AGM
29th June 2022
HONORARY SECRETARY’S REPORT
for Year ending 31st December 2021
In the past 8 months since our last AGM, I can report that all the Departments working from the Robinson Hospital site are enjoying working closer to normal routines. Unfortunately, the spectre of Coronavirus outbreaks continues to cast a shadow over our Health Services and the safety of their operation. We again wish to pay tribute to the outstanding and professional care provided by the staff working in all Robinson Hospital site departments.
ROBINSON HOSPITAL GENERAL WARD
Katrina Kelly, Community Locality Manager, reports that the Multi-Disciplinary Team in the hospital have continued to work together with commitment, resilience and mutual support. The General Ward in the hospital was designated as a COVID hospital early in the Pandemic and continues to fulfil that role. As at present, all of the patients admitted are COVID positive and receiving rehabilitation care as step down patients, thus freeing up acute hospital beds. Remarkably, last year the average length of stay was 20 days. Of 189 total admissions, 43% of discharges were to own home, 33% to nursing home and 15% returned to acute hospital. Northern Health and Social Care Trust (NHSCT) Director of Operations, Ms Wendy Magowan, continues to praise the Unit and staff for the vital care provided and the impact that the Robinson Hospital has made both Trust wide and regionally, in the management of Covid. The hospital staff have been a constant beacon of hope, transforming the way they work and the services they deliver. We are immensely proud of our Robinson team who go above and beyond in their roles to deliver excellent care in partnership with patients and families.
Retaining and recruiting trained nursing staff has continued to provide challenges. The unit is grateful for the support given from Dalriada Hospital who allowed secondment of two nurses by the temporary reduction of 6 rehabilitation beds in Dalriada Hospital.
Medical support continues from 4 GP practices who provide medical care Monday to Friday – Ballymoney Family Practice, Drs Fannin, Hutchinson and Boyd Practice, The Country Medical Practice and Portstewart Medical Centre. Dalriada Urgent Care continues to provide medical cover overnight, at weekends and on public holidays.
The NHSCT and the Robinson Board are continuing to advance a major Project to upgrade and refurbish the General Wards, family and staff areas. This will create a 16 bed unit with ensuite facilities, upgraded onsite pharmacy, staff administration areas, day care and family support areas. The initial capital budget of approximately £2.2 million is to be funded from Robinson Hospital Trust funds. Planning stages are well advanced and the Robinson Trust Board has welcomed working in close partnership with the Northern Trust Directors and are keen to see the timely completion of this important project.
We are grateful for the continued excellent management of the Robinson Hospital by Katrina Kelly, Community Locality Manager, Denise Gurney, Community Area Manager and Director for Community Care, Diane Spence, who have all been instrumental in maintaining services and staff morale at the hospital during the challenges of the recent Covid pandemic. We wish to record our thanks and best wishes to Sister Joanne Montgomery who will be retiring in July 2022 after many years of dedicated service to the Robinson Hospital. She follows a long line of Ward Sisters who have ably led the overall care team in the ward.
PHYSIOTHERAPY DEPARTMENT
Emma Cameron reports that the Physiotherapy Department works closely with the Multi-Disciplinary Team in the hospital to deliver high quality care to both inpatients and outpatients. Learning from ‘lockdown’ services, triage of patients is carried out along with Occupational Therapy to improve intermediate care pathways and outcomes.
Although outpatient services were significantly disrupted by COVID, attempts are being made to reduce the year-long waiting time for musculoskeletal conditions. Whilst waiting for initial appointments and after therapies, patients are being directed to information on the internet and through QR codes to support their recovery. Telephone reviews are still carried out although most services have reverted to face to face review consultations.
The hydrotherapy pool reopened in September 2021. New guidelines and restrictions have been implemented for this service to maximise safety but hydrotherapy does remain a valuable therapy for the multiple services that access it.
It is reported that present WiFi access has significant limitations for both staff and patients attending physiotherapy and reduces available online links that staff and service users can access to support their journey to recovery. Improvement to WiFi access needs urgent address.
HOSPITAL DIVERSION NURSING TEAM
Catherine Skeet, Team Co-ordinator, reports that with partial easing of COVID restrictions, the Team have been able to return to treating 2 patients at the same time in the unit, but both patients and staff continue to wear masks and adhere to 2m distancing during treatments. In the previous year there had been 1069 clinic attendances.
The Hospital Diversion Team has now received additional funding for an extra nurse to assist present staff in taking over the Healthcare at Home contract providing non-chemotherapy treatments to patients either in the Robinson Hospital clinic or in their own homes.
Catherine notes that patients can now have meals whilst their treatments are being administered and for some patients this is the most enjoyable meal of the week.
CRUSE BEREAVEMENT CARE SERVICE has relocated to another site to facilitate extra space for nursing administration but continues to have close links to the Robinson Hospital.
CHILD DEVELOPMENT CENTRE
Dr Jacqueline Price, Consultant Paediatrician, reports that this service continues to be very busy, cooperating with all the Community Paediatric Medical Services for the Northern Trust under the overall Clinical Leadership by Consultant Paediatrician Dr Alison Livingstone.
Services still face challenges in ensuring safe delivery of care due to COVID. Although most appointments are face to face in a controlled environment, remote technology is still used for telephone and video consultations as well as staff meetings.
Paediatrician support at the Robinson Hospital is provided by Drs Sheenagh Cameron, Sinead Higgins, Carolyn McCandless, Ruth Sutherland and, until July 2021, by Dr Shabaz Mirza who led the team and provided support for children with complex needs. This position is now led by Dr Jacqueline Price and temporarily assisted by Dr Eister Freiss. The Paediatricians continue to work closely with their Allied Health Professional colleagues from Physiotherapy, Speech and Language Therapy, Occupational Therapy, Dietetic Team and Paediatric Autism Service. They are all indebted to the invaluable clerical staff based at the Route site and supporting the CDC clinics at the Robinson Hospital.
CHATTY BENCHES
Three new ‘Chatty Benches’ were officially opened by Health Minister Robin Swann MLA on 10th February 2022 during his visit to the Robinson Hospital. These benches are part of a key new initiative by the Northern Health and Social Care Trust to prevent and address loneliness. Individuals can chat and connect with other people on these benches, supporting their positive mental health and wellbeing.
During his visit to the Robinson Hospital, Health Minister Robin Swann also dedicated a plaque and planted an Acer tree in memory of our Late esteemed colleague Dr John E Johnston, who selflessly provided many years of dedicated care in the Robinson Hospital and to many individuals and families in Ballymoney and wider area.
THE HEALTH CENTRE
BALLYMONEY FAMILY PRACTICE
Dr David Johnston noted the continuing challenges for the entire Health Service during the past year due to COVID. Care provision pathways have had to adapt to provide a wide range of services additional to normal GP care including staffing primary care Covid Centres, providing in-patient care for Covid patients in the Robinson Hospital and delivering the highly successful Covid vaccination programme. This latter programme included mass vaccination clinics at the Joey Dunlop Centre in conjunction with 3 other practices and booster clinics in the Health Centre. Overall, 11,021 doses of Coronavirus vaccines were administered to registered patients not including doses given at other Trust sites or by pharmacists. Throughout this time the Practice continued to provide high quality health care to manage acute and chronic diseases as well as keep on top of repeat prescribing and administration.
The Family Practice list has increased by 1100 patients in the past 10 years to present 12,900 registered patients. The team has expanded to 9 GPs, 2 Practice Nurses, 13 Reception Staff all ably led by Practice Manager, Nuala Lamont. In addition, GP Federation employed MDT staff now include 2 Pharmacists, 3 Social Workers, 2 Physiotherapists, and 2 Mental Health professionals. They all work closely with Trust employed staff, Health Visitors, District Nurses, Treatment Room Nurses, Midwives, and Community Palliative Care Nurse.
The Practice now hosts a Minor Surgery list open to referral from other GP practices in Causeway locality thus avoiding referrals to hospital services.
A weekly anticipatory care pilot service is carried out at St James’s Nursing Home to review all patients and be involved in their future care planning. This service pilot has reduced inappropriate hospital admissions and is soon to be rolled out to other Nursing Homes in the area.
Drs Sarah Fleming and Peter Hughes have qualified to be Postgraduate Trainers and now, as a recognised Training Practice, will welcome a new GP Registrar in August 2023.
Due to expansion in staff numbers, a further extension to the Health Centre is planned to provide 4 or 5 new consultation suites. During the year, GP Dr Roger Brown moved from the Practice to work in a private GP capacity and Receptionist Lorraine Watson retired after 27 years of service. Both made a tremendous contribution to patient care and will be greatly missed. Dr Lloyd Patterson, who has a special interest in Musculoskeletal Medicine, was welcomed to the Practice in January 2022.
DRS FANNIN, HUTCHINSON, BOYD PRACTICE
Dr Fannin reports that the Practice continues to be very busy with their usual GP services as well as providing medical cover to the Robinson Hospital and carrying out COVID booster clinics. Reception services were under extreme pressure during the Covid Pandemic when due to staff illness, on several occasions, the Practice was reduced to one receptionist. Practice Manager Debbie Michael and the GPs had to adapt their services very quickly.
There is now a full MDT in place including Physiotherapists Dawn Aitken and Shauna Cloughley, Pharmacist Hannah Forbes, and Social Worker Lyndsey Peden, the final member to join the team in April 2022. Mental Health Practitioner Joanne Hamilton is joined by a new Counsellor Gillian Bradley. Our Practice Nurse Una McCollum has retired and is replaced by Leslie Robinson as well as Diabetic Nurse Judy Mahon. Our longstanding Receptionist Elizabeth Morrison has recently retired after 20 years of valuable service to the practice.
PODIATRY
David Magill, Deputy Podiatry Manager, reports that Podiatry Services are in the process of coming out of pandemic restrictions and returning to a full service. Their caseload continues to be risk stratified to low, moderate, high and active cases. Cancellations due to patient illness average about 8.6% per month and along with Covid related staff illness, there is much pressure on maintaining appointments and adhering to a 13 week waiting list. It has been necessary to reduce clinics for low and moderate risk patients and sometimes use telephone or photo triage for these groups. High risk and active wound patients continue to receive priority care but emergency cases are also fitted in.
THE HUB
The Hub is not back to full usage yet as groups are restricted to 8 people attending due to Covid caution. Cancer support services continue and appliance fitting clinics are valuable. St John Ambulance Ballymoney now use the Hub for small group training and meetings.
ROOTS – ROBINSON OUTDOOR OCCUPATIONAL TRAINING SERVICE
Led by Valerie Craig, this service based in the Polytunnels at the rear of the hospital, now has up to 14 adults with learning disabilities working on projects. As well as looking after the grounds of the Robinson Hospital, ROOTS also maintains the grounds at the Roddens and Millbrook Homes. 3 full time staff supervise clients and there are daily sales of plants at the polytunnel between 10 am and 3 pm, as well as ongoing projects dismantling Zimmer frames for the Trust, making Christmas wreaths available for sale and organising 7,500 envelopes for schools Community Dentistry prevention programme. Valerie reported that a new lawnmower bought by the Robinson Trust was now in use.
CHILD AND ADOLESCENT MENTAL HEALTH SERVICE
Nadine Kane, Service Lead, reports that this service works with children and young people up to age 18 years as well as offering family support. Stepped Care Model programmes deal with Prevention and Early Intervention, Specialist Intervention, Crisis Response and a regional Intensive Inpatient Treatment centre at Beechcroft Unit in Belfast. The Northern Trust also has small specialist services including an Eating Disorder Team, a Drug and Alcohol Team, Family Therapy, Occupational and Psychodynamic Therapies. These teams all work collaboratively to ensure the right care is provided to children, adolescents and their families by the right part of the service and at the right time.
Multi-Disciplinary Teams include Drs, nurses, social workers, clinical psychologists, family therapists, occupational therapists, CBT therapists and a psychotherapist. At appointments the team will discuss the needs and concerns of the young person to enable a better understanding of them and together to identify what interventions might be appropriate and then help the young person and family make an informed decision about the best help needed.
COMMUNITY MENTAL HEALTH TEAM
Joanne Carey, Locality Manager of the Community Mental Health Team (CMHT) Ballymoney, reports that during the Covid Pandemic, the CMHT continued to facilitate direct face to face contact with their highest risk patient group, ensuring continuation of mental and physical health monitoring, medication administration, risk assessment, and crisis intervention for their mental health clients during what has been a significantly isolating and stressful period. The facilities of the Mental Health Resource Centre lent themselves well for safe contact.
The Team is responsible for the care of 1,000 patients and note increasing referrals every year to their service. They have postponed group activities but hope to reinstate those again whenever Covid restrictions ease.
Whilst staff have at times needed to work a blended rota at home or at the Resource Centre to facilitate social distancing, the continued use of the Resource Centre as a collective staff base has been vital in maintaining team working, peer support and morale.
ROBINSON HOSPITAL TRUST BOARD
The Robinson Hospital Trust Board were glad this year to welcome Mrs Emma McCarroll as an additional co-opted Board Member. She brings with her experience of working in Human Resources and Business Management as well as being a member of the Robinson family.
Mr Connor Taggart has notified the Board of Trustees of his intention to retire after 37 years of much valued service. Connor joined the Board in 1985 and served as Honorary Treasurer from 2003 until 2017. As Treasurer, he was meticulous and fearless in protecting the investment funds of the Robinson Hospital Trust. As ordinary Board Member, he continued to call Portfolio Managers to account for their decisions, investment changes and outcomes. Connor’s service has been immensely respected and he will be missed by his fellow Board Members. We wish him well in his continued retirement.
The Robinson Board and the Northern Trust continue to explore possible future projects involving less used properties on the Newal Road owned by the Robinson Trust. It is hoped that such future developments would enhance the existing health services based on the Robinson Hospital site.
Dr. John G Flynn
Honorary Secretary
29 June 2022
HONORARY TREASURER’S REPORT
for Year ending 31st December 2021
Just when we thought that the economic impact of the Covid pandemic was receding, the war in Ukraine erupted in February this year to create mayhem in energy markets: markets which were already in flux as a result of governments around the world competing to be the most virtuous in tackling what they perceive as anthropomorphic climate change. Oil is today trading at about $120 a barrel, double what it was last year and gas prices have followed suit. The economic background was testing last year, even before all this. Then, there was Sovereign debt in many countries at all time highs as a result of Quantitive Easing and huge government borrowing. This had been created to fund furlough and other schemes to protect employment and the economy during the Covid pandemic. The level of optimism emerging towards the end of 2021 did, in fact, create the conditions to hold up markets to levels that gave our portfolios a boost.
At 31st December our portfolios had shown a performance for the year of an increase in the restricted funds of 11.3% and an increase in the unrestricted funds of 14.4%. The benchmark against which we measure performance had an increase of 15.9%. Whilst last year our investment performance was somewhat below the benchmark, over the last three years the performance of both restricted and unrestricted funds have been more or less in line with the benchmark for that period.
The value of our combined restricted and unrestricted assets, including investment portfolios and properties has risen over the year by approximately £600,000 from £5.8million to £6.4million. As you will be aware we manage our restricted assets to produce an income which is to be transferred to the NHSCT for the purpose of looking after the Robinson Hospital. It is these transferred funds that will be used for the current planned improvements to the hospital wards. At the year end the funds previously transferred to, and held by, NHSCT were £1.520million, with £1.11million in cash and £0.41million invested in the Central Investment Fund for Charities. In our balance sheet we show a creditor of £564,000 which represents funds we hold ready to pass to NHSCT when the refurbishment of the hospital proceeds. In summary, at the year end there was available for the refurbishment project at the hospital a sum of £2.08 million, a figure which is growing by approximately £27,000 each quarter.
During 2021 our income from our investments and properties continued to rise. Overall income in 2021 was approximately £180,000 compared with £170,000 in 2020. Expenses remained contained. Excluding investment management fees, our administrative expenditure was £7,800, and that includes legal and audit and accounting fees. This compares very favourably with the average expense ratio for all charities and does raise something of a concern about the £10,872 annual charge levied by the NHSCT for simply holding the £1.52mn of funds which we have already passed to them.
The mantra in investment circles is that past performance is no guarantee of future returns. As this year progresses we see increasing volatility in world stock markets, a huge rise in inflation and a consequent increase in interest rates. This last phenomenon generally leads to an economic slowdown with the restricted borrowing for investment in the economy. So I would not be surprised to see a sell off in stock and bond markets during the year, and therefore a reduction in our asset values. However, with the spread which we have in our asset classes made up of equities, bonds and property, I anticipate that our income will be relatively unaffected. It is our income more than our capital which drives our activities and so I feel reasonably confident for the future.
Henry Algeo
Honorary Treasurer