Annual report summary 2023/24

The Trust has performed well in the context of a year that has been dominated by complex operational pressures, industrial action, high demand for our services and the implementation of Epic.

Our staff have continued to work tirelessly to deliver safe, compassionate, high quality care to as many patients as possible. This continued focus and dedication has enabled us to meet the majority of our 2023/24 operational objectives, as well as to finish the year with a small financial surplus.

We recognise we have more to do to consistently deliver the required levels of operational performance, and to drive up productivity, but we are proud of our progress this year.

The Trust has experienced significant disruption to planned activity during periods of industrial action, and it is regrettable that we had to cancel a significant number of inpatient treatments and outpatient appointments.

There have been phenomenal efforts to restore diagnostic services and planned (elective) care to pre-pandemic levels.

Significant progress has been made to reduce the number of patients waiting over 78 weeks for treatment, and we are now focused on also reducing the number of patients waiting over 65 weeks.

In January 2024 the Trust was placed into regulatory ‘tiering’ by NHS England for its under-performance against the national standard that 85% of patients will receive their first treatment for cancer within 62 days.

Since then, progress has been made to address the backlog of patients waiting over 62 days for cancer treatment and to recover and sustain our performance. This work is both internally focused, and with our partners across south east London to improve shared treatment pathways.

Our financial performance underpins all that we do, including our ability to invest in service improvements. We ended the 2023/24 financial year with a small surplus of £1.9 million, without technical adjustments such as for capital donations, depreciation on donated assets and valuations.

The financial climate across the NHS and wider public sectors remains extremely challenging, and achieving this financial outcome has taken a huge effort from staff across the Trust.

To both improve operational efficiency and respond to the changing financial regime, we have had to make some careful spending decisions, but this has enabled us to broadly hold our costs steady and has put us in a better position than many other trusts as we move into 2024/25.

In October 2023 we successfully went live with our new electronic health record system, Epic. The launch – delivered jointly with King’s College Hospital NHS Foundation Trust and Synnovis, our shared pathology provider – was the biggest ever single Epic go-live in the world.

The move to Epic integrated hundreds of IT systems previously in use across our organisations into a single, electronic system across multiple hospital and community sites.

It gives staff a complete overview of a person’s care, and will free up more time to spend on caring for patients.

Our new MyChart patient app and online service gives patients secure and easy access to information about their own health and care.

We carried out an extensive training and communication programme to ensure that all staff were ready to use the new system and this continues following go live.

Lots of teams are using the new system to improve the way they manage their services. However, some colleagues have found the transition more challenging and the system has not always worked as expected.

While this is normal and expected for a go-live of this scale, we are working hard to fix problems and make improvements, as well as to fully realise the transformational benefits of Epic.

The Trust’s 10-year sustainability strategy 2021-2031, sets out our commitment to providing sustainable healthcare and our plans to comply with the ‘NHS Net Zero’ report. While we have a long way to go to reach ‘net zero’ we are continuing to make positive progress across our 3 strategic themes of carbon zero, connecting with nature and cycle of resources.

2023/24 is the first time we have been able to report a reliable overall figure for our carbon footprint across our whole organisation.

In August 2023 we launched the Trust’s first Green Travel Plan which aims to support staff, visitors and patients to use more active and sustainable means of transport to reduce our carbon emissions.

We now only offer electric vehicles through our staff salary sacrifice scheme, and electric vehicles now make up over 70% of this fleet.

In June 2023, we published our first ever Clean Air Plan jointly with King’s College Hospital NHS Foundation Trust. This sets out how we will address air pollution, raise awareness of the issues and improve the health of our patients, staff and local communities.

We are working hard to improve biodiversity across our sites. This year we opened our Waste to Wildlife Garden opposite Guy’s Hospital, reduced mowing frequency to support wildlife at Harefield, and our Pulross Community Health Centre was recognised by the Lambeth Biodiversity Forum.

We are committed to conserving resources in everything we do. We have replaced single use cups with reusable ones on our patient beverage trolleys, continued to improve the segregation of waste so that non-infectious items can be disposed of at lower temperatures and have reduced food waste by 6% compared to 2022/23.

We recognise that systematic, unfair and avoidable differences in healthcare are present across society and within the populations that we serve. We are committed to ensuring that all people have equal access to high-quality care, and that their experiences and outcomes are as positive as possible.

We recognise the importance of collecting good quality data which enables us to understand more about the people we care for, where inequalities exist and how we can take targeted action to reduce this.

Our new Population Health Hub will allow us to scale the use of data to help identify and reach those who face the greatest inequalities in access and experience of healthcare.

Across the Trust, with our partners on the South East London Integrated Care Board, we are working hard to ensure healthcare equity is embedded into our treatment pathways.

The wellbeing and welfare of our 23,600 staff remains an absolute priority. 

In the 2023 NHS staff survey we scored above the national average in 2 areas: We each have a voice that counts and Staff engagement. At sub-score level the results were above national average in Compassionate culture, Raising concerns, Line management, Advocacy and Work pressures.

Our engagement scores remain well above the national average and 91% of our staff who responded said that they were proud to work at the Trust.

However, the survey results indicate that the employee experience at Guy’s and St Thomas’ has deteriorated since last year, with a number of scores having fallen behind the national average. This is very disappointing and we are committed to fully understanding and addressing the issues reported in the survey.

We are working with stakeholders across the Trust to respond to the results by creating robust Trust-wide and local level action plans to drive positive change across the organisation.

We are determined to create an environment where everyone truly feels welcome and valued.

We recognise that we have more to do to address inequalities across the Trust, and this is shown in our staff survey results and our performance against the Workforce Race Equality Standard and Workforce Disability Equality Standard.

As a result, we have refocused our equality, diversity and inclusion vision, and insured that building an inclusive culture is central to our Trust objectives and governance structures.

We are committed to being an anti-racism organisation which actively tackles racism in all its forms. Our anti-racism statement, published in January 2024, sets out this specific focus and priority for action, alongside our wider commitment to tackle discrimination in all its forms.

We are committed to supporting staff with long-term conditions, disabilities or who are neurodivergent, and we support a wide range of initiatives to ensure equal and inclusive access to learning and employment.