Welcome to The Princess Alexandra Hospital’s Local Healthcare Event and Annual General Meeting October 2010

1. Welcome to The Princess Alexandra Hospital’s Local Healthcare Event and Annual General Meeting October 2010

2. Introduction Gerald Coteman, Chairman Recent Advances in Screening at Epping Dr Anthony Aylwin, Director of Screening Improvements in Breast Cancer Care at The Epping Breast Unit Mr H Bradpiece, Lead Breast Consultant Now and in the Future Jane Herbert, Chief Executive Questions to the Speakers Close

3. Gerald Coteman, Chairman • Taking Control • Foundation Trust • Clinical and Patient Empowerment (inc commissioning) • Health versus Hospitals

4. Health • Long term Conditions • Long term Conditions • Long term Conditions • Biggest global disease burden facing the modern world • PAH - reinforcing our role in both managing and preventing ill-health • Deep and sustainable reform of commissioning and Local Health Economy

5. What Else is Important? • Stronger and more visible Board • Higher priority for patient quality and safety • Engagement with staff and patients has improved • Dialogue with our partners and stakeholders has increased and improved

6. Other Things that Matter • To you – • Dementia • To me – • Carers

7. Thank You • Our Staff • The Board • You

8. Recent Advances in Screening at the Epping Breast Unit Dr Anthony Aylwin Director of Screening Epping Breast Unit

9. The Breast Unit • Currently provides both breast screening and symptomatic breast services • ‘Static’ unit based at St Margaret’s Hospital • ‘Mobile’ mammography screening van

10. Breast Screening • Screening population (aged 50 to 70) = 36,000 • Women screened every 3 years • 75% attend appointments • 10,000 women screened per year • Detect approx 75 cancers per year

11. Symptomatic Unit • 2500 patients attend breast clinic per year • ‘One stop’ clinic – clinical assessment, mammogram, ultrasound and biopsy at same sitting • Approx 150 cancers per year

12. Recent Advances • ‘Encore’ Needle Biopsy System • Automated, vacuum assisted • Better samples • Improved diagnosis

13. Recent Advances • ‘Faxitron’ Digital Xray Biopsy system • Better images • Quicker • Digital

14. The Next Step…Digital Mammography

15. The Next Step… Digital Mammography • Advantages: • 50% less radiation • Better cancer detection • More comfortable • No xray storage • Reduced running costs • Integration

16. The Next Step…Digital Mammography • Disadvantages: • Set-up costs • Purchase • Building

17. GOOD NEWS!

18. Epping Breast Screening Unit • Complete replacement – 3 new digital machines • 2 at the Epping Unit • 1 on a reconditioned, refurbished Mobile van • Integration with hospital-wide computer system

19. Building works underway NOW • ‘Phased’ introduction - no interruption to service • All work finished by Christmas 2010

20. And Finally,The MRI Scanner - One Year Later • Installed a new MRI Scanner at St Margaret’s Hospital • In 12 months 3,900 patients have been scanned • What people have said: “Nice staff, clean place and attended by everyone with respect and dignity.” “I was very frightened of the scan. Staff were kind and helpful and made it all very easy.”

21. Questions?

22. Thank You

23. Improvements in Breast Cancer Care at The Epping Breast Unit Mr H Bradpiece Lead Breast Consultant

24. The Epping Breast Unit • An integral part of PAH • Staffed by dedicated professionals • For the benefit of our local community • Out-patients at St Margaret’s Hospital, Epping • Surgery at PAH, Harlow

25. We are an outstanding unit – and not just because we say so… We work to a very high standard to deliver the best possible outcomes in the difficult area of breast disease Reports from independent reviewing bodies such as the QA Team and Peer Review confirm it

26. What Makes Us Special? • Multi-disciplinary team-working • State of the art technology • Up to date approaches • Research activity • Caring attitude

27. Multi Disciplinary Team • Group of doctors, nurses, technical and clerical support staff who run the unit • Formal and informal communications • Group directed guidelines, protocols and audit

28. State of the Art Technology • Digital mammography • Stereotactic localization • Sentinel Lymph Node Biopsy • With intraoperative diagnostics

29. Immuno-histochemistry in the lab to study the chemistry of the cancer and direct specific treatments – we were among the first to do it • Family History Clinics – again early advocates • Nurse-led Follow up Clinics • Bone Health Nurse • Early discharge with home care post-surgery Up to Date Approaches

30. Research Activity • Extraordinary feature of our unit • The whole team takes part • 5 dedicated research nurses • Active fund-raising programme • Patients benefit by participating

31. The focus of our attention is our patients • They are supported by us throughout their time with us • We appreciate that they are the reason that our Unit exists Caring Attitude

32. Any Questions?

33. Jane Herbert, Chief Executive The Princess Alexandra Hospital NHS TrustNow and In the Future

34. Our Five Year Vision and Mission “To become the best general hospital in the East of England” “To deliver the best possible care in a safe, reliable, effective and respectful environment”

35. Findings and Priorities • Quality: patient safety, outcomes and patient satisfaction • Capacity and demand • Money • Compliance and access target • Strategy and strategic relationships Foundation Trust Application

36. Quality • Board focus: new assurance systems being refined • Patient experience - more action needed in some areas • Patient safety and outcomes: clinical working groups in place helping to deliver safe care and best practice • Patient perceptions: big improvement but A&E still an issue

37. Capacity and Demand

39. Capacity and Demand Management • Significant mismatch between demand and capacity • Drives financial problems • Jeopardises access targets • Poorer patient experience • Workforce issues • Threatens the Foundation Trust application • Change in strategy needed • More support for Care Closer to Home • Internal work to reduce demand • Refresh bed strategy

40. Finance – Headline Results Steady delivery of surpluses since deficit in 2005/06

41. Growth Now Decreasing Turnover

42. Capital Investment

43. Where We Spent Our Money

45. The Auditors Local Evaluation (ALE) Excellent (4) Good (3) Adequate (2) Inadequate (1) 

46. Delivery is varied Problems from increased demand Compliance and Access Targets • Focus on underlying capacity/demand mismatch • Prioritise • Ensure milestones for key targets with tight performance management systems

47. Networking important for patient care, service planning and saving money White paper maintains drive to FT for acute hospitals by 12/13 GPs to become commissioners Strategy and Strategic Relationships • New FT application with less not more activity in the future • Continue to build links with GPs, community services, local acute hospitals

48. What does this mean for our Foundation Trust Application?

49. Summary • Top priority: work with primary care on “Care Closer to Home” to address capacity and demand imbalance to underpin other key issues • Strategy therefore based on doing less, not more • Continue to drive quality agenda and refine assurance/governance • Focus on finance and cost improvement • Build performance management culture • Lots to be proud of!

50. Any Questions Please do hand your badges and feedback forms back.