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Dr John M CooneyDr Tara KingstonDr Rosaleen LannonDr Conal CunninghamDr David RobinsonDr Miriam CaseyDr Kevin McCarrollProf Rose Anne KennyProf Joseph HarbisonDr Rosaleen LannonDr Breida BoyleDr Brian O’ConnellDr Brendan CrowleyDr Eleanor McNamaraProf. Thomas RogersDr George MellotteDr Brenda GriffinDr Janice RedmondDr Colin DohertyDr Siobhan HutchinsonDr David BradleyDr Francesca BrettDr Yvonne LanganDr Michael John KennedyDr Sinead CuffeDr Dearbhaile O’DonnellDr Cliona GrantDr Crothur Fergal KelleherDr David GallagherDr Aoife DoyleDr Martin O’ConnorMr Padraig O’CeallaighProf Leo StassenMr Conor BarryMr Gerard KearnsDr Eamonn McKiernanDr Aisling O’MahonyMr Thomas McCarthyMr John McKennaMr Niall HoganMs. Catherine BossutProf Conrad TimonMr Brendan ConlonMr John KinsellaMr Paul LennonMr. Brendan FennessyProf Martina HennessyProf Michael Gerard BarryMr David OrrDr Patricia EadieMr Eamon BeausangMr David O’DonovanMs. Claragh HealyMr Odhran ShelleyMs. Ann McKennaProf Brian LawlorProf Charles GillhamDr. Moya CunninghamDr. Sinead BrennanLiaison PsychiatryLiaison PsychiatryMedicine for the ElderlyMedicine for the ElderlyMedicine for the ElderlyMedicine for the ElderlyMedicine for the ElderlyMedicine for the ElderlyMedicine for the ElderlyMedicine for the /GeneticsOphthalmologyOphthalmologyOral & Maxillofacial SurgeryOral & Maxillofacial SurgeryOral & Maxillofacial SurgeryOral & Maxillofacial SurgeryOrthodonticsOrthodonticsOrthopaedic SurgeryOrthopaedic SurgeryOrthopaedic SurgeryOrthopaedic tolaryngologyOtolaryngologyPharmacology & TherapeuticsPharmacology & TherapeuticsPlastic & Reconstructive SurgeryPlastic & Reconstructive SurgeryPlastic & Reconstructive SurgeryPlastic & Reconstructive SurgeryPlastic & Reconstructive SurgeryPlastic & Reconstructive SurgeryPlastic & Reconstructive SurgeryPsychiatry of Old AgeRadiation OncologyRadiation OncologyRadiation OncologyDr. Pierre ThieronDr. Catriona O’SullivanDr. Nazmi El BeltagiDr. Osama SalibDr Michael GuineyDr Ronan McDermottDr Niall McEniffDr Ciaran JohnstonDr Graham WilsonDr Grainne GovenderDr James MeaneyDr Susannah HarteDr Niall SheehyDr Mary KeoganDr Sylvia O’KeeffeDr Mark RyanDr Peter BeddyDr Ian BrennanDr Finbarr O’ConnellProf Joseph KeaneDr Rory A O’DonnellDr Ruairi FahyDr Anne Marie McLaughlinDr Finbar O’SheaProf Gaye CunnaneDr Michele DoranProf Thomas LynchMr TED McDermottMr Prakash MadhavanMr Sean O’NeillMr Adrian O’CallaghanMs. Zenia Martin11Radiation OncologyRadiation OncologyRadiation OncologyRadiation diologyRadiologyRadiologyRadiologyRespiratory MedicineRespiratory MedicineRespiratory MedicineRespiratory MedicineRespiratory yUrologyVascular SurgeryVascular SurgeryVascular SurgeryVascular Surgery

1.2Legal and Banking 2016AuditorsComptroller and Auditor General,Dublin Castle, Dublin 1BankersBank of Ireland, 85 James’s Street, Dublin 2Legal AdvisorsA&L Goodbody Solicitors,International Financial Services CentreNorth Wall Quay, Dublin 1.Insurance BrokersAON Ireland, Metropolitan Building,James Joyce Street, Dublin 112

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2.3Report from PatientRepresentative GroupIntroductionThe St. James’s Hospital, Patient Representative Group (PRG) wasformed in March 2016 following the reconfiguration of the longexisting Patient Advocacy Group, in response to national andinternational best practice. Monthly meetings are held in theHospital and engagement with Hospital staff is welcomed. TheRepresentatives serve as an advisory resource to staff of the hospitaland help the staff to see the hospital from the patient perspective.Representatives bring their perspectives to quality improvementprojects, service developments, information leaflets, new facilities,refurbishments, policy and educational programme development.Key performance indicators2017 objectivesTheme 1, person centred care and support, in the NationalStandards for Safer Better Healthcare states that byconsidering service users’ needs and preferences in theplanning, design and delivery of care and support services,better service-user satisfaction can be achieved. This, in turn,can lead to improved outcomes for service users includingbetter health and wellbeing. The Patient RepresentativeGroup is one of a number of measures facilitated by thePatient Experience Office to enable patient and familyfeedback and partnership.Looking to the future and 2017 the group want to continueto participate in surveys, meetings, and engagement withadditional members of the Hospital staff and departments.The PRG is interested in increasing its involvement in theHospital by being contributing to governance groups andcommittees within the Hospital.With increased awareness of the group there will naturally bemore increasing demands also. To meet this challenge andmaximise the full potential of the group they have identifiedthe need to recruit new members in 2017.Performance HighlightsConclusionIn its first year the group recruited ten members comprisingof patients, carers and family members who volunteeredThe PRG were successful in providing a perspective thatthe Health Care Professional may not have had. The PRG’srecommendations informed the actions taken by the staffwho met them. Staff members overwhelmingly reported thatthey found their engagement with the PRG very beneficial.This has led to a growing awareness amongst staff about thePRG and the value of engagement with them. By partneringwith the Hospital the PRG have actively contributed topositive change. As the group flourishes, there is excitingpotential for growth and strengthening the culture of quality,safety and person centeredness.to be representatives for a two year term. The groupparticipated in eleven monthly meetings, three focus groupsand engaged with thirty services and departments fromwithin the Hospital, HSE and HIQA. Individual membershave represented the group and St. James’s Hospital byparticipating in the ‘Mystery Shopper’ wayfinding experience,HSE multi-faith focus group, HIQA National PatientExperience Survey review meeting, patient informationmaterial, survey advisory panel and end of life steering group.The first year ended with a workshop to reflect on matters ofimportance raised over the course of the year and developingthe group’s annual report which was disseminated to SeniorHospital Managers, the Board of Management and frontlinestaff.The Hospital acknowledges and is very appreciative of thecontribution that each member of the PRG has made.14

Representatives bringtheir perspectives toquality improvementprojects, servicedevelopments, informationleaflets, new facilities,refurbishments, policy andeducational programmedevelopment.”Patient Representative Group Left-Right: Ms. Lora Ruth Wogu; Mrs. Pamela O’Reilly; Mr PatRooney; Mr Peter Hartnett, Ms. Roseanna Farrell; Mr. Richard Costello and Ms. Vivienne Duffy.15

2.4Performance Highlights201623,28150,249ACTIVITYACUTE WARDIN- PATIENT DISCHARGESDAY CASES2016 ActivityPeriod Jan - Dec 2016CardiologyDermatology2016 Projected activityAcute WardIn- ses% In-ptsVariance% 0-41%24%344690280-39%23%Emergency Dept1ENT423General 829676454564%28%Maxillo %38%Medicine for the 2550%24%Orthopaedics10185201320211-23%146%Plastic umatology720157Psychiatry49246%Cardio-Thoracic Surgery95633860Urology569161150187914%83%Vascular 35%Total Acute ActivityACTIVITY and PROJECTECD Levels for 20161611%

Period Jan - Dec 20162016 Non Acute Ward In-patient DischargesENT1Medicine for the logyOUT-PATIENT ACTIVITY VARIANCE33% 88%2Total Non Acute ActivityNEWRETURN1296Out-Patient ote 1: Medicine Inpatients includes ephrology/Immunology/Pain Management/General Medical patients.Note 2: Medicine Daycases includes Pain Therapy/Anaesthesiology/General MedicineNote 3: Oncology Daycases includes Clinical(Medical) GeneticsNote 4: Outpatient Consultant and Nurse Led Activity17

3.1Finance DirectorateSimon MooresDirector of FinanceIntroductionThe St. James’s Hospital Finance Directorate is a contemporaryFinance function that incorporates three main divisions. Theseare the Transaction Processing Units, including Accounts Payable/Settlements, Accounts Receivable and Payroll. The TechnicalExpertise Units comprising of the Compliance Unit, SAP SupportUnit and the Procurement Unit. Finally the Decision Support Unitwhich includes the Clinical Funding Unit and the ManagementAccounts Unit.The Finance Directorate operates over two main sites. TheTransaction Processing Units, the Compliance Unit and SAPSupport Unit are based off site at the Brickfield Campus withthe remaining units based on site within St. James’s Hospital.the Procurement Unit provides procurement expertise, assistsDirectorates in identifying value for money initiatives throughmarket engagement, provides oversight of the NationalFactor Blood budget and ensures the Hospital is compliantwith all procurement legislation.The Transaction Processing Units have significant experienceand expertise in all transactions that are processed. ThePayroll Unit processes payroll, every fortnight, for overThe Decision Support Unit has been a national leader in itsability to deliver information to end users. With the changein funding model during 2016 from a block grant to beingreimbursed on the basis of hospital activity, grouped bypatient diagnosis according to Diagnosis Related Groups(DRG) for inpatient and day case attendances, the focus ofthe department has also had to shift.4,000 employees and have extremely efficient controls andprocesses in place most of which are either electronic oronline. The Accounts Payable/Settlements Unit processesall invoices and again is predominantly receiving invoiceselectronically and allowing them to be directly uploadedwithout human intervention. Finally the Accounts ReceivableUnit invoices and collects over 100m in revenue.The Clinical Funding Unit has developed expertise in PatientLevel Costing and the new funding model (ABF) with a realfocus on Patient Level data that drives accurate costing andensuring clinical activity is coded correctly which in turndrives the revenue.The technical expertise based within the Finance Directorateis second to none. The SAP Support Unit ensures thefinancial integrity of the SAP system, provides invaluableproject management expertise and continually strives toensure the SAP environment evolves with the Hospitalsrequirements. The Compliance Unit ensures that robustcontrols and processes are in place for all areas of transactionprocessing and manages the Hospital’s balance sheet. FinallyThe Management Accounts team, within the DecisionSupport Unit, encompasses several Business Partners whoare providing the Directorates with a significant amount offinancial expertise and guidance in service developments,efficiency developments and cost containment initiatives.18

Doing more withless is the biggestfinancial challengethat the Hospital hashad to face.”19

Pay mManagement / Administration25,375Non PayDirect Patient Care108,106Medical / Dental I (NCHDs)27,241Support Services51,623Medical / Dental II (Consultants)31,545Financial and l35,440Catering & Housekeeping / SupportServices / Porters32,619Maintenance / Technical3,773Pensions & Gratuities17,090Total257,144Total Gross Expenditure439,854Income86,101Exchequer Funding340,544Total Funding426,645In year Deficit13,209Annual report - DataPerformance highlightsKey highlights include the workundertaken by the Compliance Unitduring 2016. The team providedoversight and had financialresponsibility of two major capitalprojects, namely the completion of theMISA development and the decantingassociated with the National PaediatricHospital, totalling approximately 100million. The discipline and expertiseshown on financially managing bothprojects was extraordinary, consideringthe speed at which both projectsmoved.Another highlight was the start ofan exciting project called “Scan 4Surgery” within Theatre. The projectallows for the scanning of consumablesper patient and achieves three corefunctions – reorders consumables used,captures data for safety/traceabilityand provides patient level cost peritem consumed. The project is a truecollaboration between clinical (theatre)and non-clinical (finance and logistics)areas. The expertise from the SapSupport Unit and Decision Support Unithas been critical to the success of theproject. The Scan 4 Surgery project hasalso leveraged off the electronic datacapture and ICT infrastructure alreadydeveloped by the Sap Support Unit andwill provide a scalable platform to allowthe Hospital to understand the truecost of its patients at the patient level.The final key highlight was the financialperformance of the Hospital. TheFinancial Statements for the reportingperiod 1st of January, 2016 to 31st ofDecember, 2016 resulted in a deficitof 13,209m. The Hospital grossexpenditure was 439,854m whilethe income and exchequer fundingamounted to 426,645m. The openingsurplus of 18,006m carried forwardinto 2016 now stands at 4,797m. The 13,209m deficit arose due to theHospital making significant investmentsin key projects. The majority of thedeficit was due to the decantingassociated with the National PaediatricHospital and that project also allowedfor other key strategic investmentBlood / Blood productsMedical GasesMedical & Surgical Supplies2017 objectivesDoing more with less is the biggestfinancial challenge that the Hospitalhas had to face. Going into 2017this is still the case. Inflationary costpressure, payroll pressure as the variousagreements are rolled back and thevolume of patients attending theHospital on both an emergency andelective basis pose the biggest financialchallenge the Hospital faces in 2017.Yet, in spite of this, excitingopportunities still remain for 2017; thecontinuous improvement of day to dayoperations and projects the FinanceDirectorate will undertake will hopefullyadd real value to the Hospital andindirectly for the patients that we serve.Further developing our skill in Patientlevel costing and the analytical platformto share the key financial informationwill be focused on during 2017. Also,embedding and constantly promoting50000Direct Patient CareDrugs & Medicinesdecisions, like refurbishing severalward areas and buying key pieces ofequipment.Other Medical EquipmentSupplies / Contracts On28,33145,69241030,169Other Medical Equipment1,500Other Medical EquipmentSupplies / Contracts On2,00440000Other Medical Equipment30000Medical & Surgical Supplies20000Medical GasesBlood / Blood products10000Drugs & Medicines108,1060Annual report - Data20

a culture of financial responsibilityacross the Hospital through engagingwith Directorates will still remain a coretheme of 2017, especially as we seekopportunities to deliver efficiency andvalue for money so that we can domore with what we have.ConclusionThe work ethic, dedication and overallability within the Finance team hasmeant 2016, whilst interesting attimes, has been a really positive yearespecially considering the level ofchange that seen both impactingon the Finance Directorate andthe Hospital overall. 2017, I have nodoubt will come with its own uniquechallenges. The dedication and workethic of the team gives confidence for2017 for the directorate not only tostrive to find opportunities but also togo above and beyond to add value tothe Hospital overall.21

3.2Human Resources DirectorateKen Hardy,DirectorIntroductionThe Human Resources Directorate, (HRD), function withinSt. James’s Hospital has evolved significantly from that ofadministrative ‘doer’ to strategic facilitator. It now plays a centralrole in helping shape the organisation through key organisationalchanges and development plans thereby ensuring the hospitalsuccessfully meets local and national key performance indicators inaccordance with its mission, vision and values.Key Performance IndicatorsGerry Heffernan,Deputy Director In order to fully support and underpin the hospital’slearning and organisation development strategy theCentre for Learning and Development launched a new online learning platform, ‘LearnPath’. Spring 2016 marked the re-launch of ‘In Touch’ by ourCommunications Team. The magazine, later renamed ‘SJHTimes’, is now a regular and much anticipated quarterlypublication directed towards enhancing staff engagement. A number of additional Contact Support Persons wereselected and trained to provide advice and support forstaff under the Dignity at Work Policy. This is a key role inhelping and empowering employees in making informeddecisions in relation to workplace issues which comewithin the scope of the policy. The hospital achieved a 100% rate of compliance for fourof the five key EWTD performance indicators. A 74% fullEWTD compliance rate was achieved. Following an extensive tendering process, a preferredsupplier was identified for the purpose of developing anelectronic time and attendance /e-rostering solution forworkforce management. Our Occupational Health Department successfully coordinated fit testing of respiratory masks for 1074 staff: theonly hospital in Ireland delivering this training. The numberof staff members vaccinated against influenza continuedThe primary external and internal performance indicators forthe HRD include: Compliance with the Pay Bill Management and ControlFramework and requirement for the hospital to workwithin the funded pay envelope Management of absenteeism in accordance with anational/HSE target of 3.5% Reduction in the cost and reliance on agency staff andovertime Implementation of the European Working Time Directive,(EWTD), for non-Consultant Hospital Doctors Mandatory Training CompliancePerformance Highlights2016 proved to be a busy year across all the divisions withinthe Directorate and, similar to 2015, much of the focus wasconcentrated on recruitment activity which increased inline with a 14% increase in vacancies approved for filling.A turnover rate of 10.4% for both nursing and allied healthprofessional grades contributed largely to this activity andwas to have service implications across all HR specialistdivisions. The following

The Mercer's Institute for Successful Ageing Unit, Stroke Service, Bone Health and Osteoporosis, Unit, Falls and Blackout Unit, Local Asset Mapping Project, The Irish Longitudinal Study, on Ageing, Dementia Services Information and Development Centre. 50 4.3 Medicine and Emergency Directorate (MED)