, biscuits, bottle of wine). The market value of the items is estimated at less than £15. Technical advice. Usually consulted at conferences. Given the relatively low value, perishable nature, and inconvenience of returning the item to the supplier, it was deemed appropriate for the team to keep this food box. 01/06/2021 22/06/2022 21/12/2023 21/12/2023 One-time receipt of cheque to value of £152 payable to myself from Mortuary Fund. Mortuary fund accrues voluntary donations from various/multiple external bodies (namely funeral directors) to UHS mortuary in recognition of additional assistance provided to these companies by mortuary team outside of their contracted role (e.g. patient handling & chasing paperwork). The total amount donated to the fund in each calendar year is divided equally amongst all mortuary employees annually, with all members of team (9x staff B3-B8a) receiving an equal share. No interests as received from multiple & various different donors on a voluntary basis. No service contracts are in place between UHS mortuary & donors and so no opportunity for influence in decision making. Terema Ltd: provision of teaching for Human Factors training company. Paid daily rate on attendance. No financial stake in business. As above 01/04/2021 31/03/2022 06/02/2022 31/12/2024 Founder of REN Think Ltd Facilitation of education and training in team skills, human factors, leadership; speaker 13/04/2025 30/04/2034 Spire Southampton Hospital Chalybeate Close Southampton SO16 6UY Occasional spinal cord monitoring performed during spinal operations (usually scoliosis correction). 2-3 cases per year. 01/01/2015 Coordinator of the Wessex Branch of the Infection Prevention society Infection Prevention society Blackburn House, Redhouse Road, Seafield, Bathgate, West Lothian, EH4 7AQ BSIR 2022 attenda
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RIPCORD Privacy Notice UHS v7_12th August 2025
Description
This is a PRIVACY NOTICE for patients who took part in the RIPCORD 2 study Chief Investigator: Professor Nicholas Curzen, University Hospital of Southampton 1. Background The RIPCORD 2 study was a collaboration between University Hospital Southampton (UHS) and Liverpool Heart and Chest Hospital (LHCH). The chief investigator and sponsor of the study are based at UHS. Patients were recruited into the study from 17 different hospital sites in the UK. The study compared two strategies for managing patients undergoing investigation for known or suspected problems in the heart arteries. Patients enrolled into the study were randomly assigned to either: • Standard investigation undergoing coronary angiography alone or • Study investigation undergoing coronary angiography with pressure wire assessment (a wire used to measure blood flow in the heart arteries) Patients were followed up for a period of 12 months after enrolment in the study which successfully completed enrolment of 1100 patients July 2018 2. Objectives The RIPCORD 2 study assessed whether the routine use of pressure wire technology in the investigation of coronary artery disease would bring an overall benefit to patients and reduce healthcare costs. It was published in “CIRCULATION” an international, high impact journal in August 2022 and demonstrated no significant reduction in cost or improvement in quality of life between the two groups. This was a major surprise because many observational studies had suggested that the use of pressure wire in this way did indeed have a major effect on these outcome measures. It is possible, based upon longer term follow up from other similar randomised trials, that a difference in outcomes will emerge at longer term follow up. This is plausible because many clinical events, such as heart attack, death and requirement for coronary revascularisation, are attritional and increase over time. Thus, it is conceivable that the more accurate guidance in the group that assessed coronary anatomy and physiology would yield lower event rates and requirement for less tests and procedures than the angiography alone guidance in the other arm. Version 7 Dated 12th August 2025 The RIPCORD 2 study now proposes to undertake long-term 5year remote follow-up of this cohort of study participants. 3. Data collection The RIPCORD 2 study protocol was approved by a regional ethics committee. Participants were consented for involvement in the trial. A wide variety of data were collected from the patient and their case notes during the original hospital admission including details of procedures and treatments at that time. Participants also gave consent for the study team to later acquire data from their electronic records, held by the NHS National Informatics Services (NHS Digital in England, NHS Wales Informatics Service in Wales, Public Benefit and Privacy Panel for Health and Social Care in Scotland). These data were collected with consent and formed an integral part of the reporting process for the main trial. For the long term remote 5-year follow-up the study sponsor, UHS, will act as both the data controller and the data processor and will be the sole recipient of all patient data from NHS Informatics Services. UHS will request all hospital admission and mortality data for all patients in the RIPCORD 2 study starting from the date of the final participant follow-up at 12 months out to 5 years. The data set will be pseudonymised when sent from NHS informatics services to UHS and kept securely. All data analysis for the 5-year follow-up will be undertaken at the study sponsor site at Southampton. This data linkage process is undertaken with s251 support provided by the Health Research Authority (HRA) on advice from the Confidentiality Advisory Group (CAG) as the common law legal basis, as the initial consent provided by study participants was not considered specific enough. 4. Database information The databases of patients enrolled in the RIPCORD 2 study were collated and stored securely at LHCH during the study. In the longer term they will be transferred to the sponsor site at Southampton where they will be stored securely for up to 15years. Information gathered during the original hospital stay and subsequent data from quality-of-life questionnaires performed at one year, as well as the electronic healthcare data obtained from NHS informatics services is included in these databases. 5. Secure storage and processing of patient information The data is currently stored securely in line with necessary standards set out in the Data Protection Act. All members of the research team accessing the data underwent the necessary training in the handling of personal healthcare/research data. The legal basis for processing the data is covered under General Data Protection Regulations (GDPR), Article 6 (1) (e) and Article 9 (2) (j). This means that data is being processed in the public interest for scientific/research purposes. Personal data of patients (NHS/CHI number, date of birth, sex, and unique study ID) are securely stored at Southampton. These data were forwarded to NHS Informatics Service in England, Scotland and Wales, who control the Civil Registration Mortality (survival) and Hospital Episode Statistics (HES) data. These are considered personal data according to data protection rules (data protection act 2018, GDPR). The purpose of sending this personal data between Southampton and NHS Informatics Services is to link these data Version 7 Dated 12th August 2025 together for the same patients, to provide accurate and complete information for researchers who can track a patient’s journey through the NHS system. NHS Informatics Services will securely transfer pseudonymised data to researchers at UHS. Pseudonymised means that identifying fields within a database are replaced with artificial identifiers, or pseudonyms so patient information can be processed without researchers being able to identify patients. All data processing will occur at UHS. All patient information will be stored on a secure network that is password-protected, and only accessible by those with specialised training and access for the duration of the study. The study will not use automated decision making or profiling. The data will be stored by researchers at UHS until 2029 for analysis and dissemination purposes. All data will be published anonymously in peer-reviewed medical journals and/or presented at (inter)national medical conferences. In terms of data processing, there is no change in the right for participants to access their data. Furthermore, GDPR does provide participants with additional rights including to: rectify their data; restrict processing, object to their data being processed and withdraw their data from being processed. However, it may not be possible for these rights to be granted in the case of a research study, please contact the research team (details at the end of this document) if you would like to discuss your data and how it is being processed. Participants are free to withdraw their consent at any time and no further data will be processed, however, it may be impossible to withdraw data already collected for the purposes of the study. Please see the following link to the UK Information Commissioner’s Office (ICO) for further information: https://ico.org.uk/ University Hospital Southampton Data Protection: UHS, as the data controller, is required by law to comply with data protection legislation. This hospital is committed to ensuring compliance with the data protection act and GDPR. UHS processes the personal data of living individuals such as its staff, students, contractors, research subjects and customers. UHS has its own data protection and confidentiality policy (2022) as a commitment to the safeguarding of personal data processed by its staff and students, and to ensure compliance with the legislation. It is the duty of data controllers, such as UHS, to comply with the data protection principles with respect to personal data. This policy describes how UHS will discharge its duties in order to ensure continuing compliance with the Act in general and the data protection principles and rights of data subjects in particular. Data Protection Officer UHS Contact Details: Data protection officer Trust Headquarters University Hospital Southampton Tremona Road Southampton SO16 6YD Version 7 Dated 12th August 2025 Opting out We are happy to discuss your rights to protect your data, and how exactly it will be used in our research. If you would like further information about the use of your data in this research study or would like to lodge a complaint to a supervisory authority – please contact us on the details given below or you can contact the UK Information Commissioner’s Office (ICO): https://ico.org.uk/ If you would like to request that your patient information is not included in this study, please contact us. Contact details (UHS): Dr Tevin Browne Southampton General Hospital Tremona Road SO16 6YD 02381 208538 Tevin.browne@uhs.nhs.uk Version 7 Dated 12th August 2025
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UHS AR 22-23-6
Description
2022/23 Incorporating the quality account University Hospital Southampton NHS Foundation Trust Annual Report and Accounts 2022/23 Presented to Parliament pursuant to Schedule 7, paragraph 25(4)(a) of the National Health Service Act 2006 © 2023 University Hospital Southampton NHS Foundation Trust Contents Welcome from our chair and chief executive 6 Overview and performance 8 Performance report 9 Overview 10 Accountability report 33 Directors’ report 34 Remuneration report 57 Staff report 71 Annual governance statement 91 Quality account 106 Statement on quality from the chief executive 107 Priorities for improvement and statements of assurance from the board 110 Other information 188 Annual accounts 222 Statement from the chief financial officer 223 Auditor’s report 224 Foreword to the accounts 230 Statement of Comprehensive Income 231 Statement of Financial Position 232 Statement of Changes in Taxpayers’ Equity 233 Statement of Cash Flows 234 Notes to the accounts 235 5 Welcome from the Chair and Chief Executive Officer University Hospital Southampton NHS Foundation Trust (‘UHS’ or the ‘Trust’) experienced another challenging year during 2022/23. Nonetheless, the Trust and its staff have continued to deliver for patients and the wider system in which it operates. Trust highlights from 2022/23 include: • Delivering an 8% increase in activity (compared to 2019/20) under the elective recovery programme, which places us as one of the top performing trusts in England. • Being recognised in the NHS staff survey as the seventh highest trust for recommendation as a place to work nationally and the best performing trust in opportunities for career development. • Celebrating 50 years as a medical school with the University of Southampton and continuing to pioneer UK and world-first research studies. • Enhancing the reputation of our specialist care – for example our bone marrow transplant team at UHS have the best patient outcomes in Europe. However, as was the picture across the country, UHS had an extremely challenging winter with attendances at our emergency department often in excess of 400 a day. This was driven in part by high prevalence of streptococcus A (strep A) in the community along with other seasonal illnesses such as influenza and high incidences of COVID-19 at times. Moreover, the lack of availability of care home beds and other care packages in the community has resulted in challenges in discharging patients who are ready to leave hospital and therefore we have been operating at or near to capacity throughout the year. At the time of writing, there continues to be operational pressures due to industrial action by the Royal College of Nursing and British Medical Association. Throughout the disputes, we have attempted to balance the right of our staff to strike with the need to minimise the impact on the Trust’s operations and patients and ensure that safety was not compromised. Our leadership team has engaged proactively with the unions to agree, where possible, derogations (i.e. services that will continue to be staffed during strikes) to ensure that the running of our hospitals can continue and that patients remain safe. We would like to express our thanks to all staff who have gone over and above during these periods of industrial action by being willing to do different work to usual, often at anti-social times of the day. While we cannot influence national negotiations, we are focusing on what we can control within UHS. Our people strategy published last year sets out how we will grow and deploy our workforce of today and the future as part of a thriving community to deliver world-class patient care. Building on this, we have recently launched our inclusion and belonging strategy so that as a leadership team we can deliver what is required for all our workforce to feel they can belong and thrive at UHS. The Trust achieved its Cost Improvement Plan (CIP) target of £45.6m for 2022/23, the highest in our history but despite this, ended the year with a deficit of £11m. The deficit was driven by a combination of factors including a substantial increase in energy prices, higher costs of medicines and equipment and temporary staffing costs as well as changes in recent years in respect of the NHS funding infrastructure, which adversely impacted the Trust relative to others during the year. In terms of the broader context, the Hampshire and Isle of Wight Integrated Care System, in which the Trust operates, reported an overall deficit for 2022/23 driven in part by a significant increase in staffing numbers when compared to 2019/20 as well as structural factors. 6 We have continued to make progress on our estates strategy, building new theatres and carrying out improvements to existing facilities, as well as opening a new park and ride for staff at Adanac Park and progressing plans for a new innovation campus there. During 2022/23 we invested over £88m of capital expenditure to meet our ambition of increasing capacity and improving services in order to manage the increasing demand. All development is underpinned by our green plan, which sets out areas of focus for decarbonising UHS and achieving the net zero target set by the NHS. The Trust has continued to support the Hampshire and Isle of Wight Integrated Care System, which was formed on 1 July 2022 to facilitate integration and collaboration across health and social care partners in the region. In particular, UHS has worked closely with the Integrated Care Board and other providers in the development of the operating plan for 2023/24. We have also continued to work with other partners in the region, including local authorities and the University of Southampton. The 13,000 staff of UHS are our greatest asset and we would like to express our gratitude to them for continuing to go above and beyond to put patients first under very challenging circumstances. Without our staff, we would be unable to fulfil our ambition to be a world-class organisation with world-class people delivering world-class care. Jenni Douglas-Todd Chair 26 June 2023 David French Chief Executive Officer 26 June 2023 7 PERFORMANCE REPORT Performance report Introduction from the Chief Executive Officer The Trust experienced another challenging year with the need to balance the delivery of quality patient care with a significant increase in demand for the Trust’s resources and the need to do so whilst maintaining a sustainable financial position. The Trust saw the number of patients on a waiting list under the 18-week referral to treatment pathway increase to just over 55,000 patients at the end of the year. Despite this, however, the Trust was successful in reducing the number of patients waiting more than 104 weeks to nil and in reducing the number of patients waiting more than 78 weeks to 14 by the end of the year. In addition, the Trust’s performance under the elective recovery programme placed it as one of the topperforming trusts in the country. Demand for non-elective care also significantly increased during the year with the emergency department seeing more than 400 attendances per day at some points, especially during the winter months. The industrial action seen in the latter part of 2022/23 placed further pressure on the Trust and resulted in a need to cancel elective procedures and outpatients appointments. However, on balance, the Trust was able to manage these events through effective planning and the engagement and support of its staff. Although the Trust was successful in recruiting to substantive roles, especially in terms of reducing the number of Health Care Assistant vacancies, the anticipated reduction in use of bank and agency staff was not seen. This, among other factors, such as the substantial increase in energy costs and the rate of inflation, posed a significant challenge in terms of the Trust’s financial position. Despite achieving savings of £45.6m, the Trust reported a deficit of £11m for 2022/23. 9 Overview About the Trust Our services University Hospital Southampton NHS Foundation Trust is one of the largest acute teaching trusts in England with a turnover of more than £1 billion in 2022/23. It is based on the coast in southeast England and provides services to over 1.9 million people living in Southampton and south Hampshire and specialist services, including neurosciences, respiratory medicine, cancer care, cardiovascular, obstetrics and specialist children’s services, to more than 3.7 million people in central southern England and the Channel Islands. The Trust is also a designated major trauma centre, one of only two places in the south of England to offer adults and children full major trauma care provision. As a leading centre for teaching and research, the Trust has close working relationships with the University of Southampton, the Medical Research Council, National Institute for Health and Care Research (NIHR), Wellcome Trust and Cancer Research UK. The Trust is consistently one of the UK’s highest recruiting trusts of patients to clinical trials and one of the top nationally for research study volumes as ranked by the NIHR Clinical Research Network. Every year the Trust: treats around 160,000 inpatients and day patients, including about 75,000 emergency admissions sees over 650,000 people at outpatient appointments deals with around 150,000 cases in our emergency department delivers more than 100 outpatient clinics across the south of England, keeping services local for patients The Trust provides most of its services from the following locations: • Southampton General Hospital – the Trust’s largest location, where a great number of specialist services are based alongside emergency and critical care and which includes Southampton Children’s Hospital. • Princess Anne Hospital – located across the road from Southampton General Hospital and providing maternity care and specialist care for women with medical problems during pregnancy and babies who need extra care around birth across the region. • Royal South Hants Hospital – although the Trust does not operate this site near the centre of Southampton it provides a smaller number of services from this location. • New Forest Birth Centre – located at Ashurst on the edge of the New Forest and run by experienced midwives and support staff it acts as a community midwifery hub. The services provided by the Trust are commissioned and paid for by the Hampshire and Isle of Wight Integrated Care System (ICS) and, in the case of more specialised services (such as treatments for rare conditions), by NHS England. Trust services are supported by clinical income, of which 55% is paid for by NHS England and 43% by the Hampshire and Isle of Wight Integrated Care Board. These are provided under a standard NHS contract, which incorporates ongoing monitoring of the Trust and the quality of the services provided. 10 Our structure UHS gained foundation trust status on 1 October 2011. A foundation trust is a public benefit corporation providing NHS services in line with the core NHS principles: that care should be universal, comprehensive and free at the point of need. The Trust is licensed as a foundation trust to provide these services by NHS England and the healthcare services we provide are regulated by the Care Quality Commission. Since 1 July 2022, the Trust has been part of the Hampshire and Isle of Wight Integrated Care System (ICS) when this was established through the Health and Social Care Act 2022. Each ICS has two statutory elements: an integrated care partnership (ICP) and an integrated care board (ICB). The ICP is a statutory committee jointly formed between the NHS integrated care board and all uppertier local authorities that fall within the ICS area. The ICP will bring together a broad alliance of partners concerned with improving the care, health and wellbeing of the population, with membership determined locally. The ICP is responsible for producing an integrated care strategy on how to meet the health and wellbeing needs of the population in the ICS area. The ICB is a statutory NHS organisation responsible for developing a plan for meeting the health needs of the population, managing the NHS budget and arranging for the provision of health services in the ICS area. The establishment of ICBs resulted in clinical commissioning groups (CCGs) being closed down. The Trust has been a university teaching hospital since 1971. The diagram below provides an overview of the overall organisational structure of the Trust. Division A Surgery Critical Care Opthalmology Theatres and Anaesthetics Public and foundation trust members Council of Governors Board of Directors Executive Directors Division B Division C Division D Cancer Care Emergency Medicine Helicopter Emergency Medical Services Medicine and Medicine for Older People Pathology Specialist Medicine Women and Newborn Maternity Child Health Clinical Support Cardiovascular and Thoracic Neurosciences Trauma and Orthopaedics Radiology Trust Headquarters Division 11 Our values Our values describe how we do things at UHS and act as a guide to all staff working with colleagues to deliver high quality patient care and a great patient experience every day. Our values are: Patients, their families and carers are at the heart of what we do. Their experience of our services will be our measure of success. Partnership between clinicians, patients and carers is critical to achieving our vision, both within hospital teams and extending across organisational boundaries in the NHS, social care and the third sector. We will ensure we are always improving services for patients through research, education, clinical effectiveness and quality improvement. We will continue to incorporate new ideas, technologies and create greater efficiencies in the services we provide. 12 Our strategy 2021-25 The Trust’s strategy was updated during 2020/21 to take account of everything our staff had experienced during the COVID-19 pandemic and what we had learnt from this. The vision for UHS is to become an organisation of world class people delivering world class care. Our strategy is organised around five themes and for each of these it describes a number of ambitions we aim to achieve by 2025. Theme Ambitions Outstanding patient outcomes, • We will monitor clinical outcomes, safety and experience of our experience and safety patients regularly to ensure they are amongst the best in the UK By 2025 we will strengthen our and the world. national reputation for outstanding • We will reduce harm, learning from all incidents through our patient outcomes, experience and proactive patient safety culture. safety, providing high quality care • We will ensure all patients and relatives have a positive experience and treatment across an extensive of our care, as a result of the environment created by our people range of services from foetal and our facilities. medicine, through all life stages and conditions, to end-of-life care Pioneering research • We will recruit and enable people to deliver pioneering research in and innovation Southampton. We will continue to be a leading teaching hospital with a growing, reputable and innovative research and development portfolio • We will optimise access to clinical research studies for our patients. • We will enable innovation in everything we do, and ensure that ‘cutting edge’ investigations and treatments are delivered in Southampton. that attracts the best staff and efficiently delivers the best possible treatments and care for our patients. World class people • We will recruit and develop enough people with the right Supporting and nurturing our knowledge and skills to meet the needs of our patients. people through a culture that values • We will provide satisfying and fulfilling roles, growing our talent diversity and builds knowledge and through development and opportunity for progression. skills to ensure everyone reaches • We will empower our people, embracing diversity and embedding their full potential. We must provide compassion, inclusion and equity of opportunity. rewarding career paths within empowered, compassionate, and motivated teams. Integrated networks and collaboration We will deliver our services with partners through clinical networks, collaboration and integration across geographical and organisational boundaries. • We will work in partnership with key stakeholders across the Hampshire and Isle of Wight integrated care system. • We will strengthen our acute clinical networks across the region, centralising when necessary and supporting local care when appropriate. • We will foster local integration with primary and community care as well as mental health and social care services for seamless delivery across boundaries. • We will build on our successful partnership with University of Southampton (UoS), growing our reputation as a national leading university teaching hospital. 13 Theme Foundations for the future Making our enabling infrastructure (finance, digital, estate) fit for the future to support a leading university teaching hospital in the 21st century and recognising our responsibility as a major employer in the community of Southampton and our role in broader environmental sustainability. Ambitions • We will deliver best value to the taxpayer as a financially efficient and sustainable organisation. • We will support patient self-management and seamless care across organisational boundaries through our ambitious digital programme, including real time data reporting, to inform our care. • We will expand and improve our estate, increasing capacity where needed and providing modern facilities for our patients and our people. • We will strengthen our role in the community as an employer of choice, a partner in delivery of services to our population and by leading the Greener NHS agenda locally. During each year of the strategy the Trust sets out a more detailed series of objectives to achieve and progress towards the delivery of its ambitions. In 2022/23 these objectives included: Outstanding patient outcomes, experience and safety Pioneering research and innovation World class people Integrated networks and collaboration Foundations for the future • Recovery, restoration and improvement of clinical services • Introducing a robust and proactive safety culture • Empowering and developing staff to improve services for patients • Always Improving strategy • Delivering a high-quality experience of care for all • Delivery of year two of the research and innovation investment plan • Strategy and partnership working • Growing, developing and innovating our workforce • A great place to work, develop and achieve • Compassionate and inclusive workplace for all • We Work in partnership with Integrated Care System and Primary Care Networks • Integrated Networks and Collaborations • Establishing Southern Counties Pathology Network • Establishing the Wessex Imaging Network • Develop Collaborations strategy • Creating a sustainable financial infrastructure • Making our corporate infrastructure fit for the future to support a leading university teaching hospital in the 21st century • Recognising our responsibility as a major employer in the community of Southampton and our role in delivering a greener NHS Performance against these objectives will be monitored and reported to the Trust’s Board on a quarterly basis. 14 Principal risks to our strategy and objectives The Board has identified and manages the principal risks to the delivery of its strategy and objectives through its board assurance framework. The principal risks to the delivery of its strategy and objectives identified by the Trust during 2022/23 were that: • There would be a lack of capacity to appropriately respond to emergency demand, manage the increasing waiting lists for elective demand, and provide timely diagnostics, that results in avoidable harm to patients. • Due to the current challenges, the Trust fails to provide patients and their families with a high-quality experience of care and positive patient outcomes. • The Trust would not effectively plan for and implement infection prevention and control measures that reduce the number of hospital-acquired infections and limit the number of nosocomial outbreaks of infection. • The Trust is unable to meet current and planned service requirements due to unavailability of qualified staff to fulfil key roles. • The Trust fails to develop a diverse, compassionate and inclusive workforce, providing a more positive experience for all staff. • The Trust fails to create a sustainable and innovative education and development response to meet the current and future workforce needs identified in the Trust’s longer-term workforce plan. • The Trust does not implement effective models to deliver integrated and networked care, resulting in sub-optimal patient experience and outcomes, increased numbers of admissions and increases in patients’ length of stay. • The Trust is unable to deliver a financial breakeven position and support prioritised investment as identified in the Trust’s capital plan within locally available limits (capital departmental expenditure limit (CDEL)). • The Trust does not adequately maintain, improve and develop its estate to deliver its clinical services and increase capacity. • The Trust fails to introduce and implement new technology and expand the use of existing technology to transform its delivery of care through the funding and delivery of the digital strategy. • The Trust fails to prioritise green initiatives to deliver a trajectory that will reduce its direct and indirect carbon footprint by 80% by 2028-2032 (compared with a 1990 baseline) and reach net zero direct carbon emissions by 2040 and net zero indirect carbon emissions by 2045. During 2022/23, the Trust continued to experience the impact of the COVID-19 pandemic. The need to ensure a safe environment for patients through stringent infection control processes impacted the Trust’s capacity due to the need to isolate patients with COVID-19 in separate areas of the hospital. In addition, outbreaks of norovirus during the winter months placed further pressure on hospital capacity. The impact of the pandemic continued to be felt in terms of staff absence due to becoming infected with COVID-19 as well as the significant impact on staff mental health. The higher than normal (i.e. pre-COVID) levels of staff absence placed additional strain on the Trust’s operations and led to increased expenditure due to the requirement to enlist bank and/or agency staff to maintain safe staffing levels. 15 Performance overview The Trust monitors a broad range of key performance indicators within its departments, divisions, directorates and through Trust executive committees. On a monthly basis, the Board and executive committee receives a performance report containing a variety of indicators intended to provide assurance in respect of the Trust’s strategy and that the care provided is safe, caring, effective, responsive and well-led. This report also includes the Trust’s performance against the national targets set by NHS England. The performance reports include a ‘spotlight’ section, which provides more detailed analysis of a particular area. Typically, this is one of either the national targets or the Trust’s performance against the expectations set out in the NHS Constitution. The monthly performance report is also published on the Trust’s website. The Chief Executive Officer provides a regular report on performance to the Council of Governors, which includes a range of non-financial and financial performance information. Capacity The pressures of the COVID-19 pandemic led to increases in the waiting times for patients and the number of patients waiting for more than a year increased significantly. During the year, the Trust achieved its goal of no patients waiting more than 104 weeks by July 2022 and finished the year with only 14 patients waiting for more than 78 weeks. However, the length of time patients are waiting for treatment remains one of the key risks for the Trust. This situation was compounded by the sustained demand for non-elective activity, which saw attendances at the emergency department rise to over 400 patients per day during some periods of 2022/23 and was consistently higher than previously was the case. The significant increase in referrals, often requiring more complex treatment, has seen the number of patients on a waiting list under the 18-week referral to treatment pathway increase to just over 55,000 patients at the end of the year. In addition, the industrial action during the year placed further strain on the Trust’s ability to both provide urgent care and manage its elective recovery programme. Quality and compliance Furthermore, difficulties in obtaining care home beds and other care packages in the community has resulted in challenges in discharging patients who are ready to leave hospital and therefore the Trust has been operating at or near to capacity throughout the year. The Trust continued to monitor the quality of care delivered throughout 2022/23. The Trust continued its focus on infection prevention and control, which had proven successful during the COVID-19 pandemic. The Trust progressed its Always Improving strategy and successfully supported the identification and implementation of 84 quality improvement projects. In addition, the Trust continued to implement the patient safety incident response framework as well as taking other steps to drive a safety culture within the organisation. Furthermore, the Trust conducted further trials of shared decision making between clinicians and patients and is a leading site nationally for shared decision-making principles. Further information can be found in the Quality Account. 16 Partnerships The new arrangements for integrated care systems were implemented in July 2022 with the Trust becoming part of the Hampshire and Isle of Wight Integrated Care System. As such, the Trust’s senior management frequently meets with peers from across the system to consider and agree matters of wider concern across the system. In addition, the Trust worked with the Integrated Care Board in order to develop its financial and capital plans for 2023/24 and beyond. The Trust also attends the Southampton Health and Wellbeing Board at Southampton City Council and in the Hampshire and Isle of Wight Acute Provider Partnership Board. During 2022/23, the Trust continued to progress research activities and opportunities with the University of Southampton and Wessex Health Partners. Workforce In addition, work continued in the development of an elective hub at Winchester with Hampshire Hospitals NHS Foundation Trust, which will provide the Trust with additional capacity to carry out its elective programme. The Trust’s key areas of focus during 2022/23 were in respect of increasing the substantive workforce and reducing staff turnover. Although the Trust was successful in recruiting to substantive posts, the expected reduction in reliance on bank and agency staff did not materialise, which meant that the Trust was 1,068 whole-time equivalents above its plan for 2022/23. Included in this figure is the TUPE transfer of genomics staff from Salisbury. A particular area of focus was the recruitment of Health Care Assistants where the Trust was successful in reducing the number of vacancies from 27% to 18%. Whilst the Trust was successful in reducing staff turnover from 14.9% in 2021/22 to 13.5%, it remained above the 12% target. However, the Trust did experience a reduction in staff absence from 4.7% in April 2022 to 4.3% in March 2023, and initiatives to improve staff wellbeing were an area of focus during the year. Estate Innovation and technology The industrial action in late 2022 and early 2023 posed significant challenges for the Trust, including in terms of the need to engage additional temporary staff to ensure patient safety. The Trust continued to invest in and develop its estate during 2022/23 including successful completion of the Paediatric Intensive Care Unit project, which delivered single rooms and specialist accent lighting alongside delivery of a ‘twin care’ room. There were a number of other significant projects during the year, including refurbishments of wards and work on creating new theatres as well as projects to improve staff wellbeing. These were part of over £88m of capital expenditure in 2022/23 that also included equipment, digital and the backlog maintenance programme. The Trust continued to promote research and development during 2022/23, including through partnerships with the University of Southampton and Wessex Health Partners. Furthermore, the Trust continued to examine ways to make use of technology to improve its service delivery. In particular, the Trust has promoted the use of MyMedicalRecord, which gives patients the ability to co-manage their healthcare online and through an app. 17 Sustainable financial model The Trust did not achieve breakeven status at the end of 2022/23 and reported a deficit of £11.037m at year-end. This was due to a number of factors, including the Trust’s underlying deficit as well as the increase in energy prices. The Trust was more exposed than most to fluctuations in the wholesale price of gas due to its reliance on a gas-powered energy supply. In addition, the Trust’s 8% uplift in elective activity when compared to 2019/20 was not fullyfunded, which placed further pressure on the Trust’s existing financial resources, which had been used to ensure a breakeven position in 2021/22. The continued use of bank and agency staff as well as the costs of industrial action in late 2022 and early 2023 further eroded the Trust’s financial position. Notwithstanding the above, the Trust did succeed in obtaining a number of sources of nonrecurrent funding during the year, including a successful bid for £29.4m of funding through the Public Sector De-Carbonisation Fund, which will be used to fund green initiatives as part of the Trust’s capital programme. The financial outlook across the NHS continues to appear very challenging during 2023/24 and the Hampshire and Isle of Wight Integrated Care System is forecasting one of the highest deficits in England. 18 Performance analysis COVID-19 Impacts Although the pandemic has ended and serious cases of COVID-19 have reduced significantly, the Trust continued to be impacted by COVID-19 during 2022/23. Heightened infection prevention control measures in respect of patients with COVID-19 placed additional stress on the Trust’s capacity due to the need to isolate those patients and there was a consequential reduction in the Trust’s ability to make most efficient use of its available spaces. Furthermore, the ongoing impact on the Trust’s staff has led to higher staff absence than was the case prior to the pandemic, particularly due anxiety, infectious diseases and colds and flu. • The Trust experienced an average number of 98.7 patients per day who tested positive for COVID-19. During the winter months, this number increased substantially to nearly 200. • During the year, an average of 3.6 intensive care/high-dependency beds per day were occupied by COVID-19 patients. However, at times this increased to as much as ten. • Although staff sickness rates remained higher than pre-pandemic, the Trust saw a decrease in the absence rate from 4.7% at the beginning of 2022/23 to 4.3% by the end of the period. COVID-19 Cases UHS average number of confirmed COVID-19 patients in bed (08:00 census) 250 200 150 100 50 0 4/1/20225/1/2022 6/1/20227/1/2022 8/1/2022 9/1/202210/1/202211/1/202212/1/2022 1/1/2023 2/1/20233/1/2023 Intensive care/higher care beds UHS average number of confirmed COVID-19 patients in an ICU/HDU bed (08:00 census) 12 10 8 6 4 2 0 4/1/20225/1/2022 6/1/20227/1/2022 8/1/2022 9/1/202210/1/202211/1/202212/1/2022 1/1/2023 2/1/20233/1/2023 19 Number of patients Emergency access through the emergency department The Trust continued to experience high demand from patients presenting to receive care in the emergency department throughout the year above that seen prior to the COVID-19 pandemic. In particular, during the period between January and March 2023, the Trust averaged 352 attendances per day compared to 301 during the same period in 2019/20, an increase of 17%. The Trust also saw a significant increase in attendances during December due to both seasonal illnesses, but also due to the prevalence of streptococcus A in the community with attendances sometimes over 400 per day. Furthermore, the industrial action during the latter part of 2022 and early 2023 placed further pressure on the Trust’s ability to deliver services. In addition, the difficulties in discharging patients in need of care either at home or in another setting resulted in reduced flow from the emergency department to the relevant ward(s), which placed further strain on the Trust’s performance. During the year, in order to reduce emergency department attendances, the Trust trialled using General Practitioners to triage and see more straightforward patients who would otherwise have presented to the emergency department. Although this trial did result in a slight reduction in terms of number of patients and waiting times in ambulatory majors and majors, the affordability and value for money of this scheme is under review. Number of patients presenting to the emergency department 16,000 14,000 12,000 10,000 8,000 6,000 4,000 2,000 0 Apr-22 May-22 Jun-22 Jul-22 Aug-22 Sep-22 Oct-22 Nov-22 Dec-22 Jan-23 Feb-23 Mar-23 As a result of the increase in demand upon the emergency department, there continued to be a significant adverse impact on timeliness of care. The Trust failed to meet the national target of 95% of main emergency department/type 1 attendances seen within four hours, achieving 64.5% in March 2023, although this performance was above average in England. 20 % standard met Emergency access 4hr standard UHS vs NHSE average Type 1 performance 70% 0 10 60% 20 50% 30 40 40% 50 Apr-22 May-22 Jun-22 Jul-22 Aug-22 Sep-2 2 Oct-22 Nov-22 Dec-22 Jan-23 Feb-2 3 Mar-23 UH S NHSE average UHS rank amongst NHSE trusts Rank Ambulance handovers are an area of focus for NHS England, with a target of all handovers having to take place within 15 minutes and none waiting more than 30 minutes. The Trust performed well in this area with an average handover time of 17 minutes, having made the conscious decision to ensure that patients did not queue in ambulances at the expense of patients being queued within emergency department majors – thus impacting the Trust’s four-hour target, but meaning that ambulances were not queued outside the hospital as was seen in other areas of the country. Elective Waiting times Demand The year saw a continuation of the trend of increasing elective referrals experienced in 2021/22 following the pandemic, and referral rates continued to be above those seen prior to the pandemic. UHS Accepted Referrals 30,000 25,000 20,000 15,000 10,000 5,000 0 Apr-22 May-22 Jun-22 Jul-22 Aug-22 Sep-2 2 Oct-22 Nov-22 Dec-22 Jan-23 Feb-2 3 Mar-23 Number of accepted referrals 21 Activity The Trust experienced significant increases in terms of the number of hospital appointments, diagnostic tests and elective admissions during the year, exceeding levels in previous years. The Trust was one of the top performing trusts in terms of its elective recovery programme, achieving an 8% increase in its elective activity during the year when compared to 2019/20. However, performance in this area and in terms of outpatients appointments was negatively affected by the industrial action by nurses, junior doctors and other members of staff, which took place in late 2022 and early 2023 due to the need to cancel non-urgent procedures and appointments in favour of maintaining safe staffing levels in areas such as the emergency department. In addition, the continued presence of COVID-19 as well as other illnesses such as influenza and norovirus placed significant pressure at times on the Trust’s capacity due to the need to implement appropriate infection prevention control measures. Furthermore, difficulties in discharging patients fit to be discharged, but in need of a care package, placed additional strain on the Trust’s capacity. Elective admissions (including day case) Post-COVID-19 pandemic Elective (including day case) recovery (% of same month compared between March 2019 – February 2020) 105% 100% 95% 90% 85% 80% 75% Apr-22 May-22 Jun-22 Jul-22 Aug-22 Sep-22 Oct-22 Nov-22 Dec-22 Jan-23 Feb-23 % recovery Outpatient attendances Post-COVID-19 pandemic outpatient seen recovery (% of same month compared between March 2019 – February 2020) 140% 0 90% 10 20 40% 30 Apr-22 May-22 Jun-22 Jul-22 Aug-22 Sep-22 Oct-22 Nov-22 Dec-22 Jan-23 Feb-23 UH S UHS rank amongst NHSE trusts % recovery Rank 22 Diagnostics The Trust measures performance on a total of 15 frequently used diagnostic tests. In March 2023, 22% of patients were waiting more than six weeks for diagnostics compared with the national target of less than 1%. Patients waiting for a diagnostic test to be performed (sum of 15 different frequently used tests) UHS diagnostic waiting list volume 12,000 11,500 11,000 10,500 10,000 9,500 Apr-22 May-22 Jun-22 Jul-22 Aug-22 Sep-2 2 Oct-22 Nov-22 Dec-22 Jan-23 Feb-2 3 Mar-23 Diagnostic waiting list volume Percentage of patients waiting over 6 weeks for a diagnostic test to be performed Diagnostic 6 week wait performance UHS vs. NHSE average 35% 30% 25% 20% 15% 10% 5% 0% Apr-22 May-22 Jun-22 Jul-22 Aug-22 Sep-22 Oct-22 Nov-22 Dec-22 Jan-23 Feb-23 Mar-23 UH S NHSE average % standard met 23 Referral to Treatment The Trust continued to see an increase in the number of patients being referred for treatment during 2022/23 with just over 55,000 patients on a waiting list under the 18-week referral to treatment pathway at the end of the year. Averaged across the year, the volume of referrals exceeded the Trust’s theoretical capacity by around 3.5%. Due to this significant demand, the Trust only achieved 63.2% of patients being treated within 18 weeks of referral in March 2023 compared with the monthly target of more than 92%. However, despite this, the Trust remained in the top quartile when compared to other teaching hospitals, reflecting that this growth in demand continues to be a national challenge. During 2022/23, the national target was to ensure that there were no patients waiting over two years for treatment by July 2022, and that there were no patients waiting more than 78 weeks by the end of March 2023. Long-waiting patients were an area of particular focus for the Trust during the year with no reported two-year waits since November 2022 and only two between the period June-November due to patients choosing to delay their treatment. This was a significant improvement compared to the peak of 171 patients reported in December 2021. Similarly, the Trust made progress in reducing the number of patients waiting over 78 weeks for treatment. In February 2023, the Trust reported 84 patients in this category compared to the peak of over 900 patients in September 2021. By the end of March 2023, the Trust had managed to further reduce this number of patients to 14, with those in breach of the target all due to the complexity of the cases. UHS referral to treatment waiting list 56,000 54,000 52,000 50,000 48,000 46,000 44,000 Apr-22 May-22 Jun-22 Jul-22 Aug-22 Sep-22 Oct-22 Nov-22 Dec-22 Jan-23 Feb-23 Mar-23 24 Number on waiting list % standard met Percentage of patients waiting up to 18 weeks between referral and treatment RTT 18 week performance UHS vs. NHSE average 70% 65% 60% 55% 50% Apr-22 May-22 Jun-22 Jul-22 Aug-22 Sep-22 Oct-22 Nov-22 Dec-22 Jan-23 Feb-23 Mar-23 UH S NHSE average Percentage of patients waiting more than 52 weeks between referral and commencement of a treatment for their condition Number of patients Rank UHS Referral to treatment patients waiting more than 52 weeks 3,000 0 2,500 10 2,000 20 1,500 30 1,000 40 500 50 0 60 Apr-22 May-22 Jun-22 Jul-22 Aug-22 Sep-22 Oct-22 Nov-22 Dec-22 Jan-23 Feb-23 Mar-23 UH S UHS rank amongst NHSE trusts % of RTT patients RTT % of patients waiting more than 52 weeks UHS vs. NHSE average 5.0% 0 4.5% 20 40 4.0% 60 3.5% 80 Apr-22 May-22 Jun-22 Jul-22 Aug-22 Sep-22 Oct-22 Nov-22 Dec-22 Jan-23 Feb-23 Mar-23 UH S UHS rank amongst NHSE trusts Rank 25 % standard met Cancer Waiting Times The Trust is one of 12 regional cancer centres in the UK offering treatment for rare and complex cancers as well as cancer in children and brain cancer. The Trust has historically been in the upper quartile, relative to teaching hospital peers. Due to loss of key members of staff and industrial action, the Trust’s performance has slipped over the year with 72.5% of patients seen within two weeks in March 2023 following referral by a General Practitioner for suspected cancer (national target: > 93% per month). Cancer waiting times - 2 week wait performance UHS vs NHSE average 100% 0 80% 50 60% 100 40% 150 Apr-22May-22 Jun-22 Jul-22 Aug-22 Sep-22 Oct-22 Nov-22 Dec-22 Jan-23 Feb-23Mar-23 UH S NHSE average UHS rank amongst NHSE trusts Rank Referrals for January to March 2023 were at the highest for that month for the past five years and overall referral volumes in 2022/23 averaged 2,049 patients per month, 8% higher than in 2021/22 and 28% higher than in 2019/20. The national target was for 96% of patients to commence treatment within 31 days of diagnosis. However, in March 2023, the Trust only achieved 87.9%, but this figure hides considerable variation dependent on the tumour site and type of cancer with a range of 100% for haematology and children’s cancers to 71% for skin. The high rate of referrals led to a significant backlog in terms of patients waiting longer than 62 days for treatment. However, the Trust took steps to reduce this backlog by more than 50% through a dedicated recovery programme. In March 2023, the Trust treated 54.8% of patients within 62 days of referral compared to the target of more than 85%. Treatment for Cancer within 62 days of an urgent GP referral to hospital Cancer waiting times 62 day RTT performance UHS vs. NHSE average 80% 60% 40% 20% 0% Apr-22 May-22 Jun-22 Jul-22 Aug-22 Sep-22 Oct-22 Nov-22 Dec-22 Jan-23 Feb-23 Mar-23 UH S NHSE average % standard met 26 First definitive treatment for cancer within 31 days of a decision to treat % standard met Cancer waiting times 31 day RTT performance UHS vs. NHSE average 95% 90% 85% 80% 75% Apr-22 May-22 Jun-22 Jul-22 Aug-22 Sep-22 Oct-22 Nov-22 Dec-22 Jan-23 Feb-23 Mar-23 UH S NHSE average Quality priorities The Trust set eight quality priorities in 2022/23, which were aimed at ensuring it continued to deliver the highest quality of care. The quality priorities were shaped by a range of national and regional factors as well as local and Trust‐wide considerations. The Trust recognised the overriding issues of significant operational pressures being felt right across the health and social care system, including those associated with the previous two years of the COVID-19 pandemic. The challenge was to deliver the best quality care in the context of these operational pressures, and the Trust set its quality priorities accordingly. Out of the eight priories set, the Trust achieved five and partially achieved three. Priority One: Enhancing capability in Quality Improvement (QI) through our Always Improving strategy The transformation team has grown to over thirty team members including project support officers, project managers, benefit realisation managers. This has allowed the Trust to develop that systematic organisational approach to guide and support its staff in their QI projects. The Trust originally set a target of delivering fifty quality improvement projects but have successfully supported a total of 84 (55 local and 29 flow improvements). These are local change projects which were identified, proposed, led, and delivered by the people who do the work. To date over 1500 people have been trained in the Trust’s improvement approach, which exceeds the original target of 500. The Trust also developed a QI project register and held an Always Improving conference. Priority Two: Developing a culture of kindness and compassion to drive a safety culture The Trust only partially achieved this priority as plans to fully deliver training were affected by operational pressures. However, during the year a variety of communication platforms were used to make sure staff understood the Trust’s vision and were kept up to date with plans and progress. The Trust worked to develop and embed a ‘just culture’ allowing staff to speak up and ask, “what happened and how do we learn?” and developed ‘stop for safety’ staff huddles. Priority Three: We will improve mental health care across the Trust including support for staff delivering care The Trust only partially achieved this priority as several key quality improvement projects have not yet been delivered, and the mental health strategy not yet been finalised. However, a training needs analysis was completed and significant staff training and an education scheme were introduced in response to the findings of the analysis. Mental health champion training has been delivered to 153 staff and IT systems have been improved to help capture vital data to help shape the Trust’s service. 27 Priority Four: Recognising and responding to deterioration in patients During 2021/22 the Trust successfully introduced national Paediatric Early Warning System (nPEWS) into its Southampton Children’s Hospital and UHS is now part of the national test and trial of nPEWS which is assessing the usability of the scoring system. The Trust has also explored how nPEWS can be adapted for children with complex medical conditions requiring interventions (including non-invasive ventilation) as part of their normal care. A daily heat map of escalation times over a 24-hour period was piloted in 2022 and will be rolled out across all adult’s inpatient areas during 2023. The Trust has also performed well with its cardiac arrest audits, and training and education programmes have consistently been delivered. September 2022 saw the implementation of a 24-hour paediatric outreach service. There is a deteriorating patient group and several successful QI projects have been introduced. Priority Five: Improving how the organisation learns from deaths The Trust only partially achieved this priority as it has been unable to establish a learning from deaths steering group. The Trust has introduced a mortality governance coordinator/analyst and grown its bereavement care service. Priority Six: Shared Decision Making (SDM) The shared decision models started at UHS in 2021/22 and have continued to grow with investment in pilot roles to expand these models, which include several advanced nurse practitioner roles, models in paediatrics bringing Shared Decision Making to patients who are transitioning from paediatric to adult services, while in maternity we have introduced SDM in birth planning. When assessing delivery of SDM against NICE guidelines, UHS performs well, especially in targets related to Trust buy-in, governance and practices of pilot areas. This year the Trust has implemented training through key platforms and expanded patient involvement in the project. As a leading site nationally for SDM principles, UHS have worked with NHS England on creating materials for others to learn from. Priority Seven: Working with our local community to expose and address health inequalities During the year the Trust refocused its efforts on making sure that its involvement and participation activities support the health inequalities agenda, while also working to deliver responsive information and advice to patients, carers, and families. Priority Eight: Ensure patients are involved, supported, and appropriately communicated with on discharge During the year the Trust has focused on improved patient, carer and family involvement, and improved communication during the discharge process as well as prompting a more collaborative working between social and health care staff. Strong partnership working with external agencies has been developed to support a system approach to hospital discharge, develop digital solutions, develop the patient hub to support discharge and delivered education to UHS staff. More information can be found about how the Trust delivered and measured its quality priorities, including feedback from patients and staff and improvement aims and quality priorities for 2023/24, in the Trust’s Quality Account for 2022/23. 28 Financial performance The Trust delivered a deficit of £11 million from a revenue position of over £1.2 billion, once items deemed as “below the line” by NHS England, such as the financial position of the Southampton Hospitals Charity, were removed. The Trust was unable to deliver the planned breakeven position. Several material cost pressures were incurred, including unfunded high-cost drugs costs and energy prices. These were unable to be off set in full by a savings programme, despite delivery of £45.6m of efficiencies (2021/22: £15m). Trust operating income rose by £64m from the previous financial year, most notably funding the NHS pay award, as well as additional elective recovery funding. Income reduced from the prior year in relation to ending a nationally funded project regarding testing for COVID-19. The Trust has however been successful in increasing funding for research and development. Trust operating expenditure rose by £78m, incorporating funded inflationary costs as well as the cost pressures outlined above. The Trust has also continued its reinvestment of surplus cash into infrastructure for the Trust, with capital investmen
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Annual report 20-21
Description
2020/21 Incorporating the quality report University Hospital Southampton NHS Foundation Trust Annual Report and Accounts 2020/21 Presented to Parliament pursuant to Schedule 7, paragraph 25(4)(a) of the National Health Service Act 2006 © 2021 University Hospital Southampton NHS Foundation Trust Table of contents Welcome from our chair and chief executive 6 Overview and performance 8 Performance report 9 Overview 10 Accountability report 29 Directors’ report 30 Remuneration report 53 Staff report 65 NHS Foundation Trust Code of Governance 81 NHS Oversight Framework 81 Annual governance statement 84 Quality report 95 Statement on quality from the chief executive 96 Priorities for improvement and statements of assurance from the board 99 Other information 153 Annual accounts 180 Statement from the chief financial officer 181 Auditor’s report 182 Foreword to the accounts 188 Statement of Comprehensive Income 189 Statement of Financial Position 190 Statement of Changes in Taxpayers’ Equity 191 Statement of Cash Flows 192 Notes to the accounts 193 5 Welcome from our chair and chief executive 2020/21 was undoubtedly the most challenging year in the history of the NHS, and we have felt the impact of the COVID-19 pandemic here at University Hospital Southampton NHS Foundation Trust (UHS) in full. Responding to this has meant there isn’t a single part of our organisation that hasn’t changed in some way over the last year and we have all had to adapt to a rapidly changing environment. Our staff have been unwavering in their dedication, hard work and commitment to keeping our hospitals running, our patients cared for, and their colleagues supported. Every single member of the UHS family has played their part. The loss of life from COVID-19 has been devastating, and at UHS we stand shoulder-to-shoulder with everyone affected by this tragedy, including the families of staff members whom we lost. We must recognise the incredible work of Southampton Hospital Charity, which has funded boost boxes, wellness rooms, a helpline and so much more to support staff at a time when their wellbeing is more important than ever. As the nationwide vaccination programme continues to offer hope of life more like pre-pandemic times, we are proud to have been at the forefront of these efforts - from being part of early research for the Oxford-AstraZeneca vaccine, to the opening of one of the largest vaccination hubs in the region on our site in December 2020. We will continue to play a key role in vaccination development by leading the world’s first clinical trial into the effectiveness of COVID-19 booster vaccines, as well as taking part in a study involving pregnant people. Our response to COVID-19 has prompted innovation and new ways of working across the Trust, to the benefit of patient experience. At the start of the pandemic we faced real challenges of capacity and increases in waiting times, which led to us working with Spire Southampton so cancer treatment and surgery could continue for patients at highest risk. We also increased the number of outpatient attendances which took place by telephone or video call, and our patient support hub was set up to provide a single point of support for patients who had been advised to shield. We are immensely proud of the record of the Trust during the pandemic, exemplified by the number of patients we were able to take into our care from well outside the local area. The Trust is in a strong financial position as a result of careful spending and efficiencies, which has allowed us to invest significantly in upgrading our estate. These improvements have seen the opening of the general intensive care unit, and the new cancer ward, which was built in just six months. These formed part of overall capital expenditure of £80 million during the year. The last year has seen us say goodbye to two members of our executive leadership team. Paula Head left the chief executive officer role in November to join the national response to COVID-19, before becoming a senior fellow at The King’s Fund. Derek Sandeman moved on from being our chief medical officer to take the same position at the Hampshire and Isle of Wight Integrated Care System. We are grateful to both for their efforts on the Trust leadership team during the most challenging of years. One of our non-executive directors, Jenni Douglas-Todd, also left the Trust to take on the important role of director of equality and inclusion with NHS England and NHS Improvement. 6 Looking ahead to the future, UHS will play a key role in the Hampshire and Isle of Wight Integrated Care System. Our commitment is to deliver services with partners through clinical networks, collaboration and integration across geographical and organisational boundaries for seamless patient care. We as a Trust board are looking forward to implementing our own five year strategy, which sets out ambitions for what we want the hospital to be in 2025, for both patients and staff. Our focus will always be on enabling world class people to deliver world class care. Peter Hollins David French Chair Chief Executive Officer 7 OVERVIEW AND PERFORMANCE Performance report Introduction from our chief executive Over the last year, the way in which the Trust has worked and performance it has achieved, has been transformed by the COVID-19 pandemic. • UHS saw a number of large surges in demand for inpatient care, and for intensive respiratory support in particular, due to COVID-19 infection rates. Our capacity to deliver intensive care had to be increased, and many of our staff moved from other services such as our elective theatres in order to meet this need for care. • We have introduced and continue to maintain a number of changes to reduce the risk of COVID-19 being transmitted, or adversely affecting patient outcomes, within the Trust. Changes have included the wearing of additional personal protective equipment by our staff (especially when caring for patients who might have COVID-19 or undertaking higher risk procedures), reducing the number of patients coming to our outpatient departments and increasing the number of telephone and video consultations, separating elective and emergency patients within our departments and regular testing of our staff and all patients on or prior to their admission to hospital for treatment. • Public concerns about safety, government restrictions and the efforts of community services actually contributed to reductions in the total number of patients who sought hospital care this year. • Treatment plans have been modified by a number of services, in partnership with patients, to reduce the risk posed by COVID-19 to those patients. This was often appropriate in those circumstances in which the normal treatment would significantly reduce the patient’s own resistance to infections. Our performance has, in many cases, been strongly influenced by these profound changes. We have responded well to the need to provide the most urgent care, and the adverse impacts on elective care have been slightly less than the average across the NHS. However, we remain very concerned by the significant increase in the numbers of patients waiting longer than they should for elective care. It will take concerted and sustained action within both the Trust and the wider NHS in order to return elective performance to levels achieved before the pandemic whilst also continuing to meet urgent care needs as the restrictions that have been implemented within our society are progressively relaxed. 9 Overview About the Trust Our services University Hospital Southampton NHS Foundation Trust is one of the largest acute teaching trusts in England with a turnover of more than £1 billion in 2020/21. It is based on the coast in south east England and provides services to over 1.9 million people living in Southampton and south Hampshire and specialist services, including neurosciences, respiratory medicine, cancer care, cardiovascular, obstetrics and specialist children’s services, to more than 3.7 million people in central southern England and the Channel Islands. The Trust is also a designated major trauma centre, one of only two places in the south of England to offer adults and children full major trauma care provision. As a leading centre for teaching and research, the Trust has close working relationships with the University of Southampton, the Medical Research Council, National Institute for Health Research (NIHR), Wellcome Trust and Cancer Research UK. UHS is consistently one of the UK’s highest recruiting trusts of patients to clinical trials and in the top ten nationally for research study volume as ranked by the NIHR Clinical Research Network. 12,000 Every year over staff at UHS: treat around 160,000 inpatients and day patients, including about 75,000 emergency admissions see over 650,000 people at outpatient appointments deal with around 150,000 cases in our emergency department deliver more than 100 outpatient clinics across the south of England, keeping services local for patients The Trust provides most of its services from the following locations: • Southampton General Hospital – the Trust’s largest location, where a great number of specialist services are based alongside emergency and critical care and which includes Southampton Children’s Hospital. • Princess Anne Hospital – located across the road from Southampton General Hospital and providing maternity care and specialist care for women with medical problems during pregnancy and babies who need extra care around birth across the region. • Royal South Hants Hospital – although the Trust does not operate this site near the centre of Southampton it provides a smaller number of services from this location. • New Forest Birth Centre – located at Ashurst on the edge of the New Forest and run by experienced midwives and support staff it offers a safe, ‘home away from home’ environment for women having a healthy pregnancy and expecting a straightforward birth. The services provided by the Trust are commissioned and paid for by local clinical commissioning groups (CCGs) and, in the case of more specialised services (such as treatments for rare conditions), by NHS England. Over 50% of UHS services are paid for by CCGs and approximately 48% by NHS England. We provide these under a standard NHS contract, which incorporates ongoing monitoring of the Trust and the quality of the services provided. 10 Our structure UHS gained foundation trust status on 1 October 2011. A foundation trust is a public benefit corporation providing NHS services in line with the core NHS principles: that care should be universal, comprehensive and free at the point of need. The Trust is licensed as a foundation trust to provide these services by Monitor (the independent regulator, now part of NHS England and NHS Improvement) and the healthcare services we provide are regulated by the Care Quality Commission. Being a foundation trust has enabled greater local accountability and greater financial freedom and has supported the delivery of the Trust’s mission and strategy over a number of years. The diagram below provides an overview of the overall organisational structure of the Trust. Public and foundation trust members Council of Governors Board of Directors Executive Directors Division A Surgery Critical Care Opthalmology Theatres and Anaesthetics Division B Division C Cancer Care Emergency Medicine Helicopter Emergency Medical Services Medicine and Medicine for Older People Pathology Specialist Medicine Women and Newborn Maternity Child Health Clinical Support Division D Trust Headquarters Division Cardiovascular and Thoracic Neurosciences Trauma and Orthopaedics Radiology Corporate Affairs Communications Estates, Facilities and Capital Development Finance Human Resources Informatics Patient Support Services Procurement and Supply Transformation and Improvement (‘Always Improving’) Research and Development Strategy and Business Development 11 The Trust is also part of an integrated care system in Hampshire and the Isle of Wight, which is a partnership of NHS and local government organisations working together to improve the health and wellbeing of the population across Hampshire and the Isle of Wight. Our values Our values describe how we do things at UHS and act as a guide to all staff working with colleagues to deliver high quality patient care and a great patient experience every day. Our values are: Patients, their families and carers are at the heart of what we do. Their experience of our services will be our measure of success. Partnership between clinicians, patients and carers is critical to achieving our vision, both within hospital teams and extending across organisational boundaries in the NHS, social care and the third sector. We will ensure we are always improving services for patients through research, education, clinical effectiveness and quality improvement. We will continue to incorporate new ideas, technologies and create greater efficiencies in the services we provide. 12 Our strategy 2021-25 The Trust’s strategy was updated during 2020/2021 to take account of everything our staff had experienced during the COVID-19 pandemic and what we had learnt from this. The vision for UHS is to continue on its journey to become an organisation of world class people delivering world class care. Our strategy is organised around five themes and for each of these describes a number ambitions we aim to achieve by 2025. Theme Ambitions Outstanding patient outcomes, • We will monitor clinical outcomes, safety and experience of our experience and safety patients regularly to ensure they are amongst the best in the UK By 2025 we will strengthen our and the world. national reputation for outstanding • We will reduce harm, learning from all incidents through our patient outcomes, experience and proactive patient safety culture. safety, providing high quality care • We will ensure all patients and relatives have a positive experience and treatment across an extensive of our care, as a result of the environment created by our people range of services from foetal and our facilities. medicine, through all life stages and conditions, to end-of-life care. Pioneering research • We will recruit and enable people to deliver pioneering research and innovation in Southampton. We will continue to be a leading teaching hospital with a growing, reputable and innovative research and development portfolio • We will optimise access to clinical research studies for our patients. • We will enable innovation in everything we do, and ensure that ‘cutting edge’ investigations and treatments are delivered in Southampton. that attracts the best staff and efficiently delivers the best possible treatments and care for our patients. World class people • We will recruit and develop enough people with the right Supporting and nurturing our knowledge and skills to meet the needs of our patients. people through a culture that values • We will provide satisfying and fulfilling roles, growing our talent diversity and builds knowledge and through development and opportunity for progression. skills to ensure everyone reaches • We will empower our people, embracing diversity and embedding their full potential. We must provide compassion, inclusion and equity of opportunity. rewarding career paths within empowered, compassionate, and motivated teams. Integrated networks and collaboration We will deliver our services with partners through clinical networks, collaboration and integration across geographical and organisational boundaries. • We will work in partnership with key stakeholders across the Hampshire and Isle of Wight integrated care system. • We will strengthen our acute clinical networks across the region, centralising when necessary and supporting local care when appropriate. • We will foster local integration with primary and community care as well as mental health and social care services for seamless delivery across boundaries. • We will build on our successful partnership with University of Southampton (UoS), growing our reputation as a national leading university teaching hospital. 13 Theme Foundations for the future Making our enabling infrastructure (finance, digital, estate) fit for the future to support a leading university teaching hospital in the 21st century and recognising our responsibility as a major employer in the community of Southampton and our role in broader environmental sustainability. Ambitions • We will deliver best value to the tax payer as a financially efficient and sustainable organisation. • We will support patient self-management and seamless care across organisational boundaries through our ambitious digital programme, including real time data reporting, to inform our care. • We will expand and improve our estate, increasing capacity where needed and providing modern facilities for our patients and our people. • We will strengthen our role in the community as an employer of choice, a partner in delivery of services to our population and by leading the Greener NHS agenda locally. During each year of the strategy the Trust will set out a more detailed series of objectives to achieve and progress towards the delivery of its ambitions. In 2020/21 these objectives included: • Recovery, restoration and improvement of clinical services • Implementing the ‘Always Improving’ strategy • Restoring a full research portfolio • Continuing our focus on staff wellbeing including the long-term effects of coronavirus (long COVID) • Working in partnership with the newly established integrated care system • Creating a sustainable financial infrastructure • Making our corporate infrastructure (digital, estate) fit for the future to support a leading university teaching hospital in the 21st century, including an estates masterplan. Performance against these objectives will be monitored and reported to the Trust’s board of directors on a quarterly basis. Principal risks to our strategy and objectives The board of directors has identified and manages the principal risks to the delivery of its strategy and objectives through its board assurance framework. The principal risks to the delivery of its strategy and objectives identified by the Trust during 2020/21 were that: • it would be unable to form effective partnerships that achieve networked care for patients; • it could not develop the estate in line with the ambitions set out in the strategy; • it would fail to restore and increase capacity following the COVID-19 pandemic to meet waiting times for elective care and cancer care needs; • it would fail to introduce and implement new technology for the transformation of care; • it would be unable to retain, recruit, develop and train a diverse and inclusive workforce necessary to meet the strategic goals; • it could not develop a sustainable model within the new financial regime that preserves quality care; • it would fail to provide vulnerable service users with timely and high quality and appropriate care; • it would not reach the ambition of outstanding compliance and quality standards; • it could not sufficiently engage with key stakeholders and system partners to support effective interventions and maintain the health of the local population; • it would be unable to respond to the needs of the NHS in order to deliver our strategy; • it would fail to capitalise on its relationship with the universities in Southampton and other health education providers in line with our strategy; • it would not develop innovative education and training approaches. 14 While the COVID-19 pandemic presented the Trust with new risks as it introduced more stringent infection control processes, stopped certain types of activity and responded quickly to care for large numbers of seriously ill patients who had tested positive for COVID-19, it also prompted innovation across a wide range of areas. However the ongoing impact of the pandemic on both our staff, patients who have had COVID-19 and patients who have waited longer than expected for treatment as a result, added to the risks facing the Trust. National targets for performance have not been amended as a result of the pandemic, although the national plan has focussed on the recovery of activity levels as the first stage in a restoration of elective services. Capacity – The initial and subsequent waves of the COVID-19 pandemic have led to increases in the waiting times for patients and the number of patients waiting more than 52 and 78 weeks has increased significantly. While the Trust was able to recover capacity quickly between waves of the pandemic, its ability to reduce the overall waiting list and the length of time patients are waiting for treatment remains one of the key risks for the Trust. This may be compounded by the reduction in the number of referrals from GPs during the pandemic, leading to a potential future increase in the number of patients being referred as people visit their GPs for the first time with more advanced disease. During the pandemic the Trust utilised the support available from the independent sector to continue cancer treatment and surgery for those patients at highest risk. It also increased the number of outpatient attendances which took place by telephone or video call. The Trust developed a clinical assurance framework during the year to better assess the risk of harm to patients as a result of delays in treatment and this has been utilised in decision-making around the allocation of resources to those areas where there is the greatest risk of potential harm to patients. In addition to opening additional capacity during 2020/21 (described in the Estates section below), the Trust also committed expenditure and commenced construction works in 2020/21 in order to be in a position to open an additional endoscopy room and four further operating theatres during 2021/22 and prepared plans for a significant expansion in ophthalmology outpatient capacity. These initiatives will contribute to improvements in elective waiting times that needed following the pandemic. Quality and compliance – The Trust continued to monitor the quality of care delivered throughout 2020/21. During the COVID-19 pandemic the primary focus became infection prevention and control, with the launch of a successful COVID ZERO campaign that saw the Trust reduce the transmission of the virus in hospital (nosocomial transmission). The Trust also achieved its annual target for reduction in Clostridium Difficile infections, however, there was one MRSA Bacteraemia during March 2021, the only such event in 2020/21. The Trust continued to develop its proactive patient safety culture during 2020/21 with changes to the way in which patient safety incidents are investigated and the approval of its Always Improving strategy, which will be launched in 2021. Reporting and investigation of incidents continued during 2020/21. Partnerships – During 2020/21, the Trust and its partners worked together very effectively to discharge patients safely and provide ongoing support to patients who had tested positive for COVID-19, to ensure patients requiring urgent cancer treatment and surgery were able to continue their treatment in the independent sector and to develop a COVID-19 saliva testing pilot with the University of Southampton and local authorities. Work to respond to the COVID-19 pandemic, however, meant that as a system we were unable to progress the Hampshire and Isle of Wight strategic plan delivery at the pace we would have wanted or had set out to achieve, particularly the development of networks. Nonetheless the application for Hampshire and Isle of Wight to become an integrated care system was approved with effect from 1 April 2021. 15 Existing networks continued to develop and improve. The Trust also became the Wessex Cancer Surgical Hub during 2020 as a result of a national initiative with the aim of maximising the number of patients receiving curative surgery. Both the Wessex Cancer Alliance and the Trust ended the year as the second highest performing among their respective peers for cancer treatment. Workforce – While additional staff were recruited to specifically assist the Trust during the pandemic, the Trust continued to recruit nurses from overseas during 2020/21 meaning that the number of vacancies has reduced compared to the position prior to the pandemic. Changes to recruitment processes were approved in 2020/21 to improve the fairness, transparency and quality of these. The Trust also continued to work with its staff networks and specific focus groups to increase diversity in leadership roles. While workforce capacity continues to be one of the biggest challenges faced by the Trust, during 2020/21 our main focus has been on supporting our staff to respond to the COVID-19 pandemic and providing both the tools and time to help staff recovery. We are incredibly proud of the way that staff responded to the pandemic and continue to recognise this in whatever ways we can, however, we also want to ensure that staff continue to be able to contribute to patient care at their best and want to stay and develop with the Trust. Technology was also used at levels not previously achieved to continue to deliver training to staff and enable staff to work from home where possible, ensuring a safer environment for patients and staff in the hospitals. Estate – The Trust continued to invest in and develop its estate during 2020/21 including the opening a new general intensive care unit (GICU), a new operating theatre and a new cancer care ward, built in just six months. These were part of £80 million of capital expenditure in 2020/21. The Trust has also established a programme to reduce backlog maintenance in addition to continuing to add to and improve the environment in which services are provided to patients and the working environment for staff. Innovation and technology – There have been exceptional levels of achievement in relation to COVID-19 related research activity, including in partnership with the universities. You can read more about these from page 167 of the quality report. The board of directors also supported the funding of an expansion of research and innovation activity to allow the continued delivery of the Trust’s ambitions to innovate and improve and transform its services. Sustainable financial model – The Trust achieved its forecast breakeven position in 2020/21. Income was more predictable in 2020/21 as block contract arrangements were put in place in response to the COVID-19 pandemic and ensured that costs were covered. The Trust continues to maintain a strong cash position and to implement improvements and efficiency savings, allowing it to continue to invest in its services. 16 Summary of performance COVID-19 bed occupancy UHS has experienced two distinct peaks in inpatient care for patients with COVID-19 infection, with smaller numbers of patients continuing to receive care outside these peak times. Bed occupancy reached a maximum of 173 in the first peak in April 2020, and 322 in the second peak in January 2021. All bed types Intensive care/higher care beds 17 Emergency access through our emergency and eye casualty departments Public concerns about safety, government restrictions on the activities people were able to do, and the efforts of community services contributed to significant reductions in the total number of patients who presented to our departments. All patients presenting to the emergency department Many changes were introduced within our departments in the course of the year to ensure that emergency assessment and treatment could be provided safely, including wearing of protective equipment by staff and patients, providing care in separate areas for patients suspected or known to have COVID-19, and using rapid laboratory tests to identify infection and confirm/exclude COVID-19 as a cause. Emergency access performance (measured as the percentage of patients discharged from emergency department care or admitted to a hospital bed within four hours of arrival to the department) improved significantly in 2020/21 compared to previous years. The national target of 95% was not achieved, however, the performance of our departments compared favourably with the average for acute trusts in England. 18 Emergency access four hour performance 19 Elective Waiting times Demand We saw a significant reduction in the number of elective referrals to hospital in the early part 2020/21, though they had returned close to pre-pandemic levels by the end of the year. It is likely that this pattern relates to a range of factors including reluctance from members of the public to attend healthcare facilities at that time, changes to the ways in which primary care was accessed, and efforts made within primary and community to avoid hospital referrals needing to be made. Accepted referrals The number of patients referred to hospital with suspected cancer also reduced during 2020/21; 7% fewer patients were seen across the year as a whole, though referrals returned to pre-pandemic levels or higher from July 2020 onwards. Patients seen following ‘Two week wait’ urgent referral for suspected cancer 20 Activity UHS hospital appointments, diagnostic tests and elective admissions were all significantly reduced during 2020/21 due to the impact of COVID-19. • During periods of higher bed occupancy with COVID-19 it was necessary to significantly reduce the number of elective admissions undertaken in order that additional staff could work in intensive care. Less clinically urgent and therefore longer waiting patients were primarily those affected. • Throughout the year, additional infection prevention measures have reduced the number of patients that can be seen in each session, particularly when higher risk ‘aerosol generating’ procedures are planned, but also as a result of additional PPE being worn or to enable greater distancing of patients attending outpatient departments. UHS was offered additional capacity at local independent sector hospitals and used this effectively to minimise these adverse impacts. Approximately 30% of outpatient appointments are now undertaken by telephone or video, helping to maintain the capacity for patient care whilst reducing the infection risk for those patients and helping to maintain distancing measures for those patients still attending our outpatient departments. The graphs below show 2020/21 activity levels as a percentage of those achieved in the previous year. Elective admissions (including daycase) 21 Outpatient attendances Performance The average waiting time for first outpatient appointments has remained close to nine weeks for the majority of the year. UHS has however experienced very significant deteriorations in the waiting times our patients experience for diagnostic tests to be undertaken and elective treatment to be provided. The reduced number of new patients referred to hospital early in 2020/21 has moderated the extent of the growth in the total numbers of patients waiting, and the greatest rate of growth has unfortunately been amongst those groups of patients already waiting longest. 22 Diagnostics Our performance measures for diagnostics report on a total of 15 different frequently used tests. The waiting list is approximately 50% bigger than it was before the pandemic and stable through the second half of the year. At the end of the year 28% of patients were waiting more than six weeks to receive their investigation compared to the national target of 1%. The tests with the largest numbers of longer waiting patients include non-obstetric ultrasound, MRI and endoscopies, and further recovery will be driven through a combination of recruitment, independent sector capacity and an additional endoscopy room which opened at the start of April 2021. Patients waiting for a diagnostic test to be performed (sum of 15 different frequently used tests) Percentage of patients waiting over 6 weeks for a diagnostic test to be performed 23 Referral to Treatment Our waiting list from referral to treatment increased in size by 6% (2,220 patients) during 2020/21, rising when the recovery in referral numbers exceeded the recovery in clinical activity, the total increase in waiting list size would have been significantly higher had it not been for the significant reduction in the referrals received by the hospital especially during the early months of the pandemic. Looking forward, we anticipate referrals numbers returning to pre-pandemic levels, and being able to maintain the total size of our waiting list by delivering an equivalent number of treatments each month. Number of patients waiting between referral and commencement of a treatment for their condition The national target is that at least 92% of patients should be waiting for treatment no more than 18 weeks from their referral to hospital. Our performance against this measure is now 12% worse than one year ago, at 66%. Our performance continues to be typical of the major teaching hospital trusts that we benchmark with and the trend has been similar to that experienced across trusts in England. Percentage of patients waiting up to 18 weeks between referral and treatment 24 Unfortunately, the number of patients waiting significantly longer than the 18 week target has increased at a faster rate than the size of the waiting list as a whole. The graph below shows how the percentage of patients who have waited more 52 weeks increased. The number of patients who have waited more 52 weeks increased from 40 in March 2020 to 3,419 by March 2021 (of these 445 patients had waited more than 78 weeks). Such patients often require surgical treatment, particularly in the orthopaedic, ear nose and throat and oral surgery specialities. The impact on surgical care has been greater than that in outpatients during the pandemic, and it is also more challenging to increase capacity due to the need for additional operating theatres and a combination of different healthcare professionals to work within them. UHS opened an additional operating theatre in 2020/21, and has a further four theatres scheduled to open during 2021/22, which will make a significant contribution to our capacity to treat more patients. Unfortunately, the number of patients waiting significantly longer than the 18 week target is likely to continue to grow further in the short term, due to diagnostic investigations having been progressed less quickly than usual during the pandemic, the need to prioritise our increased treatment capacity according to the clinical urgency of conditions and because our scheduled capacity increases will not be completed before the autumn of 2021. Percentage of patients waiting more than 52 weeks, between referral and commencement of a treatment for their condition 25 Cancer Waiting Times UHS has been mostly successful in maintaining the timeliness of urgent services for patients with suspected cancer through the pandemic, and our performance has been amongst the best in both the south-east and nationally. UHS prioritised the theatre and intensive care capacity we were able to provide during the pandemic in order to meet the needs of those patients with the greatest clinical urgency, used capacity offered by independent sector hospitals to supplement that available within NHS, and operated a hub through which hospitals in Wessex were able to collaborate to continue critical cancer surgery during periods of peak COVID-19 demand. The national target is to provide the first definitive treatment to at least 85% of patients with cancer with 62 days of referral to hospital. Whilst UHS performance remained below this level in the majority of months, our performance has been significantly better than the national average, and has improved relative to other trusts. Treatment for Cancer within 62 days of an urgent GP referral to hospital 26 The national target is to provide the first definitive treatment to at least 96% of patients within 31 days of a decision to treat being made and agreed with the patients; both for the first and any subsequent treatments for cancer. UHS achieved this level on average across the year, and in the majority of months. The treatments provided are typically by means of surgery, chemotherapy/immunotherapy or radiotherapy. The most significant performance challenge this year has been in radiotherapy, where more sophisticated treatment plans improve patient outcomes but take longer to prepare, and there was also reduced treatment capacity whilst we replaced one of our ‘Linear Accelerator’ treatment machines with a new model. First definitive treatment for cancer within 31 days of a decision to treat Equality in service delivery Identifying and addressing health inequalities have been the central part of the Trust’s approach to improving the experience of care for our patients, families and carers. Over the past year, new initiatives have augmented progress on existing work to ensure there is appropriate support, due regard and recognition of those patients and their families and carers who are most at risk of poor experiences, outcomes and access to services. In 2020 we added two questions to our patient surveys, asking first if patients felt themselves to have a disability or require a reasonable adjustment, and, if yes, whether the Trust met this need. In 2020/21, the results were: TOTAL Had a disability / required a reasonable adjustment 27% Had this need met by the Trust (positive response) 95% This question was added to our major Friends and Family Test surveys as well as our local service-specific patient surveys. In June 2020 the Trust launched the sunflower lanyard scheme for hidden disabilities, participating in the national initiative to ensure that people whose disabilities are not visible are able to access further support and reasonable adjustments by means of a nationally recognised indicator (the sunflower). In 2020/21, 618 lanyards were issued with those needs recorded to ensure future reasonable adjustments are made for those individuals. 27 Carers have always been essential partners in the care that we provide, and having introduced a new post at the end of 2019 to focus solely on carer experience, this work has culminated in a Trust strategy for improving the involvement, support and experience carers have of our services. We have, over the past year, introduced carers cards, virtual peer support and carer-specific information about services while actively participating in local and regional work on carers. In January 2021 we realised our ambition of becoming an accredited ‘Veterans Aware’ hospital, with our submission of evidence being recognised as ‘strong’ and indicative of an organisation that has made great progress in helping to provide enhanced support for the armed forces community. Towards the end of 2019 we worked with the disability organisation AccessAble to produce accessibility guides for all of our services and estate. These online guides allow patients and visitors with disabilities to plan their journey and identify potential challenges to the environment. In 2020/21 our guides had 5,000 unique visits per month. One of our COVID-19 initiatives, a patient support hub, was set up in May 2020 to provide a single point of support for our patients who had been advised to shield. The service has grown and now offers support to patients and carers who are vulnerable, disabled or with additional needs. This includes coordinating community transport, arranging companions to assist with attending appointments, hosting a technology library to support those who are digitally excluded in accessing virtual appointments and information, and most recently receiving funding to pilot volunteer-led support for diabetes patients. Across the Trust, we continue to actively promote the importance of asking patients and carers about disabilities and reasonable adjustments, flagging needs on our patient administrative system to prompt our services to take proactive steps to ensure that any needs or adjustments are met on each and every visit. This has been of vital importance for meeting accessible information and communication needs. We are currently one of first trusts to pilot a new translation app that provides immediate interpretation into different languages, and we have worked closely with our communication support partners to ensure that where virtual appointments are needed, people with communication needs (BSL, foreign language) are supported to access care virtually. Our specialist nursing liaison teams continued to support access to services throughout the pandemic, ensuring that patients with dementia, with learning disabilities and autism, were supported to attend hospital where necessary. Further information about the Trust’s work in relation to equality, diversity and inclusion can be found on page 69 and pages 106 and 160 in the quality report. Going concern After making enquiries, the directors have a reasonable expectation that the services provided by the Trust will continue to be provided by the public sector for the foreseeable future. For this reason, the directors have adopted the going concern basis in preparing the accounts, following the definition of going concern in the public sector adopted by HM Treasury’s Financial Reporting Manual. David French Chief Executive Officer 28 June 2021 28 Accountability report Directors’ report Board of directors The board of directors is usually made up of six executive directors and seven non-executive directors, including the chair. Since 1 January 2021 the number of non-executive directors has been reduced by one as Jane Bailey’s reappointment as a non-executive director was deferred to allow her to lead the Hampshire and Isle of Wight saliva mass testing programme. Jane is expected to return to the board of directors in her non-executive director role by 1 July 2021. Paragraph B.1.2 of the NHS foundation trust code of governance provides that at least half the board of directors, excluding the chair, should comprise non-executive directors determined by the board to be independent. Pending the reappointment of Jane Bailey as a non-executive director, the Trust has been operating with one fewer non-executive directors than is required by the Trust’s constitution and the Trust has been non-compliant with this paragraph of the code. During this period the provisions of the Trust’s constitution that a quorum for meetings of the board of directors requires at least one non-executive director and one executive director to be present and for the chair to have a second and casting vote in the case of an equal vote continued to apply. The board of directors has given careful consideration to the range of skills and experience it requires to run the Trust. Together the members of the board of directors bring a wide range of skills and experience to the Trust, such that the Board achieves balance and completeness at the highest level. The chair was determined to be independent on his appointment and the other non-executive directors have been determined to be independent in both character and judgement. This included specific consideration of Jane Bailey’s continued independence following her role leading the Hampshire and Isle of Wight saliva mass testing programme. The chair, executive directors and non-executive directors have declared any business interests that they have. Each director has declared their interests at public meetings of the board of directors. The register of interests is available on the Trust’s website. 30 The current members of the board of directors are: Non-executive directors Peter Hollins Chair Peter graduated in chemistry from Hertford College, Oxford. Joining Imperial Chemical Industries in 1973, he undertook a series of increasingly senior roles in marketing and then general management. Following three years in the Netherlands as general manager of ICI Resins BV, in 1992 he was appointed as chief operating officer of EVC in Brussels – a joint venture between ICI and Enichem of Italy. He played a key role in the flotation of the company in 1994, before returning in 1998 to the UK as chief executive officer of British Energy where he remained until 2001. From 2001, he held various chairmanships and non-executive directorships. In 2003, he decided to return to an executive role as chief executive of the British Heart Foundation in which post he remained until retirement in March 2013. He joined Southampton University Hospital Trust as a non-executive director in 2010, became senior independent director and deputy chairman of UHS in 2014 and was appointed chair in April 2016. Trust roles: • Chair of remuneration and appointment committee • Chair of governors’ nomination committee Jane Bailey Non-executive director In 1985, Jane joined the pharmaceutical company Glaxo as a management trainee, having graduated from London University with a degree in environmental science and pharmacology. Here she rose to senior commercial vice-president, gaining experience of a broad range of disease areas across different regions of the world. She specialised in leading global research and development teams in the formation of strategies to bring new medicines to patients. She also worked to ensure that the medicines developed were supported by robust evidence demonstrating their clinical and cost-effectiveness. In delivering this she gained extensive experience of leading large diverse teams across a complex global organisation. For five years, Jane ran her own strategy development consultancy, working across a breadth of healthcare organisations. In 2017 Jane gained an MSc in public health, with distinction, at King’s College, London University. Her studies focused on how to ensure the public are engaged in development of healthcare services and how social theories can help inform effective disease prevention and management. Jane is a director of Wessex NHS Procurement Limited, a joint venture between the Trust and Hampshire Hospitals NHS Foundation Trust and a director of Healthwatch Portsmouth. Trust roles: • Deputy chair and senior independent director • Chair of finance and investment committee • Audit and risk committee member • Charitable funds committee member • People and organisational development committee member • Remuneration and appointment committee member • Wellbeing Guardian 31 Non-executive directors Dave Bennett Non-executive director Dave graduated in chemistry from the University of Southampton before entering management consulting, becoming a partner in Accenture’s strategy practice. In 2003 he joined Exel Logistics (later acquired by DHL), managing the company’s healthcare business across Europe and the Middle East. During this time, he established NHS Supply Chain, a UK organisation responsible for procuring and delivering medical consumables for the NHS in England, as well as sourcing capital equipment. Dave joined the board of Cable & Wireless as sales director in 2008. He later set up his own strategy consulting practice serving the healthcare sector, completing numerous projects in the UK and the US. Dave has also served as a non-executive director at The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust between 2009 and 2016, where he chaired the Trust’s quality committee. Dave is a non-executive director at the Faculty of Leadership and Medical Management and a director of Royal College of General Practitioners (RCGP) Enterprises Ltd and RCGP Conferences Ltd. Trust roles: • Chair of charitable funds committee • Chair of finance and investment committee (from 1 January 2021) • Audit and risk committee member (from 9 February 2021) • Quality committee member • Remuneration and appointment committee member • Chair of Trust’s organ donation committee 32 Non-executive directors Cyrus Cooper Non-executive director Cyrus Cooper is professor of rheumatology and director of the MRC Lifecourse Epidemiology Unit. He is also vice-dean of the faculty of medicine at the University of Southampton and professor of epidemiology at the Nuffield Department of Orthopaedics (rheumatology and musculoskeletal sciences, University of Oxford). He leads an internationally competitive programme of research into the epidemiology of musculoskeletal disorders, most notably osteoporosis. His key research contributions have been: • discovery of the developmental influences which contribute to the risk of osteoporosis and hip fracture in late adulthood • demonstration that maternal vitamin D insufficiency is associated with sub-optimal bone mineral accrual in childhood • characterisation of the definition and incidence rates of vertebral fractures • leadership of large pragmatic randomised controlled trials of calcium and vitamin D supplementation in the elderly as immediate preventative strategies against hip fracture. He is president of the International Osteoporosis Foundation, chair of the BHF Project Grants Committee, an emeritus NIHR senior investigator, a director of The Rank Prize Funds and associate editor of Osteoporosis International. He has previously served as chairman of the Scientific Advisors Committee (International Osteoporosis Foundation), the MRC Population Health Sciences Research Network and the National Osteoporosis Society of Great Britain. He has also been president of the Bone Research Society of Great Britain and has worked on numerous Department of Health, European Community and World Health Organisation committees and working groups. Cyrus has published extensively on osteoporosis and rheumatic disorders and pioneered clinical studies on the developmental origins of peak bone mass. In 2015, he was awarded an OBE for services to medical research. Trust roles: • Quality committee member • Remunerati
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Florence FAQs_v1.0
Description
Florence FAQ’s Introduction During the 2023 MHRA inspection UHS received a finding and some advice regarding working electronically for clinical trials. It was decided in line with the Department of health steer towards going paper-light and creating a more sustainable way of working that UHS would find a solution for the management and storage of Trial Master Files (TMF) and Investigator Site Files (ISF). After a great deal of work reviewing and evaluating several available solutions it was decided that the Florence Healthcare solution was the best fit for UHS requirements. It also has a number of other features which have made it a more attractive and cost effective solution. Going forward, the plan is to have all new studies set up and managed through Florence and to replace QPulse with functionality within Florence. The Florence steering group have put together this set of FAQs to alleviate any concerns and to ensure information is accurate and centrally located. These questions will be updated as further information becomes available and more questions arise. 1) Who is on the steering group/project management group. Currently the steering group consists of 4 people who have undergone in depth training with the Florence implementation team and passed the super user examination. The members are of different seniority in the R&D office and have different functions: Laura Purandare – Deputy Director of R&D, Chair of the steering group and liaison with senior management. Mikayala King – R&D Governance, QA and Sponsorship Manager, Governance lead. Sharon Davies-Dear – R&D Deputy QA Manager, Operations lead. Luke Atwill – R&D QA Officer, Florence project manager. A number of other people are helping with the build, validation and roll-out: Marie Nelson - R&D Head of Nursing and Health Professions Liliana Goncalves cordeiro – Head of Clinical Trials Pharmacy Kim Lee – Senior QA Lead for the CRF – lead for the transfer from QPulse to Florence. Sue Wellstead - Clinical Research Specialist in Education and QA Hope Howard – Senior QA lead for ATIMPs Gemma Scott – R&D QA Officer Richard Munday - Commercial Business Development Manager Angela Darekar - Head of MRI Physics and UHS Lead for Imaging Research Gavin Babbage - Translational Scientist Laboratory Manager Once through the initial phase of roll out the steering group will involve further senior members of staff from across the infrastructure. Version 1.0 12/12/2024 Page 1 of 4 2) Will it replace Edge? No, Florence will not replace EDGE. The functions and purpose of the two systems are different therefore EDGE will still be used as a communication tool, monitoring recruitment, set up management, finances and reporting. 3) Will workflows on Edge move to Florence? No, the term workflow when applied to Florence has a different meaning to what is recognisable as a workflow in Edge; therefore, these will remain on Edge. 4) Are we moving existing studies? Existing studies will remain in their current format. Florence will be rolled out for new studies only. 5) Will it replace QPulse? Yes, Florence will replace QPulse and your SOPs will be transferred over. You will be required to sign your SOP acknowledgement in the Florence system. The contract for QPulse will come to an end in March 2025. 6) Will there be training? Yes, there will be training, on roll out of the software which will be on a study by study basis. The team delivering that study will be given training, additionally they will have support for roughly 2 weeks where someone will be with them during the day so that all questions can be answered, and support given. This will start with a UHS Sponsored study and will gradually move outwards. Once fully rolled out there will be champions, similar to Edge. There is also a support email that has been set up, in case of any questions and concerns florenceadmin@uhs.nhs.uk Training on the use of Florence to replace QPulse will be separate to the study training and will be rolled out to larger groups, team by team. 7) When can we get access? The building and roll out of Florence is a huge undertaking and takes time to ensure we get it right first time. We are therefore not rushing the roll out and are ironing out glitches as we move forward. The first study is currently being put into Florence and the associated study and support teams have been given access and are undergoing training. The full roll out of Florence for new studies will take some time and we are anticipating this will not be fully complete until the end of 2025. However, everyone who needs to have access to view and acknowledge SOPs etc will have access to that function before the end of March 2025. 8) What is happening at the moment? We have just completed the first UAT development stage of the software, and this code has been built by the central Florence team. The system has to be built section by section and we have been following Florence’s implementation plan and the timescales set by Florence. We have just started building the first study into the system and have given access to the study team and associated support staff. Training is underway and further studies are being prepared to go into the system. Version 1.0 12/12/2024 Page 2 of 4 The filing structure for the SOPs and other controlled documents are being built in the ‘live’ version of Florence prior to the SOPs etc being transferred from QPulse. The second stage of development is due to commence in January 2025 and will again follow the timescales set by the central Florence team. 9) Will the system be validated? Yes, the system is fully validated. The installation and software aspects of the system are centrally validated by the central Florence team and we have all of the associated documentation to demonstrate this. We have also been working on validating the system so that it performs as expected in the live system and have completed this prior to roll out. Validation will be ongoing as more functionality comes into use. 10) Who will validate this? The Florence project manager (Luke Atwill) is leading on the validation of the system with assistance from the QA team, UHS digital and the central Florence Team. Volunteers have also been called on to validate different aspects of the system and document their findings. 11) Who is the asset owner and responsible for the system? The Research and Development Governance, Quality Assurance and Sponsorship manager is responsible for oversight of the entire system and is the registered asset owner. 12) How will it be managed? The current steering group will be expanded to ensure input from all appropriate parties. There is also a national Florence group being established in order to share best practice with other users within the UK. The day-to-day management of the software will be managed by the QA and Sponsorship teams in the first instance and then by a team of appropriately trained champions. 13) What access will I get? Florence has been built to have specific roles and responsibilities that can be applied to users dependant on their role in the study. You may have more than one role in a study or different roles on different studies and this will be customised study by study. If you have studies, either commercial or non-commercial, that are already using Florence, you will be able to see this in your account. Your roles in these trials will not be affected. Unlike Edge it is one log in for the system rather than organisation specific and you can be assigned to different teams dependant on the access you need and your role. 14) Will this replace the sharedrive? The sharedrive should not be used for any documents that should be in your site file. All documents that should be in your site file should either be kept as paper or in a validated eISF system supplied by the sponsor. EDGE and the sharedrive are not suitable for this purpose. 15) Will Florence replace my paper ISF or TMF? Florence will only be for new studies in which case yes it would replace the paper ISF and TMF. However, if your study is already running in a paper format, this will continue and will not be replicated or reproduced in Florence. Version 1.0 12/12/2024 Page 3 of 4 16) What about archiving? Florence has an inbuilt archive facility which will preserve electronic data and will store for the regulated amount of time. This will not replace the paper archiving for existing studies but will be used for all studies that are in Florence. 17) Does Florence meet the regulatory requirements? Yes, Florence is compliant. Florence’s Compliance Team has reviewed regulations set forth by the Medicines and Healthcare products Regulatory Agency (MHRA) and confirmed that the use of electronic systems such as Florence is compliant with United Kingdom (UK) requirements. Florence complies with numerous regulations within the UK, which directly facilitate the use of Florence across various areas, including electronic document management, electronic signatures, remote monitoring, and remote source data verification. • MHRA Good Clinical Practice Guide • “GxP” Data Integrity Guidance • UK MHRA TMF Q&A • Guidance on Access to Electronic Health Records by Sponsor representatives in clinical trials • Joint statement on seeking consent by electronic methods Florence is compliant with The Data Protection Act 2018, and utilizes General Data Protection Regulation (GDPR) as the foundational basis for global privacy. Florence additionally adheres to the Caldicott Principles and is active under the UK Extension to the EU-U.S. Data Privacy Framework to provide adequate data protection. Florence has completed the Digital Technology Assessment Criteria (DTAC) to ensure the Site Enablement Platform meets the assessment criteria. Additionally, Florence has completed a Data Security and Protection Toolkit self-assessment to demonstrate we are practicing good data security and that personal information is handled correctly. 18) Will external monitors be able to access Florence? Yes, external monitors will be able to access Florence via unique log ins and with specific roles limiting what actions they are able to complete. Monitors are also able to raise queries within the system and these can be answered in the system too. 19) Does Florence have other features we can use? Yes, Florence has a number of features that are being explored including upload of documents via an ePrinter and email, document redaction and eSignatures, and these will be rolled out in due course. 20) Will there be any demonstration prior to full roll out? The Florence system is being built from scratch using the tools and advice supplied by the central Florence team. Since Florence originated in the USA, a lot of work has to be done to adapt it to the UK and then to how NHS organisations work. This work is ongoing and therefore as soon as we are ready to show the system we will be running some demonstration days prior to full roll out. Version 1.0 12/12/2024 Page 4 of 4
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Dr Kristin Veighey, associate director and academic career development lead for medical clinical research fellows
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Southampton Academy of Research Auto Generated Title Dr Veighey aims to identify and promote research training opportunities for current and future resea
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