• Wirral Community Trust
  • Wirral Community Trust
  • Wirral Community Trust
  • Wirral Community Trust
Wirral Community NHS Trust Annual Report 2012-2013



Wirral Community NHS Trust Annual Report 2012-2013


Welcome to our 2nd Annual Report and Accounts.

Wirral Community NHS Trust has a duty to produce detailed annual reports for the whole organisation providing information about our progress and performance over the last financial year.

You can access the full account in this section of the website, alternatively you can download a PDF version of the document under Key Publications.

A summary annual report is also available.

The report will be formally presented at our Annual General Meeting (AGM) on the 18 September 2013.


more 1. Message from the Chairman and Chief Executive 


As we celebrate two years since becoming a community trust in 2011 we can reflect on the significant progress we have made in providing improved outcomes for our local communities delivering services that are better able to meet a wide range of health needs across our diverse communities.


Our strategic vision is clear; to be the outstanding provider of high quality, integrated community care services in Wirral and beyond. Over the last year we have started to make that vision a reality.


At the heart of this vision is the creation of an integrated care system for Wirral, with us, as a strong and credible Trust right at the centre, doing what we do best - supporting people as partners in care in their own homes, supporting speedy access to hospital when people need it and rapid discharge back home as soon as they are ready. And with quality and care at the heart of everything we do.


Over the last year, the NHS and other care providers have seen significant change and increased scrutiny. Although we are confident in our services, we are not complacent and have taken the opportunity to review the recommendations of reports such as the Francis Report and have a programme to ensure that we implement any changes that will further improve our services and care of patients even further.


Quality is key, and without the feedback from our patients and staff we would be unable to deliver the right services in the right way to the right people at the right time. We have continued to ask patients and staff for feedback with 96% over the last year saying they would recommend our services to family and friends. We are committed to listening, learning and ensuring the continued delivery of high quality care in the years ahead is built from the front line services up.


Amongst our many achievements over the last year, we include:


  • Our lead role in the integration and improvement of services focusing on people with long term conditions, bringing together health, social care and the third sector.

  • The opening of the new St Catherine's Health Centre in August means we were significantly able to improve patient facilities and experience.

  • Our successful bid to continue to deliver integrated sexual health services across Wirral from 1 April 2013 with Wirral University Teaching Hospital NHS Foundation Trust (WUTH) and Wirral Brook.

  • Approval in October 2012 as an Any Qualified Provider (AQP) for the delivery of Core Podiatry services beyond Wirral into the wider NHS Merseyside area.


As the leading provider locally of high quality community services we have the opportunity to grow the range and volume of the services we are commissioned to provide across Wirral and the neighbouring areas. To achieve this we will continue to build meaningful and productive relationships with our commissioners, our already established partners, Wirral Borough Council, and with Cheshire and Wirral Partnership NHS Foundation Trust (CWP) and with Wirral University Teaching Hospitals NHS Foundation Trust (WUTH).


This year we have also seen significant progress in our plan to become a Foundation Trust. This includes passing our target of 3,600 members needed for our foundation status application and demonstrates the increasing connection we have with local people, staff and partners who are informed and involved in the life of the Trust. We are also delighted to strengthen the experience of our Board and welcome GP, Dr Murray Freeman as a new Non-Executive Director.


Our volunteers have continued to grow in numbers and we thank them for their passion and ongoing commitment to supporting our services.


Finally we must recognise all our staff who are dedicated to providing excellent services. It was a pleasure and privilege to celebrate and recognise their achievements 2012/13 with our first For You Thank You staff awards highlighting the innovation and commitment of individuals and teams within our Trust.


Best wishes


FrancesStreet                         SimonGilby

Frances Street


                               Simon Gilby

                               Chief Executive

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more 2. Our Strategy


We are focusing on four strategic themes. These themes are key to the delivery of our plan, and how we will measure the success of each element of the plan.


All four themes are supported by strategic objectives or actions, each of which has an executive lead individual. This will ensure what we are delivering as we should and an individual lead is accountable for progress.


Our Four Strategic Themes



Integrated Business Plan (IBP)

The IBP is our five year plan to achieve our vision and is a key document that sets out our strategic direction and plans for delivering a successful and sustainable future. We have taken steps to ensure that our stakeholders, and in particular our employees, understand our plans and purpose, enabling a culture of joint ownership and commitment.


We will be working with our services to develop meaningful annual plans for the Trust, for each team and for individual objectives. These annual plans will inform our priorities for the year and future years and ensure that our individual priorities contribute to our vision.


Our performance management framework supports managers and staff through the appraisal process, an important factor in ensuring staff understand how what they do contributes to the bigger picture.

The NHS Landscape is Changing

The Trust exists in a changing environment and there have been major changes to who commissions the services needed by patients across local areas. No longer can NHS Trusts expect to be the only provider of NHS services – competition from private companies is not only on the horizon, for some of our services it is here.


Therefore as an organisation, we have been clear about what we are aiming to achieve, how we want to get there, what we need to do it and how we measure success.

Over the last year, we have been working hard to ensure that as a Trust we are sure about how to secure a sustainable future for our patients and employees with a clear purpose, a clear direction and clear goals.




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more 3. Our Services


We aim as a Trust to provide the care and support needed to reduce health inequalities and promote health and wellbeing within our communities. We work with people to improve their lives through self-care and prevention.


Our divisions define the five core areas of patient facing service delivery. In addition to this are our Corporate Support Services, which include: Quality and Governance, Human Resources and Corporate Affairs and Finance.


A summary of our divisions and services is set out below.


divisions and services


Who we serve


We provide community health services across the following twenty five wards that make up the Wirral:


Birkenhead, Bidston, Leasowe, Claughton, Moreton, Upton, Oxton, Tranmere, Egerton, Prenton, Wallasey, New Brighton, Liscard, Seacombe, Bebington, Bromborough, Clatterbridge, Eastham, Heswall, Hoylake and Meols, West Kirby and Thurstaston, Greasby, Frankby and Irby, Pensby and Thingwall.


We also serve some patients in areas of Cheshire which border the Wirral peninsula and the wider NHS Merseyside area.


The profile of Wirral is diverse and our services aim to be as flexible as possible in our delivery of services to ensure that they can be accessed by the people who need them most. Many of our services offer the convenience of visiting patients in their own homes.


We provide a range of high quality community based patient healthcare services:


  • to over 307,000 (Office of National Statistics) residents living in Wirral across 145,000 households, as well as people living in the surrounding area of Cheshire;

  • in nearly 50 bases;

  • with over 1,300 members of staff, 85% of whom work directly with patients.

Wirral has an ageing population and has areas of both extreme affluence and poverty, with significant health inequalities across the area. Some of the 3% most deprived areas in the country fall within the urban areas of Birkenhead and parts of Wallasey. There are more pensioners living alone and more one parent families than elsewhere in the North West of England.

Working together

Over the last year there has been significant change across the healthcare landscape. We have worked closely with NHS Wirral (PCT) and the emergent Clinical Commissioning Groups (CCGs) to ensure a seamless transition from 1 April 2013 when the PCT and Strategic Health Authorities (SHA) ceased to exist.

Their responsibilities now lie with Wirral CCG and the local area teams of the national commissioners for Cheshire, Warrington and Wirral.


We will continue to build on already strong and productive relationships, working with them to improve health, life expectancy and deliver person centred care through partnership.


The main commissioners of our services are:


  • Wirral Heath Alliance

  • Wirral GP Commissioning Consortium

  • Wirral Health Commissioning Consortium

  • National Commissioning and Public Health


With the transfer of public health responsibility to the local authority, Wirral Borough Council is also becoming an increasingly important commissioner.


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Performance Review

Performance Review


more 1. Performance Highlights

We have achieved a high level of performance against the community indicators that we are measured against. These are consolidated in our overall comprehensive performance management framework which provides a consistent process to measure and monitor performance across all levels within the organisation. Details of which are shown in Appendix 2 (Operational Review).

In 2012/13 we:

  • Had around 1.1 million patient contacts across our core service divisions

And for a second year:

  • Performed above, or within defined tolerance thresholds of 92% of our contractual targets

  • Exceeded the 18 week referral to treatment time patient experience indicator with an actual performance average of 12 weeks

  • For Walk In Centre services providing urgent medical care, we exceeded the quality target with over 99% of patients spending less than 4 hours in the Centre.

We are working with the Strategic Health Authority (SHA) and the Foundation Trust Network to support the development of Community Foundation Trust indicators which will measure our future performance.

Patient Contacts

We have seen consistency in the number of patient contacts with an increase of over 30,000 within our Therapy Division.


(*2011/12 figures for Health Visiting previously part of Nursing. 2012/13 figures reflect divisional transfer to Lifestyle Services)

Here are just a few of our highlights for 2012/13:

  • Over 281,500 Community Nursing appointments / visits

  • 230,000 patient blood samples taken by our Phlebotomy Service

  • Over 115,000 Health Visitors Healthy Child team appointments

  • Nearly 85,000 patients treated at Walk in Centres at Eastham, Wallasey and Arrowe Park

  • Over 72,000 consultations through the MSK/Community Therapy Service

  • Over 41,000 pieces of equipment delivered by our Community Equipment Service

  • 16,600 appointments and gym attendances with our Heart and Cardiac Services

  • Over 14,600 people attended walk in and pre-booked appointments with our Sexual Health team

  • Over 34,006 walk in patients treated and nearly 10,500 pre-booked patients treated by our GP Out of Hours and All Day Health Centre, helping to reduce pressure on A&E services

Public Health

Offering a range of free health and wellbeing activities, our public health teams had approximately 18,000 contacts working with people of all ages across the Wirral. Supporting individuals to make positive lifestyle changes through their stop smoking, weight management and healthy eating programmes.


We are proud of our achievements and aim to celebrate and recognise those teams and individuals who go above and beyond what is expected and are innovative in how they approach patient care. Detailed below are some of our awards including our own inaugural 'For You Thank You' staff awards.

Nursing Times Award - Shortlisted

Wirral Community NHS Trust's Integrated Continence team were shortlisted in the Nursing Times Awards for their innovative approach and enhanced care provided to children across the borough.

The specially trained continence nurses work closely with other healthcare professionals to ensure that the correct care and support is given to each child.

With continence problems affecting children and their quality of life, the knowledgeable and passionate team focuses on assessing the child to ensure that the child and their parents are given advice and treatment based on eliminating or improving the condition rather than dealing with the consequences.

Naidex National 2012 Excellence Awards – Winner

The awards celebrate the quality of care across the sector and play a significant role in sharing best practice. They form a vital part of sharing innovation, independent thinking and improvements to care.

Wirral Integrated Continence Service were proud to win the category of Joint working and collaboration with their poster campaign that communicated the outcomes of how joint working was key to the success of the continence service.

UNICEF Baby Friendly Accreditation

Wirral Community NHS Trust in a joint venture with Wirral Sure Start Children's centres were awarded the prestigious Baby Friendly Award!

This means Wirral is one of only three healthcare organisations in the UK so far to win international recognition and accreditation from UNICEF as a Baby Friendly organisation that delivers best practice care in support of breastfeeding.

The Baby Friendly Initiative, set up by UNICEF and the World Health Organisation, is a global programme which provides a practical and effective way for health services to improve the care provided for all mothers and babies. The Award was given to Wirral Community NHS Trust and Wirral Sure Start Children's Centres after an assessment by a UNICEF team has shown that recognised best practice standards are in place.

'For You Thank You' staff awards

Launched in December 2012, over 60 entries were received from all over the Trust in the following categories:

  • Customer Care Award

  • Most effective initiative

  • Volunteer of the year

  • Inspiration Manager/Team Leader of the Year

  • Non-clinical team of the year

  • Clinical team of the year

  • Outstanding achievement award

  • Promoting equality and diversity

Judged by a panel of 9 including patient representatives, the awards highlighted the passion and commitment to patient care not just on the front line, but also from those people behind the scenes that support the work of the Trust.

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more 2. Patient, Community & Commissioners



We strive to improve the outcomes of our patients and the communities we serve   
whilst building and developing excellent relationships with our commissioners

  • Improve quality outcomes and patient satisfaction

  • Increase service provision in Wirral, Merseyside & Cheshire

  • Promote integration and joint working



Below are some examples of how we have delivered against this strategic theme.

Unplanned Care – NHS 111

During 2012 the Unplanned Care Team worked closely with our commissioners to support the introduction of the new national number for urgent care – NHS 111.

This involved considerable change and challenge for our call handling and triage staff, and a thorough review of the way in which we delivered face to face care in our GP Out of Hours service.

The new service has not yet gone live locally, but our call centre and GP Out Of Hours service continue to deliver high performance and excellent care to the residents of Wirral who need to see a GP at evenings and weekends.

It is expected that the NHS 111 service will be launched fully in the Summer of 2013.

Liverpool Podiatry Services AQP

The Trust was approved in October 2012 as an Any Qualified Provider (AQP) for the delivery of Core Podiatry services across the NHS Merseyside area reaching patients registered with a GP practice within: Liverpool, Knowsley, Sefton, St Helens, Halton, Southport and Formby.

The process of AQP allows patients to choose from a range of approved providers based on what is important to them, for example location or waiting times.

In addition to delivering services across Wirral, the podiatry team and back office support have worked together in developing systems and processes to support the implementation and delivery of the service beyond Wirral whilst actively marketing the new service to new customers across Merseyside.

The service has been proactive in building relationships with GPs in ensuring we meet their needs by providing a flexible and specialist service to their patients.

Integration Programme

During 2012, Wirral CT has played a leading role in developing the structures and processes that underpin the delivery of more effective integrated care to patients across Wirral.

Focusing initially on supporting people who have long term conditions, the Integration Programme brings together health, social care and third sector organisations, who, together with members of the public, are developing new services that will completely change the way that people receive care in a community setting. The primary objective is to focus care around the patient and provide services to people in their own homes, twenty four hours a day, delivered by integrated teams, which will help to avoid unnecessary hospital admissions and will deliver better outcomes to patients.

The work is being supported by both Aqua and the Kings Fund, and is being driven by patients and frontline staff from all organisations. Wirral is helping shape the national agenda through its on-going involvement with the Kings Fund.

Public Health Re-design

Following the transfer of Public Health commissioning to the local authority, the Trust's Public Health Team was redesigned in 2012 to offer an integrated and holistic service. Clients were involved from the very start and consultation took place with the wider population in order to reach those who do not currently use our services. This feedback was invaluable in helping to shape the new service and what it delivers.

From the 1 April 2013 the six geographically based teams now deliver all elements of Public Health Commissioned Services (Stop Smoking, Weight Management, Health Trainers, Community Programme, Health Promotion and Healthy Settings).

They offer a single point of access and streamlined pathways making it easy for individuals to access the services and for health professional to refer in.

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more 3. Clinical Delivery


We will deliver quality services and continually improve them – meeting the
expectations of the commissioners and patients. Patient safety and robust risk    
management will be in the forefront


  • Meet commissioned contracts

  • Improve patient safety and risk management

  • Improve efficiency and effectiveness of care services


There is nothing more important to us than ensuring that our patients receive the highest standard of clinical care. In line with the national Quality, Innovation, Productivity and Prevention (QIPP) agenda, we continue to develop and implement robust plans to improve the quality of care we provide while releasing resources, where possible, that can be invested in future service improvements.

We continue to report separately on the quality of the care our patients receive through the Quality Account.

Below are some examples of how we have delivered against this strategic theme.

Wirral Integrated Sexual Health Services

Sexual Health Services across Wirral were offered out to tender by the commissioners in April 2012, as the commissioners wanted one accountable provider for the provision of these services. The Trust intended to deliver the new three year Sexual Health Wirral Service in partnership with Wirral University Teaching Hospital NHS Foundation Trust (Arrowe Park Hospital) and Brook. After months of bid development last year, in January 2013 we were awarded the contract and now deliver the new integrated service from 1 April 2013.

The new integrated service sees sexual health clinics available seven days a week at seven locations across Wirral. We now offer most of our services at all clinics including a range of contraception choices, health screening, treatment and sexual health advice for people regardless of age or gender.

The majority of services will be available at all clinics on a drop in basis and appointments or GP referral will only be required for a limited number of specialist and consultant led services. People will be able to attend clinics with both female and male doctors and our partnership with Brook means that we are able to offer an extended range of specific young people's clinics.

Centralised Booking

Centralised Booking commenced on 17 December 2012, with the creation of a single number for patients. The service manages the partial booking of all podiatry appointments and will see that turn to full booking in June 2013.

The centralised booking team successfully manage patient contacts for anything relating to the booking of phlebotomy appointments, emergency dental appointments, All Day Health Centre booked appointments and manages calls from patients known to the Community Nursing service in addition to the Trust's single point of access service for clinicians.

Included in plans for 2013/14 are the migration of fully booked appointments for Physiotherapy, Speech and Language Therapies, Dietetics and the new Integrated Sexual Health Service. The service will be measured to establish enhancements in patient experience choice and quality of service. It will also look to deliver enhanced revenue generation and cost savings.

Safety and Quality

We have worked hard to ensure that we have a clear focus on safety and quality in our services. We have supported this by investing in staff skills and training and introducing strong governance structures and processes, designed to ensure that collectively we know how well we are doing.

In April 2012, the Care Quality Commission (CQC) registered all our services without conditions and in November 2012 our Walk-in Centre at Arrowe Park Hospital was inspected and assessed as demonstrating compliance in all areas. This follows on from the successful inspection of our Community Dental Service in 2011 and is fantastic recognition of the ongoing hard work and commitment of our staff confirming the excellent standards of quality and safety provided throughout our services.

During 2012/13 we have produced evidence that demonstrates our commitment to high quality, safe clinical care, including the achievement of our CQUIN schemes and quality objectives in areas such as dementia care, long term conditions, end of life care and infection prevention and control.

We have further developed our patient experience model introducing a programme of leadership walk-rounds which have seen members of the Trust Board visiting services and discussing with patients and carers their experiences of our services. In the last twelve months we have had a 30% increase in patient feedback and share patient stories and feedback at our monthly Trust Board meetings.

Our Patient Experience Champions appointed in 2011/12 have led to improvements in referral pathways and patient information across a variety of services. Continued implementation of our Patient and Staff Quality Groups will strengthen the confidence and pride of people who access our services.

See our Quality Account 2012/13 for further details.

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more 4. People and Resources


We will be the employer of choice and invest in our people. We will maximise   
our finances and resources to ensure we are providing value for money
  • Improve human resource development and engagement

  • Maintain financial stability

  • Provide value for money services

Wirral Community NHS Trust continues to create an environment where staff are supported to do the very best they can in their job to ensure that the Trust achieves its vision. Staff report that they feel able to make significant contributions to improving the health and wellbeing of the local population and understand how their roles contribute to the delivery of a quality service to all.

Staff Survey 2012

The staff survey was distributed to all Wirral Community NHS Trust staff (approx. 1400), excluding temporary staff, and the Trust achieved a response rate of 52%. This compares with a response rate of 58% for 2011. (The full results are published on the Department of Health website)

The survey shows that 23% of the key findings have improved and 18 of the 28 key findings show better than average performance.

Areas of improvement included:

  • Staff reporting greater job satisfaction compared to 2011

  • An increase in the number of staff recommending the Trust as a place to work or receive treatment

  • An increase in staff receiving equality and diversity training

  • Staff reporting fairness and effectiveness of incident reporting procedures.

  • Improved support for staff from immediate line managers.

Staff engagement has also improved and is above the national average when compared to other community trusts.

The staff survey results have been shared with staff and staff side colleagues. Based on the findings of the survey, the following areas will be developed further over the coming year:

  • Equality and Diversity and Health and Safety Training

  • Ensuring the Wellbeing Strategy continues to be implemented providing a supportive culture for staff health and wellbeing

  • Ongoing focus on the quality of staff appraisals.

Staff Wellbeing

In 2012 the Trust developed a Wellbeing Strategy to help bring about a change in culture in relation to attendance in the workplace. Actions have included:

  • Introduction of an Employee Assistance Programme which provides confidential support to staff and their families 24 hours a day 365 days a year

  • A new occupational health service

  • Fast track physiotherapy services appointments for staff.

A revised Managing Attendance Policy and bespoke training for managers ensures that they have the skills and are better equipped to support staff who are absent through sickness.

The Trust has also signed up to the Public Health Responsibility Deal which provides an opportunity to link in with the wider health and wellbeing agenda and supports the health and wellbeing pledge in the NHS Constitution.

The Trust has been successful in reducing and maintaining sickness absence at a rate of 4.5% from its highest point of 6.4% in the last financial year and will continue to look for new and innovative ways to enable staff to maintain their health and wellbeing.

Staff Engagement

We recognise that every member of staff has an interest in the decisions of the Trust and engagement with staff has developed significantly over the last twelve months.

Our staff care for the people of Wirral every day of the year and can give first hand feedback on the services we provide. Good internal communication will ensure that our team understand the role of the Trust, its vision and values, aims and objectives and the ways we work.

Alongside existing channels of communications and engagement, new developments include:

  • Quarterly Staff and Member Magazine – 'For You'

  • IBP specific briefings on the 5 year business plan

  • Staff Zone – staff intranet (with 80% of staff registered as of 31/3/2013)

  • Annual 'For You Thank You' Staff Awards

  • Listening events – opportunities for staff to talk to directors and board members

  • Leadership walk rounds

Additionally, with the creation of a Communications and Marketing Strategy, the Trust has set out how it will communicate and manage relationships not only with staff, but all its stakeholders. It links to the Trust's Stakeholder Engagement Plan and is supported by the Membership Strategy.

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more 5. Supporting Functions

Our support services and infrastructure including finance, HR, corporate,
information, technology and estates will support and enhance the delivery of  
our front-line service

  • Improve utilisation of informatics and technology

  • Ensure we are well run with high quality support services

  • Ensure we are well run with high quality support services

Systems Improvements

The Trust has continued to develop its information management systems during 2012/13 to ensure the Trust is best able to support our staff in the delivery of high quality care to patients. The use of the latest technological innovations to support the delivery of integrated care closer to home forms a key part of the Trust's Strategy.

The Trust's Information Management and Technology (IM&T) Programme Management Board over saw the development of a number of clinical information systems including the development of a new electronic system for the Community Nursing and Health Visiting Service which will be concluded in 2013/14.

We also continue to roll out mobile technology enabling better access to systems at point of care including patients own homes. 2012/13 saw the implementation of mobile solutions for a number of services including Physiotherapy, Speech and Language Therapy and Lifestyle services.

Financial Performance

The Trust received a total of £66m of income for delivering Healthcare services to the public and patients of Wirral and surrounding areas in 2012/13. The majority of which was received from NHS Wirral (£62.2m) in return for the provision of a variety of healthcare services in the community.

  • The majority of Trust expenditure incurred (£46.9m or 72%) relates to staffing costs

  • The Trust delivered an operating surplus of £917,000 which was in line with plans and represents around 1.4% of overall turnover.

  • The Trust achieved the Statutory duties required, by Parliament, of all NHS Trusts.

  • We performed well against the financial risk ratings applied to NHS Foundation Trusts by the independent regulator Monitor. The 5 risk ratings measure the financial performance, efficiency and liquidity of an NHS Foundation Trust. Had the Trust been subject to this regime in 2012/13, we would have received an overall risk rating of 3, a good level of financial performance.

We have continued the modernisation of our infrastructure which will see the housing of services in 21st century accommodation that are fit for purpose.

St Catherine's Health Centre

The rebuilding of St Catherine's in Birkenhead was completed during 2012-13. The new Health Centre building was completed in August 2012 which was followed shortly afterwards by the demolition of the old hospital buildings.

All services previously located on a dispersed health campus or off site are now housed within the new Health Centre at St Catherine's enabling us and our partners to provide integrated community services on Wirral, alongside our GPs and other local services. It allows us to host outpatient services in improved facilities therefore offering a better patient journey.



Caring for the environment

Since the creation of Wirral Community NHS Trust in April 2011, we have continued to build on the progress made by Wirral Primary Care Trust (PCT) and have been implementing a bespoke sustainability approach for our organisation. We have:

  • Continued with our progress against setting up an Environment Management System

  • Reduced our carbon emissions to 2,897 tonnes CO2 equivalent;

  • Recovered or recycled 65% of our waste – equivalent to 232 tonnes

  • Carried out clinical waste audits across our premises, in line with Environment Agency requirements

  • Engaged with local suppliers to monitor and reduce the amount of energy used and waste produced to help meet our sustainability objectives

  • Continued to assess the viability of using renewable energy sources to generate energy at our properties and reduce carbon emissions and costs;

  • Assessed our St. Catherine's redevelopment against the BREEAM standards (Building Research Establishment Environmental Assessment Methodology). The scheme is currently at the 'Post Construction' assessment stage and is predicted to achieve an 'Excellent' rating, in line with Department of Health requirements.

The estate continues to perform well in terms of energy efficiency. Areas in need of further improvement are being assessed alongside the development of premises as part of the Estates Strategy. Further improvements in general environmental management will continue to make improvements across the Wirral Community NHS Trust estate.

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more 6. Patient Feedback

Below are a selection of the positive feedback we have received across the different services over the last year.



Acute Assessment Unit

"I was looked after and treated with the upmost care by all

members of staff"

Wirral Heart Support

"I can't praise this department highly enough. The advice

and care I have received has been brilliant"



"I found that the member of staff listened to me and was

very understanding of my situation. She has motivated me

to healthier living habits and to be more active"



"Very educational very comfortable experience my child

was relaxed and fully understood his treatment and follow

up arrangements thank you"

All Day Health Centre

"Very impressed all round, long live the NHS!"

Community Nursing

"The service I received from the District Nursing Team

was very professional, the staff were friendly and helpfu

l at all times. They are a credit to the nursing profession"

Walk in Centres

"I received excellent care from all staff, from Reception

to Nursing. Many thanks"

"First visit here and was thoroughly pleased with the care

I received"

"Both nurses over 2 days were exceptional"

"Friendly, helpful team as usual"

Integrated Specialist Palliative
Care Team

"I found the staff to be most helpful, informative and

professional. He's very patient and responsive to my


Speech and Language

"Delighted with progress I am making"

Wirral Integrated Continence

"Even though I was very nervous I was put at my ease"

Physiotherapy and Rehabilitation

"The courtesy shown by clerks and physios is excellent

and environment very beneficial"

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more 7. Performance Tables





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Financial Performance

Financial Performance

Wirral Community NHS Trust is pleased to say it has met all of its statutory financial duties for 2012/2013, our second year of operation.


Our financial performance is in line with the plans approved by the Trust board in March 2012 and is evidence of the continued financial strength of the Trust as well as the effectiveness of the financial planning, monitoring, forecasting and control within the organisation.

more 1. Financial Review

 The Trust performance against its statutory duties is summarised below:


Statutory Duty




Break Even Duty


£900k Surplus

£917k Surplus

Capital Cost Absorption Rate




Capital Resource Limit

£500k or less



External Financing Limit





The Trust delivered an operating surplus of £917,000 which was in line with plans and represents around 1.4% of its overall turnover. All other financial duties have been achieved, including a significant overachievement against the Trust's external financing limit which reflects the efficient management of cash and working capital by the Trust. As well as delivering the statutory requirements of an NHS Trust, we have also performed well against the financial risk ratings applied to NHS Foundation Trusts by the independent regulator Monitor. The 5 risk ratings are set out in Monitor's Compliance Framework and measure the financial performance, efficiency and liquidity of an NHS Foundation Trust. Wirral Community Trust would have received an overall risk rating of 3 if it were subjected to this regime in 2012/13. This is regarded by Monitor as a good level of financial performance.

Analysis of Income

The Trust received a total of £66m income for delivering Healthcare services to commissioners in 2012/13. The majority of this income was received from NHS Wirral (£62.2m) in return for the provision of a variety of healthcare services in the community. The Trust also received income form NHS Western Cheshire (£0.9m), Wirral Metropolitan Borough Council (£0.9m) and a number of other organisations

Analysis of Income Recieved 2012/2013


Analysis of Expenditure

The Trust expended 98.6% of the income it earned on pay, non-pay and other expenditure items. The majority of expenditure incurred (£46.9m) relates to staffing costs. A breakdown of expenditure is shown below

Analysis of Expenditure 2012/2013




Capital Expenditure

The Trust spent £500,000 on capital items in 2012/2013. Capital expenditure is expenditure on items that cost more than £5,000 and last for more than one year. The Trust's expenditure related to planned investment in IT infrastructure and investment in medical equipment and was in line with both financial and IMT investment strategies. As an NHS Trust we also have to maintain capital expenditure within an agreed limit set by the Department of Health. This limit was set for 2012/13 at £500,000 so the Trust has complied with this duty.

Public Sector Payment Policy

The Trust is required to pay its suppliers promptly in line with the Better Payment Practice Code, aiming to pay all undisputed invoices within 30 days. The performance is shown below:



Invoices by

Invoices by Number

Percentage of Non NHS Bills paid within Target



Percentage of NHS Bills paid within Target




Performance was below the level expected of an NHS Trust which is 95%. Plans are in place to ensure that this performance is much improved in 2013/14

Non-Current Assets

The Trust anticipates, under guidance from the Department of Health, that the assets held by NHS Wirral and utilised by the Trust to deliver services, will transfer to the community trust on 1st April 2013. The Trust non-current assets are, therefore, limited to the purchases of IT equipment in 2011/12 and the in-year purchases of both IT and medical equipment in 2012/13

Liquidity and Working Capital Management

At 31st March 2013 the Trust held working capital balances of £619k. This was made up of £2,450k of cash at bank and equivalent, £3,719k of money owed to us in the form of accounts receivable and £5,550k owed to other bodies and individuals as accounts payable.

The Trust is committed to managing its working capital balances in an effective and efficient manner including the maintenance of a strong liquidity position in line with Monitor's requirements. Our investment actions are in line with treasury rules and ensure that the security and safety of public funds is paramount. In 2012/2013 all our cash balances were held in government banking service accounts.

External Auditors

The Trust's External Auditors for 2012/13 are Grant Thornton. They charged the Trust a total of £56k for their work in this financial year.

Counter Fraud

The Trust is committed to the prevention, detection and remedy of any fraud committed against ourselves or our partners. We have a dedicated counter fraud service which helps develop an anti-fraud culture as well as supporting the trust's management in identifying and investigating individual incidents of fraud.

Cost Improvement Plans and Efficiencies

As with the vast majority of public sector service providers, the Trust faces significant financial challenges as part of the difficult economic circumstances. In 2012/13 our commissioners imposed a 4% efficiency requirement as part of the contract settlement for the year. This has required the Trust to deliver £2.8m of cost releasing savings. These savings targets have been delivered in full by individual services and departments.

Long Term Financial Plans

This report sets out the Community Trust's vision, values and strategic objectives for the next 5 years. In addition to this work we have developed a comprehensive financial model covering the same time period. Effective financial planning will form a key part of the Trust submission to become a Foundation Trust with the three tests for foundation trust status being that the Trust can show it is:

  • Legally constituted

  • Well governed, and

  • Financial stable.

The Trust's plans show that whilst it will remain financially stable with good levels of performance against Monitor's financial risk ratings throughout the planning period, the required level of cost improvements will remain between 4% and 5% annually, equating to the release of some 23% of total costs by 2017/2018. This will present a significant challenge and the Trust has put in place a process to support this delivery and also to ensure that whilst the Trust does all that is necessary to deliver on this financial position, quality is not impaired by the need to deliver efficiencies. To this end all savings proposals will have to be signed off by the Trust's Director of Quality and Governance following a full quality impact assessment.

Financial Risks

As we have described above the Trust will face a number of risks to the delivery of its financial duties in the future. In addition to the risks relating the required levels of efficiencies and resultant cost improvement programmes the Trust will also face general risks which will have financial implications, these are detailed below:

  1. Commissioning Changes – The NHS commissioning landscape is undergoing significant changes culminating in the abolition of PCTs and SHAs in April 2013. The Trust is working closely with the shadow clinical commissioning groups and the Health and Wellbeing board to ensure effective working relationships and to minimise risks during the transition period.

  2. Any Qualified Provider – The Trust faces an increasingly competitive market with the introduction of Any Qualified Provider (AQP) contracts, a number of services provided by the Trust will be exposed to these mechanisms and managers are working closely with services to ensure the we are in the best possible position to respond to these developments whilst mitigating the impact of any loss of activity.

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more 2. Remuneration Report


The tables shown on the following pages provide information on the remuneration and pension benefits for senior managers for the year ended 31 March 2013. These tables are subject to external audit review.

What this report covers

This report to stakeholders:

  • Sets out the Trust's remuneration policy

  • Explains the policy under which the Chairman, Executive Directors, and Non-executive Directors were remunerated for the year ended 31 March 2013

  • Sets out tables of information showing details of the salary and pension interests of all directors for the year ended 31 March 2013; and

  • Details of the pay multiples from the Trust's highest paid director to the median paid member of staff within the Trust.

Role of the Remuneration Committee

The Remuneration Committee is a committee of the Trust Board. An effective committee is key to ensuring that Executive Directors' remuneration is aligned with stakeholders' interests and that directors are motivated to enhance the performance of the Trust.

Membership of the Remuneration Committee

The members of the committee are the Chairman and all Non-Executive Directors. Committee meetings are considered to be quorate when the Chairman and two Non-Executive Directors are present.

The Chief Executive and Director of Human Resources and Corporate Affairs also attend in an advisory role but are not members of the committee and do not participate in any discussion or decision making in respect of their own remuneration or other terms of service.

Service Contracts

All Executive Directors have service contracts, which are usually awarded on a permanent basis, unless the post is for a fixed term. Directors have a three month notice period within their contracts of employment.

Termination payments are made in accordance with contractual agreements.

Remuneration policy for Executive Directors

Directors' posts (with the exception of the Chief Executive and Medical Director) are currently evaluated using the national Agenda for Change Job Evaluation Framework. The Chief Executive and Medical Director posts are evaluated using the North West Strategic Health Authority Job Evaluation Panel. All executive posts are subject to approval by the Remuneration Committee. Any pay awards are agreed by the committee.

Directors participate in an annual appraisal process which identifies and agrees objectives to be met. This is supported by a personal development plan.

The Trust does not operate a performance related pay scheme.

Remuneration policy for the Chairman and Non-executive Directors

Increases in the remuneration of the Chairman and Non-executive Directors are agreed nationally by the Department of Health and implemented locally by the Trust.


Directors' Remuneration for the year ended 31 March 2013 




Name and       title






Salary (bands of £5,000)





(bands of £5000)



 Benefits in kind

(Rounded to the nearest £00)


Salary (bands of £5,000)





(bands of £5000)



Benefits in kind

(Rounded to the nearest £00)


Non-executive Directors







Frances Street- Chairman


20 - 25 

 -  -

15 - 20



Gary Gray


5 - 10 

 -  -

5 - 10



Chris Allen


5 - 10

 -  -

5 - 10



Brian Simmons


5 - 10

 -  -

0 - 5



Murray Freeman


0 - 5

- -




Executive Directors







Simon Gilby - Chief Executive


105 - 110






John South– Chief Executive


 -  -

100 - 110



Steve Wilson – Director of Finance


95 - 100 

 -  28

75 - 80



John Lancaster– Director of Operations and Executive Nurse


65 - 70 

 -  7

65 - 70



Lisa Cooper– Director of Quality and Governance


75 - 80 

 -  -

70 - 75



Jo Harvey– Director of Human Resources and Corporate Affairs


80 - 85 

 -  55

75 - 80



Dr Ewen Sim– Medical Director


40 - 45 

 -  -

40 - 45






1 Brian Simmons was appointed as a Non-executive Director on 1 July 2011

Murray Freeman was appointed as a Non-executive Director on 1 October 2012

Simon Gilby was appointed as Chief Executive on 1 April 2012

John South retired as Chief Executive on 31 March 2012

Steve Wilson was appointed as Director of Finance on 31 May 2011

Dr Ewen Sim was appointed as Medical Director on 13 June 2011 


Pension Benefits


Name and title

Real increase in pension at age 60 (bands of £2,500)
Real increase in pension lump sum at aged 60
(bands of £2,500)
Total accrued pension at age 60 at 31 March 2012 (bands of £5,000)
Lump sum at age 60 related to accrued pension at 31 March 2013 (bands of £5,000)
Cash Equivalent Transfer Value at 31 March 2013

Cash Equivalent Transfer Value at 31 March 2012

Real increase in Cash Equivalent Transfer Value
Employer’s contribution to stakeholder pension



Simon Gilby – Chief Executive


0 - 2.5


5.0 - 7.5


40 - 45


125 - 130









Steve Wilson– Director of Finance


0 - 2.5


2.5 - 5.0


15 - 20


55 - 60









John Lancaster– Director of Operations and Executive Nurse


0 - 2.5


0 - 2.5


25 - 30


85 - 90









Lisa Cooper– Director of Quality and Governance


0 – 2.5


2.5 – 5.0


15 - 20


50 - 55









Jo Harvey– Director of Human Resources and Corporate Affairs


0 – 2.5


2.5 - 5.0


10 - 15


30 - 35









Dr Ewen Sim– Medical Director

5.0 - 7.5

20.0 - 22.5

30 - 35

95 - 100






As Non-Executive members do not receive pensionable remuneration, there will be no entries in respect of pensions for Non-Executive members.

Cash Equivalent Transfer Values

A Cash Equivalent Transfer Value (CETV) is the actuarially assessed capital value of the pension scheme benefits accrued by a member at a particular point in time. The benefits valued are the member's accrued benefits and any contingent spouse's pension payable from the scheme. A CETV is a payment made by a pension scheme or arrangement to secure pension benefits in another pension scheme or arrangement when the member leaves a scheme and chooses to transfer the benefits accrued in their former scheme. The pension figures shown relate to the benefits that the individual has accrued as a consequence of their total membership of the pension scheme, not just their service in a senior capacity to which disclosure applies. The CETV figures and the other pension details include the value of any pension benefits in another scheme or arrangement which the individual has transferred to the NHS pension scheme. They also include any additional pension benefit accrued to the member as a result of their purchasing additional years of pension service in the scheme at their own cost. CETVs are calculated within the guidelines and framework prescribed by the Institute and Faculty of Actuaries.

Real Increase in CETV

This reflects the increase in CETV effectively funded by the employer. It takes account of the increase in accrued pension due to inflation, contributions paid by the employee (including the value of any benefits transferred from another scheme or arrangement) and uses common market valuation factors for the start and end of the period.

Pay Multiples

Reporting bodies are required to disclose the relationship between the remuneration of the highest-paid director in their organisation and the median remuneration of the organisation's workforce.

The banded remuneration of the highest paid director in Wirral Community NHS Trust in the financial year 2012-13 was £107,500 (2011-12: £112,500). This was 5.2 times (2011-12: 5.6 times) the median remuneration of the workforce, which was £20,513 (2011-12: £20,168).

The pay multiple of the highest paid director compared to the median remuneration of the Trust as a whole has reduced slightly from 2011-12. This is due to a new Chief Executive being appointed in April 2012 and the Trust recruiting to vacant posts, pushing up the median remuneration of the workforce from the previous year.

In 2012-13, 1 employee received remuneration in excess of the highest-paid director (2011-12: 1). Remuneration ranged from £457 to £120,000 (2011-12: £451 to £120,000).

Total remuneration includes salary, but excludes non-consolidated performance-related pay and benefits in kind. This is a departure from the guidance with the Department of Health Manual for Accounts; however the Trust does not consider that this has a material impact on the figures reported.

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Future Priorities


Future Priorities


more 1. Business Priorities for 2013/14


During 2013/14 we will continue to build on the success of the last year towards the achievement of our IBP. We will continue to develop the best community care services within Wirral and beyond and develop integrated services. We will continually review our operational efficiency and quality of care and focus on achieving our vision and strategic themes.



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more 2. Foundation Trust Journey

2012/13 has seen the Trust make significant progress in its application to become an NHS Foundation Trust. This is an important process which will enable the Trust to improve our already high performing services and offer a unique and accessible range of healthcare to all our patients.


Becoming a Foundation Trust (FT) will allow us greater freedoms and will allow our staff and the public to have a much greater say in the running of the Trust as members and governors.

The application process to achieve Foundation Trust status involves an extensive and rigorous process of external assessment. The Trust has performed extremely well throughout this process and this culminated in the North West Strategic Health Authority considering the Trust's application in January 2013 and recommending to the Department of Health, that the Trust be put forward for assessment by Monitor, the Independent regulator of Foundation Trusts, for final assessment.

The structural changes to the NHS set out in the Health and Social Care Act 2012 have given responsibility for final approval of application prior to submission to Monitor to the newly established NHS Trust Development Authority (TDA). The Trust is working closely with colleagues from the TDA to progress our application and there is every expectation that it will progress to the point where the Trust achieves Foundation status during 2013.

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more 3. Membership


Becoming a Foundation Trust is based on the idea of membership: local people, staff and partners who are informed and involved in the life of the Trust.

In May 2012 the Trust completed its public consultation to ask local people about our plans to become a Foundation Trust. We had over 750 responses and a strong majority were supportive of each of our 12 proposals. This has informed the development of a draft constitution.

Developing a membership that is large enough to fully represent the people of Wirral has been a focus during 2012/13. We have recruited over 3600 local people, mainly face to face at over 60 events across Wirral. This is over 1% of the Wirral population and exceeds the Trust's first year target for membership. Recruitment will continue during 2013/14; our aim is to add a further 900 members by April 2014.

Our member engagement programme has included member tours of the new St Catherine's Health Centre, information sessions for prospective governors in each of the four public constituency areas, and the launch of 'For You' the magazine for staff, public members and volunteers.

Elections are scheduled to take place when Monitor receives our Foundation Trust application. During the coming year we look forward to holding elections and inducting and providing training for those elected, in preparation for our authorisation as a Foundation Trust.

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more 1. Directors Report 2012/13


The Board of Directors

The Board of Directors has overall responsibility for ensuring that we are delivering high quality services that are efficient and effective. They oversee the running of the Trust, make the decisions that shape future direction, monitor performance, ensure accountability and look for opportunities to improve.

The Board is made up of the Chairman, Non-executive Directors, Chief Executive and other Executive Directors. The Chief Executive and Executive Directors are full time members of staff who bring skills and expertise from their positions in key areas of the Trust. The Chairman and Non-executive Directors work part-time. They each bring insight and experience from a range of professional backgrounds. They are not involved in the day-to-day running of the organisation but offer an independent view which both constructively challenges and contributes to the performance and management of the Trust.

Non-executive Directors

Frances Street, Chairman - Frances was appointed Chairman of Wirral Community NHS Trust by the NHS Appointments Commission in January 2011. She has extensive experience in NHS leadership, having served as Chairman of NHS Wirral, Birkenhead and Wallasey Primary Care Trust (PCT), and a Non-executive Director of Wirral Hospital Trust and Wirral Health Authority. Frances is also a Governor of Birkenhead Sixth Form College.

Brian Simmons, Chair of Audit Committee - Brian was formerly the Assistant Chief Officer and Finance Director for the Cheshire Constabulary. Brian joined the Civil Service in 1972 working in accounts and audit for the Property Service Agency. He has also worked as Business Services Director for a Ministry of Agriculture Science Laboratory. Brian is a fellow of the Chartered Institute of Management Accountants.

Garry Gray - Garry has over 20 years' experience as a Chief Executive in the private sector, having run a number of complex, consumer-focussed, multi-site businesses. He has successfully devised and implemented comprehensive performance improvement strategies, and had lead responsibility for major investment projects with substantial financial scale. Garry has a Diploma in Strategic Resource Management from the Institute for Management Development in Lausanne, Switzerland, and an M.A. and B.A.(Hons) in Modern Languages from the University of Cambridge.

Chris Allen - Chris is currently Chief Executive of Forum Housing Association. She was Vice Chair of Wirral Community Health Council (WCHC) when it was in existence representing the Voluntary, Community and Faith sector. This included working in partnership with health professionals during the early transitions between Primary Care Groups (PCG) and PCTs. Chris holds a number of other public roles in education and criminal justice. Chris was awarded the British Empire Medal in January 2013 for services to the community across Merseyside.

Murray Freeman (from 1st October 2012) - Murray has been a GP in Rock Ferry for nearly 30 years and has a particular interest in palliative care and end of life care. Over the years he has held a number of additional posts including GP Trainer, Cancer Lead for NHS Wirral, Chairman of Wirral Local Medical Committee, Medical Director of Wirral Community Healthcare NHS Trust and most recently GP Executive Member of Wirral Health Commissioning Consortium.

Executive Directors

Simon Gilby, Chief Executive - Simon joined the Trust in April 2012 and has a wealth of experience in the NHS at local, regional and national levels. Immediately prior to joining, he spent a short period with NHS South Yorkshire supporting the implementation of national policy. For the five years before that he was the Managing Director of Sheffield Primary Care Trust Community Services. Previous roles include Chief Executive of Sheffield West Primary Care Trust and Chief Executive of Southern Derbyshire Health Authority.

Steve Wilson, Director of Finance - Steve joined the Trust in May 2011 and has worked in NHS finance for over 16 years. Following graduation from the University of Leeds he entered the National Financial Management Training Scheme in 1996. Based in the North West his first role on the training scheme was at Salford Community NHS Trust and he has since had a varied career across a range of NHS organisations including community, acute and specialist providers. He has also gained significant experience in commissioning through roles at Sefton Primary Care Trust and most recently as Deputy Director of Finance and latterly Acting Director of Finance at NHS Manchester.

John Lancaster, Director of Operations and Performance - John has worked for the NHS for over 30 years and in Wirral since 2007. After several years working as a clinician in Orthopaedics and Trauma services, John's management career has been diverse and has included IT Project Management and senior management roles in both Acute Trusts and Primary Care organisations. More recently John was Programme Manager in the Emergency Services Action Team, which led Urgent Care redesign across Cheshire and Merseyside. Prior to obtaining his current post he has held the roles of Head of Unplanned Care and Head of Provider Services in NHS Wirral. John is a registered Nurse and has an MBA.

Dr Ewen Sim, Medical Director - Since leaving Edinburgh Medical School in 1990, Ewen has had a varied career in healthcare holding a range of Junior Doctor posts including Histopathology and A&E. He has also worked at the North West Deanery and at the Department of Health regulating working conditions of doctors in training. He came to Wirral in 2001 to train as a GP and is now a GP partner in Fender Way Health Centre. Prior to joining Wirral Community NHS Trust in June 2011 as a Medical Director he was a Clinical Director in Liverpool. Ewen was a union leader for doctors in the British Medical Association in charge of education and training, working with the General Medical Council, the British National Formulary and the Royal College of General Practitioners. He is also a founder member of the Postgraduate Medical and Education Training Board (now part of the GMC).

Lisa Cooper, Director of Quality and Governance* - Lisa is the Director of Quality and Governance, and the Director for Infection Prevention and Control and Safeguarding for Wirral Community NHS Trust. Lisa qualified as a Dietitian from Queen Margaret College, Edinburgh in 1992 and has worked in Wirral since 1994. Lisa was previously Clinical Director and Transforming Community Services Lead for NHS Wirral Provider Services. Lisa remains a registered Dietitian and graduated from Chester University with an MBA (Distinction).

Jo Harvey, Director of Human Resources and Corporate Affairs*- Jo has over 15 years' experience as a Human Resources professional and has worked in the NHS since 2002. Prior to the role of Director of Human Resources at Wirral Community NHS Trust, Jo was Human Resources Director for NHS Wirral and before that the Assistant Director of Human Resources at United Lincolnshire Hospitals NHS Trust. Previously Jo worked for ten years in both managerial and HR roles in the Civil Service, at the Lord Chancellor's Department and OFSTED. She is a member of the Chartered Institute of Personnel and Development.

* Non-voting members of the Board

Board Committees

The Board is supported by the following committees:

  • Audit Committee

  • Remuneration Committee

  • Quality & Governance Committee

  • Finance & Performance Committee

  • Education & Workforce Committee

Audit Committee

The Audit Committee has a key role to play in the production of the Trust's annual report and annual accounts. The Audit Committee is chaired by one of the Non-executive Directors, Brian Simmons, and comprises of two other Non-executive Directors.

The Audit Committee works closely with both internal and external auditors and supports the Trust Board in ensuring that effective controls are in place to deliver value for money, transparency and probity in financial matters. The committee has delegated authority to approve the Trust's annual financial statements and advises the Board on the adequacy and effectiveness of internal controls, as well as the arrangements for managing risk and wider control and governance processes.

Responsibility for preparing the Accounts

The Chief Executive is our designated Accounting Officer with the duty to prepare the accounts in accordance with statutory requirements.


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more 2. Annual Governance Statement


Scope of Responsibility

As the Accountable Officer, I have responsibility for maintaining a sound system of internal control that supports the achievement of the Trust's policies, aims and objectives, whilst safeguarding the public funds and departmental assets for which I am personally responsible, in accordance with the responsibilities assigned to me. I am also responsible for ensuring that the Trust is administered prudently and economically and that resources are applied efficiently and effectively.

I acknowledge my responsibilities as set out in the Accountable Officer Memorandum.

The Governance Structure

The Trust Board functions as a corporate decision-making body, considering the key strategic issues facing the Trust in carrying out its statutory and other functions.

During 2012, the Board met monthly in public and agreed that for the year 2013 it would meet in public on 8 occasions with a further 4 meetings being held in private. The Board is comprised of Executive and Non-Executive Directors who share equal responsibility for the Board's decisions and for the direction and control of the organisation.

The Board membership currently consists of the following:

  • Chairman (Non-Executive)

  • 4 Non-Executive Directors

  • 4 Executive Directors

    • Chief Executive

    • Director of Finance

    • Medical Director

    • Director of Operations and Performance/Executive Nurse

All above mentioned Directors have voting rights at Board. In addition, Board meetings are attended by the Director of Quality and Governance and the Director of Corporate Affairs and Human Resources, both of whom are non-voting members. Representatives from stakeholder groups are also invited to attend public Board meetings in a non-voting capacity.

Following work undertaken last year to review the capacity and capability of the Non-Executive constituency, a Non-Executive Director with a clinical background was appointed with effect from 1st October 2012. This appointment further enhanced the skills, knowledge and expertise of the Non-Executive group ensuring an appropriate blend of experience from the public, private and voluntary sectors.

The appointment of a Deputy-Chairman, according to the Standing Orders of the Trust (section 2, 'The Trust Board: Composition of Membership, Tenure and Role of Members') was approved at the formal meeting of the Board in May 2012.

The NHS Act 2006, Section 33, allows for applicant Trusts to prepare for Foundation Trust status prior to authorisation. The Monitor NHS Foundation Trust Code of Governance requires the Board of Directors to appoint one of the Non-Executive Directors to be the Senior Independent Director (SID). This is also cited in the Board Governance Assurance Framework (BGAF) as good practice. The Board approved the appointment of the SID at the formal meeting of the Board in May 2012.

Additional governance roles are also undertaken by members of the Executive Team including Director of Infection Prevention and Control (DIPC), Caldicott Guardian, Senior Information Risk Owner (SIRO) and Responsible Officer (RO).

The names of Board members, who served during the year, and their biographical details, are included in the Directors Report.

There were 10 Public Board meetings held during the year and the Board will meet more or less frequently as required. According to the Standing Orders of the Trust, the Chairman may call a meeting of the Board at any time and one-third or more members of the Board may request a meeting in writing to the Chairman.

The table below shows the attendance record for each Board member compared to the maximum number of meetings they could have attended in 2012/13. Your attention is also drawn to the notes underneath the table.






Remuneration Committee



Audit Committee

(x5 times)


Quality and Governance Committee



Finance and Performance Committee



Education and Workforce Committee


Number of Meetings








Non - Executive Directors            

Frances Street





Chris Allen







Garry Gray







Murray Freeman*







Brian Simmons














Executive Directors            

Simon Gilby







John Lancaster







Ewen Sim







Steve Wilson







Lisa Cooper ^







Jo Harvey ^








Prior to 7 September 2012, all Board members were entitled to attend Committee meetings. A revised Committee and membership structure was introduced on this date. Details of the revised membership of each Committee are provided in this statement.

*Murray Freeman, Non-executive Director, in post from 1 October 2012

**Attend by Invitation only

^ Non-voting members

The Board Committee structures reporting through to Board have been clearly defined following a comprehensive review of Terms of Reference and reporting arrangements, led by the Committees. The Board has formally delegated specific responsibilities to the Committees listed below, full minutes of which are provided to Board.

  • Quality & Governance Committee (Monthly)

  • Finance & Performance Committee (Monthly)

  • Education & Workforce Committee (Monthly)

  • Remuneration & Terms of Service Committee (at least once per annum)

  • Audit Committee (up to 5 meetings per annum)

Prior to September 2012, the Trust had adopted a policy where all Board members attended all Committees. This had significant benefits in ensuring that all members of the Board became well versed in the issues facing the Trust and highlighted the commitment of Board members to working to create an effective and viable Trust.


However, the Board undertook a detailed review of its governance structures and arrangements in place including board and Committee meetings frequency and membership. As a result of this review, changes were made to the Committee membership to ensure there was a robust accountability framework to support greater strategic scrutiny at Board when members have not been involved in every aspect of the detail. The revised Committee membership was agreed by the Board at its formal meeting on 7 September 2012 and is outlined below.




Non - Executive Director(s)


Audit Committee

Brian Simmons (Chair)
Garry Gray
Murray Freeman


By invitation
(not formal members)

Finance & Performance Committee

Garry Gray (Chair)
Brian Simmons
Frances Street

Steve Wilson
John Lancaster
Jo Harvey

Quality & Governance Committee

Murray Freeman (Chair)

Brian Simmons

Chris Allen

Lisa Cooper
John Lancaster
Ewen Sim

Education & Workforce Committee

Chris Allen (Chair)
Garry Gray
Murray Freeman

Jo Harvey
Lisa Cooper
Ewen Sim

Remuneration Committee

Frances Street (Chair)
Chris Allen
Murray Freeman
Garry Gray
Brian Simmons

Simon Gilby (by invitation only)
Jo Harvey (by invitation only)


 As part of the Trust's governance arrangements, the Chair of each Committee provides an update on the matters considered and any decisions made at its meetings at each relevant Board meeting.

The table below provides an overview of the work/function of each committee of the Board. The primary role of each committee is to provide assurance to the Board on the areas of responsibility.





Quality & Governance

Review the findings and ensure implementation of recommendations arising from internal audits of Trust risk processes; report to the Board on all aspects of quality, governance and compliance; receive assurance that the Trust meets all relevant statutory and regulatory obligations in relation to quality, clinical governance and compliance through its reporting and monitoring structures; advise the Trust Board of all significant risks, areas for development and exceptional good practice, ensuring lessons are learned and shared.


Finance & Performance

Monitor the financial and contractual/commissioning performance of the Trust against all relevant objectives and targets.

Education & Workforce

Co-ordinate, develop, prioritise, monitor, review and oversee the implementation of a range of Human Resources and Workforce Development Plans.

Remuneration & Terms of Service

Advise the Trust about appropriate remuneration and terms of service for the Chief Executive, all individuals on the VSM pay scale and other managers on local pay.


Undertake wide responsibility for scrutinising the risks and controls which affect all aspects of the Trust's business. The Committee receives regular reports on the work and findings of the internal and external auditors and counter fraud. The minutes of these meetings are provided to the Trust Board and the annual report will be presented to Board in July 2013.

The Committee is chaired by a Non-Executive Director.


It can be confirmed that the Board has received assurance from the Quality and Governance Committee that the arrangements for the discharge of its statutory functions have been checked for irregularities and are legally compliant.

As an aspirant Foundation Trust, the Trust continues to embrace the Board Governance Assurance Framework (BGAF) as an excellent tool to guide a baseline assessment of our current capacity and capability. This framework is used to underpin our assessment in the Board Governance Memorandum (BGM) submitted in June 2012. The Board held a session to review the detail of the BGAF in April 2012 and developed actions around the collection of evidence to support our self-assessment.


The Board is committed to on-going development and evaluation of core skills to further support the work of the BGAF.

The work of the Board in 2012/13 has complied with the core principles of the Corporate Governance Code;

Leadership - The Trust has an effective Board which is collectively responsible for the long-term success of the organisation

Effectiveness -  The Board has an appropriate balance between Board members skills, experience and knowledge which has been further supported by the recruitment of a further NED with clinical experience.

Accountability - The Board maintains sound risk management and internal control systems through the Quality & Governance Committee and the Board Assurance Framework (BAF).

Remuneration - The Trust has a transparent procedure for developing policy on Executive remuneration, delegated to the Remuneration & Terms of Service Committee.

Risk Assessment

The Trust's corporate strategy for risk management is preventative, aimed at influencing behaviour and developing a culture within which risks are recognised and addressed. This process is aligned to both controlling clinical and non-clinical risks and seeks to develop a persuasive safety culture, together with robust operational systems designed to deliver optimal care and minimise risk simultaneously.

The risk strategy outlines the process through which risk management is embedded and managed locally within the organisation. Risks are recorded at service, divisional and organisational level forming the overall risk register.

The overall responsibility for the management of risk lies with the Chief Executive as Accounting Officer.

The Board of Directors, collectively and individually, ensures that robust systems of internal control and management are in place, and the Risk Management Strategy sets out the responsibility and role of the Chief Executive and Directors in relation to Risk Management.

The Trust has identified key strategic risks as part of the overall development of its organisational and financial strategy which formed the basis for the development of the Integrated Business Plan (IBP). These strategic risks are reflected in both the IBP and the Board Assurance Framework. In 2012/13 the key strategic risks related to the following:

  • Clinical Delivery - The ability to continue to deliver high quality services in a demanding environment of change, taking into account the unavoidable risk of human and external factors.

  • Finance - Loss of a service and the impact this would have on the Trust's financial stability, together with a challenging Cost Improvement Programme.

  • Technology - The ability to provide robust data for further development of KPI reporting due to lack of fit for purpose IT systems.

  • People and Culture - The on-going challenge to staff to respond to the requirements of FT and competition, and the resistance to change and new ways of working

  • FT Process - The increasing and challenging demands of the FT process and organisational capacity to respond.

No new strategic risks have been identified during 2012/13.

As the Trust moves forward, these risks are being reviewed and refined both as part of the BAF and any future review of the IBP.

The BAF was developed with full Board involvement from October 2011 to March 2012. The Trust Board reviewed and approved the BAF in March 2012 and agreed to review it on a quarterly basis. The purpose of the BAF is to provide a robust structure and process that enables the Trust to focus on risks that might compromise achievement of its most important objectives. During 2012/13, the Board has continued to review the BAF on a quarterly basis which provided updates on the controls in place to mitigate the risks to the objectives set. In February 2013, the Board undertook a development session, facilitated by Mersey Internal Audit Agency (MIAA), to review the content of the current BAF, the setting of principles for the development of a new BAF and assessing the current strategic objectives. Following this session, work has continued to refresh the strategic objectives through engagement with the Board and staff. In the meantime, the current BAF is considered to be fit for purpose and will continue to be reviewed on a quarterly basis by the Board.

The process in place also allows for the Board to review risks and associated action plans that have been escalated through the Quality and Governance Committee, the principal Committee that monitors areas of risk across the organisation. This Committee provides an opportunity for close scrutiny of risk registers before escalation, if required, to Board.

In addition, the Board receives a monthly risk report, detailing defined high-level organisational risks, and those high level risks associated with the FT programme, that require Board review.

The Trust has taken full account of the findings of the Francis Report and has discussed and considered its contents and recommendations at Board level. An action plan has been developed and will be implemented in line with the Trust's governance structures.

There were no lapses of security identified during 2012/13.

The risk and control framework

As mentioned in Section 3, the BAF was approved by the Trust Board in March 2012 and had been reviewed on a quarterly basis throughout the year. This informed the Assurance Framework Review completed by internal audit (MIAA) which confirms that "an assurance framework has been established which is designed and operating to meet the requirements of the Annual Governance Statement and provides reasonable assurance that there is an effective system of internal control to manage the principle risks identified by the organisation".

Further development work is on-going to review the identified risks included in the BAF and the risk reporting mechanisms.

Executive Directors have responsibility for the development and maintenance of the system of internal control and providing assurance. Any areas of risk identified through the Trust's risk management programme or audit are the responsibility of the relevant Executive Director to address and ensure mitigation where appropriate.

The process of risk management has been embedded within the organisation and cascaded to service areas to assist with the development of an organisation-wide risk awareness culture. This is supported by operational risk registers which enable risk management decision-making to occur as near as practicable to the risk source, and for those risks that cannot be dealt with locally to be passed upwards to the appropriate level within the organisation.

Risk Management training is mandatory for all staff and is a key part of the organisation's core induction and essential learning programmes. This ensures that risk management, risk assessment, health and safety, information governance and incident reporting are highlighted together with key Trust strategies, policies and procedures. These include risk management strategy, infection control and complaints.

The Quality, Patient Experience and Risk Group discuss and monitor responses to all reported risks, incidents, concerns and complaints. This Group ensures that lessons learned from incidents, complaints, audits, research and other sources are shared across the organisation and enable views from patients and the public to be considered. The Group provides assurance to the Quality and Governance Committee which advises the Board of all significant risks, areas for development and exceptional good practice ensuring lessons are learnt and shared from incidents, concerns and complaints.

Staff are made aware of Trust policies and procedures through Corporate and local Induction on commencement with the Trust, staff bulletins and thereafter via mandatory and service specific training.

Incidents are reported externally via the National Patient Safety Agency reporting systems, and more serious incidents to the Strategic Health Authority via the Strategic Executive Information System (StEIS).

During 2012/13 the Trust had 4 SUI (Serious Untoward Incidents) all of which were reported to the Strategic Health Authority in accordance with the Department of Health protocols. All issues were resolved and appropriate action taken in respect of all SUIs. There were no SUIs in relation to Information Governance that required reporting to the Information Commissioners Office.

All risk registers for the Trust are centralised on an electronic database. This system is supported through a monthly risk review processes in the Quality, Patient Experience and Risk Group which reports directly to the Quality & Governance Committee.

The Trust also has an electronic system of incident reporting, to further refine incident information, identify emerging risks, pinpoint trends and improve organisational transparency and access to incident information.

In 2012/13, there has been comprehensive implementation of a web based system in the following key areas:

  • Incident reporting includes the development of dashboards to allow for effective monitoring of incident trends

  • A risk register module which provides a record of key risks and risk control plans which reports to high level risk committees
    and the visibility of the risk at all levels within the organisation

  • Patient Experience/Concerns

  • Complaints and Claims.

In October, 2012 relevant Trust policies were assessed against the NHSLA risk management standards culminating with the achievement of Level 1. In addition, the Trust successfully achieved the IG Toolkit level 2 in March 2013.

The Trust commissions the services of Wirral Fraud & Probity Service to provide a bespoke anti-fraud agenda. There is an annual risk based work-plan in place. The Trust utilises the services of two fully accredited Counter Fraud Specialists both of whom are fully accredited and experienced. Prevention & deterrence are the cornerstones of their work, undertaking regular proactive anti-fraud initiatives. All reports of fraud are dealt with professionally, diligently and in line with all current legislation and the requirements of NHS Protect. The Director of Finance is personally briefed on a monthly basis and the Audit Committee are updated at every meeting. Staff have access to a 24/7 fraud advice and reporting line and are regularly reminded of the need to be vigilant. A Fraud & Corruption Policy and a Bribery Policy are in place and accessible to all staff via the intranet. There were no reportable incidents of fraud within the Trust during 2012/13. There were no reportable incidents of fraud within the Trust during 2012/13.

The effectiveness of risk management and internal control

The Trust has a comprehensive manual of policies and procedures which is disseminated to all staff, via the Trust's internet and intranet sites and through regular staff communication bulletins. This suite of policies is regularly reviewed and approved by the appropriate Committees of the Board and risk assessment processes are included within a wide range of these policies.

In particular:

  • Incident Reporting Policy which includes Serious Untoward Incidents

  • Policy and Procedures for Handling Complaints and Claims

  • Health & Safety Policies and Procedures

  • Fraud Policy

The Trust is compliant with the Care Quality Commission 'Essential Standards of Quality and Safety' and this is monitored via the Compliance Group which reports to the Quality and Governance Committee.

The Information Governance Group monitors performance of action plans designed to meet the requirements of the Information Governance Toolkit and reports to the Quality and Governance Committee. The Trust has self-assessed as meeting level 2 requirements of the Information Governance Toolkit (version 9.0) with 96% of all staff completing and passing the Information Governance e-learning training during 2012/13.

The Director of Quality and Governance has been designated as the Caldicott Guardian and completed all required training to support this role during 2012/13.

The Director of Operations and Performance has been designated as the Senior Information Risk Owner.

In accordance with NHS Internal Audit Standards, the Director of Internal Audit is required to provide an annual opinion, based upon and limited to the work performed, on the overall adequacy and effectiveness of the organisation's risk management, control and governance processes (i.e. the organisation's system of internal control). This is achieved through a risk-based plan of work, agreed with the Senior Management Team and approved by the Audit Committee.

The overall opinion for 2012/13 provides Significant Assurance.

Internal audit conducted 12 reviews during 2012/13 of which 8 received significant assurance and 4 received limited assurance. The Trust provided a full response to each of the reviews and action plans are in place to deliver on the recommendations. In addition, the follow up work arising from the 2011/12 reviews have been satisfactorily concluded and given significant assurance.

Significant Issues

As Accountable Officer I confirm that there are no significant issues to report.


SimonGilby                5th June 2013


Simon Gilby

Chief Executive

Wirral Community NHS Trust


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more 3. Sustainability Report


The Trust is committed to conducting all aspects of its activities with due consideration to sustainability, whilst providing high quality patient care in line with the NHS Carbon Reduction Strategy.

Sustainable Development Management Plan

Since the creation of the Trust in April 2011 we have been realigned and recalculated our activity to the new organisational structure and are in the process of updating our Sustainable Development Management Plan. The NHS Wirral Carbon Reduction Strategy (effectively the SDMP) was published in 2009, and is undertaking review in 2013. This strategy was adopted by the Trust as it applies to the same properties and procedures as NHS Wirral.

In 2012/13 the Trust has continued with the implementation of an Environmental Management System, enabling us to monitor the Trust's sustainability performance against key performance indicators such as carbon emissions, utility consumption and waste.

The plan has Board level accountability through the Director of Operations and ensures that sustainability issues have visibility and ownership at the highest level of the organisation.

Adaption to climate change will pose a challenge to both service delivery and infrastructure in the future. It is therefore appropriate that we consider it when planning how we will best serve patients in the future. As such sustainability issues form an integral part of our Estates Strategy and our approach to managing risk.

In addition to our focus on carbon, we are also committed to reducing the wider environmental and social impacts associated with the procurement of goods and services. This is set out within our policies on sustainable procurement.

The NHS places a burden on the transport infrastructure, whether through patient, clinician or other business activity. This generates an impact on air quality and greenhouse gas emissions. It is therefore important that we consider what steps are appropriate to reduce or change travel patterns and are included in our Sustainable Transport Plan. The STP produced for NHS Wirral was adopted by WCT.

Carbon Emissions

The NHS aims to reduce its carbon footprint by 10% between 2009 and 2015. In 2012/13 The Trust's measured Greenhouse Gas emissions were 3,221 tCO2e (tonnes of CO2 equivalent); a reduction of 664 tC02e on the previous year. This shows a gradual reduction in carbon emissions associated with gas and electricity consumption and business travel.



As an organisation our main impact areas are associated with our premises (gas and electricity) and business travel as a result of the community based nature of our services.

Carbon emissions have reduced overall over the last three years as a result of the implementation of the NHS Wirral Carbon Reduction Strategy (produced in 2009) and an investment in energy efficiency of the Community Trust Estate properties (e.g. replacement of old building stock, improved thermal insulation in existing properties, building controls and installation of Solar PV). A 4kWhp Solar PV system was installed at Fender Way Health Centre in January 2011 that continues to generate renewable energy and reduce carbon emissions associated with our premises.






Total energy consumption

8,907 MWh

10,171 MWh


Relative energy consumption

0.37 MWh/square metre

0.42 MWh/square metre


Water consumption

23,780 m3

29,746 m3


Business travel - road

566.2 tCO2e

642.8 tCO2e



A reduction in energy consumption, in addition to a partnership with a specialist energy procurement partner (Government Procurement Service), have resulted in an overall reduction in energy costs of 17.8% over the last 12 months.

We do not currently purchase renewable energy for energy use but the Trust generates 0.036% of our energy on site from the 4kWhp Solar PV system installed at Fender Way Health Centre in January 2011.


Waste recycling initiatives have been implemented across the estate, with all locations encouraged to recycle paper, cardboard, bottles, cans and mixed recyclable waste.

We recover or recycle 176.7 tonnes of waste, which is approximately 65% of the total waste we produce.



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more 4. Independant Auditors Report

more 5. Emergency Preparedness


Wirral Community NHS Trust is a category 1 NHS responder under the Civil Contingencies Act 1994. As a result the Trust has to be able to respond to provide operational support to a local major incident.

The Trust has a Board approved major incident plan which details its response. In addition the Trust has plans to deal with specific incidents such as fuel disruption, winter planning, heat wave, cold weather planning and hazardous substances.

These Trust plans are referenced within individual service business continuity plans with service level responses documented to cope with periods of increased demand or reduced clinical capacity. These plans are all formally reviewed annually. The Trust has a senior manager on call rota to support resilience and business continuity 24/7

The Trust ensures that the plans reflect the requirements of the EPRR ( Emergency planning resilience and Response) agenda through membership of the Cheshire Local Resilience Forum and the Merseyside Local Resilience Forum.

Over the last 12 months, The Trust has sought to develop further its Emergency Preparedness arrangements including the following developments exercises and training:

  • Multiple Casualty Exercise (Exercise Gurney)

  • A shore based response (Operation Heron)

  • A Flooding Recovery Phase exercise

  • Emergency Preparedness Awareness Session and training of staff In Major Incident room setup.

During 2012 The Major incident plan, Flu Plan and business continuity plans have been assessed by the Head of NHS Resilience for Cheshire, Warrington and Wirral and received scores of 96% and above.


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more 6. Priniciples of Remedy


The Trust follows the six principles set down by the Parliamentary and Health Service Ombudsman in 'Principles for Remedy' (revised February 2009). The aim is to provide redress for any instances of injustice or hardship as a result of maladministration or poor service.

The principles involve:

  • Getting it right

  • Being customer focused

  • Being open and accountable

  • Acting fairly and proportionately

  • Putting things right

  • Seeking continuous improvement.

The Trust has met these principles by:

  • incorporating the NHS complaints procedures into our own policy;

  • the Chief Executive takes a personal interest in all complaints and the quality of investigation and response;

  • having a Patient Experience Service which aims to resolve many problems or concerns without the need for a formal complaint;

  • having in place a 'losses and compensations' procedure; and

  • regular reporting to the Quality and Governance Committee of complaints received as part of the Trust's performance monitoring.


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more 7. Statement of the Chief Executive's responsibilities as the accountable officer of the Trust


The Chief Executive of the NHS has designated that the Chief Executive should be the Accountable Officer to the trust. The relevant responsibilities of Accountable Officers are set out in the Accountable Officers Memorandum issued by the Department of Health. These include ensuring that:

 - there are effective management systems in place to safeguard public funds and assets and assist in the implementation of corporate governance

- value for money is achieved from the resources available to the Trust

- the expenditure and income of the Trust has been applied to the purposes intended by Parliament and conform to the authorities which govern them

- effective and sound financial management systems are in place; and

- annual statutory accounts are prepared in a format directed by the Secretary of State with the approval of the Treasury to give a true and fair view of the state of affairs as at the end of the financial year and the income and expenditure, recognised gains and losses and cash flows for the year.


To the best of my knowledge and belief, I have properly discharged the responsibilities set out in my letter of appointment as an Accountable Officer.


Signed SimonGilby     Chief Executive

Date    5th June 2013


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more 8.  Statement of the Directors' responsibilities in respect of the accounts


The directors are required under the National Health Service Act 2006 to prepare accounts for each financial year. The Secretary of State, with the approval of the Treasury, directs that these accounts give a true and fair view of the state of affairs of the trust and of the income and expenditure, recognised gains and losses and cash flows for the year. In preparing those accounts, directors are required to:

- apply on a consistent basis accounting policies laid down by the Secretary of State with the approval of the Treasury;

- make judgements and estimates which are reasonable and prudent;

- state whether applicable accounting standards have been followed, subject to any material departures disclosed and explained in the accounts.

The directors are responsible for keeping proper accounting records which disclose with reasonable accuracy at any time the financial position of the trust and to enable them to ensure that the accounts comply with requirements outlined in the above mentioned direction of the Secretary of State. They are also responsible for safeguarding the assets of the Trust and hence for taking reasonable steps for the prevention and detection of fraud and other irregularities.

The directors confirm to the best of their knowledge and belief they have complied with the above requirements in preparing the accounts.

By order of the Board
5th June 2013                  Date   SimonGilbyChief Executive

5th June 2013                  Date           financial Finance Director      


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Last Updated: Wednesday, 02 November 2016 16:21

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