Annual Report 2008 - 2009 - NHS Lanarkshire

Lanarkshire NHS BoardANNUALREPORT& Accounts 2008/09Staff perform specialistheart treatment on a patientat Hairmyres Hospital. ThePrincess Royal officiallyopened the new reperfusionservice by unveiling acommemorative plaque.

Chairman’s forewordTHIS has been an excitingyear for NHS Lanarkshirewith new services andbuildings adding to thehigh standard of care wealready provide.One of the highlights of2008/09 was without the doubtthe official opening of theoptimal reperfusion service atHairmyres Hospital. This newWest of Scotland service isproviding life-saving and lifechangingtreatment for someheart attack patients.The service was officiallyopened by the PrincessRoyal in February and staffand patients lined Hairmyrescorridors to greet her.We also opened the new BellshillCommunity Health Clinic topatients which provides excellentnew facilities for the localcommunity and work continuesapace on several other newbuildings and facilities.Staff have continued to workincredibly hard to ensure wehave met and sustained ourwaiting time guarantees. Ourcancer performance continuesto improve with more andmore patients being seen within62 days of an urgent referral.We have also seen waiting timesin accident and emergencyreduce and be maintainedacross all three of NHSLanarkshire’s acute hospitals.We have also made greatprogress in improving existingservices for patients through thepatient experience programmeand the LEAN programme.Both of these programmeswill be further rolled out in thecoming years and will continueto deliver service improvementsacross Lanarkshire.Staff have worked hard alsoto reduce the incidence ofhealthcare associated infection.Key to all decisions andinitiatives within Lanarkshireis our shared working withstaff, partnership, the PublicPartnership Forums and ourlocal authority colleagues -all of which means we arewell-placed to tackle healthinequalities and improvethe health of the people ofLanarkshire in coming yearsKen CorsarChairman NHS Lanarkshire.ContentsChairman’s foreword .........................2New heart service ..............................3Annual Review .......................................4Public Health Report .........................6Improving Services ..............................8Success highlights ..............................10International award ..........................12Patient feedback ................................13Annual Accounts ...............................14Contact us .............................................1602 Chairman’s foreword

New heart service 03Princess Royal opens new service forheart patientsHAIRMYRES Hospitalbecame one of two centresin the West of Scotland toprovide a new specialisedservice for heart patients.On 18 February 2009 HRHThe Princess Royal visitedthe East Kilbride hospital tosee first hand the optimalreperfusion service, commonlyknown as primary angioplastyor PPCI (Primary PercutaneousCoronary Intervention).This service means patientshaving a heart attack due toa blocked artery will receivea procedure to unblock theartery within 90 minutes oftheir diagnosis.During the visit PrincessAnne met with staff, wasprovided with a demonstrationof the optimal reperfusionservice and witnessed a liveprocedure being carried out.Unveiling a plaquecommemorating the startof the new service, she said:“While it is the technologythat does the actual job, it isthe management of the serviceand the work that goes onbehind the scenes which makesure the technology is used toits fullest extent.“It’s nice to have thetechnology and it is nice tohave the specialists but it iseven better when you are ableto reach so many of the peoplewho need this service most.”Dr Barry Vallance, NHSLanarkshire’s divisionalmedical director and consultantcardiologist said: “This is afantastic service for patientsand the clinical benefitsare undeniable.“We are providing aconsultant led 24 hour, sevenday a week service so that nomatter when a patient takes ill,treatment will be available.“We have a dedicatedteam of experts working inHairmyres and at our sisterprovider at the Golden JubileeNational Hospital providingcare for patients across theWest of Scotland.“There is world-widerecognition of the successand patient benefits that theoptimal reperfusion servicewith primary angioplasty canbring and I am delighted thatwe can now offer this to ourpatients.”• Hairmyres Hospitaland the Golden JubileeNational Hospital inClydebank jointly host thespecialist service for heartattack patients in the Westof Scotland.• The service beganat Hairmyres on1 November 2008 for allLanarkshire patients andis now fully operationalproviding a service toLanarkshire, Ayrshireand Arran and someareas of South Glasgow.• The Golden Jubilee servesGlasgow and Clyde, Argyleand Bute, Dumfries andGalloway and Forth Valley.• Patients are broughtstraight to the specialistcentre for treatment toreopen the blocked arteryusing balloon angioplasty.This involves threading along, thin balloon throughthe artery and inflating itto clear any obstructionand leaving in place a stent,which is a small piece ofmetal scaffolding, to holdthe artery open.

04 Annual ReviewFrom left: physiotherapy team leader Kenny Murray, south clusterphysiotherapy team leader Ruth Currie, Hamilton locality generalmanager Geoff Sage and Public Health Minister Shona Robison

Annual Review 05Annual ReviewTHE Minister for PublicHealth and Sport ShonaRobison held the annualreview of NHS Lanarkshireon 20 October 2009.In addition to meeting withthe Area Partnership Forum,the Area Clinical Forum andpatients, Ms Robison alsovisited the new Douglas StreetCommunity Health Clinic.Following the annualreview meeting, the Ministerhighlighted, in a letter tochairman Ken Corsar, a numberof areas which demonstratedgood practice.She praised the Board fortheir progress made on theAction Points agreed in the2008 Annual Review.Ms Robison wrote: “Icongratulated the Board onthe progress it has made inaddressing the action points,achieving financial balanceand delivering on servicedevelopments.“I was particularly pleasedto note the progress NHSLanarkshire has made in thenumber of smokers successfullyquitting at four weeks and thattwo thirds of those successfulare from the most deprivedcommunities in Lanarkshire.”Ms Robison continued:“I took the opportunity tothank staff for their efforts onpandemic flu.“I also highlighted thecontribution from Tim Davison,chief executive, to supportNHS Scotland’s work on anumber of national initiatives.”The Board were alsocommended for improvinghealth and reducing inequalitiesand she highlighted the stopsmoking service.Ms Robision wrote:“The pan-Lanarkshire StopSmoking Service has placedspecial emphasis on themost deprived communitiesin Lanarkshire and has hadconsiderable success onsmoking cessation in thosecommunities.“I commended the Board forthe number of smokers quittingat four weeks which was aheadof plan in March 2009.”The Minister for PublicHealth and Sport also praisedNHS Lanarkshire for meetingall the key waiting time targetsin 2008/09 and wrote:“I am grateful for the effortsof all staff in securing these.”Ms Robison commendedNHS Lanarkshire’s financialperformance and wrote:“I was pleased that theBoard had met all threefinancial targets and the twoper cent efficient governmenttarget for 2008/09.”The Minister concludedher letter by complimentingthe Lanarkshire NHS Board,and all staff, for their efforts in2008/09.Ms Robision wrote:“NHS Lanarkshire is workinghard to deliver against settargets and I am confidentthe Board is well prepared totackle the challenges ahead.”Key ActionPointsDURING the annualreview the Minister forPublic Health and Sporthighlighted a number ofaction points for NHSLanarkshire to focus onin the coming year.These included:• The Board must continue towork to achieve in-year andrecurring financial balance,and maintain regular contactwith Scottish GovernmentHealth Directorates (SGHD).• The Board should regularlyupdate SGHD on effortsto maintain the downwardmomentum in sicknessabsence rates.• Continue to deliverrobust arrangements forcontrolling healthcareassociated infection (HAI).• Sustain progress in meetingthe targets around mentalhealth services.• Continue to work towardsa ‘whole journey’ maximumwaiting time of 18 weeksfrom GP referral toreceiving treatment.• Keep us informed of theprogress of your capitalinvestment projects.• The Board should provideregular updates on thework of the anti-microbialmanagement team.

People’s health in Lanarkshire- continuing to improvePEOPLE’S health inLanarkshire is continuingto improve - but increasingunemployment, an agingpopulation and continuedinequalities are amongthe challenges the NHSmust overcome for thisto continue.These are some of the keyissues highlighted by NHSLanarkshire’s director of publichealth Dr Harpreet Kohli in hisannual report for 2008/09.Harpreet said: “Lifeexpectancy in Lanarkshire hasincreased by around two yearsover the last decade for bothmen and women.“However, men in southLanarkshire live 1.4 yearslonger, and women live 1.1years longer, than those inthe north.”Evidence suggestsunemployment results inpoorer health.As the rate ofunemployment in Lanarkshirehas increased markedly overthe last year, the impact thismay have on people’s health,warns the report, mustbe considered.Coronary heart disease(CHD) and cancer are thetwo main causes of death inLanarkshire, particularly inpeople aged less than 75 years.Harpreet said: “While theoverall trend in deaths fromthese two causes is downward,the rates in Lanarkshire are stillhigher than the Scottish average.“By reducing rates ofsmoking, NHS Lanarkshire’sStop Smoking Service andcommunity pharmacists, whichoffer group or one-to-onesupport in addition to freenicotine replacement therapy(NRT), are contributing toreducing CHD.“This service is also vitalin reducing mortality fromlung, head and neck andoesophageal cancer.”The national pilot KeepWell project - which identifiespeople with, or at risk ofdeveloping, cardiovasculardisease and offering appropriatetreatment - has now beenestablished across a number oflocalities in Lanarkshire.The predicted continuingaging of Lanarkshire’spopulation is also highlighted inthe report.Between 2008 and 2018it is estimated Lanarkshire’spopulation aged 85 and over willincrease by around 60 per cent- compared to a three per centrise in the whole population.Harpreet said: “Variousmeasures are in place topromote and protect the healthand wellbeing of older people,06 Public Health Reportincluding the promotion ofgood nutrition and physicalactivity, immunisations againstinfluenza and pneumococcalpneumonia, and initiatives tohelp with maintaining social andmental activity.“The majority of olderpeople live at home and preferto do so, and collaborationbetween the NHS and socialwork has improved over theyears in order to make thispossible for an increasingnumber of people.”The numbers of overweightchildren in 2008 remainedsimilar to the 2007 figures, of14.8 per cent of all primaryone pupils within NHSLanarkshire. It is estimatedthere are about 16,000overweight five to 15-year-olds.Harpreet said: “NHSLanarkshire’s Fit for Funprogramme for primary schoolpupils is one of the initiativeslaunched to improve children’shealth and it encourageschildren to understand thebenefits of healthy eating andan active lifestyle through fungames and activities.”The Annual Report of theDirector of Public Health2008/09 provides moreinformation and analysis onall these topics and others.Copies of the full reportare available online atwww.nhslanarkshire.org.uk/publicationsor by writing to:Dr Harpreet KohliDirector of Public Health14 Beckford StreetHamilton, ML3 0TA

Public Health Report 07NHS Lanarkshire promoteshealthy eating and active lifestylesthrough various projects

Wishaw General’s theatre staff used Lean to make improvementsthrough simple changes.LEAN efficiency initiativePATIENTS are waitingless time for their surgerywithin NHS Lanarkshire’sthree acute hospitalsthanks to a new efficiencyinitiative.LEAN, a programme which aimsto eliminate waste in workingpractices and processes, wasintroduced by NHS Lanarkshireacross all its theatres.The first stage of thisprogramme was completed atWishaw General in August 2008with some impressive results.These included the averagewaiting time for a patient intheatre, from admission toprocedure, being reduced byalmost an hour and 20 minutes.Rosemary Lyness, director ofacute services, said: “Staff havebeen really enthusiastic and thechanges they have suggestedhave made a real impact inimproving our efficiency and as aresult the patient’s experience.”The LEAN programme usesa technique called Kaizen -which means “to change forthe good of all” in Japanese.Having received training inLEAN methodologies, the staffidentified a number of areaswhere they could make quick,simple changes to deliverrapid improvements intheir department.They also identified areasfor improvement that willbe worked on over time toensure ongoing and continuousimprovement.Lanarkshire’s first Kaizenevent began in July 2008 witha week-long event where staffworked in teams to cover fiveareas identified for improvement.These areas were -admissions, changeover,recovery, performance andplanning and environment.Changes implemented include:• Two admission times,compared to only one -reduces the times patientsneed to wait before theiroperation and reducescongestion in the wards.• Reducing numbers ofpatients staying overnightbefore their operation- vastly increasing thenumbers of patients havingsame day surgery.Theatres at Wishaw are nowcarrying out, on average, theequivalent of three extraprocedures every week.A similar LEAN programmewas undertaken withintheatres at Monklands andHairmyres hospitals.National 18 weeks referral to treatment targetPATIENT waiting timescontinue to fall as NHSLanarkshire works towardsthe national 18 weeksreferral to treatment target.This Scottish Government’s18 Week Referral to Treatment(RTT) target states that by2011 all patients must betreated within 18 weeks oftheir first contact with their GP.Embracing this challenge, NHSLanarkshire established an 18Week RTT programme board.This group is now lookingto ensure the target is metthrough service redesignand transformation, planning,information and performancemanagement.Rosemary Lyness, directorof acute services and executivelead for the programme, said:“Lanarkshire has made vastimprovements in waiting timesand cancer targets over thepast few years and we want tobuild on this experience.”Dr Jane Burns, clinical leadfor the programme, added:“Achieving an 18 week pathwayfrom referral to treatmentby 2011 is both ambitiousand exciting, requiring acontribution from everyone08 Improving services

Improving services 09Healthcare associated infection (HAI)TACKLING healthcareassociated infection (HAI)is a key priority for NHSLanarkshire.In 2008-09 the healthboard launched a raft ofmeasures to further improveinfection control.NHS Lanarkshire chiefexecutive Tim Davison said:“We are committed tomaintaining excellent infectioncontrol practices throughoutour hospitals and otherpremises. But we can’t do thisjust by talking about it. Weneed all staff throughout theorganisation to put the higheststandards of infection controlinto practice every single day- so that we provide the safestenvironment and care we canfor patients.”NHS Lanarkshire formed ashort-life Executive HAI ActionGroup, chaired by medicaldirector Dr Alison Graham.The group developed an actionplan to drive improvements ininfection control.working in NHS Lanarkshire.”Cathy Dunn, 18 Weeksprogramme manager, said: “Weaim to improve the patient’sOne key aspect of this plan washand hygiene. Quarterly handhygiene audits are carried outthroughout NHS Lanarkshirewards to check staff arewashing their hands.In addition, the IntensiveTreatment Unit (ITU) andsix wards at MonklandsHospital piloted approaches toimproving hand hygiene as partof the Scottish Patient SafetyProgramme.Alison said: “Staff involvedin the pilot took ownershipof hand hygiene issues andworked extremely hard toimprove hand hygiene.”The pilot areas focusedon the five key moments forhand hygiene:• Before patient contact• Before an aseptic task• After body fluidexposure risk• After patient contact• After contact with patientsurroundings.Meet the 18 week teamexperience using techniquessuch as Lean to deliver betteraccess to services, earlierdiagnosis and treatment.”Hand hygiene: clinical supportworker Lorraine Smith, left,and senior charge nurseMaria Lamb from Ward 17,Monklands hospitalA Health Protection Scotlandreport showed these measureswere working in reducing HAI.Rates of both Staphylococcusaureus Bacteraemia, whichincludes MRSA, and Clostridiumdifficile were shown to have fallen.The health board had alsofurther improved its handhygiene compliance, achieving93 per cent for the audit period3 - 14 November 2008, upfrom 91 per cent for 4 - 15August 2008.Alison said: “Good handhygiene is the single mostimportant way we can reducethe spread of germs withinour hospitals.“These figures indicate thatthe wide-ranging initiatives andhard work put in by staff arebringing results.”Other initiatives in theaction plan, including improvedinfection control signage andrevised handwashing policy,were overseen by a revisedLanarkshire Infection ControlCommittee (LICC), which tookover from the short-life HAIExecutive Action Group.

Bellshill Community Health ClinicBELLSHILL’S brand new£4.5 million CommunityHealth Clinic was officiallyopened on Monday 16March 2009.The building of this stateof-the-art,modern facility,demonstrated NHSLanarkshire’s aim of providingfirst class healthcare in theprimary care setting.The clinic, on GreenmossPlace, near Main Street,provides a wide range of healthservices and replaced theexisting Bellshill Health Clinicon Main Street.NHS Lanarkshire’s chairman,Ken Corsar, said: “Throughconsultations with localcommunities, one of the majorissues people highlighted wasthe need for improved facilitiesand accessibility to primary careand to mental health services.“This new BellshillCommunity Health Clinic willhelp NHS Lanarkshire providethe people of Bellshill with thehighest standard of care.”The new clinic opened topatients in December 2008.NHS Lanarkshire’s Bellshilllocality manager, Tom Bryce,said:“Being a purpose builtfacility means ease of access forpatients is first class and thestaff are enjoying working insuch pleasant surroundings.“The new clinic will help toimprove the health outcomesfor the people of Bellshill andwill allow us to provide thevery latest and highest standardof care.”The new clinic was officiallyby Michael McMahon MSP. MrMcMahon, who received aguided tour and unveiledan official plaque, praised thenew facility.The MSP for HamiltonNorth and Bellshill, said: “This isa wonderful facility which wasbadly needed in this area.”Bellshill Community HealthClinic accommodates publichealth nursing, long termconditions nursing, podiatry,speech and language therapy,community dental servicesand a range of mentalhealth services.Services provided at the newclinic include:• podiatry,• speech & languagetherapy,• child immunisation andsurveillance,• physiotherapy,• dietetics,• well woman clinic,• antenatal,• adult mental healthservices,• community dentalservices,• minor surgery,• cervical screening,• coronary heart diseasesurveillance,• long term condition,• counselling,• public health team andhealth promotion,• EVA (ending violence andabuse) project.10 Success highlights

Success highlights 11New pre-assessment unitPATIENTS requiringsurgery are benefiting froma new facility that openedat Monklands Hospital inOctober 2008.The pre-admissionsassessment unit ensures patientsare prepared for their operation.It also ensures patients arehealthy enough for surgery.Carole Young, senior chargenurse for the pre-admissionassessment unit and daysurgery unit, said: “The patientsfeel a lot better knowing whatto expect when they come infor their surgery and what toexpect afterwards.“We’ve also significantlyreduced the amount ofcancellations in surgery.“Not only were these amajor inconvenience topatients, who would havebuilt themselves up for theirprocedure that day, it was awaste of resources in surgery.“The new unit means it’s abetter experience for patientsand more procedures can becarried out.”Although the pre-admissionsteam had been operating atMonklands for several years, thelack of a dedicated facility meantit was sometimes impossible toassess every patient before theycame in for surgery.Now there is a modern,welcoming unit where patientscan be assessed in pleasantsurroundings by a friendly andhighly professional team.Carole Young, second fromthe left, is pictured withmembers of the pre-admissionassessment unit teamThe pre-admission assessmentunit covers a wide range ofsurgeries, including generalsurgery, orthopaedics,maxillofacial, gynaecology,colorectal, urology, and ear,nose and throat (ENT).Sickness/absence rates greatly reducedNHS Lanarkshire madetremendous progress inreducing sickness/absencerates among staff in 2008/09.From having one of the highestlevels of absence in March2008, when the rate was 6.16per cent, the health boardmanaged to lower this to only4.25 per cent by March 2009.The health board iscontinuing to move towardsthe Scottish Government’starget of reducing sicknessabsence to four per cent.NHS Lanarkshire directorof human resources LynneKhindria said: “We’re workinghard across NHS Lanarkshireto meet the target and areseeing a gradual reduction inthe sickness levels thanks to theefforts of staff and managers.”Hugh Sweeney, NHSLanarkshire’s employeedirector in 2008-09 added: “Inrecent years, we’ve introduceda wide range of initiatives,policies and services to givestaff better support than everbefore to stay healthy and tohelp them back to work whenthey are ill.“For NHS Lanarkshire, a onepercent reduction in sicknessabsence means an extra 120staff at work every day.“This has the potential tomake a massive difference topatients as well as easing thepressure on colleagues who arealready at work.”Health initiatives available tostaff include:• Healthy Working Lives• Health PromotingHospitals• Staff stop smoking sessions• EASY - Early Access toSupport for You• SALUS OccupationalHealth• Employee CounsellingService• Staff Physiotherapy Service• Work/life balance policies.

Left to right Theresa McElhone, a professional officer from UNICEF, Liz Kearney, service developmentmanager Coatbridge locality and Anne Marie Lee, NHS Lanarkshire breastfeeding coordinator.UNICEF baby friendly awardNHS Lanarkshire wasrecognised in 2008-09 bythe United Nations for itsefforts in promoting andsupporting breastfeeding.Coatbridge was the firstlocality in Lanarkshire, andonly the third in Scotland, toreceive full United Nation’sChildren’s Fund (UNICEF)accreditation.The UNICEF Awardrecognises the work done bystaff in endorsing breastfeedingas the healthiest option formothers and babies.The other nine communityhealth partnership (CHP)localities in Lanarkshire wereawarded a Certificate ofCommitment which is the firststep to gaining full internationalrecognition from UNICEF.This certificate recognisesthat a health care facility isdedicated to implementingbest practice standards forbreastfeeding.Theresa McElhone, aprofessional officer fromUNICEF, presented the awardsto NHS Lanarkshire.Theresa said: “I amdelighted to present staff withthis award from UNICEF.“I’d like to thank all staff fortheir commitment and hardwork which will help to improvethe health of local families.“The UNICEF award meansmums in Lanarkshire can be12 International awardassured all the help and advicethey need on feeding theirbabies is available when theyneed it.”Anne Marie Lee, NHSLanarkshire breastfeedingco-ordinator, added: “Mothersin Lanarkshire can have thesatisfaction of knowing theirmidwives and health visitors areproviding the highest standardof care for breastfeeding.“Breastfeeding mothers inLanarkshire are also lucky tohave access to the CommunityMothers programme, wherelocal women who havebreastfed their own childrenvolunteer their help andexpertise to other local mumswho are breastfeeding.”

Patient feedback 13Patient feedbackDURING 2008-09 NHSLanarkshire staff receivedmany expressions ofthanks for the care theyhad given patients.It is good to hear about thepositive experience of ourpatients and visitors.However, to ensure NHSLanarkshire continues toprovide the highest possiblequality of care, we also wantto hear about occasions wherewe could have done better.Shona Welton, NHSLanarkshire’s head of patientaffairs, said: “We listen carefullyto the feedback received frompatients and visitors and takeappropriate action wheneverwe can.“This helps us ensure we’reproviding the best healthcareservice possible.”Shona continued: “Thecomplaints received by NHSLanarkshire reflect the nationaltrends and tend to be aroundpoor staff attitude, behaviouror communication and clinicaltreatment.“We’re working hard toensure we tackle these concerns.“It’s hoped, for example,the roll-out of customer carestandards, which encouragestaff to use plain English andto take account of the needsof the individual, will bring areduction in complaintsrelating to communicationand clinical treatment.“De-brief sessions arenow held withnursing staffin relation tosignificantcomplaintsor where aparticulararea hasreceived aseries ofsimilarcomplaints.“Thesesessionsallow staff tothink aboutwhat theycould havedone better.“And at allstaff inductionsand in trainingsessions thereis a focuson goodcustomer care.”Formal complaints receivedrose from the previous year.There were 138 to thecommunity health partnershipsin 2008/09 - an increase of 31per cent from 2007/08 - and488 formal complaints to theacute services division - a slightincrease of three per cent.Complaints regardingwaiting times have been halved- from 42 in 2007/08 to 21 in2008/09. This is in line with thesignificant reductions made towaiting times for appointmentsand admissions.The national target forresponding to formal complaintsis 20 working days.The community healthpartnerships met this target in82 per cent of cases – thesame percentage as in 2007/08.Acute services met thedeadline in 99 per cent of cases- the same as in the previoustwo years.Shona said: “This continuinghigh level of performancefor dealing with complaintscompares extremely favourablywith national figures.“This demonstrates NHSLanarkshire’s commitment toresponding promptly to issuesraised with us.”When an individual isunhappy with the responsethey receive to a formalcomplaint they have the optionof referring the matter tothe Scottish Public ServicesOmbudsman.During 2008/09 theOmbudsman issued ninereports on complaints aboutacute services provided byNHS Lanarkshire.

Meeting Lanarkshire’s financial targetsLAURA ACE:“The financial position at theend of the 2008-09 year wasextremely positive”NHS Lanarkshire has metall its financial targets in2008/09.Laura Ace, who took overfrom Susan Goldsmith as NHSLanarkshire’s director of financein January 2009, reported thatthe health board maintained abalanced financial position.She said: “The financialposition at the end of the2008-09 year was extremelypositive and marks a hugeachievement for NHSLanarkshire.“The NHS Lanarkshireteam worked incredibly hard inensuring the board’s financesremained in good health.“We are also continuingto support the Board’s strongperformance against healthtargets and in the developmentof strategies and deliveryof service improvementand redesign.”In line with the approvedfinancial plan for the year, theBoard achieved a cumulativesurplus of £14.9m as at 31March 2009.Through ongoing tightfinancial management, costcontainment and the deliveryof savings across acute andprimary care services andcorporate departments, NHSLanarkshire managed tomaintain recurring balancethroughout the year.Although NHS Lanarkshire’sfinances have been wellmanaged Laura acknowledgesthat tight financial managementwill be of key importance forthe future.She said: “Given the currentglobal financial climate we arewell aware that we can expecta challenging few years ahead.“Over the past few yearsNHS Lanarkshire has shownit can rise to the financialchallenge and can continueto provide quality clinicalservices.”Total expenditure by Lanarkshire NHS Board onHospital, Community and Family Health ServicesFamily Health Services £240.9 millionMaternity £29.5 millionLearning Disabilities £31.9 millionGeriatric Continuing Care £32.6 millionAcute £379.9 millionMental Health £69.7 millionGeriatric Assessment £36.8 millionCommunity Services £108.1 millionOther £17.5 million14 Annual accounts

ContactdetailsFURTHER information and anelectronic version of this AnnualReport and Accounts can befound on the NHS Lanarkshirewebsite atwww.nhslanarkshire.org.ukIf you require extra copiesof the report or would likethis document on audiotape, inBraille, in large print or in Arabic,Hindi, Chinese, Bengali, Punjabi,Gaelic, Urdu or Polish pleaseemailmarysia.morkis@lanarkshire.scot.nhs.ukOr write to: Marysia Morkis,Communications Manager,NHS Lanarkshire, StrathclydeHospital, Airbles Road,Motherwell ML1 3BW

Annual Report 2008 - 2009 - NHS Lanarkshire

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