Sunday 3 September 2017

A new era? The Southern Health Annual Report and Accounts 2016/17

Just over a year ago, I went through Southern Health’s Annual Report and Accounts for 2015/16, looking mainly at what the figures told us about what Southern Health was doing and where it was heading. My conclusion at the time was that the figures showed Southern Health to be failing and flailing: shrinking; shipping skilled professionals at a rate of knots and replacing them with unskilled staff; paying executive directors more whilst paying other staff less; and still forking out a fortune in dubious ‘training’ and ‘consultancy’ contracts. At the same time, the annual report was trying desperately to fend off and ignore the pressing realities of their situation and to pretend that everything would be fine if it wasn’t for those meddling kids/#JusticeforLB/#JusticeforNico/other campaigners/the media/Monitor (sort of)/CQC (sort of)…the list goes on.



The year 2016/17 has been somewhat, er, turbulent, for Southern Health, with the Chief Executive, Katrina Percy, departing with a humungous payout and an almost complete replacement of everyone (both Executive Director and non Executive Director) on the Southern Health board. This blog looks at the 2016/17 annual report figures to see if there are any signs of changes in Southern Health’s direction as they moved into the post-KP era.

The money

Southern Health is continuing to shrink, for two main reasons: 1) shuffling off their social care service, TQ21, to other organisations (why were Southern Health running social care services in the first place?); 2) continuing to offload learning disability services acquired during the ‘absorption’ of Ridgeway/Oxfordshire Learning Disabilities NHS Trust in 2012. By the end of 2017, when services in Oxfordshire will finally transfer to the Oxford Health NHS Trust, I think this will mean that none of the Ridgeway services acquired by Southern Health will remain in their hands, although Southern Health will have pocketed over £8 million in reserves transferred from Ridgeway and kept the proceeds from the sale of a number of former Ridgeway properties. To my mind, it is no coincidence that both TQ21 and the Ridgeway acquisition were driven by the venture capital mindset of Katrina Percy and the Board at the time. People died preventable deaths in these services.

Financially, this means that the income to Southern Health continues to shrink, from £353.9 million in 2013/14 through £330.8 million in 2015/16 to £321.6 million in 2016/17 (a decrease of 9.1% in three years). Overall expenditure has also dropped over this time period, from £348.5 million in 2013/14 (when there was an operating surplus of £5.4 million) through £331.6 million in 2015/16 (with an operating loss of -£5.8 million) to £314.4 million in 2016/17 (a decrease of 9.8% in three years). The income figure for 2016/17 includes a bung of £5.3 million from the Sustainability and Transformation Fund, resulting in an operating surplus of £7.2 million. It is also worth noting a final financial gift from Ridgeway in 2016/17 – the sale of the West View/Home Farm site for £0.8 million.

How does Southern Health spend this income? Some specific lines of expenditure suggest that Southern Health is still an organisation in trouble. For example, ‘purchase of healthcare from non-NHS bodies’ (principally buying inpatient mental health services from private companies such as Huntercombe) rose from £5.0 million in 2015/16 to £9.1 million in 2016/17. Expenditure on clinical negligence cases continues to increase rapidly; from £0.6 million in 2013/14 through £1.1 million in 2015/16 and £1.6 million in 2016/17.

As with all NHS Trusts, by far the biggest expenditure is on staff. Reflecting the continuing shrinkage of Southern Health, spending on all staff (excluding Directors) continued to drop; from £258.9 million in 2013/14 through £236.5 million in 2015/16 to £225.2 million in 2016/17 (a decrease of 13.0% in three years).

Continuing to buck this trend is expenditure on Executive Directors. This has increased from £1.0 million in 2013/14 through £1.6 million in 2015/16 to £1.9 million in 2016/17, a 90% increase in three years. Some of this is undoubtedly due to changes in the Board throughout 2016/17, where there are signs of attempts to regularise some of the more outrageous ways in which Executive Directors (and a select few others) were paid in the Katrina Percy era. Of course, this doesn’t mean that new Executive Directors are exactly donning hairshirts and taking vows of poverty themselves.

First of all there is Katrina Percy herself. Including her pay-off of a year’s salary and pension benefits, she ‘earned’ £295,000 - £300,000 in 2016/17 (and she wasn’t even there for the whole financial year). Senior cronies such as the Chief Operating Officer, Chris Gordon (now gently eased to a secondment to, er, NHS Improvement) still raked in as a Director £105,000 - £110,000 from Southern Health in 2016/17 – not to mention an additional £70,000 - £75,000 in income from Southern Health for his work in ‘other roles’ for them. Whether appointed at the tail-end of KP’s reign or just afterwards, other Executive Directors include Christopher Ash (Director of Strategy; £180,000 - £185,000 including pension contributions), Gethin Hughes (Director of Integrated Services; £185,000 - £190,000 including pension contributions), Sara Courtney (Acting Director of Nursing and Allied Health Care Professionals; £165,000 - £170,000 including pension contributions) and Paul Streat (Director of Corporate Governance; £155,000 - £160,000 including pension contributions).

The new Interim Chief Executive Officer, Julie Dawes, took home £150,000 - £155,000 in salary and a further £62,500 - £65,000 in pension contributions in 2016/17. The Interim Chair Alan Yates, appointed by fiat by NHS Improvement, isn’t doing badly either, taking home £100,000 - £105,000 in total in 2016/17.

The Director of Operations for Mental Health, Learning Disabilities and Social Care is Mark Morgan, who seemed to perform a similar selling off role for Castlebeck after Winterbourne View. Under the KP era he was being paid eye-watering amounts by Southern Health via his company. The annual report for 2016/17 reports that he now takes a salary rather than being paid through this company, although he still managed to rake in £265,000 - £270,000 from Southern Health in 2016/17. A number of other Directors were earning substantial additional amounts for ‘other roles’ in Southern Health under the KP era in 2015/16, but this seems to have stopped for four Directors in 2016/17.

For reasons which are not obvious to an outsider like me, the great survivor of this turbulent period is the Medical Director, Lesley Stevens, with a total £165,000 - £170,000 (including pension contributions) from Southern Health in 2016/17.

One of the indicators that NHS Trusts have to report is the ratio between the highest salary in the Trust and the median salary of all staff in the Trust. In 2015/16 the median salary in Southern Health was £24,500 and the ratio was 7.6. In 2016/17 the median salary increased to £26,900 (largely because poorly paid workers in the social care TQ21 service no longer worked for Southern Health). The 2016/17 annual report states that the ratio of highest paid worker to median salary dropped dramatically to 5.7. It turns out this is because the Trust decided that Katrina Percy’s income didn’t count because of the payoff – the ratio would then have rocketed to around 11. The Trust also decided that the next highest income, for Mark Morgan, didn’t count either, because he was paid via his company for most of the time (or something like that) – the ratio would then be approaching 10.

Through the nose

Last summer, Michael Buchanan of the BBC reported the hugeamounts of money being paid by Southern Health to two consultancy companies, Talent Works and Consilium, both of which were led by people with connections to Katrina Percy. Trusts have to report in their annual report and accounts total spending to external agencies in three categories: legal fees; consultancy; and training/courses/conferences. Much of the gargantuan spending to Talent Works in particular was categorised as training rather than consultancy, particularly for the infamous ‘Going Viral’ collection of happenings (I’m struggling to find a neutral but descriptive term) inflicted across Southern Health.
In 2016/17 are there signs that Southern Health is curbing its dangerous addiction to consultants, in whatever form?

First, Southern Health spending on legal fees is continuing to increase: from £1.1 million in 2014/15 through £1.4 million in 2015/16 to £1.7 million in 2016/17. How much of this legal spending is necessary to work through the consequences of Katrina Percy’s actions (the annual report states expenditure of £14,256 to the legal firm Capsticks specifically related to Katrina Percy’s departure), and how much is engaged in aggressive and unnecessary actions like the legal bullying involved in the @LBInquest, is unclear.

Second, spending on training, which had shot up from 2014/15 (£1.0 million) to 2015/16 (£2.7 million), possibly involving recategorising consultancy spending during that time, decreased slightly to 2016/17, but was still running at £1.9 million.

Thirdly, spending on consultancy, which had ostensibly dropped from 2014/15 (£1.5 million) to 2015/16 (£0.7 million), increased again in 2016/17 to £1.3 million.

Across all three categories, spending increased from 2014/15 (£3.6 million) through 2015/16 (£4.8 million) to 2016/17 (£4.9 million). Southern Health’s addiction continues under new management.

If you want to look in more detail at who Southern Health have been paying, this Freedom of Information request has details of exactly when Southern Health paid invoices to which organisations in 2016/17 under the three categories of training, consultancy and legal/professional fees. I haven’t gone through all of this myself (yet), but one thing did jump out at me: even at the end of March 2017, after KP had departed, Southern Health were still paying large sums to Talent Works Psychologists Ltd for ‘training’, over £137,000 in March 2017 alone.

Staffing

As I mentioned earlier, Southern Health continued to shrink in 2016/17, with expenditure on (non-Director) staff also decreasing. What have the consequences been for the number of staff in different roles employed in Southern Health? A year ago, it looked to me like the figures were suggesting a deprofessionalisation of the Southern Health workforce, with from 2014/15 to 2015/16 big reductions in the number of doctors/dentists; nurses/midwives/health visitors; and scientific/therapeutic/technical staff to set alongside a big increase in healthcare assistants/other support staff.

What has happened from 2015/16 to 2016/17? As you would expect from a shrinking organisation, the total Whole Time Equivalent (WTE) staffing time available reduced again, from 7,282 WTE staff in 2014/15, through 6,468 WTE staff in 2015/16, to 6,028 WTE staff in 2016/17.

However, within these overall figures there are signs of at least a stalling of the staffing plans of the late-KP era. For example, the WTE number of healthcare assistants/other support staff, after increasing drastically from 1,587 in 2014/15 to 2,033 in 2015/16, dropped dramatically in 2016/17 to 1,484.

Other groups of staff that had reduced from 2014/15 to 2015/16 showed signs of small reversals in 2016/17. The WTE number of doctors/dentists, which had reduced from 238 in 2014/15 to 211 in 2015/16, increased again to 230 in 2016/17. The WTE number of nurses/midwives/health visitors, which had plummeted from 2,507 in 2014/15 to 1,748 in 2015/16, had stabilised at 1,786 in 2016/17. Similarly, the number of scientific/therapeutic/technical staff, which had dropped from 823 in 2014/15 to 529 in 2015/16, has stabilised at 557 in 2016/17.

Southern Health is still quite highly reliant on agency staff (227 WTE in 2016/17 compared to 211 in 2015/16 and 287 in 2014/15) and Bank staff (350 WTE in 2016/17 compared to 365 in 2015/16 and 461 in 2014/15). Staff sickness rates are high at 4.5% in 2016/17 compared to 4.8% in 2015/16, with an average of 11 working days per full-time post lost due to sickness.

Who let this happen?

As Southern Health struggles to emerge from the disastrous reign of Katrina Percy (and unlike when it is applied to football managers, the word ‘reign’ feels appropriate here), there are so many unanswered questions. Principally, how was the catastrophic direction Katrina Percy took Southern Health not only allowed to happen, but actively encouraged? There are so many people and organisations part of making this happen who have evaded any scrutiny or accountability. The murky deal for Southern Health to ‘absorb’ Ridgeway brokered by the Primary Care Trust at the time (remember that the other NHS Trust shortlisted to take it on was Calderstones). The replacement health service commissioners (Clinical Commissioning Groups) who studiously looked the other way while continuing to blandly hand over the cash. Oxfordshire social services commissioners who were so busy protecting their own reputations they neglected to do their jobs. The whole self-serving shiny panoply of the Health Service Journal awards circuit. Where were Monitor/NHS Improvement? The CQC? NHS England? The Department of Health? (who they?). Without #JusticeforLB and other campaigners wanting accountability and justice at Southern Health, Katrina Percy would still be in post now rather than advertising her wares as aStrategic Consultant on LinkedIn, and I shudder to think where Southern Health (and the people using its services, and its staff) would be headed.


I’m not privy to the internal workings of these organisations so I have no idea whether they have engaged in any real reflection on their role in this disaster, and whether they have changed what they do as a result. My question to them would be, not only could it happen again, but is it happening somewhere on their watch right now, and does it look to them like failure or success?

63 comments:

  1. Interesting articles and great content, thanks for sharing enough important information - Visit also my blog Penyebab Sipilis

    ReplyDelete

  2. It is really a great work and the way in which you are sharing the knowledge is excellent.Thanks for your informative article

    Hadoop Training in Chennai

    ReplyDelete
  3. haha sangat lucu dan tidak masuk kal, tapi sangat menghibur

    Bakteri Sipilis

    ReplyDelete
  4. Thanks for ones marvelous posting! I genuinely enjoyed reading it,you are a great author. I will be sure to bookmark your blog and may come back very soon....

    Best Training Institute in chennai

    ReplyDelete
  5. Woah this blog is wonderful i like studying your posts. Keep up the great work! You understand, lots of persons are hunting around for this info, you could help them greatly.
    python course in pune
    python course in chennai
    python course in Bangalore

    ReplyDelete
  6. This is beyond doubt a blog significant to follow. You’ve dig up a great deal to say about this topic, and so much awareness. I believe that you recognize how to construct people pay attention to what you have to pronounce, particularly with a concern that’s so vital. I am pleased to suggest this blog.
    Java training in Bangalore | Java training in Kalyan nagar

    Java training in Bangalore | Java training in Kalyan nagar

    Java training in Bangalore | Java training in Jaya nagar

    ReplyDelete
  7. I always enjoy reading quality articles by an individual who is obviously knowledgeable on their chosen subject. Ill be watching this post with much interest. Keep up the great work, I will be back
    Best Devops training in sholinganallur
    Devops training in velachery
    Devops training in annanagar
    Devops training in tambaram

    ReplyDelete
  8. This comment has been removed by the author.

    ReplyDelete
  9. Hmm, it seems like your site ate my first comment (it was extremely long) so I guess I’ll just sum it up what I had written and say, I’m thoroughly enjoying your blog. I as well as an aspiring blog writer, but I’m still new to the whole thing. Do you have any recommendations for newbie blog writers? I’d appreciate it.
    AWS Interview Questions And Answers | AWS Interviews Questions and Answers for Devops | AWS interview questions and answers for Sysops
    AWS Interview questions and answers for freshers | AWS Interview Question for devops
    AWS Training in Bangalore with placements | AWS Training in Bangalore cost

    ReplyDelete
  10. Some us know all relating to the compelling medium you present powerful steps on this blog and therefore strongly encourage
    contribution from other ones on this subject while our own child is truly discovering a great deal.
    Have fun with the remaining portion of the year.

    Selenium training in bangalore | best selenium training in bangalore | advanced selenium training in bangalore | no.1 selenium training in bangalore

    ReplyDelete
  11. Thanks For sharing the Information The Information Shared Is Very valuable please Keep Updating Us The InFormation Shared Is Very Valuable Python Online Training Hadoop Online Training <a href="https://nareshit.com/data-science-online-training/>DataScience Online Training</a>

    ReplyDelete
  12. Its really an Excellent post. I just stumbled upon your blog and wanted to say that I have really enjoyed reading your blog. posts. I hope you post again soon.

    Selenium Training in OMR Chennai

    ReplyDelete
  13. Attend The Python training in bangalore From ExcelR. Practical Python training in bangalore Sessions With Assured Placement Support From Experienced Faculty. ExcelR Offers The Python training in bangalore.
    python training in bangalore

    ReplyDelete
  14. Really impressive post. I read it whole and going to share it with my social circules. I enjoyed your article and planning to rewrite it on my own blog.
    big data course

    ReplyDelete
  15. Thanks for the good words! I Really appreciate, it is really wonderful and useful for me to understand many concepts and helped me a lot. Keep it up!! Machine Learning Course

    ReplyDelete

  16. ขอบคุณที่แบ่งปันโพสต์นี้ ฉันสนุกกับการอ่านมันมีประโยชน์สำหรับฉันจริงๆ

    ยินดีต้อนรับสู่ g-win88.com เกมคาสิโนออนไลน์อันดับ 1 ที่ดีที่สุดในประเทศไทยและเอเชีย!

    ⮚ รับโบนัสฟรี 100% สำหรับสมาชิกใหม่
    ⮚ โปรโมชั่น แทงบอลออนไลน์ รับค่าคอม x3
    ⮚ โปรโมชั่น ลูกค่าบาคาร่า รับคืนยอดเสีย ฟรีๆ 10%

    ฝาก-ถอน โอนไว 24 ชั่วโมง⏰, ได้เงินชัว ไม่มีโกง 💯%, โปรโมชั่นดีดีไม่เหมือนที่อื่นแน่นอน

    ╔══════════════════╗
    ♛สมัครวันนี้เลย ADD LINE : https://lin.ee/1ZdZara
    ☎️Call Center บริการตลอด 24 ชม. 0929553889
    💋💋รับสิทธิ์ ฟรี!! จำนวนจำกัด💋💋
    ╚══════════════════╝

    ReplyDelete
  17. Glad to chat your blog, I seem to be forward to more reliable articles and I think we all wish to thank so many good articles, blog to share with us.
    Data Science Institute in Bangalore

    ReplyDelete
  18. Great tips and very easy to understand. This will definitely be very useful for me when I get a chance to start my blog.
    Data Science Course in Bangalore

    ReplyDelete
  19. Excellent effort to make this blog more wonderful and attractive.
    Data Science Training in Bangalore

    ReplyDelete
  20. I want you to thank for your time of this wonderful read!!! I definately enjoy every little bit of it and I have you bookmarked to check out new stuff of your blog a must read blog!
    Data Science Certification in Bangalore

    ReplyDelete
  21. Great blog found to be well written in a simple manner that everyone will understand and gain the enough knowledge from your blog being more informative is an added advantage for the users who are going through it. Once again nice blog keep it up.

    360DigiTMG Python Course

    ReplyDelete
  22. Thank you for the informative post. It was thoroughly helpful to me. Keep posting more such articles and enlighten us.


    AI Training in Hyderabad

    ReplyDelete
  23. This is a great motivational article. In fact, I am happy with your good work. They publish very supportive data, really. Continue. Continue blogging. Hope you explore your next post
    hrdf claimable courses

    ReplyDelete
  24. You re in motivation behind fact an on-target site administrator. The site stacking speed is amazing. It kind of feels that you're doing a specific trick. What's more, The substance is a masterpiece. you have done a marvelous development concerning this issue!
    360DigiTMG Data Analytics Course

    ReplyDelete
  25. The content is utmost interesting! I have completely enjoyed reading your points and have come to the conclusion that you are right about many of them. You are great,

    DevOps Training in Hyderabad

    ReplyDelete
  26. Your astounding wise data involves a lot to me and particularly to my friends. Much obliged a ton; from us all.
    data science course noida

    ReplyDelete
  27. Especially superb!!! Exactly when I search for this I found this webpage at the top of every single online diary in web crawler.
    360DigiTMG data science course in malaysia

    ReplyDelete
  28. Two full endorsement for this magnificent article of yours. I've genuinely refreshing scrutinizing this article today and I figure this might be uncommon contrasted with other articles that I've examined now. On the off chance that it's not all that much difficulty prop this work up on in a comparable quality.
    data science course in delhi

    ReplyDelete
  29. I have to search sites with relevant information on given topic ExcelR Machine Learning Course and provide them to teacher our opinion and the article.

    ReplyDelete
  30. If your looking for Online Illinois license plate sticker renewals then you have need to come to the right place.We offer the fastest Illinois license plate sticker renewals in the state.
    Best Institute for Data Science in Hyderabad

    ReplyDelete
  31. I've read this post and if I could I desire to suggest you some interesting things or suggestions. Perhaps you could write next articles referring to this article. I want to read more things about it!
    Data Science course in Hyderabad

    ReplyDelete

  32. Very informative post ! There is a lot of information here that can help any business get started with a successful social networking campaign !

    Best Data Science Courses in Hyderabad

    ReplyDelete
  33. A good blog always comes-up with new and exciting information and while reading I have feel that this blog is really have all those quality that qualify a blog to be a one
    data scientist training and placement

    ReplyDelete
  34. This is my first time i visit here. I found so many interesting stuffs in your blog especially its discussion. From the tons of comments on your articles, I guess I am not the only one having all the enjoyment here! keep up the good work
    Data Science Training in Hyderabad
    Data Science Course in Hyderabad

    ReplyDelete
  35. Thanks for posting this info. I just want to let you know that I just check out your site and I find it very interesting and informative. I can't wait to read lots of your posts.
    DevOps Training in Hyderabad
    DevOps Course in Hyderabad

    ReplyDelete
  36. I am impressed by the information that you have on this blog. It shows how well you understand this subject.
    data science course


    ReplyDelete




  37. I was basically inspecting through the web filtering for certain data and ran over your blog. I am flabbergasted by the data that you have on this blog. It shows how well you welcome this subject. Bookmarked this page, will return for extra. data science course in jaipur

    ReplyDelete
  38. Thank you so much for this great blog. Honestly, I found the information useful on your blog, thanks for giving us the blog.
    wordpress
    ufa88kh.blogspot
    youtube
    ufa88cambodia

    ReplyDelete
  39. Pretty good post. I just stumbled upon your blog and wanted to say that I have really enjoyed reading your blog posts. Any way I’ll be subscribing to your feed and I hope you post again soon. data science training in gurgaon

    ReplyDelete
  40. Very good message. I came across your blog and wanted to tell you that I really enjoyed reading your articles.
    Data Scientist Course in Bangalore

    ReplyDelete
  41. Really awesome blog. Useful information and knowledge. Thanks for posting this blog. Keep sharing more blogs again soon.
    Best Data Science Courses in Hyderabad

    ReplyDelete
  42. Learn the fundamentals of Data Science and master the skills to handle epic amounts of data collected by organizations today. Gain expertise in organizing, analyzing, and transforming data to uncover its hidden power. Drive your career forward with a Data Science course in Bangalore and learn to uncover insights to present critical findings using visualization tools. Not only this, avail the best-in-class content delivered by stellar faculty who use a blended approach of theory as well as practical knowledge to ensure all the concepts are crystal clear.

    Data Science in Bangalore

    ReplyDelete
  43. Industries generating tons of data and now moving towards digitization and automation to create various job opportunities for Data professionals. Sign up for the Data science courses in Marathahalli and avail benefits of attending sessions that are conducted using real-life case studies and projects which are accompanied by extra assignments. The content is designed to match the growing market needs to keep you updated with the latest skills and tools used in this ever-evolving field.


    Data Science Course in Bangalore

    ReplyDelete
  44. Simple Linear Regression is a logistic method used to find out the relation between a single input variable and an output variable when both variables are continuous. To learn more about Simple Linear Regression start your Data Science course today with 360DigiTMG.

    Data Analytics Course in Calicut

    ReplyDelete
  45. Data Science is a dynamic domain with a promising future, start your Data Science Course today with 360DigiTMG and become a Data Scientist without hassle.

    Data Science Training in Jodhpur

    ReplyDelete
  46. Data Science is emerging as a top job domain in the IT industry. If you are looking forward to starting your career in Data Science, then 360DigiTMG is your go-to place with the best placement success for Data Science Certification Training.

    Data Scientist Course in Delhi

    ReplyDelete
  47. Fast forward your career with the best Data Analyst Course offered by 360DigiTMG.Gettrained by expert trainers with placement assistance.
    <a href="https://360digitmg.com/india/business-analytics-course-in-gorakhpur''>business analytics course in gorakhpur</a>

    ReplyDelete
  48. I think this is an informative post and it is very useful and knowledgeable. therefore, I would like to thank you for the efforts you have made in writing this article.
    full stack web development course in malaysia

    ReplyDelete
  49. The information you have posted is very useful. The sites you have referred was good. Thanks for sharing.
    full stack web development course malaysia

    ReplyDelete
  50. Great post. keep sharing such a worthy information.
    AWS Training institute in Chennai

    ReplyDelete
  51. Excellent post, Thanks for sharing this.

    Learn more about Product Management Certification and also many other courses to get the best knowledge.

    ReplyDelete