Annual Report summary 2022/23

It has been another challenging year, dominated by high demand for our services and complex operational pressures, including industrial action. Our staff have continued to work tirelessly to deliver safe, compassionate, high quality care to as many patients as possible. 

We remain focused on the restoration and recovery of services following the COVID-19 pandemic, and although we have seen good progress in many areas, we have more to do to consistently deliver against all the national performance standards, particularly in our cancer services. 

In the past year we have focused particular attention on eliminating the very longest waits and speeding up access to diagnostic tests and treatment for our patients. However, repeated periods of industrial action have made it difficult to progress as quickly as we'd like. 

More positively, our emergency department is consistently amongst the best performing in London and in the top 10 nationally. 

We continue to look for innovative ways to increase the number of patients we can treat and including expanding our pioneering robotic surgery programme – the largest in the NHS – which not only allows us to treat more patients, but improves patient outcomes and experience. 

It is positive that improvements to the early stages of our cancer pathways have continued, including through our rapid diagnostic services. We recognise that we have more to do to achieve other cancer standards, including the 62-day maximum wait from referral for treatment to begin, and we have developed Trust-wide plans to provide a relentless focus on moving this forward. 

It is reassuring that we have seen outpatient activity return to pre-pandemic levels, and we continue to work hard to increase the number of new outpatients we can see in our clinics across all specialties. 

Through the hard work of our staff, we have set a good foundation on which to build going forward.

Our financial performance underpins all that we do, including our ability to invest in service improvements. 

The Trust agreed a financial target to deliver a breakeven position for 2022/23 with NHS England, and we are pleased to report that we ended the year with a surplus of £13.1 million, after technical adjustments.  

The key national priority last year was on the restoration of planned care to above pre-pandemic levels and additional funding was made available to support this. 

As we respond to the new national financial regime, which came into effect in April this year, we have implemented a wide-ranging efficiency programme alongside our ongoing efforts to increase activity as we fully recognise the need to ensure our services are delivered safely and also cost effectively.

Despite the financial constraints across the NHS, we are still committed to investing in our facilities and services where possible to ensure we can provide our patients with the best possible care. 

We continue to invest in state of-the-art imaging and diagnostic capacity. Additional cardiac MRI capacity has been provided at Harefield, building on the Diagnostic Centre at Royal Brompton Hospital, which opened in early 2022. 

In December last year, we opened our new world-class medical imaging centre at St Thomas' Hospital which incorporates the latest artificial intelligence technology and clinical MRI scanners to improve patient care and support research.

We look forward to opening our new Children's Day Treatment Centre in the summer.

We have continued to invest significant capital in improving our estate, digital technology and medical devices to support the needs and expectations of our patients. A key focus has been on safely implementing the Trust's new electronic health record system through our 'Apollo Programme' whilst ensuring minimal disruption to the services that we provide.

The safe implementation of the new electronic health record system is one of the Trust's main priorities for 2023/24.Once live, our new electronic health record will help transform the way we deliver care and empower our patients to get more involved in decisions about their health.

The system is expected to go live later in 2023 jointly with King's College Hospital NHS Foundation Trust. A comprehensive implementation and training programme, as well as a number of associated digital infrastructure programmes, are underway and on track to support this.

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

As in previous years, the NHS Staff Survey showed that our staff reported a positive experience of working for the Trust, and the results show there is much to be proud of at Guy's and St Thomas'. 

We achieved some of the best scores nationally and in London for the number of staff who agree that the care of patients is the organisation’s top priority and for staff recommending the Trust to a friend or relative as a place to receive care or treatment or a place to work. 91% of our staff said that they were proud to work at the Trust.

However, we are not complacent and we absolutely know that there are also a number of areas where we must do more and improve. 

We recognise the need to take further action on equality, diversity and inclusion so that all our staff, patients and visitors feel confident that we are a welcoming and supportive organisation and that we treat everyone fairly. We also must drive out bullying and harassment wherever it occurs.

We are proud to serve diverse communities, both locally and further afield. This diversity is reflected in the profile of our patients and workforce, and brings many benefits. 

We recognise we have more to do to address inequalities across the Trust and we have refocused our staff equality, diversity and inclusion strategy into 5 key improvement areas which include:

•  ending unfair treatment; 
•  understanding and including each other; 
•  fair employment processes; 
•  fair access to learning and development; 
•  clear governance and accountabilities. 

Our Board have made a clear commitment to focus on anti-racism in 2023 and to renew our equality, diversity and inclusion action plan to eliminate discrimination and create a compassionate and fair organisation that has inclusion and equity at its core

We are committed to supporting staff with long term health conditions, those with a disability or who are neurodivergent, including anyone who acquires a disability during their employment. 

We also offer internships for young autistic people and supports a number of initiatives to ensure equal and inclusive access to learning and employment.

Our 10 year sustainability strategy, launched in June 2021, recognises the Trust's environmental impact and our responsibility to actively protect our environment by providing sustainable healthcare. 

Our strategy considers both our national and sector obligations, as well as our position as an 'anchor institution'. We continue to work closely with our Integrated Care Systems to deliver a joined-up approach to sustainability initiatives across south east and north west London. 

The Trust is committed to delivering a net zero health service as part of the Greener NHS Programme, and over the past year we have focused on three strategic themes where we can make the biggest difference: carbon zero, connecting with nature, and cycle of resources. This includes:

• continuing to encourage active and sustainable travel for patients and staff to reduce emissions, working towards operating 'greener fleets', using electric vehicles, and supporting staff to work remotely where appropriate.
• enhancing our surroundings for patients and staff by increasing access to the naturel environment, encouraging active transport and improving air quality.
• We are reducing waste through a range of projects which focus on repair, reuse, recycling and innovation.